Full Text Available Abstract Background The prone leg extension (PLE is a clinical test used to evaluate the function of the lumbopelvis. It has been theorized that a normal and consistent pattern of muscle activation exists. Previous research has found two contradictory patterns of muscle activation during PLE in normal individuals. One study shows an almost simultaneous activation of the lower erector spinae and hamstring muscle group with a delayed activation of the gluteus maximus, while the second describes the order of activation being ipsilateral erector spinae (to the leg being extended, hamstrings, contralateral erector spinae and gluteus maximus. Due to the different conclusions from these two studies and the lack of quantified muscle onset times, expressed in absolute time this study attempted to quantify the muscle onset times (in milliseconds during the prone leg extension, while noting if a consistent order of activation exists and whether a timing relationship also exists between the gluteus maximus and contralateral latissimus dorsi. Methods 10 asymptomatic males (Average height: 175.2 cm (SD 6.5, Average Weight 75.9 kg (SD 6.5, Average Age: 27.1(SD 1.28 and 4 asymptomatic females (Average height 164.5 (SD 2.9, weight: 56.2 (SD 8.9, Average Age: 25 (SD 1 performed the prone leg extension task while the myoelectric signal was recorded from the bilateral lower erector spinae, gluteus maximus and hamstring muscle groups. Activation onsets were determined from the rectified EMG signal relative to the onset of the hamstrings muscle group. Results No consistent recruitment patterns were detected for prone leg extension among the hamstring muscle group and the erector spinae. However, a consistent delay in the Gluteus Maximus firing of approximately 370 ms after the first muscle activated was found. Five out of 14 asymptomatic subjects showed a delay in gluteus maximus firing exceeding the average delay found in previous research of subjects considered to
Doshi, Neel; Goldberg, Benjamin; Jayaram, Kaushik; Wood, Robert
Origami inspired layered manufacturing techniques and 3D-printing have enabled the development of highly articulated legged robots at the insect-scale, including the 1.43g Harvard Ambulatory MicroRobot (HAMR). Research on these platforms has expanded its focus from manufacturing aspects to include design optimization and control for application-driven tasks. Consequently, the choice of gait selection, body morphology, leg trajectory, foot design, etc. have become areas of active research. HAMR has two controlled degrees-of-freedom per leg, making it an ideal candidate for exploring leg trajectory. We will discuss our work towards optimizing HAMR's leg trajectories for two different tasks: climbing using electroadhesives and level ground running (5-10 BL/s). These tasks demonstrate the ability of single platform to adapt to vastly different locomotive scenarios: quasi-static climbing with controlled ground contact, and dynamic running with un-controlled ground contact. We will utilize trajectory optimization methods informed by existing models and experimental studies to determine leg trajectories for each task. We also plan to discuss how task specifications and choice of objective function have contributed to the shape of these optimal leg trajectories.
Cantergi, Débora; Loss, Jefferson Fagundes; Jinha, Azim; Brodt, Guilherme Auler; Herzog, Walter
Considering the kinematics of leg extensions performed on a Reformer apparatus, one would expect high activation of hip and knee extensor muscle groups. However, because of the bi-articular nature of some lower limb muscles, and the possibility to vary the direction of force application on the Reformer bar, muscles can be coordinated theoretically in a variety of ways and still achieve the desired outcome. Hence, the aim of this study was to determine the knee and hip moments during leg extensions performed on the Reformer apparatus and to estimate the forces in individual muscles crossing these joints using static optimization. Fifteen subjects performed leg extensions exercises on the Reformer apparatus using an individually chosen resistance. To our big surprise, we found that subjects performed the exercise using two conceptually different strategies (i) the first group used simultaneous hip and knee extension moments, (ii) while the second group used simultaneous hip flexion and knee extension moments to perform the exercise. These different strategies were achieved by changing the direction of the resultant force applied by the subject's feet on the Reformer bar. While leg extensions on the Reformer apparatus have been thought to strengthen the hip and knee extensors muscles, our results demonstrate that patients can perform the exercise in a different and unexpected way. In order to control the hip and knee moments and achieve the desired outcome of the exercise, the direction of force application on the Reformer bar must be controlled carefully. Copyright © 2014 Elsevier Ltd. All rights reserved.
Kierkegaard, Signe; Jørgensen, Peter Bo; Dalgas, Ulrik
INTRODUCTION: During movement tasks, patients with medial compartment knee osteoarthritis use compensatory strategies to minimise the joint load of the affected leg. Movement strategies of the knees and trunk have been investigated, but less is known about movement strategies of the pelvis during...... compartment knee osteoarthritis use greater pelvic movements during advanced functional performance tests, particularly when these involve descending tasks. Further studies should investigate if it is possible to alter these movement strategies by an intervention aimed at increasing strength and power...... advancing functional tasks, and how these strategies are associated with leg extension power. The aim of the study was to investigate pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis compared with controls. MATERIALS AND METHODS: 57...
Clark, David J; Neptune, Richard R; Behrman, Andrea L; Kautz, Steven A
To test the hypothesis that participants with stroke will exhibit appropriate increase in muscle activation of the paretic leg when taking a long step with the nonparetic leg compared to during steady-state walking, with a consequent increase in biomechanical output and symmetry during the stance phase of the modified gait cycle. Single-session observational study. Clinical research center in an outpatient hospital setting. Adults with chronic poststroke hemiparesis (N=15). Participants walked on an instrumented treadmill while kinetic, kinematic, and electromyogram data were recorded. Participants performed steady-state walking and a separate trial of the long-step adaptability task in which they were instructed to intermittently take a longer step with the nonparetic leg. Forward progression, propulsive force, and neuromuscular activation during walking. Participants performed the adaptability task successfully and demonstrated greater neuromuscular activation in appropriate paretic leg muscles, particularly increased activity in paretic plantarflexor muscles. Propulsion and forward progression by the paretic leg were also increased. These findings support the assertion that the nonparetic long-step task may be effective for use in poststroke locomotor rehabilitation to engage the paretic leg and promote recovery of walking. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Fransz, Duncan P.; Huurnink, Arnold; Kingma, Idsart; van Dieën, Jaap H.
We aimed to verify whether the static phase after a single leg drop jump (DJ) landing on a force plate may serve as a proxy for a single leg stance (SLS) balance task, as this would increase the application possibilities of landing tasks in the evaluation of sensorimotor function in relation to
Buyalich, Gennadiy Daniilovich; Buyalich, K. G.; Voyevodin, V. V.
Current methods of calculation of parameters of hydraulic legs of powered supports are in most cases analytical and do not consider all complex of factors. Finite element model was developed to study this problem and used to analyze the influence of hydraulic legs extension on radial deformations of cylinder of different producers of powered supports at variation of hydraulic fluid pressure. It was revealed that radial deformations of cylinders along the axis of hydraulic legs increase in mag...
Kalliokoski, Kari K; Boushel, Robert; Langberg, Henning
to mean GU in QF (=100%), GU was on average 73% in VL, 84% in rectus femoris, 115% in vastus medialis, and 142% in VI. Variable activation of hamstring muscles and muscles of the lower leg was also observed. These results show that GU of different muscles of quadriceps muscle group as well as between......One-legged dynamic knee-extension exercise (DKE) is a widely used model to study the local cardiovascular and metabolic responses to exercise of the quadriceps muscles. In this study, we explored the extent to which different muscles of the quadriceps are activated during exercise using positron...... in the vastus intermedius (VI) and lowest in the vastus lateralis (VL; VI vs VL, p muscles in the exercising leg was 35 ± 9%. Compared...
Full Text Available One-legged dynamic knee-extension exercise (DKE is a widely used model to study the local cardiovascular and metabolic responses to exercise of the quadriceps muscles. In this study, we explored the extent to which different muscles of the quadriceps are activated during exercise using positron emission tomography (PET determined uptake of [18F]-fluoro-deoxy-glucose (GU during DKE. Five healthy male subjects performed DKE at 25 W for 35 min and both the contracting and contralateral resting leg were scanned with PET from mid-thigh and distally. On average, exercise GU was the highest in the vastus intermedius (VI and lowest in the vastus lateralis (VL (VI vs VL, p<0.05, whereas the coefficient of variation was highest in VL (VL vs VI, p<0.05. Coefficient of variation between the mean values of the four QF muscles in the exercising leg was 35±9%. Compared to mean GU in QF (=100%, GU was on average 73% in VL, 84% in rectus femoris, 115% in vastus medialis, and 142% in VI. Variable activation of hamstring muscles and muscles of the lower leg was also observed. These results show that GU of different muscles of quadriceps muscle group as well as between individuals vary greatly during DKE, and suggests that muscle activity is not equal between quadriceps muscles in this exercise model. Furthermore, posterior thigh muscles and lower leg muscles are more active than hitherto thought even during this moderate exercise intensity.
Hart, Stephen W (Inventor); Yamokoski, John D. (Inventor); Wightman, Brian J (Inventor); Dinh, Duy Paul (Inventor); Gooding, Dustin R (Inventor)
A system for developing distributed robot application-level software includes a robot having an associated control module which controls motion of the robot in response to a commanded task, and a robot task commander (RTC) in networked communication with the control module over a network transport layer (NTL). The RTC includes a script engine(s) and a GUI, with a processor and a centralized library of library blocks constructed from an interpretive computer programming code and having input and output connections. The GUI provides access to a Visual Programming Language (VPL) environment and a text editor. In executing a method, the VPL is opened, a task for the robot is built from the code library blocks, and data is assigned to input and output connections identifying input and output data for each block. A task sequence(s) is sent to the control module(s) over the NTL to command execution of the task.
Nagai, Takashi; Sell, Timothy C; House, Anthony J; Abt, John P; Lephart, Scott M
The importance of the sensorimotor system in maintaining a stable knee joint has been recognized. As individual entities, knee-joint proprioception, landing kinematics, and knee muscles play important roles in functional joint stability. Preventing knee injuries during dynamic tasks requires accurate proprioceptive information and adequate muscular strength. Few investigators have evaluated the relationship between knee proprioception and strength and landing kinematics. To examine the relationship between knee proprioception and strength and landing kinematics. Cross-sectional study. University research laboratory. Fifty physically active men (age = 26.4 ± 5.8 years, height = 176.5 ± 8.0 cm, mass = 79.8 ± 16.6 kg). Three tests were performed. Knee conscious proprioception was evaluated via threshold to detect passive motion (TTDPM). Knee strength was evaluated with a dynamometer. A 3-dimensional biomechanical analysis of a single-legged stop-jump task was used to calculate initial contact (IC) knee-flexion angle and knee-flexion excursion. The TTDPM toward knee flexion and extension, peak knee flexion and extension torque, and IC knee-flexion angle and knee flexion excursion. Linear correlation and stepwise multiple linear regression analyses were used to evaluate the relationships of both proprioception and strength against landing kinematics. The α level was set a priori at .05. Enhanced TTDPM and greater knee strength were positively correlated with greater IC knee-flexion angle (r range = 0.281-0.479, P range = .001-.048). The regression analysis revealed that 27.4% of the variance in IC knee-flexion angle could be accounted for by knee-flexion peak torque and TTDPM toward flexion (P = .001). The current research highlighted the relationship between knee proprioception and strength and landing kinematics. Individuals with enhanced proprioception and muscular strength had better control of IC knee-flexion angle during a dynamic task.
Cara L Lewis
Full Text Available The single leg squat and single leg step down are two commonly used functional tasks to assess movement patterns. It is unknown how kinematics compare between these tasks. The purpose of this study was to identify kinematic differences in the lower extremity, pelvis and trunk between the single leg squat and the step down. Fourteen healthy individuals participated in this research and performed the functional tasks while kinematic data were collected for the trunk, pelvis, and lower extremities using a motion capture system. For the single leg squat task, the participant was instructed to squat as low as possible. For the step down task, the participant was instructed to stand on top of a box, slowly lower him/herself until the non-stance heel touched the ground, and return to standing. This was done from two different heights (16 cm and 24 cm. The kinematics were evaluated at peak knee flexion as well as at 60° of knee flexion. Pearson correlation coefficients (r between the angles at those two time points were also calculated to better understand the relationship between each task. The tasks resulted in kinematics differences at the knee, hip, pelvis, and trunk at both time points. The single leg squat was performed with less hip adduction (p ≤ 0.003, but more hip external rotation and knee abduction (p ≤ 0.030, than the step down tasks at 60° of knee flexion. These differences were maintained at peak knee flexion except hip external rotation was only significant in the 24 cm step down task (p ≤ 0.029. While there were multiple differences between the two step heights at peak knee flexion, the only difference at 60° of knee flexion was in trunk flexion (p < 0.001. Angles at the knee and hip had a moderate to excellent correlation (r = 0.51-0.98, but less consistently so at the pelvis and trunk (r = 0.21-0.96. The differences in movement patterns between the single leg squat and the step down should be considered when selecting a
Sargent, Barbara; Reimann, Hendrik; Kubo, Masayoshi; Fetters, Linda
Task-specific actions emerge from spontaneous movement during infancy. It has been proposed that task-specific actions emerge through a discovery-learning process. Here a method is described in which 3-4 month old infants learn a task by discovery and their leg movements are captured to quantify the learning process. This discovery-learning task uses an infant activated mobile that rotates and plays music based on specified leg action of infants. Supine infants activate the mobile by moving their feet vertically across a virtual threshold. This paradigm is unique in that as infants independently discover that their leg actions activate the mobile, the infants' leg movements are tracked using a motion capture system allowing for the quantification of the learning process. Specifically, learning is quantified in terms of the duration of mobile activation, the position variance of the end effectors (feet) that activate the mobile, changes in hip-knee coordination patterns, and changes in hip and knee muscle torque. This information describes infant exploration and exploitation at the interplay of person and environmental constraints that support task-specific action. Subsequent research using this method can investigate how specific impairments of different populations of infants at risk for movement disorders influence the discovery-learning process for task-specific action.
Mello, L.F.B.; Barcelos, M.G.; Nogueira Neto, N.C.; Meohas, W.; Pinto, L.W.; Melo, P.A.; Smith, J.
Chronic ulcers of the leg are common in Brazil, perhaps more common than in the developed world. We report a case of a chronic ulcer of the leg following extensive scarring due to a bite by a venomous snake, which eventually led to a squamous cell carcinoma. (orig.)
Full Text Available This paper discusses the research into information seeking and its directions at a general level. We approach this topic by analysis and argumentation based on past research in the domain. We begin by presenting a general model of information seeking and retrieval (IS&R which is used to derive nine broad dimensions that are needed to analyze IS&R. Past research is then contrasted with the dimensions and shown not to cover the dimensions sufficiently. Based on an analysis of the goals of information seeking research, and a view on human task performance augmentation, it is then shown that information seeking is intimately associated with, and dependent on, other aspects of work; tasks and technology included. This leads to a discussion on design and evaluation frameworks for IS&R, based on which two action lines are proposed: information retrieval research needs extension towards more context and information seeking research needs extension towards tasks and technology.
Aalund, Peter K; Larsen, Kristian; Hansen, Torben Bæk
: Cross-sectional, exploratory study. SETTING: Laboratory at a regional hospital. PARTICIPANTS: Thirty-nine individuals with an average age of 65.5±10.3 yrs, who all had unilateral TKA 28 days prior. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The patients performed maximal isometric knee extensions......OBJECTIVE: (s): To investigate which of the two muscle-impairment measures for the operated leg, normalized knee extension strength or leg press power, is more closely associated to performance-based and self-reported measures of function shortly following total knee arthroplasty (TKA). DESIGN...... and dynamic leg presses to determine their body-mass normalized knee extension strength and leg press power, respectively. The 10-m fast speed walking and 30-s chair stand tests were used to determine performance-based function, while the Western Ontario McMaster University Osteoarthritis Index (WOMAC...
Wolf, Erik J; Everding, Vanessa Q; Linberg, Alison A; Czerniecki, Joseph M; Gambel, Jeffrey M
For U.S. military service members with transfemoral amputations there are different prosthetic knee systems available that function differently. For example the C-Leg(®) (C-Leg, Otto Bock Healthcare, GmbH, Duderstadt, Germany) is a passive microprocessor knee, and the Power Knee™ (PK, Ossur, Reykjavík, Iceland) provides active positive power generation at the knee joint. This study examined both step-up and sit-to-stand tasks performed by service members using C-Leg and PK systems to determine if the addition of positive power generation to a prosthetic knee can improve symmetry and reduce impact to the remaining joints. For both tasks, average peak sagittal knee powers and vertical ground reaction forces (GRFs) were greater for the intact limb versus the amputated limb across PK and C-Leg groups. For the sit-to-stand task, peak knee power of the amputated limb was greater for PK users versus C-Leg users. Vertical GRFs of the intact limb were greater for the C-Leg versus the PK. The performance of the PK relative to the C-Leg during a STS task illustrated few differences between components and no effect on the intact limb. Published by Elsevier B.V.
Full Text Available To achieve robust and stable legged locomotion in uneven terrain, animals must effectively coordinate limb swing and stance phases, which involve distinct yet coupled dynamics. Recent theoretical studies have highlighted the critical influence of swing-leg trajectory on stability, disturbance rejection, leg loading and economy of walking and running. Yet, simulations suggest that not all these factors can be simultaneously optimized. A potential trade-off arises between the optimal swing-leg trajectory for disturbance rejection (to maintain steady gait versus regulation of leg loading (for injury avoidance and economy. Here we investigate how running guinea fowl manage this potential trade-off by comparing experimental data to predictions of hypothesis-based simulations of running over a terrain drop perturbation. We use a simple model to predict swing-leg trajectory and running dynamics. In simulations, we generate optimized swing-leg trajectories based upon specific hypotheses for task-level control priorities. We optimized swing trajectories to achieve i constant peak force, ii constant axial impulse, or iii perfect disturbance rejection (steady gait in the stance following a terrain drop. We compare simulation predictions to experimental data on guinea fowl running over a visible step down. Swing and stance dynamics of running guinea fowl closely match simulations optimized to regulate leg loading (priorities i and ii, and do not match the simulations optimized for disturbance rejection (priority iii. The simulations reinforce previous findings that swing-leg trajectory targeting disturbance rejection demands large increases in stance leg force following a terrain drop. Guinea fowl negotiate a downward step using unsteady dynamics with forward acceleration, and recover to steady gait in subsequent steps. Our results suggest that guinea fowl use swing-leg trajectory consistent with priority for load regulation, and not for steadiness of gait
Blum, Yvonne; Vejdani, Hamid R.; Birn-Jeffery, Aleksandra V.; Hubicki, Christian M.; Hurst, Jonathan W.; Daley, Monica A.
To achieve robust and stable legged locomotion in uneven terrain, animals must effectively coordinate limb swing and stance phases, which involve distinct yet coupled dynamics. Recent theoretical studies have highlighted the critical influence of swing-leg trajectory on stability, disturbance rejection, leg loading and economy of walking and running. Yet, simulations suggest that not all these factors can be simultaneously optimized. A potential trade-off arises between the optimal swing-leg trajectory for disturbance rejection (to maintain steady gait) versus regulation of leg loading (for injury avoidance and economy). Here we investigate how running guinea fowl manage this potential trade-off by comparing experimental data to predictions of hypothesis-based simulations of running over a terrain drop perturbation. We use a simple model to predict swing-leg trajectory and running dynamics. In simulations, we generate optimized swing-leg trajectories based upon specific hypotheses for task-level control priorities. We optimized swing trajectories to achieve i) constant peak force, ii) constant axial impulse, or iii) perfect disturbance rejection (steady gait) in the stance following a terrain drop. We compare simulation predictions to experimental data on guinea fowl running over a visible step down. Swing and stance dynamics of running guinea fowl closely match simulations optimized to regulate leg loading (priorities i and ii), and do not match the simulations optimized for disturbance rejection (priority iii). The simulations reinforce previous findings that swing-leg trajectory targeting disturbance rejection demands large increases in stance leg force following a terrain drop. Guinea fowl negotiate a downward step using unsteady dynamics with forward acceleration, and recover to steady gait in subsequent steps. Our results suggest that guinea fowl use swing-leg trajectory consistent with priority for load regulation, and not for steadiness of gait. Swing-leg
Force-velocity relationships reported in the literature for functional tasks involving a combination of joint rotations tend to be quasilinear. The purpose of this study was to explain why they are not hyperbolic, like Hill's relationship. For this purpose, a leg press task was simulated with a
Mendez-Gallardo, Valerie; Roberto, Megan E; Kauer, Sierra D; Brumley, Michele R
The development of postural control is considered an important factor for the expression of coordinated behavior such as locomotion. In the natural setting of the nest, newborn rat pups adapt their posture to perform behaviors of ecological relevance such as those related to suckling. The current study explores the role of posture in the expression of three behaviors in the newborn rat: spontaneous limb activity, locomotor-like stepping behavior, and the leg extension response (LER). One-day-old rat pups were tested in one of two postures--prone or supine--on each of these behavioral measures. Results showed that pups expressed more spontaneous activity while supine, more stepping while prone, and no differences in LER expression between the two postures. Together these findings show that posture affects the expression of newborn behavior patterns in different ways, and suggest that posture may act as a facilitator or a limiting factor in the expression of different behaviors during early development. Copyright © 2015 Elsevier Inc. All rights reserved.
Bahareh Zeynalzadeh Ghoochani
Discussion: Standing on non-dominant leg is a challenging task that requires a well-balanced system to survive the primary decreased somatosensory input. Therefore, the examinee had to have the requisite capabilities to cope with the changes caused when extra manipulation was included. During the course of the study, the most challenging situation was encountered when the subjects were standing on their non-dominant leg with eyes shut, which should be exactingly checked not to create a risky point as an Achilles’ heel of balance system. It was observed that the non-dominant leg was more susceptible to be affected when an aging adult did not have access to the visual input or during performing dual tasks with eyes shut. It is thus recommended that such conditions should be included in balance assessment tests or interventions.
Hahn, Daniel; Herzog, Walter; Schwirtz, Ansgar
Force and torque production of human muscles depends upon their lengths and contraction velocity. However, these factors are widely assumed to be independent of each other and the few studies that dealt with interactions of torque, angle and angular velocity are based on isolated single-joint movements. Thus, the purpose of this study was to determine force/torque-angle and force/torque-angular velocity properties for multi-joint leg extensions. Human leg extension was investigated (n = 18) on a motor-driven leg press dynamometer while measuring external reaction forces at the feet. Extensor torque in the knee joint was calculated using inverse dynamics. Isometric contractions were performed at eight joint angle configurations of the lower limb corresponding to increments of 10° at the knee from 30 to 100° of knee flexion. Concentric and eccentric contractions were performed over the same range of motion at mean angular velocities of the knee from 30 to 240° s(-1). For contractions of increasing velocity, optimum knee angle shifted from 52 ± 7 to 64 ± 4° knee flexion. Furthermore, the curvature of the concentric force/torque-angular velocity relations varied with joint angles and maximum angular velocities increased from 866 ± 79 to 1,238 ± 132° s(-1) for 90-50° knee flexion. Normalised eccentric forces/torques ranged from 0.85 ± 0.12 to 1.32 ± 0.16 of their isometric reference, only showing significant increases above isometric and an effect of angular velocity for joint angles greater than optimum knee angle. The findings reveal that force/torque production during multi-joint leg extension depends on the combined effects of angle and angular velocity. This finding should be accounted for in modelling and optimisation of human movement.
Cronin, Baker; Johnson, Samuel T; Chang, Eunwook; Pollard, Christine D; Norcross, Marc F
The relationships between hip abductor and extensor strength and frontal plane hip and knee motions that are associated with anterior cruciate ligament injury risk are equivocal. However, previous research on these relationships has evaluated relatively low-level movement tasks and peak torque rather than a time-critical strength measure such as the rate of torque development (RTD). Females with greater hip abduction and extension RTD would exhibit lesser frontal plane hip and knee motion during a single-leg jump-cutting task. Descriptive laboratory study. Forty recreationally active females performed maximal isometric contractions and single-leg jump-cuts. From recorded torque data, hip extension and abduction RTD was calculated from torque onset to 200 ms after onset. Three-dimensional motion analysis was used to quantify frontal plane hip and knee kinematics during the movement task. For each RTD measure, jump-cut biomechanics were compared between participants in the highest (high) and lowest (low) RTD tertiles. No differences in frontal plane hip and knee kinematics were identified between high and low hip abduction RTD groups. However, those in the high hip extension RTD group exhibited lower hip adduction (high, 3.8° ± 3.0°; low, 6.5° ± 3.0°; P = .019) and knee valgus (high, -2.5° ± 2.3°; low, -4.4° ± 3.2°; P = .046) displacements during the jump-cut. In movements such as cutting that are performed with the hip in a relatively abducted and flexed position, the ability of the gluteus medius to control hip adduction may be compromised. However, the gluteus maximus, functioning as a hip abductor, may take on a pivotal role in controlling hip adduction and knee valgus motion during these types of tasks. Training with a specific emphasis on increasing explosive strength of the hip extensors may be a means through which to improve frontal plane hip and knee control during high-risk maneuvers such as cutting.
Kongsted, Alice; Kent, Peter; Jensen, Tue Secher
or below the knee. CONCLUSIONS: Subgrouping LBP patients, based on pain location and neurological signs, was associated with activity limitation and sick leave, but not with GPE. The presence of neurological signs and pain in the leg both have prognostic implications but whether that leg pain without...... if this was explained by measured baseline factors. METHODS: Routine clinical data were collected during the first visit to an outpatient department and follow-ups were performed after 3 and 12 months. Patients were divided into the four subgroups and associations between subgroups and the outcomes of activity...... limitation, global perceived effect (GPE) after 3 months, and sick leave after 3 months were tested by means of generalised estimating equations. Models were univariate (I), adjusted for duration (II), and adjusted for all baseline differences (III). RESULTS: A total of 1,752 patients were included...
Full Text Available The present study examined the effects of exercise utilising traditional resistance training (leg press or ‘cardio’ exercise (recumbent cycle ergometry modalities upon acute physiological responses. Nine healthy males underwent a within session randomised crossover design where they completed both the leg press and recumbent cycle ergometer conditions. Conditions were approximately matched for effort and duration (leg press: 4 × 12RM using a 2 s concentric and 3 s eccentric repetition duration controlled with a metronome, thus each set lasted 60 s; recumbent cycle ergometer: 4 × 60 s bouts using a resistance level permitting 80–100 rpm but culminating with being unable to sustain the minimum cadence for the final 5–10 s. Measurements included VO2, respiratory exchange ratio (RER, blood lactate, energy expenditure, muscle swelling, and electromyography. Perceived effort was similar between conditions and thus both were well matched with respect to effort. There were no significant effects by ‘condition’ in any of the physiological responses examined (all p > 0.05. The present study shows that, when both effort and duration are matched, resistance training (leg press and ‘cardio’ exercise (recumbent cycle ergometry may produce largely similar responses in VO2, RER, blood lactate, energy expenditure, muscle swelling, and electromyography. It therefore seems reasonable to suggest that both may offer a similar stimulus to produce chronic physiological adaptations in outcomes such as cardiorespiratory fitness, strength, and hypertrophy. Future work should look to both replicate the study conducted here with respect to the same, and additional physiological measures, and rigorously test the comparative efficacy of effort and duration matched exercise of differing modalities with respect to chronic improvements in physiological fitness.
Ruiz Garate, Virginia; Parri, Andrea; Yan, Tingfang; Munih, Marko; Molino Lova, Raffaele; Vitiello, Nicola; Ronsse, Renaud
An emerging approach to design locomotion assistive devices deals with reproducing desirable biological principles of human locomotion. In this paper, we present a bio-inspired controller for locomotion assistive devices based on the concept of motor primitives. The weighted combination of artificial primitives results in a set of virtual muscle stimulations. These stimulations then activate a virtual musculoskeletal model producing reference assistive torque profiles for different locomotion tasks (i.e., walking, ascending stairs, and descending stairs). The paper reports the validation of the controller through a set of experiments conducted with healthy participants. The proposed controller was tested for the first time with a unilateral leg exoskeleton assisting hip, knee, and ankle joints by delivering a fraction of the computed reference torques. Importantly, subjects performed a track involving ground-level walking, ascending stairs, and descending stairs and several transitions between these tasks. These experiments highlighted the capability of the controller to provide relevant assistive torques and to effectively handle transitions between the tasks. Subjects displayed a natural interaction with the device. Moreover, they significantly decreased the time needed to complete the track when the assistance was provided, as compared to wearing the device with no assistance. PMID:28367121
Hodgson, J. A.; Riazansky, S. N.; Goulet, C.; Badakva, A. M.; Kozlovskaya, I. B.; Recktenwald, M. R.; McCall, G.; Roy, R. R.; Fanton, J. W.; Edgerton, V. R.
Rhesus monkeys (Macaca mulatta) were trained to perform a foot lever pressing task for a food reward. EMG activity was recorded from selected lower limb muscles of 2 animals before, during, and after a 14-day spaceflight and from 3 animals during a ground-based simulation of the flight. Integrated EMG activity was calculated for each muscle during the 20-min test. Comparisons were made between data recorded before any experimental manipulations and during flight or flight simulation. Spaceflight reduced soleus (Sol) activity to 25% of preflight levels, whereas it was reduced to 50% of control in the flight simulation. During flight, medial gastrocnemius (MG) activity was reduced to 25% of preflight activity, whereas the simulation group showed normal activity levels throughout all tests. The change in MG activity was apparent in the first inflight recording, suggesting that some effect of microgravity on MG activity was immediate.
Lehman Gregory J
Full Text Available Abstract Background and case presentation The prone leg extension (PLE is commonly used to identify dysfunction of muscle recruitment patterns. The prone leg extension is theorized to identify proximal muscle disturbances which are a result of distal injury or dysfunction (i.e. an ankle sprain. This case study compares the trunk and hip muscle (bilateral lower erector spine, ipsilateral hamstring and ipsilateral gluteus maximus timing during a PLE of a 27 year old female runner during a healthy state (pre ankle sprain and 2 and 8 weeks post ankle sprain. Results and discussion The gluteus maximus muscle onsets at 8 weeks post injury appeared to occur earlier compared with 2 weeks post injury. The Right Erector Spinae at 8 weeks post injury was also active earlier compared with the participant's non-injured state. A large degree of variability can be noted within trials on the same day for all muscle groups. Conclusion An acute ankle injury did not result in a delay in gluteus maximus muscle activation. The utility of the prone leg extension as a clinical and functional test is questionable due to the normal variability seen during the test and our current inability to determine what is normal and what is dysfunctional.
Lehman, Gregory J
Background and case presentation The prone leg extension (PLE) is commonly used to identify dysfunction of muscle recruitment patterns. The prone leg extension is theorized to identify proximal muscle disturbances which are a result of distal injury or dysfunction (i.e. an ankle sprain). This case study compares the trunk and hip muscle (bilateral lower erector spine, ipsilateral hamstring and ipsilateral gluteus maximus) timing during a PLE of a 27 year old female runner during a healthy state (pre ankle sprain) and 2 and 8 weeks post ankle sprain. Results and discussion The gluteus maximus muscle onsets at 8 weeks post injury appeared to occur earlier compared with 2 weeks post injury. The Right Erector Spinae at 8 weeks post injury was also active earlier compared with the participant's non-injured state. A large degree of variability can be noted within trials on the same day for all muscle groups. Conclusion An acute ankle injury did not result in a delay in gluteus maximus muscle activation. The utility of the prone leg extension as a clinical and functional test is questionable due to the normal variability seen during the test and our current inability to determine what is normal and what is dysfunctional. PMID:16504168
Biscarini, Andrea; Benvenuti, Paolo; Botti, Fabio M; Brunetti, Antonella; Brunetti, Orazio; Pettorossi, Vito E
A number of research studies provide evidence that hamstring cocontraction during open kinetic chain knee extension exercises enhances tibiofemoral (TF) stability and reduces the strain on the anterior cruciate ligament. To determine the possible increase in hamstring muscle coactivation caused by a voluntary cocontraction effort during open kinetic chain leg-extension exercises, and to assess whether an intentional hamstring cocontraction can completely suppress the anterior TF shear force during these exercises. Descriptive laboratory study. Knee kinematics as well as electromyographic activity in the semitendinosus (ST), semimembranosus (SM), biceps femoris (BF), and quadriceps femoris muscles were measured in 20 healthy men during isotonic leg extension exercises with resistance (R) ranging from 10% to 80% of the 1-repetition maximum (1RM). The same exercises were also performed while the participants attempted to enhance hamstring coactivation through a voluntary cocontraction effort. The data served as input parameters for a model to calculate the shear and compressive TF forces in leg extension exercises for any set of coactivation patterns of the different hamstring muscles. For R≤ 40% 1RM, the peak coactivation levels obtained with intentional cocontraction (l) were significantly higher (P hamstring muscle, maximum level l was reached at R = 30% 1RM, corresponding to 9.2%, 10.5%, and 24.5% maximum voluntary isometric contraction (MVIC) for the BF, ST, and SM, respectively, whereas the ratio l/l 0 reached its maximum at R = 20% 1RM and was approximately 2, 3, and 4 for the BF, SM, and ST, respectively. The voluntary enhanced coactivation level l obtained for R≤ 30% 1RM completely suppressed the anterior TF shear force developed by the quadriceps during the exercise. In leg extension exercises with resistance R≤ 40% 1RM, coactivation of the BF, SM, and ST can be significantly enhanced (up to 2, 3, and 4 times, respectively) by a voluntary hamstring
Phlebogram - leg; Venography - leg; Angiogram - leg ... into a vein in the foot of the leg being looked at. An intravenous (IV) line is ... vein. A tourniquet may be placed on your leg so the dye flows into the deeper veins. ...
McLean, Scott G; Borotikar, Bhushan; Lucey, Sarah M
Female neuromuscular control during dynamic landings is considered central to their increased ACL injury risk relative to males. There is limited insight, however, into the neuromuscular parameters governing this risk, which may hinder prevention success. This study targeted a new screenable and potentially trainable neuromuscular risk factor. Specifically, we examined whether lower limb muscle pre-motor times, being the time between stimulus presentation and initiation of the muscle EMG burst, elicited during a simple choice reaction task correlated with knee abduction loads during separate single leg landings. Twenty female NCAA athletes had muscle (n=8) pre-motor time and knee biomechanics data recorded bilaterally during a choice reaction task. Knee biomechanics were also quantified during anticipated and unanticipated single (dominant and non-dominant) leg landings. Mean peak knee abduction loads during landings were submitted to a two-way ANOVA to test for limb and decision effects. Individual regression coefficients were initially computed between-limb-based muscle pre-motor times and peak abduction moments elicited during both the choice reaction and landing tasks. Limb-based linear stepwise regression coefficients were also computed between muscle PMT's demonstrating significant (Pmuscle pre-motor times during a specific choice reaction task are associated with peak knee abduction loads during separate single leg landings. These muscles appear critical in stabilizing the knee against the extreme dynamic load states associated with such tasks. Targeted screening and training of supraspinal processes governing these muscle pre-motor times may ultimately enable external knee loads associated with landings to be more effectively countered by the overarching neuromuscular strategy. Copyright (c) 2010 Elsevier Ltd. All rights reserved.
...-AM08 Federal Acquisition Regulation; Extension of Sunset Date for Protests of Task and Delivery Orders... against the award of task or delivery orders by DoD, NASA, and the Coast Guard from May 27, 2011, to... of the following methods: Regulations.gov : http://www.regulations.gov . Submit comments via the...
Full Text Available Cross contamination is one of the most important contributing factors in foodborne illness originating in household environments. The objective of this research was to determine the transfer between naturally contaminated chicken liver and leg to cutting board, hand glove, knife and cucumber, during slicing. The microorganism tested was Campylobacter jejuni and the results showed that the pathogen transferred to all utensils, at different transfer rate, despite the low level of the naturally contaminating pathogen. With unknown concentration bacteria in the naturally contaminated samples, a proportion of the utensils were still contaminated with C. jejuni and not surprisingly, when the sample were contaminated with higher concentrations of the pathogen, a higher proportion of the utensils had detectable C. jejuni cells present, though in many cases cross contamination seems to be a random event. Transfer of the naturally contaminating C. jejuni from the chicken liver and leg to the utensils were <3.0 to 9.2 MPN/g and <3.0 to 3.0 MPN/g, respectively. The results of this study highlighted the potential for cross contamination of food borne pathogens in the kitchen environment.
Cronin, Baker; Johnson, Samuel T.; Chang, Eunwook; Pollard, Christine D.; Norcross, Marc F.
Background: The relationships between hip abductor and extensor strength and frontal plane hip and knee motions that are associated with anterior cruciate ligament injury risk are equivocal. However, previous research on these relationships has evaluated relatively low-level movement tasks and peak torque rather than a time-critical strength measure such as the rate of torque development (RTD). Hypothesis: Females with greater hip abduction and extension RTD would exhibit lesser frontal plane...
A. S. Diakov
Full Text Available One of the main trends for development of promising military equipment is to create transport robot systems (TRS.To conduct a theoretical study of the potential properties of TRS mobility was used a software package for invariant simulation of multibody dynamics system "Euler", which allows us to solve problems regarding the "large displacements", typical for TRS.The modelling results of TRS motion dynamics when overcoming the single-stage and two stages, which are higher than the roller diameter of propeller are obtained.Analysis of modelling results of the TRS motion dynamics to overcome obstacles commensurate with its dimensions allows us to conclude that the use of wheel-legged three-roller propulsion can provide the required level of permeability and, as a result, increasing TRS mobility.
Phillips, Megan; Bazrgari, Babak; Shapiro, Robert
While effective in the prevention of otherwise lethal injuries, military body armour (BA) has been suggested to reduce warfighter's performance and increase injury-related musculoskeletal conditions. Providing the significant role of joint biomechanics in both performance and risk of injury, the immediate and prolonged effects of wearing BA on biomechanics of the lower back and knee during toe-touch (TT) and two-legged squat (TLS) tasks were investigated. The immediate effects of BA were an increase of >40 ms (p ≤ 0.02) in flexion duration of the dominant joint and an ∼1 s (p ≤ 0.02) increase in overall task duration as well as an ∼18% (p = 0.03) decrease in the lumbopelvic rhythm ratio near the mid-range of trunk flexion. In general the prolonged duration of wearing BA (i.e. 45 min of walking) was not found to cause more changes in our measures than walking without BA. The effects of wearing military BA on biomechanics of the lower back and knee during TT and TLS tasks were investigated. The immediate effects of BA were increased flexion duration, increased overall trial duration and decreased lumbopelvic rhythm near the mid-range of trunk flexion.
Pinto, Rafael Zambelli; Ferreira, Paulo Henrique; Franco, Marcia Rodrigues; Ferreira, Mariana Calais; Ferreira, Manuela Loureiro; Teixeira-Salmela, Luci Fuscaldi; Oliveira, Vinicius C; Maher, Christopher
This study investigated the effect of lumbar posture on function of transversus abdominis (TrA) and obliquus internus (OI) in people with and without non-specific low back pain (LBP) during a lower limb task. Rehabilitative ultrasound was used to measure thickness change of TrA and OI during a lower limb task that challenged the stability of the spine. Measures were taken in supine in neutral and flexed lumbar postures in 30 patients and 30 healthy subjects. Data were analysed using a two-way (groups, postures) ANOVA. Our results showed that lumbar posture influenced percent thickness change of the TRA muscle but not for OI. An interaction between group and posture was found for TrA thickness change (F(1,56) = 6.818, p = 0.012). For this muscle, only healthy participants showed greater thickness change with neutral posture compared to flexed (mean difference = 6.2%; 95% CI: 3.1-9.3%; p posture can facilitate an increase in thickness of the TrA muscle while performing a leg task, however this effect was not observed for this muscle in patients with LBP. No significant difference in TrA and OI thickness change between people with and without non-specific LBP was found. Copyright © 2011 Elsevier Ltd. All rights reserved.
...-AM26 Federal Acquisition Regulation; Extension of Sunset Date for Protests of Task and Delivery Orders... delivery orders from May 27, 2011, to September 30, 2016. DATES: Effective date: July 26, 2012. Comment... by FAC 2005-60, FAR Case 2012- 007, by any of the following methods: Regulations.gov : http://www...
Haber, Cassandra Kay; Ritchie, Laura J; Strike, Siobhan C
In a dynamic elastic response prosthesis (DERP), spring-like properties aim to replace the loss of musculature and soft tissues and optimise dynamic movement biomechanics, yet higher intact limb (IL) loading exists. It is unknown how amputees wearing a DERP will perform in start-stop movements and how altering the prosthetic stiffness will influence the performance and loading. This study assessed movement dynamics through comparisons in spatiotemporal, kinematic and kinetic variables and leg stiffness of intact, prosthetic and control limbs. The effect of prosthetic stiffness on movement dynamics was also determined. Eleven male unilateral transtibial amputees performed a start-stop task with one DERP set at two different stiffness - Prescribed and Stiffer. Eleven control participants performed the movement with the dominant limb. Kinematic and kinetic data were collected by a twelve-camera motion capture system synchronised with a Kistler force platform. Selected variables were compared between intact, prosthetic and control limbs, and against prosthetic stiffness using ANOVA and effect size. Pearson's Correlation was used to analyse relationship between leg stiffness and prosthetic deflection. Amputees showed a more horizontal approach to the bound during the start-stop movement, with lower horizontal velocities and a longer stance time on the IL compared to controls. In both stiffness conditions, the IL showed selected higher anteroposterior and vertical forces and impulses when compared to the controls. Leg stiffness was not significantly different between limbs as a result of the interplay between angle swept and magnitude of force, even with the change in prosthetic stiffness. A main effect for prosthetic stiffness was found only in higher impact forces of the prosthetic limb and more horizontal touchdown angles of the IL when using the prescribed DERP. In conclusion, amputees achieve the movement with a horizontal approach when compared to controls which
Cooper, Michael A; Herda, Trent J; Fry, Andrew C; Vardiman, John P; Gallagher, Phillip M
The purpose of the present study was to examine possible correlations between the b terms (slopes) form the log-transformed mechanomyographic amplitude (MMG RMS )–force relationships and the fatigue index calculated from 50 maximal concentric contractions. Forty healthy subjects (age = 21 ± 2 yr) performed isometric ramp contractions from 5% to 85% of their maximal voluntary contraction followed by a 50-repetition concentric fatigue protocol of the leg extensors, fatigue index (%) was calculated from the 50-repetitions. MMG was recorded during the ramp contractions from the vastus lateralis (VL) and rectus femoris (RF). The b terms (slopes) were calculated from the log-transformed MMG RMS –force relationships. Correlations were performed comparing the b terms from the MMG RMS –force relationships for the VL and RF with the fatigue index. Significant positive correlations were found among the b terms from the MMG RMS –force relationships for the VL (p = 0.007, r = 0.417) and RF (p = 0.014, r = 0.386) with the fatigue index. The b terms from the log-transformed MMG RMS –force relationships for the VL and RF may have reflected muscle fiber type composition and, thus, correlated with the fatigue index. This adds further support that the MMG RMS –force relationships may reflect muscle fiber type composition. (paper)
Huurnink, Arnold; Fransz, Duncan P; Kingma, Idsart; van Dieën, Jaap H
Training and testing of balance have potential applications in sports and medicine. Laboratory grade force plates (FP) are considered the gold standard for the measurement of balance performance. Measurements in these systems are based on the parameterization of center of pressure (CoP) trajectories. Previous research validated the inexpensive, widely available and portable Nintendo Wii Balance Board (WBB). The novelty of the present study is that FP and WBB are compared on CoP data that was collected simultaneously, by placing the WBB on the FP. Fourteen healthy participants performed ten sequences of single-leg stance tasks with eyes open (EO), eyes closed (EC) and after a sideways hop (HOP). Within trial comparison of the two systems showed small root-mean-square differences for the CoP trajectories in the x and y direction during the three tasks (mean±SD; EO: 0.33±0.10 and 0.31±0.16 mm; EC: 0.58±0.17 and 0.63±0.19 mm; HOP: 0.74±0.34 and 0.74±0.27 mm, respectively). Additionally, during all 420 trials, comparison of FP and WBB revealed very high Pearson's correlation coefficients (r) of the CoP trajectories (x: 0.999±0.002; y: 0.998±0.003). A general overestimation was found on the WBB compared to the FP for 'CoP path velocity' (EO: 5.3±1.9%; EC: 4.0±1.4%; HOP: 4.6±1.6%) and 'mean absolute CoP sway' (EO: 3.5±0.7%; EC: 3.7±0.5%; HOP: 3.6±1.0%). This overestimation was highly consistent over the 140 trials per task (r>0.996). The present findings demonstrate that WBB is sufficiently accurate in quantifying CoP trajectory, and overall amplitude and velocity during single-leg stance balance tasks. Copyright © 2013 Elsevier Ltd. All rights reserved.
Poortvliet, Peter C; Tucker, Kylie J; Finnigan, Simon; Scott, Dion; Sowman, Paul; Hodges, Paul W
Neural control differs between position- and force-control tasks as evident from divergent effects of fatigue and pain. Unlike force-control tasks, position-control tasks focus on a postural goal to maintain a joint angle. Cortical involvement is suggested to be less during postural control, but whether this differs between position- and force-control paradigms remains unclear. Coherence estimates the functional communication between spatially distinct active regions within the cortex (cortico-cortical coherence; CCC) and between the cortex and muscles (corticomuscular coherence; CMC). We investigated whether cortical involvement differed between force-control and more posturally focused, position-control tasks. Seventeen adults performed position- and force-control knee extensor efforts at a submaximal load (10 % maximum voluntary contraction). Surface electromyography was recorded from the right knee extensor and flexor muscles and brain activity using electroencephalography (EEG). CCC and CMC in the beta (13-30 Hz) and gamma (30-45 Hz) frequency bands were calculated between combinations of intra- and inter-hemispheric pairs of electrodes, and between four EEG electrodes that approximated the left motor cortical area, and right knee extensor EMG, respectively. Differences in EEG power and muscle activity were also calculated. CCC was greater across distributed regions in the force-control task. Beta EEG power in the left hemisphere was higher for the position-control task. Although averaged CMC data differed between tasks, there was no task difference for individual CMC data. Muscle activity and force did not differ between tasks. The results demonstrate differential cortical contributions to control force- versus position-control tasks. This might contribute to differences in performance outcomes of these tasks that have been shown previously.
Bráulio N. Lima, Paulo R.G. Lucareli, Willy A. Gomes, Josinaldo J. Silva, Andre S. Bley, Erin H. Hartigan, Paulo H. Marchetti
Full Text Available The aim of this study was to investigate the acute effects of unilateral ankle plantar flexors static- stretching on surface electromyography (sEMG and the center of pressure (COP during a single-leg balance task in both lower limbs. Fourteen young healthy, non-athletic individuals performed unipodal quiet standing for 30s before and after (stretched limb: immediately post-stretch, 10 and 20 minutes and non-stretched limb: immediately post-stretch a unilateral ankle plantar flexor static- stretching protocol [6 sets of 45s/15s, 70-90% point of discomfort (POD]. Postural sway was described using the COP area, COP speed (antero-posterior and medio-lateral directions and COP frequency (antero-posterior and medio-lateral directions. Surface EMG (EMG integral [IEMG] and Median frequency[FM] was used to describe the muscular activity of gastrocnemius lateralis. Ankle dorsiflexion passive range of motion increased in the stretched limb before and after the static-stretching protocol (mean ± SD: 15.0° ± 6.0 and 21.5° ± 7.0 [p < 0.001]. COP area and IEMG increased in the stretch limb between pre-stretching and immediately post-stretching (p = 0.015 and p = 0.036, respectively. In conclusion, our static- stretching protocol effectively increased passive ankle ROM. The increased ROM appears to increase postural sway and muscle activity; however these finding were only a temporary or transient effect.
Desta, Firew Ayalew; Shifa, Girma Temam; Dagoye, Damtew WoldeMariam; Carr, Catherine; Van Roosmalen, Jos; Stekelenburg, Jelle; Nedi, Assefa Bulcha; Kols, Adrienne; Kim, Young Mi
Background: Health extension workers (HEWs) are the frontline health workers for Ethiopia's primary health care system. The Federal Ministry of Health is seeking to upgrade and increase the number of HEWs, particularly in remote areas, and address concerns about HEWs' pre-service education and
... ed. New York, N.Y.: The McGraw Hill Companies; 2016. http://www.accessmedicine.com. Accessed Dec. 31, ... http://www.mayoclinic.org/symptoms/leg-swelling/basics/definition/SYM-20050910 . Mayo Clinic Footer Legal Conditions and ...
Momma, Haruki; Niu, Kaijun; Kobayashi, Yoritoshi; Huang, Cong; Otomo, Atsushi; Chujo, Masahiko; Tadaura, Hiroko; Nagatomi, Ryoichi
Post-traumatic stress disorder (PTSD) is a common psychological problem following natural disasters. Although pre-disaster risk factors are important for early detection and proactive support, the examination of such has been limited to sociodemographic factors, which were largely unaffected by the disasters. We examined the association between pre-disaster physical functioning and lifestyle and PTSD symptoms five months after the earthquake in the Great East Japan Earthquake survivors who were participating in a pre-existing cohort study. We designed a retrospective cohort study of a cooperative association in Sendai from August 2010 to August 2011. In 2010, lifestyle, physical condition, and sociodemographic factors were examined by self-reported questionnaires completed by 522 employees of this organization. We also measured the leg extension power of all the participants. PTSD symptoms were evaluated by the Japanese version of the Impact of Event Scale-Revised (IES-R-J) following the earthquake of 2011. In multivariate linear regression analysis, leg extension power (β = -0.128, P = 0.025), daily drinking (β = 0.203, P = 0.006), and depressive symptoms (β = 0.139, P = 0.008) were associated with total score of the IES-R-J among men. Moreover, for the IES-R-J subscale, leg extension power was also negatively associated with Intrusion (β = -0.114, P = 0.045) and Hyperarousal (β = -0.163, P = 0.004) after adjusting for all other significant variables. For women, hypertension (β = 0.226, P = 0.032) and depressive symptoms (β = 0.205, P = 0.046) were associated with the total score of the IES-R-J. Leg extension power is a potentially modifiable pre-disaster risk factor among men for attenuating the severity of PTSD symptoms associated with great disasters such as the Great East Japan Earthquake among men.
Full Text Available BACKGROUND: Post-traumatic stress disorder (PTSD is a common psychological problem following natural disasters. Although pre-disaster risk factors are important for early detection and proactive support, the examination of such has been limited to sociodemographic factors, which were largely unaffected by the disasters. We examined the association between pre-disaster physical functioning and lifestyle and PTSD symptoms five months after the earthquake in the Great East Japan Earthquake survivors who were participating in a pre-existing cohort study. METHODS: We designed a retrospective cohort study of a cooperative association in Sendai from August 2010 to August 2011. In 2010, lifestyle, physical condition, and sociodemographic factors were examined by self-reported questionnaires completed by 522 employees of this organization. We also measured the leg extension power of all the participants. PTSD symptoms were evaluated by the Japanese version of the Impact of Event Scale-Revised (IES-R-J following the earthquake of 2011. RESULTS: In multivariate linear regression analysis, leg extension power (β = -0.128, P = 0.025, daily drinking (β = 0.203, P = 0.006, and depressive symptoms (β = 0.139, P = 0.008 were associated with total score of the IES-R-J among men. Moreover, for the IES-R-J subscale, leg extension power was also negatively associated with Intrusion (β = -0.114, P = 0.045 and Hyperarousal (β = -0.163, P = 0.004 after adjusting for all other significant variables. For women, hypertension (β = 0.226, P = 0.032 and depressive symptoms (β = 0.205, P = 0.046 were associated with the total score of the IES-R-J. CONCLUSIONS: Leg extension power is a potentially modifiable pre-disaster risk factor among men for attenuating the severity of PTSD symptoms associated with great disasters such as the Great East Japan Earthquake among men.
... the leg, which can result in a fracture. Stress fractures outside of sport situations are more common in people who have: ... shoes. Choose the appropriate shoe for your favorite sports or activities. And ... can prevent stress fractures. Rotate running with swimming or biking. If ...
Charyeva, Zulfiya; Oguntunde, Olugbenga; Orobaton, Nosa; Otolorin, Emmanuel; Inuwa, Fatima; Alalade, Olubisi; Abegunde, Dele; Danladi, Saba'atu
Contraceptive use remains low in Nigeria, with only 11% of women reporting use of any modern method. Access to long-acting reversible contraceptives (LARCs) is constrained by a severe shortage of human resources. To assess feasibility of task shifting provision of implants, we trained community health extension workers (CHEWs) to insert and remove contraceptive implants in rural communities of Bauchi and Sokoto states in northern Nigeria. We conducted 2- to 3-week training sessions for 166 selected CHEWs from 82 facilities in Sokoto state (September 2013) and 84 health facilities in Bauchi state (December 2013). To assess feasibility of the task shifting approach, we conducted operations research using a pretest-posttest design using multiple sources of information, including surveys with 151 trained CHEWs (9% were lost to follow-up) and with 150 family planning clients; facility observations using supply checklists (N = 149); direct observation of counseling provided by CHEWs (N = 144) and of their clinical (N = 113) skills; as well as a review of service statistics (N = 151 health facilities). The endline assessment was conducted 6 months after the training in each state. CHEWs inserted a total of 3,588 implants in 151 health facilities over a period of 6 months, generating 10,088 couple-years of protection (CYP). After practicing on anatomic arm models, most CHEWs achieved competency in implant insertions after insertions with 4-5 actual clients. Clinical observations revealed that CHEWs performed implant insertion tasks correctly 90% of the time or more for nearly all checklist items. The amount of information that CHEWs provided clients increased between baseline and endline, and over 95% of surveyed clients reported being satisfied with CHEWs' services in both surveys. The study found that supervisors not only observed and corrected insertion skills, as needed, during supervisory visits but also encouraged CHEWs to conduct more community
Symptoms Night leg cramps By Mayo Clinic Staff Night leg cramps, also called nocturnal leg cramps, are painful, involuntary contractions or spasms of muscles in your legs, usually occurring when you're in bed. Night ...
Guidelines for the first-line treatment of restless legs syndrome/Willis-Ekbom disease, prevention and treatment of dopaminergic augmentation: a combined task force of the IRLSSG, EURLSSG, and the RLS-foundation.
Garcia-Borreguero, Diego; Silber, Michael H; Winkelman, John W; Högl, Birgit; Bainbridge, Jacquelyn; Buchfuhrer, Mark; Hadjigeorgiou, Georgios; Inoue, Yuichi; Manconi, Mauro; Oertel, Wolfgang; Ondo, William; Winkelmann, Juliane; Allen, Richard P
A Task Force was established by the International Restless Legs Syndrome Study Group (IRLSSG) in conjunction with the European Restless Legs Syndrome Study Group (EURLSSG) and the RLS Foundation (RLS-F) to develop evidence-based and consensus-based recommendations for the prevention and treatment of long-term pharmacologic treatment of dopaminergic-induced augmentation in restless legs syndrome/Willis-Ekbom disease (RLS/WED). The Task Force made the following prevention and treatment recommendations: As a means to prevent augmentation, medications such as α2δ ligands may be considered for initial RLS/WED treatment; these drugs are effective and have little risk of augmentation. Alternatively, if dopaminergic drugs are elected as initial treatment, then the daily dose should be as low as possible and not exceed that recommended for RLS/WED treatment. However, the physician should be aware that even low dose dopaminergics can cause augmentation. Patients with low iron stores should be given appropriate iron supplementation. Daily treatment by either medication should start only when symptoms have a significant impact on quality of life in terms of frequency and severity; intermittent treatment might be considered in intermediate cases. Treatment of existing augmentation should be initiated, where possible, with the elimination/correction of extrinsic exacerbating factors (iron levels, antidepressants, antihistamines, etc.). In cases of mild augmentation, dopamine agonist therapy can be continued by dividing or advancing the dose, or increasing the dose if there are breakthrough night-time symptoms. Alternatively, the patient can be switched to an α2δ ligand or rotigotine. For severe augmentation the patient can be switched either to an α2δ ligand or rotigotine, noting that rotigotine may also produce augmentation at higher doses with long-term use. In more severe cases of augmentation an opioid may be considered, bypassing α2δ ligands and rotigotine
Jansen, H.M.; Kals, J.
