Impact of restless legs syndrome in patients with inflammatory bowel disease on sleep, fatigue, and quality of life.

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Schindlbeck, Katharina A; Becker, Janek; Berger, Felix; Mehl, Arne; Rewitzer, Charlotte; Geffe, Sarah; Koch, Peter M; Preiß, Jan C; Siegmund, Britta; Maul, Jochen; Marzinzik, Frank

2017-01-01

Inflammatory bowel disease has been associated with neurological symptoms including restless legs syndrome. Here, we investigated the impact of restless legs syndrome in patients with inflammatory bowel disease on sleep, fatigue, mood, cognition, and quality of life. Two groups of inflammatory bowel disease patients, with and without restless legs syndrome, were prospectively evaluated for sleep disorders, fatigue, daytime sleepiness, depression, anxiety, and health-related quality of life. Furthermore, global cognitive function, executive function, attention, and concentration were assessed in both groups. Disease activity and duration of inflammatory bowel disease as well as current medication were assessed by interview. Inflammatory bowel disease patients with and without restless legs syndrome were matched for age, education, severity, and duration of their inflammatory bowel disease. Patients with inflammatory bowel disease and clinically relevant restless leg syndrome suffered significantly more frequent from sleep disturbances including sleep latency and duration, more fatigue, and worse health-related quality of life as compared to inflammatory bowel disease patients without restless legs syndrome. Affect and cognitive function including cognitive flexibility, attention, and concentration showed no significant differences among groups, indicating to be not related to restless legs syndrome. Sleep disorders including longer sleep latency, shorter sleep duration, and fatigue are characteristic symptoms of restless legs syndrome in inflammatory bowel disease patients, resulting in worse health-related quality of life. Therefore, clinicians treating patients with inflammatory bowel disease should be alert for restless legs syndrome.

The effects of two methods of reflexology and stretching exercises on the severity of restless leg syndrome among hemodialysis patients

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Nahid Shahgholian

2016-01-01

Full Text Available Background: Restless leg syndrome prevalence is high among the patients undergoing hemodialysis. Due to several side effects of medicational treatments, the patients prefer non-medicational methods. Therefore, the present study aimed to investigate the effects of two methods of reflexology and stretching exercises on the severity of restless leg syndrome among patients undergoing hemodialysis. Materials and Methods: This study is a randomized clinical trial that was done on 90 qualified patients undergoing hemodialysis in selected hospitals of Isfahan, who were diagnosed with restless leg syndrome through standard restless leg syndrome questionnaire. They were randomly assigned by random number table to three groups: Reflexology, stretching exercises, and control groups through random allocation. Foot reflexology and stretching exercises were conducted three times a week for 30–40 min within straight 4 weeks. Data analysis was performed by SPSS version 18 using descriptive and inferential statistical analyses [one-way analysis of variance (ANOVA, paired t-test, and least significant difference (LSD post hoc test]. Results: There was a significant difference in the mean scores of restless leg syndrome severity between reflexology and stretching exercises groups, compared to control (P < 0.001, but there was no significant difference between the two study groups (P < 0.001. Changes in the mean score of restless leg syndrome severity were significantly higher in reflexology and stretching exercises groups compared to the control group (P < 0.001, but it showed no significant difference between reflexology massage and stretching exercises groups. Conclusions: Our obtained results showed that reflexology and stretching exercises can reduce the severity of restless leg syndrome. These two methods of treatment are recommended to the patients.

The effects of two methods of reflexology and stretching exercises on the severity of restless leg syndrome among hemodialysis patients.

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Shahgholian, Nahid; Jazi, Shahrzad Khojandi; Karimian, Jahangir; Valiani, Mahboubeh

2016-01-01

Restless leg syndrome prevalence is high among the patients undergoing hemodialysis. Due to several side effects of medicational treatments, the patients prefer non-medicational methods. Therefore, the present study aimed to investigate the effects of two methods of reflexology and stretching exercises on the severity of restless leg syndrome among patients undergoing hemodialysis. This study is a randomized clinical trial that was done on 90 qualified patients undergoing hemodialysis in selected hospitals of Isfahan, who were diagnosed with restless leg syndrome through standard restless leg syndrome questionnaire. They were randomly assigned by random number table to three groups: Reflexology, stretching exercises, and control groups through random allocation. Foot reflexology and stretching exercises were conducted three times a week for 30-40 min within straight 4 weeks. Data analysis was performed by SPSS version 18 using descriptive and inferential statistical analyses [one-way analysis of variance (ANOVA), paired t-test, and least significant difference (LSD) post hoc test]. There was a significant difference in the mean scores of restless leg syndrome severity between reflexology and stretching exercises groups, compared to control (P reflexology and stretching exercises groups compared to the control group (P reflexology massage and stretching exercises groups. Our obtained results showed that reflexology and stretching exercises can reduce the severity of restless leg syndrome. These two methods of treatment are recommended to the patients.

Well-leg compartment syndrome after gynecological laparoscopic surgery

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Boesgaard-Kjer, Diana H; Boesgaard-Kjer, Daniel; Kjer, Jens Jørgen

2013-01-01

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...

Ehlers-Danlos Syndrome Type VIII: A Rare Cause of Leg Ulcers in Young Patients

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Sophie Ronceray

2013-01-01

Full Text Available Ehlers-Danlos syndrome type VIII (EDS-VIII is a very rare autosomal dominant disease characterized by early-onset periodontitis associated with features of Ehlers-Danlos syndrome. We report a 32-year-old man whose chronic leg ulcer led to the diagnosis of EDS-VIII. He had severe periodontitis with complete loss of permanent teeth and skin fragility with thin skin, atrophic scars, and brownish atrophic pretibial plaques. Leg ulcer is not a prominent feature of EDS-VIII. We suggest adding EDS-VIII to the list of rare diseases accounting for chronic leg ulcers, if this case report prompts others to report leg ulcers associated with EDS-VIII.

European guidelines on management of restless legs syndrome

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Garcia-Borreguero, Diego; Ferini-Strambi, Luigi; Kohnen, Ralf

2012-01-01

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 pa...