The overall objective of the task was to extend the spawning period of ‘wild’ common perch from some weeks (generally 3 or 4) to 6 months. In order to reach this objective three experiments were performed. During all experiments high mortalities (mostly due to fungal infections) were observed. In
Jansen, H.M.; Kals, J.
The overall objective of the task was to extend the spawning period of ‘wild’ common perch from some weeks (generally 3 or 4) to 6 months. In order to reach this objective three experiments were performed. During all experiments high mortalities (mostly due to fungal infections) were observed. In previous studies also high mortality rates of wild breeders were observed after capture and in the first phase of captivity conditions. The present results indicate that these mortalities were relate...
Your legs are made up of bones, blood vessels, muscles, and other connective tissue. They are important for motion ... falling, or having an accident can damage your legs. Common leg injuries include sprains and strains, joint ...
The author has the opinion that an extension of protection of individuals against environmental pollution is not desirable in the field of fundamental rights. The atomic energy and radiation protection law extends the protection of individuals even further than to warding off a danger. An extension is limited by the structure and complexity of modern environmental pollution. The existing system of individual protection generally is sufficient, the author objects esspecially against the action of an association. (CW) [de
Peripheral vascular disease; PVD; PAD; Arteriosclerosis obliterans; Blockage of leg arteries; Claudication; Intermittent claudication; Vaso-occlusive disease of the legs; Arterial insufficiency of ...
Ali, Asraf; Sundaraj, Kenneth; Badlishah Ahmad, R; Ahamed, Nizam Uddin; Islam, Anamul; Sundaraj, Sebastian
The objective of the present study was to investigate the time to fatigue and compare the fatiguing condition among the three heads of the triceps brachii muscle using surface electromyography during an isometric contraction of a controlled forceful hand grip task with full elbow extension. Eighteen healthy subjects concurrently performed a single 90 s isometric contraction of a controlled forceful hand grip task and full elbow extension. Surface electromyographic signals from the lateral, long and medial heads of the triceps brachii muscle were recorded during the task for each subject. The changes in muscle activity among the three heads of triceps brachii were measured by the root mean square values for every 5 s period throughout the total contraction period. The root mean square values were then analysed to determine the fatiguing condition for the heads of triceps brachii muscle. Muscle fatigue in the long, lateral, and medial heads of the triceps brachii started at 40 s, 50 s, and 65 s during the prolonged contraction, respectively. The highest fatiguing rate was observed in the long head (slope = -2.863), followed by the medial head (slope = -2.412) and the lateral head (slope = -1.877) of the triceps brachii muscle. The results of the present study concurs with previous findings that the three heads of the triceps brachii muscle do not work as a single unit, and the fiber type/composition is different among the three heads.
Ali Md. Asraf
Full Text Available The objective of the present study was to investigate the time to fatigue and compare the fatiguing condition among the three heads of the triceps brachii muscle using surface electromyography during an isometric contraction of a controlled forceful hand grip task with full elbow extension. Eighteen healthy subjects concurrently performed a single 90 s isometric contraction of a controlled forceful hand grip task and full elbow extension. Surface electromyographic signals from the lateral, long and medial heads of the triceps brachii muscle were recorded during the task for each subject. The changes in muscle activity among the three heads of triceps brachii were measured by the root mean square values for every 5 s period throughout the total contraction period. The root mean square values were then analysed to determine the fatiguing condition for the heads of triceps brachii muscle. Muscle fatigue in the long, lateral, and medial heads of the triceps brachii started at 40 s, 50 s, and 65 s during the prolonged contraction, respectively. The highest fatiguing rate was observed in the long head (slope = −2.863, followed by the medial head (slope = −2.412 and the lateral head (slope = −1.877 of the triceps brachii muscle. The results of the present study concurs with previous findings that the three heads of the triceps brachii muscle do not work as a single unit, and the fiber type/composition is different among the three heads.
Ronellenfitsch, M.; Wolf, R.
In the opinion of the author an substantial extension of the protection of the individual against environmental encroachments is not necessary. In many fields of law, for instance in the atomic law or the law for the protection against nuisance, the protection of the individual can be improved by minor corrections. In civil law the same improvement can be gained by an interpretation of existing provisions taking into account the requirements of environmental protection. (WG) [de
Doorenbosch, C.A.M.; Veeger, H. E J; van Zandwijk, J. P.; van Ingen Schenau, G. J.
In guided movements, limb kinematics is determined by the object on which a force is applied (as in cycling). Consequently, the force direction may deviate from the effective direction. It is examined how effective force application is related to maximal power output. A recent study, where subjects
Déficit bilateral nos movimentos de flexão e extensão de perna e flexão do cotovelo Déficit bilateral en los movimientos de flexion y extension de la pierna y flexion del codo Bilateral deficit in leg flexion and extension and elbow flexion movements
Christianne Pereira Giesbrecht Chaves
áxima (CM en la flexión y extensión de pierna e flexión del de codo aisladamente y entre la suma de esos dos resultados con aquel desarrollado simultaneamente por las dos piernas y los dos brazos, respectivamente. Sometemos a 60 indivíduos al ejercicio de flexión y extensión de pierna y a flexión de codo a un test de 1RM. Los resultados para los movimientos de flexión y extensión de pierna y flexión de codo izquierdos y derechos en la CM fueron de 31,6 (± 7,9, 32,0 (± 8,0, 20,2 (± 9,2, 20,2 (± 9,8, 29,3 (± 13,9 e 29,8 (± 14,1 kg respectivamente, y se mostraron similares (p > 0,05 y fuertemente asociados (r = 0,96, 0,96 e 0,98. Comparando la suma de los valores unilaterales con los de ejecución bilateral, la CM presentó una diferencia significativa para los movimientos de extensión de pierna (p = 0,04 y flexión de codo (p = 0,03, el mismo no fué observado en el movimiento de flexión de pierna (p = 0,75. Este resultado puede ser explicado por el menor incremento de carga - dos kilos y medio en este último movimiento en relación a los dos movimientos anteriores - cinco kilos. A pesar de la mayoría de los sujetos sean diestros, no hubo diferencias unilaterales en la CM a pesar de no todos estar entrenados. La suma de los resultados unilaterales fué mayor en 9,8% y 4,0% para los movimientos de extensión de la pierna y flexión del codo, respectivamente, de aquel obtenido bilateralmente, mostrando, probablemente una limitación central en la coordenación motora de un movimiento complejo hecho en máxima velocidad y con carga elevada. Por otro lado, en el movimiento de flexión de pierna, la suma de los resultados unilaterales fué inferior a la bilateral (-0,6%, presentando un posible aprendizage del movimiento y adaptación al entrenamiento con pesos a partir de las doce semanas.Endurance exercises (EE may be performed unilaterally and bilaterally. The objective was to compare the maximum load (ML in leg flexion and extension and elbow flexion alone
... this page: //medlineplus.gov/ency/presentations/100127.htm Leg lengthening - series—Indications To use the sharing features ... with lengthening procedures are the bones of the leg, the tibia and the femur. Surgical treatment may ...
... medlineplus.gov/ency/presentations/100155.htm Arterial bypass leg - series—Normal anatomy To use the sharing features ... Overview The arteries which supply blood to the leg originate from the aorta and iliac vessels. Review ...
Picchietti, Daniel L; Bruni, Oliviero; de Weerd, Al; Durmer, Jeffrey S; Kotagal, Suresh; Owens, Judith A; Simakajornboon, Narong
Specific diagnostic criteria for pediatric restless legs syndrome (RLS) were published in 2003 following a workshop at the National Institutes of Health. Due to substantial new research and revision of the adult RLS diagnostic criteria, a task force was chosen by the International Restless Legs Syndrome Study Group (IRLSSG) to consider updates to the pediatric diagnostic criteria. A committee of seven pediatric RLS experts developed a set of 15 consensus questions to review, conducted a comprehensive literature search, and extensively discussed potential revisions. The committee recommendations were approved by the IRLSSG executive committee and reviewed by the IRLSSG membership. The pediatric RLS diagnostic criteria were simplified and integrated with the newly revised adult RLS criteria. Specific recommendations were developed for pediatric application of the criteria, including consideration of typical words used by children to describe their symptoms. Pediatric aspects of differential diagnosis, comorbidity, and clinical significance were then defined. In addition, the research criteria for probable and possible pediatric RLS were updated and criteria for a related condition, periodic limb movement disorder (PLMD), were clarified. Revised diagnostic criteria for pediatric RLS have been developed, which are intended to improve clinical practice and promote further research. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.
Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema ... Foot, leg, and ankle swelling is common when the person also: Is overweight Has a blood clot in the leg Is older Has ...
Full Text Available Sujith Ovallath, P DeepaJames Parkinson's Movement Disorder Research Centre, Kannur Medical College, Kerala, IndiaBackground: Restless legs syndrome (RLS is a common sleep-related disorder characterized by abnormal sensation and an urge to move the lower limbs. Symptoms occur at rest in the evening or at night, and they are alleviated by moving the affected extremity or by walking. Although the exact etiopathogenesis of RLS remains elusive, the rapid improvement of symptoms with dopaminergic agents suggests that dopaminergic system dysfunction may be a basic mechanism. Dopaminergic agents are the best-studied agents, and are considered first-line treatment of RLS.Objective: To review the diagnostic criteria, clinical features, etiopathogenesis, and the treatment options of RLS.Methods: The suggestions are based on evidence from studies published in peer-reviewed journals, or upon a comprehensive review of the medical literature.Results/conclusion: Extensive data are available for proving the link between the dopaminergic system and RLS. A possible genetic link also has been studied extensively. Dopamine agonists, especially pramipexole and ropinirole, are particularly useful in the treatment of RLS. Pharmacological treatment should however be limited to those patients who suffer from clinically relevant RLS with impaired sleep quality or quality of life.Keywords: dopamine, levodopa, pramipexole
Nelson, E Andrea; Adderley, Una
Leg ulcers usually occur secondary to venous reflux or obstruction, but 20% of people with leg ulcers have arterial disease, with or without venous disorders. Between 1.5 and 3.0 in 1000 people have active leg ulcers. Prevalence increases with age to about 20 in 1000 people aged over 80 years. We conducted a systematic overview, aiming to answer the following clinical questions: What are the effects of treatments for venous leg ulcers? What are the effects of organisational interventions for venous leg ulcers? What are the effects of advice about self-help interventions in people receiving usual care for venous leg ulcers? What are the effects of interventions to prevent recurrence of venous leg ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview). At this update, searching of electronic databases retrieved 116 studies. After deduplication and removal of conference abstracts, 63 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 43 studies and the further review of 20 full publications. Of the 20 full articles evaluated, four systematic reviews were updated and four RCTs were added at this update. We performed a GRADE evaluation for 23 PICO combinations. In this systematic overview, we categorised the efficacy for 13 interventions based on information about the effectiveness and safety of advice to elevate leg, advice to keep leg active, compression stockings for prevention of recurrence, compression bandages and stockings to treat venous leg ulcers, laser treatment (low level), leg ulcer clinics, pentoxifylline, skin grafting, superficial vein surgery for prevention of recurrence, superficial vein surgery to treat venous leg ulcers, therapeutic ultrasound, and topical negative pressure.
Younse, Paulo; Aghazarian, Hrand
The figure depicts selected aspects of a six-legged robot that moves by hopping and that can be steered in the sense that it can be launched into a hop in a controllable direction. This is a prototype of hopping robots being developed for use in scientific exploration of rough terrain on remote planets that have surface gravitation less than that of Earth. Hopping robots could also be used on Earth, albeit at diminished hopping distances associated with the greater Earth gravitation. The upper end of each leg is connected through two universal joints to an upper and a lower hexagonal frame, such that the tilt of the leg depends on the relative position of the two frames. Two non-back-driveable worm-gear motor drives are used to control the relative position of the two frames along two axes 120 apart, thereby controlling the common tilt of all six legs and thereby, further, controlling the direction of hopping. Each leg includes an upper and a lower aluminum frame segment with a joint between them. A fiberglass spring, connected via hinges to both segments, is used to store hopping energy prior to launch into a hop and to cushion the landing at the end of the hop. A cable for loading the spring is run into each leg through the center of the universal joints and then down along the center lines of the segments to the lower end of the leg. A central spool actuated by a motor with a harmonic drive and an electromagnetic clutch winds in all six cables to compress all six springs (thereby also flexing all six legs) simultaneously. To ensure that all the legs push off and land in the same direction, timing- belt pulley drives are attached to the leg segments, restricting the flexing and extension of all six legs to a common linear motion. In preparation for a hop, the spool can be driven to load the spring legs by an amount corresponding to a desired hop distance within range. The amount of compression can be computed from the reading of a shaft-angle encoder that
van Melick, Nicky; Meddeler, Bart M.; Hoogeboom, Thomas J.; Nijhuis-van der Sanden, Maria W. G.; van Cingel, Robert E. H.
CONTEXT: Since decades leg dominance is suggested to be important in rehabilitation and return to play in athletes with anterior cruciate ligament injuries. However, an ideal method to determine leg dominance in relation to task performance is still lacking. OBJECTIVE: To test the agreement between self-reported and observed leg dominance in bilateral mobilizing and unilateral stabilizing tasks, and to assess whether the dominant leg switches between bilateral mobilizing tasks and unilateral ...
Full Text Available This paper presents a brief survey on multi-legged robots and their applications in agriculture such as for harvesting. Multi-legged robots have the benefit of more flexibility and adapt to different rough terrain in a better way. They also have very important applications in fulfilling the dangerous tasks such as mine detecting.
balanced itself in 31) using a tabular ctontrol sclwnme. With only thUiee actuated degrees it used a shuffling gait to balance that reminds one of Charlie ... Chaplin . * The present study explores the control of a physical one-legged hopping machine. The objective of using a machine with only one leg was to
Præsentation af seniorforsker-projekt Lyden-af-Leg i et traderingsperspektiv og med indledende fokus på YouTube som traderings-platform.......Præsentation af seniorforsker-projekt Lyden-af-Leg i et traderingsperspektiv og med indledende fokus på YouTube som traderings-platform....
van Rijssen, L. B.; Brenninkmeijer, E. E. A.; Nieveen van Dijkum, E. J. M.
Most leg ulcers are vascular based. Only if vascular therapy fails other causes are considered. We report the case of a female with incapacitating leg ulcers caused by a rare condition which was only diagnosed after failing treatment. PRESENTATION OF CASE: The female had an extensive previous
Huurnink, Arnold; Fransz, Duncan P; Kingma, Idsart; Hupperets, Maarten D W; van Dieën, Jaap H
In research regarding postural stability, leg preference is often tested and controlled for. However, leg preference may vary between tasks. As athletes are a group of interest for postural stability testing, we evaluated the effect of five leg preference tasks categorization (step up, hop, ball kick, balance, pick up) on single-leg postural stability of 16 field hockey athletes. The 'center of pressure speed' was calculated as the primary outcome variable of single-leg postural stability. Secondary variables were 'mean length of the GRF vector in the horizontal plane', 'mean length of the ankle angular velocity vector', and 'mean length of the hip angular velocity vector', as well as the separate outcomes per degree of freedom. Results showed that leg preference was inconsistent between leg preference tasks. Moreover, the primary and secondary variables yielded no significant difference between the preferred and non-preferred legs, regardless of the applied leg preference task categorization (p>0.05). The present findings do not support the usability of leg preference tasks in controlling for bias of postural stability. In conclusion, none of the applied leg preference tasks revealed a significant effect on postural stability in healthy field hockey athletes. © 2013 Published by Elsevier Ltd.
Dmitriy Valer'evich Artem'ev
Full Text Available The paper describes the epidemiology, etiology, pathogenesis, clinical picture, diagnosis, differential diagnosis, and treatment of restless legs syndrome. Recommendations are given how to choose therapeutic modalities and drugs in relation to different factors.
Venkateshiah, Saiprakash B; Ioachimescu, Octavian C
Restless legs syndrome is a common sensorimotor disorder characterized by an urge to move, and associated with uncomfortable sensations in the legs (limbs). Restless legs syndrome can lead to sleep-onset or sleep-maintenance insomnia, and occasionally excessive daytime sleepiness, all leading to significant morbidity. Brain iron deficiency and dopaminergic neurotransmission abnormalities play a central role in the pathogenesis of this disorder, along with other nondopaminergic systems, although the exact mechanisms are still. Intensive care unit patients are especially vulnerable to have unmasking or exacerbation of restless legs syndrome because of sleep deprivation, circadian rhythm disturbance, immobilization, iron deficiency, and use of multiple medications that can antagonize dopamine. Published by Elsevier Inc.
Toebes, Marcel J P; Hoozemans, Marco J M; Dekker, Joost; van Dieën, Jaap H
This study assessed effects of unilateral leg muscle fatigue (ULMF) on balance control in gait during the stance and swing phases of the fatigued leg in healthy elderly, to test the assumption that leg muscle strength limits balance control during the stance-phase. Ten subjects (aged 63.4, SD 5.5 years) walked on a treadmill in 4 conditions: unperturbed unfatigued, unperturbed fatigued, perturbed unfatigued, and perturbed fatigued. The perturbations were lateral trunk pulls just before contralateral heel contact. ULMF was evoked by unilateral squat exercise until task failure. Isometric knee extension strength was measured to verify the presence of muscle fatigue. Between-stride standard deviations and Lyapunov exponents of trunk kinematics were used as indicators of balance control. Required perturbation force and the deviation of trunk kinematics from unperturbed gait were used to assess perturbation responses. Knee extension strength decreased considerably (17.3% SD 8.6%) as a result ULMF. ULMF did not affect steady-state gait balance. Less force was required to perturb subjects when the fatigued leg was in the stance-phase compared to the swing-phase. Subjects showed a faster return to the unperturbed gait pattern in the fatigued than in the unfatigued condition, after perturbations in swing and stance of the fatigued leg. The results of this study are not in line with the hypothesized effects of leg muscle fatigue on balance in gait. The healthy elderly subjects were able to cope with substantial ULMF during steady-state gait and demonstrated faster balance recovery after laterally directed mechanical perturbations in the fatigued than in the unfatigued condition. Copyright © 2014 Elsevier B.V. All rights reserved.
Bot, Arjan G. J.; Souer, J. Sebastiaan; van Dijk, C. Niek; Ring, David
Symptoms and psychosocial factors are suggested to account for more of the variation in disability than physical impairment, but perhaps less so at the level of specific tasks. This study assessed the influence of impaired wrist motion on specific tasks on the Disabilities of the Arm, Shoulder, and
Nelson, E Andrea
Leg ulcers usually occur secondary to venous reflux or obstruction, but 20% of people with leg ulcers have arterial disease, with or without venous disorders. Between 1.5 and 3.0/1000 people have active leg ulcers. Prevalence increases with age to about 20/1000 in people aged over 80 years. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of standard treatments, adjuvant treatments, and organisational interventions for venous leg ulcers? What are the effects of advice about self-help interventions in people receiving usual care for venous leg ulcers? What are the effects of interventions to prevent recurrence of venous leg ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 101 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: compression bandages and stockings, cultured allogenic (single or bilayer) skin replacement, debriding agents, dressings (cellulose, collagen, film, foam, hyaluronic acid-derived, semi-occlusive alginate), hydrocolloid (occlusive) dressings in the presence of compression, intermittent pneumatic compression, intravenous prostaglandin E1, larval therapy, laser treatment (low-level), leg ulcer clinics, multilayer elastic system, multilayer elastomeric (or non-elastomeric) high-compression regimens or bandages, oral treatments (aspirin, flavonoids, pentoxifylline, rutosides, stanozolol, sulodexide
.... This work synthesizes air planning data messages, Air Tasking Order(ATO) data messages, written in XML and based upon the USMTF standard, and displays these messages as a three-dimensional (3D...
Zhou Xiaodong; Bi Shusheng
The roles of biological springs in vertebrate animals and their implementations in compliant legged robots offer significant advantages over the rigid legged ones in certain types of scenarios. A large number of robotics institutes have been attempting to work in conjunction with biologists and incorporated these principles into the design of biologically inspired robots. The motivation of this review is to investigate the most published compliant legged robots and categorize them according to the types of compliant elements adopted in their mechanical structures. Based on the typical robots investigated, the trade-off between each category is summarized. In addition, the most significant performances of these robots are compared quantitatively, and multiple available solutions for the future compliant legged robot design are suggested. Finally, the design challenges for compliant legged robots are analysed. This review will provide useful guidance for robotic designers in creating new designs by inheriting the virtues of those successful robots according to the specific tasks. (topical review)
.... To more effectively exchange and share data, the Defense Information Systems Agency (DISA), the lead agency for the USMTF, is actively engaged in extending the USMTF standard with a new data sharing technology called Extensible Markup Language (XML...
Nicky van Melick
Full Text Available Since decades leg dominance is suggested to be important in rehabilitation and return to play in athletes with anterior cruciate ligament injuries. However, an ideal method to determine leg dominance in relation to task performance is still lacking.To test the agreement between self-reported and observed leg dominance in bilateral mobilizing and unilateral stabilizing tasks, and to assess whether the dominant leg switches between bilateral mobilizing tasks and unilateral stabilizing tasks.Cross-sectional study.Forty-one healthy adults: 21 men aged 36 ± 17 years old and 20 women aged 36 ±15 years old.Participants self-reported leg dominance in the Waterloo Footedness Questionnaire-Revised (WFQ-R, and leg dominance was observed during performance of four bilateral mobilizing tasks and two unilateral stabilizing tasks. Descriptive statistics and crosstabs were used to report the percentages of agreement.The leg used to kick a ball had 100% agreement between the self-reported and observed dominant leg for both men and women. The dominant leg in kicking a ball and standing on one leg was the same in 66.7% of the men and 85.0% of the women. The agreement with jumping with one leg was lower: 47.6% for men and 70.0% for women.It is appropriate to ask healthy adults: "If you would shoot a ball on a target, which leg would you use to shoot the ball?" to determine leg dominance in bilateral mobilizing tasks. However, a considerable number of the participants switched the dominant leg in a unilateral stabilizing task.
John A Bender
Full Text Available High-speed video can provide fine-scaled analysis of animal behavior. However, extracting behavioral data from video sequences is a time-consuming, tedious, subjective task. These issues are exacerbated where accurate behavioral descriptions require analysis of multiple points in three dimensions. We describe a new computer program written to assist a user in simultaneously extracting three-dimensional kinematics of multiple points on each of an insect's six legs. Digital video of a walking cockroach was collected in grayscale at 500 fps from two synchronized, calibrated cameras. We improved the legs' visibility by painting white dots on the joints, similar to techniques used for digitizing human motion. Compared to manual digitization of 26 points on the legs over a single, 8-second bout of walking (or 106,496 individual 3D points, our software achieved approximately 90% of the accuracy with 10% of the labor. Our experimental design reduced the complexity of the tracking problem by tethering the insect and allowing it to walk in place on a lightly oiled glass surface, but in principle, the algorithms implemented are extensible to free walking. Our software is free and open-source, written in the free language Python and including a graphical user interface for configuration and control. We encourage collaborative enhancements to make this tool both better and widely utilized.
Bender, John A; Simpson, Elaine M; Ritzmann, Roy E
High-speed video can provide fine-scaled analysis of animal behavior. However, extracting behavioral data from video sequences is a time-consuming, tedious, subjective task. These issues are exacerbated where accurate behavioral descriptions require analysis of multiple points in three dimensions. We describe a new computer program written to assist a user in simultaneously extracting three-dimensional kinematics of multiple points on each of an insect's six legs. Digital video of a walking cockroach was collected in grayscale at 500 fps from two synchronized, calibrated cameras. We improved the legs' visibility by painting white dots on the joints, similar to techniques used for digitizing human motion. Compared to manual digitization of 26 points on the legs over a single, 8-second bout of walking (or 106,496 individual 3D points), our software achieved approximately 90% of the accuracy with 10% of the labor. Our experimental design reduced the complexity of the tracking problem by tethering the insect and allowing it to walk in place on a lightly oiled glass surface, but in principle, the algorithms implemented are extensible to free walking. Our software is free and open-source, written in the free language Python and including a graphical user interface for configuration and control. We encourage collaborative enhancements to make this tool both better and widely utilized.
Myers, William Neil (Inventor)
Knee braces generally have been rigid in both the knee bending direction and in the knee straightening direction unless a manually operated release is incorporated in them to allow the knee to bend. Desirably a braced knee joint should effectively duplicate the compound, complex, actions of a normal knee. The key to knee braces is the knee joint housing. The housing herein carries a number of cam action pawls. with teeth adapted to engage the internal teeth of a ratchet ring mounted in the housing. Cam action return springs and the shape of the cam action pawl teeth allow rotation of the ratchet ring in a leg straightening direction while still supporting a load. The leg can then be extended during walking while at the same time being prevented by the cam action pawls from buckling in the knee bending direction.
Zheng, Xiaoting; Zhou, Zhonghe; Wang, Xiaoli; Zhang, Fucheng; Zhang, Xiaomei; Wang, Yan; Wei, Guangjin; Wang, Shuo; Xu, Xing
Recent discoveries of large leg feathers in some theropods have implications for our understanding of the evolution of integumentary features on the avialan leg, and particularly of their relevance for the origin of avialan flight. Here we report 11 basal avialan specimens that will greatly improve our knowledge of leg integumentary features among early birds. In particular, they provide solid evidence for the existence of enlarged leg feathers on a variety of basal birds, suggest that extensively scaled feet might have appeared secondarily at an early stage in ornithuromorph evolution, and demonstrate a distal-to-proximal reduction pattern for leg feathers in avialan evolution.
Autore teorētiski analizē legāta jēdzienu testamentārās mantošanas ietvaros un atspoguļo praktiska pētījuma rezultātus. Teorētiskā daļa apskata legāta nodibināšanas formu un spēkā esamību, tā iegūšanu un atraidīšanu, izpildi un zaudēšanu, novēlējuma robežas un aprobežojumus. Pētījums veikts aptaujas veidā ar mērķi noskaidrot, cik liela Latvijas iedzīvotāju daļa apzinās legāta nodrošinātās priekšrocības testamentārajā mantošanā. Apskatīts notāra neitralitātes jautājums attiecībā pret mantošana...
Merker, Andreas; Rummel, Juergen; Seyfarth, Andre
Asymmetric leg function is often an undesired side-effect in artificial legged systems and may reflect functional deficits or variations in the mechanical construction. It can also be found in legged locomotion in humans and animals such as after an accident or in specific gait patterns. So far, it is not clear to what extent differences in the leg function of contralateral limbs can be tolerated during walking or running. Here, we address this issue using a bipedal spring-mass model for simulating walking with compliant legs. With the help of the model, we show that considerable differences between contralateral legs can be tolerated and may even provide advantages to the robustness of the system dynamics. A better understanding of the mechanisms and potential benefits of asymmetric leg operation may help to guide the development of artificial limbs or the design novel therapeutic concepts and rehabilitation strategies.
Schatz, Enid; Gilbert, Leah
Compromised health negatively impacts older persons' ability to participate in expected social roles. Researchers have published little empirical work, however, to explore these issues in HIV endemic African settings. Qualitative interviews with 30 women, aged 60-plus, in rural South Africa, provide insight into the relationship between health and daily activities, with attention to the fulfillment of social roles. In this poor HIV endemic context, older women make connections between their compromised health and their (lack of) capacity to perform the daily tasks that they view as expected of them. By expanding the conceptualization of health to include the capacity to achieve the expectations and perform the tasks expected of one, we better understand how and why health and performance of daily activities are so intricately linked in the minds of respondents. This also provides a starting point for thinking about the social and structural support needed by older persons in these settings, especially as HIV erodes familial supports.
Hensley, Jennifer G
Sleep disturbance during pregnancy can result in excessive daytime sleepiness, diminished daytime performance, inability to concentrate, irritability, and the potential for an increased length of labor and increased risk of operative birth. Sleep disturbance may be the result of a sleep disorder, such as leg cramps, a common yet benign disorder, or restless legs syndrome, a sensorimotor disorder. Both disrupt sleep, are distressing to the pregnant woman, and mimic one another and other serious disorders. During pregnancy, up to 30% of women can be affected by leg cramps, and up to 26% can be affected by restless legs syndrome.
Rafeiner, Ph; Templeton, A J; Vonesch, H J
We report the case of a 84-year-old woman suffering from strong pain in her right leg initially resembling thrombosis of deep veins. Eight hours after admission a superficial blister developed at the calf with following hemorrhagic aspect and spontanous eruption of clear yellowish fluid. Later on a new blister appeared at the thigh. The patient died 33 hours after admission of streptococcal toxic shock syndrome. The latter was based on a necrotizing fasciitis. Streptoccus pyogenes (group A) could be cultivated from the blood and fluid of the blister. We discuss the clinical presentation of necrotizing fasciitis with "pain out of proportion" as characteristic complaint and the appropriate management.
Full Text Available Textiloma is defined as a tumor formed due to retained gauze. It is rarely reported in the musculoskeletal system. We are presenting a case with a soft tissue swelling over the lateral aspect of the lower third of the leg, come for implant removal of the distal tibia and fibular fracture. We removed the soft tissue mass enbloc thinking it to be a benign tumor. On cutting the mass on the operation table, a gauze piece encased by fibrous tissue was found. Textiloma can present as tumoral forms and can mimic as a pseudo-tumor.
Jørring, S; Kolmos, H J; Klareskov, B
Five weeks after an episode of gastroenteritis, a 65-year-old diabetic male developed an extensive myonecrosis, with gas production in the left leg caused by Salmonella enteritidis. The patient was treated with surgical revision and antibiotics. To our knowledge, this is the first case of myonecr......Five weeks after an episode of gastroenteritis, a 65-year-old diabetic male developed an extensive myonecrosis, with gas production in the left leg caused by Salmonella enteritidis. The patient was treated with surgical revision and antibiotics. To our knowledge, this is the first case...
Cao, Feng; Zhang, Chao; Vo Doan, Tat Thang; Li, Yao; Sangi, Daniyal Haider; Koh, Jie Sheng; Huynh, Ngoc Anh; Aziz, Mohamed Fareez Bin; Choo, Hao Yu; Ikeda, Kazuo; Abbeel, Pieter; Maharbiz, Michel M.; Sato, Hirotaka
In this study, a biological microactuator was demonstrated by closed-loop motion control of the front leg of an insect (Mecynorrhina torquata, beetle) via electrical stimulation of the leg muscles. The three antagonistic pairs of muscle groups in the front leg enabled the actuator to have three degrees of freedom: protraction/retraction, levation/depression, and extension/flexion. We observed that the threshold amplitude (voltage) required to elicit leg motions was approximately 1.0 V; thus, ...
Chilibeck, Philip D; Cornish, Stephen M; Schulte, Al; Jantz, Nathan; Magnus, Charlene R A; Schwanbeck, Shane; Juurlink, Bernhard H J
We hypothesized that spinal manipulation (SM) would reduce strength imbalances between legs. Using an un-blinded randomized design, 28 males and 21 females (54 ± 19y) with at least a 15% difference in isometric strength between legs for hip flexion, extension, abduction, or knee flexion were randomized to treatment or placebo (mock spinal manipulation). Strength of the stronger and weaker legs for hip flexion, extension, abduction, and/or knee flexion was assessed before and after the intervention. SM reduced the relative strength difference between legs for knee flexion (mean ± SD 57 ± 53 to 5 ± 14%) and hip flexion (24 ± 12 to 11 ± 15%) compared to placebo (34 ± 29 to 24 ± 36%, and 20 ± 18 to 22 ± 26%, respectively) (p = 0.05). SM also improved strength in the weak leg for hip abduction (104 ± 43 to 116 ± 43 Nm) compared to placebo (84 ± 24 to 85 ± 31 Nm) (p = 0.03). This study suggests that spinal manipulation may reduce imbalances in strength between legs for knee and hip flexion.
Full Text Available We report a 50-year-old man with poorly controlled diabetes mellitus who presented with a painful, swollen right leg. He had also experienced right flank pain for 1 week prior to admission. Physical examination was notable for tenderness over the right flank. The right leg was diffusely swollen and exquisitely tender to touch, with palpable crepitance. Laboratory tests revealed leukocytosis and pyuria. Computed tomography showed a right ureteral stone with hydronephrosis and characteristic findings of emphysematous pyelonephritis. Furthermore, a right perirenal gas-forming abscess with extension to the right leg was noted. The patient was successfully treated with antibiotic therapy, aggressive control of blood sugar, percutaneous drainage of the hydronephrosis and perirenal abscess, and aggressive debridement of the leg.
Teixeira, Luis Augusto; de Oliveira, Dalton Lustosa; Romano, Rosangela Guimaraes; Correa, Sonia Cavalcanti
To examine the effect of long lasting practice on pedal behavior in sport, we compared experienced adult soccer players and nonsoccer players on leg preference in motor tasks requiring general mobilization, soccer related mobilization, and body balance stabilization. We also evaluated performance asymmetry between the right and left legs in static…
van Dieen, J.H.; van Leeuwen, M.; Faber, G.S.
We investigated motor and sensory changes underlying learning of a balance task. Fourteen participants practiced balancing on one leg on a board that could freely rotate in the frontal plane. They performed six, 16-s trials standing on one leg on a stable surface (2 trials without manipulation, 2
Rana, Abdul Qayyum; Khan, Fatima; Mosabbir, Abdullah; Ondo, William
Leg pain and discomfort are common complaints in any primary physician's clinic. Two common causes of pain or discomfort in legs are nocturnal leg cramps (NLC) and restless leg syndrome (RLS). NLC present as painful and sudden contractions mostly in part of the calf. Diagnosis of NLC is mainly clinical and sometimes involves investigations to rule out other mimics. RLS is a condition characterized by the discomfort or urge to move the lower limbs, which occurs at rest or in the evening/night. The similarity of RLS and leg cramps poses the issue of errors in diagnosing and differentiating the two. In this paper we review the pathopysiology of each entity and their diagnosis as well as treatment. The two conditions are then compared to appreciate the differences and similarities. Finally, suggestions are recommended for complete assessment.
Kawa, Jacek; Stępień, Paula; Kapko, Wojciech; Niedziela, Aleksandra; Derejczyk, Jarosław
Falls are a major risk in elder population. Early diagnosis is therefore an important step towards increasing the safety of elders. One of the common diagnostic tests is the Berg Balance Scale (BBS), consisting of 14 exercises arranged from the easiest (sitting-to-standing) to the most demanding (one-leg stance). In this study a novel approach to the automatic assessment of the time in which the patient can remain in the one-leg stance position without loosing balance is introduced. The data is collected using a regular video camera. No markers, special garments, or system calibration are required. Two groups are examined. The first group consists of 16 students: healthy, young adults (12 female, 4 male, avg. 20yrs±1). The second group consists of 50 elders (39 female, 11 male, avg. 78.8yrs±5.9). Data (short, one minute recordings) are collected in a controlled environment using a digital video recorder (50fps, 1920×1080) fixed to a tripod. Data are processed off-line. First, the region of interest is determined. Next, the Kanade-Lucas-Tomasi tracking is performed. Best tracks are selected based on the registered vertical movement and two tracks are obtained corresponding to the left and right leg movements. Tracks are later subjected to the sparse signal baseline estimation, denoising and thresholding to detect the raised leg. Results are compared frame-wise to the ground truth reference obtained in the manual processing procedure. Both legs are evaluated in the elder group (in all cases several attempts featuring both legs were registered), resulting in 89.18%±11.27% DICE, 93.07%±5.43% sensitivity and 96.94%±6.11% specificity values for both legs. The signal of a single leg is evaluated in the student group (in all cases only one attempt was needed to perform the full examination) resulting in 98.96%±1.2% DICE, 98.78%±1.65% sensitivity and 98.73%±2.69% specificity values. This is the first step towards a video-based system enabling the automatic
Full Text Available Leg ulcers are frequently caused by venous insufficiency, arterial insufficiency, neuropathy, or a combination of these factors. Klinefelter syndrome in association with chronic leg ulcers have been reported earlier. We report a case of Klinefelter syndrome with non- healing ulcer. The diagnosis of the Klinefelter syndrome was confirmed by karyotyping.
Full Text Available The purpose of this study was to investigate trunk and knee strength in practitioners of hard-style martial arts. An additional objective was to examine reaction times in these participants by measuring simple reaction times (SRT, choice reaction times (CRT and movement times (MT. Thirteen high-level martial artists and twelve sedentary participants were tested under isokinetic and isometric conditions on an isokinetic dynamometer. Response and movement times were also measured in response to simple and choice auditory cues. Results indicated that the martial arts group generated a greater body-weight adjusted peak torque with both legs at all speeds during isokinetic extension and flexion, and in isometric extension but not flexion. In isokinetic and isometric trunk flexion and extension, martial artists tended to have higher peak torques than controls, but they were not significantly different (p > 0.05. During the SRT and CRT tasks the martial artists were no quicker in lifting their hand off a button in response to the stimulus [reaction time (RT] but were significantly faster in moving to press another button [movement time (MT]. In conclusion, the results reveal that training in a martial art increases the strength of both the flexors and extensors of the leg. Furthermore, they have faster movement times to auditory stimuli. These results are consistent with the physical aspects of the martial arts
Full Text Available Restless legs syndrome is a distressing condition, with negative effects on sleep and daytime activities that affect personal, family and occupational life. The overall impact of restless legs syndrome on quality of life is comparable to that of chronic and frustrating conditions such as depression and diabetes. Misdiagnosis and inappropriate treatment may increase patients' suffering in terms of uncertainty, overuse or misuse of care services and lack of trust. Presenting a synthesis of the main topics in the literature on restless legs syndrome facilitates for a better understanding and its management in primary care settings.
Sung, R; Lau, P; Yu, C; Lam, P; Nelson, E
AIMS—(1) To validate a leg to leg bioimpedance analysis (BIA) device in the measurement of body composition in children by assessment of its agreement with dual energy x ray absorptiometry (DXA) and its repeatability. (2) To establish a reference range of percentage body fat in Hong Kong Chinese children. METHODS—Sequential BIA and DXA methods were used to determine body composition in 49 children aged 7-18 years; agreement between the two methods was calculated. Repea...
Lee, David V.; Isaacs, Michael R.; Higgins, Trevor E.; Biewener, Andrew A.; McGowan, Craig P.
Trotting, bipedal running, and especially hopping have long been considered the principal bouncing gaits of legged animals. We use the radial-leg spring constant krad to quantify the stiffness of the physical leg during bouncing gaits. The radial-leg is modeled as an extensible strut between the hip and the ground and krad is determined from the force and deflection of this strut in each instance of stance. A Hookean spring is modeled in-series with a linear actuator and the stiffness of this spring krad is determined by minimizing the work of the actuator while reproducing the measured force-deflection dynamics of an individual leg during trotting or running, and of the paired legs during hopping. Prior studies have estimated leg stiffness using kleg, a metric that imagines a virtual-leg connected to the center of mass. While kleg has been applied extensively in human and comparative biomechanics, we show that krad more accurately models the spring in the leg when actuation is allowed, as is the case in biological and robotic systems. Our allometric analysis of krad in the kangaroo rat, tammar wallaby, dog, goat, and human during hopping, trotting, or running show that krad scales as body mass to the two-third power, which is consistent with the predictions of dynamic similarity and with the scaling of kleg. Hence, two-third scaling of locomotor spring constants among mammals is supported by both the radial-leg and virtual-leg models, yet the scaling of krad emerges from work-minimization in the radial-leg model instead of being a defacto result of the ratio of force to length used to compute kleg. Another key distinction between the virtual-leg and radial-leg is that krad is substantially greater than kleg, as indicated by a 30–37% greater scaling coefficient for krad. We also show that the legs of goats are on average twice as stiff as those of dogs of the same mass and that goats increase the stiffness of their legs, in part, by more nearly aligning their
Cao, Feng; Zhang, Chao; Vo Doan, Tat Thang; Li, Yao; Sangi, Daniyal Haider; Koh, Jie Sheng; Huynh, Ngoc Anh; Aziz, Mohamed Fareez Bin; Choo, Hao Yu; Ikeda, Kazuo; Abbeel, Pieter; Maharbiz, Michel M.; Sato, Hirotaka
In this study, a biological microactuator was demonstrated by closed-loop motion control of the front leg of an insect (Mecynorrhina torquata, beetle) via electrical stimulation of the leg muscles. The three antagonistic pairs of muscle groups in the front leg enabled the actuator to have three degrees of freedom: protraction/retraction, levation/depression, and extension/flexion. We observed that the threshold amplitude (voltage) required to elicit leg motions was approximately 1.0 V; thus, we fixed the stimulation amplitude at 1.5 V to ensure a muscle response. The leg motions were finely graded by alternation of the stimulation frequencies: higher stimulation frequencies elicited larger leg angular displacement. A closed-loop control system was then developed, where the stimulation frequency was the manipulated variable for leg-muscle stimulation (output from the final control element to the leg muscle) and the angular displacement of the leg motion was the system response. This closed-loop control system, with an optimized proportional gain and update time, regulated the leg to set at predetermined angular positions. The average electrical stimulation power consumption per muscle group was 148 µW. These findings related to and demonstrations of the leg motion control offer promise for the future development of a reliable, low-power, biological legged machine (i.e., an insect–machine hybrid legged robot). PMID:25140875
Full Text Available In this study, a biological microactuator was demonstrated by closed-loop motion control of the front leg of an insect (Mecynorrhina torquata, beetle via electrical stimulation of the leg muscles. The three antagonistic pairs of muscle groups in the front leg enabled the actuator to have three degrees of freedom: protraction/retraction, levation/depression, and extension/flexion. We observed that the threshold amplitude (voltage required to elicit leg motions was approximately 1.0 V; thus, we fixed the stimulation amplitude at 1.5 V to ensure a muscle response. The leg motions were finely graded by alternation of the stimulation frequencies: higher stimulation frequencies elicited larger leg angular displacement. A closed-loop control system was then developed, where the stimulation frequency was the manipulated variable for leg-muscle stimulation (output from the final control element to the leg muscle and the angular displacement of the leg motion was the system response. This closed-loop control system, with an optimized proportional gain and update time, regulated the leg to set at predetermined angular positions. The average electrical stimulation power consumption per muscle group was 148 µW. These findings related to and demonstrations of the leg motion control offer promise for the future development of a reliable, low-power, biological legged machine (i.e., an insect-machine hybrid legged robot.
Peuker, Frank; Maufroy, Christophe; Seyfarth, André
The dynamics of the center of mass (CoM) in the sagittal plane in humans and animals during running is well described by the spring-loaded inverted pendulum (SLIP). With appropriate parameters, SLIP running patterns are stable, and these models can recover from perturbations without the need for corrective strategies, such as the application of additional forces. Rather, it is sufficient to adjust the leg to a fixed angle relative to the ground. In this work, we consider the extension of the SLIP to three dimensions (3D SLIP) and investigate feed-forward strategies for leg adjustment during the flight phase. As in the SLIP model, the leg is placed at a fixed angle. We extend the scope of possible reference axes from only fixed horizontal and vertical axes to include the CoM velocity vector as a movement-related reference, resulting in six leg-adjustment strategies. Only leg-adjustment strategies that include the CoM velocity vector produced stable running and large parameter domains of stability. The ability of the model to recover from perturbations along the direction of motion (directional stability) depended on the strategy for lateral leg adjustment. Specifically, asymptotic and neutral directional stability was observed for strategies based on the global reference axis and the velocity vector, respectively. Additional features of velocity-based leg adjustment are running at arbitrary low speed (kinetic energy) and the emergence of large domains of stable 3D running that are smoothly transferred to 2D SLIP stability and even to 1D SLIP hopping. One of the additional leg-adjustment strategies represented a large convex region of parameters where stable and robust hopping and running patterns exist. Therefore, this strategy is a promising candidate for implementation into engineering applications, such as robots, for instance. In a preliminary comparison, the model predictions were in good agreement with the experimental data, suggesting that the 3D SLIP is an
Credeur, Daniel P.; Holwerda, Seth W.; Restaino, Robert M.; King, Phillip M.; Crutcher, Kiera L.; Laughlin, M. Harold; Padilla, Jaume
Rapid-onset vasodilation (ROV) following single muscle contractions has been examined in the forearm of humans, but has not yet been characterized in the leg. Given known vascular differences between the arm and leg, we sought to characterize ROV following single muscle contractions in the leg. Sixteen healthy men performed random ordered single contractions at 5, 10, 20, 40, and 60% of their maximum voluntary contraction (MVC) using isometric knee extension made with the leg above and below heart level, and these were compared with single isometric contractions of the forearm (handgrip). Single thigh cuff compressions (300 mmHg) were utilized to estimate the mechanical contribution to leg ROV. Continuous blood flow was determined by duplex-Doppler ultrasound and blood pressure via finger photoplethysmography (Finometer). Single isometric knee extensor contractions produced intensity-dependent increases in peak leg vascular conductance that were significantly greater than the forearm in both the above- and below-heart level positions (e.g., above heart level: leg 20% MVC, +138 ± 28% vs. arm 20% MVC, +89 ± 17%; P leg. Collectively, these data demonstrate the presence of a rapid and robust vasodilation to single muscle contractions in the leg that is largely independent of mechanical factors, thus establishing the leg as a viable model to study ROV in humans. PMID:25539935
Singh, Lilly; Stevens, Erin E
Gynecologic malignancies affect more than 83 000 women in the United States, each year. Because the disease involves the pelvis, many patients have side effects distal to this area in their lower extremities. The differential diagnosis of leg pain can be divided into vascular, neurologic, and musculoskeletal causes. In this review article, we address numerous etiologies of leg pain, reviewing the prevalence of disease, physical examination findings, diagnostic as well as treatment modalities.
Buchfuhrer, Mark J
It has been well established that restless legs syndrome (RLS) manifests with symptoms most frequently in the legs followed by the arms. Other body parts may be affected but it has been somewhat controversial as to whether symptoms may extend to the face. We are reporting two cases of RLS showing unusual extension of symptoms. These two patients presented with symptoms which extended to body parts beyond the legs, including to the face. The facial symptoms can be relieved by walking, massage or medication. It is important to be aware of unusual extension of symptoms either as progression of the disease or as manifestation of augmentation.
Suzuki, Keisuke; Miyamoto, Masayuki; Miyamoto, Tomoyuki; Hirata, Koichi
Sleep disturbances are important nonmotor symptoms in Parkinson's disease (PD) that are associated with a negative impact on quality of life. Restless legs syndrome (RLS), which is characterized by an urge to move the legs accompanied by abnormal leg sensations, can coexist with PD, although the pathophysiology of these disorders appears to be different. RLS and PD both respond favorably to dopaminergic treatment, and several investigators have reported a significant relationship between RLS and PD. Sensory symptoms, pain, motor restlessness, akathisia, and the wearing-off phenomenon observed in PD should be differentiated from RLS. RLS in PD may be confounded by chronic dopaminergic treatment; thus, more studies are needed to investigate RLS in drug-naïve patients with PD. Recently, leg motor restlessness (LMR), which is characterized by an urge to move the legs that does not fulfill the diagnostic criteria for RLS, has been reported to be observed more frequently in de novo patients with PD than in age-matched healthy controls, suggesting that LMR may be a part of sensorimotor symptoms intrinsic to PD. In this paper, we provide an overview of RLS, LMR, and PD and of the relationships among these disorders.
Pettigrew, T.J.; Casey, J.F.; Miller, D.J.; Araki, E.; Boissonnas, R.; Busby, R.; Einaudi, F.; Gerdom, M.; Guo, Z.P.; Hopkins, H.; Myers, G.; Rao, D.G.; Shibata, T.; Thy, P.
on the east rim of the Atlantis II Fracture Zone, ~200 m northwest of Hole 735B (32°43.32′S, 57°15.85′E; Fig. F2). This site was selected based on a video survey beginning at Hole 735B, by which we sought to find a reasonably flat, large outcrop to initiate... of the system. A frequency analyzer for monitoring hammer operations was built and installed during the transit. After a 4-hr video survey starting at the Hole 735B guide base, we selected a location with extensive, relatively flat-appearing outcrop and set...
Rye, David B; Trotti, Lynn Marie
Women are more commonly affected than men by restless legs syndrome, and prevalence is highest amongst those of northern European heritage. The motor manifestations include nonvolitional myoclonus (periodic leg movements). Disinhibition of spinal sensorimotor circuits may underlie these primary features and can be affected by peripheral as well as supraspinal networks. Insufficient mobilizable iron stores increase expressivity in some individuals. The sensorimotor features are relieved by dopamine, especially dopamine agonists, gabapentin and its derivatives, and opioids. A diagnosis relies on recognition of key primary and supportive features, and treatments are generally well tolerated, efficacious, and life-changing. Copyright © 2012 Elsevier Inc. All rights reserved.
Manini, Todd M; Cook, Summer B; VanArnam, Tom; Marko, Moshe; Ploutz-Snyder, Lori
Modification of everyday tasks in older adults is associated with risk of deleterious health outcomes. The purpose of this study was to develop a task modification scale to examine its reliability and comparability to timed performance and common measures of physical function and impairment. Eighty-two (21 men, 61 women) older adults (74.4 +/- 8.2 years) were observed performing a chair rise (sitting heights: 43 cm, 38 cm, and 30 cm), stair ascent/descent, and kneel and supine rise tasks. Six hierarchically ranked categories (0-5) of modification were created for each task and then summed across tasks (summary modification [MOD] score: range 0-35). Comparisons were made with timed performance, knee extension strength, single-leg balance, self-reported function, five chair stands, and gait speed. Inter-rater reliability (intra-class correlation = 0.98) and participant repeatability (intra-class correlation = 0.92) of the MOD score were excellent. Ninety-six percent of participants modified at least one task (MOD score: 10.5 +/- 7.51, range 0-27). After adjusting for task modification, timed performance showed a lower association with gait speed (time vs MOD score, semipartial r2 = 0.31 vs 0.68), strength (semipartial r2 = 0.14 vs 0.65), and single-leg balance (semipartial r2 = 0.10 vs 0.40) than did the MOD score. The MOD score showed higher correlations with muscle strength and balance impairment than did other measures of functional limitation such as gait speed, time to complete five chair stands, and self-reported physical function. Documentation of task modification is reliable across raters and repeatable within participants; in addition, it compares well with other measures of physical function and impairment. Task modification reveals important and intuitive information regarding physical limitation, and deserves greater attention.
AM Girbik; PA Dilorenzo
The Naval Reactors Prime Contractor Team (NRPCT) recommended the development of a gas cooled reactor directly coupled to a Brayton energy conversion system as the Space Nuclear Power Plant (SNPP) for NASA's Project Prometheus. The section of piping between the reactor outlet and turbine inlet, designated as the hot leg piping, required unique design features to allow the use of a nickel superalloy rather than a refractory metal as the pressure boundary. The NRPCT evaluated a variety of hot leg piping concepts for performance relative to SNPP system parameters, manufacturability, material considerations, and comparison to past high temperature gas reactor (HTGR) practice. Manufacturability challenges and the impact of pressure drop and turbine entrance temperature reduction on cycle efficiency were discriminators between the piping concepts. This paper summarizes the NRPCT hot leg piping evaluation, presents the concept recommended, and summarizes developmental issues for the recommended concept
Krupa Shankar D
Full Text Available Chronic leg ulcers are rare in young adults and generally indicate a vascular cause. We report a case of a 26-year-old man with leg ulcers of eight months duration. Doppler study indicated venous incompetence and a postphlebitic limb. However, as the distribution and number of ulcers was not consistent with stasis alone and no features of collagen vascular disease were noted, a hyperviscosity state was considered and confirmed with significantly elevated homocysteine level in the serum. Administration of vitamins B1, B2, B6 and B12, trimethyl-glycine, mecobalamine, folic acid and povidone iodine dressings with culture-directed antibiotic therapy led to a satisfactory healing of ulcers over a period of one month. Hyperhomocysteinemia must be considered in the differential diagnosis of leg ulcers in young individuals.
Full Text Available Abstract Aims: Cross-training is the process whereby training of one limb gives rise to enhancements in the performance of the opposite, untrained limb and may be dependent on type of muscle contractions performed. The aim of this study was to investigate whether unilateral resistance training using eccentric contraction is more effective than concentric resistance training to improve time to task failure in the contralateral untrained limb. Methods:Subjects completed 12 weeks of resistance training consisting of 36 sessions, using unilateral leg exercise. Sustained isometric knee extension performed at 50% of maxmal force until task failure for the contralateral untrained leg. Surface electromyography (EMG signals were simultaneously recorded from contralateral untrained quadriceps (vastusmedialis, rectus femoris, and vastuslateralis. Results: Time to task failure of the contralateraluntrained leg and associated EMG activitiessignificantly increased after 12 weeks ofunilateral resistance training(p<0.05. However, percent increase in time to task failure and EMG amplitude after eccentric resistance training was significantly higher than concentric resistance training (p<0.05. Conclusion: This study concluded that unilateral eccentric resistancetraining is superior to concentric resistance training to increase time to task failure in the contralateral untrained limb.
Choi, Jin-Seung; Kang, Dong-Won; Seo, Jeong-Woo; Kim, Dae-Hyeok; Yang, Seung-Tae; Tack, Gye-Rae
[Purpose] In this study, a program was developed for leg-strengthening exercises and balance assessment using Microsoft Kinect. [Subjects and Methods] The program consists of three leg-strengthening exercises (knee flexion, hip flexion, and hip extension) and the one-leg standing test (OLST). The program recognizes the correct exercise posture by comparison with the range of motion of the hip and knee joints and provides a number of correct action examples to improve training. The program mea...
The present article is a re-evaluation of a marvellous element in a medieval Welsh romance, Chwedl Iarlles y Ffynnawn ‘Tale of the Lady of the Fountain’, also known as Owein. One of the characters encountered by the hero is a one-eyed one-legged dark giant forester who appears to have a particular
Melick, N. van; Meddeler, B.M.; Hoogeboom, T.J.; Sanden, M.W. van der; Cingel, R.E. van
CONTEXT: Since decades leg dominance is suggested to be important in rehabilitation and return to play in athletes with anterior cruciate ligament injuries. However, an ideal method to determine leg dominance in relation to task performance is still lacking. OBJECTIVE: To test the agreement between
Full Text Available Abstract Background Restless legs syndrome (RLS is a neurological disorder with a lifetime prevalence of 3-10%. in European studies. However, the diagnosis of RLS in primary care remains low and mistreatment is common. Methods The current article reports on the considerations of RLS diagnosis and management that were made during a European Restless Legs Syndrome Study Group (EURLSSG-sponsored task force consisting of experts and primary care practioners. The task force sought to develop a better understanding of barriers to diagnosis in primary care practice and overcome these barriers with diagnostic and treatment algorithms. Results The barriers to diagnosis identified by the task force include the presentation of symptoms, the language used to describe them, the actual term "restless legs syndrome" and difficulties in the differential diagnosis of RLS. Conclusion The EURLSSG task force reached a consensus and agreed on the diagnostic and treatment algorithms published here.
Garcia-Borreguero, Diego; Stillman, Paul; Benes, Heike; Buschmann, Heiner; Chaudhuri, K Ray; Gonzalez Rodríguez, Victor M; Högl, Birgit; Kohnen, Ralf; Monti, Giorgio Carlo; Stiasny-Kolster, Karin; Trenkwalder, Claudia; Williams, Anne-Marie; Zucconi, Marco
Restless legs syndrome (RLS) is a neurological disorder with a lifetime prevalence of 3-10%. in European studies. However, the diagnosis of RLS in primary care remains low and mistreatment is common. The current article reports on the considerations of RLS diagnosis and management that were made during a European Restless Legs Syndrome Study Group (EURLSSG)-sponsored task force consisting of experts and primary care practitioners. The task force sought to develop a better understanding of barriers to diagnosis in primary care practice and overcome these barriers with diagnostic and treatment algorithms. The barriers to diagnosis identified by the task force include the presentation of symptoms, the language used to describe them, the actual term "restless legs syndrome" and difficulties in the differential diagnosis of RLS. The EURLSSG task force reached a consensus and agreed on the diagnostic and treatment algorithms published here.
1989. 4. J. Hodgins, J. Koechling, and M. H. Raibert, "Running experiments with a planar biped ," in The 3rd International Symposium on Robotics ...controlling a hopping robot . The approach focuses on the interaction between the hopper and its surroundings at points of con- tact. It is only through...locomotion of legged robots . Walking, running, and hopping are distinguished from most conventional robot tasks in several respects. A stationary robot
Pinsornsak, P.; Naratrikun, K.; Kanitnate, S.; Sangkomkamhang, T.
Objectives The purpose of this study was to compare the joint space width between one-leg and both-legs standing radiographs in order to diagnose a primary osteoarthritis of the knee. Methods Digital radiographs of 100 medial osteoarthritic knees in 50 patients were performed. The patients had undergone one-leg standing anteroposterior (AP) views by standing on the affected leg while a both-legs standing AP view was undertaken while standing on both legs. The severity of the osteoarthritis wa...
Vulfsons, Simon; Bar, Negev; Eisenberg, Elon
The clinical diagnostic dilemma of low back pain that is associated with lower limb pain is very common. In relation to back pain that radiates to the leg, the International Association for the Study of Pain (IASP) states: "Pain in the lower limb should be described specifically as either referred pain or radicular pain. In cases of doubt no implication should be made and the pain should be described as pain in the lower limb." Bogduks' editorial in the journal PAIN (2009) helps us to differentiate and define the terms somatic referred pain, radicular pain, and radiculopathy. In addition, there are other pathologies distal to the nerve root that could be relevant to patients with back pain and leg pain such as plexus and peripheral nerve involvement. Hence, the diagnosis of back pain with leg pain can still be challenging. In this article, we present a patient with back and leg pain. The patient appears to have a radicular pain syndrome, but has no neurological impairment and shows signs of myofascial involvement. Is there a single diagnosis or indeed two overlapping syndromes? The scope of our article encompasses the common diagnostic possibilities for this type of patient. A discussion of treatment is beyond the scope of this article and depends on the final diagnosis/diagnoses made.
Dansk Boldspil Union skruer ned for den præstationsorienterede tilgang til børnefodbold. I stedet skal børnenes leg med bolden i fokus. Målet er at forhindre massivt frafald i børne- og ungdomsfodbolden og højne niveauet hos topspillerne....
Peripheral vascular disease - Doppler; PVD - Doppler; PAD - Doppler; Blockage of leg arteries - Doppler; Intermittent claudication - Doppler; Arterial insufficiency of the legs - Doppler; Leg pain and ...
van Soest, A J; Roebroeck, M.E.; Bobbert, M F; Huijing, P A; van Ingen Schenau, G J
Ten well-trained male volleyball players performed one-legged and two-legged vertical countermovement jumps. Ground reaction forces, cinematographic data, and electromyographic data were recorded. Jumping height in one-legged jumps was 58.5% of that reached in two-legged jumps. Mean net torques in
Hornyak, M; Stiasny-Kolster, K; Evers, S; Happe, S
Pain in the legs belongs to the five most frequent regional pain symptoms. Restless legs syndrome (RLS) presents a particular differential diagnosis for pain in the legs, which is characterized by a nocturnal urge to move the legs often associated with painful sensations in the legs. It is one of the most common neurological disorders and probably the leading cause of nocturnal pain in the legs. In this overview, the diagnosis and therapy of RLS as well as aspects of pain therapy of the disorder are presented. In addition, the differential diagnoses for exclusion of other specific causes of nocturnal pain in the legs are discussed.
Dissemond, J; Protz, K; Hug, J; Reich-Schupke, S; Kröger, K
Compression therapy, together with modern moist wound treatment, is the basis for a successful conservative treatment of patients with chronic leg ulcers. In clinical practice, it is often the patients themselves who apply compression therapies. Many of the mostly elderly patients, however, are not able to reach their legs and feet due to movement restrictions, such as arthritis, arthrosis and even obesity. An adequate compression therapy also requires extensive experience and regular training. In practice only the minority of patients can perform bandaging well and therefore this should not be recommended. Self-management with do-it-yourself medical devices will become more and more important in the future. In addition to the psychological factors, cost aspects and demographic change, an expected lack of qualified nursing staff due to the number of elderly patients who are potentially in need of care means that self-management is becoming increasingly more important. For the essentially important compression therapy of patients with chronic leg ulcers, there already exist various therapy options. The needs, preferences and abilities of the patients concerned can be considered when selecting the appropriate system. Particularly for the self-management of compression therapy, adaptive compression bandages are suitable for patients with leg ulcers during the initial decompression phase and ulcer stocking systems in the subsequent maintenance phase.
Etiological diagnosis of leg ulcers must be the first step of treatment, even if we know that veinous disease is often present. We can build a clinical decisional diagram, which helps us to understand and not forget the other causes of chronic wounds and choose some basic examination, like ultrasound and histological findings. This diagnosis helps to choose the right treatment in order to cure even the oldest venous ulcers. Educational programs should be improved to prevent recurrence.
Reich-Schupke, Stefanie; Altmeyer, Peter; Stücker, Markus
Due to its increased presence in the press and on television, the diagnosis of lipedema is on the way to becoming a trendy diagnosis for those with thick legs. Despite this, one must recognize that lipedema is a very rare disease. It is characterized by disproportional obesity of the extremities, especially in the region of the hip and the legs, hematoma development after minimal trauma, and increased pressure-induced or spontaneous pain. Aids for making the correct diagnosis are (duplex) sonography, the waist-hip index or the waist-height index and lymphoscintigraphy. Important differential diagnoses are constitutional variability of the legs, lipohypertrophy in obesity, edema in immobility, edema in chronic venous insufficiency and rheumatic diseases. The symptom-based therapy of lipedema consists of conservative (compression, manual lymphatic drainage, exercise) and surgical treatments (liposuction). Until now there is no curative therapy. Obesity is an important risk factor for the severity and prognosis of lipedema. Further studies for a better understanding of the pathogenesis of lipedema and in the end possible curative treatments are urgently needed. © The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin.
Full Text Available In recent years robotics has been influenced by a new approach, soft-robotics, bringing the idea that safe interaction with user and more adaptation to the environment can be achieved by exploiting easily deformable materials and flexible components in the structure of robots. In 2016, the soft-robotics community has promoted a new robotics challenge, named RoboSoft Grand Challenge, with the aim of bringing together different opinions on the usefulness and applicability of softness and compliancy in robotics. In this paper we describe the design and implementation of a terrestrial robot based on two soft legged wheels. The tasks predefined by the challenge were set as targets in the robot design, which finally succeeded to accomplish all the tasks. The wheels of the robot can passively climb over stairs and adapt to slippery grounds using two soft legs embedded in their structure. The soft legs, fabricated by integration of soft and rigid materials and mounted on the circumference of a conventional wheel, succeed to enhance its functionality and easily adapt to unknown grounds. The robot has a semi stiff tail that helps in the stabilization and climbing of stairs. An active wheel is embedded at the extremity of the tail in order to increase the robot maneuverability in narrow environments. Moreover two parallelogram linkages let the robot to reconfigure and shrink its size allowing entering inside gates smaller than its initial dimensions.
Plummer, Hillary A; Oliver, Gretchen D; Powers, Christopher M; Michener, Lori A
Impaired trunk motion during pitching may be a risk factor for upper extremity injuries. Specifically, increased forces about the shoulder and elbow have been observed in pitchers with excessive contralateral trunk lean during pitching. Because of the difficulty in identifying abnormal trunk motions during a high-speed task such as pitching, a clinical screening test is needed to identify pitchers who have impaired trunk motion during pitching. The purpose of this study was to determine the relationship between the degree of lateral trunk lean during the single-leg squat and amount of trunk lean during pitching and if trunk lean during pitching can be predicted from lean during the single-leg squat. Controlled Laboratory Study; Cross-sectional. Seventy-three young baseball pitchers (11.4 ± 1.7 years; 156.3 ± 11.9 cm; 50.5 ± 8.8 kg) participated. An electromagnetic tracking system was used to obtain trunk kinematic data during a single-leg squat task (lead leg) and at maximum shoulder external rotation of a fastball pitch. Pearson correlation coefficients for trunk lean during the single-leg squat and pitching were calculated. A linear regression analysis was performed to determine if trunk lean during pitching can be predicted from lean during the single-leg squat. There was a positive correlation between trunk lean during the single-leg squat and trunk lean during pitching (r = 0.53; plean during the single-leg squat predicted the amount of lateral trunk lean during pitching (R 2 = 0.28; p lean during an SLS and pitching. Trunk lean during the single-leg squat explained 28% of the variance in trunk lean during pitching. Diagnosis, level 3.
King, Adam C; Wang, Zheng
The motor control properties of the right and left legs are dependent on the stabilization and mobilization features of the motor tasks. The current investigation examined the right and left leg control differences - interlateral asymmetries - during static single leg stance and dynamic goal directed kicking with an emphasis of the asymmetrical stabilization and mobilization components of movements. Ten young, healthy, right-leg preferred individuals with minimal kicking experience completed both tests on each limb. During static single leg stance, participants were requested to stand as still as possible with one leg in contact with a force platform. Interlateral asymmetries of the standing leg were quantified using postural variability measures of the center of pressure (COP) standard deviation in the anterior-posterior (SD-COP AP ) and medial-lateral (SD-COP ML ) directions, resultant COP length and velocity, and 95% COP elliptical area. During dynamic goal directed kicking, participants stood on two adjacent force platforms in a side-by-side foot position and kicked a soccer ball toward three different directions as soon as they received an auditory cue of kicking. Three targets were located -30°, 0° or 30° in front and 3.05 m away from the participants' midline. Participants kicked the ball toward the targets with each of their feet. The vertical ground reaction force (vGRF) of the kicking leg was used to define the preparation (from above two standard deviations of vGRF baseline to toe-off) and swing (from toe-off to toe-return) phases of dynamic kicking. To determine the presence of interlateral asymmetries during dynamic kicking, the magnitude and timing of the anticipatory postural adjustments (APA) during the preparation phase of kicking were quantified using the lateral net COP (COPnet-ML) time series derived from both force platforms. Postural variability measures of the support leg and the kinematic joint range of motion (JROM) trajectories of the
Aoi, Shinya; Manoonpong, Poramate; Ambe, Yuichi
for legged robots induced by various factors (locomotion speed, environmental situation, body properties, and task). In addition, we show characteristic properties of adaptive interlimb coordination, such as gait hysteresis and different time-scale adaptations. We also discuss the underlying mechanisms......Walking animals produce adaptive interlimb coordination during locomotion in accordance with their situation. Interlimb coordination is generated through the dynamic interactions of the neural system, the musculoskeletal system, and the environment, although the underlying mechanisms remain unclear....... Recently, investigations of the adaptationmechanisms of living beings have attracted attention, and bio-inspired control systems based on neurophysiological findings regarding sensorimotor interactions are being developed for legged robots. In this review, we introduce adaptive interlimb coordination...
Simmons, Reid; Apfelbaum, David
Task Description Language (TDL) is an extension of the C++ programming language that enables programmers to quickly and easily write complex, concurrent computer programs for controlling real-time autonomous systems, including robots and spacecraft. TDL is based on earlier work (circa 1984 through 1989) on the Task Control Architecture (TCA). TDL provides syntactic support for hierarchical task-level control functions, including task decomposition, synchronization, execution monitoring, and exception handling. A Java-language-based compiler transforms TDL programs into pure C++ code that includes calls to a platform-independent task-control-management (TCM) library. TDL has been used to control and coordinate multiple heterogeneous robots in projects sponsored by NASA and the Defense Advanced Research Projects Agency (DARPA). It has also been used in Brazil to control an autonomous airship and in Canada to control a robotic manipulator.
Geyer, James D; Geyer, Emery E; Fetterman, Zachary; Carney, Paul R
Restless legs syndrome (RLS) is a common neurological movement disorder occurring in approximately 10% of the general population. The prevalence of moderately severe RLS is 2.7% overall (3.7% for women and 1.7% for men). Epilepsy is also a common neurological disorder with significant associated morbidity and impact on quality of life. We evaluated the severity and frequency of primary RLS in patients with localization-related temporal lobe epilepsy (TLE) and investigated the role of prodromal RLS symptoms as a warning sign and lateralizing indicator. All epilepsy patients seen in the outpatient clinic were screened for movement disorders from 2005 to 2015. Ninety-eight consecutive patients with localization-related TLE (50 right TLE and 48 left TLE) who met inclusion criteria were seen in the outpatient clinic. The control group consisted of 50 individuals with no history or immediate family history of epilepsy. Each patient was evaluated with the International Restless Legs Study Group (IRLSSG) questionnaire, NIH RLS diagnostic criteria, ferritin level, and comprehensive sleep screening including polysomnography. Furthermore, patients with obstructive sleep apnea or a definite cause of secondary restless legs syndrome such as low serum ferritin or serum iron levels were also excluded from the study. There was a significant association between the type of epilepsy and whether or not patients had RLS χ 2 (1)=10.17, prestlessness was typically described as moderately severe. The RLS symptoms were more common and somewhat more severe in the right TLE group than the left TLE group. Copyright © 2016 Elsevier Inc. All rights reserved.
Man-Son-Hing, Malcolm; Wells, George; Lau, Anita
OBJECTIVE With respect to the use of quinine for the treatment of nocturnal leg cramps, to determine whether the findings of a previously performed meta-analysis of published data are altered with the addition of unpublished data, and whether publication bias is present in this area. DESIGN A meta-analysis of eight (four published and four unpublished) randomized, double-blind, placebo-controlled trials, seven of which had a crossover design. SETTING Randomized trials that were available as of July 1997. SUBJECTS Ambulatory patients (659) who suffered from regular nocturnal leg cramps. MAIN RESULTS When individual patient data from all crossover studies were pooled, persons had 3.60 (95% confidence interval [CI] 2.15, 5.05) fewer cramps in a 4-week period when taking quinine compared with placebo. This compared with an estimate of 8.83 fewer cramps (95% CI 4.16, 13.49) from pooling published studies alone. The corresponding relative risk reductions were 21% (95% CI 12%, 30%) and 43% (95% CI 21%, 65%), respectively. Compared with placebo, the use of quinine was associated with an increased incidence of side effects, particularly tinnitus. Publication bias is present in the reporting of the efficacy of quinine for this indication, as almost all published studies reported larger estimates of its efficacy than did unpublished studies. CONCLUSIONS This study confirms that quinine is efficacious in the prevention of nocturnal leg cramps. However, its benefit may not be as large as reported from the pooling of published studies alone. Given the side effect profile of quinine, nonpharmacologic therapy (e.g., regular passive stretching of the affected muscle) is the best first-line treatment. For persons who find this ineffective and whose quality of life is significantly affected, a trial of quinine is warranted. Prescribing physicians must closely monitor the risks and benefits in individual patients. Publication bias is present in this area even though there is
Taylor, Jeffrey B; Ford, Kevin R; Nguyen, Anh-Dung; Shultz, Sandra J
Double-leg forward or drop-jump landing activities are typically used to screen for high-risk movement strategies and to determine the success of neuromuscular injury prevention programs. However, research suggests that these tasks that occur primarily in the sagittal plane may not adequately represent the lower extremity biomechanics that occur during unilateral foot contact or non-sagittal plane movements that are characteristic of many multidirectional sports. To examine the extent to which lower extremity biomechanics measured during a jump landing on a double leg (DL) after a sagittal plane (SAG) movement is representative of biomechanics measured during single-leg (SL) or frontal plane (FRONT) jump landing tasks. Controlled laboratory study. Lower extremity biomechanics were measured in 15 recreationally active females (mean age [±SD], 19.4 ± 2.1 years; mean height, 163.3 ± 5.9 cm; mean weight, 61.1 ± 7.1 kg) while performing SAGDL, SAGSL, FRONTDL, and FRONTSL jump landing tasks. Repeated-measures analyses of variance examined differences in lower extremity biomechanics between the 4 tasks, and linear regressions examined the extent to which an individual's biomechanics during SAGDL were representative of their biomechanics during SAGSL, FRONTDL, and FRONTSL. Lower extremity kinematics and kinetics differed by condition, with the SAGDL task generally eliciting greater hip and knee flexion angles and lower hip and knee forces than the other tasks (P plane jump landing tasks used to screen for ACL injury risk and the effectiveness of ACL injury prevention programs may not adequately represent the lower extremity biomechanics that occur during single-leg activities. These results support further investigation of single-leg multidirectional landings to identify high-risk movement strategies in female athletes playing multidirectional sports.
Kuroda, Shigeru; Kunita, Itsuki; Tanaka, Yoshimi; Ishiguro, Akio; Kobayashi, Ryo; Nakagaki, Toshiyuki
Crawling using muscular waves is observed in many species, including planaria, leeches, nemertea, aplysia, snails, chitons, earthworms and maggots. Contraction or extension waves propagate along the antero-posterior axis of the body as the crawler pushes the ground substratum backward. However, the observation that locomotory waves can be directed forward or backward has attracted much attention over the past hundred years. Legged organisms such as centipedes and millipedes exhibit parallel phenomena; leg tips form density waves that propagate backward or forward. Mechanical considerations reveal that leg-density waves play a similar role to locomotory waves in limbless species, and that locomotory waves are used by a mechanism common to both legged and limbless species to achieve crawling. Here, we report that both mode switching of the wave direction and friction control were achieved when backward motion was induced in the laboratory. We show that the many variations of switching in different animals can essentially be classified in two types according to mechanical considerations. We propose that during their evolution, limbless crawlers first moved in a manner similar to walking before legs were obtained. Therefore, legged crawlers might have learned the mechanical mode of movement involved in walking long before obtaining legs. PMID:24718452
Vena, Daniel; Rubianto, Jonathan; Popovic, Milos; Yadollahi, Azadeh
The accumulation of fluid in the legs due to sedentariness can be a health risk in extreme cases. Negative health impacts associated with leg fluid accumulation include leg edema and risk of blood clots. Furthermore, fluid accumulating in the legs is accompanied by fluid shift into the upper body which is also associated with health risks such as: increased blood pressure when lying down, respiratory problems in people with heart failure, and increased sleep apnea. Understanding the pattern by which fluid accumulates in the legs can aid in the development of devices for reducing leg fluid accumulation. The purpose of this study was to characterize the time course of fluid accumulation over a two-and-half-hour seated period. Non-obese participants with sleep apnea and no other co-morbidities were included in the sample as part of a larger study. Leg fluid was measured continuously using a method of bioelectrical impedance. Participants were first asked to lie supine for 30 minutes as a washout, and then sat with their legs still for two and a half hours. The main finding of this study is that the pattern of leg fluid accumulation differed in the first 45 minutes compared to the latter 105 minutes. In the first 45 minutes, fluid accumulated according to first order exponential function. In the latter period, fluid accumulated according to a linear function. The initial exponential accumulation is likely due to the large increase in capillary pressure caused by rapid blood flow into the legs due to gravity, leading to substantial filtration of blood plasma into the tissue spaces. The latter linear portion likely represents continued slow filtration of fluid out of the vasculature and into the tissue spaces. This is the first study to show that fluid accumulation in the legs is a combination of an exponential and linear functions. The linear increase identifies that there is no foreseeable point in which leg fluid stops accumulating while sitting for prolonged periods.
Silder, Amy; Besier, Thor; Delp, Scott L
Spring-mass models have been used to characterize running mechanics and leg stiffness in a variety of conditions, yet it remains unknown how running while carrying a load affects running mechanics and leg stiffness. The purpose of this study was to test the hypothesis that running with a load increases leg stiffness. Twenty-seven subjects ran at a constant speed on a force-measuring treadmill while carrying no load, and while wearing weight vests loaded with 10%, 20%, and 30% of body weight. We measured lower extremity motion and created a scaled musculoskeletal model of each subject, which we used to estimate lower extremity joint angles and leg length. We estimated dimensionless leg stiffness as the ratio of the peak vertical ground reaction force (normalized to body weight) and the change in stance phase leg length (normalized to leg length at initial foot contact). Leg length was calculated as the distance from the center of the pelvis to the center-of-pressure under the foot. We found that dimensionless leg stiffness increased when running with load (p=0.001); this resulted from an increase in the peak vertical ground reaction force (pleg length (p=0.025). When running with load, subjects had longer ground contact times (pleg stiffness to accommodate an added load. Copyright © 2015 Elsevier Ltd. All rights reserved.
Högl, Birgit; Stefani, Ambra
Restless legs syndrome is a frequent neurological disorder with potentially serious and highly distressing treatment complications. The role and potential implications of periodic leg movements during sleep range from being a genetic risk marker for restless legs syndrome to being a cardiovascular risk factor. The diagnosis of restless legs syndrome in patients with daytime movement disorders is challenging and restless legs syndrome needs to be differentiated from other sleep-related movement disorders. This article provides an update on the diagnosis of restless legs syndrome as an independent disorder and the role of periodic leg movements and reviews the association of restless legs syndrome with Parkinson's disease and other movement disorders. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.
Brøchner Nielsen, Niels-Peter; Hug, François; Guével, Arnaud; Colloud, Floren; Lardy, Julien; Dorel, Sylvain
This study investigated how muscle coordination is adjusted in response to a decrease in the force-generating capacity of one muscle group during a sprint cycling task. Fifteen participants were tested during a sprint before and after a fatigue electromyostimulation protocol was conducted on the quadriceps of one leg. Motor coordination was assessed by measuring myoelectrical activity, pedal force and joint power. The decrease in force-generating capacity of the quadriceps (-28.0±6.8%) resulted in a decrease in positive knee extension power during the pedaling task (-34.4±30.6 W; P=0.001). The activity of the main non-fatigued synergist and antagonist muscles (triceps surae, gluteus maximus and hamstrings) of the ipsilateral leg decreased, leading to a decrease in joint power at the hip (-30.1±37.8 W; P=0.008) and ankle (-20.8±18.7 W; P=0.001). However, both the net power around the knee and the ability to effectively orientate the pedal force were maintained during the extension by reducing the co-activation and the associated negative power produced by the hamstrings. Adaptations also occurred in flexion phases in both legs, exhibiting an increased power (+17.9±28.3 [P=0.004] and +19.5 ± 21.9 W [P=0.026]), associated with an improvement in mechanical effectiveness. These results demonstrate that the nervous system readily adapts coordination in response to peripheral fatigue by i) decreasing the activation of adjacent non-fatigued muscles to maintain an effective pedal force orientation (despite reducing pedal power) and ii) increasing the neural drive to muscles involved in the flexion phases such that the decrease in total pedal power is limited.
Ortiz, Alexis; Olson, Sharon L; Etnyre, Bruce; Trudelle-Jackson, Elaine E; Bartlett, William; Venegas-Rios, Heidi L
Dynamic knee joint stability may be affected by the onset of metabolic fatigue during sports participation that could increase the risk for knee injury. The purpose of this investigation was to determine the effects of metabolic fatigue on knee muscle activation, peak knee joint angles, and peak knee internal moments in young women during 2 jumping tasks. Fifteen women (mean age: 24.6 +/- 2.6 years) participated in one nonfatigued session and one fatigued session. During both sessions, peak knee landing flexion and valgus joint angles, peak knee extension and varus/valgus internal moments, electromyographic (EMG) muscle activity of the quadriceps and hamstrings, and quadriceps/hamstring EMG cocontraction ratio were measured. The tasks consisted of a single-legged drop jump from a 40-cm box and a 20-cm, up-down, repeated hop task. The fatigued session included a Wingate anaerobic protocol followed by performance of the 2 tasks. Although participants exhibited greater knee injury-predisposing factors during the fatigued session, such as lesser knee flexion joint angles, greater knee valgus joint angles, and greater varus/valgus internal joint moments for both tasks, only knee flexion during the up-down task was statistically significant (p = 0.028). Metabolic fatigue may perhaps predispose young women to knee injuries by impairing dynamic knee joint stability. Training strength-endurance components and the ability to maintain control of body movements in either rested or fatigued situations might help reduce injuries in young women athletes.
Kveladze, Irma; Agerholm, Niels
is the influence of workload capacity on bicyclists spatial behaviour in a natural environment of four-legged intersections. Method: Due to the traffic safety of test participants, the study is divided in two phases. In the first phase, the actual physical environment of the four-legged intersection and bicyclists...... natural spatial behaviour will be observed and recorded through eye tracking glasses without any interference of participants from their primary riding task. In total 50 test participants with their own bicycles will be selected to cover, approximately 500m predefined bicycle path, with focus on the four...... (similar to the driving simulator) of the same four-legged intersection will be used in usability laboratory with the same test participants. Differing from the first experiment, the test participants' cognitive workload will be increased by giving them secondary tasks as a distraction from the primary...
Lee, David V; Isaacs, Michael R; Higgins, Trevor E; Biewener, Andrew A; McGowan, Craig P
Trotting, bipedal running, and especially hopping have long been considered the principal bouncing gaits of legged animals. We use the radial-leg spring constant [Formula: see text] to quantify the stiffness of the physical leg during bouncing gaits. The radial-leg is modeled as an extensible strut between the hip and the ground and [Formula: see text] is determined from the force and deflection of this strut in each instance of stance. A Hookean spring is modeled in-series with a linear actuator and the stiffness of this spring [Formula: see text] is determined by minimizing the work of the actuator while reproducing the measured force-deflection dynamics of an individual leg during trotting or running, and of the paired legs during hopping. Prior studies have estimated leg stiffness using [Formula: see text], a metric that imagines a virtual-leg connected to the center of mass. While [Formula: see text] has been applied extensively in human and comparative biomechanics, we show that [Formula: see text] more accurately models the spring in the leg when actuation is allowed, as is the case in biological and robotic systems. Our allometric analysis of [Formula: see text] in the kangaroo rat, tammar wallaby, dog, goat, and human during hopping, trotting, or running show that [Formula: see text] scales as body mass to the two-third power, which is consistent with the predictions of dynamic similarity and with the scaling of [Formula: see text]. Hence, two-third scaling of locomotor spring constants among mammals is supported by both the radial-leg and virtual-leg models, yet the scaling of [Formula: see text] emerges from work-minimization in the radial-leg model instead of being a defacto result of the ratio of force to length used to compute [Formula: see text]. Another key distinction between the virtual-leg and radial-leg is that [Formula: see text] is substantially greater than [Formula: see text], as indicated by a 30-37% greater scaling coefficient for [Formula
Zambelis, Th; Wolgamuth, B R; Papoutsi, S N; Economou, N T
Α case of a chronic idiopathic form of a severe type of Restless Legs Syndrome (RLS), which developed during pregnancy and persisted after this, misdiagnosed for 34 years as radiculopathy S1, is reported. In spite of the thorough clinical and laboratory investigation, in addition to constant changes of the therapeutic approach, the diagnosis of S1 radiculopathy could not be confirmed, resulting in a chronic clinical course; the latter was characterized by relapses and remissions not attributed or linked in any way to the treatment (various types of). In fact, it was due to a routine workup in a sleep clinic, where the patient was referred because of a coincident chronic insomnia (Restless Legs Syndrome is a known and important cause of insomnia/chronic insomnia), which resulted in a proper diagnosis and treatment of this case. With the use of Restless Legs Syndrome appropriate treatment (Pramipexole 0.18 mg taken at bedtime, a dopaminergic agent and Level A recommended drug for Restless Legs Syndrome) an excellent response and immediate elimination of symptoms was achieved. Restless Legs Syndrome may present with a variety of symptoms (with the most prominent shortly being reported with the acronym URGE: Urge to move the legs usually associated with unpleasant leg sensations, Rest induces symptoms, Getting active brings relief, Evening and night deteriorate symptoms); given the fact that Restless Legs Syndrome presents with a great variety and heterogeneity of symptoms (mostly pain, dysesthesia and paresthesia), which may occur in several other diseases (the so called "RLS mimics"), proper diagnosis of Restless Legs Syndrome usually fails. Restless Legs Syndrome misinterpreted as S1 radiculopathy, to the best of our knowledge, has not been reported yet in the literature. Here, case history, clinical course and common RLS mimics are presented. Different forms of Restless Legs Syndrome manifestations, which are commonly -as in this case- misinterpreted due to their
... in the bath tub, a hot tub, or swimming pool. Ask your provider when you can start ... College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol . 2013; ...
Full Text Available Although individual heads of triceps surae, soleus (SO and medial gastrocnemius (MG muscles, are often considered close functional synergists, previous studies have shown distinct activity patterns between them in some motor behaviors. The goal of this study was to test two hypotheses explaining inhibition of slow SO with respect to fast MG: (1 inhibition occurs at high movement velocities and mediated by velocity-dependent sensory feedback and (2 inhibition depends on the ankle-knee joint moment combination and does not require high movement velocities. The hypotheses were tested by comparing the SO EMG/MG EMG ratio during fast and slow motor behaviors (cat paw shake responses vs. back, straight leg load lifting in humans, which had the same ankle extension-knee flexion moment combination; and during fast and slow behaviors with the ankle extension-knee extension moment combination (human vertical jumping and stance phase of walking in cats and leg load lifting in humans. In addition, SO EMG/MG EMG ratio was determined during cat paw shake responses and walking before and after removal of stretch velocity-dependent sensory feedback by self-reinnervating SO and/or gastrocnemius. We found the ratio SO EMG/MG EMG below 1 (p<0.05 during fast paw shake responses and slow back load lifting, requiring the ankle extension-knee flexion moment combination; whereas the ratio SO EMG/MG EMG was above 1 (p<0.05 during fast vertical jumping and slow tasks of walking and leg load lifting, requiring ankle extension-knee extension moments. Removal of velocity-dependent sensory feedback did not affect the SO EMG/MG EMG ratio in cats. We concluded that the relative inhibition of SO does not require high muscle velocities, depends on ankle-knee moment combinations, and is mechanically advantageous for allowing a greater MG contribution to ankle extension and knee flexion moments.
Pereira de Godoy Jose
Full Text Available Background: Despite of all the problems caused by lymphedema, this disease continues to affect millions of people worldwide. Thus, the identification of the most efficacious forms of treatment is necessary. Aim: The aim of this study was to evaluate a novel intensive outpatient treatment for leg lymphedema. Methods: Twenty-three legs of 19 patients were evaluated in a prospective randomized study. The inclusion criteria were patients with Grade II and III lymphedema, where the difference, measured by volumetry, between the affected limb below the knee and the healthy limb was greater than 1.5 kg. Intensive treatment was carried out for 6- to 8-h sessions in the outpatient clinic. Analysis of variance was utilized for statistical analysis with an alpha error of 5% (P-value < 0.05 being considered significant. Results: All limbs had significant reductions in size with the final mean loss being 81.1% of the volume of edema. The greatest losses occurred in the first week (P-value < 0.001. Losses of more than 90% of the lymphedema occurred in 9 (39.13% patients; losses of more than 80% in 13 (56.52%, losses of more than 70% in 17 (73.91% and losses of more than 50% were recorded for 95.65% of the patients; only 1 patient lost less than 50% (37.9% of the edema. Conclusion: The intensive treatment of lymphedema in the outpatient clinic can produce significant reductions in the volume of edema over a short period of time and can be recommended for any grade of lymphedema, in particular the more advanced degrees.
Kilbom, A; Persson, J
Leg blood flow was studied with the constant infusion dye technique during static exercise of the thigh muscles (quadriceps) and during hand-grips at 15 and 25-30% of MVC. Blood flow and oxygen uptake in the leg increased in quadriceps exercise and reached their highest values (around 1.21/min and 165 ml/min respectively) at 25-30% of MVC, whereas leg vascular resistance decreased. Regional circulatory adaptations and the oxygen uptake - leg blood flow relationship were in close agreement with the responses found in dynamic leg exercise. In view of the marked rise in intramuscular pressure previously observed during quadriceps contractions, a restriction of blood flow and an increased vascular resistance had been expected. Involuntary activation of leg muscles other than the quadriceps may explain the finding. Contractions of the contralateral quadriceps induced a slight increase in leg blood flow, whereas hand-grips had no influence on blood flow or vascular resistance in the leg. The distribution of the cardiac output during static contractions is discussed, and it is concluded that during hand-grips the increase in blood flow is predominantly distributed to the upper part of the body.
Damgaard Warrer, Sarah; Broström, Stig
Børns leg og eksperimenterende virksomhed er et rigt felt med mange perspektiver, indgangsvinkler og nuancer. I denne bog kædes leg og det eksperimenterende og skabende sammen som to gensidigt forbundne fænomener og belyses i pædagogisk og didaktisk perspektiv. Desuden beskrives potentialet i båd...
Gordon, Nicole; Abbiss, Chris R; Ihsan, Mohammed; Maiorana, Andrew J; Peiffer, Jeremiah J
Leg order during sequential single-leg cycling (i.e. exercising both legs independently within a single session) may affect local muscular responses potentially influencing adaptations. This study examined the cardiovascular and skeletal muscle hemodynamic responses during double-leg and sequential single-leg cycling. Ten young healthy adults (28 ± 6 y) completed six 1-min double-leg intervals interspersed with one minute of passive recovery and, on a separate occasion, 12 (six with one leg followed by six with the other leg) 1-min single-leg intervals interspersed with one minute of passive recovery. Oxygen consumption, heart rate, blood pressure, muscle oxygenation, muscle blood volume and power output were measured throughout each session. Oxygen consumption, heart rate and power output were not different between sets of single-leg intervals but the average of both sets was lower than the double-leg intervals. Mean arterial pressure was higher during double-leg compared with sequential single-leg intervals (115 ± 9 mmHg vs. 104 ± 9 mmHg; p<0.05) and higher during the initial compared with second set of single-leg intervals (108 ± 10 mmHg vs. 101 ± 10 mmHg; p<0.05). The increase in muscle blood volume from baseline was similar between the active single-leg and double-leg (267 ± 150 μM[BULLET OPERATOR]cm vs. 214 ± 169 μM[BULLET OPERATOR]cm; p=0.26). The pattern of change in muscle blood volume from the initial to second set of intervals was significantly different (p<0.05) when the leg was active in the initial (-52.3 ± 111.6%) compared with second set (65.1 ± 152.9%). These data indicate that the order in which each leg performs sequential single-leg cycling influences the local hemodynamic responses, with the inactive muscle influencing the stimulus experienced by the contralateral leg.
Wyon, M A; Nevill, A M; Dekker, K; Brown, D D; Clarke, F; Pelly, J; Koutedakis, Y
We investigated the associations between leg length and specific ballet movements in different skill groups. Volunteers were from an undergraduate dance programme (n=18), a pre-professional school (n=43) and from an elite classical ballet company (n=45). Individual data were collected for anthropometry, vertical jump, leg dexterity, and leg active and passive ROM. ANCOVA identified both main effects as significant with regard to vertical jump (gender Peffects with gender, skill or leg length. Active and passive range of motion noted gender (P=0.001) and skill (Peffects of leg length on fundamental ballet skills. The longer legs that benefit vertical jump have a negative influence on range of motion and leg dexterity except for highly skilled dancers, who through skill, seem to have overcome the effects of some of these dichotomies. Georg Thieme Verlag KG Stuttgart . New York.
Vazquez, Alejandro; Statton, Matthew A.; Busgang, Stefanie A.
Motor learning during reaching not only recalibrates movement but can also lead to small but consistent changes in the sense of arm position. Studies have suggested that this sensory effect may be the result of recalibration of a forward model that associates motor commands with their sensory consequences. Here we investigated whether similar perceptual changes occur in the lower limbs after learning a new walking pattern on a split-belt treadmill—a task that critically involves proprioception. Specifically, we studied how this motor learning task affects perception of leg speed during walking, perception of leg position during standing or walking, and perception of contact force during stepping. Our results show that split-belt adaptation leads to robust motor aftereffects and alters the perception of leg speed during walking. This is specific to the direction of walking that was trained during adaptation (i.e., backward or forward). The change in leg speed perception accounts for roughly half of the observed motor aftereffect. In contrast, split-belt adaptation does not alter the perception of leg position during standing or walking and does not change the perception of stepping force. Our results demonstrate that there is a recalibration of a sensory percept specific to the domain of the perturbation that was applied during walking (i.e., speed but not position or force). Furthermore, the motor and sensory consequences of locomotor adaptation may be linked, suggesting overlapping mechanisms driving changes in the motor and sensory domains. PMID:26424576
Infantile myofi bromatosis is a rare mesenchymal disorder of infancy and childhood characterised by the formation of tumours in the soft tissues, muscles, bones and viscera. Only 61 cases have been reported in the literature. This paper describes the management of a 3 year-old boy with extensive IMF of the right leg.
Matthew F. Moran
Full Text Available Sensory processing deficits are common within autism spectrum disorders (ASD. Deficits have a heterogeneous dispersion across the spectrum and multimodal processing tasks are thought to magnify integration difficulties. Two-legged hopping in place in sync with an auditory cue (2.3, 3.0 Hz was studied in a group of six individuals with expressive language impaired ASD (ELI-ASD and an age-matched control group. Vertical ground reaction force data were collected and discrete Fourier transforms were utilized to determine dominant hopping cadence. Effective leg stiffness was computed through a mass-spring model representation. The ELI-ASD group were unsuccessful in matching their hopping cadence (2.21±0.30 hops•sec-1, 2.35±0.41 hops•sec-1 to either auditory cue with greater deviations at the 3.0 Hz cue. In contrast, the control group was able to match hopping cadence (2.35±0.06 hops•sec-1, 3.02±0.10 hops•sec-1 to either cue via an adjustment of effective leg stiffness. The ELI-ASD group demonstrated a varied response with an interquartile range (IQR in excess of 0.5 hops•sec-1 as compared to the control group with an IQR < 0.03 hops•sec-1. Several sensorimotor mechanisms could explain the inability of participants with ELI-ASD to modulate motor output to match an external auditory cue. These results suggest that a multimodal gross motor task can (1 discriminate performance among a group of individuals with severe autism, and (2 could be a useful quantitative tool for evaluating motor performance in individuals with ASD individuals.
Sasada, Syusaku; Tazoe, Toshiki; Nakajima, Tsuyoshi; Futatsubashi, Genki; Ohtsuka, Hiroyuki; Suzuki, Shinya; Zehr, E Paul; Komiyama, Tomoyoshi
Neural interactions between regulatory systems for rhythmic arm and leg movements are an intriguing issue in locomotor neuroscience. Amplitudes of early latency cutaneous reflexes (ELCRs) in stationary arm muscles are modulated during rhythmic leg or arm cycling but not during limb positioning or voluntary contraction. This suggests that interneurons mediating ELCRs to arm muscles integrate outputs from neural systems controlling rhythmic limb movements. Alternatively, outputs could be integrated at the motoneuron and/or supraspinal levels. We examined whether a separate effect on the ELCR pathways and cortico-motoneuronal excitability during arm and leg cycling is integrated by neural elements common to the lumbo-sacral and cervical spinal cord. The subjects performed bilateral leg cycling (LEG), contralateral arm cycling (ARM), and simultaneous contralateral arm and bilateral leg cycling (A&L), while ELCRs in the wrist flexor and shoulder flexor muscles were evoked by superficial radial (SR) nerve stimulation. ELCR amplitudes were facilitated by cycling tasks and were larger during A&L than during ARM and LEG. A low stimulus intensity during ARM or LEG generated a larger ELCR during A&L than the sum of ELCRs during ARM and LEG. We confirmed this nonlinear increase in single motor unit firing probability following SR nerve stimulation during A&L. Furthermore, motor-evoked potentials following transcranial magnetic and electrical stimulation did not show nonlinear potentiation during A&L. These findings suggest the existence of a common neural element of the ELCR reflex pathway that is active only during rhythmic arm and leg movement and receives convergent input from contralateral arms and legs. Copyright © 2016 the American Physiological Society.
Zhou, Xiaoxiao; Wang, Qi; Zhang, Xianlong; Chen, Yunsu; Peng, Xiaochun; Mao, Yuanqing; Yang, Yang; Fu, Beigang; Wang, Xiuhui; Tang, Tingting
Leg-length inequality is an extensively studied complication of total hip arthroplasty in normal patients. However, few studies have focused on the pelvic obliquity of coronal pelvic malrotation. We hypothesized that pelvic obliquity with a fixed abduction/adduction contracture deformity of the hip may intraoperatively affect the release of soft tissues, ultimately resulting in a leg-length inequality. This study also investigated whether the femoral and vertical offsets of total hip arthropl...
With Naval Reactors (NR) approval of the Naval Reactors Prime Contractor Team (NRPCT) recommendation to develop a gas cooled reactor directly coupled to a Brayton power conversion system as the space nuclear power plant (SNPP) for Project Prometheus (References a and b) the reactor outlet piping was recognized to require a design that utilizes internal insulation (Reference c). The initial pipe design suggested ceramic fiber blanket as the insulation material based on requirements associated with service temperature capability within the expected range, very low thermal conductivity, and low density. Nevertheless, it was not considered to be well suited for internal insulation use because its very high surface area and proclivity for holding adsorbed gases, especially water, would make outgassing a source of contaminant gases in the He-Xe working fluid. Additionally, ceramic fiber blanket insulating materials become very friable after relatively short service periods at working temperatures and small pieces of fiber could be dislodged and contaminate the system. Consequently, alternative insulation materials were sought that would have comparable thermal properties and density but superior structural integrity and greatly reduced outgassing. This letter provides technical information regarding insulation and materials issues for the Hot Leg Piping preconceptual design developed for the Project Prometheus space nuclear power plant (SNPP)
methods included task analysis as a critical phase in developing instruction and training. Mon- temerlo and Tennyson (1976) noted that from 1951 to 1976...designed. The trend in the U.S . Department of Defense toward extensive procedural documentation noted by Montemerlo and Tennyson (1976) has not...M. Gagne’ (Ed.), Psychological principles in system development (pp. 187-228). New York: Holt. Montemerlo, M. D., & Tennyson , M. E. (1975
Leg pain in older children or young adolescents can occur for many reasons. An Osgood-Schlatter lesion results from continued trauma to the anterior tibial bone and causes a visible lump below the knee.
Kermond, John; Konz, Stephen
Maximum distance in football punt kicking is associated with a maximum force transfer to the ball rather than a maximum force transfer through the ground via the support leg. For maximum distance, tred lightly. (Author)
... nervous system (neurocutaneous) and is associated with Port Wine Stain, red vascular markings on the face and other parts of the body (shown here on the legs). This is an unusual case, due to the large size of the lesion ( ...
Das, Sakti Prasad; Ojha, Niranjan; Ganesh, G Shankar; Mohanty, Ram Narayan
Presence of single umbilical persistent vitelline artery distinguishes sirenomelia from caudal regression syndrome. We report a case of a12-year-old boy who had bilateral umbilical arteries presented with fusion of both legs in the lower one third of leg. Both feet were rudimentary. The right foot had a valgus rocker-bottom deformity. All toes were present but rudimentary. The left foot showed absence of all toes. Physical examination showed left tibia vara. The chest evaluation in sitting re...
which we substitute into (4.42) : ( -mv s J O=-km+ mvc -k __ c __ V v 2 c c 46 (4.43) (4.44) (4.45) (4.46) to fInd the switching curve m 3 s...Legged Mechanisms. IVSS. Traverse City, MI Muench, P., Alexander, J., Quinn, R., & Aschenbeck, K. (2005) Pneumatic Spring for Legged Walker. SPIE
A 30 MV tandem Van de Graaff accelerator is at present under construction at Daresbury Laboratory. The insulating stack of the machine is of modular construction, each module being 860 mm in length. Each live section stack module contains 8 insulating legs mounted between bulkhead rings. The design, fabrication (from glass discs bonded to stainless steel discs using an epoxy film adhesive) and testing of the stack legs is described. (U.K.)
Garrick, Lachlan E; Alexander, Bryce C; Schache, Anthony G; Pandy, Marcus G; Crossley, Kay M; Collins, Natalie J
It is important to validate single-leg squat visual rating criteria used in clinical practice and research. Foot orthoses may improve single-leg squat performance in those who demonstrate biomechanics associated with increased risk of lower-limb injury. Validate visual rating criteria proposed by Crossley et al, by determining whether athletes rated as poor single-leg squat performers display different single-leg squat biomechanics than good performers; and evaluate immediate effects of foot orthoses on single-leg squat biomechanics in poor performers. Comparative cross-sectional study. University laboratory. 79 asymptomatic athletes underwent video classification of single-leg squat performance based on established visual rating criteria (overall impression, trunk posture, pelvis 'in space', hip movement, knee movement), and were rated as good (n=23), fair (n=41) or poor (n=15) performers. A subset of good (n=16) and poor (n=12) performers underwent biomechanical assessment, completing five continuous single-leg squats on their dominant limb while three-dimensional motion analysis and ground reaction force data were recorded. Poor performers repeated the task standing on prefabricated foot orthoses. Peak external knee adduction moment (KAM) and peak angles for the trunk, hip, knee and ankle. Compared to good performers, poor performers had a significantly lower peak KAM (mean difference 0.11 Nm/kg, 95% confidence interval [CI] 0.02 to 0.2 Nm/kg), higher peak hip adduction angle (-4.3°, -7.6° to -0.9°), and higher peak trunk axial rotation towards their stance limb (3.8°, 0.4° to 7.2°). Foot orthoses significantly increased the peak KAM in poor performers (-0.06 Nm/kg, -0.1 to -0.01 Nm/kg), with values approximating those observed in good performers. Findings validate Crossley et al's visual rating criteria for single-leg squat performance in asymptomatic athletes, and suggest that 'off-the-shelf' foot orthoses may be a simple intervention for poor performers
Full Text Available A 60 year old male had Gustilo type III C open fracture of the right lower leg. After radical debridement, the large open defect including certain loss of the bone tissue was successfully augmented and covered, by consecutive three cross-leg flaps, which consisted of the free rectus abdominis musculocutaneous flap, the fibula osteocutaneous flap and the conventional sural flap. Although indication for amputation or preservation is decided with multiple factors in each case, a strategic combination of cross-leg flap, free flap, external fixation and vascular delay could increase the potential of preservation of the lower leg with even disastrous Gustilo type III C.
Full Text Available Walking animals produce adaptive interlimb coordination during locomotion in accordance with their situation. Interlimb coordination is generated through the dynamic interactions of the neural system, the musculoskeletal system, and the environment, although the underlying mechanisms remain unclear. Recently, investigations of the adaptation mechanisms of living beings have attracted attention, and bio-inspired control systems based on neurophysiological findings regarding sensorimotor interactions are being developed for legged robots. In this review, we introduce adaptive interlimb coordination for legged robots induced by various factors (locomotion speed, environmental situation, body properties, and task. In addition, we show characteristic properties of adaptive interlimb coordination, such as gait hysteresis and different time-scale adaptations. We also discuss the underlying mechanisms and control strategies to achieve adaptive interlimb coordination and the design principle for the control system of legged robots.
Feedback systems that control the leg joints of animals must be highly flexible in adapting to different behavioural tasks. One manifestation of such flexibility is changes in the gain of joint control networks. The femurtibia (FT) control network of the locust leg is one of the feedback systems most thoroughly studied with regard to its neural circuitry. Despite excellent information concerning network topology, however, actual gain changes and their underlying mechanisms have not yet been examined because of the marked spontaneous variations in the action of the control network for this joint. We describe a behavioural situation and a preparation in which the locust (Locusta migratoria L.) FT control network exhibits reproducible changes in gain, allowing investigation of the neuronal basis of gain control. After ('fictive') flight motor activity, the gain of resistance reflexes in the FT joint of the locust middle leg is significantly decreased, with the flexor tibiae muscles being affected more strongly than the extensor muscles. Immediately after flight motor activity, the gain may be as low as 30 % of pre-flight levels. It returns to pre-flight values in under 150 s. The decrease in gain following flight motor activity is due to a decrease in motoneurone recruitment in the resistance reflex elicited by stimulation of the appropriate mechanoreceptor, the femoral chordotonal organ. Motoneurone recruitment is changed as a result of a drastic decline in the stimulus-related synaptic input to the motoneurones, which appears to be produced exclusively at the level of the pre-motor network. Two factors led to this conclusion: first, we found no indication of changes in membrane potential or membrane conductance of the tibia flexor and extensor motoneurones; second, recording from identified pre-motor nonspiking interneurones demonstrated that these may be involved in the observed gain changes. The putative behavioural relevance is discussed.
Struzik, Artur; Zawadzki, Jerzy
The aim of this study was to present the methodology for estimation of a leg stiffness during a countermovement jump. The question was asked whether leg stiffness in the countermovement and take-off phases are similar to each other as demonstrated in previous reports. It was also examined whether the stiffness in left lower limb is similar to the one in right lower limb. The research was conducted on 35 basketball players. Each participant performed three countermovement jumps with arm swing to the maximum height. Measurements employed a Kistlerforce plate and a BTS SMART system for motion analysis. Leg stiffness (understood as an inclination of the curve of ground reaction forces vs. length) was computed for these parts of countermovement and take-off phases where its value was relatively constant and F(Δl) relationship was similar to linear. Mean value (±SD) of total stiffness of both lower limbs in the countermovement phase was 7.1 ± 2.3 kN/m, whereas this value in the take-off phase was 7.5 ± 1 kN/m. No statistically significant differences were found between the leg stiffness in the countermovement and the take-off phases. No statistically significant differences were found during the comparison of the stiffness in the right and left lower limb. The calculation methodology allows us to estimate the value of leg stiffness based on the actual shape of F(Δl) curve rather than on extreme values of ΔF and Δl. Despite different tasks of the countermovement and the take-off phases, leg stiffness in these phases is very similar. Leg stiffness during a single vertical jump maintains a relatively constant value in the parts with a small value of acceleration.
Full Text Available This paper presents the use of Rowat and Selverston-type of CPG to control locomotion. It focuses on the role of afferent exteroceptive and proprioceptive signals in the dynamic phase synchronization in CPG legged robots. The sensori-motor neural network architecture is evaluated to control a two-joint planar robot leg that slips on a rail. Then, the closed loop between the CPG and the mechanical system allows to study the modulation of rhythmic patterns and the effect of the sensing loop via sensory neurons during the locomotion task. Firstly simulations show that the proposed architecture easily allows to modulate rhythmic patterns of the leg, and therefore the velocity of the robot. Secondly, simulations show that sensori-feedbacks from foot/ground contact of the leg make the hip velocity smoother and larger. The results show that the Rowat-Selverston-type CPG with sensory feedbacks is an effective choice for building adaptive Neural Central Pattern Generators for legged robots.
Laursen, M. V.; Boelling, D.; Mark, Thomas
The purpose of this study was to estimate the genetic correlations among claw and leg health and potential indicator traits. Claw health was defined as absence of heel horn erosion, interdigital dermatitis, interdigital phlegmon, interdigital hyperplasia, laminitis, and sole ulcer. Leg health...
The extension workers were exposed to hazards / risks such as accident on the farm, car/motor/bicycle accident, injury to the leg/hand, encounter with ... practices among workers in government establishment include: lack of safety training, absence of risk management policy and non-provision of safety gargets. Keywords: ...
Cooled carcasses were dissected into primal cuts. Breast and leg muscle (thigh and drumstick) samples were used for chemical analyses. The obtained results suggested that free range rearing system was more favourable than extensive indoor system, as it resulted in a significantly higher protein content and a lower fat ...
Rud, B; Foss, O; Krustrup, Peter
Aim: As a consequence of enhanced local vascular conductance, perfusion of muscles increases with exercise intensity to suffice the oxygen demand. However, when maximal oxygen uptake (VO(2) max) and cardiac output are approached, the increase in conductance is blunted. Endurance training increases...... muscle metabolic capacity, but to what extent that affects the regulation of muscle vascular conductance during exercise is unknown. Methods: Seven weeks of one-legged endurance training was carried out by twelve subjects. Pulmonary VO(2) during cycling and one-legged cycling was tested before and after...... training, while VO(2) of the trained leg (TL) and control leg (CL) during cycling was determined after training. Results: VO(2) max for cycling was unaffected by training, although one-legged VO(2) max became 6.7 (2.3)% (mean ± SE) larger with TL than with CL. Also TL citrate synthase activity was higher...
Beach, Aaron J; Ferdinands, René E D; Sinclair, Peter J
Spin bowling is generally coached using a standard technical framework, but this practice has not been based upon a comparative biomechanical analysis of leg-spin and off-spin bowling. This study analysed the three-dimensional (3D) kinematics of 23 off-spin and 20 leg-spin bowlers using a Cortex motion analysis system to identify how aspects of the respective techniques differed. A multivariate ANOVA found that certain data tended to validate some of the stated differences in the coaching literature. Off-spin bowlers had a significantly shorter stride length (p = 0.006) and spin rate (p = 0.001), but a greater release height than leg-spinners (p = 0.007). In addition, a number of other kinematic differences were identified that were not previously documented in coaching literature. These included a larger rear knee flexion (p = 0.007), faster approach speed (p < 0.001), and flexing elbow action during the arm acceleration compared with an extension action used by most of the off-spin bowlers. Off-spin and leg-spin bowlers also deviated from the standard coaching model for the shoulder alignment, front knee angle at release, and forearm mechanics. This study suggests that off-spin and leg-spin are distinct bowling techniques, supporting the development of two different coaching models in spin bowling.
Fabrigar, Danica Joy; Hubbart, Christina; Miles, Alistair; Rockett, Kirk
Recent developments in genotyping technologies coupled with the growing desire to characterize genome variation in Anopheles populations open the opportunity to develop more effective genotyping strategies for high-throughput screening. A major bottleneck of this goal is nucleic acid extraction. Here, we examined the feasibility of using intact portions of a mosquito's leg as sources of template DNA for whole-genome amplification (WGA) by primer-extension preamplification. We used the Agena Biosciences MassARRAY(®) platform (formerly Sequenom) to genotype 78 SNPs for 265 WGA leg samples. We performed nucleic acid extraction on 36 mosquito carcasses and compared the genotype call concordance with their corresponding legs and observed full concordance. Using three legs instead of one improved genotyping success rates (96% vs. 89%, respectively), although this difference was not significant. We provide a proof of concept that WGA reactions can be performed directly on mosquito legs, thereby eliminating the need to extract nucleic acid. This approach is straightforward and sensitive and allows both species determination and genotyping of Anopheles mosquitoes to be performed in a high-throughput manner. Our protocol also leaves the mosquito body intact facilitating other experimental analysis to be undertaken on the same sample. Based on our findings, this method would also be suitable for use with other insect species. © 2015 John Wiley & Sons Ltd.