Presenting Symptoms in Pediatric Restless Legs Syndrome Patients

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de Weerd, Al; Arico, Irene; Silvestri, Rosalia

2013-01-01

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

Restless Legs Syndrome in shift workers: A cross sectional study on male assembly workers

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Rahimi Mohsen

2009-09-01

Full Text Available Abstract Background Restless Legs Syndrome (RLS is a common neurological movement disorder characterized by symptoms that follow a circadian pattern. Night and rotating shift work schedules exert adverse effects on functions of the human body by disturbing circadian rhythms, and they are known to cause sleep disturbances and insomnia. In this paper, we investigate the possible association between shift work and RLS. Methods This cross sectional study was conducted in an automobile manufacturing factory in Tehran, Iran. A total of 780 male assembly workers were recruited in three groups, each with 260 workers: workers on a permanent morning shift (A and two different rotating shift schedules (B and C with morning, afternoon and night shifts. We used the international RLS study group criteria for diagnosis of RLS, and the severity scale for severity assessment in subjects with RLS. Self administered questionnaires were used to gather information on age, smoking, work history, medical condition, and existence and severity of RLS symptoms. Results The prevalence of RLS was significantly higher in rotational shift workers (15% than workers with permanent morning work schedule (8.5%. In workers suffering from RLS, we found greater mean values of age and work experience, higher percentages of drug consumption, smoking, and co-morbid illnesses compared with subjects who did not have RLS, although these differences were statistically significant only for age, work experience and drug consumption. Conclusion Rotational shift work acts as a risk or exacerbating factor for Restless Legs Syndrome.

Restless Legs Syndrome in shift workers: A cross sectional study on male assembly workers.

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Sharifian, Akbar; Firoozeh, Marjan; Pouryaghoub, Gholamreza; Shahryari, Mehran; Rahimi, Mohsen; Hesamian, Mohammad; Fardi, Ali

2009-09-14

Restless Legs Syndrome (RLS) is a common neurological movement disorder characterized by symptoms that follow a circadian pattern. Night and rotating shift work schedules exert adverse effects on functions of the human body by disturbing circadian rhythms, and they are known to cause sleep disturbances and insomnia. In this paper, we investigate the possible association between shift work and RLS. This cross sectional study was conducted in an automobile manufacturing factory in Tehran, Iran. A total of 780 male assembly workers were recruited in three groups, each with 260 workers: workers on a permanent morning shift (A) and two different rotating shift schedules (B and C) with morning, afternoon and night shifts. We used the international RLS study group criteria for diagnosis of RLS, and the severity scale for severity assessment in subjects with RLS. Self administered questionnaires were used to gather information on age, smoking, work history, medical condition, and existence and severity of RLS symptoms. The prevalence of RLS was significantly higher in rotational shift workers (15%) than workers with permanent morning work schedule (8.5%). In workers suffering from RLS, we found greater mean values of age and work experience, higher percentages of drug consumption, smoking, and co-morbid illnesses compared with subjects who did not have RLS, although these differences were statistically significant only for age, work experience and drug consumption. Rotational shift work acts as a risk or exacerbating factor for Restless Legs Syndrome.

Effects of immobility on sensory and motor symptoms of restless legs syndrome.

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Michaud, Martin; Lavigne, Gilles; Desautels, Alex; Poirier, Gaétan; Montplaisir, Jacques

2002-01-01

Restless legs syndrome (RLS) is defined by an irresistible need to move associated with leg paresthesia. Two additional features are essential for diagnosis: (1) worsening of symptoms at rest with temporary relief by activity, and (2) worsening of symptoms during the evening and/or during the night. The suggested immobilization test (SIT) has been developed to evaluate the presence of these criteria. This test quantifies leg movements and leg discomfort during a 1-hour period of immobility prior to bedtime. We used the SIT to evaluate the effects of immobility on leg discomfort and leg movements experienced by 19 patients with RLS and 19 control subjects. Results show that immobility significantly worsens both leg discomfort and periodic leg movements (PLM) in patients with RLS but not in controls. Patients with RLS showed a higher leg discomfort score (32.6 +/- 15.1 mm vs. 5.7 +/- 7.9 mm; P < 0.00001), a greater maximum leg discomfort value (63.4 +/- 27.4 mm vs. 13.7 +/- 23.0 mm; P < 0.00001) and a greater PLM index (88.4 +/- 62.6 vs. 10.4 +/- 20.6; P < 0.00004) than control subjects. These results further validate the use of the SIT as a diagnostic and research tool for RLS and confirm the contention of the International RLS study group that RLS symptoms worsen at rest. Copyright 2001 Movement Disorder Society.

Remission of severe restless legs syndrome and periodic limb movements in sleep after bilateral excision of multiple foot neuromas: a case report

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Lettau Ludwig A

2010-09-01

quality index, fatigue severity scale, and the international restless legs syndrome rating scale (36 to 4. Polysomnography six weeks post-operatively showed improved sleep efficiency, a marked increase in rapid eye movement sleep, and marked reductions in hourly rates of both periodic limb movements in sleep with arousal (135.3 to 3.3 and spontaneous arousals (17.3 to 0. Conclusion The immediate and near complete remission of symptoms, the histopathology of the excised tissues, and the marked improvement in polysomnographic parameters documented six weeks after surgery together indicate that this patient's severe restless legs syndrome and periodic limb movements in sleep was of peripheral nerve (foot neuroma origin. Further study of foot neuromas as a source of periodic limb movements in sleep and as a cause of sleep dysfunction in patients with or without concomitant restless legs syndrome, is warranted.

Cardiovascular comorbidity in patients with restless legs syndrome: current perspectives

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Vargas-Pérez NJ

2017-05-01

Full Text Available Noel J Vargas-Pérez, Kanika Bagai, Arthur S Walters Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA Introduction: Restless legs syndrome (RLS is a sensorimotor neurological disorder associated with poor quality of life. Growing evidence links RLS and periodic limb movement in sleep (PLMS with increased risk of cardiovascular and cerebrovascular disease. This article reviews the association of RLS and PLMS with cardiovascular disease (CVD. Methods: PubMed and Medline database (1990 to July 2016 were searched for the terms “restless legs,” “restless legs syndrome,” “periodic limb movements,” “periodic limb movements in sleep” cross-referenced with “cardiovascular disease,” “heart disease,” “coronary artery disease,” “coronary heart disease,” “heart arrhythmia,” “heart failure,” “congestive heart failure,” “echocardiogram,” “echocardiographic,” “hypertension,” “high blood pressure,” “cerebrovascular disease,” “stroke,” “autonomic nervous system,” “heart rate,” “heart rate variability,” “hypoxia,” “microcirculation,” “oxidative stress,” “inflammation,” “chronic kidney disease,” “end-stage renal disease,” “renal disease,” “hemodialysis,” “multiple sclerosis,” “Parkinson,” “Parkinson’s,” “iron deficiency anemia,” and “mortality.” Other relevant articles from the reference list of the above-matched manuscripts were also reviewed. Studies that did not specify the diagnostic criteria for RLS or manuscripts in languages other than English were excluded. Articles with emphasis in RLS secondary to pregnancy were not included in this manuscript.Results: Eighty-six original articles were included in this review. Although mixed results were found regarding the association of RLS and PLMS with CVD, hypertension, stroke and mortality, an informal review of the literature does suggest that the

Gabapentin enacarbil – clinical efficacy in restless legs syndrome

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Pinky Agarwal

2010-04-01

Full Text Available Pinky Agarwal1, Alida Griffith1, Henry R Costantino2, Narendra Vaish31Booth Gardner Parkinson’s Center, Kirkland, WA, USA; 2Costantino Consulting, Woodinville, WA, USA; 3Kirkland, WA, USAAbstract: Restless legs syndrome (RLS is a sleep-related movement disorder commonly involving an unpleasant urge to move the limbs, typically the legs. Dopaminergic agents represent the first-line therapy for RLS; however, long-term use of such drugs results in worsening symptoms due to “augmentation” or other adverse events. Gabapentin, an analog of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA, is an anticonvulsant/analgesic agent. Gabapentin is only mildly effective in relieving RLS symptoms, perhaps a result of its poor absorption from the gastrointestinal (GI tract. Gabapentin enacarbil is a prodrug of gabapentin specifically designed to enhance absorption via the GI tract, and hence provide improved circulating levels of gabapentin on metabolism. Clinical trials to date have demonstrated favorable safety and (compared to traditional gabapentin improved pharmacokinetics and efficacy in treating RLS symptoms. Thus, gabapentin enacarbil may prove to be a useful drug in treating RLS. An application of gabapentin enacarbil for treatment of RLS is currently pending with FDA for approval.Keywords: restless legs syndrome, gabapentin enacarbil, movement disorder

Imbalance between thyroid hormones and the dopaminergic system might be central to the pathophysiology of restless legs syndrome: a hypothesis

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Jose Carlos Pereira Jr.

2010-01-01

Full Text Available Data collected from medical literature indicate that dopaminergic agonists alleviate Restless Legs Syndrome symptoms while dopaminergic agonists antagonists aggravate them. Dopaminergic agonists is a physiological regulator of thyroid-stimulating hormone. Dopaminergic agonists infusion diminishes the levels of thyroid hormones, which have the ability to provoke restlessness, hyperkinetic states, tremors, and insomnia. Conditions associated with higher levels of thyroid hormones, such as pregnancy or hyperthyroidism, have a higher prevalence of Restless Legs Syndrome symptoms. Low iron levels can cause secondary Restless Legs Syndrome or aggravate symptoms of primary disease as well as diminish enzymatic activities that are involved in dopaminergic agonists production and the degradation of thyroid hormones. Moreover, as a result of low iron levels, dopaminergic agonists diminishes and thyroid hormones increase. Iron therapy improves Restless Legs Syndrome symptoms in iron deprived patients. Medical hypothesis. To discuss the theory that thyroid hormones, when not counterbalanced by dopaminergic agonists, may precipitate the signs and symptoms underpinning Restless Legs Syndrome. The main cause of Restless Legs Syndrome might be an imbalance between the dopaminergic agonists system and thyroid hormones.

Painful legs and moving toes syndrome

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Qiu-ying Ma

2015-10-01

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

A Wolf in Sheep's Clothing: An "Alien Leg" in Corticobasal Syndrome

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Diana A. Olszewska

2017-04-01

Full Text Available Background: Alien limb phenomenon occurs in 50–60% of patients with corticobasal syndrome (CBS and usually presents with an “alien hand” phenomenon. The “alien foot” presentation is rarer and may be misdiagnosed, as foot involvement can lead to erroneous localization of the clinical problem to the knee, hip, or back. Subsequently misdiagnoses such as myelopathy, radiculopathy, functional disorder, stiff leg syndrome, neuromyotonia, and painful leg moving toes syndrome may occur.Case report: We describe two patients with alien foot symptoms that resulted in multiple opinions from different specialists, multiple diagnostic and therapeutic procedures, and delayed diagnosis. Eventually a diagnosis of CBS was made in both. Alien foot symptoms may be more common than initially thought and can result in a delayed diagnosis of CBS.Conclusion: The inclusion of this clinical finding in recently proposed diagnostic criteria highlights the need for increased clinical awareness. 

A Single Center Study of the Clinical Features and Comorbidities of Patients with Restless Legs Syndrome

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Eun-Kyoung Han

2011-12-01

Full Text Available This study investigated the clinical features and comorbidities of patients with restless legs syndrome (RLS. A total of 128 RLS patients (68 women, 60 men; mean age = 58.03 ± 12.58 years were assessed. The severity of RLS was evaluated by the International RLS Study Group (IRLSSG Severity Scale. Among the subjects with RLS, depressive symptoms (65.5% and poor sleep quality (95.4% were frequently reported, and 88.3% of the patients showed moderate-to-severe symptom severity on the IRLSSG Severity Scale. The most common complaint was insomnia (70.3%, and 16 patients (12.5% reported leg discomfort as their main symptom. Obstructive sleep apnea was observed in 66% of RLS patient. Iron deficiency was not prevalent in RLS patients. The severity of RLS was not significantly correlated with depression, sleep quality or sleepiness. We conclude that when assessing insomnia patients, RLS symptoms should be evaluated.

Actometry in measuring the symptom severity of restless legs syndrome.

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Tuisku, K; Holi, M M; Wahlbeck, K; Ahlgren, A J; Lauerma, H

2005-05-01

In a previous, controlled study we demonstrated that the general lower limb activity measured by three-channel actometry is a promising objective measure of restless legs syndrome (RLS) severity. In the present study we have further evaluated the method in measuring RLS symptom severity in an open, single-day pramipexole intervention with 15 RLS patients. Both our standardized actometric parameters (nocturnal lower limb activity and controlled rest activity) decreased significantly during the intervention in parallel with the subjectively reported relief of RLS symptoms.

Using near infrared light to manage symptoms associated with restless legs syndrome.

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Guffey, J Stephen; Motts, Susan; Barymon, Deanna; Wooten, Amber; Clough, Tim; Payne, Emily; Henderson, McCall; Tice, Neal

2016-01-01

The purpose of this study was to determine whether the application of near infrared (NIR) light could positively modulate symptoms associated with restless legs syndrome (RLS). Twenty-one subjects with RLS were treated with NIR three times weekly for four weeks. Baseline measures of: (1) international restless legs syndrome rating scale (IRLSRS) score; (2) Semmes Weinstein monofilament (SWM) test; (3) visual analog pain scale (VAS); (4) ankle-brachial index (ABI); and (5) sonographic imaging of the popliteal and posterior tibial arteries were compared to post-treatment values. NIR (850 nm) was delivered transcutaneously at 8 J/cm(2) to four locations on each leg and the plantar surface of each foot. A pre-test-post-test one group design was employed. Baseline and post-treatment measures were compared using either a dependent t-test when data were normal or the Wilcoxon signed rank test in the absence of normality. A significant improvement in IRLSRS scores was observed. Sensation improved from less than protective in 16.6% of sites tested at the baseline to 13.4% post-intervention. There was a significant improvement in ABI scores. VAS and sonographic imaging measures other than ABI remained unchanged. The use of NIR to modulate symptoms associated with RLS was supported by the data.