Full Text Available The construct of sarcopenia is still discussed with regard to best appropriate measures of muscle volume and muscle function. The aim of this post-hoc analysis of a cross-sectional experimental study was to investigate and describe the hierarchy of the association between thigh muscle volume and measurements of functional performance in older women. Thigh muscle volume of 68 independently living older women (mean age 77.6 years was measured via magnetic resonance imaging. Isometric strength was assessed for leg extension in a movement laboratory in sitting position with the knee flexed at 90° and for hand grip. Maximum and habitual gait speed was measured on an electronic walk way. Leg muscle power was measured during single leg push and during sit-to-stand performance. Thigh muscle volume was associated with sit-to-stand performance power (r = 0.628, leg push power (r = 0.550, isometric quadriceps strength (r = 0.442, hand grip strength (r = 0.367, fast gait speed (r = 0.291, habitual gait speed (r = 0.256, body mass index (r = 0.411 and age (r = -0.392. Muscle power showed the highest association with thigh muscle volume in healthy older women. Sit-to-stand performance power showed an even higher association with thigh muscle volume compared to single leg push power.
Kockum, Britta; Heijne, Annette I-L M
To measure the absolute and relative reliability and the smallest real difference (SRD) in three commonly used hop tests, two leg-power tests and the single-leg squat jump. Methodological study. Clinical setting. Fourteen healthy athletes (seven women and seven men) were evaluated in a standardized test-retest design. The Intra-class correlation coefficient (ICC2.1), Standard Error of Measurement (SEM) and SRD were calculated for the vertical jump, one-leg hop for distance, side-hop, single-leg squat jump and knee-flexion and knee-extension power tests. All tests showed good to excellent ICC (0.84-0.98). The SEM (%) ranged between 3.4 and 11.1 for the four hop tests and between 8.1 and 12.4 for the leg-power tests. The SRD (%) for the hop tests ranged between 9.3 and 30.7 and for the three power tests between 22.4 and 34.3. The absolute reliability of this test protocol showed good to excellent ICC values and measurement errors of approximately 10%. This instrument can be recommended for determining function in terms of power in healthy athletes or late in the rehabilitation process. The tests' methodological errors must be considered and caution should be taken regarding the standardization procedure during testing. Copyright © 2014 Elsevier Ltd. All rights reserved.
Tsai, Feng-Chou; Chen, Chien-Hao; Lin, Chan-Yi; Ho, Li-Yung
In addition to the conventional methods used to improve leg contours, total leg sculpture, including liposuction, selective neurectomy, and transilluminated powered phlebectomy, provides a one-time solution of leg contour problems, which is a major aesthetic concern among Asian women. The authors present the postoperative results of total leg sculpture and determine any significance and correlation between the leg variables and body mass index by statistical analysis. Thirty female patients who underwent total leg sculpture between 2005 and 2008 were included in the study, and prospective analysis of the patients' data was performed during a follow-up period of 1 year. Local measurement variables and body mass index were recorded, and the correlation between them was determined by Pearson's correlation and regression analysis. A paired t test was used to compare the postoperative outcomes. Subjectively, all patient results were satisfactory. There were significant differences between preoperative and postoperative measurements for all variables for total leg sculpture. Body mass index was strongly correlated with all leg indexes, and there was a significant positive correlation between the index and variables related to the buttocks and upper thigh. The satisfactory postoperative leg variables were buttocks circumference (87.85 cm), thigh circumference (T60, 44.20 cm), maximal calf circumference (32.24 cm), and calf ratio (0.78). Each preoperative body mass index increment represents a 0.3 percent circumference improvement around the buttocks after surgery. No obvious morbidities or long-term hospital stays were noted. Total leg sculpture provides a combined aesthetic solution for improving limb contours with minimal morbidity. Patients with larger body mass index values exhibit better aesthetic improvement than those with smaller values.
Donovan, Oliver O; Cheung, Jeanette; Catley, Maria; McGregor, Alison H; Strutton, Paul H
The purpose of this study was to investigate trunk and knee strength in practitioners of hard-style martial arts. An additional objective was to examine reaction times in these participants by measuring simple reaction times (SRT), choice reaction times (CRT) and movement times (MT). Thirteen high-level martial artists and twelve sedentary participants were tested under isokinetic and isometric conditions on an isokinetic dynamometer. Response and movement times were also measured in response to simple and choice auditory cues. Results indicated that the martial arts group generated a greater body-weight adjusted peak torque with both legs at all speeds during isokinetic extension and flexion, and in isometric extension but not flexion. In isokinetic and isometric trunk flexion and extension, martial artists tended to have higher peak torques than controls, but they were not significantly different (p > 0.05). During the SRT and CRT tasks the martial artists were no quicker in lifting their hand off a button in response to the stimulus [reaction time (RT)] but were significantly faster in moving to press another button [movement time (MT)]. In conclusion, the results reveal that training in a martial art increases the strength of both the flexors and extensors of the leg. Furthermore, they have faster movement times to auditory stimuli. These results are consistent with the physical aspects of the martial arts. Key PointsMartial artists undertaking hard-style martial arts have greater strength in their knee flexor and extensor muscles as tested under isokinetic testing. Under isometric testing conditions they have stronger knee extensors only.The trunk musculature is generally higher under both conditions of testing in the martial artists, although not significantly.The total reaction times of the martial artists to an auditory stimulus were significantly faster than the control participants. When analysed further it was revealed that the decrease in reaction time
Högl, Birgit; Comella, Cynthia
Levodopa and dopamine agonists have been the main treatment for restless legs syndrome during the past decades. Although their efficacy has been well documented over the short term, long-term dopaminergic treatment is often complicated by augmentation, loss of efficacy, and other side effects. Recent large randomized controlled trials provide new evidence for the efficacy of high-potency opioids and α2δ ligands, and several post hoc analyses, meta-analyses, algorithms, and guidelines have been published, often with a specific focus, for example, on augmentation, or on management of restless legs syndrome during pregnancy. Several new contributions to understanding the pathophysiology of restless legs syndrome have been published, but at this time, whether they will have an impact on treatment possibilities in the future cannot be estimated. © 2015 International Parkinson and Movement Disorder Society.
Sakti Prasad Das
Full Text Available Presence of single umbilical persistent vitelline artery distinguishes sirenomelia from caudal regression syndrome. We report a case of a12-year-old boy who had bilateral umbilical arteries presented with fusion of both legs in the lower one third of leg. Both feet were rudimentary. The right foot had a valgus rocker-bottom deformity. All toes were present but rudimentary. The left foot showed absence of all toes. Physical examination showed left tibia vara. The chest evaluation in sitting revealed pigeon chest and elevated right shoulder. Posterior examination of the trunk showed thoracic scoliosis with convexity to right. The patient was operated and at 1 year followup the boy had two separate legs with a good aesthetic and functional results.
Silva, Priscila de Brito; Oliveira, Anderson Souza; Mrachacz-Kersting, Natalie
(p CoP and WB angular movement measures were weakly and not significantly correlated between tasks. This lack of correlation indicates that WB balance maintenance...... to calculate trunk and contralateral-leg excursion (EXC) and velocity (VEL), and center of pressure (CoP) EXC and VEL during FS on a force platform. From the WB test, standing time (WBTIME) was determined and the board's angular EXC and VEL were calculated from four markers on the WB as surrogate measures...... for CoP dynamics. Electromyographic average rectified values (ARV) from eight leg and thigh muscles of the supporting limb were calculated for both tasks. WB ARV amplitudes were normalized with respect to the value of FS ARV and presented significantly higher peroneus longus and biceps femoris activity...
Full Text Available Background. Spasticity of the legs is common in multiple sclerosis (MS, but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal and 4 (contracted. Patients completed the 6-minute walk (6 MW, timed 25 foot walk (T25FW, and timed up-and-go (TUG, and O2 cost of walking was measured during the 6 MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc. for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12 and wore an accelerometer over a seven-day period. Results. 52% (n=44 of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6 MW (P=0.0001, d=-0.86, T25FW (P=0.003,d=0.72, TUG (P=0.001, d=0.84, MSWS-12 (P=0.0001,d=1.09, O2 cost of walking (P=0.001, d=0.75, average steps/day (P<0.05, d=-0.45, and walking velocity (P<0.05, d=-0.53 and cadence (P<0.05, d=-0.46. Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking.
Rye, David B
Restless legs syndrome (RLS) is a common sensorimotor trait defined by symptoms that interfere with sleep onset and maintenance in a clinically meaningful way. Nonvolitional myoclonus while awake and asleep is a sign of the disorder and an informative endophenotype. The genetic contributions to RLS/periodic leg movements are substantial, are among the most robust defined to date for a common disease, and account for much of the variance in disease expressivity. The disorder is polygenic, as revealed by recent genome-wide association studies. Experimental studies are revealing mechanistic details of how these common variants might influence RLS expressivity. Copyright © 2015 Elsevier Inc. All rights reserved.
Butler, J; Mulkerrin, E; O'Keeffe, S
Nocturnal leg cramps are common in older people. Such cramps are associated with many common diseases and medications. Physiological methods may be useful for preventing cramps in some people, but there have been no controlled trials of these approaches. Quinine is moderately effective in preventing nocturnal leg cramps. However, there are concerns about the risk/benefit ratio with this drug. In patients with severe symptoms, a trial of 4–6 weeks' treatment with quinine is probably still justified, but the efficacy of treatment should be monitored, for example using a sleep and cramp diary. PMID:12415081
Lee, Chung Suk; Kim, Tae; Lee, Sumin; Jeon, Hong Jun; Bang, Young Rong; Yoon, In-Young
This study examines the clinical course of restless legs syndrome according to its severity and factors associated with the remission of restless legs syndrome symptoms. The remission or persistence of restless legs syndrome symptoms was investigated by considering patients with restless legs syndrome at the sleep clinic of Seoul National University Bundang Hospital. All subjects were observed for at least 18 months, and an incidence of remission was defined as having no restless legs syndrome symptoms for at least 1 year. Restless legs syndrome severity was evaluated by the International Restless Legs Syndrome Study Group Rating Scale. A total of 306 patients participated in this study. Over the observation periods of 4.1 ± 1.6 years, the cumulative incidence of remission is 32.5% (95% confidence interval [CI], 27.0-38.0) and decreased with baseline restless legs syndrome severity (P restless legs syndrome cases, respectively. Most cases of remission (82/96) were observed within 1 year, and the remission occurred sooner for mild restless legs syndrome. The hazard ratios of remission by Cox proportional hazards model were lower for moderate (0.556; 95% CI, 0.340-0.909) and severe to very severe (0.193; 95% CI, 0.108-0.343) restless legs syndrome than for mild restless legs syndrome. The remission incidence was lower for those patients who had a family history of restless legs syndrome and were older at restless legs syndrome diagnosis. Mild restless legs syndrome severity, no family history, and young age at restless legs syndrome diagnosis were significant predictors of restless legs syndrome remission. More than 80% of patients with severe restless legs syndrome showed a chronic clinical course. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available Periodic limb movement (PLM and Restless leg syndrome (RLS are types of sleep disorders that are not very well recognized in clinical practice. While RLS is a clinical diagnosis, the diagnosis of PLM is made by polysomnography. They share the same pathophysiology and often respond to the same treatment. To date all the epidemiological studies have reported the prevalence between 2% and 15%. It has recently become known that mild obstructive sleep apnea and upper airway resistance syndrome (UARS can masquerade as PLM syndrome. New discoveries have been made with regard to genetics and PLM and RLS. Detailed review on this subject should improve the awareness of these disorders, both among general physicians and specialists. Extensive review of journals in the past 20 years was made using Medline search.
Nining W. Kusnanik
Full Text Available The main purpose of this study was to determine the effect of single leg hop progression and double legs hop progression exercise to increase speed and explosive power of leg muscles. Plyometric is one of the training methods that can increase explosive power. There are many models of plyometric training including single leg hop progression and double leg hop progression. This research was experimental using match subject design techniques. The subjects of this study were 39 students who joined basketball school club. There were 3 groups in this study: Group 1 were 13 students who given sin¬gle leg hop progression exercise, Group 2 were 13 students who given double legs hop progression exercise, Group 3 were 13 students who given conventional exercise. The data was collected during pre test and post test by testing 30m speed running and vertical jump. The data was analyzed using Analysis of Varians (Anova. It was found that there were significantly increased on speed and explosive power of leg muscles of Group 1 and Group 2. It can be stated that single leg hop progression exercise was more effective than double leg hop progression exercise. The recent findings supported the hypothesis that single leg hop progression and double legs hop progression exercise can increase speed and explosive power of leg muscles. These finding were supported by some previous studies (Singh, et al, 2011; Shallaby, H.K., 2010. The single leg hop progression is more effective than double legs hop progression. This finding was consistent with some previous evidences (McCurdy, et al, 2005; Makaruk et al, 2011.
Zhu, Xiao-Ying; Liu, Ye; Zhang, Xiao-Jin; Yang, Wen-Hao; Feng, Ya; Ondo, William G; Tan, Eng-King; Wu, Yun-Cheng
There is limited data on motor restlessness in Parkinson's disease (PD). Here we evaluate for clinical differences between cohorts of idiopathic Restless Legs Syndrome (iRLS), PD patients with leg restlessness, and PD with RLS. We examined 276 consecutive PD patients for leg restlessness symptoms, we compared clinical features of PD patients with RLS, PD patients with leg restlessness but not meeting RLS criteria, PD patient without RLS and iRLS. A total of 262 PD patients who satisfied the inclusion criteria were analyzed. After excluding 23 possible secondary RLS or mimics, 28 were diagnosed with RLS and 18 with leg motor restlessness (LMR). Compared with iRLS patients, PD patients with RLS or LMR had older age of RLS/LMR onset, shorter duration of leg restlessness, less positive family history, different seasonal trends and more unilaterality of leg restlessness symptom (Pleg restlessness. PD with LMR had less severe Parkinsonism (Pleg restlessness (P<0.01) symptoms than PD with RLS. Clinical characteristics of PD patients with RLS and LMR were different from iRLS, differentiating these various subtypes can facilitate optimal treatment. Copyright © 2015 Elsevier B.V. All rights reserved.
Magrini, Mitchel A; Thiele, Ryan M; Colquhoun, Ryan J; Barrera Curiel, Alejandra; Blackstock, Taryn S; DeFreitas, Jason M
There is need for a functional ability test that appropriately assesses the rapid integration of the sensory and motor systems required for older adults to recover from a slip. The purpose of this study was to assess the efficacy and reliability of a novel test, the reactive leg drop, for assessing sensory-motor function in older adults. Fourteen young (YW; mean age = 20yrs) and 11 older women (OW; mean age = 76yrs) participated in this study. For each drop, the leg was passively moved to full extension and then released. The subjects had to recognize their leg was free-falling and reactively kick up as quickly as possible during varying sensory conditions. To assess the leg drop's reliance on proprioception, other proprioceptive tests (e.g. patellar tendon reflexes and balance) were separately performed. Leg drops performed with the eyes closed (p=0.011) and with a blocked view of their leg (p=0.033) showed significant differences in drop angle between the YW and OW. Significant relationships between leg drop conditions and balance were observed in the OW that were not present within YW. When collapsed across groups, reflex latency was correlated with drop angle when the eyes were closed. The reactive leg drop was age sensitive, reliable, and likely reliant on proprioception, as shown by relationships to other sensory-motor assessments, such as balance and the patellar reflex. Although more research is needed, we propose that the reactive leg drop is an effective tool to assess sensory-motor integration in a manner that may mimic fall recovery.
Matsushita, Satoru; Ando, Koichi; Koike, Sachiko
To evaluate the protective effect of WR-151327 on late radiation-induced damaged to normal tissues in mice, the right hind legs of mice with or without WR-151327 administration (400 mg/kg) were irradiated with 137 Cs gamma rays. Leg contracture and skin shrinkage assays were performed at 380 days after irradiation. The mice were killed on day 400 postirradiation and histological sections of the legs were made. The thickness of the dermis, epidermis, and skin (dermis plus epidermis) was measured. The muscular area of the legs and the posterior knee angle between the femur and tibia were also measured. The left hind legs were similarly assessed as nonirradiated controls. Group means and standard deviations were calculated and dose-response curves were drawn for every endpoint. Then, the dose modifying factor (DMF) for each endpoint and the correlations among endpoints were determined. Latae damage assayed by leg contracture and skin shrinkage progressed with increasing radiation dose. However, it was reduced by drug treatment. The significant effect was indicated for skin shrinkage by a DMF of 1.8 at 35%. The DMF for leg contracture was 1.3 at 6 mm. In the irradiated legs, epidermal hyperplasia and dermal fibrosis in the skin, muscular atrophy, and extension disturbance of the knee joint were observed. These changes progressed with increasing radiation dose. Skin damage assayed by the present endpoints was also reduced by drug treatment by DMFs of 1.4 to 1.7. However, DMFs for damage to the muscle and knee were not determined because no isoeffect was observed. There were good correlations between leg contracture or skin shrinkage and the other endpoints in both untreated and drug-treated mice. WR-151327 has the potential to protect against radiation-induced late normal tissue damage. 17 refs., 6 figs., 2 tabs
Arellano, Christopher J; Kram, Rodger
Compared with other species, humans can be very tractable and thus an ideal "model system" for investigating the metabolic cost of locomotion. Here, we review the biomechanical basis for the metabolic cost of running. Running has been historically modeled as a simple spring-mass system whereby the leg acts as a linear spring, storing, and returning elastic potential energy during stance. However, if running can be modeled as a simple spring-mass system with the underlying assumption of perfect elastic energy storage and return, why does running incur a metabolic cost at all? In 1980, Taylor et al. proposed the "cost of generating force" hypothesis, which was based on the idea that elastic structures allow the muscles to transform metabolic energy into force, and not necessarily mechanical work. In 1990, Kram and Taylor then provided a more explicit and quantitative explanation by demonstrating that the rate of metabolic energy consumption is proportional to body weight and inversely proportional to the time of foot-ground contact for a variety of animals ranging in size and running speed. With a focus on humans, Kram and his colleagues then adopted a task-by-task approach and initially found that the metabolic cost of running could be "individually" partitioned into body weight support (74%), propulsion (37%), and leg-swing (20%). Summing all these biomechanical tasks leads to a paradoxical overestimation of 131%. To further elucidate the possible interactions between these tasks, later studies quantified the reductions in metabolic cost in response to synergistic combinations of body weight support, aiding horizontal forces, and leg-swing-assist forces. This synergistic approach revealed that the interactive nature of body weight support and forward propulsion comprises ∼80% of the net metabolic cost of running. The task of leg-swing at most comprises ∼7% of the net metabolic cost of running and is independent of body weight support and forward propulsion. In
Ewing, Katie A; Fernandez, Justin W; Begg, Rezaul K; Galea, Mary P; Lee, Peter V S
Anterior cruciate ligament (ACL) injury can be a painful, debilitating and costly consequence of participating in sporting activities. Prophylactic knee bracing aims to reduce the number and severity of ACL injury, which commonly occurs during landing maneuvers and is more prevalent in female athletes, but a consensus on the effectiveness of prophylactic knee braces has not been established. The lower-limb muscles are believed to play an important role in stabilizing the knee joint. The purpose of this study was to investigate the changes in lower-limb muscle function with prophylactic knee bracing in male and female athletes during landing. Fifteen recreational athletes performed double-leg drop landing tasks from 0.30m and 0.60m with and without a prophylactic knee brace. Motion analysis data were used to create subject-specific musculoskeletal models in OpenSim. Static optimization was performed to calculate the lower-limb muscle forces. A linear mixed model determined that the hamstrings and vasti muscles produced significantly greater flexion and extension torques, respectively, and greater peak muscle forces with bracing. No differences in the timings of peak muscle forces were observed. These findings suggest that prophylactic knee bracing may help to provide stability to the knee joint by increasing the active stiffness of the hamstrings and vasti muscles later in the landing phase rather than by altering the timing of muscle forces. Further studies are necessary to quantify whether prophylactic knee bracing can reduce the load placed on the ACL during intense dynamic movements. Copyright © 2016 Elsevier Ltd. All rights reserved.
Ploutz-Snyder, Lori; Ryder, J.; Hackney, K.; Scott-Pandorf, M.; Redd, E.; Buxton, R.; Bloomberg, J.
There is a large degree of variability among crewmembers with respect to decrements in muscle strength and power following long duration spaceflight, ranging from 0 to approx.30% reductions. The purpose of this study was to investigate the influence of varying decrements in lower body muscle strength and power (relative to body weight) on the performance of 2 occupationally relevant tasks (ladder climb and supine egress & walk). Seventeen participants with leg strength similar to US crewmembers performed a leg press power test, an isokinetic knee extension strength test and they were asked to complete the 2 functional tasks as quickly as possible. On additional test days the participants were asked to repeat the functional tasks under 3 conditions where a different external load was applied each time using a weighted suit in order to experimentally manipulate participants strength/body weight and power/body weight ratios. The weight in the suit ranged from 20-120% of body weight and was distributed in proportion to limb segment weights to minimize changes in center of gravity. The ladder task consisted of climbing 40 rungs on a ladder treadmill as fast as possible. The supine egress & walk task consisted of rising from a supine position and walking through an obstacle course. Results show a relatively linear relationship between strength/body weight and task time and power/body weight with task time such that the fastest performance times are associated with higher strength and power with about half the variance in task time is accounted for by a single variable (either strength or power). For the average person, a 20% reduction in power/body weight (from 18 to 14.4 W/kg) induces an increase (slowing) of about 10 seconds in the ladder climb task from 14 to 24 seconds (approx.70%) and a slowing of the supine egress & walk task from 14 to 21 seconds (approx.50%). Similar relationships were observed with strength/body weight and task performance. For the average
Full Text Available The classical model of spring-loaded inverted pendulum (SLIP and its extensions have been widely accepted as a simple description of dynamic legged locomotion at various scales in humans, legged robots and animals. Similar to the majority of models in the literature, the SLIP model assumes ideal sticking contact of the foot. However, there are practical scenarios of low ground friction that causes foot slippage, which can have a significant influence on dynamic behaviour. In this work, an extension of the SLIP model with two masses and torque actuation is considered, which accounts for possible slippage under Coulomb's friction law. The hybrid dynamics of this model is formulated and numerical simulations under representative parameter values reveal several types of stable periodic solutions with stick-slip transitions. Remarkably, it is found that slippage due to low friction can sometimes increase average speed and improve energetic efficiency by significantly reducing the mechanical cost of transport.
Kazennikov, O V; Kireeva, T B; Shlykov, V Iu
Anticipatory postural adjustment is an essential part of equilibrium maintainance during standing in human. So changes in stance condition could affect both control of equilibrium and anticipatory adjustment. Anticipatory changes in the stabilogram of each leg were studied in standing subject during the early stage of quick right arm lifting while legs were on two separated supports. The center of pressure (CP) movement was analyzed in three variants of experiment: both legs on immovable support, with only right leg on the movable support and with only left leg on the moveable support. In each standing condition subject stood with symmetrical load on two legs or with the load voluntary transferred to one leg. The anticipatory CP shift depended on the mobility of the support under the leg and on loading of the leg. While standing on unmovable supports with symmetrical load on the legs before lifting of the right arm CP of right leg shifted backward and CP of left leg--forward. While standing with one leg on movable support the anticipatory CP shift of this leg was small and did not depend on the load on the leg. However the shift of CP of the leg that was placed on the unmovable support depended on the load in the same way as in the case when both legs were on unmovable supports. Results suggested that since on movable support the support and proprioceptive afferent flow from distal part of the leg that was did not supply unambiguous information about body position, the role of distal joints in posture control is reduced.
Rietman, J. S.; Goudsmit, J.; Meulemans, D.; Halbertsma, J. P. K.; Geertzen, J. H. B.
This paper describes a new automatic hinge system for leg orthoses, which provides knee stability in stance, and allows knee-flexion during swing. Indications for the hinge system are a paresis or paralysis of the quadriceps muscles. Instrumented gait analysis was performed in three patients, fitted
Rietman, J.S.; Goudsmit, J.; Meulemans, D.; Halbertsma, J.P.K.; Geertzen, J.H.B.
This paper describes a new, automatic hinge system for leg orthoses, which provides knee stability in stance, and allows knee-flexion during swing. Indications for the hinge system are a paresis or paralysis of the quadriceps muscles. Instrumented gait analysis was performed in three patients,
Loots, Miriam A. M.; de Jong, Menno D.; van Soolingen, Dick; Wetsteyn, José C. F. M.; Faber, William R.
Rare tropical skin diseases are seen more frequently in Western countries because of the increased popularity of visiting tropical regions. A 55-year-old white man developed a painless leg ulcer after traveling in Guatemala and Belize. A mycobacterium was cultured from a biopsy specimen and was
... Staying Safe Videos for Educators Search English Español X-Ray Exam: Femur (Upper Leg) KidsHealth / For Parents / X- ... Muscles, and Joints Broken Bones Getting an X-ray (Video) X-Ray (Video) View more Partner Message About Us ...
Apr 30, 1983 ... same distribution as the paraesthesiae; and (v) anxiety, tension or mild depression. Paraesthesiae or creeping sensations are usually confined to the calves. They are extremely unpleasant and deep-seated in muscles or bones rather than in the skin, mostly affecting the legs between the knee and ankle.
Leg synes at have et potentiale som metode til at fremme læring. Men hvordan? Legen har en vis grad af parallelitet med den virkelige verden i dens interaktive og relationelle strukturer. Det bliver muligt at finde nye meninger i interaktioner, som refererer til vante interaktionsformer, men...
Daniszewska, Barbara; Zolynski, Krystian
Introduction Leg length discrepancy (LLD) causes pelvic obliquity in the frontal plane and lumbar scoliosis with convexity towards the shorter extremity. Leg length discrepancy is observed in 3-15% of the population. Unequalized lower limb length discrepancy leads to posture deformation, gait asymmetry, low back pain and discopathy. Material and methods In the years 1998-2006, 369 children, aged 5 to 17 years (209 girls, 160 boys) with LLD-related functional scoliosis were treated. An external or internal shoe lift was applied. Results Among 369 children the discrepancy of 0.5 cm was observed in 27, 1 cm in 329, 1.5 cm in 9 and 2 cm in 4 children. During the first follow-up examination, within 2 weeks, the adjustment of the spine to new static conditions was noted and correction of the curve in 316 examined children (83.7%). In 53 children (14.7%) the correction was observed later and was accompanied by slight low back pain. The time needed for real equalization of limbs was 3 to 24 months. The time needed for real equalization of the discrepancy was 11.3 months. Conclusions Leg length discrepancy equalization results in elimination of scoliosis. Leg length discrepancy < 2 cm is a static disorder; that is why measurements should be performed in a standing position using blocks of adequate thickness and the position of the posterior superior iliac spine should be estimated. PMID:22371777
Full Text Available The purpose of developing hybrid locomotion systems is to merge the advantages and to eliminate the disadvantages of different type of locomotion. The proposed solution combines wheeled and legged locomotion methods. This paper presents the mechatronic design approach and the development stages of the prototype.
Robot with multiple degrees of freedom comprising five legs (2) linked at a first of their ends to a base ( 3), and at a second of their ends opposite to the first ends to a mobile platform (4), which platform carries at least one tool (5, 6, 121, 12 "), and wherein the robot further comprises an
Doherty, C; Bleakley, C; Hertel, J; Caulfield, B; Ryan, J; Delahunt, E
No research exists predicating a link between acute ankle sprain injury-affiliated movement patterns and those of chronic ankle instability (CAI) populations. The aim of the current study was to perform a biomechanical analysis of participants, 6 months after they sustained a first-time acute lateral ankle sprain (LAS) injury to establish this link. Fifty-seven participants with a 6-month history of first-time LAS and 20 noninjured participants completed a single-leg drop landing task on both limbs. Three-dimensional kinematic (angular displacement) and sagittal plane kinetic (moment of force) data were acquired for the joints of the lower extremity, from 200 ms pre-initial contact (IC) to 200 ms post-IC. Individual joint stiffnesses and the peak magnitude of the vertical component of the ground reaction force (GRF) were also computed. LAS participants displayed increases in hip flexion and ankle inversion on their injured limb (P < 0.05); this coincided with a reduction in the net flexion-extension moment at the hip joint, with an increase in its stiffness (P < 0.05). There was no difference in the magnitude of the peak vertical GRF for either limb compared with controls. These results demonstrate that altered movement strategies persist in participants, 6 months following acute LAS, which may precipitate the onset of CAI. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Hatton, Anna L; Kemp, Joanne L; Brauer, Sandra G; Clark, Ross A; Crossley, Kay M
Impaired balance control has been reported in the elderly with hip osteoarthritis, yet this relationship has not been explored in young adults with hip chondropathy. This study aimed to determine whether people with hip chondropathy demonstrated impaired balance ability during a dynamic single-leg squat with eyes open (SquatEO) and a single-leg standing task with eyes closed (StandEC) and whether hip range of motion (ROM) and hip muscle strength were correlated with balance measures in adults with hip chondropathy. Sixty-three adults with hip chondropathy and 60 controls performed 2 tasks: SquatEO and StandEC while standing on a Nintendo Wii Balance Board. Center of pressure (COP) movement in mediolateral and anteroposterior directions was extracted. Hip ROM and muscle strength were measured with an inclinometer and dynamometer. Data were analyzed using an analysis of covariance and stepwise multiple regression model. During SquatEO, greater COP mediolateral range (P = 0.023) and anteroposterior SD (P = 0.043) were observed in those with hip chondropathy compared to controls. No significant between-group differences were observed for StandEC. Hip external rotation ROM was significantly associated with mediolateral range during SquatEO. Dynamic single-leg balance squat performance is reduced in people with hip chondropathy compared to healthy adults, but static single-leg standing balance is not. This may be reflective of reduced control of dynamic movements. Those with greater hip joint external rotation ROM appear to have worse single-leg squat balance performance. Further investigation into balance deficits associated with hip disease is necessary to establish early identification strategies and a tailored approach to rehabilitation. Copyright © 2014 by the American College of Rheumatology.
Christenson, James A.; And Others
The article describes the work activities of the extension sociologist, the relative advantage and disadvantage of extension roles in relation to teaching/research roles, and the relevance of sociological training and research for extension work. (NQ)
The tasks performed by the extension staff ranged from advising farmers on improving methods of farming to new task on health issues such as campaign on HIV/AIDS. The study identified strong training needs for Edo State extension agents on communication skills (X= 4.60), planning demonstration (X=4.60), evaluation of ...
Su, Chao; Zheng, Yuan F.
Multilimbed industrial robots that have at least one arm and two or more legs are suggested for enlarging robot workspace in industrial automation. To plan the motion of a multilimbed robot, the arm-leg motion-coordination problem is raised and task decomposition is proposed to solve the problem; that is, a given task described by the destination position and orientation of the end-effector is decomposed into subtasks for arm manipulation and for leg locomotion, respectively. The former is defined as the end-effector position and orientation with respect to the legged main body, and the latter as the main-body position and orientation in the world coordinates. Three approaches are proposed for the task decomposition. The approaches are further evaluated in terms of energy consumption, from which an optimal approach can be selected.
This longitudinal study explored leg preference in infancy during half-kneel pulling-to-stand (PTS) and asymmetrical four-point kneeling, which is part of the typical motor repertoire of infants. The special characteristics of the half-kneel PTS as a discrete task, performed in a bilateral context provide the opportunity to explore leg preference during an asymmetrical behaviour. Twenty-seven infants were observed in their homes, every 3 weeks between the ages of 7-12 months. Leg preference was determined by the "lead-out" limb used as the infants pulled to stand from the half-kneeling position (half-kneel PTS). As a complementary measure, the leading leg during asymmetrical four-point kneeling and crawling ("asymmetrical four-point patterns") was used in the 10 infants who developed these patterns. The infants studied showed a general preference for using a leading leg during half-kneel PTS, which was mostly consistent over the study period. A strong correlation was found between leg preferences during half-kneel PTS and asymmetrical four-point patterns. The findings documented functional asymmetry in infant lower limbs during half-kneel PTS and asymmetrical four-point patterns, highlighting the importance of the tasks used to define leg preference.
Zhou, Kunyan; West, Helen M; Zhang, Jing; Xu, Liangzhi; Li, Wenjuan
Leg cramps are a common problem in pregnancy. Various interventions have been used to treat them, including drug, electrolyte and vitamin therapies, and non-drug therapies. To assess the effectiveness and safety of different interventions for treating leg cramps in pregnancy. We searched the Cochrane Pregnancy and Childbirth Group's Register (31 March 2015) and reference lists of retrieved studies. Randomised controlled trials (RCTs) of any intervention (drug, electrolyte, vitamin or non-drug therapies) for treatment of leg cramps in pregnancy compared with placebo, no treatment or other treatment. Quinine was excluded for its known adverse effects (teratogenicity). Cluster-RCTS were considered for inclusion. Quasi-RCTs and cross-over studies were excluded. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We included six studies (390 women). Four trials compared oral magnesium with placebo/no treatment, two compared oral calcium with no treatment, one compared oral vitamin B versus no treatment, and one compared oral calcium with oral vitamin C. Two of the trials were well-conducted and reported, the other four had design limitations. The process of random allocation was sub-optimal in three studies, and blinding was not attempted in two. Outcomes were reported in different ways, precluding the use of meta-analysis and limiting the strength of our conclusions.The 'no treatment' group in one four-arm trial has been used as the comparison group for the composite outcome (intensity and frequency of leg cramps) in magnesium, calcium, and vitamin B versus no treatment. This gives it disproportionate weight in the overall analysis, thus interpretation of these results should be cautious. Oral magnesium versus placebo/no treatmentMagnesium (taken orally for two to four weeks) did not consistently reduce the frequency of leg cramps compared with placebo or no treatment. Outcomes that showed
The purpose of the study was to compare the leg power among Malaysian national netball players according to their age and playing position. The Vertical Jump Test was chosen to measure the leg power by using “Digital Indication Jump Meter” device. The results of the Vertical Jump Test were used to compare the leg ...
Petersen, Karin K; Hørlyck, Arne; Østergaard, Kristine Hovkjær
The high blood pressure in giraffe leg arteries renders giraffes vulnerable to edema. We investigated in 11 giraffes whether large and small arteries in the legs and the tight fascia protect leg capillaries. Ultrasound imaging of foreleg arteries in anesthetized giraffes and ex vivo examination...
Pinto, Carla M. A.; Santos, Alexandra P.
The study of locomotor patterns has been a major research goal in the last decades. Understanding how intralimb and interlimb coordination works out so well in animals' locomotion is a hard and challenging task. Many models have been proposed to model animal's rhythms. These models have also been applied to the control of rhythmic movements of adaptive legged robots, namely biped, quadruped and other designs. In this paper we study gait transition in a central pattern generator (CPG) model for bipeds, the 4-cells model. This model is proposed by Golubitsky, Stewart, Buono and Collins and is studied further by Pinto and Golubitsky. We briefly resume the work done by Pinto and Golubitsky. We compute numerically gait transition in the 4-cells CPG model for bipeds. We use Morris-Lecar equations and Wilson-Cowan equations as the internal dynamics for each cell. We also consider two types of coupling between the cells: diffusive and synaptic. We obtain secondary gaits by bifurcation of primary gaits, by varying the coupling strengths. Nevertheless, some bifurcating branches could not be obtained, emphasizing the fact that despite analytically those bifurcations exist, finding them is a hard task and requires variation of other parameters of the equations. We note that the type of coupling did not influence the results.
Hunter, N.; Milas, L.
S-2-(3-Aminopropylamino)ethylphosphorothioic acid (WR-2721) was shown to provide marked protection against development of radiation-induced leg contractures in C3Hf/Kam mice whose legs were exposed to single doses of gamma-radiation. The radiation doses ranged from 3300 to 6200 rads delivered to the right hind thighs from two parallelly opposed 137Cs sources. WR-2721 was given i.p. 30 min before irradiation. The severity of radiation-induced leg contractures in untreated and WR-2721-treated mice was followed for 342 days after irradiation. The degree of leg contractures in both control and WR-2721-treated mice increased up to 100 days after radiation, when the change stabilized, remaining more or less at the same level to the end of the observation period. During this entire period, the severity of contractures was less in WR-2721-treated mice. The dose-modifying factor for the level of 5 mm reduction in leg extension was 1.5 at 182 days after irradiation. Since WR-2721 did not prevent the radiocurability of 8-mm fibrosarcomas growing in the same legs, these data imply that WR-2721 has a high potential for increasing therapeutic gain when combined with irradiation in the treatment of tumors of an appreciable size
Kim, Jwa-jun; Park, Se-yeon
[Purpose] The purpose of this study was to evaluate the immediate effect of stabilizing exercise using the PNF technique on standing balance in one-leg and double-leg stances. [Subjects and Methods] The present study recruited 34 healthy participants from a local university. The Participants performed four balance tests (double-leg stance with and without vision, one-leg stance with and without vision), before and after exercise. The exercise consisted of exercises performed using PNF techniq...
Suzuki, Kazuyoshi; Sekiguchi, Miho; Midorikawa, Hirofumi; Sato, Koichi; Akase, Kazuyoshi; Sawada, Renshi; Konno, Shin-Ichi
The objective of this study was to use non-invasive laser Doppler flowmeter to measure changes in blood flow in peripheral vessels in the legs before and after stress induced by leg elevation stress test and investigate correlations with the ankle-brachial pressure index (ABI). Subjects included 28 patients over 20 years of age (mean, 73 years) who reported chiefly of leg symptoms such as intermittent claudication, numbness, chills, or cramps had been examined at the study institution, and agreed to participate in the study. The ABI of both legs was measured, and patients were divided into two groups: low ABI (ABI ≤0.9) and normal ABI (ABI ≥0.9). Blood flow in the big toe was measured using a box-type laser Doppler flowmeter before, during, and after leg-elevation stress. Amplitude of the recorded waveform and changes in blood flow were compared. Average ABI was 1.09 ± 0.10 in the normal ABI group (33 legs) and 0.68 ± 0.17 in the low ABI group (21 legs). Amplitude before and during stress was significantly smaller in the low ABI group than in the normal ABI group (p leg extension and elevation stress, there was a correlation between change in blood flow and amplitude, and ABI during stress. A box-type laser Doppler flowmeter may provide a means of screening for peripheral arterial disease.
Tobaa, Adil A; Best, Matthew D; Balasubramanian, Karthikeyan; Takahashi, Kazutaka; Hatsopoulos, Nicholas G
Large, spatially-distributed populations of motor cortical neurons are recruited during upper limb movements. Here, we examined how beta attenuation, a mesoscopic reflection of unit engagement, varies across a spatially expansive sampling of primary motor cortex in a non-human primate (macaca mulatta). We found that electrodes in both the trunk and leg representation of motor cortex exhibit qualitatively similar behavior to electrodes in the arm representation during a planar reaching task, despite the fact that there were no overt movements of the trunk or leg. These findings are interpreted in the context of a state-based brain machine interface.
Kjaer, Monica L; Mainz, Jan; Soernsen, Lars T
and reliable evidence-based quality indicators of venous leg ulcer care. A Scandinavian multidisciplinary, cross-sectional panel of wound healing experts developed clinical quality indicators on the basis of scientific evidence from the literature and subsequent group nominal consensus of the panel......; an independent medical doctor tested the feasibility and reliability of these clinical indicators, assessing the quality of medical technical care on 100 consecutive venous leg ulcer patients. Main outcome measures were healing, recurrence, pain, venous disease diagnosis, differential diagnosis and treatment......%) were assessed for venous surgery. Distal arterial pressure was measured following initial examination in 33 of the patients (34%). All patients (100%) were prescribed compression therapy. Of the 98 patients, 11 (11%) had ulcers recur in 3 months and 72 (73%) healed in 12 months, which is in line...
Akesson, Nina; Oien, Rut Frank; Forssell, Henrik; Fagerström, Cecilia
The aim of this study was to compare venous leg ulcer patients with and without ulcer pain to see whether ulcer pain affected the use of antibiotic treatment and compression therapy throughout healing. A total of 431 patients with venous leg ulcers were included during the study period. Every patient was registered in a national quality registry for patients with hard-to-heal leg, foot, and pressure ulcers. A high incidence of ulcer pain (57%) was found when the patients entered the study. Patients with ulcer pain had been treated more extensively with antibiotics both before and during the study period. Throughout healing there was a significant reduction of antibiotic use among patients in the 'no pain' group, from 44% to 23% (P=0.008). There was no significant difference between the two groups concerning compression therapy (85% vs. 88%), but 12% of patients in the 'pain' group did not get their prescribed compression compared with 6% of patients in the 'no pain' group. The groups did not differ significantly in terms of ulcer duration, ulcer size or healing time. This study shows a high incidence of ulcer pain, confirming that pain has a great impact on patients with venous leg ulcers. Results further suggest that the presence of ulcer pain increases the prescription of antibiotics but does not affect the use of compression therapy. Several advantages were found from using a national quality registry. The registry is a valuable clinical tool showing the importance of accurate diagnosis and effective treatment.
Verstraaten, M.; Kok, S.; Poss, R.; Grelck, C.; Grelck, C.; Hammond, K.; Scholz, S.B.
We propose an extension to S-NET’s light-weight parallel execution layer (LPEL): dynamic migration of tasks between cores for improved load balancing and higher throughput of S-NET streaming networks. We sketch out the necessary implementation steps and empirically analyse the impact of task
Ramirez, J O; Cabrera, S A S; Hidalgo, H; Cabrera, S G; Linnebank, M; Bassetti, C L; Kallweit, U
OBJECTIVE: Restless legs syndrome (RLS) is a common neurologic disorder. Secondary RLS includes pregnancy and iron deficiency. Prevalence of RLS in pregnancy ranges from 11% to 27%. We aimed to assess the frequency and characteristics of RLS in pregnancy in a Peruvian population and to evaluate the possible pregnancy or delivery complications due to RLS. METHODS: We assessed 218 consecutive expectant mothers at the inpatient clinic of the Hospital San Bartolome in Lima, Peru. Assessment wa...
Dhawan, V; Ali, M; Chaudhuri, K R
Restless legs syndrome (RLS), also known as Ekbom syndrome, is a common movement disorder with sensorimotor symptoms occurring during sleep and quiet wakefulness. The underlying cause for RLS is unknown but genetic influences play a strong part in the pathogenesis of RLS, particularly when the condition starts at a young age. This review explores the genetic basis of RLS and related phenotypic variations. Recently, three loci showing vulnerability to RLS have been described in French‐Canadian...
Srivanitchapoom, Prachaya; Pandey, Sanjay; Hallett, Mark
Restless legs syndrome (RLS) is a common sensorimotor neurological disorder that is diagnosed according to the revised criteria of the International RLS Study Group (IRLSSG). The pathophysiology of RLS is still unknown and its prevalence is influenced by ethnicity, age, and gender. RLS is divided into two types by etiology: primary or idiopathic and secondary. Primary RLS is strongly influenced by a genetic component while secondary RLS is caused by other associated conditions such as end-sta...
Kim, Sangbae; Wensing, Patrick; Biomimetic Robotics Lab Team
Designing an actuator system for highly-dynamic legged locomotion exhibited by animals has been one of the grand challenges in robotics research. Conventional actuators designed for manufacturing applications have difficulty satisfying challenging requirements for high-speed locomotion, such as the need for high torque density and the ability to manage dynamic physical interactions. It is critical to introduce a new actuator design paradigm and provide guidelines for its incorporation in future mobile robots for research and industry. To this end, we suggest a paradigm called proprioceptive actuation, which enables highly- dynamic operation in legged machines. Proprioceptive actuation uses collocated force control at the joints to effectively control contact interactions at the feet under dynamic conditions. In the realm of legged machines, this paradigm provides a unique combination of high torque density, high-bandwidth force control, and the ability to mitigate impacts through backdrivability. Results show that the proposed design provides an impact mitigation factor that is comparable to other quadruped designs with series springs to handle impact. The paradigm is shown to enable the MIT Cheetah to manage the application of contact forces during dynamic bounding, with results given down to contact times of 85ms and peak forces over 450N. As a result, the MIT Cheetah achieves high-speed 3D running up to 13mph and jumping over an 18-inch high obstacle. The project is sponsored by DARPA M3 program.
Full Text Available No abstract available. Article truncated after 150 words. Ms. Jones (not her real name is a 63-year-old woman who states that she gets very fidgety when sitting in a theater, watching a movie or when flying long distances on a plane. She is unable to find words to describe the sensation but she states that moving her legs make them feel better. Lately, she has been getting this feeling almost every night. She reports no leg discomfort in the daytime. She denies muscle cramps her legs. She had some recent investigations done by her primary care physician because of complaints of fatigue. Which of the following will be helpful in the diagnosis and management in this patient? 1. An overnight polysomnogram showing apnea hypopnea index of 1.6 events per hour and no periodic limb movements (PLMs 2. Ferritin level of 18 ng/ml (normal range 20-200 ng/ml 3. Serum Bicarbonate of 29 mEq/L (normal range 23-29 mEq/L 4. Thyroid …
Full Text Available Restless legs syndrome is a sleep and movement disorder that affects 5–15% of the general population, with an increased prevalence among the elderly population. It not only affects quality of life but also increases risk of mortality among older adults. The diagnosis is based on clinical symptoms of the patient by four minimal essential criteria. Restless legs syndrome can be divided into primary or secondary causes. Examination should be performed to rule out potentially treatable illnesses, such as iron deficiency, renal failure or peripheral neuropathy, especially among elderly patients. The initial approach to restless legs syndrome should be nonpharmacologic management, such as good sleep hygiene, regular exercise, cognitive behavioral therapy and avoidance of certain aggravating drugs. An algorithm based on scientific evidence and expert opinion was developed for guidance of treatment. Combination or change of medication can be applied to resistant or difficult cases. Since elderly patients are prone to treatment-related side effects, the best strategy is to start medication cautiously and at the lowest recommended dosage.
Yang, Yang; Yong-Ming, Lv; Pei-jian, Ding; Jia, Li; Ying-ze, Zhang
Hidden blood loss is a major factor influencing functional recovery and quality of life in patients undergoing total knee arthroplasty. Special hip and knee flexion positions after have been reported to have promising results with respect to reducing perioperative blood loss. The purpose of this study was to determine the effect of postoperative leg position on blood loss and functional recovery after total knee arthroplasty. We enrolled 46 consecutive patients with degenerative osteoarthritis of the knee in this prospective, randomized study. The patients were randomly allocated to a flexion or an extension group. In the flexion group, the affected leg was elevated by 60° at the hip, and the knee was flexed by 60°, while in the extension group, the affected knee was fully extended postoperatively. Blood loss, hemoglobin level, knee circumference and range of motion (ROM) were recorded to determine the influence of postoperative leg position on clinical outcomes. Although the transfusion rate was similar between the two groups (P > 0.05), other parameters related to blood loss (including calculated blood loss, hidden blood loss and postoperative knee circumference) were significantly lower in the flexion group than in the extension group (P group had gained a better ROM in the affected knee than had patients from the extension group (P = 0.04). At 6 months, however, the ROM of the affected knee was similar in both groups. The hospital stay was 1.9 days shorter in the flexion group than in the extension group. Wound infection rates were similar in both groups, and no proven case of deep vein thrombosis was observed in either group. Elevation of the hip by 60° with 60° knee flexion is an effective and simple method to reduce blood loss after primary unilateral total knee arthroplasty, and contributes to better recovery of the functional ROM in the early postoperative period. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights
... Sleep? Wise Choices Recognizing Restless Legs Restless legs syndrome brings all 4 of these characteristics: A strong urge to move your legs, often with unpleasant feelings like tingling, burning or throbbing in the legs. Symptoms that get better ... Legs Syndrome Fact Sheet What Is Restless Legs Syndrome? Brain ...
Full Text Available Sleep disturbances are important nonmotor symptoms in Parkinson’s disease (PD that are associated with a negative impact on quality of life. Restless legs syndrome (RLS, which is characterized by an urge to move the legs accompanied by abnormal leg sensations, can coexist with PD, although the pathophysiology of these disorders appears to be different. RLS and PD both respond favorably to dopaminergic treatment, and several investigators have reported a significant relationship between RLS and PD. Sensory symptoms, pain, motor restlessness, akathisia, and the wearing-off phenomenon observed in PD should be differentiated from RLS. RLS in PD may be confounded by chronic dopaminergic treatment; thus, more studies are needed to investigate RLS in drug-naïve patients with PD. Recently, leg motor restlessness (LMR, which is characterized by an urge to move the legs that does not fulfill the diagnostic criteria for RLS, has been reported to be observed more frequently in de novo patients with PD than in age-matched healthy controls, suggesting that LMR may be a part of sensorimotor symptoms intrinsic to PD. In this paper, we provide an overview of RLS, LMR, and PD and of the relationships among these disorders.
Kariyama, Yasushi; Hobara, Hiroaki; Zushi, Koji
This study aimed to clarify the differences between the horizontal single-leg rebound jump (HJ) and vertical single-leg rebound jump (VJ) in terms of three-dimensional joint kinetics for the take-off leg, while focusing on frontal and transverse plane movements. Eleven male track and field athletes performed HJ and VJ. Kinematic and kinetic data were calculated using data recorded with a motion capture system and force platforms. The hip abduction torque, trunk lateral flexion torque (flexion for the swing-leg side), hip external and internal torque, trunk rotational torque, and the powers associated with these torques were larger when performing HJ because of resistance to the impact ground reaction force and because of pelvic and posture control. Pelvic rotation was noted in HJ, and this was controlled not only by the hip and trunk joint torque from the transverse plane but also by the hip abduction torque. Therefore, hip and trunk joint kinetics in the frontal and transverse plane play an important role in a single-leg jump, regardless of the jumping direction, and may also play a more important role in HJ than in VJ.
Full Text Available Painless Legs and Moving Toes Syndrome (PoLMT is a rare movement disorder characterized by flexion, extension, abduction, adduction, and torsion of toes without pain. It is considered a variant of Painful Legs and Moving Toes Syndrome (PLMT, which is characterized by similar movements but with pain. Although neuropathy and several central nervous system (CNS involvements have been reported to be associated with PoLMT, the actual cause and mechanism remain unclear. Here we describe the first case of PoLMT in Parkinson’s Disease (PD, parallel to parkinsonism in severity, who demonstrated a good response to dopaminergic therapy.
Kahvecioglu, Serdar; Yildiz, Demet; Buyukkoyuncu, Nilufer; Celik, Huseyin; Tufan, Fatih; Kılıç, Ahmet Kasım; Gul, Bulent; Yildiz, Abdulmecid
Restless legs syndrome is a disorder in which patients have irresistible urge to move legs during rest. Restless legs syndrome seems to be common in end-stage renal disease. After a successful renal transplant, symptoms ameliorate with renal function improvement and restless legs syndrome is seen less in this population. Here, we aimed to investigate restless legs syndrome frequency and associated factors in renal transplant patients. In a cross-sectional study with 193 patients (116 hemodialysis patients, 45 transplant patients, and 32 controls), the presence of restless legs syndrome was assessed using the Restless Legs Syndrome Questionnaire. Medical history, demographic, and laboratory data were collected from the patients' medical records. Patients were questioned about the presence of restless legs syndrome using the Restless Legs Syndrome Questionnaire. Patients were evaluated with Beck Depression Scale for depression and Pittsburgh tests for sleep disturbances. While the rate of restless legs syndrome was similar between transplants and controls, it was significantly greater in hemodialysis patients. Hemodialysis patients and controls had similar depression scores that were higher compared with transplant patients. Pittsburgh score was similar in transplant patients and controls and significantly increased in the hemodialysis patients. The rate of insomnia was significantly higher in the hemodialysis patients compared with the other 2 groups. Logistic regression analysis revealed independent correlates of restless legs syndrome as insomnia, Beck depression score, and being on hemodialysis. Linear regression analysis showed that independent correlates of higher Pittsburgh score were higher depression score, higher age, and presence of restless legs syndrome. The prevalence of restless legs syndrome is significantly lower in transplant patients than it is in patients on maintenance dialysis. In renal transplant patients, restless legs syndrome frequency was
Ferri, Raffaele; Manconi, Mauro; Plazzi, Giuseppe; Bruni, Oliviero; Cosentino, Filomena I I; Ferini-Strambi, Luigi; Zucconi, Marco
Approximately one third of patients with restless legs syndrome (RLS) also show periodic leg movements (PLM) during relaxed wake fulness (PLMW). In contrast with the large amount of data published on periodic leg movements during sleep (PLMS), PLMW have received less attention from the scientific community. The objective of this study was to evaluate the correlations/differences of time-structure and response to a dopamine-agonist between PLMW and PLMS in patients with RLS. Ninety idiopathic RLS patients and 28 controls were recruited. Subjects underwent clinical and neurophysiological evaluation, hematological screening, and one or two consecutive full-night polysomnographic studies. A subset of patients received 0.25mg of pramipexole or placebo before the second recording. Polysomnographic recordings were scored and LM activity was analyzed during sleep and during the epochs of wakefulness occurring during the first recording hour. RLS patients had higher LM activity during wakefulness than controls, but with a similar periodicity. Even if correlated, the ability of the PLMW index to predict the PLMS index decreased with increasing LM activity. Intermovement intervals during wakefulness showed one peak only at approximately 4s, gradually decreasing with increasing interval in both patients and controls. The effect of pramipexole was very limited and involved the small periodic portion of LM activity during wakefulness. PLMW index and PLMS index were correlated; however, the magnitude of this correlation was not sufficient to suggest that PLMW can be good predictors of PLMS. Short-interval LM activity during wakefulness and sleep might be linked to the severity of sleep disruption in RLS patients and the differences between their features obtained during wakefulness or sleep might be relevant for the diagnosis of sleep disturbances in RLS. Copyright © 2012 Elsevier B.V. All rights reserved.
Tipton, Philip W; Wszołek, Zbigniew K
Restless legs syndrome (RLS) and nocturnal leg cramps (NLCs) are common disorders affecting 7.0% and 24.1% of the population in some European countries, respectively. Patients suffering from RLS experience uncomfortable nocturnal sensations in the legs with the urge to move that dissipates while moving. NLC is characterized by abrupt muscle contraction, most often in the gastrocnemius or foot muscles, which occurs at night and may result in significant sleep disturbances. The diagnosis of these disorders has presented a challenge to health care providers because of symptom overlap with other sensory and motor disturbances with nocturnal predominance. Treatment options and approaches are lacking, partially because of our currently incomplete understanding of the pathophysiological mechanisms underlying these conditions. We reviewed the medical literature to provide a comprehensive assessment of RLS and NLC with a focus on improved diagnostic accuracy and treatment approaches.