Restless legs syndrome in patients on dialysis

International Nuclear Information System (INIS)

AlJahdali, Hamdan H; AlQadhi, Waleed A; Khogeer, Haithm A; AlHejaili, Fayez F; Al Sayyari, Abdullah A; AlGhamdi, Saeed M

2009-01-01

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

Restless legs syndrome in patients on dialysis

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Al-Jahdali Hamdan

2009-01-01

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

Insomnia and limb pain in hemodialysis patients: What is the share of restless leg syndrome?

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Majid Malaki

2012-01-01

Full Text Available Insomnia and limb pain are common problems in dialysis patients. In addition, restless leg syndrome (RLS as a specific cause of insomnia and limb pain has been reported in many studies. The purpose of this study was to estimate incidence of insomnia and RLS as a cause of insomnia in these patients. Twenty-six patients undergoing hemodialysis were investigated for insomnia, limb pain and RLS as per the defined criteria. They were evaluated for dialysis quality, dialysis duration, hemoglobin, serum phosphorous, ionized calcium, iron and ferritin levels. These variables between patients with insomnia and those with normal sleep were evaluated by independent "t" test. Without considering the etiology or pathogenesis of insomnia, we evaluated the occurrence of insomnia and limb pain in these patients, and specifically, restless leg syndrome. Insomnia and limb pain were common in dialytic patients. 46% of patients had insomnia. 91% of sleepless group had limb pain as a persistent, annoying complaint. Limb pain was not seen in groups with a normal sleep pattern. Restless leg syndrome was found in 8% of total cases (2 out of 26 and 17% among the insomnia group (2 out of 12. In spite of high incidence of insomnia among patients undergoing regular hemodialysis, role of RLS is trivial. There is a strong relationship between hemoglobin levels and duration of renal replacement therapy to insomnia occurrence.

Insomnia and limb pain in hemodialysis patients: what is the share of restless leg syndrome?

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Malaki, Majid; Mortazavi, Fakhr Sadat; Moazemi, Sussan; Shoaran, Maryam

2012-01-01

Insomnia and limb pain are common problems in dialysis patients. In addition, restless leg syndrome (RLS) as a specific cause of insomnia and limb pain has been reported in many studies. The purpose of this study was to estimate incidence of insomnia and RLS as a cause of insomnia in these patients. Twenty-six patients undergoing hemodialysis were investigated for insomnia, limb pain and RLS as per the defined criteria. They were evaluated for dialysis quality, dialysis duration, hemoglobin, serum phosphorous, ionized calcium, iron and ferritin levels. These variables between patients with insomnia and those with normal sleep were evaluated by independent "t" test. Without considering the etiology or pathogenesis of insomnia, we evaluated the occurrence of insomnia and limb pain in these patients, and specifically, restless leg syndrome. Insomnia and limb pain were common in dialytic patients. 46% of patients had insomnia. 91% of sleepless group had limb pain as a persistent, annoying complaint. Limb pain was not seen in groups with a normal sleep pattern. Restless leg syndrome was found in 8% of total cases (2 out of 26) and 17% among the insomnia group (2 out of 12). In spite of high incidence of insomnia among patients undergoing regular hemodialysis, role of RLS is trivial. There is a strong relationship between hemoglobin levels and duration of renal replacement therapy to insomnia occurrence.

Can't Curb the Urge to Move? Living with Restless Legs Syndrome

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... Special Issues Subscribe October 2012 Print this issue Can’t Curb the Urge to Move? Living With ... for people with restless legs syndrome. The condition can cause throbbing, pulling or creeping sensations in the ...

Restless legs syndrome in patients with Parkinson's disease: a comparative study on prevalence, clinical characteristics, quality of life and nutritional status.

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Fereshtehnejad, S-M; Shafieesabet, M; Shahidi, G A; Delbari, A; Lökk, J

2015-04-01

Restless legs syndrome (RLS) is a common neurological disorder that can coexist with Parkinson's disease (PD). However, the association between these two movement disorders is quite poorly explored and previous findings are controversial in different aspects. To compare prevalence of RLS in Iranian PD population with a matched control group and to investigate the impact of comorbid RLS on quality of life (QoL), nutritional status, and clinical characteristics in PD population. This study was conducted on 108 individuals with idiopathic PD (IPD) and 424 matched controls. RLS was diagnosed using the International Restless Legs Syndrome Study Group (IRLSSG) criteria. Further assessments were performed on clinical characteristics, PD severity scales, psychiatric features, nutritional status, fatigue, and QoL in PD patients with and without RLS. Restless legs syndrome was significantly more common among the patients with IPD (14.8%) compared to the controls (7.5%) [OR = 2.1 (95% CI: 1.1-4.0)]. IPD subjects with RLS had significantly higher anxiety score [10.1 (SD = 5.1) vs 5.9 (SD = 5.0); P = 0.003], worse nutritional status [23.7 (SD = 2.7) vs 25.4 (SD = 3.7); P = 0.008], and poorer QoL [26.9 (SD = 13.1) vs 17.0 (SD = 13.2); P = 0.006]. The number of positive answers to the IRLSSG diagnostic criteria had significant direct correlation with unpredictability of the off periods and the presence of symptomatic orthostasis. Our study demonstrated a higher prevalence of RLS in patients with PD compared to general population. PD patients with RLS suffer from more anxiety, worse nutritional status, and worse QoL. RLS negatively accompanies with psychiatric problems, emotional behaviors, stigma, and cognitive impairment. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Circadian variation of the effects of immobility on symptoms of restless legs syndrome.

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Michaud, Martin; Dumont, Marie; Paquet, Jean; Desautels, Alex; Fantini, Maria Livia; Montplaisir, Jacques

2005-07-01

It is now well established that symptoms of restless legs syndrome (RLS) are worsened by immobility and that their severity fluctuates according to a circadian pattern with a maximum occurring in the late evening or during the night. However, no study has ever attempted to dissociate these two effects. The objective of this study was to evaluate the nycthemeral variations in the effects of duration of immobility on symptoms of RLS. A 28-hour modified constant routine protocol. Sleep Disorders Center, Montreal Sacré-Coeur Hospital. Seven patients with primary RLS (3 men, 4 women; mean age: 43.9 years) and seven controls matched for age (42.4 years) and gender. None. A 40-minute Suggested Immobilization Test (SIT) was repeated every 2 hours during the 28-hour protocol in order to quantify both subjective leg discomfort and periodic leg movements (PLM). Regarding leg discomfort, a two-way ANOVA performed on patients' data revealed a significant interaction (p = 0.037) between Time within the SIT and Time of day. Simple effect analyses performed to decompose the interaction showed that the increase in leg discomfort with duration of immobility was found only on SIT 7, 8, 9, 10 and 12, which corresponds to the period between 21:20 and 08:00. In addition, in patients, a significant circadian variation (p immobility is closely linked to their intrinsic circadian variation.

Clinical correlates of the restless legs syndrome

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Luis Fabiano Marin

2012-07-01

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.

Two pedigrees with restless legs syndrome in Brazil

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A.M. Esteves

2008-02-01

Full Text Available Numerous studies have suggested a substantial genetic contribution in the etiology of the primary form of restless legs syndrome (RLS and periodic leg movements (PLM. We describe the symptoms, the sleep profiles and physiological parameters of two families in which several members present RLS/PLM. The proband of family 1 is a 70-year-old woman and the proband of family 2 is a 57-year-old woman; both have exhibited the symptoms since the age of 20 years. All patients in both families were diagnosed with RLS according to the criteria of the International RLS Study Group. Polysomnographic recordings were performed to quantify and to describe PLM during sleep. Sleep parameters showed decreased sleep efficiency, increased sleep latency in the arousal index and the presence of PLM in all subjects. One of the families showed an exact profile of dominant inheritance with anticipation of age at onset. In the other family, the founders were blood relatives and there was no affected member in the third generation suggesting a recessive mode of inheritance. RLS/PLM is a prevalent sleep disorder affecting about 5 to 15% of the population and one that substantially impairs healthy sleep patterns. Efforts to understand the underlying pathophysiology will contribute to improve the sleep and life quality of these patients.

The pathophysiology of restless legs syndrome

International Nuclear Information System (INIS)

Miyamoto, Masayuki; Miyamoto, Tomoyuki; Iwanami, Masaoki; Suzuki, Keisuke; Hirata, Koichi

2009-01-01

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

Diagnostic standards for dopaminergic augmentation of restless legs syndrome: report from a World Association of Sleep Medicine-International Restless Legs Syndrome Study Group consensus conference at the Max Planck Institute.

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García-Borreguero, Diego; Allen, Richard P; Kohnen, Ralf; Högl, Birgit; Trenkwalder, Claudia; Oertel, Wolfgang; Hening, Wayne A; Paulus, Walter; Rye, David; Walters, Arthur; Winkelmann, Juliane; Earley, Christopher J

2007-08-01

Augmentation of symptom severity is the main complication of dopaminergic treatment of restless legs syndrome (RLS). The current article reports on the considerations of augmentation that were made during a European Restless Legs Syndrome Study Group (EURLSSG)-sponsored Consensus Conference in April 2006 at the Max Planck Institute (MPI) in Munich, Germany, the conclusions of which were endorsed by the International RLS Study Group (IRLSSG) and the World Association of Sleep Medicine (WASM). The Consensus Conference sought to develop a better understanding of augmentation and generate a better operational definition for its clinical identification. Current concepts of the pathophysiology, clinical features, and therapy of RLS augmentation were evaluated by subgroups who presented a summary of their findings for general consideration and discussion. Recent data indicating sensitivity and specificity of augmentation features for identification of augmentation were also evaluated. The diagnostic criteria of augmentation developed at the National Institutes of Health (NIH) conference in 2002 were reviewed in light of current data and theoretical understanding of augmentation. The diagnostic value and criteria for each of the accepted features of augmentation were considered by the group. A consensus was then developed for a revised statement of the diagnostic criteria for augmentation. Five major diagnostic features of augmentation were identified: usual time of RLS symptom onset each day, number of body parts with RLS symptoms, latency to symptoms at rest, severity of the symptoms when they occur, and effects of dopaminergic medication on symptoms. The quantitative data available relating the time of RLS onset and the presence of other features indicated optimal augmentation criteria of either a 4-h advance in usual starting time for RLS symptoms or a combination of the occurrence of other features. A paradoxical response to changes in medication dose also indicates

Iron, dopamine, genetics, and hormones in the pathophysiology of restless legs syndrome.

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Khan, Farhan H; Ahlberg, Caitlyn D; Chow, Christopher A; Shah, Divya R; Koo, Brian B

2017-08-01

Restless legs syndrome (RLS) is a common, chronic neurologic condition, which causes a persistent urge to move the legs in the evening that interferes with sleep. Human and animal studies have been used to study the pathophysiologic state of RLS and much has been learned about the iron and dopamine systems in relation to RLS. Human neuropathologic and imaging studies have consistently shown decreased iron in different brain regions including substantia nigra and thalamus. These same areas also demonstrate a state of relative dopamine excess. While it is not known how these changes in dopamine or iron produce the symptoms of RLS, genetic and hormone studies of RLS have identified other biologic systems or genes, such as the endogenous opioid and melanocortin systems and BTBD9 and MEIS1, that may explain some of the iron or dopamine changes in relation to RLS. This manuscript will review what is known about the pathophysiology of RLS, especially as it relates to changes in iron, dopamine, genetics, and hormonal systems.

Prevalence of restless legs symptoms according to depressive symptoms and depression type: a cross-sectional study.

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Auvinen, Piritta; Mäntyselkä, Pekka; Koponen, Hannu; Kautiainen, Hannu; Korniloff, Katariina; Ahonen, Tiina; Vanhala, Mauno

2018-01-01

Restless legs syndrome is a sensorimotor disorder and it is associated with several other diseases especially mental illnesses. To analyze the relationship between the symptoms of restless legs syndrome and the severity of depressive symptoms and the prevalence of restless legs symptoms in depression subtypes. A cross-sectional study of primary care patients in the Central Finland Hospital District. The prevalence of restless legs symptoms was studied in 706 patients with increased depressive symptoms and 426 controls without a psychiatric diagnosis by using a structured questionnaire. The depressive symptoms were evaluated with the Beck Depression Inventory (BDI) and the psychiatric diagnosis was confirmed by means of a diagnostic interview (Mini-International Neuropsychiatric Interview). The subjects with increased depressive symptoms were divided into three groups (subjects with depressive symptoms without a depression diagnosis, melancholic depression and non-melancholic depression). In the whole study population, the prevalence of restless legs symptoms increased with the severity of depressive symptoms. The prevalence of restless legs symptoms was highest in the melancholic and non-melancholic depressive patients (52 and 46%, respectively) and then in subjects with depressive symptoms without a depression diagnosis (43.4%), but the prevalence was also substantial (24.6%) in subjects without a psychiatric diagnosis. Restless legs symptoms are very common in primary care among subjects with depression, regardless of the depression type. The prevalence of restless legs symptoms increased with increasing severity of depressive symptoms, regardless of the diagnosis. These findings should be considered in clinical evaluation and treatment of patients visiting their physician due to restless legs or depressive symptoms.