Aeles, Jeroen; Lenchant, Sietske; Vanlommel, Liesbeth; Vanwanseele, Benedicte
In many sports, athletes have a preferred leg for sport-specific tasks, such as jumping, which leads to strength differences between both legs, yet the underlying changes in force-generating mechanical properties of the muscle remain unknown. The purpose of this study was to investigate whether the muscle architecture of the medial gastrocnemius (MG) is different between both legs in well-trained jumping athletes and untrained individuals. In addition, we investigated the effect of two ankle joint positions on ultrasound muscle architecture measurements. Muscle architecture of both legs was measured in 16 athletes and 11 untrained individuals at two ankle joint angles: one with the ankle joint in a tendon slack length (TSL) angle and one in a 90° angle. Fascicle lengths and pennation angles at TSL were not different between the preferred and non-preferred legs in either group. The comparison between groups showed no difference in fascicle length, but greater pennation angles were found in the athletes (21.7° ± 0.5°) compared to the untrained individuals (19.8° ± 0.6°). Analyses of the muscle architecture at a 90° angle yielded different results, mainly in the comparison between groups. These results provide only partial support for the notion of training-induced changes in muscle architecture as only differences in pennation angles were found between athletes and untrained individuals. Furthermore, our results provide support to the recommendation to take into account the tension-length relationship and to measure muscle architecture at individually determined tendon slack joint angles.
da Silva, Rubens A; Vieira, Edgar R; Fernandes, Karen B P; Andraus, Rodrigo A; Oliveira, Marcio R; Sturion, Leandro A; Calderon, Mariane G
To compare the balance of individuals with and without chronic low back pain during five tasks. The participants were 20 volunteers, 10 with and 10 without nonspecific chronic low back pain, mean age 34 years, 50% females. The participants completed the following balance tasks on a force platform in random order: (1) two-legged stance with eyes open, (2) two-legged stance with eyes closed, (3) semi-tandem with eyes open, (4) semi-tandem with eyes closed and (5) one-legged stance with eyes open. The participants completed three 60-s trials of tasks 1-4, and three 30-s trials of task 5 with 30-s rests between trials. The center of pressure area, velocity and frequency in the antero-posterior and medio-lateral directions were computed during each task, and compared between groups and tasks. Participants with chronic low back pain presented significantly larger center of pressure area and higher velocity than the healthy controls (p tasks for all center of pressure variables (p tasks 3 and 4) and one-leg stance (task 5) were more sensitive to identify balance impairments in the chronic low back pain group than two-legged stance tasks 1 and 2 (effect size >1.37 vs. effect size tasks. Individuals with chronic low back pain presented poorer postural control using center of pressure measurements than the healthy controls, mainly during more challenging balance tasks such as semi-tandem and one-legged stance conditions. Implications for Rehabilitation People with chronic low back had poorer balance than those without it. Balance tasks need to be sensitive to capture impairments. Balance assessments during semi-tandem and one-legged stance were the most sensitive tasks to determine postural control deficit in people with chronic low back. Balance assessment should be included during rehabilitation programs for individuals with chronic low back pain for better clinical decision making related to balance re-training as necessary.
Cippà, Maria A T; Baumann, Christian R; Siccoli, Massimiliano M; Bassetti, Claudio L; Poryazova, Rositsa; Werth, Esther
The diagnosis of restless legs syndrome (RLS) relies upon diagnostic criteria which are based on history only, and dopaminergic treatment is not normally the first choice of treatment for all patients. It would be worthwhile to identify patients non-responsive to dopaminergic treatment beforehand, because they may suffer from a restless legs-like syndrome and may require alternative treatment. We included retrospectively 24 adult patients fulfilling the four essential criteria for restless legs and 12 age-matched healthy controls. They were investigated by ambulatory actigraphy from both legs over three nights, and patients started treatment with dopamine agonists after this diagnostic work-up. We examined 12 responders to dopaminergic treatment and 12 non-responders and studied the association between response to dopaminergic treatment and the periodic limb movement index (PLMI) as assessed with actigraphy. Demographic characteristics, excessive daytime sleepiness and fatigue at baseline were similar in all three groups. Baseline RLS severity was similar between responders and non-responders [International Restless Legs Severity Scale (IRLS): 25 ± 9 and 24 ± 8]. Group comparisons of PLMI before treatment initiation showed significant differences between the three groups. Post-hoc pairwise comparisons revealed that healthy controls had significantly lower PLMI (4.9 ± 4.5) than responders (29.3 ± 22.7) and non-responders (13.3 ± 11.2). Similarly, the PLMI in responders was lower than in non-responders. PLMI day-to-day variability did not differ between responders and non-responders and there was no correlation between treatment effect, as assessed by the decrease of the IRLS and baseline PLMI. Our retrospective study indicates that actigraphy to assess periodic limb movements may contribute to a better diagnosis of dopamine-responsive restless legs syndrome. © 2013 European Sleep Research Society.
Montplaisir, J; Boucher, S; Nicolas, A; Lesperance, P; Gosselin, A; Rompré, P; Lavigne, G
Patients with restless leg syndrome (RLS) complain of motor restlessness, usually occurring while they rest in the evening. Two immobilization tests have been described to assess leg restlessness in these patients. In the first test, the patient sits in bed with his or her legs outstretched while electromyograms are recorded from right and left anterior tibialis muscles for an hour (Suggested Immobilization Test [SIT]); in the second test, the legs are immobilized in a stretcher (Forced Immobilization Test [FIT]). In the current study, the SIT and the FIT were compared in patients with RLS and normal control subjects matched for age and sex. More leg movements were seen in patients than in controls during immobilization tests, especially the SIT. These movements were periodic, occurring at a frequency of approximately one every 12 seconds. The SIT (index > 40) was found to discriminate between RLS and control subjects better than the FIT (index > 25). Patients were also recorded during two consecutive nights to measure periodic leg movements in sleep (PLMS). A SIT index greater than 40 and a PLMS index greater than 11 (highest PLMS index of 2 consecutive nights) were found to discriminate patients with RLS from control subjects with similar power. With each of these two measures, the clinical diagnosis was correctly predicted in 81% of patients and 81% of the control subjects. The SIT has several advantages over the measure of the PLMS index; it does not require an all-night polygraphic recording and can be administered several times a day to measure circadian fluctuation of motor restlessness.
Ponnuru, Padmavathi; Wang, Xin-Sheng; Patton, Stephanie M.; Allen, Richard P.; Earley, Christopher J.
Restless legs syndrome is a neurological disorder characterized by an urgency to move the legs during periods of rest. Data from a variety of sources provide a compelling argument that the amount of iron in the brain is lower in individuals with restless legs syndrome compared with neurologically normal individuals. Moreover, a significant percentage of patients with restless legs syndrome are responsive to intravenous iron therapy. The mechanism underlying the decreased iron concentrations in restless legs syndrome brains is unknown. We hypothesize that the source of the brain iron deficit is at the blood–brain interface. Thus we analysed the expression of iron management proteins in the epithelial cells of the choroid plexus and the brain microvasculature in post-mortem tissues. The choroid plexus, obtained at autopsy, from 18 neurologically normal controls and 14 individuals who had primary restless legs syndrome was subjected to histochemical staining for iron and immunostaining for iron management proteins. Iron and heavy chain ferritin staining was reduced in the epithelial cells of choroid plexus in restless legs syndrome. Divalent metal transporter, ferroportin, transferrin and its receptor were upregulated in the choroid plexus in restless legs syndrome. Microvessels were isolated from the motor cortex of 11 restless legs syndrome and 14 control brains obtained at autopsy and quantitative immunoblot analyses was performed. Expression of heavy chain ferritin, transferrin and its receptor in the microvessels from restless legs syndrome was significantly decreased compared with the controls but divalent metal protein 1, ferroportin, prohepcidin, mitochondrial ferritin and light-chain ferritin remained unchanged. The presence of an iron regulatory protein was demonstrated in the brain microvasculature and the activity of this protein is decreased in restless legs syndrome; a finding similar to our earlier report in neuromelanin cells from the substantia
Zult, Tjerk; Gokeler, Alli; van Raay, Jos J A M; Brouwer, Reinoud W; Zijdewind, Inge; Hortobágyi, Tibor
injured leg's function for tasks measured in the present study, excluding dynamic balance and quadriceps activation. Rehabilitation after an ACL injury should be mainly focused on the injured leg. III.
Hart, Nicolas H; Nimphius, Sophia; Spiteri, Tania; Cochrane, Jodie L; Newton, Robert U
Kicking a ball accurately over a desired distance to an intended target is arguably the most important skill to acquire in Australian Football. Therefore, understanding the potential mechanisms which underpin kicking accuracy is warranted. The aim of this study was to examine the relationship between leg mass, leg composition and foot velocity on kicking accuracy in Australian Football. Thirty-one Australian Footballers (n = 31; age: 22.1 ± 2.8 years; height: 1.81 ± 0.07 m; weight: 85.1 ± 13.0 kg; BMI: 25.9 ± 3.2) each performed ten drop punt kicks over twenty metres to a player target. Athletes were separated into accurate (n = 15) and inaccurate (n = 16) kicking groups. Leg mass characteristics were assessed using whole body DXA scans. Foot velocity was determined using a ten-camera optoelectronic, three-dimensional motion capture system. Interactions between leg mass and foot velocity evident within accurate kickers only (r = -0.670 to -0.701). Relative lean mass was positively correlated with kicking accuracy (r = 0.631), while no relationship between foot velocity and kicking accuracy was evident in isolation (r = -0.047 to -0.083). Given the evident importance of lean mass, and its interaction with foot velocity for accurate kickers; future research should explore speed-accuracy, impulse-variability, limb co-ordination and foot-ball interaction constructs in kicking using controlled with-in subject studies to examine the effects of resistance training and skill acquisition programs on the development of kicking accuracy. Key pointsAccurate kickers expressed a very strong inverse relationship between leg mass and foot velocity. Inaccurate kickers were unable to replicate this, with greater volatility in their performance, indicating an ability of accurate kickers to mediate foot velocity to compensate for leg mass in order to deliver the ball over the required distance.Accurate kickers exhibited larger quantities of relative lean mass and lower quantities
Garcia, Elena; Arevalo, Juan Carlos; Muñoz, Gustavo; Gonzalez-de-Santos, Pablo
The development of functional legged robots has encountered its limits in human-made actuation technology. This paper describes research on the biomimetic design of legs for agile quadrupeds. A biomimetic leg concept that extracts key principles from horse legs which are responsible for the agile and powerful locomotion of these animals is presented. The proposed biomimetic leg model defines the effective leg length, leg kinematics, limb mass distribution, actuator power, and elastic energy recovery as determinants of agile locomotion, and values for these five key elements are given. The transfer of the extracted principles to technological instantiations is analyzed in detail, considering the availability of current materials, structures and actuators. A real leg prototype has been developed following the biomimetic leg concept proposed. The actuation system is based on the hybrid use of series elasticity and magneto-rheological dampers which provides variable compliance for natural motion. From the experimental evaluation of this prototype, conclusions on the current technological barriers to achieve real functional legged robots to walk dynamically in agile locomotion are presented.
Full Text Available The development of functional legged robots has encountered its limits in human-made actuation technology. This paper describes research on the biomimetic design of legs for agile quadrupeds. A biomimetic leg concept that extracts key principles from horse legs which are responsible for the agile and powerful locomotion of these animals is presented. The proposed biomimetic leg model defines the effective leg length, leg kinematics, limb mass distribution, actuator power, and elastic energy recovery as determinants of agile locomotion, and values for these five key elements are given. The transfer of the extracted principles to technological instantiations is analyzed in detail, considering the availability of current materials, structures and actuators. A real leg prototype has been developed following the biomimetic leg concept proposed. The actuation system is based on the hybrid use of series elasticity and magneto-rheological dampers which provides variable compliance for natural motion. From the experimental evaluation of this prototype, conclusions on the current technological barriers to achieve real functional legged robots to walk dynamically in agile locomotion are presented.
Rummel, J; Blum, Y; Seyfarth, A
The development of bipedal walking robots is inspired by human walking. A way of implementing walking could be performed by mimicking human leg dynamics. A fundamental model, representing human leg dynamics during walking and running, is the bipedal spring-mass model which is the basis for this paper. The aim of this study is the identification of leg parameters leading to a compromise between robustness and energy efficiency in walking. It is found that, compared to asymmetric walking, symmetric walking with flatter angles of attack reveals such a compromise. With increasing leg stiffness, energy efficiency increases continuously. However, robustness is the maximum at moderate leg stiffness and decreases slightly with increasing stiffness. Hence, an adjustable leg compliance would be preferred, which is adaptable to the environment. If the ground is even, a high leg stiffness leads to energy efficient walking. However, if external perturbations are expected, e.g. when the robot walks on uneven terrain, the leg should be softer and the angle of attack flatter. In the case of underactuated robots with constant physical springs, the leg stiffness should be larger than k-tilde = 14 in order to use the most robust gait. Soft legs, however, lack in both robustness and efficiency.
The punt kick is important in many football codes and support leg kinematics and ground reaction forces have been implicated in injury and performance in kicking. To evaluate ground reaction forces and support leg kinematics in the punt kick. Cross sectional study. Seven elite Australian football players performed maximal kicks into a net using both the preferred and non-preferred legs. A force plate measured ground reaction forces and an optical motion capture system (200Hz) collected kinematic data during the stance phase of the kick. Preferred and non-preferred legs were compared and performance was evaluated by correlating parameters with foot speed at ball contact. Vertical forces were larger than running at a similar speed but did not reach levels that might be considered an injury risk. Braking forces were directed solely posteriorly, as for soccer kicks, but lateral force patterns varied with some players experiencing greater forces medially and others laterally. A more extended support leg, larger peak vertical and braking force during the stance phase and a shorter stance contact time was associated with larger kick leg foot speed at ball contact. No difference existed between the preferred and non-preferred legs for ground reaction forces or support leg mechanics. To punt kick longer, a straighter support leg, less time on the ground and stronger braking should be encouraged. Conditioning the support leg to provide stronger braking potential is recommended. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Garcia, Elena; Arevalo, Juan Carlos; Muñoz, Gustavo; Gonzalez-de-Santos, Pablo
The development of functional legged robots has encountered its limits in human-made actuation technology. This paper describes research on the biomimetic design of legs for agile quadrupeds. A biomimetic leg concept that extracts key principles from horse legs which are responsible for the agile and powerful locomotion of these animals is presented. The proposed biomimetic leg model defines the effective leg length, leg kinematics, limb mass distribution, actuator power, and elastic energy recovery as determinants of agile locomotion, and values for these five key elements are given. The transfer of the extracted principles to technological instantiations is analyzed in detail, considering the availability of current materials, structures and actuators. A real leg prototype has been developed following the biomimetic leg concept proposed. The actuation system is based on the hybrid use of series elasticity and magneto-rheological dampers which provides variable compliance for natural motion. From the experimental evaluation of this prototype, conclusions on the current technological barriers to achieve real functional legged robots to walk dynamically in agile locomotion are presented. PMID:22247667
Hobara, Hiroaki; Tominaga, Shuichi; Umezawa, Shingo; Iwashita, Koudai; Okino, Atsuo; Saito, Taku; Usui, Fumio; Ogata, Toru
Understanding leg stiffness (K (leg)) in amputee sprinters is important for the evaluation of their sprint ability and development of running-specific prostheses (RSP). To investigate K (leg) during hopping in amputee sprinters. Cross-sectional study. Seven transtibial (TT) and seven transfemoral (TF) amputee sprinters, as well as seven non-active able-bodied subjects, performed one-legged hopping matching metronome beats at 2.2 Hz. Amputees hopped on their sound limb whereas able-bodied (AB) subjects hopped on their dominant limb. Using a spring-mass model, K (leg) was calculated from the subjects' body mass, ground contact and flight times. Both TT and TF sprinters demonstrated significantly higher K (leg) than AB subjects. K (leg) during hopping on the sound leg significantly correlated with personal records attained in a 100-m sprint in both TT (r = -0.757) and TF sprinters (r = -0.855). The results of the present study suggest that amputee sprinters have a greater K (leg) during hopping than inactive non-amputees, and that their sprint ability can be predicted from the K (leg) during hopping at 2.2 Hz on the sound limb.
Dauvilliers, Yves; Chenini, Sofiene; Vialaret, Jérôme; Delaby, Constance; Guiraud, Lily; Gabelle, Audrey; Lopez, Regis; Hirtz, Christophe; Jaussent, Isabelle; Lehmann, Sylvain
To better understand the role of iron homeostasis dysregulation in restless legs syndrome, we compared serum hepcidin and ferritin levels in drug-free patients with primary restless legs syndrome and healthy controls and studied the relationship between hepcidin level and restless legs syndrome severity. One hundred and eight drug-free patients with primary restless legs syndrome (65 women; median age, 61.5 years) and 45 controls (28 women; median age, 53.9 years) were enrolled. Inclusion criteria were: normal ferritin level (>50 ng/mL) and absence of iron disorders, chronic renal or liver failure, and inflammatory or neurological diseases. Each subject underwent a thorough clinical examination and a polysomnography assessment. Serum hepcidin-25 was quantified using a validated mass spectrometry method. Restless legs syndrome severity was evaluated according to the International Restless Legs Syndrome Study Group. Despite no group difference between normal ferritin levels and demographic features, serum hepcidin level and hepcidin/ferritin ratio were higher in patients than in controls. Hepcidin level and hepcidin/ferritin ratio, but not ferritin level, were positively correlated with periodic leg movements during sleep and wakefulness in the whole sample. Hepcidin level seem to be associated with restless legs syndrome severity in a complex U-shaped relationship, without relationship with age at restless legs syndrome onset, positive family history, sleep and depressive symptoms, genetic background, and polysomnographic measurements. No relationship was found between ferritin level and restless legs syndrome severity. In drug-free patients with primary restless legs syndrome, hepcidin level is higher than in controls and may be associated with restless legs syndrome clinical severity. This result emphasizes the complex peripheral iron metabolism deregulation in restless legs syndrome, opening potential perspectives for a personalized approach with a hepcidin
Aalbersberg, S.; Kingma, I.; van Dieen, J.H.
It has been reported that anterior cruciate ligament (ACL)-deficient subjects increase the level of hamstrings activation and this has been interpreted as a means to cope with increased anterior tibial laxity in the knee. This study aimed to establish to what extent co-activation strategies in
Ludwig, C; Grimmer, S; Seyfarth, A; Maus, H-M
The spring-loaded inverted pendulum (SLIP) model is a well established model for describing bouncy gaits like human running. The notion of spring-like leg behavior has led many researchers to compute the corresponding parameters, predominantly stiffness, in various experimental setups and in various ways. However, different methods yield different results, making the comparison between studies difficult. Further, a model simulation with experimentally obtained leg parameters typically results in comparatively large differences between model and experimental center of mass trajectories. Here, we pursue the opposite approach which is calculating model parameters that allow reproduction of an experimental sequence of steps. In addition, to capture energy fluctuations, an extension of the SLIP (ESLIP) is required and presented. The excellent match of the models with the experiment validates the description of human running by the SLIP with the obtained parameters which we hence call dynamical leg parameters. Copyright © 2012 Elsevier Ltd. All rights reserved.
Full Text Available Background/Aim. Resteless legs syndrome (RLS is chronical neurological disorder characterized by urge to move legs that is usually accompanied by unpleasant sensations in the lower extremities. Sleep disturbance is one of the main accompanying symptoms of RLS which exists in approximatelly 90% of patients. Impairment of sleep is related to daily sleepiness, depressive and anxiety disorders. The aim of this study was to detect frequency and characterisitics of sleep-related symptoms in patients with RLS, and its impairrment to daily sleepiness, fatique, anxiety and depression. Methods. We have examinated 94 patients with RLS. The diagnose of RLS was based on questionnaire with 4 specific questions according to the International Restless Legs Syndrome Study Group (IRLSSG criteria updated in 2003. Severity of symptoms was astimated with IRLSSG Rating Scale, depression and anxiety with Hamilton Depression Rating Scale (HDRS and Hamilton Anxiety Rating Scale (HARS and sleepiness with Epworth Sleepiness scale (ESS. We astimated sleep characteristics and disturbances with specific questionnaire. Results. In our study 79.9% of patients had sleep-related symptoms. Average sleep duration was 6.50 ± 1.42 hours, with average frequency of awakening 2.34 ± 1.69 times per night. Average ESS score was 5.12 ± 4.08 (0–17. Patients with more severe symptoms had higher degree of sleepiness (p = 0.005. Patients with higher symptoms frequency, significantly more often had sleep disturbance (p = 0.016, tiredness and daily sleepiness (p = 0.001. Daily sleepiness (ESS also significantly correlates with depression (p < 0.05 and anxiety (p = 0.012. Conclusion. Our results confirm that sleep disturbances are one of the key accompanying symptoms of RLS which cause daily sleepiness, tiredness, depression and anxiety. Therefore, their early recognition and appropriate treatment must be a priority in RLS patients.
Simon, Frantisek; Steger, Florian
This article addresses the issue of capturing the medical entity called 'curved legs' in a terminologically exact way. In so doing, it refers to the long-lasting process of differentiation of exact nuances of meaning in Ancient Greek and Latin. In the chronological perusal of ancient Greek literature, it becomes evident that the various adjectives employed are often vague when looking at non-medical literature. By contrast, in the Hippocratic corpus these terms are for the first time annotated with explanations intended to lead to a more precise understanding of the described deformity. Further attempts of differentiation can be found in the writings of Galen, who not only distinguishes between outward and inward curvatures, but also between deformities of the thigh and lower leg as well as between pathological and natural curvatures. Latin literature also provides a series of adjectives that were initially often used in the meaning of 'curved' but it was not until Celsus that these were differentiated with respect to the type and direction of the curvature. When comparing Greek and Latin adjectives, it turns out that though the Latin term blaesus can be traced back etymologically to the Greek word beta lambda alpha iota sigma ó zeta, the meaning of beta lambda alpha iota sigma ó zeta does not fully correspond to that of the Latin word. It is not before the later common transliteration of Greek words that this adjective took on the meaning of beta lambda alpha iota sigma ó zeta; however, this was finally lost again. In summary, the article concludes that exact word meanings in ancient literature are often unclear and precise ascriptions of meanings are inconsistent. In the case of "curved legs," this has led to misunderstandings regarding the respective types and directions of the curvature.
Steinstraesser, Lars; Sand, Michael; Steinau, Hans-Ulrich
The authors present a case of an extensive fulminant necrotizing fasciitis of the left flank, thigh, and lower parts of the leg treated with debridement, split-thickness skin grafting, and a giant negative pressure wound dressing covering 0.53 m( 2) or 18% of the body surface. To the authors' knowledge, this is the largest split-thickness grafted body surface successfully treated with negative pressure wound dressing documented in the literature.
This PhD deals with the notion of pseudo algebraically closed (PAC) extensions of fields. It develops a group-theoretic machinery, based on a generalization of embedding problems, to study these extensions. Perhaps the main result is that although there are many PAC extensions, the Galois closure of a proper PAC extension is separably closed. The dissertation also contains the following subjects. The group theoretical counterpart of pseudo algebraically closed extensions, the so-called projective pairs. Applications to seemingly unrelated subjects, e.g., an analog of Dirichlet's theorem about primes in arithmetic progression for polynomial rings in one variable over infinite fields.
Snakes are one of the most extraordinary groups of terrestrial vertebrates, with numerous specializations distinguishing them from other squamates (lizards and their allies). Their musculoskeletal system allows creeping, burrowing, swimming and even gliding, and their predatory habits are aided by chemo- and thermoreceptors, an extraordinary degree of cranial kinesis and, sometimes, powerful venoms. Recent discoveries of indisputable early fossil snakes with posterior legs are generating intense debate about the evolutionary origin of these reptiles. New cladistic analyses dispute the precise significance and phylogenetic placement of these fossils. These conflicting hypotheses imply radically different scenarios of snake origins and relationships with wide biological implications.
Fernandes, Tania Rita Moreno de Oliveira; dos Santos, Talita Suzany Siqueira; Lopes, Ramon Rodrigues de Macedo
In Brazil, leprosy is a widespread infectious and contagious disease. Clinicians and specialists view leprosy broadly as a systemic infection, since, in its manifestations, it mimics many conditions, such as rheumatic, vascular, ENT, neurological and dermatological diseases. There are few studies that characterize the factors associated with ulcers in leprosy. These injuries should be prevented and treated promptly to avoid serious problems like secondary infections, sepsis, carcinomatous degeneration and amputations. We describe a patient with ulcers on his legs, involving late diagnosis of lepromatous leprosy. PMID:27828650
Full Text Available Painful legs and moving toes syndrome (PLMT is a rare movement disorder with low diagnostic rate, which is characterized by lower limb pain with involuntary movements of feet or toes. Etiology and pathogenesis of this disease is still unclear. Patients have different clinical manifestations, so the diagnosis is difficult. Treatment methods for PLMT are numerous, but so far the treatment of this disease is still a major challenge for clinicians. Further research is still needed to guide clinical work. DOI: 10.3969/j.issn.1672-6731.2015.10.013
Worden, Timothy A; Mendes, Matthew; Singh, Pratham; Vallis, Lori Ann
Successful planning and execution of motor strategies while concurrently performing a cognitive task has been previously examined, but unfortunately the varied and numerous cognitive tasks studied has limited our fundamental understanding of how the central nervous system successfully integrates and executes these tasks simultaneously. To gain a better understanding of these mechanisms we used a set of cognitive tasks requiring similar central executive function processes and response outputs but requiring different perceptual mechanisms to perform the motor task. Thirteen healthy young adults (20.6±1.6years old) were instrumented with kinematic markers (60Hz) and completed 5 practice, 10 single-task obstacle walking trials and two 40 trial experimental blocks. Each block contained 20 trials of seated (single-task) trials followed by 20 cognitive and obstacle (30% lower leg length) crossing trials (dual-task). Blocks were randomly presented and included either an auditory Stroop task (AST; central interference only) or a visual Stroop task (VST; combined central and structural interference). Higher accuracy rates and shorter response times were observed for the VST versus AST single-task trials (peffect on motor performance in a dual-task situation compared to cognitive tasks that pose interference at only the central processing stage. Copyright © 2016 Elsevier B.V. All rights reserved.
Yoshimoto, Yoshinobu; Oyama, Yukitsuna; Tanaka, Mamoru; Sakamoto, Asuka
The purpose of the present study was to investigate the predictive accuracy of one-leg standing time at hospital discharge on falls in stroke patients. This was a retrospective cohort study. Participants included stroke patients (n = 65) who could walk when discharged from inpatient rehabilitation ward. To investigate the relationship between one-leg standing time and falls, logistic analysis was utilized with a criterion variable including the presence or absence of falls after 1-year hospital discharge as well as explanatory variables including Brunnstrom stage, knee extension strength on the affected side, Barthel Index, 10-m walking speed, and one-leg standing time on both sides. The accuracy of prediction by one-leg standing time was measured by the area under the curve of the receiver operating characteristic curve. Among the 65 patients, 38 (58.5%) experienced a fall 1 year after discharge. One-leg standing time of the affected side was not significantly associated with the falls (odds ratio: .89; 95% confidence interval: .79-1.01). When the fall incidents were assessed by area under the curve of the receiver operating characteristic curve, one-leg standing time of the affected side was observed to have increased marginally to .93 (95% confidence interval: .87-.99) as compared to the traditional prediction mode area under the curve (area under the curve .88; 95% confidence interval: .81-.97). One-leg standing time of the affected side may be considered as a moderately effective and simple assessment method for predicting postdischarge falls in a clinical setting. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Glauber Ribeiro Pereira
Full Text Available Anterior cruciate ligament (ACL injuries are common in sports. Studies investigating injury mechanisms have demonstrated that most injuries arise from landing tasks. Despite the demonstration of differences between male and female kinematics, there are no studies showing how males behave during different landing tasks. The objective of this study was to compare the angular and temporal kinematics of the lower limbs between two different landing tasks. Double leg and single leg landings were recorded in the frontal and sagittal plane in 15 male volleyball athletes by videogrammetry. Reduced hip and knee flexion and increased knee valgus were observed in the single leg landing task compared to the double leg landing task. No significant difference in landing time was observed between the two tasks. In conclusion, the results support the premise that lower limb kinematics change according to the task performed. Further studies are necessary to explore the impact of these kinematic differences on knee loading and to relate them to ACL injury mechanisms in men.
Soyata, Ahmet Z; Celebi, Fahri; Yargc, Lutfi I
Restless legs syndrome is an underdiagnosed sensori-motor disorder and psychotropic drugs are one of the main secondary causes of the illness. The most common psychotropic agents that cause restless legs syndrome are antidepressants; however, antipsychotics have also been reported to induce restless legs syndrome. The prevalence, vulnerability factors and the underlying mechanism of antipsychotic-induced restless legs syndrome are unclear. A possible explanation is that dopaminergic blockade is the main precipitator of the syndrome. Quetiapine-induced restless legs syndrome is another point of interest because of its low binding to D2 receptors. We herein report the case of a restless legs syndrome that emerged after a single low dose quetiapine administration.
Jiang, Crystal; de Armendi, Joyce T; Smith, Beth A
To determine the immediate effects of constraining or encouraging positioning devices on leg movement of infants with typical development (TD) and at-risk for developmental delay (AR). Twenty-six infants (13 TD, 13 AR) were placed in the supine position, a jungle gym, or a car seat. Movement sensors on infants' ankles measured acceleration and angular velocity. We calculated the number of leg movements, peak acceleration, and peak rotational rate of each leg movement. A 2 (group) × 3 (condition) analysis of variance with repeated measures on condition tested for a group effect, a condition effect, and a group by condition interaction for leg movement quantity, average peak acceleration, and average peak rotation. Leg movement quantity and average peak acceleration were significantly lower for the car seat condition compared with the supine position or the gym. Positioning device use has an immediate effect on infant leg movement characteristics. Long-term effects remain unknown.
Bayard, Sophie; Cochen De Cock, Valérie; Dauvillers, Yves
Dopamine replacement therapy in Parkinson's disease (PD) improves the motor symptoms. However, it has recently been shown that a small sub-group of patients suffers from motor and behavioral disturbances associated with the use of dopamine agonists (DAs). The behavioral disorders are incentive- or reward-based repetitive symptoms regrouped under the term « dopamine dysregulation syndrome » (DDS). They include pathological gambling, hypersexuality, compulsive shopping, compulsive eating, punding, and compulsive medication use. Whether these behaviors are related to the dopaminergic medications interacting with an underlying individual vulnerability or whether the primary pathological features of Parkinson's disease play a role is not entirely understood. This review is devoted to the phenomenology of the DDS and factors influencing its susceptibility. We further review the literature studies that investigated the decision-making profile using the Iowa Gambling Task in Parkinson's disease, and the recent literature devoted to these abnormal behaviors in the restless legs syndrome (RLS). Given the potential substantial impact of the DDS on personal, familial, social, and financial well-being, patients with PD or RLS should be informed that DAs use may lead to the development of impulsive and compulsive disorders, and clinicians should include the investigation of these disorders as part of routine clinical care. The refinement of clinical strategies to predict, identify and manage DDS will help the future care of motor and non-motor symptoms of Parkinson's disease.
Leung, A. K.; Wong, B. E.; Chan, P. Y.; Cho, H. Y.
The records of 2527 healthy children seen in an ambulatory care clinic were evaluated for nocturnal leg cramps in the preceding 12 months, frequency and duration of the cramps, whether the cramps affected one leg or both legs at a time, whether there was associated muscle cramps in feet, whether the cramps occurred when the child was awake or asleep, and whether there was residual tenderness in the affected muscles. Nocturnal leg cramps were present in 185 children for an overall incidence of 7.3%. Leg cramps were noted only in children aged > or = 8 years. The incidence increased at 12 years and peaked at 16 to 18 years of age. A majority (81.6%) of the affected children had nocturnal leg cramps 1 to 4 times per year. The mean duration of episodes was 1.7 minutes. Leg cramps were unilateral in 98.9% of cases and the ipsilateral foot also was involved in 18.9% of cases. One hundred thirty-five (73%) children had leg cramps while asleep, and the remaining 23 (12.4%) children had leg cramps in either state. Fifty-seven (30.8%) children had residual tenderness in the affected muscles. The mean duration of residual tenderness was 33.2 minutes (range: 2 minutes-1 day). We conclude that nocturnal leg cramps are common in children aged > 12 years. A majority of the affected children have leg cramps 1 to 4 times per year. The cramps are usually unilateral and occur when the children are asleep. Normal duration of the leg cramp is < 2 minutes. Residual tenderness is present in approximately 30% of the affected children. Residual tenderness, if present, usually lasts for half an hour. PMID:10388258
Full Text Available Leg-length inequality is an extensively studied complication of total hip arthroplasty in normal patients. However, few studies have focused on the pelvic obliquity of coronal pelvic malrotation. We hypothesized that pelvic obliquity with a fixed abduction/adduction contracture deformity of the hip may intraoperatively affect the release of soft tissues, ultimately resulting in a leg-length inequality. This study also investigated whether the femoral and vertical offsets of total hip arthroplasty were correlated with pelvic obliquity. This prospective study divided 98 patients into six groups based on the inclination of pelvic obliquity before total hip arthroplasty. Leg-length inequality, variation of pelvic obliquity, offset, and vertical offset were measured after total hip arthroplasty. Leg-length inequality and vertical offset were not significantly different among groups, whereas the variation of pelvic obliquity was significantly higher in type IIC pelvic obliquity than in other groups. Type IC pelvic obliquity had a significantly shorter offset than did the other groups, which may have been an important factor leading to type IC pelvic obliquity. Pelvic obliquity exhibited no significant effect on leg-length inequality in patients with total hip arthroplasty. A shorter offset may be caused by the higher tension of the abductor in the operated hip, which may result in the formation of type IC pelvic obliquity. Releasing the abductor contracture and restoring femoral offset are important for increasing hip stability and maintaining pelvic balance following total hip arthroplasty.
Zhou, Xiaoxiao; Wang, Qi; Zhang, Xianlong; Chen, Yunsu; Peng, Xiaochun; Mao, Yuanqing; Yang, Yang; Fu, Beigang; Wang, Xiuhui; Tang, Tingting
Leg-length inequality is an extensively studied complication of total hip arthroplasty in normal patients. However, few studies have focused on the pelvic obliquity of coronal pelvic malrotation. We hypothesized that pelvic obliquity with a fixed abduction/adduction contracture deformity of the hip may intraoperatively affect the release of soft tissues, ultimately resulting in a leg-length inequality. This study also investigated whether the femoral and vertical offsets of total hip arthroplasty were correlated with pelvic obliquity. This prospective study divided 98 patients into six groups based on the inclination of pelvic obliquity before total hip arthroplasty. Leg-length inequality, variation of pelvic obliquity, offset, and vertical offset were measured after total hip arthroplasty. Leg-length inequality and vertical offset were not significantly different among groups, whereas the variation of pelvic obliquity was significantly higher in type IIC pelvic obliquity than in other groups. Type IC pelvic obliquity had a significantly shorter offset than did the other groups, which may have been an important factor leading to type IC pelvic obliquity. Pelvic obliquity exhibited no significant effect on leg-length inequality in patients with total hip arthroplasty. A shorter offset may be caused by the higher tension of the abductor in the operated hip, which may result in the formation of type IC pelvic obliquity. Releasing the abductor contracture and restoring femoral offset are important for increasing hip stability and maintaining pelvic balance following total hip arthroplasty.
Vigelsø Hansen, Andreas; Gram, Martin; Wiuff, Caroline
OBJECTIVE: To determine the effect of aerobic retraining as rehabilitation after short-term leg immobilization on leg strength, leg work capacity, leg lean mass, leg muscle fibre type composition and leg capillary supply, in young and older men. SUBJECTS AND DESIGN: Seventeen young (23 ± 1 years...... immobilization had marked effects on leg strength, and work capacity and 6 weeks' retraining was sufficient to increase, but not completely rehabilitate, muscle strength, and to rehabilitate aerobic work capacity and leg lean mass (in the young men)....
Vo Doan, Tat Thang; Tan, Melvin Y W; Bui, Xuan Hien; Sato, Hirotaka
In this study, we describe the most ultralightweight living legged robot to date that makes it a strong candidate for a search and rescue mission. The robot is a living beetle with a wireless electronic backpack stimulator mounted on its thorax. Inheriting from the living insect, the robot employs a compliant body made of soft actuators, rigid exoskeletons, and flexure hinges. Such structure would allow the robot to easily adapt to any complex terrain due to the benefit of soft interface, self-balance, and self-adaptation of the insect without any complex controller. The antenna stimulation enables the robot to perform not only left/right turning but also backward walking and even cessation of walking. We were also able to grade the turning and backward walking speeds by changing the stimulation frequency. The power required to drive the robot is low as the power consumption of the antenna stimulation is in the order of hundreds of microwatts. In contrast to the traditional legged robots, this robot is of low cost, easy to construct, simple to control, and has ultralow power consumption.
Full Text Available Restless legs syndrome (RLS is a neurological disorder characterized by uncomfortable sensation of paresthesia in legs that subsequently causes involuntary and continuous movement of the lower limbs, especially at rest. Its prevalence in hemodialysis is more than that in the general population. Different risk factors have been suggested for RLS. We studied the prevalence and risk factors of RLS in 137 hemodialysis patients followed up at our center. The patients completed at least three months on dialysis and fulfilled four criteria for the diagnosis of RLS. We compared the patients with and without RLS, and the odds ratios (ORs were estimated by the logistic regression models. The prevalence of RLS was 36.5% in the study patients. Among the variables, diabetes was the only predicting factor for the development of RLS. The diabetic patients may be afflicted with RLS 2.25 times more than the non-diabetics. Women developed severe RLS 5.23 times more than men. Neurodegeneration, decrease in dopamine level, higher total oxidant status, and neuropathy in diabetic patients may explain the RLS symptoms.
J. P. Benigni
Full Text Available Background. In order to treat venous leg ulcers, it is recommended to use high pressure compression (30–40 mmHg at the ankle. Compression stockings which are not operator dependant could be the best option because of their pressure control. However 30–40 mmHg compression stockings are often hard to put on. Putting two lower pressure compression stockings over each other could be a good therapeutic alternative. Objectives. To compare the in vitro pressures given by the manufacturers of 2 antiulcer kits with the in vivo interface pressures measured in healthy subjects and to evaluate the stiffness and friction indices from those kits based on the interface pressure in order to assess their clinical properties. Material and Methods. Using a Kikuhime pressure device, interface pressure was measured in 12 healthy subjects at the reference point B1. One stiffness index (Static Stiffness Index (SSI and a friction index have been calculated. Results. Mediven Ulcer kit gets the recommended pressures whereas Jobst’s Ulcer Care kit does not for treating a venous leg ulcer. Jobst’s Ulcer Care transmits entirely the pressure in relation to a friction index close to 1. Conclusion. This antiulcer kit study underlines that in vivo and in vitro pressures can be different (Jobst’s Ulcer Care kit and Mediven Ulcer kit. In order not to lose pressure, it is important to take into account the friction index when superimposing two stockings.
Weiss, Margaret; Mahoney, Anne M; Gold, Michael; Lawrence, Naomi
Patients increasingly seek to enhance the appearance of their legs. Elimination of unwanted leg veins, reduction of epidermal photo-aging changes such as solar lentigines and keratoses, tightening of skin laxity and reduction of adipose tissue are among the most commonly requested goals. Many patients require a combination approach to address their concerns. It is important for dermatologists to be aware of the multitude of procedures that can be performed, often in combination, to rejuvenate the leg. The purpose of this review article was to discuss procedures for improving the appearance of the leg and to share the authors experience, especially in the combination approach to leg rejuvenation. A literature search was performed to investigate cosmetic procedures being performed on the leg, with an emphasis on controlled or randomized studies. In addition, the authors contributed their personal experience. Our discussion of the literature review highlights the treatments for leg veins, unwanted fat, cellulite, and photodamage of the legs that are most supported in peer-reviewed publications. A synergistic, combination approach to leg rejuvenation works best. This includes the use of injectable agents, energy-based devices, and more invasive surgical procedures.
Fulco, C S; Lewis, S F; Frykman, Peter
Using an exercise device that integrates maximal voluntary static contraction (MVC) of knee extensor muscles with dynamic knee extension, we compared progressive muscle fatigue, i.e., rate of decline in force-generating capacity, in normoxia (758 Torr) and hypobaric hypoxia (464 Torr). Eight...... healthy men performed exhaustive constant work rate knee extension (21 +/- 3 W, 79 +/- 2 and 87 +/- 2% of 1-leg knee extension O2 peak uptake for normoxia and hypobaria, respectively) from knee angles of 90-150 degrees at a rate of 1 Hz. MVC (90 degrees knee angle) was performed before dynamic exercise...... and during MVC force was 578 +/- 29 N in normoxia and 569 +/- 29 N in hypobaria before exercise and fell, at exhaustion, to similar levels (265 +/- 10 and 284 +/- 20 N for normoxia and hypobaria, respectively; P > 0.05) that were higher (P
Liebherr, Magnus; Weiland-Breckle, Hanna; Grewe, Tanja; Schumacher, Petra B
We often walk around when we have to think about something, but suddenly stop when we are confronted with a demanding cognitive task, such as calculating 1540*24. While previous neurophysiological research investigated cognitive and motor performance separately, findings that combine both are rare. To get a deeper understanding of the influence of motor demands as well as the difficulty of a simultaneously performed cognitive task, we investigated 20 healthy individuals. Participants performed two cognitive tasks with different levels of difficulty while sitting or standing on one leg. In addition to behavioral data, we recorded the electroencephalogram from 26Ag/AgCI scalp electrodes. The critical time-windows, predefined by visual inspection, yielded an early (200-300 ms, P2) and a subsequent positivity (350-500 ms, P3). Statistical analysis of the early time window registered a motor × cognition interaction. Resolution of this interaction revealed an effect of the cognitive task in the one-legged stance motor condition, with a more pronounced positivity for the difficult task. No significant differences between cognitive tasks emerged for the simple motor condition. The time-window between 350 and 500 ms registered main effects of the motor task and a trend for the cognitive task. While the influence of cognitive task difficulty (in the P3) is in accordance with previous studies, the motor task effect is specific to one-legged stance (cf. no effects for running in previous research). The motor-cognition interaction found in the P2 indicates that the more difficult motor task (one-legged stance) facilitates cognitive task performance. Copyright © 2018 Elsevier B.V. All rights reserved.
Full Text Available Current kinematic navigation systems provide real-time spatial analyses of leg alignments during total knee arthroplasty (TKA instead of delayed radiographic verification after surgery. A prospective study was conducted to investigate leg alignments of TKAs that underwent different surgical guidance [intramedullary (IM jig-based vs. navigation-assisted] using a kinematic navigation system. Since May 2007, patients admitted for primary TKA were considered for inclusion. Within 6 months, 38 sets of intraoperative analyses on the operated legs have been performed. Excluding seven unreliable data sets, 15 conventional IM jig-based TKAs and 16 navigation-assisted TKAs were available. The leg alignments in maximum knee extension were retrieved for comparison. Although similar final coronal alignments were accurately achieved in both groups (0.21 valgus in the IM group vs. 0.17 valgus in the NA group, p=0.993, a more flexed sagittal axis was constructed with conventional IM jigs (1.93 flexion in the IM group vs. 0.58 extension in the NA group, p<0.05. The study suggests that comparable coronal precision could be achieved with conventional IM jigs by trained surgeons, although computer-assisted navigation is a documented method to restore accurate alignment. Different sagittal alignments observed in this study indicate the inherent discrepancy between different surgical guides as well as their according concepts.
O'Keeffe, Shaun T
Studies that examined Internet searches for restless legs and leg cramps have found a strong seasonal effect with peaks in summer and troughs in winter months. The present study used an econometric approach to examine the seasonality of such searches in greater detail. Monthly relative search volumes for 'restless legs' and 'leg cramps' from 2004 to March 2017 in the United Kingdom (UK) and Australia were obtained from Google Trends. Average percentage change from winter to summer months was examined. The TRAMO-SEATS procedure from the DEMETRA statistical software was used to decompose the data into trend, seasonal and noise components and to determine whether a combined seasonality test was positive. There were substantial percentage increases in Google Trends searches between winter and summer months regarding restless legs in the UK (median increase 46%) and Australia (33%) and regarding leg cramps in the UK (95%) and Australia (50%). However, the combined seasonality test was positive only for leg cramps and not for restless legs in both countries: although there was significant stable seasonality in restless legs searches, this was outweighed by substantial moving seasonality and noise components. Examination of average percentage increase in search volume from winter to summer exaggerates the degree of seasonality. Seasonal effects for restless legs searches are non-significant when the trend and noise components of the data are considered, although this does not exclude a clinical significance for the identified stable seasonality. Significant seasonality, with a summer peak, is present for leg cramps searches and suggests an increase in the incidence or severity of leg cramps in summer. Copyright © 2017 Elsevier B.V. All rights reserved.
Lauszus, Finn F; Petersen, Astrid Christine; Neumann, Gudrun
in postmenopausal women was associated with surgery including hysterectomy and bilateral oophorectomy (pcarcinoma was found 138 times (95% CI: 48, 275) more prevalent than the expected rate. CONCLUSION......: The survival of women was better in AGCT than in epithelial ovarian tumor. Age and type of surgery, besides stage, influenced survival. Total abdominal hysterectomy and bilateral salpingo-oophorectomy is the recommended treatment with advancing age. At younger age less extensive surgery was associated...
However, Age (ƒÓ2 =39.33;ƒâ>0.05), religion (ƒÓ2 =2.752; ƒâ >0.05) and cassava association membership (ƒÓ2= 3.438, ƒâ>0.05) were not significant. Therefore, agricultural marketing techniques should be incorporated into agricultural extension delivery packages to ensure continuous farming practices and adoption of ...
Hansen, E A
The overall purpose of the present dissertation was to contribute to the understanding of voluntary human rhythmic leg movement behaviour and control. This was achieved by applying pedalling as a movement model and exposing healthy and recreationally active individuals as well as trained cyclists to for example cardiopulmonary and mechanical loading, fatiguing exercise, and heavy strength training. As a part of the background, the effect of pedalling frequency on diverse relevant biomechanical, physiological, and psychophysiological variables as well as on performance was initially explored. Freely chosen pedalling frequency is considerably higher than the energetically optimal pedalling frequency. This has been shown by others and was confirmed in the present work. As a result, pedal force is relatively low while rates of VO2 and energy turnover are relatively high during freely chosen pedalling as compared to a condition where a lower and more efficient pedalling frequency is imposed. The freely chosen pedalling frequency was in the present work, and by others, found to most likely be less advantageous than the lower energetically optimal pedalling frequency with respect to performance during intensive cycling following prolonged submaximal cycling. This stimulates the motivation to understand the behaviour and control of the freely chosen pedalling frequency during cycling. Freely chosen pedalling frequency was in the present work shown to be highly individual. In addition, the pedalling frequency was shown to be steady in a longitudinal perspective across 12 weeks. Further, it was shown to be unaffected by both fatiguing hip extension exercise and hip flexion exercise as well as by increased loading on the cardiopulmonary system at constant mechanical loading, and vice versa. Based on this, the freely chosen pedalling frequency is considered to be characterised as a highly individual, steady, and robust innate voluntary motor rhythm under primary influence of
Heebner, Nicholas R; Rafferty, Deirdre M; Wohleber, Meleesa F; Simonson, Andrew J; Lovalekar, Mita; Reinert, Andrew; Sell, Timothy C
Several tasks have been used to examine landing biomechanics for evaluation and rehabilitation, especially as related to anterior cruciate ligament injuries. However, comparing results among studies in which different tasks were used can be difficult, and it is unclear which task may be most appropriate. To compare lower extremity biomechanics across 5 commonly used landing tasks. Descriptive laboratory study. University-operated US Air Force Special Operations Forces human performance research laboratory. A total of 65 US Air Force Special Tactics Operators (age = 27.7 ± 5.0 years, height = 176.5 ± 5.7 cm, mass = 83.1 ± 9.1 kg). Kinematic and kinetic analysis of double- and single-legged drop landing, double- and single-legged stop jump, and forward jump to single-legged landing. Hip-, knee-, and ankle-joint kinematics; knee-joint forces and moments; and ground reaction forces (GRFs) were the dependent measures. We used repeated-measures analyses of variance or Friedman tests, as appropriate, to assess within-subject differences across tasks. Peak vertical GRF and peak knee-flexion angle were different among all tasks ( P tasks elicited different biomechanical responses; no single task was best for assessing a wide range of biomechanical variables related to anterior cruciate ligament injuries. Therefore, depending on the goals of the study, using multiple assessment tasks should be considered.
Wang, Mingfeng; Ceccarelli, Marco
Three-degree of freedom(3-DOF) translational parallel manipulators(TPMs) have been widely studied both in industry and academia in the past decades. However, most architectures of 3-DOF TPMs are created mainly on designers' intuition, empirical knowledge, or associative reasoning and the topology synthesis researches of 3-DOF TPMs are still limited. In order to find out the atlas of designs for 3-DOF TPMs, a topology search is presented for enumeration of 3-DOF TPMs whose limbs can be modeled as 5-DOF serial chains. The proposed topology search of 3-DOF TPMs is aimed to overcome the sensitivities of the design solution of a 3-DOF TPM for a LARM leg mechanism in a biped robot. The topology search, which is based on the concept of generation and specialization in graph theory, is reported as a step-by-step procedure with desired specifications, principle and rules of generalization, design requirements and constraints, and algorithm of number synthesis. In order to obtain new feasible designs for a chosen example and to limit the search domain under general considerations, one topological generalized kinematic chain is chosen to be specialized. An atlas of new feasible designs is obtained and analyzed for a specific solution as leg mechanisms. The proposed methodology provides a topology search for 3-DOF TPMs for leg mechanisms, but it can be also expanded for other applications and tasks.
Wei Chen; Rodpongpun, Sura; Luo, William; Isaacson, Nathan; Kark, Lauren; Khamis, Heba; Redmond, Stephen J
It is well known that a tangential force larger than the maximum static friction force is required to initiate the sliding motion between two objects, which is governed by a material constant called the coefficient of static friction. Therefore, knowing the coefficient of static friction is of great importance for robot grippers which wish to maintain a stable and precise grip on an object during various manipulation tasks. Importantly, it is most useful if grippers can estimate the coefficient of static friction without having to explicitly explore the object first, such as lifting the object and reducing the grip force until it slips. A novel eight-legged sensor, based on simplified theoretical principles of friction is presented here to estimate the coefficient of static friction between a planar surface and the prototype sensor. Each of the sensor's eight legs are straight and rigid, and oriented at a specified angle with respect to the vertical, allowing it to estimate one of five ranges (5 = 8/2 + 1) that the coefficient of static friction can occupy. The coefficient of friction can be estimated by determining whether the legs have slipped or not when pressed against a surface. The coefficients of static friction between the sensor and five different materials were estimated and compared to a measurement from traditional methods. A least-squares linear fit of the sensor estimated coefficient showed good correlation with the reference coefficient with a gradient close to one and an r(2) value greater than 0.9.
Hayward, J. A.
Agricultural extension is one component in an array including research, training, education, marketing, international trade, etc. which develop together to bring about growth, and sustained growth determines the priorities for extension. These priorities depend inevitably on the stage of development of a country or region, and on the current…
Full Text Available Restless Legs Syndrome (RLS is a prevalent sleep-associated movement disorder greatly affecting patients’ quality of life (QoL. Several drugs can be used to control this condition although the first-line dopamine agents often cause adverse effects. Non-dopaminergic drugs such as oral gabapentin (GBP have been more recently advocated. Despite ameliorating RLS symptoms, GBP's pharmacokinetic limitations restrict its overall effectiveness. A novel specifically designed prodrug, gabapentin enacarbil (GE, has demonstrated successful RLS alleviation with a superior pharmacokinetic profile. This review aims to examine the efficacy and tolerability of both GBP and GE as pharmacotherapy for RLS. Despite some heterogeneity and limitations across research methodologies, GE appears to be a potential RLS therapy superior to GBP and other dopaminergic agents.
Ignjatović, M; Cerović, S
Lipedema represents a form of lipodistrophy, which consists of abnormal accumulation of fat in subcutaneous tissue of the lower limbs with consecutive development of lymphostasis and lymphedema. The aim of this article was to review one clear case of lower limbs lipedema, of unusual occurrence and appearance, which was associated with dermatomyositis. A moderately manifested lipedema in 8 years old little girl was reported with its expressive segmental distribution to upper and lower legs, without significant increase in its size during last 10 years and without signs of lymphostasis. The hereditary influence was not confirmed. Histological examination of lipedematous tissue revealed significant presentation of immune component of the disease. According to the available literature, association between lipedema and dermatomyositis, lower limbs lipedema with segmental distribution as noticed above and its appearance as a consequence of corticosteroid therapy have not yet been published.
von Heymann, W
Pseudo-radicular leg pain as initially described by Bruegger more than 55 years ago was at that time a genius explanation for so many non-radicular pain syndromes that needed not any kind of surgical intervention but in first line a manual treatment or a treatment by therapeutic local anesthetics. Today we describe this pain as a "referred pain" originating from other anatomic structures that may occur during the development of chronic pain. Nevertheless this pain is found in many patients and it still seems to be a big problem for many physicians and surgeons. Imaging does not help either. The history and the clinical symptoms, the examinations, the chain reactions in the motor system as well as the treatment options from the point of view of manual medicine are described.
Raju, Seshadri; Kirk, Orla K; Jones, Tamekia L
Compression is the current "standard" in the treatment of venous leg ulcers, and corrective surgery is ancillary. The emergence of safe and effective minimally invasive corrective techniques prompts a reappraisal of this paradigm. Among 192 consecutive limbs with venous leg ulcers, 189 were treated by (1) endovenous laser ablation (n = 30), (2) iliac vein stent placement (n = 89), or (3) both (n = 69). Residual deep reflux was not treated. No specialized wound care was used, and 38% of patients did not use stockings. Outcome measures were time to heal the ulcer and cumulative long-term healing. Sixty percent of the limbs were post-thrombotic. The median reflux segment score was 3 (range, 0-7). Thirty-seven percent had deep axial reflux. Median intravascular ultrasound-detected stenosis was 70% (range, 0%-100%) in stented patients. Sensitivity of venography to iliac vein obstruction was 52%. Postprocedural mortality was 0%, and 2% had deep venous thrombosis (ulcers approximately ≤1 inch in diameter had healed. Larger ulcers were slower in healing (P pressure). However, long-term ulcer healing was inferior in limbs with reflux segment score of ≥3 (P ulcers in this consecutive series achieved long-term healing with the described minimally invasive algorithm. Uncorrected residual reflux was not an impediment to ulcer healing. Ulcers sized ≤1 inch required no specialized or prolonged wound care. Compression was not necessary to achieve or maintain healing after interventional correction. Copyright © 2013 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.
Saleh Mohammad Yaser Salman
Full Text Available Restless legs syndrome (RLS is common among dialysis patients, with a reported prevalence of 6-60%. The prevalence of RLS in Syrian patients on hemodialysis (HD is not known. The purpose of this study is to determine the prevalence of RLS in patients on regular HD, and to find the possible correlation between the presence of RLS and demographic, clinical, and biochemical factors. One hundred and twenty-three patients (male/female = 70/53, mean age = 41.95 ± 15.11 years on HD therapy at the Aleppo University Hospital were enrolled into the study. RLS was diagnosed based on criteria established by the International Restless Legs Syn-drome Study Group (IRLSSG. Data procured were compared between patients with and without RLS. Applying the IRLSSG criteria for the diagnosis, RLS was seen in 20.3% of the study pa-tients. No significant difference in age, gender, and intake of nicotine and caffeine was found between patients with and without the RLS. Similarly, there was no difference between the two groups in the duration of end-stage renal disease (ESRD, the period of dialysis dependence, dialysis adequacy, urea and creatinine levels, and the presence of anemia. The co-morbidities and the use of drugs also did not differ in the two groups. Our study suggests that the high prevalence of RLS among patients on HD requires careful attention and correct diagnosis can lead to better therapy and better quality of life. The pathogenesis of RLS is not clear and further studies are required to identify any possible cause as well as to discover the impact of this syndrome on sleep, quality of life, and possibly other complications such as cardiovasculare disease.
Bourbakis, N. G.; Maas, M.; Tascillo, A.; Vandewinckel, C.