PTPRD (protein tyrosine phosphatase receptor type delta) is associated with restless legs syndrome

Czech Academy of Sciences Publication Activity Database

Schormair, B.; Kemlink, D.; Roeske, D.; Eckstein, G.; Xiong, L.; Lichtner, P.; Ripke, S.; Trenkwalder, C.; Zimprich, A.; Stiasny-Kolster, K.; Oertel, W.; Bachmann, C. G.; Paulus, W.; Högl, B.; Frauscher, B.; Gschliesser, V.; Poewe, W.; Peglau, I.; Vodička, Pavel; Vávrová, J.; Šonka, K.; Nevšímalová, S.; Montplaisir, J.; Turecki, G.; Rouleau, G.; Gieger, Ch.; Illig, T.; Wichmann, H.E.; Holsboer, F.; Müller-Myhsok, B.; Meitinger, T.; Winkelmann, J.

2008-01-01

Roč. 40, č. 8 (2008), s. 946-948 ISSN 1061-4036 R&D Projects: GA MZd NR8563 Institutional research plan: CEZ:AV0Z50390703 Keywords : PTPRD * syndrom restless legs Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 30.259, year: 2008

Combined brain voxel-based morphometry and diffusion tensor imaging study in idiopathic restless legs syndrome patients.

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Rizzo, G; Manners, D; Vetrugno, R; Tonon, C; Malucelli, E; Plazzi, G; Marconi, S; Pizza, F; Testa, C; Provini, F; Montagna, P; Lodi, R

2012-07-01

  The aim of this study was to evaluate the presence of abnormalities in the brain of patients with restless legs syndrome (RLS) using voxel-based morphometry and diffusion tensor imaging (DTI).   Twenty patients and twenty controls were studied. Voxel-based morphometry analysis was performed using statistical parametric mapping (SPM8) and FSL-VBM software tools. For voxel-wise analysis of DTI, tract-based spatial statistics (TBSS) and SPM8 were used.   Applying an appropriate threshold of probability, no significant results were found either in comparison or in correlation analyses.   Our data argue against clear structural or microstructural abnormalities in the brain of patients with idiopathic RLS, suggesting a prevalent role of functional or metabolic impairment. © 2011 The Author(s) European Journal of Neurology © 2011 EFNS.

Timing of muscle response to a sudden leg perturbation: comparison between adolescents and adults with Down syndrome.

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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.

Painful legs and moving toes syndrome: a 76-patient case series.

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Hassan, Anhar; Mateen, Farrah J; Coon, Elizabeth A; Ahlskog, J Eric

2012-08-01

To better characterize the clinical features, electrophysiologic features, and treatment outcomes of painful legs and moving toes (PLMT) syndrome. Large case series. Neurology outpatient clinic at a tertiary referral center, 1983-2011. All cases of PLMT seen at our institution during an 18-year period were identified using our medical record linkage system. Key demographic, clinical, imaging, and electrophysiologic features of PLMT. Treatment outcomes and long-term follow-up are also reported. Of 76 cases identified (including 50 women [66%]), the mean age at onset was 58 years (range, 24-86 years) and at neurologic evaluation was 63 years (range, 26-88 years). Pure lower limb involvement was most common (69 patients [91%]), and 44 cases (58%) were bilateral. The most frequently diagnosed causes were peripheral neuropathy (21 cases [28%]), previous trauma (8 [11%]), and radiculopathy (7 [9%]); 32 cases (42%) were cryptogenic. Electromyography consistently showed irregular 50-millisecond to 1-second bursts of normal motor unit potential firing at 2 to 200 Hz accompanying the movements. Pain occurred first in nearly all cases and was more distressing to patients than the movements. Both components were difficult to treat, with no consistent benefit from a variety of drugs and therapeutic modalities. The syndrome persisted in most patients (83%) during the mean follow-up of 4.6 years, suggesting low likelihood of spontaneous resolution. Painful legs and moving toes syndrome is a debilitating clinical syndrome, not because of the movements but rather because of the pain, which often is refractory to treatment. Segmental lower limb involvement is most common, and neurophysiologic findings support a pathophysiologic process localizing to a central generator at the spinal cord or brainstem level.

Treatment of restless legs syndrome Tratamento da síndrome das pernas inquietas

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Tiago Spolador

2006-12-01

Full Text Available OBJECTIVE: Restless legs syndrome is a neurological disorder characterized by a desire to move limbs, which is usually only present or worsens during rest or at night. The objective of this article was to review the available literature about pharmacological treatment for this disorder. METHOD: A search of recent literature was undertaken on online databases (Medline, Pubmed, Scielo and Lilacs. RESULTS: 502 articles were retrieved, of which 30 were selected. Dopaminergic agents, anticonvulsants, opioids, benzodiazepines, zolpidem, entacapone and ketamine were all effective on the restless legs syndrome treatment. One study showed that iron was not effective. CONCLUSIONS: Based on few double-blind, randomized, controlled trials, it seems that the best options to treat restless legs syndrome patients are gabapentin and L-dopa associated to its sustained release formulation.OBJETIVO: A síndrome das pernas inquietas é um transtorno neurológico caracterizado por um desejo incontrolável de mover os membros, que comumente está somente presente ou piora ao descanso ou à noite. O objetivo do trabalho foi a revisão da literatura disponível sobre o tratamento farmacológico para a síndrome das pernas inquietas. MÉTODO: Pesquisa da literatura recente realizada em bases de dados eletrônicas (Medline, Pubmed, Scielo e Lilacs. RESULTADOS: Quinhentos e dois artigos foram encontrados, dos quais 30 foram selecionados. Os agentes dopaminérgicos, os anticonvulsantes, os opióides, os benzodiazepínicos, o zolpidem, o entacapone e a ketamina foram eficazes no tratamento da síndrome das pernas inquietas. Um estudo mostrou que o ferro não foi eficaz. CONCLUSÕES: Baseado nos poucos estudos duplo-cegos, randomizados e controlados, parece que as melhores opções para tratar os pacientes com síndrome das pernas inquietas são a gabapentina e L-dopa associada à sua formulação de liberação lenta.

A prospective blinded evaluation of exercise thallium-201 SPET in patients with suspected chronic exertional compartment syndrome of the leg

International Nuclear Information System (INIS)

Trease, L.; Every, B. van; Rynderman, J.; Baldey, A.; Turlakow, A.; Kelly, Michael J.; Bennell, K.; Brukner, P.

2001-01-01

This study compared the quantitative and qualitative results of leg thallium-201 single-photon emission tomography (SPET) imaging in patients with and without raised intracompartmental pressure associated with exercise-related leg pain. The purpose of this study was to clarify the aetiology of chronic exertional compartment syndrome (CECS), and to investigate the diagnostic applications of 201 Tl SPET in CECS. Thirty-four study participants underwent compartment pressure testing (CPT) between March and August 2000. There were 25 positive CPT results (patient group), and nine negative CPT results (control group). All 34 participants underwent scintigraphy. Quantitative and qualitative assessments were performed for the anterolateral and deep posterior compartments of the lower leg. There was no significant difference in either quantitative or qualitative assessments of perfusion between those compartments with and those without CECS. In contrast, a marked effect of exercise type upon compartment perfusion pattern was noted. Results of this study indicate that there is no compartment perfusion deficit in those patients with raised intracompartmental pressure associated with CECS, and suggest a non-ischaemic basis for the pain associated with CECS. They also suggest no role for exercise perfusion scintigraphy in the diagnosis of this syndrome. (orig.)