ODYSSEUS is an autonomous walking robot, which makes use of three wheels and three legs for its movement in the free navigation space. More specifically, it makes use of its autonomous wheels to move around in an environment where the surface is smooth and not uneven. However, in the case that there are small height obstacles, stairs, or small height unevenness in the navigation environment, the robot makes use of both wheels and legs to travel efficiently. In this paper we present the detailed hardware design and the simulated behavior of the extended leg/arm part of the robot, since it plays a very significant role in the robot actions (movements, selection of objects, etc.). In particular, the leg/arm consists of three major parts: The first part is a pipe attached to the robot base with a flexible 3-D joint. This pipe has a rotated bar as an extended part, which terminates in a 3-D flexible joint. The second part of the leg/arm is also a pipe similar to the first. The extended bar of the second part ends at a 2-D joint. The last part of the leg/arm is a clip-hand. It is used for selecting several small weight and size objects, and when it is in a 'closed' mode, it is used as a supporting part of the robot leg. The entire leg/arm part is controlled and synchronized by a microcontroller (68CH11) attached to the robot base.
Bertisch, Suzanne M; Muresan, Cristen; Schoerning, Laura; Winkelman, John W; Taylor, J Andrew
To examine whether patients with restless legs syndrome demonstrate specific alterations in cardiovascular autonomic control. Patients with moderate-severe restless legs syndrome (n = 20, 80% female) and controls (n = 20) matched for age, sex, body mass index, and free of hypertension and cardiovascular disease were enrolled. We assessed cardiovagal baroreflex gain via the modified Oxford technique, sympathetically mediated vascular responses to isometric exercise to fatigue, bradycardiac response to Valsalva maneuver, and respiratory sinus arrhythmia during paced breathing. Standard electrocardiography, beat-by-beat arterial pressure, respiration, and popliteal blood flow velocity were recorded continuously. Resting blood pressure and heart rate were similar between groups. However, baroreflex gain averaged 14.3 ± 1.4 msec/mm Hg in restless legs syndrome and was lower than in controls (22.6 ± 3.5 msec/mm Hg, P = 0.04). Hemodynamic responses to isometric exercise were similar between groups, though participants with restless legs syndrome had lower leg blood flow (P leg vascular resistance (P restless legs syndrome demonstrate compromised cardiovagal control, specific to the arterial baroreflex, with greater peripheral vascular resistance, potentially due to heightened sympathetic outflow. These autonomic alterations may directly relate to the higher prevalence of cardiovascular disease in restless legs syndrome. © 2016 Associated Professional Sleep Societies, LLC.
Hallegraeff, Joannes; de Greef, Mathieu; Krijnen, Wim; van der Schans, Cees
Background: Up to 33% of the general population over 50 years of age are affected by nocturnal leg cramps. Currently there are no generally accepted clinical characteristics, which identify nocturnal leg cramps. This study aims to identify these clinical characteristics and to differentiate between
... Español How Can I Relieve My Pregnancy Leg Cramps? KidsHealth / For Parents / How Can I Relieve My Pregnancy Leg Cramps? Print Now that I'm in my third trimester, I keep getting these painful cramps in my calves. Sometimes they even wake me ...
Full Text Available Differential enlargement of hind (T3 legs represents one of the hallmarks of insect evolution. However, the actual mechanism(s responsible are yet to be determined. To address this issue, we have now studied the molecular basis of T3 leg enlargement in Oncopeltus fasciatus (milkweed bug and Acheta domesticus (house cricket. In Oncopeltus, the T3 tibia displays a moderate increase in size, whereas in Acheta, the T3 femur, tibia, and tarsus are all greatly enlarged. Here, we show that the hox gene Ultrabithorax (Ubx is expressed in the enlarged segments of hind legs. Furthermore, we demonstrate that depletion of Ubx during embryogenesis has a primary effect in T3 legs and causes shortening of leg segments that are enlarged in a wild type. This result shows that Ubx is regulating the differential growth and enlargement of T3 legs in both Oncopeltus and Acheta. The emerging view suggests that Ubx was co-opted for a novel role in regulating leg growth and that the transcriptional modification of its expression may be a universal mechanism for the evolutionary diversification of insect hind legs.
METHODS: A seven-year-old boy presented with four separate episodes of acute compartment syndrome of the legs within three years. The recurrent nature of the illness prompted detail review of the records of the child. RESULTS: There was involvement of each leg twice between the ages of three and seven years ...
Objective: To review in-patient management of leg ulcers and to compare our experiences with those from other similar centres. Design: A retrospective study. Setting: University of Benin Teaching Hospital, Nigeria. Patients: Forty five patients hospitalisad with leg ulcers. Results: There were 27 male and 18 females (MF 3:2) ...
A study was carried out to investigate the occurrence and causes of leg ailment in poultrythrough questionnaire survey and farm visitation. Post mortem and laboratory examination were also conducted. The results showed that different species of poultry were affected with varous types of leg ailments; out of which local ...
Mellemkjær, L; Christensen, J; Frederiksen, K
Tallness has consistently been associated with an increased risk of breast cancer. We investigated the association further by decomposing height into leg length and sitting height.......Tallness has consistently been associated with an increased risk of breast cancer. We investigated the association further by decomposing height into leg length and sitting height....
Persoon, A.; Heinen, M.M.; Vleuten, C.J.M. van der; Rooij, M.J.M. de; Kerkhof, P.C.M. van de; Achterberg, T. van
BACKGROUND: Current nursing care for leg ulcer patients often focuses on wound care and providing compression therapy. Nurses perceive leg ulcer patients as 'under-served' with regard to problems patients experience in daily life. An overview of patient problems is a first and essential step in the
S.W.I. Reeder (Suzan); M.B. Maessen-Visch (Birgitte); S.I. Langendoen; K.P. de Roos; H.A.M. Neumann (Martino)
textabstractIntroduction: In general, four particular causes of recalcitrant venous leg ulcers may be distinguished. These are foot pump insufficiency, chronic venous compartment syndrome and non-re-canalized popliteal vein thrombosis. The fourth cause of recalcitrant venous leg ulcers is
Rohrseitz, Kristin; Kilpinen, Ole
The leg vibrations of honeybees standing on a vibrating substrate were measured with laser Doppler vibrometry, both in freely standing bees and in bees attached to a holder. In both cases, no resonances were found. In the fixed bee preparation, the legs moved with approximately the same amplitude...
Mahfooz, Najmus; Turchyn, Nataliya; Mihajlovic, Michelle; Hrycaj, Steven; Popadić, Aleksandar
Differential enlargement of hind (T3) legs represents one of the hallmarks of insect evolution. However, the actual mechanism(s) responsible are yet to be determined. To address this issue, we have now studied the molecular basis of T3 leg enlargement in Oncopeltus fasciatus (milkweed bug) and Acheta domesticus (house cricket). In Oncopeltus, the T3 tibia displays a moderate increase in size, whereas in Acheta, the T3 femur, tibia, and tarsus are all greatly enlarged. Here, we show that the hox gene Ultrabithorax (Ubx) is expressed in the enlarged segments of hind legs. Furthermore, we demonstrate that depletion of Ubx during embryogenesis has a primary effect in T3 legs and causes shortening of leg segments that are enlarged in a wild type. This result shows that Ubx is regulating the differential growth and enlargement of T3 legs in both Oncopeltus and Acheta. The emerging view suggests that Ubx was co-opted for a novel role in regulating leg growth and that the transcriptional modification of its expression may be a universal mechanism for the evolutionary diversification of insect hind legs. PMID:17848997
Naldini, Angelica; Rossitto, Cristiano; Morciano, Andrea; Panico, Giovanni; Campagna, Giuseppe; Paparella, Pierluigi; Scambia, Giovanni
INTRODUCTION The current management of vulvar cancer depends on the extension of disease, and includes primary tumor resection with safety margin as well as inguinofemoral lymph node staging. We report the case of the first leg videoendoscopic inguinal lymphadenectomy performed in a woman with a squamous cell vulvar carcinoma. PRESENTATION OF CASE A 74 years old female referred to our institution complaining of vulvar mass associated with bleeding and swelling from external genitals, vaginal burning sensation and dysuria for 5 months. A vulvar–vaginal examination under narcosis reported a right major labium lesion of 5 cm with an irregular and ulcerated surface, easily bleeding on palpation, involving anteriorly the clitoral region and with a histological finding of a poorly differentiated squamous cell invasive carcinoma of the vulva ulcerating the surface epithelium. We performed, after adequate informed consent, a radical vulvectomy with a standard right inguinofemoral lymphadenectomy and a contralateral simultaneous video endoscopic inguinal lymphadenectomy-Leg procedure. DISCUSSION Our minimally invasive VEIL-Leg approach, performed for the first time in literature in a woman with vulvar cancer, could reduce the presence of high risk factors represented by surgical incision and by procedure-related complications, including wound infection and breakdown, hematoma, cellulitis and hernia formation. CONCLUSION A multicenter prospective randomized study will be helpful to clarify how this procedure could replace the standard laparotomic approach to inguinal lymphadenectomy in the vulvar cancer treatment and staging. PMID:24973526
Buyalich, Gennady; Buyalich, Konstantin; Byakov, Maxim
The factors that directly influence the formation of a sealing clearance between the piston and the working cylinder in hydraulic legs of powered supports are considered in this article, the size thereof has a direct effect on the tightness of the legs and, as a result, on the safety of work at the production face. A detailed description of these factors is given, which is supported by the dependencies obtained from the results of finite element modeling of various types of legs under various strength and geometric parameters, external load types and locations in the support section. The problems of formation of radial deformations of a working cylinder loaded with working fluid pressure are considered, and their dependence on the level of this pressure and extension. Based on the simulation results, the mechanisms for the formation of additional clearances due to rod and cylinder misalignments are described, and the conditions and causes of the resonant phenomena development are given. The classification of these factors according to the degree of generalization and the functional interaction between each other is proposed.
Full Text Available No abstract available. Article truncated at 150 words. History of Present Illness: A 46-year-old transferred due to concern for necrotizing fasciitis. One the day prior to transfer purple discoloration was not noted in the lower portion of the left leg. On the day of transfer the leg became more purple, painful, and swollen. She presented to a pain clinic that advised her to go to an emergency room. The emergency room performed arterial Doppler ultrasound, which was normal and transferred her due to concern of necrotizing fasciitis. Past Medical History, Social History and Family History: She has a past medical history of fibromyalgia. She had an extensive surgical history including an appendectomy, bladder implant, cholecystectomy, dilatation and curettage, esophageal repair, left femoral artery repair due to a motor vehicle accident, partial hysterectomy, left knee surgery, and several left leg operations with grafting. Family history was non-contributory. The patient was single with two children, and smoked 1-2 packs of ...
Sindrup, J H; Kastrup, J; Kristensen, J K
The blood flow rate in subcutaneous adipose tissue was measured on the lower legs of 11 patients with chronic lower-leg venous insufficiency and ulceration and in eight age-matched control subjects for 12-20 h, under ambulatory conditions, using the 133Xe wash-out technique with portable Cadmium...... telluride (CdTe(Cl)) detectors. In both groups, the change from an upright to a supine position at the beginning of the night period elicited an instantaneous increment in the blood flow rate of 30-40% with a decrease in the central and local postural sympathetic vasoconstrictor activity. After...... approximately 1 h of sleep, a considerable increase in blood flow rate was seen in both patient and control groups which persisted for nearly 100 min. In the patient group, the mean increase was 137% compared to a mean increase of 68% in the control group (P less than 0.01). The blood flow then returned...
Ferri, Raffaele; Rundo, Francesco; Silvani, Alessandro; Zucconi, Marco; Aricò, Debora; Bruni, Oliviero; Lanuzza, Bartolo; Ferini-Strambi, Luigi; Manconi, Mauro
Periodic leg movements during sleep (PLMS) are sequences of ≥4 motor events with intermovement intervals (IMI) of 10-90 s. PLMS are a supportive diagnostic criterion for restless legs syndrome (RLS) and entail cardiac activation, particularly when associated with arousal. RLS patients also over-express short-interval leg movements during sleep (SILMS), which have IMI leg movements. We found that the duration of the R-R interval decrease with SILMS doublets was significantly longer than that with PLMS, whereas the maximal decrease in R-R interval was similar. Scoring SILMS in RLS patients may therefore be relevant from a cardiac autonomic perspective. © 2017 European Sleep Research Society.
evenly throughout the body, all mounted on the waterjet cut frame. Through the use of a USB bus as the common communication method within the robot...according to the overarching “spring assisted actuation” hypothesis just described. The body of Canid is similar to XRL, built from waterjet cut aluminum...on cheap, relatively fast turn-around water jet cut frame components and compliant leg and spine materials offers some useful lessons in effective
Nicolas H. Hart, Jodie L. Cochrane, Tania Spiteri, Sophia Nimphius, Robert U. Newton
Full Text Available Kicking a ball accurately over a desired distance to an intended target is arguably the most important skill to acquire in Australian Football. Therefore, understanding the potential mechanisms which underpin kicking accuracy is warranted. The aim of this study was to examine the relationship between leg mass, leg composition and foot velocity on kicking accuracy in Australian Football. Thirty-one Australian Footballers (n = 31; age: 22.1 ± 2.8 years; height: 1.81 ± 0.07 m; weight: 85.1 ± 13.0 kg; BMI: 25.9 ± 3.2 each performed ten drop punt kicks over twenty metres to a player target. Athletes were separated into accurate (n = 15 and inaccurate (n = 16 kicking groups. Leg mass characteristics were assessed using whole body DXA scans. Foot velocity was determined using a ten-camera optoelectronic, three-dimensional motion capture system. Interactions between leg mass and foot velocity evident within accurate kickers only (r = -0.670 to -0.701. Relative lean mass was positively correlated with kicking accuracy (r = 0.631, while no relationship between foot velocity and kicking accuracy was evident in isolation (r = -0.047 to -0.083. Given the evident importance of lean mass, and its interaction with foot velocity for accurate kickers; future research should explore speed-accuracy, impulse-variability, limb co-ordination and foot-ball interaction constructs in kicking using controlled with-in subject studies to examine the effects of resistance training and skill acquisition programs on the development of kicking accuracy.
Braught, Grant; Thomopoulos, Stelios C.
Natural selection is responsible for the creation of robust and adaptive control systems. Nature's control systems are created only from primitive building blocks. Using insect neurophysiology as a guide, a neural architecture for leg coordination in a hexapod robot has been developed. Reflex chains and sensory feedback mechanisms from various insects and crustacea form the basis of a pattern generator for intra-leg coordination. The pattern generator contains neural oscillators which learn from sensory feedback to produce stepping patterns. Using sensory feedback as the source of learning information allows the pattern generator to adapt to changes in the leg dynamics due to internal or external causes. A coupling between six of the single leg pattern generators is used to produce the inter-leg coordination necessary to establish stable gaits.
Picchietti, Daniel L; Hensley, Jennifer G; Bainbridge, Jacquelyn L; Lee, Kathryn A; Manconi, Mauro; McGregor, James A; Silver, Robert M; Trenkwalder, Claudia; Walters, Arthur S
Restless legs syndrome (RLS)/Willis-Ekbom disease (WED) is common during pregnancy, affecting approximately one in five pregnant women in Western countries. Many report moderate or severe symptoms and negative impact on sleep. There is very little information in the medical literature for practitioners on the management of this condition during pregnancy. Accordingly, a task force was chosen by the International RLS Study Group (IRLSSG) to develop guidelines for the diagnosis and treatment of RLS/WED during pregnancy and lactation. A committee of nine experts in RLS/WED and/or obstetrics developed a set of 12 consensus questions, conducted a literature search, and extensively discussed potential guidelines. Recommendations were approved by the IRLSSG executive committee, reviewed by IRLSSG membership, and approved by the WED Foundation Medical Advisory Board. These guidelines address diagnosis, differential diagnosis, clinical course, and severity assessment of RLS/WED during pregnancy and lactation. Nonpharmacologic approaches, including reassurance, exercise and avoidance of exacerbating factors, are outlined. A rationale for iron supplementation is presented. Medications for RLS/WED are risk/benefit rated for use during pregnancy and lactation. A few are rated "may be considered" when RLS/WED is refractory to more conservative approaches. An algorithm summarizes the recommendations. These guidelines are intended to improve clinical practice and promote further research. Copyright © 2014. Published by Elsevier Ltd.
Restless legs syndrome (RLS) is a common neurological disorder. Dementia with Lewy bodies (DLB) is the second most common form of neurodegenerative dementia after Alzheimer's disease. Both RLS and DLB can be effectively treated by dopaminergic medications, suggesting the role of dopamine dysfunction in the pathogenesis of both diseases. Here, I report on a Japanese woman with probable DLB and RLS who was treated with gabapentin enacarbil, a non-dopaminergic agent. Because a dopamine agonist, a first-line therapy for moderate to severe RLS, caused the occurrence of metamorphopsia, an alternative treatment of gabapentin enacarbil was used; this treatment improved the patient's RLS without worsening her psychiatric symptoms. An alternative treatment is desirable for DLB patients with RLS because they often experience intolerable side-effects with a dopamine agonist, especially visual hallucinations. Administering gabapentin enacarbil also improved the continuous leg pain that occurred in conjunction with the development of RLS. Although the neurobiological mechanism in the development of pain remains unclear, a range of non-dopaminergic structures likely mediated pain processing in DLB in the present case based on neuropharmacological results. This is the first report reporting the effects of gabapentin enacarbil for RLS and leg pain in a DLB patient with psychiatric symptoms. © 2014 The Author. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.
Full Text Available We examined the effect of walk training combined with blood flow restriction (BFR on the size of blood flow-restricted distal muscles, as well as, on the size of non-restricted muscles in the proximal limb and trunk. Nine men performed walk training with BFR and 8 men performed walk training alone. Training was conducted two times a day, 6 days/wk, for 3 wk using five sets of 2-min bouts (treadmill speed at 50 m/min, with a 1-min rest between bouts. After walk training with BFR, MRI-measured upper (3.8%, P < 0.05 and lower leg (3.2%, P < 0. 05 muscle volume increased significantly, whereas the muscle volume of the gluteus maximus (-0.6% and iliopsoas (1.8% and the muscle CSA of the lumber L4-L5 (-1.0 did not change. There was no significant change in muscle volume in the walk training alone. Our results suggest that the combination of leg muscle blood flow restriction with slow walk training elicits hypertrophy only in the distal blood flow restricted leg muscles. Exercise intensity may be too low during BFR walk training to increase muscle mass in the non- blood flow restricted muscles (gluteus maximus and other trunk muscles.
Petersen, Karin K; Hørlyck, Arne; Ostergaard, Kristine H; Andresen, Joergen; Broegger, Torbjoern; Skovgaard, Nini; Telinius, Niklas; Laher, Ismael; Bertelsen, Mads F; Grøndahl, Carsten; Smerup, Morten; Secher, Niels H; Brøndum, Emil; Hasenkam, John M; Wang, Tobias; Baandrup, Ulrik; Aalkjaer, Christian
The high blood pressure in giraffe leg arteries renders giraffes vulnerable to edema. We investigated in 11 giraffes whether large and small arteries in the legs and the tight fascia protect leg capillaries. Ultrasound imaging of foreleg arteries in anesthetized giraffes and ex vivo examination revealed abrupt thickening of the arterial wall and a reduction of its internal diameter just below the elbow. At and distal to this narrowing, the artery constricted spontaneously and in response to norepinephrine and intravascular pressure recordings revealed a dynamic, viscous pressure drop along the artery. Histology of the isolated median artery confirmed dense sympathetic innervation at the narrowing. Structure and contractility of small arteries from muscular beds in the leg and neck were compared. The arteries from the legs demonstrated an increased media thickness-to-lumen diameter ratio, increased media volume, and increased numbers of smooth muscle cells per segment length and furthermore, they contracted more strongly than arteries from the neck (500 ± 49 vs. 318 ± 43 mmHg; n = 6 legs and neck, respectively). Finally, the transient increase in interstitial fluid pressure following injection of saline was 5.5 ± 1.7 times larger (n = 8) in the leg than in the neck. We conclude that 1) tissue compliance in the legs is low; 2) large arteries of the legs function as resistance arteries; and 3) structural adaptation of small muscle arteries allows them to develop an extraordinary tension. All three findings can contribute to protection of the capillaries in giraffe legs from a high arterial pressure.
Marx, Ronald W.; Walsh, John
Offers a descriptive theory of the nature of classroom tasks. Describes the interplay among (1) the conditions under which tasks are set; (2) the cognitive plans students use to accomplish tasks; and (3) the products students create as a result of their task-related efforts. (SKC)
Boonstra, T.W.; Daffertshofer, A.; Roerdink, M.; Flipse, I.; Groenewoud, K.; Beek, P.J.
To handle the rich repertoire of behavioural goals, the CNS has to control the many degrees of freedom of the musculoskeletal system in a flexible manner. This problem can be drastically simplified if muscle synergies serve as the to-be-controlled building blocks of motor performance, instead of the
Full Text Available Luke S Hopper,1 Nahoko Sato,2 Andries L Weidemann1 1Western Australian Academy of Performing Arts, Edith Cowan University, Mt Lawley, WA, Australia; 2Department of Physical Therapy, Nagoya Gakuin University, Seto, Japan Abstract: The physical assessments used in dance injury surveillance programs are often adapted from the sports and exercise domain. Bespoke physical assessments may be required for dance, particularly when ballet movements involve “turning out” or external rotation of the legs beyond that typically used in sports. This study evaluated the ability of the traditional single-leg squat to predict the leg alignment of dancers performing ballet movements with turnout. Three-dimensional kinematic data of dancers performing the single-leg squat and five ballet movements were recorded and analyzed. Reduction of the three-dimensional data into a one-dimensional variable incorporating the ankle, knee, and hip joint center positions provided the strongest predictive model between the single-leg squat and the ballet movements. The single-leg squat can predict leg alignment in dancers performing ballet movements, even in “turned out” postures. Clinicians should pay careful attention to observational positioning and rating criteria when assessing dancers performing the single-leg squat. Keywords: injury, motion capture, clinical assessment
Haines, Matthew; Hess, Bryan; Mehrotra, Piyush; Vanrosendale, John; Zima, Hans
We have recently introduced a set of Fortran language extensions that allow for integrated support of task and data parallelism, and provide for shared data abstractions (SDA's) as a method for communications and synchronization among these tasks. In this paper we discuss the design and implementation issues of the runtime system necessary to support these extensions, and discuss the underlying requirements for such a system. To test the feasibility of this approach, we implement a prototype of the runtime system and use this to support an abstract multidisciplinary optimization (MDO) problem for aircraft design. We give initial results and discuss future plans.
Alejandra Mejia Tobar
Full Text Available The classification of ankle movements from non-invasive brain recordings can be applied to a brain-computer interface (BCI to control exoskeletons, prosthesis, and functional electrical stimulators for the benefit of patients with walking impairments. In this research, ankle flexion and extension tasks at two force levels in both legs, were classified from cortical current sources estimated by a hierarchical variational Bayesian method, using electroencephalography (EEG and functional magnetic resonance imaging (fMRI recordings. The hierarchical prior for the current source estimation from EEG was obtained from activated brain areas and their intensities from an fMRI group (second-level analysis. The fMRI group analysis was performed on regions of interest defined over the primary motor cortex, the supplementary motor area, and the somatosensory area, which are well-known to contribute to movement control. A sparse logistic regression method was applied for a nine-class classification (eight active tasks and a resting control task obtaining a mean accuracy of 65.64% for time series of current sources, estimated from the EEG and the fMRI signals using a variational Bayesian method, and a mean accuracy of 22.19% for the classification of the pre-processed of EEG sensor signals, with a chance level of 11.11%. The higher classification accuracy of current sources, when compared to EEG classification accuracy, was attributed to the high number of sources and the different signal patterns obtained in the same vertex for different motor tasks. Since the inverse filter estimation for current sources can be done offline with the present method, the present method is applicable to real-time BCIs. Finally, due to the highly enhanced spatial distribution of current sources over the brain cortex, this method has the potential to identify activation patterns to design BCIs for the control of an affected limb in patients with stroke, or BCIs from motor imagery
Fereydounnia, Sara; Shadmehr, Azadeh; Talebian Moghadam, Saeed; Olyaei, Gholamreza; Jalaie, Shohreh; Tahmasebi, Ali
The aim of this study was to investigate premotor time, motor time and reaction time of the injured and non-injured leg muscles of athletes with chronic ankle instability in response to a visual stimulus during forward jumping. Surface electromyography was performed on injured and non-injured leg of eight athletes with chronic ankle instability during forward jumping. Results showed that premotor time of the peroneus longus was significantly longer in non-injured leg compared with injured leg (489.37 ± 220.22 ms vs. 306.46 ± 142.92 ms, P = 0.031); on the contrary, motor time of the peroneus longus was significantly shorter in non-injured leg compared with injured leg (569.04 ± 318.62 ms vs. 715.12 ± 328.72 ms, P = 0.022). No significant difference was noted in the timing of other calf muscles (P > 0.05). According to the results of this study, rehabilitation protocols, regarding ankle instability, need to put greater emphasis on tasks that require proper timing of muscles and muscle re-education so that protocols could reduce residual symptoms after sprain and prevent recurrent sprains. Copyright © 2015 Elsevier Ltd. All rights reserved.
Fulda, Stephany; Beitinger, Marie E; Reppermund, Simone; Winkelmann, Juliane; Wetter, Thomas C
Restless legs syndrome (RLS) is a frequent sleep-related movement disorder with disturbed sleep and quality of life. RLS patients complain about increased daytime sleepiness, but there are only few and inconsistent reports about cognitive functioning in this group. We compared cognitive performance of 23 unmedicated RLS patients to that of 23 healthy controls matched individually for age, gender, and educational level. Cognitive tasks were chosen to assess short-term attention, working memory, learning and memory, verbal fluency, and executive functioning. RLS patients performed worse than controls in the area of attention and verbal fluency, and performance in these tasks was associated with RLS severity, sleep quality, depression scores, and memory. There was no difference for working memory, memory, learning, cognitive flexibility, and abstract reasoning. We conclude that there is evidence for deficits in short-term attention and verbal fluency in RLS patients. © 2010 Movement Disorder Society.
Gombe, Sani Yakubu; Bin Suandi, Turiman; Ismail, Ismi Arif; Omar, Zohara
Research in extension education is a serious and challenging task facing Nigeria today because of new trends that keeps on emerging continuously. This paper seeks to examine some of the common research techniques used in extension education and describe their applicability and workability in helping people to help themselves. Most of the…
Full Text Available A biped robot with heterogeneous legs (BRHL is proposed to provide an ideal test-bed for intelligent bionic legs (IBL. To make artificial leg gait better suited to a human, a four-bar mechanism is used as its knee joint, and a pneumatic artificial muscle (PAM is used as its driving source. The static mathematical model of PAM is established and the mechanical model of a single degree of freedom of a knee joint driven by PAM is analyzed. A control simulation of an artificial leg based on PID control algorithm is carried out and the simulation results indicate that the artificial leg can simulate precisely a normal human walking gait.
McInerney, Tim; Akhavan Sharif, M. Reza; Pashotanizadeh, Nasrin
Snakes (Active Contour Models) are powerful model-based image segmentation tools. Although researchers have proven them especially useful in medical image analysis over the past decade, Snakes have remained primarily in the academic world and they have not become widely used in clinical practice or widely available in commercial packages. A number of confusing and specialized variants exist and there has been no standard open-source implementation available. To address this problem, we present a Java Extensible Snakes System (JESS) that is general, portable, and extensible. The system uses Java Swing classes to allow for the rapid development of custom graphical user interfaces (GUI's). It also incorporates the Java Advanced Imaging(JAI) class library, which provide custom image preprocessing, image display and general image I/O. The Snakes algorithm itself is written in a hierarchical fashion, consisting of a general Snake class and several subclasses that span the main variants of Snakes including a new, powerful, robust subdivision-curve Snake. These subclasses can be easily and quickly extended and customized for any specific segmentation and analysis task. We demonstrate the utility of these classes for segmenting various anatomical structures from 2D medical images. We also demonstrate the effectiveness of JESS by using it to rapidly build a prototype semi-automatic sperm analysis system. The JESS software will be made publicly available in early 2005.
Möller, Caroline; Wetter, Thomas C; Köster, Jürgen; Stiasny-Kolster, Karin
Restless legs syndrome (RLS) is a common neurological condition. We investigated the prevalence of RLS in patients suffering from unpleasant sensations in the legs. We included 16,543 patients consulting one of 312 primary care practices in Germany on November 8, 2007. All patients filled out a self-assessment questionnaire. Patients who reported suffering from unpleasant sensations in the legs were then assessed by the physician. Main outcome measures were the overall prevalence of unpleasant sensations in the legs and the prevalence of RLS; the most common differential diagnoses in the subpopulation suffered from unpleasant leg sensations. Out of all participating patients 7704 (46.6%) suffered from unpleasant sensations in the legs and 1758 (10.6%) were diagnosed with RLS according to the four essential clinical criteria. Among patients with unpleasant leg sensations, the prevalence of RLS was considerably higher (22.7%) than in the total population. The most common differential diagnoses were osteoarthritis (21.5%), disc lesion (19.2%), varicose veins (18.8%) and muscle cramps (14.6%). Of the patients with RLS 53.4% had already consulted their physician about their leg problems in the past. Still, only 20.1% of the RLS patients had received the correct diagnosis. Comorbidity rates were significantly increased in RLS patients compared to patients suffering from leg symptoms of other origin. This study showed a high prevalence of RLS in primary care patients with unpleasant sensations in the legs. Thus, in patients presenting with these symptoms the diagnosis of RLS should routinely be considered. 2009 Elsevier B.V. All rights reserved.
We introduce type extension trees as a formal representation language for complex combinatorial features of relational data. Based on a very simple syntax this language provides a unified framework for expressing features as diverse as embedded subgraphs on the one hand, and marginal counts...... of attribute values on the other. We show by various examples how many existing relational data mining techniques can be expressed as the problem of constructing a type extension tree and a discriminant function....
The problem of the existence of local extensions of spacetime is considered. It is shown that for a spacetime including an incomplete inextendible non-coiling causal geodesic curve there exists a particular C k (resp. C k- ) local extension provided that the curvature and its covariant derivatives are well behaved up to order k + 1 (resp. k) along a family of causal geodetics (around the chosen one). (R.P.) 15 refs
Fu, Jianxun; Gao, Feng
Researchers seldom study optimum design of a six-degree-of-freedom(DOF) parallel manipulator with three legs based upon the given workspace. An optimal design method of a novel three-leg six-DOF parallel manipulator(TLPM) is presented. The mechanical structure of this robot is introduced, with this structure the kinematic constrain equations is decoupled. Analytical solutions of the forward kinematics are worked out, one configuration of this robot, including position and orientation of the end-effector are graphically displayed. Then, on the basis of several extreme positions of the kinematic performances, the task workspace is given. An algorithm of optimal designing is introduced to find the smallest dimensional parameters of the proposed robot. Examples illustrate the design results, and a design stability index is introduced, which ensures that the robot remains a safe distance from the boundary of sits actual workspace. Finally, one prototype of the robot is developed based on this method. This method can easily find appropriate kinematic parameters that can size a robot having the smallest workspace enclosing a predefined task workspace. It improves the design efficiency, ensures that the robot has a small mechanical size possesses a large given workspace volume, and meets the lightweight design requirements.
AlJahdali, Hamdan H; AlQadhi, Waleed A; Khogeer, Haithm A; AlHejaili, Fayez F; Al Sayyari, Abdullah A; AlGhamdi, Saeed M
Restless legs syndrome (RLS) is an extremely distressing problem experienced by patients on dialysis; the prevalence appears to be greater than in the general population, with a wide variation from 6.6% to 80%. The diagnosis of RLS is a clinical one, and its definition has been clarified and standardized by internationally recognized diagnostic criteria, published in 1995 by the International Restless Legs Syndrome Study Group (IRLSSG). This study was designed to find out the prevalence of RLS in Saudi patients with end-stage renal disease (ESRD) on maintenance dialysis. This is a cross sectional study carried out between May and Sept 2007 at two centers, King Abdulaziz Medical City-King Fahad National Guard Hospital (KAMC-KFNGH), Riyadh and King Faisal Specialist Hospital and Research Centre (KFHRC), Jeddah, Saudi Arabia. Data were gathered on 227 Saudi patients on chronic maintenance hemodialysis or chronic peritoneal dialysis. The prevalence of RLS was measured using IRLSSG's RLS Questionnaire (RLSQ). Potential risk factors for RLS including other sleep disorders, underlying cause of chronic renal failure, duration on dialysis, dialysis shift, biochemical tests and demographic data were also evaluated. The overall prevalence of RLS was 50.22% including 53.7% males and 46.3% females. Their mean age was 55.7 + - 17.2 years and mean duration on dialysis 40.4 + - 37.8 months. Significant predictors of RLS were history of diabetes mellitus (DM), coffee intake, afternoon dialysis, gender and type of dialysis (P= 0.03, 0.01, < 0.001, 0.05 and 0.009 respectively). Patients with RLS were found to be at increased risk of having insomnia and excessive daytime sleepiness (EDS) (P= < 0.001 and 0.001, respectively). Our study suggests that RLS is a very common problem in dialysis population and was significantly associated with other sleep disorders, particularly insomnia, and EDS. Optimal care of dialysis patient should include particular attention to the diagnosis and
Full Text Available Restless legs syndrome (RLS is an extremely distressing problem experienced by patients on dialysis; the prevalence appears to be greater than in the general population, with a wide variation from 6.6% to 80%. The diagnosis of RLS is a clinical one, and its definition has been clarified and standardized by internationally recognized diagnostic criteria, published in 1995 by the International Restless Legs Syndrome Study Group (IRLSSG. This study was designed to find out the prevalence of RLS in Saudi patients with end-stage renal disease (ESRD on maintenance dialysis. This is a cross sectional study carried out between May and Sept 2007 at two centers, King Abdulaziz Medical City-King Fahad National Guard Hospital (KAMC-KFNGH, Riyadh and King Faisal Specialist Hospital and Research Centre (KFHRC, Jeddah, Saudi Arabia. Data were gathered on 227 Saudi patients on chronic maintenance hemodialysis or chronic peritoneal dialysis. The prevalence of RLS was measured using IRLSSG′s RLS Questionnaire (RLSQ. Potential risk factors for RLS including other sleep disorders, underlying cause of chronic renal failure, duration on dialysis, dialysis shift, biochemical tests and demographic data were also evaluated. The overall prevalence of RLS was 50.22% including 53.7% males and 46.3% females. Their mean age was 55.7 ± 17.2 years and mean duration on dialysis 40.4 ± 37.8 months. Significant predictors of RLS were history of diabetes mellitus (DM, coffee intake, afternoon dialysis, gender and type of dialysis (P= 0.03, 0.01, < 0.001, 0.05 and 0.009 respectively. Patients with RLS were found to be at increased risk of having insomnia and excessive daytime sleepiness (EDS (P= < 0.001 and 0.001, respectively. Our study suggests that RLS is a very common problem in dialysis population and was significantly associated with other sleep disorders, particularly insomnia, and EDS. Optimal care of dialysis patient should include particular attention to the diagnosis
HALBERTSMA, JPK; GOEKEN, LNH
Passive muscle stretch tests are common practice in physical therapy and rehabilitation medicine. However, the effects of stretching exercises are not well known. With an instrumental straight-leg-raising set-up the extensibility, stiffness, and electromyographic activity of the hamstring muscles
Jiangmei, Zhang; Binfeng, Yu; Haibo, Ji; Wang, Kunpeng
Multi-task learning can extract the correlation of multiple related machine learning problems to improve performance. This paper considers applying the multi-task learning method to learn a single task. We propose a new learning approach, which employs the mixture of expert model to divide a learning task into several related sub-tasks, and then uses the trace norm regularization to extract common feature representation of these sub-tasks. A nonlinear extension of this approach by using kernel is also provided. Experiments conducted on both simulated and real data sets demonstrate the advantage of the proposed approach.
Full Text Available Multi-task learning can extract the correlation of multiple related machine learning problems to improve performance. This paper considers applying the multi-task learning method to learn a single task. We propose a new learning approach, which employs the mixture of expert model to divide a learning task into several related sub-tasks, and then uses the trace norm regularization to extract common feature representation of these sub-tasks. A nonlinear extension of this approach by using kernel is also provided. Experiments conducted on both simulated and real data sets demonstrate the advantage of the proposed approach.
Ylönen, M; Stolt, M; Leino-Kilpi, H; Suhonen, R
There is an increasing prevalence of venous leg ulcers coinciding with increasing older people populations. They are therefore important health problems, which restrict daily activities and incur high costs. Efficient and comprehensive nursing care for people with venous leg ulcers requires knowledge of causes, presentations and characteristics, the effects that venous leg ulcers have on individuals and nursing care with evidence-based treatment. To identify the gaps between nurses' demonstrated knowledge of venous leg ulcers and the related nursing care treatment with evidence-based nursing care. A computerized search using MEDLINE, CINAHL the COCHRANE LIBRARY was conducted. The initial search yielded 174 citations from which 16 relevant articles were included in this review. Four themes in venous leg ulcer nursing care emerged demonstrating nurses' knowledge gaps: assessment, physiology and the healing process, nursing care and dressings, and compression treatment. This review suggests that there is a lack of knowledge related to venous leg ulcer physiology, the healing process and how this influences care and treatment. Nurses may not be using the evidence base sufficiently well to support ulcer healing and patient well-being. There is a need for a positive work culture development and ongoing educational programmes aimed at improving nurses' knowledge of venous leg ulcer treatment and care, which address the themes within the results of this review. © 2014 International Council of Nurses.
Full Text Available Multiped robots have become the focus of heated discussion lately, especially in applications involving rescue or military missions and underwater or extra-terrestrial explorations. The surroundings concerned are harsh and hazardous terrains, and predictably the malfunction rate is high. What if a leg is irreparably damaged? The original gait can no longer be used and an alternative gait must be taken for the robot to continue its mission. This paper studies and enumerates preferred alternative gaits for six- and eight-legged robots under a proposed severed leg scheme. A leg is assumed to be completely detachable when a failure occurs. Based on a new criterion called the progressive efficiency (PE, defined via the enhanced gait charts, along with other criteria like the stride length and the longitudinal stability, alternative gaits are evaluated. The tables of recommended gaits in this paper are useful for robots when a leg failure is foreseen. These tables not only provide a guideline as to what alternative gait to use, they also give insight into how important a certain leg is. A comparison between the severed leg scheme and the existing locked-joint strategy is also included.
Antosiak-Cyrak Katarzyna Z.
Full Text Available Purpose. The aim of the present study was assessment of laterality of the legs of young female soccer players and their non-training counterparts. Methods. The study sample comprised 9 female soccer players and 19 non-training girls. They underwent three measurement sessions, one every six months. The applied tests included kinesthetic differentiation, rate of local movements, static balance, single-leg hop, rate of global movements, strength and speed, and functional asymmetry of the legs tests. Results. The soccer players were better than the controls in their performance of the rate of local movements, rate of global movements, kinesthetic differentiation, single-leg 15m timed hop and static balance tests. Smaller differences between the results of the left and the right legs in soccer players, than in non-training girls, were noted in the rate of local movements, rate of global movements and kinesthetic differentiation tests. In the static balance test, the differences were greater in the group of soccer players. Conclusions. Lateralization of the lower limbs is a highly complex characteristic with a different variability in athletes than in nontraining individuals. The results of the present study also point to the specialization of soccer players’ left legs in body balance and single-leg hop tests.
Espejo-Antúnez, L; López-Miñarro, P A; Garrido-Ardila, E M; Castillo-Lozano, R; Domínguez-Vera, P; Maya-Martín, J; Albornoz-Cabello, M
To improve hamstring extensibility some methods have been analyzed and compared for determining their acute and chronic effectiveness. To compare the immediate effect of electrical muscle elongation (EME) versus Kinesio tape (KT) in hamstring muscle extensibility. One hundred and twenty adult amateur athletes with hamstring shortness (straight leg raise test angle Kinesio tape are effective techniques in the short-term in amateur athletes with decreased hamstring extensibility. The higher increase of hamstring extensibility, with a better clinical effect was achieved with the application of electrical muscle elongation. However, no significant differences were found when comparing the effectiveness of both techniques.
Lockie Robert G.
Full Text Available This study investigated relationships between 10 m sprint acceleration, step kinematics (step length and frequency, contact and flight time, and leg muscle performance (power, stiffness, strength. Twenty-eight field sport athletes completed 10 m sprints that were timed and filmed. Velocity and step kinematics were measured for the 0-5, 5-10, and 0-10 m intervals to assess acceleration. Leg power was measured via countermovement jumps (CMJ, a fivebound test (5BT, and the reactive strength index (RSI defined by 40 cm drop jumps. Leg stiffness was measured by bilateral and unilateral hopping. A three-repetition maximum squat determined strength. Pearson’s correlations and stepwise regression (p ≤ 0.05 determined velocity, step kinematics, and leg muscle performance relationships. CMJ height correlated with and predicted velocity in all intervals (r = 0.40-0.54. The 5BT (5-10 and 0-10 m intervals and RSI (5-10 m interval also related to velocity (r = 0.37-0.47. Leg stiffness did not correlate with acceleration kinematics. Greater leg strength related to and predicted lower 0-5 m flight times (r = -0.46 to -0.51, and a longer 0-10 m step length (r = 0.38. Although results supported research emphasizing the value of leg power and strength for acceleration, the correlations and predictive relationships (r2 = 0.14-0.29 tended to be low, which highlights the complex interaction between sprint technique and leg muscle performance. Nonetheless, given the established relationships between speed, leg power and strength, strength and conditioning coaches should ensure these qualities are expressed during acceleration in field sport athletes.
Allison, Kim; Bennell, Kim L; Grimaldi, Alison; Vicenzino, Bill; Wrigley, Tim V; Hodges, Paul W
Lateral hip pain during single leg loading, and hip abductor muscle weakness, are associated with gluteal tendinopathy, but it has not been shown how or whether kinematics in single leg stance differ in those with gluteal tendinopathy. To compare kinematics in preparation for, and during, single leg stance between individuals with and without gluteal tendinopathy, and the effect of hip abductor muscle strength on kinematics. Twenty individuals with gluteal tendinopathy and 20 age-matched pain-free controls underwent three-dimensional kinematic analysis of single leg stance and maximum isometric hip abductor strength testing. Maximum values of hip adduction, pelvic obliquity (contralateral pelvis rise/drop), lateral pelvic translation (ipsilateral/contralateral shift) and ipsilateral trunk lean during preparation for leg lift and average values in steady single leg stance, were compared between groups using an analysis of covariance, with and without anthropometric characteristics and strength as covariates. Individuals with gluteal tendinopathy demonstrated greater hip adduction (standardized mean difference (SMD)=0.70, P=0.04) and ipsilateral pelvic shift (SMD=1.1, P=0.002) in preparation for leg lift, and greater hip adduction (SMD=1.2, P=0.002) and less contralateral pelvic rise (SMD=0.86, P=0.02) in steady single leg stance than controls. When including strength as a covariate, only between-group differences in lateral pelvic shift persisted (SMD=1.7, P=0.01). Individuals with gluteal tendinopathy use different frontal plane kinematics of the hip and pelvis during single leg stance than pain-free controls. This finding is not influenced by pelvic dimension or the potentially modifiable factor of body mass index, but is by hip abductor muscle weakness. Copyright © 2016 Elsevier B.V. All rights reserved.
Lockie, Robert G; Jalilvand, Farzad; Callaghan, Samuel J; Jeffriess, Matthew D; Murphy, Aron J
This study investigated relationships between 10 m sprint acceleration, step kinematics (step length and frequency, contact and flight time), and leg muscle performance (power, stiffness, strength). Twenty-eight field sport athletes completed 10 m sprints that were timed and filmed. Velocity and step kinematics were measured for the 0-5, 5-10, and 0-10 m intervals to assess acceleration. Leg power was measured via countermovement jumps (CMJ), a five-bound test (5BT), and the reactive strength index (RSI) defined by 40 cm drop jumps. Leg stiffness was measured by bilateral and unilateral hopping. A three-repetition maximum squat determined strength. Pearson's correlations and stepwise regression (p ≤ 0.05) determined velocity, step kinematics, and leg muscle performance relationships. CMJ height correlated with and predicted velocity in all intervals (r = 0.40-0.54). The 5BT (5-10 and 0-10 m intervals) and RSI (5-10 m interval) also related to velocity (r = 0.37-0.47). Leg stiffness did not correlate with acceleration kinematics. Greater leg strength related to and predicted lower 0-5 m flight times (r = -0.46 to -0.51), and a longer 0-10 m step length (r = 0.38). Although results supported research emphasizing the value of leg power and strength for acceleration, the correlations and predictive relationships (r(2) = 0.14-0.29) tended to be low, which highlights the complex interaction between sprint technique and leg muscle performance. Nonetheless, given the established relationships between speed, leg power and strength, strength and conditioning coaches should ensure these qualities are expressed during acceleration in field sport athletes.
Salminen, Aaro V; Rimpilä, Ville; Polo, Olli
Previous studies have associated restless legs syndrome (RLS) with peripheral hypoxia and impaired thermoregulation in the lower extremities. We performed long-term monitoring of skin temperatures in order to investigate whether these findings could be explained by reduced blood flow to the peripheral tissues. 96-hour continuous measurements of skin temperature were performed both in the distal and proximal parts of the body of 15 patients with RLS and 14 healthy controls. During the recording, the patients participated in suggested immobilization tests both with and without pramipexole medication. We found no baseline differences in distal or proximal skin temperature between patients and controls in daytime or during immobilization. However, pramipexole significantly increased distal skin temperature in the patient group during immobilization (31.1°C vs. 32.9°C, p thermoregulation and the previous studies might have been biased by medication. Dopaminergic medication is a major confounding factor when assessing peripheral phenomena in RLS and should be controlled for in the future studies. © 2014 American Academy of Sleep Medicine.
Allen, Richard; Högl, Birgit; Paulus, Walter
Recent publications on both the genetics and environmental factors of restless legs syndrome (RLS) defined as a clinical disorder suggest that overlapping genetic risk factors may play a role in primary (idiopathic) and secondary (symptomatic) RLS. Following a systematic literature search of RLS associated with comorbidities, we identified an increased prevalence of RLS only in iron deficiency and kidney disease. In cardiovascular disease, arterial hypertension, diabetes, migraine, and Parkinson disease, the methodology of studies was poor, but an association might be possible. There is insufficient evidence for conditions such as anemia (without iron deficiency), chronic obstructive pulmonary disease, multiple sclerosis, headache, stroke, narcolepsy, and ataxias. Based on possible gene–microenvironmental interaction, the classifications primary and secondary RLS may suggest an inappropriate causal relation. We recognize that in some conditions, treatment of the underlying disease should be achieved as far as possible to reduce or eliminate RLS symptoms. RLS might be seen as a continuous spectrum with a major genetic contribution at one end and a major environmental or comorbid disease contribution at the other. PMID:26944272
Srivanitchapoom, Prachaya; Pandey, Sanjay; Hallett, Mark
Restless legs syndrome (RLS) is a common sensorimotor neurological disorder that is diagnosed according to the revised criteria of the International RLS Study Group (IRLSSG). The pathophysiology of RLS is still unknown and its prevalence is influenced by ethnicity, age, and gender. RLS is divided into two types by etiology: primary or idiopathic and secondary. Primary RLS is strongly influenced by a genetic component while secondary RLS is caused by other associated conditions such as end-stage renal disease or peripheral neuropathy. Another common condition associated with RLS is pregnancy. The prevalence of RLS during pregnancy is two to three times higher than in the normal population and is influenced by the trimester and the number of parity. The main mechanisms that may contribute to the pathophysiology of RLS during pregnancy are hormonal changes and iron and folate status. Standard medications for treating RLS during pregnancy are not established. Most medications have been used according to the evidence from non-pregnant patients. Therefore, consideration of the medical treatment for treating RLS during pregnancy should be balanced between the benefit of relieving the symptoms and maternal and fetal risk. In general, the prognosis of RLS during pregnancy is good and symptoms are usually relieved after delivery. PMID:24768121
Luis Fabiano Marin
Full Text Available OBJECTIVE: To determine the clinical correlates of the restless legs syndrome (RLS in a Brazilian sleep disorders center. METHODS: We retrospectively studied 118 patients with RLS from January, 2004, to December, 2010. The analyzed variables were: age at disease onset, gender, race, years of school instruction, primary and secondary RLS, and treatment options. RESULTS: Among the studied patients, 83.9% were women with a female/male sex ratio of 5:1. Mean age of the patients at symptom onset ± standard deviation was 41.7±17.9 years-old. The primary RLS was found in 85% of patients. The other 15% remainders consisted of secondary forms, and they were associated with neuropathy, iron deficiency anemia, end-stage renal disease, or Parkinson's disease. Drug therapy for RLS was introduced in 67% of patients. CONCLUSIONS: Most patients presented primary RLS with an early disease onset. Further epidemiological studies are welcomed to provide better information on secondary RLS in Brazil.
Ono, Kyosuke; Katsumata, Mie
Walking with prosthesis has not been well analyzed mathematically and it seems that the design of powered prosthesis has been done empirically so far. This paper presents a dynamic simulation of a normal human walking and walking with an active prosthesis. We also studied the two controlling methods of a powered thigh prosthesis based on multi-body simulation of human walking. First we measured the normal human walking gait, then, we showed that a 3-DOF human walking model can walk on level ground by applying tracking control to the measured walking gait within a certain range of tuned walking period. Next, we applied the tracking control and self-excited control to the powered thigh prosthesis and compared the robustness and efficiency of the two control methods by numerical simulation. As a result, we found that the self-excited control can significantly decrease the hip joint torque and specific cost to 1/3 compared with the tracking control. Moreover, the self-excited control is superior to the tracking control because tuning for the walking period is not needed for the active prosthetic leg.
Kroeger, K; Storck, M; Kujath, P; Rabe, E; Dissemond, J
Venous leg ulcer (VLU) counts among the most common chronic wounds in Europe. Treatment is lengthy, cumbersome and costly, and there is a high rate of recurrence. This review shows the measures that should be offered to every patient with healed VLU to permanently prevent recurrence. To prevent VLU in case of varicose veins, the progression of chronic venous insufficiency (CVI) has to be stopped. There is convincing evidence that the effective treatment of varicose veins reduces the recurrence rate in patients with VLU. In patients with post-thrombotic syndrome (PTS), further thrombosis should be prevented through targeted prophylaxis of new thromboembolic events. The benefit of endovascular revascularization on the VLU recurrence rate in patients with post-thrombotic damage in the pelvic veins has not been proven in clinical studies. On the other hand, it has been clearly demonstrated in several studies that compression therapy is the basic procedure for the prevention of recurrent VLU in patients with varicose veins or PTS, regardless of whether other measures have been implemented or not. Good adherence in patients with compression therapy is more important than choosing the highest possible compression class. Future efforts for patients with VLU must aim to provide therapists with tools and treatment strategies to guide their patients and to increase patients' acceptance and understanding of the importance of self-management, in particular regarding compression therapy for the prevention of recurrent VLU. Georg Thieme Verlag KG Stuttgart · New York.
Full Text Available Earlier studies conducted among migraineurs have shown an association between migraine and restless legs syndrome (RLS. We chose RLS patients and looked for migraine to exclude sample bias. Materials and Methods: 99 consecutive subjects of idiopathic RLS were recruited from the sleep clinic during four months period. Physician diagnosis of headache and depressive disorder was made with the help of ICHD-2 and DSM-IV-TR criteria, respectively. Sleep history was gathered. Severity of RLS and insomnia was measured using IRLS (Hindi version and insomnia severity index Hindi version, respectively. Chi-square test, one way ANOVA and t-test were applied to find out the significance. Results: Primary headache was seen in 51.5% cases of RLS. Migraine was reported by 44.4% subjects and other types of ′primary headaches′ were reported by 7.1% subjects. Subjects were divided into- RLS; RLS with migraine and RLS with other headache. Females outnumbered in migraine subgroup (χ2 =16.46, P<0.001. Prevalence of depression (χ2 =3.12, P=0.21 and family history of RLS (χ2 =2.65, P=0.26 were not different among groups. Severity of RLS (P=0.22 or insomnia (P=0.43 were also similar. Conclusion: Migraine is frequently found in RLS patients in clinic based samples. Females with RLS are prone to develop migraine. Depression and severity of RLS or insomnia do not affect development of headache.
Ulrike H. Mitchell
Full Text Available Objective/BackgroundRestless Legs Syndrome (RLS is a dopamine-dependent disorder characterized by a strong urge to move. The objective of this study was to evalulate blood levels of dopamine and other catecholamines and blood D2-subtype dopamine receptors (D2Rs in RLS.Patients/MethodsDopamine levels in blood samples from age-matched unmedicated RLS subjects, medicated RLS subjects and Controls were evaluated with high performance liquid chromatography and dopamine D2R white blood cell (WBC expression levels were determined with fluorescence-activated cell sorting and immunocytochemistry.ResultsBlood plasma dopamine levels, but not norepinepherine or epinephrine levels, were significantly increased in medicated RLS subjects vs unmedicated RLS subjects and Controls. The percentage of lymphocytes and monocytes expressing D2Rs differed between Control, RLS medicated and RLS unmedicated subjects. Total D2R expression in lymphocytes, but not monocytes, differed between Control, RLS medicated and RLS unmedicated subjects. D2Rs in lymphocytes, but not monocytes, were sensitive to dopamine in Controls only.ConclusionDownregulation of WBCs D2Rs occurs in RLS. This downregulation is not reversed by medication, although commonly used RLS medications increase plasma dopamine levels. The insensitivity of monocytes to dopamine levels, but their downregulation in RLS, may reflect their utility as a biomarker for RLS and perhaps brain dopamine homeostasis.
Chronic wounds can take a long time to heal despite appropriate therapy based upon aetiology and use of suitable dressings. The success of electrostimulation is based upon the existence within the skin of the endogenous currents involved in the wound healing process. Where skin continuity is broken by a wound, these electrical potentials are short-circuited, resulting in leakage of electrical current. Woundel(®) therapy is the only such treatment currently available in France and is based on the use of continuous pulsed current that generates an electrical field near the endogenous electrical fields. It utilises a console to deliver the electrical impulses, a dressing electrode and a dispersion electrode. The electrode dressing is left on the wound for 3 days, and venous compression bandaging may be applied to the leg, taking care to leave the connector free. Negative polarity stimulates migration of fibroblasts, resulting in elimination of fibrin. Positive polarity causes keratinocyte migration, which in turn leads to epidermisation. Electrostimulation is of recognised utility in the healing of chronic wounds: it has been assigned a high-level recommendation in the European and American guidelines for the treatment of venous ulcers and bedsores with proof level of A. Further, the analgesic effect of electrostimulation has been demonstrated in several studies. Electrostimulation is already well developed in France among wound specialists, but prospective studies are planned so that it may be used at patients' homes. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Full Text Available Current biological treatments for non-healing wounds aim to address the common deviations in healing mechanisms, mainly inflammation, inadequate angiogenesis and reduced synthesis of extracellular matrix. In this context, regenerative medicine strategies, i.e., platelet rich plasmas and mesenchymal stromal cell products, may form part of adjuvant interventions in an integral patient management. We synthesized the clinical experience on ulcer management using these two categories of biological adjuvants. The results of ten controlled trials that are included in this systematic review favor the use of mesenchymal stromal cell based-adjuvants for impaired wound healing, but the number and quality of studies is moderate-low and are complicated by the diversity of biological products. Regarding platelet-derived products, 18 controlled studies investigated their efficacy in chronic wounds in the lower limb, but the heterogeneity of products and protocols hinders clinically meaningful quantitative synthesis. Most patients were diabetic, emphasizing an unmet medical need in this condition. Overall, there is not sufficient evidence to inform routine care, and further clinical research is necessary to realize the full potential of adjuvant regenerative medicine strategies in the management of chronic leg ulcers.