Restless leg syndrome, sleep quality and fatigue in multiple sclerosis patients

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N.C.V. Moreira

2008-10-01

Full Text Available We have tested the hypothesis that restless leg syndrome (RLS is related to quality of sleep, fatigue and clinical disability in multiple sclerosis (MS. The diagnosis of RLS used the four minimum criteria defined by the International Restless Legs Syndrome Study Group. Fatigue was assessed by the Fatigue Severity Scale (FSS >27, quality of sleep by the Pittsburgh Sleep Quality Index (PSQI >6, excessive daytime sleepiness by the Epworth Sleepiness Scale (ESS >10 and clinical disability by the Expanded Disability Status Scale (EDSS. Forty-four patients (32 women aged 14 to 64 years (43 ± 14 with disease from 0.4 to 23 years (6.7 ± 5.9 were evaluated. Thirty-five were classified as relapsing-remitting, 5 as primary progressive and 4 as secondary progressive. EDSS varied from 0 to 8.0 (3.6 ± 2.0. RLS was detected in 12 cases (27%. Patients with RLS presented greater disability (P = 0.01, poorer sleep (P = 0.02 and greater levels of fatigue (P = 0.03. Impaired sleep was present in 23 (52% and excessive daytime sleepiness in 3 cases (6.8%. Fatigue was present in 32 subjects (73% and was associated with clinical disability (P = 0.000 and sleep quality (P = 0.002. Age, gender, disease duration, MS pattern, excessive daytime sleepiness and the presence of upper motor neuron signs were not associated with the presence of RLS. Fatigue was best explained by clinical disability and poor sleep quality. Awareness of RLS among health care professionals may contribute to improvement in MS management.

Insomnia and limb pain in hemodialysis patients: What is the share of restless leg syndrome?

OpenAIRE

Majid Malaki; Fakhr Sadat Mortazavi; Sussan Moazemi; Maryam Shoaran

2012-01-01

Insomnia and limb pain are common problems in dialysis patients. In addition, restless leg syndrome (RLS) as a specific cause of insomnia and limb pain has been reported in many studies. The purpose of this study was to estimate incidence of insomnia and RLS as a cause of insomnia in these patients. Twenty-six patients undergoing hemodialysis were investigated for insomnia, limb pain and RLS as per the defined criteria. They were evaluated for dialysis quality, dialysis duration, hemoglobin, ...

Leg ulcer in Werner syndrome (adult progeria): a case report.

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Fumo, Giuseppe; Pau, Monica; Patta, Federico; Aste, Nicola; Atzori, Laura

2013-03-15

Werner syndrome (WS; MIM#277700) or adult progeria, is a rare disease, associated with mutations of a single gene (RECQL2 or WRN), located on chromosome 8 (8p12). It codes a DNA-helicase, whose defects cause genomic instability. The highest incidences are reported in Japan and Sardinia (Italy). On this major island of the Mediterranean Basin, the WS cases have been observed in the northern areas. The authors describe the apparently first case reported in southern Sardinia, a 51-year-old woman, who was born in and resides in the province of Cagliari. She presented with a 9-year history of an intractable leg ulcer and other characteristic symptoms, including "bird-like" face, high-pitched voice, premature greying, short stature, abdominal obesity in contrast with thin body type, scleroderma-like legs, decreased muscle mass, diabetes, atherosclerosis, and premature menopause. A specialized genetic Institute of Research (IRCCS-IDI, Rome) confirmed the clinical diagnosis. There is no cure or specific treatment and patients must be periodically screened for an increased risk of cardiovascular and cerebrovascular disease and malignancies. Among the many findings, leg ulcers significantly affect the patient's quality of life. This problem may send the patient to the dermatologist, who finally suspects the diagnosis. Poor response to medical treatment may require aggressive repeated surgery, with poor or temporary results.

Peripheral Dopamine in Restless Legs Syndrome

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Ulrike H. Mitchell

2018-03-01

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.

Dopaminergic treatment of restless legs syndrome in spinal cord injury patients with neuropathic pain.

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Kumru, Hatice; Albu, Sergiu; Vidal, Joan; Barrio, Manuela; Santamaria, Joan

2016-01-01

Recent studies report high incidence of restless legs syndrome (RLS) in patients with spinal cord injury (SCI), who may also present pain and sensory disturbances. In the present manuscript, we examine and discuss diagnostic and treatment challenges of comorbid RLS and neuropathic pain (NP) in SCI. We evaluated seven men with a mean age of 55.6 (s.d.=14.0) years, with chronic complete or incomplete SCI at the thoracic or lumbar level, for complaints of sensory disturbances in the legs, which initially were attributed to drug-resistant NP. Because overlapped RLS was suspected, clinical evaluation of NP and RLS, serum ferritin and iron level assessment, and video polysomnographic (VPSG) studies were conducted. Pramipexole (0.18 mg q.d. -1 ) was added to treat RLS, and a follow-up was performed at 2 months. We found that in six subjects the RLS was comorbid with NP and in one subject the symptoms of RLS were misdiagnosed as NP. VPSG revealed periodic limb movements (PLMs) in all patients, including PLMs of the legs, arms or both. Serum ferritin was patients. RLS improved significantly after 2 months with pramipexole. On the basis of current findings, we recommend physicians to be aware of the comorbidity between RLS and NP secondary to SCI to include suitable diagnostic procedures and effective treatments.

Quantifying Leg Movement Activity During Sleep.

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Ferri, Raffaele; Fulda, Stephany

2016-12-01

Currently, 2 sets of similar rules for recording and scoring leg movement (LM) exist, including periodic LM during sleep (PLMS) and periodic LM during wakefulness. The former were published in 2006 by a task force of the International Restless Legs Syndrome Study Group, and the second in 2007 by the American Academy of Sleep Medicine. This article reviews the basic recording methods, scoring rules, and computer-based programs for PLMS. Less frequent LM activities, such as alternating leg muscle activation, hypnagogic foot tremor, high-frequency LMs, and excessive fragmentary myoclonus are briefly described. Copyright © 2016 Elsevier Inc. All rights reserved.