Lei, J; Zhu, J; Xie, P; Tokhi, MO
© The Author(s) 2017. When the quadruped robot is in locomotion such as jumping and running with higher speed, there is non-continuous contact force between the foot and the environment inevitably. In order to achieve the flexible force interaction of the bionic legs with the environment, it is necessary to analyze the joint angular stiffness of the bionic leg. In this article, based on the designing principles of the bionics, light-weighted, and flexible, a kind of musculoskeletal bionic leg...
Mouthon, A; Ruffieux, J; Wälchli, M; Keller, M; Taube, W
Non-physical balance training has demonstrated to be efficient to improve postural control in young people. However, little is known about the potential to increase corticospinal excitability by mental simulation in lower leg muscles. Mental simulation of isolated, voluntary contractions of limb muscles increase corticospinal excitability but more automated tasks like walking seem to have no or only minor effects on motor-evoked potentials (MEPs) evoked by transcranial magnetic stimulation (TMS). This may be related to the way of performing the mental simulation or the task itself. Therefore, the present study aimed to clarify how corticospinal excitability is modulated during AO+MI, MI and action observation (AO) of balance tasks. For this purpose, MEPs and H-reflexes were elicited during three different mental simulations (a) AO+MI, (b) MI and (c) passive AO. For each condition, two balance tasks were evaluated: (1) quiet upright stance (static) and (2) compensating a medio-lateral perturbation while standing on a free-swinging platform (dynamic). AO+MI resulted in the largest facilitation of MEPs followed by MI and passive AO. MEP facilitation was significantly larger in the dynamic perturbation than in the static standing task. Interestingly, passive observation resulted in hardly any facilitation independent of the task. H-reflex amplitudes were not modulated. The current results demonstrate that corticospinal excitability during mental simulation of balance tasks is influenced by both the type of mental simulation and the task difficulty. As H-reflexes and background EMG were not modulated, it may be argued that changes in excitability of the primary motor cortex were responsible for the MEP modulation. From a functional point of view, our findings suggest best training/rehabilitation effects when combining MI with AO during challenging postural tasks. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Manconi, Mauro; Ferri, Raffaele; Zucconi, Marco; Bassetti, Claudio L; Fulda, Stephany; Aricò, Debora; Ferini-Strambi, Luigi
The purpose of this study was to characterize the nature of the relation between periodic leg movements during sleep (PLMS) and cortical arousals to contribute to the debate on the clinical significance and treatment of PLMS. A prospective, placebo-controlled, single-blind, parallel group study was carried out including 46 drug-naive patients with idiopathic restless legs syndrome (RLS). Each patient underwent 2 consecutive full-night polysomnographic studies. The first night was the baseline night. Prior to the second night, 1 group received a single oral dose of 0.25mg pramipexole, whereas a second group received a single oral dose of 0.5mg clonazepam, and the remaining patients received placebo. Sleep stages, cyclic alternating pattern (CAP), and leg movement activity were scored following standard criteria; symptoms of RLS were also assessed. Pramipexole suppressed PLMS without affecting electroencephalographic (EEG) instability (CAP) and arousals (corresponding to CAP A3 and, partially, A2 subtypes), whereas clonazepam did the opposite, reducing non-rapid eye movement sleep EEG instability without effects on PLMS. Both drugs were effective on sensory RLS symptoms. This study demonstrates that a selective pharmacological approach can disconnect PLMS from arousal events, suggesting an indirect relation between each other. These results might weaken the hypothesis of a direct pathological role of PLMS in sleep disruption and can be important for the discussion on the existence of a distinct entity called periodic limb movements disorder. Moreover, the study opens the doors to the possibility of a joint treatment for RLS targeting sensory and motor symptoms, as well as sleep instability. Copyright © 2012 American Neurological Association.
Morgana Alves de Britto
Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2015v17n6p661 Landing asymmetry is a risk factor for knee anterior cruciate ligament injury. The aim of this study was to identify kinetic asymmetries in healthy recreational athletes performing different jump-landing techniques. Twelve recreational athletes engaged in regular training underwent kinetic evaluation using two 3D force plates and were analyzed for: (a three-dimensional peak forces, (b time to peak vertical force, and (c initial phase asymmetries. All data were collected during performance of unilateral and bilateral trials of forward and drop jump tasks. Forward jump-landing tasks elicited greater kinetic asymmetry than drop-landing tasks. Regardless of jump-landing technique, the preferred leg experienced higher forces than the non-preferred leg. The initial landing phase showed more kinetic asymmetries than the later phase when peak vertical forces occur. It was concluded that when screening athletes for kinetic asymmetries that may predispose them to injury, forward jump-landing tasks and the early landing phase might show more kinetic asymmetries than drop jump-landing tasks and the late landing phase, respectively.
Hughes, William E; Kruse, Nicholas T; Casey, Darren P
Contraction-induced rapid vasodilation is attenuated similarly in the upper and lower limbs of older adults. In the forearm, this attenuation is in part due to a greater sympathetic vasoconstriction. We examined whether the age-related reduction in contraction-induced vasodilation in the leg is also due to a sympathetic vasoconstrictive mechanism. Thirteen young (24 ± 1 yr) and twelve older adults (67 ± 1 yr) performed single-leg knee extension at 20 and 40% of work-rate maximum (WR max ) during control and cold-pressor test (CPT) conditions. Femoral artery diameter and blood velocity were measured using Doppler ultrasound. Vascular conductance (VC; ml·min -1 ·mmHg -1 ) was calculated using blood flow (ml/min) and mean arterial pressure (mmHg). Peak (ΔVC from baseline) and total VC were blunted in older adults during control conditions across exercise intensities ( P ROV). Within the forearm, this attenuation is partially due to enhanced sympathetic vasoconstriction. In the current study, we found that sympathetic vasoconstriction reduces contraction-induced ROV within the leg of both young and older adults, with the magnitude of change being similar between age groups. Our current results suggest that age-related attenuations in contraction-induced ROV within the leg are not fully explained by a sympathetic vasoconstrictor mechanism. Copyright © 2017 the American Physiological Society.
Durmer, Jeffrey S; Quraishi, Ghazala H
The characteristic symptoms of restless legs syndrome (RLS) have been known for hundreds of years and were first reported in medicine in the 1600s. Clinicians must consider potential mimics, comorbid, and associated conditions when evaluating children with RLS symptoms. The traditional differentiation of RLS from periodic limb movement disorder (PLMD) is noted in children as well as adults. Because current pediatric RLS research is sparse, this article provides the most up-to-date evidence-based as well as consensus opinion-based information on the subject of childhood RLS and PLMD. Prevalence, pathophysiology, diagnosis, treatment, and clinical associations are discussed. Copyright © 2011 Elsevier Inc. All rights reserved.
Full Text Available The main objective of this work is to analyze and extend security model of mobile devices running on Android OS. Provided security extension is a Linux kernel security module that allows the system administrator to restrict program's capabilities with per-program profiles. Profiles can allow capabilities like network access, raw socket access, and the permission to read, write, or execute files on matching paths. Module supplements the traditional Android capability access control model by providing mandatory access control (MAC based on path. This extension increases security of access to system objects in a device and allows creating security sandboxes per application.
Sørensen, Torben; Hansen, Poul Erik
Description of the compulsary project tasks to be carried out as a part of DTU course 72238 Robotics......Description of the compulsary project tasks to be carried out as a part of DTU course 72238 Robotics...
Watenpaugh, D. E.; Ballard, R. E.; Stout, M. S.; Murthy, G.; Whalen, R. T.; Hargens, A. R.
These results clearly demonstrate that dynamic leg exercise against the footward force produced by LBNP substantially improves tolerance to LBNP, and that even cyclic ankle flexion without load bearing also increases tolerance. This exercise-induced increase of tolerance was actually an underestimate, because subjects who completed the tolerance test while exercising could have continued for longer periods. Exercise probably increases LBNP tolerance by multiple mechanisms. Tolerance was increased in part by skeletal muscle pumping venous blood from the legs. Rosenhamer and Linnarsson and Rosenhamer also deduced this for subjects cycling during centrifugation, although no measurements of leg volume were made in those studies: they found that male subjects cycling at 98 W could endure 3 Gz centrifugation longer than when they remained relaxed during centrifugation. Skeletal muscle pumping helps maintain cardiac filling pressure by opposing gravity-, centrifugation-, or LBNP-induced accumulation of blood and extravascular fluid in the legs.
Van Hall, Gerrit; Jensen-Urstad, M; Rosdahl, H
To study the role of muscle mass and muscle activity on lactate and energy kinetics during exercise, whole body and limb lactate, glucose, and fatty acid fluxes were determined in six elite cross-country skiers during roller-skiing for 40 min with the diagonal stride (Continuous Arm + Leg) followed...... by 10 min of double poling and diagonal stride at 72-76% maximal O(2) uptake. A high lactate appearance rate (R(a), 184 +/- 17 micromol x kg(-1) x min(-1)) but a low arterial lactate concentration ( approximately 2.5 mmol/l) were observed during Continuous Arm + Leg despite a substantial net lactate...... release by the arm of approximately 2.1 mmol/min, which was balanced by a similar net lactate uptake by the leg. Whole body and limb lactate oxidation during Continuous Arm + Leg was approximately 45% at rest and approximately 95% of disappearance rate and limb lactate uptake, respectively. Limb lactate...
Full Text Available To provide an ideal platform for research on intelligent bionic leg (IBL, this paper proposes a model of a biped robot with heterogeneous legs (BRHL. A prototype of an artificial leg is developed based on biological structure and motion principle analysis of human lower extremities. With regard to the driving sources, servomotors are chosen for the hip joint and ankle joint, while pneumatic muscle actuators (PMAs are chosen for the knee joint. The control system of the bionic artificial leg is designed and a physical experimental platform is established. The physical control experiments are done based on proportional-integral-derivative (PID control strategy. The experimental results show that such a system can realize the expected goals.
Sanusi Umar, MD
Full Text Available Summary: Fine hairs of the head and nape areas have been used as donor sources in eyelash transplantation but are straight, coarse, and grow rapidly, requiring frequent eyelash maintenance. This is the first reported case of eyelash transplantation by follicular unit extraction using leg hair as a donor source; findings were compared with that of another patient who underwent a similar procedure with donor hairs from the nape area. Although both patients reported marked improvement in fullness of eyelashes within 3 months postsurgery, the transplanted leg hair eyelashes required less frequent trimming (every 5–6 weeks compared with nape hair eyelashes (every 2–3 weeks. Additionally, in leg hair eyelashes, the need for perming to sustain a natural looking eyelash curl was eliminated. Eyelash transplantation using leg donor hair in hirsute women may result in good cosmetic outcomes and require less maintenance compared with nape donor hair.
El Khatib AM
Full Text Available Arij M El Khatib,1 Shady N Hayek2 1Division of Plastic and Reconstructive Surgery, Department of Surgery, American University of Beirut Medical Center (AUBMC, 2Private Practice, Cosmetic Surgery Center, Beirut, Lebanon Abstract: Sickle cell disease is an autosomal recessive hemoglobinopathy caused by an amino acid substitution from glutamic acid to valine in the beta hemoglobin chain. One of the common symptoms occurring in sickle cell patients are leg ulcers, which are notoriously painful, difficult to treat, and frequently recurrent. These ulcers pose a therapeutic challenge with multiple modalities proposed for treatment, but with scarce evidence of efficacy of any single modality. Ulcer prevention, rigorous wound care, pain control, and surgery are the current mainstays of sickle cell leg ulcer treatment. Keywords: sickle cell leg ulcer, leg wound, sickle cell disease
Full Text Available Primary of hereditary lymphedema is a rare but progressive disease. It is yet not curable. We present a 48-year-old male patient with hereditary lymphedema of his left leg, that was realised by minor trauma (able twist when he was seven years old. He had never been treated for lymphedema but experienced multiple erysipelas during his life. After diagnostic procedures to exclude other causes of leg swelling, the diagnosis of hereditary lymphedema of the leg, stage III was confirmed. We initialized complex decongestive therapy. During two weeks of intensive treatment, the circumference of the left leg could be reduced by 10 cm. This case illustrates the "natural course" hereditary lymphedema. But it raises the hope that even after decades of ignorance, the patients benefits from complex decongestive treatment. Therapeutic nihilism is unnecessary and poses lymphedema patients to risks of infection and secondary malignancies like Stewart-Trewes syndrome.
... the syndrome. Risk factors include the following: A sedentary lifestyle Smoking Obesity Many people with narcolepsy or rapid eye movement (REM) behavior disorder move their legs periodically during sleep. Both ...
Full Text Available Objective: To identify the main changes in the daily life of people with leg ulcer and how that affects the person’s quality of life. Methodology: We used the methodology PI [C] OD and selected four research articles, taken from EBSCO, PubMed, and EWMA. Results: The main changes identified in the people’s daily live with leg ulcers are physical (pain, decreased mobility, presence of exudate, bad smell from the wound and change in the style of clothing, psychological (sleep disorders, depression, anxiety, feelings of rejection and low self-steem, social (isolation, restriction in leisure activities, inability to perform household chores. Conclusions: The literature about the person’s quality of life with leg ulcer reported a significant impact in the daily life. The care provided by nurses should be centered on the person, integrating all the kind of needs and the leg ulcer must not be the sole focus of care
Miyamoto, Masayuki; Miyamoto, Tomoyuki; Iwanami, Masaoki; Suzuki, Keisuke; Hirata, Koichi
Restless legs syndrome (RLS) is a sensorimotor disorder that is frequently associated with periodic leg movements (PLMS). RLS is generally considered to be a central nervous system (CNS)-related disorder although no specific lesion has been found to be associated with the syndrome. Reduced intracortical inhibition has been demonstrated in RLS by transcranial magnetic stimulation. Some MRI studies have revealed the presence of morphologic changes in the somatosensory cortex, motor cortex and thalamic gray matter. The results of single photon emission computed tomography (SPECT) and positron emission tomography (PET) studies showed that the limbic and opioid systems also play important roles in the pathophysiology of RLS. A functional MRI study revealed abnormal bilateral cerebellar and thalamic activation during the manifestation of sensory symptoms, with additional red nucleus and reticular formation activity during PLMS. PLMS is likely to occur in patients with spinal cord lesions, and some patients with sensory polyneuropathy may exhibit RLS symptoms. RLS symptoms seem to depend on abnormal spinal sensorimotor integration at the spinal cord level and abnormal central somatosensory processing. PLMS appears to depend on increased excitability of the spinal cord and a decreased supraspinal inhibitory mechanism from the A11 diencephalic dopaminergic system. RLS symptoms respond very dramatically to dopaminergic therapy. The results of analysis by PET and SPECT studies of striatal D2 receptor binding in humans are inconclusive. However, studies in animal models suggest that the participation of the A11 dopaminergic system and the D3 receptor in RLS symptoms. The symptoms of RLS are aggravated in those with iron deficiency, and iron treatment ameliorates the symptoms in some patients. Neuroimaging studies, analysis of the cerebrospinal fluid, and studies on postmortem tissue and use of animal models have indicated that low brain iron concentrations and dysfunction of
An important task of a manager is to motivate her subordinates. One way in which a manager can give incentives to junior employees is through the assignment of tasks. How a manager allocates tasks in an organization, provides information to the junior employees about his ability. Without coaching
C∗. -algebra extensions, Ext groups do not classify extension algebras. So one has to study the isomorphism equivalence of extensions. In fact, a homomorphism between two extension algebras may not map the essential ideal into the other in general, so we have to consider properties of extension homomorphisms.
Drill, Sabrina L.
Mobile computing devices (smart phones, tablets, etc.) are rapidly becoming the dominant means of communication worldwide and are increasingly being used for scientific investigation. This technology can further our Extension mission by increasing our power for data collection, information dissemination, and informed decision-making. Mobile…
Opdam, E.; Solleveld, M.
Let π, π′ be irreducible tempered representations of an affine Hecke algebra H with positive parameters. We compute the higher extension groups Ext nH(π,π′) explicitly in terms of the representations of analytic R-groups corresponding to π and π′. The result has immediate applications to the
Mission Statement The mission of the "Journal of Agricultural Extension" is to publish conceptual papers and empirical research that tests, extends, or builds ... Symbol recognition and interpretation of HIV/AIDS pictorial messages among rural women in Abia State Nigeria · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT
Hallegraeff, Joannes; de Greef, Mathieu; Krijnen, Wim; van der Schans, Cees
Up to 33% of the general population over 50 years of age are affected by nocturnal leg cramps. Currently there are no generally accepted clinical characteristics, which identify nocturnal leg cramps. This study aims to identify these clinical characteristics and to differentiate between them and the characteristics of restless leg syndrome and periodic limb disorder. A systematic literature study was executed from December 2015 to May 2016. This study comprised of a systematic literature review of randomized clinical trials, observational studies on nocturnal and rest cramps of legs and other muscles, and other systematic and narrative reviews. Two researchers independently extracted literature data and analyzed this using a standardized reviewing protocol. Modified versions of the Cochrane Collaboration tools assessed the risk of bias. A Delphi study was conducted to assess agreement on the characteristics of nocturnal leg cramps. After systematic and manual searches, eight randomized trials and ten observational studies were included. On the basis of these we identified seven diagnostic characteristics of nocturnal leg cramps: intense pain, period of duration from seconds to maximum 10 minutes, location in calf or foot, location seldom in thigh or hamstrings, persistent subsequent pain, sleep disruption and distress. The seven above characteristics will enhance recognition of the condition, and help clinicians make a clear distinction between NLC and other sleep-related musculoskeletal disorder among older adults.
Schmitt, J; Clark, J
The spring loaded inverted pendulum template has been shown to accurately model the steady locomotion dynamics of a variety of running animals, and has served as the inspiration for an entire class of dynamic running robots. While the template models the leg dynamics by an energy-conserving spring, insects and animals have structures that dissipate, store and produce energy during a stance phase. Recent investigations into the spring-like properties of limbs, as well as animal response to drop-step perturbations, suggest that animals use their legs to manage energy storage and dissipation, and that this management is important for gait stability. In this paper, we extend our previous analysis of control of the spring loaded inverted pendulum template via changes in the leg touch-down angle to include energy variations during the stance phase. Energy variations are incorporated through leg actuation that varies the force-free leg length during the stance phase, yet maintains qualitatively correct force and velocity profiles. In contrast to the partially asymptotically stable gaits identified in previous analyses, incorporating energy and leg angle variations in this manner produces complete asymptotic stability. Drop-step perturbation simulations reveal that the control strategy is rather robust, with gaits recovering from drops of up to 30% of the nominal hip height.
Bolt, Caroline; O'Keeffe, Francis; Finnegan, Pete; Dickson, Kristofer; Smit, De Villiers; Fitzgerald, Mark C; Mitra, Biswadev
Pelvic x-ray is frequently used as a screening tool during initial assessment of injured patients. However routine use in the awake and alert blunt trauma patient may be questioned due to low yield. We propose a clinical tool that may avoid unnecessary imaging by examining whether the ability to straight leg raise, without pain, can rule out pelvic injury. We conducted a prospective cohort study with the exposure variables of ability to straight leg raise and presence of pain on doing so, and presence of pelvic fracture on x-ray as the primary outcome variable. Of the 328 participants, 35 had pelvic fractures, and of these 32 were either unable to straight leg raise, or had pain on doing so, with a sensitivity of 91.43% (95% CI: 76.94-98.2%) and a negative predictive value of 98.57% (95% CI: 95.88-99.70%). The 3 participants with a pelvic fracture who could straight leg raise with no pain, all had a GCS of less than 15, and therefore, among the sub-group of patients with GCS15, a 100% sensitivity and 100% negative predictive value for straight leg raise with no pain to rule out pelvic fracture was demonstrated. Among awake, alert patients, painless straight leg raise can exclude pelvic fractures and be incorporated into initial examination during reception and resuscitation of injured patients. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
Monnin-Delhom, E D; Gallix, B P; Achard, C; Bruel, J M; Janbon, C
To evaluate the accuracy of computed tomography (CT) scan imaging in distinguishing lymphedema from deep venous thrombosis (DVT) and lipodystrophy (lipedema) in patients with swollen legs. CT scans of the lower limbs were performed in 55 patients with 76 swollen legs (44 lymphedemas, 12 DVT and 20 lipedemas). Thirty-four normal contralateral legs were also similarly evaluated. Primary lymphedema was verified by lymphography or lymphoscintigraphy, whereas secondary lymphedema was documented by a typical clinical history. DVT was established by ultrasound Doppler imaging. The diagnosis of lipedema was made with bilateral swollen legs where lymphoscintigraphy and Doppler examination were both unremarkable. Qualitative CT analysis was based on skin thickening, subcutaneous edema accumulation with a honeycombed pattern, and muscle compartment enlargement. Sensitivity and specificity of CT scan for the diagnosis of lymphedema was 93 and 100%, respectively; for lipedema it was 95 and 100%, respectively; andfor DVT it was 91 and 99%, respectively. Skin thickening was found in 42 lymphedemas (95%), in 9 DVT (75%), and in 2 lipedemas (16%). Subcutaneous edema accumulation was demonstrated in 42 legs (95%) with lymphedema and in 5 (42%) with DVT but in none with lipedema. A honeycombed pattern was present only in lymphedema (18 legs or 41%); muscle enlargement was present in all patients with DVT, in no patient with lipedema, and in 4 (9%) with lymphedema. Edema accumulation is readily demonstrated with plain CT scan and is not present in lipedema. Specific CT features of the subcutaneous fat and muscle compartments allow accurate differentiation between lymphedema and DVT.
Barshes, Neal R; Mindru, Cezarina; Ashong, Chester; Rodriguez-Barradas, Maria; Trautner, Barbara W
We sought to identify factors associated with treatment failure and leg amputations among those patients who presented with foot osteomyelitis. Characteristics, treatments, and outcomes for all patients treated for probable or definite foot osteomyelitis (per consensus definition) between January 2011 and March 2015 were reviewed. Multivariate Cox regression models were used to identify risk factors for treatment failure (unanticipated resection of additional bone or leg amputation) and of leg amputation alone. A total of 184 episodes of foot osteomyelitis met inclusion criteria. Treatment failure occurred in 53 (28.8%) and leg amputation in 21 (11.4%). Risk factors for treatment failure included severe/unaddressed peripheral artery disease, homelessness, Pseudomonas aeruginosa or Escherichia coli bone isolates, serum albumin <2.8 mg/dL, hallux involvement, insulin therapy, 60 or more pack-years smoking, and <7 days of directed antibiotic therapy for a positive bone margin. Delayed primary wound closure (ie, staged operations) had significantly lower treatment failure risk. Unanticipated resection of bone was not associated with leg amputation. Foot osteomyelitis treatment failure is common. Various factors can help identify those at risk for treatment failure and/or leg amputation, and further studies should focused whether initial management or follow-up should change when these factors are present.
Schmitt, J [Department of Mechanical Engineering, Oregon State University, Corvallis, OR 97331 (United States); Clark, J, E-mail: email@example.com [Department of Mechanical Engineering, Florida State University, Tallahassee, FL 32310 (United States)
The spring loaded inverted pendulum template has been shown to accurately model the steady locomotion dynamics of a variety of running animals, and has served as the inspiration for an entire class of dynamic running robots. While the template models the leg dynamics by an energy-conserving spring, insects and animals have structures that dissipate, store and produce energy during a stance phase. Recent investigations into the spring-like properties of limbs, as well as animal response to drop-step perturbations, suggest that animals use their legs to manage energy storage and dissipation, and that this management is important for gait stability. In this paper, we extend our previous analysis of control of the spring loaded inverted pendulum template via changes in the leg touch-down angle to include energy variations during the stance phase. Energy variations are incorporated through leg actuation that varies the force-free leg length during the stance phase, yet maintains qualitatively correct force and velocity profiles. In contrast to the partially asymptotically stable gaits identified in previous analyses, incorporating energy and leg angle variations in this manner produces complete asymptotic stability. Drop-step perturbation simulations reveal that the control strategy is rather robust, with gaits recovering from drops of up to 30% of the nominal hip height.
Heinen, M.M.; Achterberg, T. van; Reimer, W.S. op; Kerkhof, P.C.M. van de; Laat, H.E.W. de
BACKGROUND: Having a leg ulcer has a major impact on daily life. Lifestyle is mentioned in most leg ulcer guidelines but mostly without much emphasis on the subject. AIMS AND OBJECTIVES: Evidence for the effect of nutrition, leg elevation and exercise on the healing of leg ulcers was reconsidered.
Uematsu, Azusa; Tsuchiya, Kazushi; Kadono, Norio; Kobayashi, Hirofumi; Kaetsu, Takamasa; Hortobagyi, Tibor; Suzuki, Shuji
We examined a behavioral mechanism of how increases in leg strength improve healthy old adults' gait speed. Leg press strength training improved maximal leg press load 40% (p = 0.001) and isometric strength in 5 group of leg muscles 32% (p = 0.001) in a randomly allocated intervention group of
Simmelink, Elisabeth K; Wervelman, Thijs; de Vries, Hendrik S; Geertzen, Jan H B; Dekker, Rienk; van der Woude, Lucas H V
This study aims to research whether there is a difference in cardiorespiratory variables and gross mechanical efficiency (GE) in healthy individuals during low-intensity one-legged and two-legged exercise on the combined arm-leg (Cruiser) ergometer and whether motor learning occurs. The outcome of
Yamauchi, Junichiro; Nakayama, Satoshi; Ishii, Naokata
Because demands of functional exercise training with using own bodyweight for elderly individuals were increasing, the present study investigated the effects of bodyweight-based exercise training on muscle functions of leg multi-joint movements in elderly individuals. Twenty-seven untrained healthy elderly individuals (mean +/- standard deviation, 66.0 +/- 5.7 years) completed the training program for 10 months. The exercise program consisted mainly of exercises for large leg muscle groups without using external weight, performing 10-50 repetitions and 1-3 sets for each exercise. Before and after the training period, force-velocity relations of knee-hip extension movements were measured with a servo-controlled dynamometer and the maximum force (Fmax), velocity (Vmax) and power (Pmax) were determined. After the training, Fmax and Pmax increased and these increases represented 15% (P elderly individuals; however, the initial training status is important for progressive increases in muscle force.
Two types of seemingly unrelated extension problems are discussed in this book. Their common focus is a long-standing problem of Johannes de Groot, the main conjecture of which was recently resolved. As is true of many important conjectures, a wide range of mathematical investigations had developed, which have been grouped into the two extension problems. The first concerns the extending of spaces, the second concerns extending the theory of dimension by replacing the empty space with other spaces. The problem of de Groot concerned compactifications of spaces by means of an adjunction of a set of minimal dimension. This minimal dimension was called the compactness deficiency of a space. Early success in 1942 lead de Groot to invent a generalization of the dimension function, called the compactness degree of a space, with the hope that this function would internally characterize the compactness deficiency which is a topological invariant of a space that is externally defined by means of compact extensions of a...
Heinen, M.M.; Borm, G.F.; Vleuten, C.J.M. van der; Evers, A.W.M.; Oostendorp, R.A.B.; Achterberg, T. van
OBJECTIVE: Investigating the effectiveness of the Lively Legs program for promoting adherence with ambulant compression therapy and physical exercise as well as effects on leg ulcer recurrence. DESIGN: A randomized controlled trial. SETTING: Eleven outpatient clinics for dermatology in the
van Hedel, H J A; Dietz, V
Knowledge about locomotor task performance and learning in the elderly is important in optimizing rehabilitation strategies. The aim of this study was to evaluate differences between young and elderly subjects in the acquisition and performance of a precision locomotor task, with full and restricted vision. The subjects walked on a treadmill and had to step as low as possible over an obstacle, without touching it. They received acoustic warning and feedback signals, indicating obstacle appearance and foot clearance, respectively. Full vision was provided during the first two runs and became restricted during the third run. The number of obstacle hits and adaptations in foot clearance, leg muscle activity, range of motion of leg joints and swing phase duration were assessed. With vision, the performance improved in both groups. Restricted vision reduced the task accuracy in both the young and the elderly. However, only the young subjects regained optimal foot clearance with practice. Elderly subjects rely more on visual control when acquiring and performing a precision locomotor task. We suggest that this is due to an impaired function of proprioceptive feedback mechanisms, which can replace visual information in young subjects. In the elderly, therapeutical attention should be directed towards optimizing the use of the remaining proprioceptive inputs.
Bianchi, M T; Goparaju, B; Moro, M
Insomnia and restless legs syndrome (RLS) are defined by self-reported symptoms, and polysomnography (PSG) is not routinely indicated. Occult obstructive sleep apnea (OSA), common even in asymptomatic adults, may complicate management of patients presenting with insomnia or restless legs. To this end, we investigated objective sleep apnea metrics in a large retrospective cohort according to self-reported symptom profiles. We compared sleep apnea findings in patients referred to our center according to self-reported symptoms associated with insomnia, sleep apnea, and restless legs. The cohort included over 1900 adults who underwent diagnostic (n = 1418) or split-night (n = 504) PSGs and completed a symptom and medical history questionnaire. More than 30% of patients who did not endorse any OSA symptoms, but did endorse insomnia or restless legs symptoms, were found to have OSA based on apnea-hypopnea index (AHI) >5 during overnight laboratory testing. Regression models of the full cohort showed that the risk of OSA was related, as expected, to older age, male sex, elevated body mass index, and presence of OSA symptoms. The presence of insomnia symptoms did not alter the risk of OSA. The presence of restless legs symptoms showed a small odds ratio for lowered OSA risk. Objective evidence of OSA occurs similarly in those with insomnia or restless legs symptoms, even among those without self-reported OSA symptoms. Providers should be aware of the potential for occult OSA in populations with insomnia and restless legs, which may complicate their management in addition to presenting an independent medical risk itself. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
van der Harst, J. J.; Gokeler, A.; Hof, A. L.
Background. Anterior cruciate ligament (ACL) deficiency can be a major problem for athletes and subsequent reconstruction of the ACL may be indicated if a conservative regimen has failed. After ACL reconstruction signs of abnormality in the use of the leg remain for a long time. It is expected that
Koo, Brian B
There are more than 50 epidemiologic studies measuring the prevalence of restless legs syndrome/Willis-Ekbom disease (RLS/WED) across 5 of the 6 inhabited continents (not Australia), most conducted in North America and Europe. Sufficient studies have been conducted in Asia, North America, and Europe to make inferences on RLS/WED prevalence by region. RLS/WED prevalence is thought to be highest in North America and Europe and lower in Asia. These differences across regions may be explained by cultural, environmental, and genetic factors. Future investigation is needed to determine to what extent these factors affect expression of RLS/WED according to world region. Published by Elsevier Inc.
Full Text Available Objective: pesplanus is one of the changes that brings about changes in muscle activation patterns. Being aware of muscles activity changes in various standing positions among pesplanus patients provides insights into preventing lower extremity injuries in this population. The aim of this study was to compare leg muscles electromyography during various standing positions in pesplanus and normal subjects. Methods: 60 healthy male university students, 30 subjects with pesplanus deformity (with average age 23/54±3/57 year, average height 175/34±7/62 cm, average weight 74/87±10/72 kg and 30 normal subjects (with average age 22/97±2/38 year, average height 176/6±5/59 cm, average weight 73/58±8/36 kg participated in this comparative study. Deformity of pesplanus was assessed with navicular drop test. Each subject performed single-leg landing dropping from 30cm height onto a force platform where muscles activity was recorded with EMG device. For data analysis, Matlab and Spss softwares were used and independent sample t-test was used to compare the dependent variables at a significance level of P &le 0/05. Results: Significant differences were observed between the two groups for the activities of the longus peroneus and anterior tibialis muscles ( p&le0/05 while no significant differences were observed in other muscles. Conclusion: The changes in the normal structure of the foot might affect muscle activities during standing, which can cause changes in the injury patterns. Therefore, it is proposed that focusing on corrective exercises and therapy plan can reduce these risks.
Lloret Linares, Célia; Ciangura, Cécile; Bouillot, Jean-Luc; Coupaye, Muriel; Declèves, Xavier; Poitou, Christine; Basdevant, Arnaud; Oppert, Jean-Michel
Bioelectrical impedance analysis (BIA) is a safe and easy method of assessing body composition. Its accuracy to predict fat mass (FM) in obesity and the change in FM following weight loss is questioned. Our objective was to compare leg-to-leg BIA to dual-energy X-ray absorptiometry (DXA) in the assessment of FM in a large population, the changes in FM after Roux-en-Y gastric bypass (RYGB) and to estimate between-method differences (bias) and limits of agreement. BIA (Tanita BC-420MA) and DXA (Hologic Discovery W) were used in 5,740 consecutive patients (mean BMI, 37.7 ± 8.2 kg/m(2)) examined in a clinical nutrition department and in 72 women undergoing RYGB (BMI, 47.2 ± 7.2 kg/m(2)). Analyses included correlations between methods and Bland Altman analysis. In the entire population, BIA significantly overestimated FM in comparison with DXA (1.1 ± 6.1 kg, 0.8 ± 5.6%). FM estimates by each method were significantly correlated in absolute value (kg; r(2) = 0.9 in the whole population), and in percentage (r(2) = 0.6). However, wide limits of agreement were observed. In surgery patients, BIA significantly overestimated FM both before and 12 months after bypass. BIA significantly overestimated changes in FM after RYGB at 3 months (2.9 ± 5.0 kg) and at 12 months (1.9 ± 3.9 kg) but not at 6 months (0.9 ± 5.0 kg; p = 0.08). Estimates of changes in FM by each method were significantly correlated (r (2) = 0.4, 0.6, and 0.9, respectively). According to the wide limits of agreement, BIA seems more interesting for epidemiological rather than individual use to evaluate body FM and FM changes in obese women undergoing RYGB.
Chang, Hsien-Cheng Leon; Burbridge, Hayley; Wong, Conroy
The average time spent playing video games is increasing. Prolonged immobility associated with gaming may therefore be an important risk factor for venous thromboembolism. We report a case of deep vein thrombosis associated with prolonged playing of PlayStation® games. A 31-year-old Caucasian man, an exterior painter, presented with a three-day history of left leg pain and swelling after playing PlayStation® games for almost eight hours a day for four consecutive days. Doppler ultrasound of the left leg confirmed extensive left leg deep venous thrombosis requiring thrombolysis and anticoagulation. Video gaming should be considered a risk factor for venous thromboembolism. Further studies are needed to estimate the degree of risk associated with prolonged periods of playing video games, and education for preventing venous thrombosis should be provided to gamers.
Dimachkie, Mazen M; Muzyka, Iryna M; Katz, Jonathan S; Jackson, Carlayne; Wang, Yunxia; McVey, April L; Dick, Arthur; Pasnoor, Mamatha; Mozaffar, M Tahseen; Xiao-Song, Z; Kissel, John T; Ensrud, E; Rosenfeld, Jeffrey; Barohn, Richard J
To identify the frequency of leg amyotrophic diplegia (LAD) at a US academic center, describe the pattern of weakness, and provide comparative data from 8 additional major US academic institutions. LAD is a leg onset variant of progressive muscular atrophy (PMA). LAD weakness is confined to the legs for at least 2 years, and there are no upper motor neuron signs. We present a retrospective chart review of 24 patients with the LAD presentation from the University of Kansas Medical Center ( n = 8 cases) and from 8 US academic institutions (n = 16 cases). Of the 318 subjects identified in the University of Kansas Medical Center Neuromuscular Research Database, 82% (260 subjects) had amyotrophic lateral sclerosis (ALS), 1.9% (6) had familial ALS, 6.6% (21) had primary lateral sclerosis, and 9.2% (29) had lower motor neuron (LMN) disease. Of these 29 cases, 16 had PMA, 5 had brachial amyotrophic diplegia, while 8 had LAD. The mean LAD age of onset was 58 years with a male/female ratio of 3/1. Onset was asymmetric in 7/8. We identified a pelviperoneal pattern of weakness (sparing of knee extension and/or ankle plantar flexion) in 4 cases and distal predominant weakness in 3 cases. All patients had electrodiagnostic findings consistent with motor neuron disease confined to the lower extremities. We present LAD disease duration and survival data from 8 major academic neuromuscular centers. At last follow-up, weakness progressed to involve the arms in 6/24 LAD cases and of these 6 cases, 2 patients died from progression to typical ALS. From onset of symptoms, mean survival in LAD is 87 months, with 92% of cases being alive. The natural history of LAD differs from typical forms of ALS and PMA. LAD is a slowly progressive disorder that accounts for a fourth of LMN disease cases. An asymmetric pelviperoneal pattern of weakness should heighten the suspicion for LAD.
Roseguini, Bruno T; Mehmet Soylu, S; Whyte, Jeffrey J; Yang, H T; Newcomer, Sean; Laughlin, M Harold
Application of intermittent pneumatic compressions (IPC) is an extensively used therapeutic strategy in vascular medicine, but the mechanisms by which this method works are unclear. We tested the hypothesis that acute application (150 min) of cyclic leg compressions in a rat model signals upregulation of angiogenic factors in skeletal muscle. To explore the impact of different pressures and frequency of compressions, we divided rats into four groups as follows: 120 mmHg (2 s inflation/2 s deflation), 200 mmHg (2 s/2 s), 120 mmHg (4 s/16 s), and control (no intervention). Blood flow and leg oxygenation (study 1) and the mRNA expression of angiogenic mediators in the rat tibialis anterior muscle (study 2) were assessed after a single session of IPC. In all three groups exposed to the intervention, a modest hyperemia (approximately 37% above baseline) between compressions and a slight, nonsignificant increase in leg oxygen consumption (approximately 30%) were observed during IPC. Compared with values in the control group, vascular endothelial growth factor (VEGF) and monocyte chemotactic protein-1 (MCP-1) mRNA increased significantly (P < 0.05) only in rats exposed to the higher frequency of compressions (2 s on/2 s off). Endothelial nitric oxide synthase, matrix metalloproteinase-2, and hypoxia-inducible factor-1alpha mRNA did not change significantly following the intervention. These findings show that IPC application augments the mRNA content of key angiogenic factors in skeletal muscle. Importantly, the magnitude of changes in mRNA expression appeared to be modulated by the frequency of compressions such that a higher frequency (15 cycles/min) evoked more robust changes in VEGF and MCP-1 compared with a lower frequency (3 cycles/min).
Erden, İsmail; Çakcak Erden, Emine; Durmuş, Hacer; Tıbıllı, Hakan; Tabakçı, Mustafa; Kalkan, Mehmet Emin; Türker, Yasin; Akçakoyun, Mustafa
Restless legs syndrome (RLS) is a common sleep disorder in which patients feel unpleasent leg sensations and urge to move the legs during rest, especially at night, and symptoms are improved by leg movement. Prior studies analyzing the associations between cardiovascular disease and restless legs syndrome has shown controversial results. The goal of the study was to estimate the relationship between restless legs syndrome and slow coronary flow (SCF). The present study was cross-sectional and observational and consists of 176 individuals who underwent coronary angiography and had angiographically normal coronary arteries of varying coronary flow rates. The study included 86 patients with isolated SCF and 90 control participants with normal coronary flow (NCF). RLS was assessed the day after the coronry flow was evaluated, using a self-administered questionnaire based on the International Restless Legs Study Group criteria. The following question was asked: "Do you have unpleasant leg sensations (like crawling, paraesthesia, or pain) combined with motor restlessness and an urge to move?" The possible responses were as follows: no, less than once/month, 2-4 times/month, 5-14 times/month, and 15 or more times per month. Those who answered that they had these feelings were asked the following two more questions: 1) "Do these symptoms occur only at rest and does moving improve them?" and 2) "Are these symptoms worsen in the evening/at night compared with the morning?" RLS is considered to be probable if the participant has answered "yes" for all three of the above questions, and has a frequency of ≥5 times/month. Student's t-test, Mann-Whitney U test, multiple logistic regression analysis were used for statistical analysis. The prevalence of restless legs syndrome was 48 (27%) and increased significantly with age. Patients with SCF have more likely had RLS than the control group (p<0.001). The age-adjusted prevalence odds of SCF were 3.11 times higher (95% CI: 1
The Transport Task Force (TTF) was initiated as a broad-based US magnetic fusion community activity during the fall of 1988 to focus attention on and encourage development of an increased understanding of anomalous transport in tokamaks. The overall TTF goal is to make progress on Characterizing, Understanding and Identifying how to Reduce plasma transport in tokamaks -- to CUIR transport
Rothbart, Brian A
The objective of this study was to determine whether a correlation exists between abnormal pronation and functional leg-length discrepancies. Visual assessment and a pelvic thrust maneuver were used to identify the functionally short leg in 56 indigenous Mexicans (20 males and 36 females; mean age, 33 years; mean weight, 59 kg; and mean height, 1.60 m). The Foot Posture Index was used with a modified stance position to identify the more pronated foot. The posterosuperior iliac spines were used to identify the "relative" position of the innominate bones. The raw data obtained from this study were evaluated using the McNemar test for paired proportions. A significant positive correlation was found between abnormal pronation and hip position and between hip position and functional leg-length discrepancy. These results are consistent with a theoretical ascending dysfunctional pelvic model: Abnormal pronation pulls the innominate bones anteriorly (forward); anterior rotation of the innominate bones shifts the acetabula posteriorly and cephalad (backward and upward); and this shift in the acetabula hyperextends the knees and shortens the legs, with the shortest leg corresponding to the most pronated foot.
Full Text Available Background: The pattern of eczema is altered by geography, habits of people and environmental factors and regional variation in skin structure and function. Aims: Our study was done to estimate frequency and patterns of lower leg and foot eczemas. Methods: A total of 200 patients with various types of lower leg and foot eczemas were recruited over a period of 2 years. Demographic and clinical characteristics were noted. Suspected cases of allergic contact dermatitis were patch tested. Results: The frequency of these eczemas was 2.5 per 1000 out patients. Mean age of patients was 40.49 years. Female to male ratio was 1.6:1. Sixty (30% patients were farmers, sixty (30% were housewives, forty (20% were students, nineteen (9.5% were daily laborers, nine had sedentary jobs and three were teachers. Most eczemas were bilateral (72%. Mean duration of eczema was 36.6 months. Most common type of eczema was lichen simplex chronicus (36% followed by discoid eczema (18.5%, allergic contact dermatitis (14.5% and stasis eczema (7.5%. Other eczemas noted were juvenile plantar dermatosis, cumulative irritant contact dermatitis, infected eczema, hyperkeratotic eczema, asteatotic eczema, pompholyx, infective eczema and unclassified endogenous eczema. Common sites of involvement were dorsa of feet (49.5%, followed by lateral aspect of lower leg (31%, medial aspect of lower leg (17.5% and ankle (12%. Conclusion : Our study highlights lichen simplex chronicus as the most common eczema affecting the lower legs and feet.
Sîrbi, Adelina Gabriela; Florea, Marius; Pătraşcu, Virgil; Rotaru, Maria; Mogoş, Dan Gabriel; Georgescu, Claudia Valentina; Mărgăritescu, Nicolae Dragoş
Chronic venous leg ulcers (VLU), especially long-lasting non-healing ulcers, are among the risk factors for squamous cell carcinoma (SCC). Malignant transformation of a VLU is a rare finding and the relative risk of carcinomatous transformation is quite low (about 5.8). SCC arising in the context of a VLU has a particularly aggressive behavior. A 76-year-old male patient with no relevant medical familial history, with chronic venous insufficiency CEAP C6 for 10 years [recurrent leg ulcers with favorable outcome (healing) after specific local and systemic treatment], showing for about three years one ulcerated lesion located on the anterior upper third of the right calf non-responsive to specific treatment, which subsequently increased their size and merged. Biopsy sample was taken. Histopathology showed epidermal acanthosis, papillomatosis, intense parakeratosis, pseudoepitheliomatous hyperplasia, dysplasia and moderately differentiated squamous cell carcinoma with areas of acantholysis. Immunohistochemistry (Ki67, EMA, cytokeratin 34βE12 and p63) was performed and all types of immunostaining were moderately to intense positive. Above-knee leg amputation and specific oncologic treatment were proposed as possible curative solutions but the patient refused. Ten months after diagnosis and discharge form the Department of Dermatology, the patient died. Patients with chronic venous leg ulcers and clinically suspicious lesions should be evaluated for malignant transformation of the venous lesion. When diagnosed, malignancy complicating a chronic venous leg ulcer requires a resolute treatment as it may be fatal.
Yoganandan, Narayan; Schlick, Michael; Arun, Mike W J; Pintar, Frank A
Biomechanical tests to understand injury mechanisms and derive injury tolerance information using Post-Mortem Human Subjects (PMHS) have not used foot protection and they have primarily focused on civilian environments such as automotive and athletic- and sports-related events. As military personnel use boots, tests with the boot are required to understand their effect on attenuating lower leg loads. The purpose of this study was therefore, to determine the modulation of human lower leg kinematics with boot compressions and share of the force absorbed by the boot from underbody blast loading. Axial impacts were delivered to the Hybrid III dummy lower leg in the neutral position. The dummy leg was instrumented with its internal upper and lower tibia load cells, and in addition, a knee load cell was attached to the proximal end. Tests were conducted at 4.4 to 8.9 m/s, with and without boots, and repeat tests were done. Morphologies of the force-time responses were similar at the three load cell locations and for all input combinations and booted and unbooted conditions. However, booted tests resulted in considerably lower maximum forces (approximately two-third reduction) than unbooted tests. These results clearly show that boots can absorb a considerable share of the impact energy and decrease impact loads transmitted to the lower leg under vertical loading, thus necessitating the generation of tolerance data using PMHS for this environment.
Rao, M V S
Ultrahigh energy cosmic rays carry information about their sources and the intervening medium apart from providing a beam of particles for studying certain features of high energy interactions currently inaccessible at man-made accelerators. They can at present be studied only via the extensive air showers (EAS's) they generate while passing through the Earth's atmosphere, since their fluxes are too low for the experiments of limited capability flown in balloons and satellites. The EAS is generated by a series of interactions of the primary cosmic ray and its progeny with the atmospheric nucle
George M Jacobs
Full Text Available This article offers guidance to teachers and students in selecting materials for extensive reading (ER. First, the article explains characteristics of ER and reviews some of the potential gains for students who do ER. Second, the article considers criteria for teachers to bear in mind when selecting ER materials. Third, the article then suggests ways that teachers and students can find ER materials. Fourth, guidance is provided to students for when they select what to read from among the ER materials available to them. Finally, advice is given on integrating ER with course textbooks.
The Freund-Weinman multivariate exponential extension is generalized to the case of nonidentically distributed marginal distributions. A fatal shock model is given for the resulting distribution. Results in the bivariate case and the concept of constant multivariate hazard rate lead to a continuous distribution related to the multivariate exponential distribution (MVE) of Marshall and Olkin. This distribution is shown to be a special case of the extended Freund-Weinman distribution. A generalization of the bivariate model of Proschan and Sullo leads to a distribution which contains both the extended Freund-Weinman distribution and the MVE
dos Santos, Marcio José; Gorges, Ana Luiza; Rios, Jaqueline Lourdes
Individuals with chronic ankle instability (CAI) usually experience deficits in balance control, which increase displacement in the body's center of pressure (COP) when they balance on a single leg. Little is known, however, about whether or not these individuals use the strategies of postural adjustment properly, especially during functional tasks that may predispose them to ankle sprain. The aim of this study was to investigate anticipatory (APA) and compensatory (CPA) postural adjustments in individuals with and without CAI as they kick a ball while standing in a single-leg stance with their ankle in neutral and supinated positions. COP displacements were calculated and their magnitudes (range) analyzed during APA and CPA intervals and over the duration of the whole task, represented by the COP area of sway and mean velocity. The CAI group exhibited a significant decrease in CPA and area of sway over the whole task, relative to controls. These results suggest that the decreased balance sway could be caused by the need for further stabilization of the ankle in more unstable postures to prevent recurrent sprain. Our findings could help clinicians to better understand the strategies of postural adjustments in individuals with CAI, and may assist and motivate new investigations into balance control interventions in such individuals, as well as proactively address recurrent ankle sprain conditions. Published by Elsevier B.V.
Dwyer, Maureen K.; Boudreau, Samantha N.; Mattacola, Carl G.; Uhl, Timothy L.; Lattermann, Christian
Abstract Context: Closed kinetic chain exercises are an integral part of rehabilitation programs after lower extremity injury. Sex differences in lower extremity kinematics have been reported during landing and cutting; however, less is known about sex differences in movement patterns and activation of the hip musculature during common lower extremity rehabilitation exercises. Objective: To determine whether lower extremity kinematics and muscle activation levels differ between sexes during closed kinetic chain rehabilitation exercises. Design: Cross-sectional with 1 between-subjects factor (sex) and 1 within-subjects factor (exercise). Setting: Research laboratory. Patients or Other Participants: Participants included 21 women (age = 23 ± 5.8 years, height = 167.6 ± 5.1 cm, mass = 63.7 ± 5.9 kg) and 21 men (age = 23 ± 4.0 years, height = 181.4 ± 7.4 cm, mass = 85.6 ± 16.5 kg). Intervention(s): In 1 testing session, participants performed 3 trials each of single-leg squat, lunge, and step-up-and-over exercises. Main Outcome Measure(s): We recorded the peak joint angles (degrees) of knee flexion and valgus and hip flexion, extension, adduction, and external rotation for each exercise. We also recorded the electromyographic activity of the gluteus maximus, rectus femoris, adductor longus, and bilateral gluteus medius muscles for the concentric and eccentric phases of each exercise. Results: Peak knee flexion angles were smaller and peak hip extension angles were larger for women than for men across all tasks. Peak hip flexion angles during the single-leg squat were smaller for women than for men. Mean root-mean-square amplitudes for the gluteus maximus and rectus femoris muscles in both the concentric and eccentric phases of the 3 exercises were greater for women than for men. Conclusions: Sex differences were observed in sagittal-plane movement patterns during the rehabilitation exercises. Because of the sex differences
Miyamoto, Naokazu; Hirata, Kosuke; Kimura, Noriko; Miyamoto-Mikami, Eri
The passive straight-leg-raise (PSLR) and the sit-and-reach (SR) tests have been widely used to assess hamstring extensibility. However, it remains unclear to what extent hamstring stiffness (a measure of material properties) contributes to PSLR and SR test scores. Therefore, we aimed to clarify the relationship between hamstring stiffness and PSLR and SR scores using ultrasound shear wave elastography. Ninety-eight healthy subjects completed the study. Each subject completed PSLR testing, and classic and modified SR testing of the right leg. Muscle shear modulus of the biceps femoris, semitendinosus, and semimembranosus was quantified as an index of muscle stiffness. The relationships between shear modulus of each muscle and PSLR or SR scores were calculated using Pearson's product-moment correlation coefficients. Shear modulus of the semitendinosus and semimembranosus showed negative correlations with the two PSLR and two SR scores (absolute r value≤0.484). Shear modulus of the biceps femoris was significantly correlated with the PSLR score determined by the examiner and the modified SR score (absolute r value≤0.308). The present findings suggest that PSLR and SR test scores are strongly influenced by factors other than hamstring stiffness and therefore might not accurately evaluate hamstring stiffness. © Georg Thieme Verlag KG Stuttgart · New York.
1 - Description of test facility: The LOFT Integral Test Facility is a scale model of a LPWR. The intent of the facility is to model the nuclear, thermal-hydraulic phenomena which would take place in a LPWR during a LOCA. The general philosophy in scaling coolant volumes and flow areas in LOFT was to use the ratio of the LOFT core [50 MW(t)] to a typical LPWR core [3000 MW(t)]. For some components, this factor is not applied; however, it is used as extensively as practical. In general, components used in LOFT are similar in design to those of a LPWR. Because of scaling and component design, the LOFT LOCA is expected to closely model a LPWR LOCA. 2 - Description of test: The second OECD LOFT experiment was conducted on 23 June 1983. It simulated a 3-in (7.62 cm) equivalent break diameter located in the hot leg of the operating loop. The major objective of this experiment was to determine system transient characteristics for small hot leg break loss-of-coolant accidents with early pump trip. The experiment was conducted from initial temperature and pressure conditions representative of typical commercial PWRs. 3 - Experimental limitations or shortcomings: Short core and steam generator, excessive core bypass, other scaling compromises, and lack of adequate measurements in certain areas
1 - Description of test facility: The LOFT Integral Test Facility is a scale model of a LPWR. The intent of the facility is to model the nuclear, thermal-hydraulic phenomena which would take place in a LPWR during a LOCA. The general philosophy in scaling coolant volumes and flow areas in LOFT was to use the ratio of the LOFT core [50 MW(t)] to a typical LPWR core [3000 MW(t)]. For some components, this factor is not applied; however, it is used as extensively as practical. In general, components used in LOFT are similar in design to those of a LPWR. Because of scaling and component design, the LOFT LOCA is expected to closely model a LPWR LOCA. 2 - Description of test: The third OECD LOFT experiment was conducted on 14 July 1983. It simulated a 3-in (7.62 cm) equivalent break diameter located in the hot leg of the operating loop. The major objective of this experiment was to determine system transient characteristics for small hot leg break loss-of-coolant accidents with delayed pump trip. The experiment was conducted from initial temperature and pressure conditions representative of typical commercial PWRs. 3 - Experimental limitations or shortcomings: Short core and steam generator, excessive core bypass, other scaling compromises, and lack of adequate measurements in certain areas
Full Text Available Reconstructive surgery following an internal hemipelvectomy for a malignant pelvic tumor is difficult due to the structural complexity of the pelvis and the massive extension of the tumor. While high complication rates have been encountered in various types of reconstructive surgery, resection without reconstruction reportedly involved fewer complications. However, this method often results in limb shortening with resultant instability during walking. We reported herein leg lengthening performed to correct lower limb shortening after an internal hemipelvectomy, which improved ambulatory stability and overall QOL. An 18-year-old male patient came to our hospital to correct a lower limb discrepancy resulting from a left internal hemipelvectomy. His left pelvis and proximal femur had been resected, and the femur remained without an acetabular roof. His left lower limb was about 8 centimeters shorter. The left tibia was lengthened 8 centimeters with an external fixator. After the lengthening, the patient was able to walk without support and his gait remarkably improved. Additionally he no longer required placing a wallet in his back pocket as a pad as a means of raising the left side of his torso while sitting. Leg lengthening was a useful method of improving ambulation after an internal hemipelvectomy.
Calbet, J A L; Holmberg, H-C; Rosdahl, H
To determine whether conditions for O2 utilization and O2 off-loading from the hemoglobin are different in exercising arms and legs, six cross-country skiers participated in this study. Femoral and subclavian vein blood flow and gases were determined during skiing on a treadmill at approximately 76...... exercise (diagonal stride), the corresponding mean values were 93 and 85% (n = 3; P hemoglobin to be 50% saturated (P50: r = 0.93, P ...Hg, respectively. Because conditions for O2 off-loading from the hemoglobin are similar in leg and arm muscles, the observed differences in maximal arm and leg O2 extraction should be attributed to other factors, such as a higher heterogeneity in blood flow distribution, shorter mean transit time, smaller...
Nerkar, D.P.; Kumta, U.S.; Sreenivasan, A.
Large consignments of frogs legs are exported annually from India. Failure to satisfy some of the strict microbiological standards, especially in relating to Salmonellae contamination, has resulted in the rejection of large quantities of the product in recent years. This has emphasised the need for better and more effective methods than those currently in use for the elimination of Salmonellae. With a view to developing an irradiation process for the control of this public health problem, commercial samples of frog legs have been screened to assess the incidence of Salmonella. The various serotypes have been identified and their radiation sensitivities determined. Based on these data, a radiation treatment of frozen frog legs for the elimination of Salmonella has been developed. (author)
Ito, Yuzo; Taguma, Kiyohiko; Yatsuzuka, Mitsuo
A patient (57-year-old man) had open fracture of the leg due to a bullet wound penetrating the right leg in 1941, and had arteriography from the right popliteal fossa at an army hospital in 1942. He complained of painful swelling ranging from the inward site of the right femur to the popliteal fossa in 1977. As a result of the examination using a scintillation counter, it was diagnosed as an injury of the right leg long term after thorotrast injection. There was no deposition of thorotrast in the liver, the spleen, or the epigastric lymph nodes. Histopathologically, there was no finding of malignancy but granuloma. The findings on the postoperative examination were restored to the normal, but long-time-course observation seemed to be necessary in future considering a possibility of its exacerbation. (Ichikawa, K.)
"This book provides a comprehensive presentation of issues and challenges faced by researchers and practicing engineers in motion planning and hybrid control of dynamical legged locomotion. The major features range from offline and online motion planning algorithms to generate desired feasible periodic walking and running motions and tow-level control schemes, including within-stride feedback laws, continuous time update laws and event-based update laws, to asymptotically stabilize the generated desired periodic orbits. This book describes the current state of the art and future directions across all domains of dynamical legged locomotion so that readers can extend proposed motion planning algorithms and control methodologies to other types of planar and 3D legged robots".
Helena Xavier Soares
Full Text Available A survey of the leg exocrine glands in the termite workers of 16 species of the families Kalotermitidae and Termitidae was carried out through scanning electron microscope. Glandular openings were not found in the legs of Anoplotermes sp., Ruptitermes sp. (Apicotermitinae, Termitidae or Glyptotermes planus (Kalotermitidae, but they are present, spread over the ventral surface of the first, second and third tarsomeres of other Termitidae such as Armitermes euamignathus, Cornitermes cumulans, Nasutitermes coxipoensis, Rhynchotermes nasutissimus, Syntermes nanus, Embiratermes festivellus (Nasutitermitinae, Amitermes beaumonti, Hoplotermes amplus, Microcerotermes sp., Neocapritermes opacus, Orthognathotermes sp., Spinitermes brevicornutus and Termes sp. (Termitinae. The pores are usually isolated but they can also be grouped inside a round depression. The occurrence of leg exocrine glands in the family Termitidae is reported for the first time.
Daniel Cassany Comas
Full Text Available Following the distinction between intensive and extensive reading, we introduce the extensive written tasks to promote the following learning objectives: 1 bringing writing closer to the learner’s personal life; 2 practicing the epistemic and communicative language functions; 3 giving the learner full responsibility for the creative act; 4 facilitating the development of cognitive processes, and 5 developing habits of written production in a variety of situations. As a consequence, extensive writing assignments produce longer texts, last longer, are self-directed by the learner-author, treat interdisciplinary topics and are not in the textbook. These tasks markedly differ from the more frequent written exercises in the classroom, which are teacher-led, contain shorter texts, work on executive or instrumental functions, and their correction is focused on spelling and grammar. We propose several educational tools in order to develop this type of tasks: portfolios (to save drafts, corrections and final versions of each text, formats (such as reading logs, lecture notes and laboratory protocols and contexts (common communicative tasks. We also discuss some basic parameters of extensive tasks, such as the length of the text, the use of several working sessions for text production, the practice of composition processes and the use of peer review, in pairs or teams.
Loriaux, E.F.; Jehee, J.N.T.
Report on CRP-OSS Task 4.1.1. ''Survey of existing documentation relevant to this programme's goals'' and report on CRP-OSS Task 4.1.2. ''Survey of existing Operator Support Systems and the experience with them'' are presented. 2 tabs
India's Unfinished Telecom Tasks · India's Telecom Story is now well known · Indian Operators become an enviable force · At the same time · India Amongst the Leaders · Unfinished Tasks as Operators · LightGSM ON: Innovation for Rural Area from Midas · Broadband Access Options for India · Broadband driven by DSL: ...
Mortensen, Stefan Peter; Askew, Christopher D; Walker, Meegan
interstitial space. Inhibition of NO synthesis lowered the vasodilatory response to passive leg movement by ~90%. The increase in leg blood flow was lower in elderly subjects compared to young subjects and leg blood flow did not increase when passive leg movement was performed by elderly with peripheral artery...... disease. The results suggest that the hyperaemia induced by passive leg movement is NO dependent. The hyperaemic response to passive leg movement and to ACh was also assessed in elderly subjects and patients with peripheral artery disease.......Key points Passive leg movement is associated with a ~3-fold increase in blood flow to the leg, but the underlying mechanisms remain unknown. Passive leg movement increased venous levels of metabolites of nitric oxide (NO) in young subjects, whereas they remained unaltered in the muscle...
Carlos, K; Prado, L B F; Carvalho, L B C; Prado, G F
Restless Legs Syndrome (RLS) or Willis-Ekbom Disease (WED) is highly prevalent, but patients and healthcare providers alike know little about it. Furthermore, controversy persists as to the best way of diagnosing this nosological entity. To verify whether the term used to refer to this disease entity (Restless Legs Syndrome or Willis-Ekbom Disease) affects the prevalence of self-diagnosed RLS/WED in a sample of newly graduated physicians. Newly graduated physicians were asked to self-evaluate for the presence of RLS/WED. Briefly, participants were allocated randomly across two groups. One was asked to self-assess for RLS, while the other was asked to self-assess for WED. The evaluation form given to one group asked 'Do you have Restless Legs Syndrome?' whereas the form given to participants in the other group asked 'Do you have Willis-Ekbom Disease?'. Both forms also contained the four criteria for diagnosing RLS proposed by the International Restless Legs Syndrome Study Group (IRLSSG) and instructions for self-diagnosis according to these criteria. The study sample comprised 1413 newly graduated physicians. Of the 708 participants who were given the form that used the term RLS, 87 (12.28%) diagnosed themselves with the condition. Conversely, of 705 physicians given the form with the term WED, 13 (1.84%) diagnosed themselves with the condition (p Restless Legs Syndrome than when presented with the term Willis-Ekbom Disease. This suggests that the term Restless Legs Syndrome may not be the most appropriate term to denote this nosological entity. Copyright © 2015 Elsevier B.V. All rights reserved.
Full Text Available Abstract Background Effective control of (upright body posture requires a proper representation of body orientation. Stroke patients with pusher syndrome were shown to suffer from severely disturbed perception of own body orientation. They experience their body as oriented 'upright' when actually tilted by nearly 20° to the ipsilesional side. Thus, it can be expected that postural control mechanisms are impaired accordingly in these patients. Our aim was to investigate pusher patients' spontaneous postural responses of the non-paretic leg and of the head during passive body tilt. Methods A sideways tilting motion was applied to the trunk of the subject in the roll plane. Stroke patients with pusher syndrome were compared to stroke patients not showing pushing behaviour, patients with acute unilateral vestibular loss, and non brain damaged subjects. Results Compared to all groups without pushing behaviour, the non-paretic leg of the pusher patients showed a constant ipsiversive tilt across the whole tilt range for an amount which was observed in the non-pusher subjects when they were tilted for about 15° into the ipsiversive direction. Conclusion The observation that patients with acute unilateral vestibular loss showed no alterations of leg posture indicates that disturbed vestibular afferences alone are not responsible for the disordered leg responses seen in pusher patients. Our results may suggest that in pusher patients a representation of body orientation is disturbed that drives both conscious perception of body orientation and spontaneous postural adjustment of the non-paretic leg in the roll plane. The investigation of the pusher patients' leg-to-trunk orientation thus could serve as an additional bedside tool to detect pusher syndrome in acute stroke patients.
Frantsevich, Leonid; Frantsevich, Ludmilla
A dragonfly larva migrates from the water to the shore, perches on a plant stem and grasps it with strongly flexed legs. Adult legs inside the larval exoskeleton fit to the larval legs joint-to-joint. The adult emerges with stretched legs. During the molt, an imaginal leg must follow all the angles in exuvial joints. In turn, larval apodemes are withdrawn from imaginal legs. We visualized transient shapes of the imaginal legs by the instant fixation of insects at different moments of the molt, photographed isolated exuvial legs with the imaginal legs inside and then removed the exuvial sheath. Instant shapes of the imaginal tibia show sharp intrapodomere bends copying the angle in the larval femoro-tibial joint. The site of bending shifts distad during the molt. This is possible if the imaginal leg is pliable. The same problem of leg squeezing is also common in hemimetabolous insects as well as in other arthropods, whereas holometabolous insects overcome problems of a tight confinement either by using leg pliability in other ways but not squeezing (cyclorrhaphan flies, mosquitoes) or by pulling hardened legs out without change of their pupal zigzag configuration (moths, ants, honey bees). The pupal legs are not intended to grasp any external substrate. Copyright © 2018 Elsevier GmbH. All rights reserved.
At this meeting, the main tasks of the study group were to discuss their task report with other task groups and to formulate the five-year research program, including next year's plans. A summary of the discussion with other task groups is presented. The general objective of the five-year program is to gather all elements necessary for a decision on the technical feasibility of the subseabed option. In addition, site selection criteria consistent with both radiological assessment and engineering capability will be produced. The task group report discussed radiological assessments, normal or base-case assessments, operational failures, low-probability postdisposal events, engineering studies, radiological criteria, legal aspects, social aspects, institutional aspects, generic comparison with other disposal options, and research priorities. The text of the report is presented along with supporting documents
Logadottir, Asta; Ardkapan, Siamak Rahimi; Johnsen, Kjeld
made lenses, capable of providing the desired light distribution. The user test shows that when working with general lighti ng of 100 lx in the room the developed task lig ht with its wide light distribution provides flexibility in choosing a reading task area on the desk and provides more visibility......The objectives of this work is to develop a task light for office lighting that fulfils the minimum requirements of the European standard EN12464 - 1 : Light and lighting – Lighting of work places, Part 1: Indoor workplaces and the Danish standard DS 700 : Lys og belysning I arbejdsrum , or more...... specifically the requirements that apply to the work area and the immediate surrounding area. By providing a task light that fulfils the requirements for task lighting and the immediate surrounding area, the general lighting only needs to provide the illuminance levels required for background lighting...
Full Text Available Abstract Background Leg pain associated with low back pain (LBP is recognized as a risk factor for a poor prognosis, and is included as a component in most LBP classification systems. The location of leg pain relative to the knee and the presence of a positive straight leg raise test have been suggested to have clinical implications. To understand differences between such leg pain subgroups, and whether differences include potentially modifiable characteristics, the purpose of this paper was to describe characteristics of patients classified into the Quebec Task Force (QTF subgroups of: 1 LBP only, 2 LBP and pain above the knee, 3 LBP and pain below the knee, and 4 LBP and signs of nerve root involvement. Methods Analysis of routine clinical data from an outpatient department. Based on patient reported data and clinical findings, patients were allocated to the QTF subgroups and described according to the domains of pain, activity limitation, work participation, psychology, general health and clinical examination findings. Results A total of 2,673 patients aged 18–95 years (median 47 who were referred for assessment of LBP were included. Increasing severity was consistently observed across the subgroups from LBP only to LBP with signs of nerve root involvement although subgroup differences were small. LBP patients with leg pain differed from those with LBP only on a wide variety of parameters, and patients with signs of nerve root involvement had a more severe profile on almost all measures compared with other patients with back-related leg pain. Conclusion LBP patients with pain referral to the legs were more severely affected than those with local LBP, and patients with signs of nerve root involvement were the ones most severily affected. These findings underpin the concurrent validity of the Quebec Task Force Classification. However, the small size of many between-subgroup differences amid the large variability in this sample of cross
Saraç, Hatice Sezgi
In this study, it was aimed to compare two distinct methodologies of grammar instruction: task-based and form-focused teaching. Within the application procedure, which lasted for one academic term, two groups of tertiary level learners (N = 53) were exposed to the same sequence of target structures, extensive writing activities and evaluation…
Muyor, José M; Arrabal-Campos, Francisco M
The purpose of the present study was to evaluate the influence of acute fatigue of the hip flexor muscles on scores attained in tests frequently used in literature to measure hamstring muscle extensibility, namely the passive straight leg raise (PSLR), active straight leg raise (ASLR), passive knee extension (PKE), active knee extension (AKE), sit-and-reach (SR) and toe-touch (TT) tests. A total of seventy-five healthy and recreationally active adults voluntarily participated in this study. To reach fatigue, the participants actively lifted their legs alternately as many times as possible. In the passive tests, the results were 7.10 ± 5.21° and 5.68 ± 4.54° higher (p fatigue. However, in the ASLR test, the results were lower post-fatigue than pre-fatigue (mean difference = -5.30° ± 9.51°; p fatigue (p > 0.05). Moderate (r = 0.40) to high (r = 0.97) correlation coefficients were found, which were statistically significant among all the measured flexibility tests both pre- and post-fatigue. In conclusion, the active implication of the hip flexor muscles until reaching fatigue had acute influences on the results of the PSLR, PKE and ASLR tests, but not on the results of the AKE, SR and TT tests. It is recommended to use the AKE test to assess hamstring muscle extensibility in situations where athletes show fatigue in their hip flexor muscles.
Muyor José M.
Full Text Available The purpose of the present study was to evaluate the influence of acute fatigue of the hip flexor muscles on scores attained in tests frequently used in literature to measure hamstring muscle extensibility, namely the passive straight leg raise (PSLR, active straight leg raise (ASLR, passive knee extension (PKE, active knee extension (AKE, sit-and-reach (SR and toe-touch (TT tests. A total of seventy-five healthy and recreationally active adults voluntarily participated in this study. To reach fatigue, the participants actively lifted their legs alternately as many times as possible. In the passive tests, the results were 7.10 ± 5.21° and 5.68 ± 4.54° higher (p 0.05. Moderate (r = 0.40 to high (r = 0.97 correlation coefficients were found, which were statistically significant among all the measured flexibility tests both pre- and post-fatigue. In conclusion, the active implication of the hip flexor muscles until reaching fatigue had acute influences on the results of the PSLR, PKE and ASLR tests, but not on the results of the AKE, SR and TT tests. It is recommended to use the AKE test to assess hamstring muscle extensibility in situations where athletes show fatigue in their hip flexor muscles.
Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance.
Allen, Richard P; Picchietti, Daniel L; Garcia-Borreguero, Diego; Ondo, William G; Walters, Arthur S; Winkelman, John W; Zucconi, Marco; Ferri, Raffaele; Trenkwalder, Claudia; Lee, Hochang B
In 2003, following a workshop at the National Institutes of Health, the International Restless Legs Syndrome Study Group (IRLSSG) developed updated diagnostic criteria for restless legs syndrome/Willis-Ekbom disease (RLS/WED). These criteria were integral to major advances in research, notably in epidemiology, biology, and treatment of RLS/WED. However, extensive review of accumulating literature based on the 2003 NIH/IRLSSG criteria led to efforts to improve the diagnostic criteria further. The clinical standards workshop, sponsored by the WED Foundation and IRLSSG in 2008, started a four-year process for updating the diagnostic criteria. That process included a rigorous review of research advances and input from clinical experts across multiple disciplines. After broad consensus was attained, the criteria were formally approved by the IRLSSG executive committee and membership. Major changes are: (i) addition of a fifth essential criterion, differential diagnosis, to improve specificity by requiring that RLS/WED symptoms not be confused with similar symptoms from other conditions; (ii) addition of a specifier to delineate clinically significant RLS/WED; (iii) addition of course specifiers to classify RLS/WED as chronic-persistent or intermittent; and (iv) merging of the pediatric with the adult diagnostic criteria. Also discussed are supportive features and clinical aspects that are important in the diagnostic evaluation. The IRLSSG consensus criteria for RLS/WED represent an international, interdisciplinary, and collaborative effort intended to improve clinical practice and promote further research. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.
Knutson Gary A
Full Text Available Abstract Background Part II of this review examines the functional "short leg" or unloaded leg length alignment asymmetry, including the relationship between an anatomic and functional leg-length inequality. Based on the reviewed evidence, an outline for clinical decision making regarding functional and anatomic leg-length inequality will be provided. Methods Online databases: Medline, CINAHL and Mantis. Plus library searches for the time frame of 1970–2005 were done using the term "leg-length inequality". Results and Discussion The evidence suggests that an unloaded leg-length asymmetry is a different phenomenon than an anatomic leg-length inequality, and may be due to suprapelvic muscle hypertonicity. Anatomic leg-length inequality and unloaded functional or leg-length alignment asymmetry may interact in a loaded (standing posture, but not in an unloaded (prone/supine posture. Conclusion The unloaded, functional leg-length alignment asymmetry is a likely phenomenon, although more research regarding reliability of the measurement procedure and validity relative to spinal dysfunction is needed. Functional leg-length alignment asymmetry should be eliminated before any necessary treatment of anatomic LLI.
Full Text Available A 56-year-old woman presented with gradually worsening shortness of breath associated with dull left leg pain over 5 days. She denied any recent travel, recent surgeries or immobilization. CT pulmonary angiography and CT venography revealed multiple bilateral pulmonary emboli and extensive left pelvic and left lower extremity deep vein thromboses. Contrast-enhanced CT showed that the right common iliac artery crossed the left common iliac vein and compressed it externally, indicative of May–Thurner syndrome. Catheter-directed thrombolysis of the left lower extremity was performed and heparin infusion was started. The patient also underwent left iliac vein balloon angioplasty with stenting and infra-renal inferior vena cava filter placement via the jugular approach to prevent further embolization.
Full Text Available Objectives: The aim and rationale of our study was to determine the acute effect of kinesio taping on theextensibility of the hamstring muscle among university students.Design: An intra-subject experimental design was used to evaluate the possible acute effects of KT using the Xshapedtaping technique in order to affect hamstring muscle extensibility.Method: Forty-three healthy university students (age 21.98 ± 4.68 years, body mass 71.50 ± 13.49 kg, height172.35 ± 8.17 cm were assessed for hamstring flexibility. All participants had both legs tested under threedifferent randomly ordered conditions (kinesio tape, sham tape and control using the Passive Straight Leg RaiseTest. All measurements were made during the same testing session. Participants performed three sets of tests,each set measured twice, to determine hamstring extensibility in both legs. There was a 12 minute rest periodbetween each set and a one minute break between each repetition.Results: An analysis of variance (ANOVA with repeated measurements showed no statistically significantdifferences either in the right (p=0.503 or the left leg (p=0.948 between the three study conditions.Conclusions: The application of kinesio taping does not seem to acutely increase hip flexion range of motion inhealthy subjects.
Jang, Sung Ho; Lee, Han Do
This study reports on a patient with mild traumatic brain injury (TBI) who showed severe and extensive traumatic axonal injury (TAI) of various neural tracts following minor and indirect head trauma, which was demonstrated by diffusion tensor tractography (DTT). A 26-year-old female patient suffered from indirect head trauma resulting from flexion-hyperextension injury after being hit from behind by a slowly moving car. At the time of head trauma, she felt tingling sensation on her four extremities; however, she did not experience loss of consciousness. At 5-day after onset, she began to experience tremor on the right leg and, subsequently, tremor had also developed in the left leg. At 8-days after onset, she could not even stand due to tremor of both legs and began to feel a tingling sensation on both legs. Since ~ 2 weeks after head trauma, myoclonus had developed mainly in the trunk. After 10-weeks after head trauma, when she started rehabilitation, she showed mild quadriparesis (4 + /4 + ) with severe weakness of the proximal joint (shoulder/hip, 4 - /4 - ), severe resting and intentional tremor, ataxic gait and severe myoclonus. Severe and extensive TAI of various neural tracts was demonstrated in a patient with mild TBI following minor and indirect head trauma, using DTT.
Amorim, R.; Barcelos-Neto, J. (Universidade Federal do Rio de Janeiro, RJ (Brazil). Inst. de Fisica)
With the motivation that critical dimensions D[ne]4 might be suggeting that string theories have not been completely formulated, we study more general alternatives. We first consider a direct extension in the world-sheet formulation with N[sub B] bosons and N[sub F] fermions and analyze the conditions for canceling the anomaly in all possible combinations of N[sub B], N[sub F] and D. Later on we incorporate degrees of freedom of antisymmetric tensors to the previous model. The only possibility to cancel the anomaly in this case is with N[sub B]=N[sub F]=1 and the our everyday spacetime dimension D=4. (orig.).
Full Text Available Motor unit activity is coordinated between many synergistic muscle pairs but the functional role of this coordination for the motor output is unclear. The purpose of this study was to investigate the short-term modality of coordinated motor unit activity-the synchronized discharge of individual motor units across muscles within time intervals of 5ms-for the Vastus Medialis (VM and Lateralis (VL. Furthermore, we studied the task-dependency of intermuscular motor unit synchronization between VM and VL during static and dynamic squatting tasks to provide insight into its functional role.Sixteen healthy male and female participants completed four tasks: Bipedal squats, single-leg squats, an isometric squat, and single-leg balance. Monopolar surface electromyography (EMG was used to record motor unit activity of VM and VL. For each task, intermuscular motor unit synchronization was determined using a coherence analysis between the raw EMG signals of VM and VL and compared to a reference coherence calculated from two desynchronized EMG signals. The time shift between VM and VL EMG signals was estimated according to the slope of the coherence phase angle spectrum.For all tasks, except for singe-leg balance, coherence between 15-80Hz significantly exceeded the reference. The corresponding time shift between VM and VL was estimated as 4ms. Coherence between 30-60Hz was highest for the bipedal squat, followed by the single-leg squat and the isometric squat.There is substantial short-term motor unit synchronization between VM and VL. Intermuscular motor unit synchronization is enhanced for contractions during dynamic activities, possibly to facilitate a more accurate control of the joint torque, and reduced during single-leg tasks that require balance control and thus, a more independent muscle function. It is proposed that the central nervous system scales the degree of intermuscular motor unit synchronization according to the requirements of the movement
Miller, S. W.; Greene, E.
The National Oceanic and Atmospheric Administration (NOAA) and National Aeronautics and Space Administration (NASA) are jointly acquiring the next-generation civilian weather and environmental satellite system: the Joint Polar Satellite System (JPSS). The Joint Polar Satellite System will replace the afternoon orbit component and ground processing system of the current Polar-orbiting Operational Environmental Satellites (POES) managed by NOAA. The JPSS satellites will carry a suite of sensors designed to collect meteorological, oceanographic, climatological and geophysical observations of the Earth. The ground processing system for JPSS is known as the JPSS Common Ground System (JPSS CGS). Developed and maintained by Raytheon Intelligence, Information and Services (IIS), the CGS is a multi-mission enterprise system serving NOAA, NASA and their national and international partners, such as NASA's Earth Observation System (EOS), NOAA's current POES, the Japan Aerospace Exploration Agency's (JAXA) Global Change Observation Mission - Water (GCOM-W1), and DoD's Defense Meteorological Satellite Program (DMSP). The CGS provides a wide range of support to a number of national and international missions, including command and control, mission management, data acquisition and routing, and environmental data processing and distribution. The current suite of CGS-supported missions has demonstrated the value of interagency and international partnerships to address global observation needs. With its established infrastructure and existing suite of missions, the CGS is extensible to a wider array of potential new missions. This paper will describe how the inherent scalability and extensibility of the CGS enables the addition of these new missions, with an eye on global enterprise needs in the 2020's and beyond.
Schrade, Stefan O; Dätwyler, Katrin; Stücheli, Marius; Studer, Kathrin; Türk, Daniel-Alexander; Meboldt, Mirko; Gassert, Roger; Lambercy, Olivier
Powered exoskeletons are a promising approach to restore the ability to walk after spinal cord injury (SCI). However, current exoskeletons remain limited in their walking speed and ability to support tasks of daily living, such as stair climbing or overcoming ramps. Moreover, training progress for such advanced mobility tasks is rarely reported in literature. The work presented here aims to demonstrate the basic functionality of the VariLeg exoskeleton and its ability to enable people with motor complete SCI to perform mobility tasks of daily life. VariLeg is a novel powered lower limb exoskeleton that enables adjustments to the compliance in the leg, with the objective of improving the robustness of walking on uneven terrain. This is achieved by an actuation system with variable mechanical stiffness in the knee joint, which was validated through test bench experiments. The feasibility and usability of the exoskeleton was tested with two paraplegic users with motor complete thoracic lesions at Th4 and Th12. The users trained three times a week, in 60 min sessions over four months with the aim of participating in the CYBATHLON 2016 competition, which served as a field test for the usability of the exoskeleton. The progress on basic walking skills and on advanced mobility tasks such as incline walking and stair climbing is reported. Within this first study, the exoskeleton was used with a constant knee stiffness. Test bench evaluation of the variable stiffness actuation system demonstrate that the stiffness could be rendered with an error lower than 30 Nm/rad. During training with the exoskeleton, both users acquired proficient skills in basic balancing, walking and slalom walking. In advanced mobility tasks, such as climbing ramps and stairs, only basic (needing support) to intermediate (able to perform task independently in 25% of the attempts) skill levels were achieved. After 4 months of training, one user competed at the CYBATHLON 2016 and was able to perform 3
Aditya, Sai Krishna Venkata; Ignasov, Jevgeni; Filonenko, Konstantin
The African dung beetle Scarabaeus galenus can use its front legs to walk and manipulate or form a dung ball. The interesting multifunctional legs have not been fully investigated or even used as inspiration for robot leg design. Thus, in this paper, we present the development of real dung beetle......-like front legs based on biological investigation. As a result, each leg consists of three main segments which were built using 3D printing. The segments were combined with in total four active DOFs in order to mimic locomotion and object manipulation of the beetle. Kinematics analysis of the leg was also...
Yam, Timothy T T; Fong, Shirley S M
Previous studies have shown that children with developmental coordination disorder (DCD) have a higher body fat and greater gait variability. Little research has investigated the gait muscle activity and lean mass measures in children with DCD. To compare the leg muscle activation patterns of the gait cycle and leg lean mass between children with and without DCD. Fifty-one children were in the DCD group (38 males and 13 females; 7.95 ± 1.04 years) and fifty-two in the control group (34 males and 18 females; 8.02 ± 1.00 years). Peak muscle activation patterns of treadmill walking in the right leg for the eight-gait phases were measured by means of surface electromyography, an electrogoniometer, and foot contact switches. Leg lean mass measures were evaluated using a whole-body dual energy X-ray absorptiometry scan. Children with DCD had a lower leg lean mass and appendicular lean mass index compared to the control group. Furthermore, they exhibited a less-pronounced peak muscle activation during the heel strike (gastrocnemius medialis), early swing (biceps femoris) and late swing phases (gastrocnemius medialis) of gait. Although lower limb total mass was similar between groups, the DCD group displayed lower lean mass measures than controls. Furthermore, children with DCD illustrated a lower leg peak muscle activation during the heel strike, early swing and late swing phases of gait when walking on a treadmill. Our results emphasize the need to incorporate lower limb phasic muscle strengthening components into gait rehabilitation programs for children with DCD. Copyright © 2017 Elsevier Ltd. All rights reserved.
In order to make the attitudes of extension workers more affirmative, the paper recommended, inter alia, staff motivation, minimizing political and administrative interference in staff work and a reasonable reduction in the work load of extension staff. Key words: attitude, extension personnel, training and visit. Journal of ...
Caulfield, H. John
Since the early 1960s, a major part of optical computing systems has been Fourier pattern recognition, which takes advantage of high speed filter changes to enable powerful nonlinear discrimination in `real time.' Because filter has a task quite independent of the tasks of the other filters, they can be applied and evaluated in parallel or, in a simple approach I describe, in sequence very rapidly. Thus I use the name ITFF (independent task Fourier filter). These filters can also break very complex discrimination tasks into easily handled parts, so the wonderful space invariance properties of Fourier filtering need not be sacrificed to achieve high discrimination and good generalizability even for ultracomplex discrimination problems. The training procedure proceeds sequentially, as the task for a given filter is defined a posteriori by declaring it to be the discrimination of particular members of set A from all members of set B with sufficient margin. That is, we set the threshold to achieve the desired margin and note the A members discriminated by that threshold. Discriminating those A members from all members of B becomes the task of that filter. Those A members are then removed from the set A, so no other filter will be asked to perform that already accomplished task.
Pedersen, Michael Svendsen
Definition af task-baseret sprogundervisning, kriterier for task. Forskning i Second Language Acquisition med brug af task, tilrettelæggelse af task-baseret kommunikativ undervisning. Begrænsninger i og perspektiver for videreudvikling af task-baseret sprogundervising-......Definition af task-baseret sprogundervisning, kriterier for task. Forskning i Second Language Acquisition med brug af task, tilrettelæggelse af task-baseret kommunikativ undervisning. Begrænsninger i og perspektiver for videreudvikling af task-baseret sprogundervising-...
Minichilli, Alessandro; Zattoni, Alessandro; Nielsen, Sabina
influence board tasks, and how the context moderates the relationship between processes and tasks. Our hypotheses are tested on a survey-based dataset of 535 medium-sized and large industrial firms in Italy and Norway, which are considered to substantially differ along legal and cultural dimensions...... identify three board processes as micro-level determinants of board effectiveness. Specifically, we focus on effort norms, cognitive conflicts and the use of knowledge and skills as determinants of board control and advisory task performance. Further, we consider how two different institutional settings...
Howell, Emily R
This case study reported the conservative management of a patient presenting with left sided low back and leg pain diagnosed as a left sided L5-S1 disc prolapse/herniation. A 31-year-old male recreational worker presented with left sided low back and leg pain for the previous 3-4 months that was exacerbated by prolonged sitting. The plan of management included interferential current, soft tissue trigger point and myofascial therapy, lateral recumbent manual low velocity, low amplitude traction mobilizations and pelvic blocking as necessary. Home care included heat, icing, neural mobilizations, repeated extension exercises, stretching, core muscle strengthening, as well as the avoidance of prolonged sitting and using a low back support in his work chair. The patient responded well after the first visit and his leg and back pain were almost completely resolved by the third visit. Conservative chiropractic care appears to reduce pain and improve mobility in this case of a L5-S1 disc herniation. Active rehabilitative treatment strategies are recommended before surgical referral.
Beurskens, Rainer; Gollhofer, Albert; Muehlbauer, Thomas; Cardinale, Marco; Granacher, Urs
The term “bilateral deficit” (BLD) has been used to describe a reduction in performance during bilateral contractions when compared to the sum of identical unilateral contractions. In old age, maximal isometric force production (MIF) decreases and BLD increases indicating the need for training interventions to mitigate this impact in seniors. In a cross-sectional approach, we examined age-related differences in MIF and BLD in young (age: 20–30 years) and old adults (age: >65 years). In addition, a randomized-controlled trial was conducted to investigate training-specific effects of resistance vs. balance training on MIF and BLD of the leg extensors in old adults. Subjects were randomly assigned to resistance training (n = 19), balance training (n = 14), or a control group (n = 20). Bilateral heavy-resistance training for the lower extremities was performed for 13 weeks (3 × / week) at 80% of the one repetition maximum. Balance training was conducted using predominately unilateral exercises on wobble boards, soft mats, and uneven surfaces for the same duration. Pre- and post-tests included uni- and bilateral measurements of maximal isometric leg extension force. At baseline, young subjects outperformed older adults in uni- and bilateral MIF (all p training (all p training (all p training (p training regimens resulted in increased MIF and decreased BLD of the leg extensors (HRT-group more than BAL-group), almost reaching the levels of young adults. PMID:25695770
It is known that humans intentionally choose skipping in special situations, e.g. when descending stairs or when moving in environments with lower gravity than on Earth. Although those situations involve uneven locomotion, the dynamics of human skipping on uneven ground have not yet been addressed. To find the reasons that may motivate this gait, we combined experimental data on humans with numerical simulations on a bipedal spring-loaded inverted pendulum model (BSLIP). To drive the model, the following parameters were estimated from nine subjects skipping across a single drop in ground level: leg lengths at touchdown, leg stiffness of both legs, aperture angle between legs, trailing leg angle at touchdown (leg landing first after flight phase), and trailing leg retraction speed. We found that leg adjustments in humans occur mostly in the trailing leg (low to moderate leg retraction during swing phase, reduced trailing leg stiffness, and flatter trailing leg angle at lowered touchdown). When transferring these leg adjustments to the BSLIP model, the capacity of the model to cope with sudden-drop perturbations increased. PMID:29410879
have been described in the axilla, periolecranon, forearm, lower extremity, hand, and trunk. In spite of the versatility of perforator‑based flaps, literature search reveals ... Anatomy of distal leg perforators. Perforators are small diameter vessels that originate from a main pedicle and perforate the fascia or muscle to ...
The participants (N=32) were divided into two groups according to the Fatigue Index value [Group I: Less Fatigue Resistant (LFR), n=17; Group II: More Fatigue Resistant (MFR), n=15]. The repeated EMG activities of four leg muscles [rectus femoris, biceps femoris, vastus lateralis and vastus medialis] were analysed during ...
Full Text Available Abstract Diverticulosis of the colon is a common condition of increasing age. Complications of diverticulitis including stricture, perforation and fistula formation often require surgery. Perforated diverticulitis may rarely present with spreading superficial sepsis. We describe for the first time, to our knowledge, a case of retroperitoneal diverticula perforation presenting as necrotising fasciitis of the leg necessitating hind-quarter amputation.
Canine hip dysplasia (CHD) is hereditary developmental condition that involves a lack of conformity between the femoral head and acetabulum. It invariably leads to osteoarthritis. We hereby review the standard hip ventrodorsal leg extended view to be adopted by our Tanzanian veterinarians. Diagnostic radiography is the ...
van Oosterhout, W P J; van Someren, E J W; Louter, M A; Schoonman, G G; Lammers, G J; Rijsman, R M; Ferrari, M D; Terwindt, G M
BACKGROUND AND PURPOSE: Our aim was to study not only the prevalence but more importantly the severity and the correlation between sleep quality and restless legs syndrome (RLS) in a large population of well-defined migraine patients as poor sleep presumably triggers migraine attacks. METHODS: In a
Garcia-Borreguero, Diego; Ferini-Strambi, Luigi; Kohnen, Ralf
Since the publication of the first European Federation of Neurological Societies (EFNS) guidelines in 2005 on the management of restless legs syndrome (RLS; also known as Willis-Ekbom disease), there have been major therapeutic advances in the field. Furthermore, the management of RLS is now a part...
Boesgaard-Kjer, Diana H; Boesgaard-Kjer, Daniel; Kjer, Jens Jørgen
Well-leg compartment syndrome in the lower extremities after surgery in the lithotomy position is a rare but severe complication requiring early diagnosis and intervention. Several circumstances predispose to this condition as a consequence of increased intra-compartmental pressure, such as posit...
Dec 7, 2017 ... A 5-year-old intact female black-legged seriema (Chunga burmeisteri) was presented for behavioral changes and slight decrease in activity (minor ... panel did not reveal any abnormalities as compared to reference individuals from .... Cloacolith in a blue-fronted Amazon parrot. (Amazona aestiva). J. Avian ...
... Staying Safe Videos for Educators Search English Español X-Ray Exam: Lower Leg (Tibia and Fibula) KidsHealth / For ... Muscles, and Joints Broken Bones Getting an X-ray (Video) X-Ray (Video) View more Partner Message About Us ...
Salavert, M; Franck, F; Amarger, S; Mansard, S; Souteyrand, P; D'Incan, M
Erosive pustular dermatosis of the legs is a rare and recently described condition seen in elderly subjects. It is characterised by symmetric erosions of the legs resulting from a confluence of sterile pustules, usually following minor trauma. Treatment with dermal corticosteroids is rapidly effective but is not codified and relapse is common. Three patients aged respectively 74, 84 and 92 years presented ulcers of the legs and ankles associated with peripheral pustules following minor injury. These pustules were sterile and exhibited a spongiform appearance on histological examination. None of these patients had a prior history of psoriasis. However, all presented zinc deficiency. Treatment with dermal corticosteroids combined with oral zinc gluconate resulted in complete resolution in two of the patients after several days of therapy and proved effective during relapse in the third patient. Erosive pustular dermatosis of the legs is a benign dermatosis that is probably under-reported that should be included in the category of inflammatory neutrophilic dermatoses. The cases we present suggest a triggering or enhancing role of zinc deficiency.
Aigner, F; Husmann, M; Huber, L C; Benden, C; Schuurmans, M M
Critical limb ischemia (CLI) with distal leg necrosis in lung transplant recipients (LTR) is associated with a high risk for systemic infection and sepsis. Optimal management of CLI has not been defined so far in LTR. In immunocompetent individuals with leg necrosis, surgical amputation would be indicated and standard care. We report on the outcome of four conservatively managed LTR with distal leg necrosis due to peripheral arterial disease (PAD) with medial calcification of the distal limb vessels. Time interval from lung transplantation to CLI ranged from four years (n = 1) to more than a decade (n = 3). In all cases a multimodal therapy with heparin, acetylsalicylic acid, iloprost and antibiotic therapy was performed, in addition to a trial of catheter-based revascularization. Surgical amputation of necrosis was not undertaken due to fear of wound healing difficulties under long-term immunosuppression and impaired tissue perfusion. Intensive wound care and selective debridement were performed. Two patients developed progressive gangrene followed by auto-amputation during a follow-up of 43 and 49 months with continued ambulation and two patients died of unrelated causes 9 and 12 months after diagnosis of CLI. In conclusion, we report a conservative treatment strategy for distal leg necrosis in LTR without surgical amputation and recommend this approach based on our experience. Copyright © 2017 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.
Junka, Adam; Wojtowicz, Wojciech; Ząbek, Adam; Krasowski, Grzegorz; Smutnicka, Danuta; Bakalorz, Barbara; Boruta, Agnieszka; Dziadas, Mariusz; Młynarz, Piotr; Sedghizadeh, Parish Paymon; Bartoszewicz, Marzenna
Chronic leg ulceration is a disease usually associated with other comorbidities, and significantly reduces patient quality of life. Infected leg ulcers can lead to limb-threatening sequelae or mortality. Leg ulcerations are colonized by a number of microbes that are able to cause life-threating infections in susceptible patients. Wound exudate is a body fluid that collects metabolites from patient eukaryotic cells and from prokaryotic bacterial communities inhabiting the wound. This study aimed at identification of metabolites in exudates collected from chronic leg ulcers, and correlation of this metabolome with patient comorbidities and microbiological status of the wound. By means of NMR spectroscopy we detected 42 metabolites of microbial or patient origin. The metabolites that were in abundance in exudates analyzed were lactate, lysine, and leucine. Metabolites were associated with the presence of neutrophils in wounds and destruction of high quantities of microbes, but also with hypoxia typical for venous insufficiency. The combination of nuclear magnetic resonance spectroscopy technique and partial least squares discriminant analysis allowed us to further discriminate groups of metabolites with regards to potential clinical meaning. For example, to discriminate between S.aureus versus all other isolated microbial species, or between patients suffering from type I or II diabetes versus patients without diabetes. Therefore, wound exudate seems to be highly applicable material for discriminant analysis performed with the use of NMR technique to provide for rapid metabolomics of chronic wound status. Copyright © 2017 Elsevier B.V. All rights reserved.
Retrospective study was conducted with the objective of assessing the vaccination coverage of Kafta Humera through observation of different woredas against black leg from records of the Humera veterinary clinic in Tigray region of Ethiopia, from 207/8-2012/13. The result revealed that there was vaccination program ...
Lythgo, Noel; Eser, Prisca; de Groot, Patricia; Galea, Mary
The effect of whole-body vibration dosage on leg blood flow was investigated. Nine healthy young adult males completed a set of 14 random vibration and non-vibration exercise bouts whilst squatting on a Galileo 900 plate. Six vibration frequencies ranging from 5 to 30 Hz (5 Hz increments) were used
Reverse sural artery fasciocutaneous flap has become a workhorse for the reconstruction of distal leg soft tissue defects. When its use is not feasible, perforator‑based propeller flap offers a better, easier, faster, and cheaper alternative to free flap. We present our experience with two men both aged 34 years who sustained ...
S.W.I. Reeder (Suzan); K.P. de Roos; R.J.M. Vogels (R. J M); H.A.M. Neumann (Martino)
textabstractAim: To get insight into the frequency of venous leg ulceration in the Dutch dermatologic practice, and into how this profession treats this disease. Design: Material and Methods: An e-survey was conducted. To all Dutch dermatologists and residents dermatology an email was sent with an
Ginsberg, J. S.; Brill-Edwards, P.; Burrows, R. F.; Bona, R.; Prandoni, P.; Büller, H. R.; Lensing, A.
In order to determine the relative frequencies of left and right leg venous thrombosis during pregnancy and the frequencies of venous thrombosis during the three trimesters, a cohort study of 60 consecutive patients with a first episode of venous thrombosis during pregnancy was performed.
ABSTRACT. Retrospective study was conducted with the objective of assessing the vaccination coverage of. Kafta Humera through observation of different woredas against black leg from records of the. Humera veterinary clinic in Tigray region of Ethiopia, from 207/8-2012/13. The result revealed that there was vaccination ...
Mellado, J.M. [Radiology Department, Hospital Virgen de la Cinta, Tortosa, Tarragona (Spain)]|[IDI - Centre Tarragona, Ressonancia Magnetica, Hospital Joan XXIII, Tarragona (Spain); Perez del Palomar, L. [Radiology Department, Hospital Virgen de la Cinta, Tortosa, Tarragona (Spain)
Muscle hernias of the lower leg involving the tibialis anterior, peroneus brevis, and lateral head of the gastrocnemius were found in three different patients. MRI findings allowed recognition of herniated muscle in all cases and identification of fascial defect in two of them. MR imaging findings and the value of dynamic MR imaging is emphasized. (orig.) With 3 figs., 10 refs.
This includes the health sector. The framework is based on the four pillars of leadership, ethics, governance and systems, hence called LEGS framework. It can complement the six World Health Organization building blocks that guide inputs to help a health system achieve the intended goals. Despite all the strengths of the ...
... of only a quantitative assessment. These findings indicate that, when evaluating the one leg balance in children aged 3-6 years, a quantitative and qualitative assessment should be used in combination together to assure a more accurate assessment. (S. African J. for Research in Sport, Physical Ed. and Recreation: 2001 ...
Park, Jae Hong; Lee, Jong In [Korea Institute of Nuclear Safety, Taejon (Korea, Republic of)
Previous MELCOR and SCDAP/RELAP5 nodalizations for simulating the counter-current, natural circulation behavior of vapor flow within the RCS hot legs and SG U-tubes when core damage progress can not be applied to the steady state and water-filled conditions during the initial period of accident progression because of the artificially high loss coefficients in the hot legs and SG U-tubes which were chosen from results of COMMIX calculation and the Westinghouse natural circulation experiments in a 1/7-scale facility for simulating steam natural circulation behavior in the vessel and circulation modeling which can be used both for the liquid flow condition at steady state and for the vapor flow condition at the later period of in-vessel core damage. For this, the drag forces resulting from the momentum exchange effects between the two vapor streams in the hot leg was modeled as a pressure drop by pump model. This hot leg natural circulation modeling of MELCOR was able to reproduce similar mass flow rates with those predicted by previous models. 6 refs., 2 figs. (Author)
Zwerver, J.; Bredeweg, S. W.; Hof, A. L.
Background: The single-leg squat on a 25 decline board has been described as a clinical assessment tool and as a rehabilitation exercise for patients with patellar tendinopathy. Several assumptions have been made about its working mechanism on patellar load and patellofemoral forces, but these are
Schreuder, Ramon-Michel; Horváth, Barbara; van Dullemen, Hendrik M
A 49-year-old woman presented with painful ulcera on her right lower leg. She was known with Crohn's disease. Wound cultures were negative. Based on clinical findings she was diagnosed with pyoderma gangrenosum. After treatment with topical glucocorticoids and intravenous infliximab and ciclosporin, the ulcera gradually disappeared.
smoking, obesity, and diabetes. The treatment of venous ulcer is expensive, leading to large economic burden on health services in many countries. The aim of this communication is to determine the incidence, etiology, and presentation of chronic leg ulcer. It is also to evaluate the various modalities of treatment used in a ...
A previously well 22-year-old woman presented with progressive weakness of her legs and urinary incontinence over 7 days. Clinically she was healthy, with no skin rashes. On neurological examination she had profound bilateral weakness of the lower limbs, hypertonia, hyperreflexia, a positive Babinski sign and a T6 ...
Kurz, Eduard; Anders, Christoph
The purpose of this investigation was to assess the effect of compression sleeves on muscle activation cost during locomotion. Twenty-two recreationally active men (age: 25 ± 3 years) ran on a treadmill at four different speeds (ordered sequence of 2.8, 3.3, 2.2, and 3.9 m/s). The tests were performed without (control situation, CON) and while wearing specially designed lower leg compression sleeves (SL). Myoelectric activity of five lower leg muscles (tibialis anterior, fibularis longus, lateral and medial head of gastrocnemius, and soleus) was captured using Surface EMG. To assess muscle activation cost, the cumulative muscle activity per distance travelled (CMAPD) of the CON and SL situations was determined. Repeated measures analyses of variance were performed separately for each muscle. The analyses revealed a reduced lower leg muscle activation cost with respect to test situation for SL for all muscles (p 0.18). The respective significant reductions of CMAPD values during SL ranged between 4% and 16% and were largest at 2.8 m/s. The findings presented point towards an improved muscle activation cost while wearing lower leg compression sleeves during locomotion that have potential to postpone muscle fatigue.
Cerda Varela, Alejandro Javier; García, Asier Bengoechea; Santos, Ilmar
This work constitutes the first step in a research effort aimed at studying the feasibility of introducing an active lubrication concept in tilting pad journal bearings (TPJBs) that feature the leading edge groove (LEG) lubrication system. The modification of the oil flow into each pad supply gro...
Elkadri, N.; Slim, I.; Blondet, C.; Choquet, Ph.; Constantinesco, A.; Lecocq, J.
Leg 201 Tl-SPECT in chronic exertional compartment syndrome Background: The chronic exertional compartment syndrome is one of the most frequent origins regarding leg pain due to sport training. The diagnosis can be established by invasive compartment pressure measurement. The aim of this study is to evaluate the role that could have 201 Tl-SPECT for patients with suspicion of compartment syndrome. Patients and methods: 51 leg 201 Tl-SPECT exams were performed (exercise - and rest without reinjection) in 49 patients; 28 had compartment syndrome confirmed by pressure measurement. About 100 MBq of 201 Tl were injected during exercise, when pain appeared or at least after 25 minutes exercise. We studied mean percentages of level uptake for each compartment, referred to the maximal uptake of both legs. Results: 47 compartments were concerned by compartment syndrome and 361 compartments were not. Scintigraphic patterns in compartments are reversible ischaemia (45%), uptake stability (36%) or reverse redistribution (19%); these patterns are not linked to compartment syndrome. However, there is a significant difference of rest 201 Tl level uptake between compartments with and without compartment syndrome and a significant correlation between muscular pressure measurement and rest level uptake. Conclusion: 201 Tl-SPECT shows that only ischaemia does not explain compartment syndrome. Moreover, it allows to predict pressure variation during exercise but it does not offer any interest in order to select patients for muscular invasive pressure measurement. (author)
Potocanac, Z.; Duysens, J.E.
Online movement adjustments are crucial for daily life. This is especially true for leg movements in relation to gait, where failed adjustments can lead to falls, especially in elderly. However, most research has focused on reach adjustments following changes in target location. This arm research
de Weerd, Al; Arico, Irene; Silvestri, Rosalia
Objective: The diagnosis restless legs syndrome (RLS) in children depends on the history told by the child and his parents. The description of symptoms given by the child him or herself is most important. Additional criteria are, among others, the results of polysomnography (PSG). Description of the
Marc P. Hayes; Clara A. Wheeler; Amy J. Lind; Gregory A. Green; Diane C. Macfarlane
The foothill yellow-legged frog (Rana boylii) is a stream-breeding amphibian that has experienced significant population declines over a large portion of its historical range. This frog is nearing extirpation in much of the Sierra Nevada region where existing populations are sparse. Water development and diversions are likely to be the primary...
Swimming performance is one of the crucial factors determining the lifestyle and survival of Penaeid shrimps. This study examined under controlled laboratory conditions, the physiological responses to swimming fatigue of juvenile white-leg shrimp Litopenaeus vannamei (8.85 ± 0.05 cm TL) exposed to different current ...
age. It is thought that the incidence of ulceration is rising as a result of aging population and increased risk factors for atherosclerotic occlusion such as .... Complete healing at discharge from the hospital was. Table 2: Treatment for patients with chronic leg ulcer (n=60). Frequency Percent. Wound dressing only. 5. 8.3.
Khamis, Sam; Danino, Barry; Hayek, Shlomo; Carmeli, Eli
The aim of this study was to quantify clearance mechanics during gait. Seventeen children diagnosed with hemiplegic cerebral palsy underwent a three-dimensional gait analysis evaluation. Dynamic leg lengths were measured from the hip joint center to the heel, to the ankle joint center and to the forefoot throughout the gait cycle. Significant…
Maria Stella Valle
Full Text Available Movement disturbances associated with Down syndrome reduce mechanical stability, worsening the execution of important tasks such as walking and upright standing. To compensate these deficits, persons with Down syndrome increase joint stability modulating the level of activation of single muscles or producing an agonist-antagonist co-activation. Such activations are also observed when a relaxed, extended leg is suddenly released and left to oscillate passively under the influence of gravity (Wartenberg test. In this case, the Rectus femoris of adults with Down syndrome displayed peaks of activation after the onset of the first leg flexion. With the aim to verify if these muscular reactions were acquired during the development time and to find evidences useful to give them a functional explanation, we used the Wartenberg test to compare the knee joint kinematics and the surface electromyography of the Rectus femoris and Biceps femoris caput longus between adolescents and adults with Down syndrome. During the first leg flexion, adolescents and adults showed single Rectus femoris activations while, a restricted number of participants exhibited agonist-antagonist co-activations. However, regardless the pattern of activation, adults initiated the muscle activity significantly later than adolescents. Although most of the mechanical parameters and the total movement variability were similar in the two groups, the onset of the Rectus femoris activation was well correlated with the time of the minimum acceleration variability. Thus, in adolescents the maximum mechanical stability occurred short after the onset of the leg fall, while adults reached their best joint stability late during the first flexion. These results suggest that between the adolescence and adulthood, persons with Down syndrome explore a temporal window to select an appropriate timing of muscle activation to overcome their inherent mechanical instability.
.... They will want to use the resources to perform computing tasks. Today's computing infrastructure does not support this model of computing very well because computers interact with users in terms of low level abstractions...
Civil servants conduct the work which makes welfare states functions on an everyday bases: Police men police, school teachers teach, and tax inspectors inspect. Focus in this paper is on the core tasks of tax inspectors. The paper argues that their core task of securing the collection of revenue...... projects influence the organization of core tasks within the tax administration. The paper shows that the organizational transformations based on the use of these devices have had consequences both for the overall collection of revenue and for the employees’ feeling of “making a difference”. All in all...... has remained much the same within the last 10 years. However, how the core task has been organized has changed considerable under the influence of various “organizing devices”. The paper focusses on how organizing devices such as risk assessment, output-focus, effect orientation, and treatment...
Full Text Available Anterior cruciate ligament (ACL injuries are common in sports. Studies investigating injury mechanisms have demonstrated that most injuries arise from landing tasks. Despite the demonstration of differences between male and female kinematics, there are no studies showing how males behave during different landing tasks. The objective of this study was to compare the angular and temporal kinematics of the lower limbs between two different landing tasks. Double leg and single leg landings were recorded in the frontal and sagittal plane in 15 male volleyball athletes by videogrammetry. Reduced hip and knee flexion and increased knee valgus were observed in the single leg landing task compared to the double leg landing task. No significant difference in landing time was observed between the two tasks. In conclusion, the results support the premise that lower limb kinematics change according to the task performed. Further studies are necessary to explore the impact of these kinematic differences on knee loading and to relate them to ACL injury mechanisms in men.
J. C. W. Rayner
Full Text Available The data for the tests considered here may be presented in two-way contingency tables with all marginal totals fixed. We show that Pearson's test statistic XP2 (P for Pearson may be partitioned into useful and informative components. The first detects location differences be tween the treatments, and the subsequent components detect dispersion and higher order moment differences. For Kruskal-Wallis-type data when there are no ties, the location component is the Kruskal-Wallis test. The subsequent components are the extensions. Our approach enables us to generalise to when there are ties, and to when there is a fixed number of categories and a large number of observations. We also propose a generalisation of the well-known median test. In this situation the location-detecting first component of XP2 reduces to the usual median test statistic when there are only two categories. Subsequent components detect higher moment departures from the null hypothesis of equal treatment effects
Slominski, Ryan [Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States); Larrieu, Theodore L. [Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States)
Jefferson Lab's Web Extensible Display Manager (WEDM) allows staff to access EDM control system screens from a web browser in remote offices and from mobile devices. Native browser technologies are leveraged to avoid installing and managing software on remote clients such as browser plugins, tunnel applications, or an EDM environment. Since standard network ports are used firewall exceptions are minimized. To avoid security concerns from remote users modifying a control system, WEDM exposes read-only access and basic web authentication can be used to further restrict access. Updates of monitored EPICS channels are delivered via a Web Socket using a web gateway. The software translates EDM description files (denoted with the edl suffix) to HTML with Scalable Vector Graphics (SVG) following the EDM's edl file vector drawing rules to create faithful screen renderings. The WEDM server parses edl files and creates the HTML equivalent in real-time allowing existing screens to work without modification. Alternatively, the familiar drag and drop EDM screen creation tool can be used to create optimized screens sized specifically for smart phones and then rendered by WEDM.
We study self-duality of Grothendieck's blended extensions (extensions panach\\'ees) in the context of a tannakian category. The set of equivalence classes of symmetric, resp. antisymmetric, blended extensions is naturally endowed with a torsor structure, which enables us to compute the unipotent radical of the associated monodromy groups in various situations
Fawale, Michael B.; Ismaila, Isiaka Alani; Mustapha, Adekunle F.; Komolafe, Morenikeji A.; Adedeji, Tewogbade A.
Study Objectives: The prevalence of restless legs syndrome (RLS) is highest in the elderly in Caucasian populations; the prevalence of RLS in elderly Africans is not known. This study aimed at determining the frequency and associations of RLS in a Nigerian elderly population. Methods: The study population comprised of 633 consecutive elderly individuals aged 65–105 years attending the general outpatient clinic of the State Hospital, Ilesa, for minor complaints and routine check-up. The diagnosis of RLS was made using the 2003 minimal criteria of the International Restless Legs Syndrome Study Group. Relevant sociodemographic and clinical data, including sleep duration, were also obtained. Results: Restless legs syndrome was found in 3.5% of the study population with a male-female ratio of 2:1. There was no significant age (p = 0.427) or gender (p = 0.178) influence on the prevalence of RLS except in the 75- to 84-year age group where there was significant male preponderance (p = 0.044). A strong independent association between RLS and sleep duration (OR, 3.229; 95% CI, 1.283–8.486; p = 0.013) and past history of head injury (OR, 4.691; 95% CI, 1.750–12.577; p = 0.002) was found. Conclusions: Our finding support previous reports of a possible lower prevalence of RLS in Africans. Restless legs syndrome independently increases the odds of habitual sleep curtailment in elderly individuals. Head injury may be a risk factor for future RLS; this requires further investigation as indirect evidence for a possible link between RLS and traumatic brain injury exists. Citation: Fawale MB, Ismaila IA, Mustapha AF, Komolafe MA, Adedeji TA. Restless legs syndrome in a Nigerian elderly population. J Clin Sleep Med 2016;12(7):965–972. PMID:27070251