Restless Legs Syndrome and Morningness-Eveningness in the Korean High-School Students

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Seok Man Kim

2016-12-01

Full Text Available Background and Objective Restless legs syndrome (RLS lowers the quality of sleep, and is characterized by symptoms that follow a circadian pattern. The aim of this study was to determine the relationship between RLS and morning-eveningness in Korean adolescents. Methods Of the 867 community-dwelling high school students, 590 subjects were included in this study. All participants completed self-report questionnaires, including demographic variables, particulars about menstruation, life style, sleep duration, RLS severity, Composite Scale, Epworth Sleepiness Scale, Insomnia Severity Scale, Patient Health Questionnaire-9 (PHQ-9, Pittsburgh sleep quality index and Berlin Questionnaire. Results Participants with RLS symptoms had a higher prevalence of depression, defined by a PHQ-9 score ≥ 10 (OR 3.03, CI 1.11–8.26 and eveningness in chronotype (odds ratio 1.95 confidence interval 1.15–6.43 when adjusted for depression, excessive daytime sleepiness, insomnia symptom and morningness-eveningness. However, RLS symptoms had no association with excessive daytime sleepiness and insomnia, when adjusted for clinical factors. Conclusion sIn Korean high school students, restless leg symptom may be preceded by depression and eveningness of chronotype. For healthy sleep lifestyle in the adolescents, an appropriate evaluation of RLS symptom as well as chronotype is recommended.

Quantitative rest activity in ambulatory monitoring as a physiological marker of restless legs syndrome: a controlled study.

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Tuisku, Katinka; Holi, Matti Mikael; Wahlbeck, Kristian; Ahlgren, Aulikki Johanna; Lauerma, Hannu

2003-04-01

An objective marker of restless legs syndrome (RLS) is needed for developing diagnostic tools and monitoring symptoms. Actometric ambulatory monitoring of 15 RLS patients and 15 healthy controls was undertaken in order to differentiate between RLS-related motor symptoms and normal motor activity. Nocturnal lower-limb activity per minute differentiated and discriminated between groups with no overlap, whereas the periodic limb movement index and the controlled rest activity during sitting showed less discriminative power. The naturalistic recording of nocturnal activity by actometry may prove useful for assessing the severity of RLS and for finding an objective marker to support the diagnosis of RLS. Copyright 2002 Movement Disorder Society

Nondrug-related aspect of treating Ekbom disease, formerly known as restless legs syndrome

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Mitchell UH

2011-05-01

Full Text Available Ulrike H MitchellDepartment of Exercise Sciences, Brigham Young University, Provo, UT, USAAbstract: Ekbom disease (EKD, formerly known as restless legs syndrome (RLS has affected and bothered many people over the centuries. It is one of the most prevalent neurological disorders in Europe and North-America, affecting about 10% of the population. The main characteristics are the strong urge to move, accompanied or caused by uncomfortable, sometimes even distressing, paresthesia of the legs, described as a "creeping, tugging, pulling" feeling. The symptoms often become worse as the day progresses, leading to sleep disturbances or sleep deprivation, which leads to decreased alertness and daytime functions. Numerous studies have been conducted assessing the efficacy of dopaminergic drugs, opioids, and other pharmacologic agents in alleviating EKD symptoms. However, there is also a growing body of evidence demonstrating the effectiveness of nonpharmacologic treatments including life style changes, physical activity programs, pneumatic compression, massage, near-infrared light therapy, and complementary therapies. The working mechanisms behind these alternatives are diverse. Some increase blood flow to the legs, therefore reducing tissue hypoxia; some introduce an afferent counter stimulus to the cortex and with that "close the gate" for aberrant nerve stimulations; some increase dopamine and nitric oxide and therefore augment bio-available neurotransmitters; and some generate endorphins producing an analgesic effect. The advantages of these treatments compared with pharmacologic agents include less or no side effects, no danger of augmentation, and less cost.Keywords: RLS, modalities, massage, intermittent compression, NIR

Pain, opioids, and sleep: implications for restless legs syndrome treatment.

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Trenkwalder, Claudia; Zieglgänsberger, Walter; Ahmedzai, Sam H; Högl, Birgit

2017-03-01

Opioid receptor agonists are known to relieve restless legs syndrome (RLS) symptoms, including both sensory and motor events, as well as improving sleep. The mechanisms of action of opioids in RLS are still a matter of speculation. The mechanisms by which endogenous opioids contribute to the pathophysiology of this polygenetic disorder, in which there are a number of variants, including developmental factors, remains unknown. A summary of the cellular mode of action of morphine and its (partial) antagonist naloxone via α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors and the involvement of dendritic spine activation is described. By targeting pain and its consequences, opioids are the first-line treatment in many diseases and conditions with both acute and chronic pain and have thus been used in both acute and chronic pain conditions over the last 40 years. Addiction, dependence, and tolerability of opioids show a wide variability interindividually, as the response to opioids is influenced by a complex combination of genetic, molecular, and phenotypic factors. Although several trials have now addressed opioid treatment in RLS, hyperalgesia as a complication of long-term opioid treatment, or opioid-opioid interaction have not received much attention so far. Therapeutic opioids may act not only on opioid receptors but also via histamine or N-methyl-d-aspartate (NMDA) receptors. In patients with RLS, one of the few studies investigating opioid bindings found that possible brain regions involved in the severity of RLS symptoms are similar to those known to be involved in chronic pain, such as the medial pain system (medial thalamus, amygdala, caudate nucleus, anterior cingulate gyrus, insular cortex, and orbitofrontal cortex). The results of this diprenorphine positron emission tomography study suggested that the more severe the RLS, the greater the release of endogenous opioids. Since 1993, when the first small controlled study was performed with

Iron status and chronic kidney disease predict restless legs syndrome in an older hospital population.

LENUS (Irish Health Repository)

Quinn, Colin

2011-03-01

Iron deficiency is important in the pathogenesis of restless legs syndrome (RLS), and serum ferritin measurement, using a cutoff of 45-50ng\\/ml, is widely recommended as the optimal screening test for iron deficiency in RLS. Serum ferritin often increases with inflammation, and a higher cutoff may be better in those with acute and chronic inflammatory conditions, including those with chronic kidney disease (CKD).

Normal regional brain iron concentration in restless legs syndrome measured by MRI

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Susanne Knake

2009-12-01

Full Text Available Susanne Knake1, Johannes T Heverhagen2, Katja Menzler1, Boris Keil2, Wolfgang H Oertel1, Karin Stiasny-Kolster11Department of Neurology, Center of Nervous Diseases, 2Department of Radiology, Philipps University, Marburg, GermanyAbstract: Using a T2* gradient echo magnetic resonance imaging (MRI sequence, regional T2 signal intensity (SI values, a surrogate marker for T2 values, were determined in 12 regions of interest (substantia nigra, pallidum, caudate head, thalamus, occipital white matter, and frontal white matter bilaterally and in two reference regions (cerebrospinal fluid and bone in 12 patients suffering from moderate to severe idiopathic restless legs syndrome (RLS; mean age 58.5 ± 8.7 years for 12.1 ± 9.1 years and in 12 healthy control subjects (mean age 56.8 ± 10.6 years. Iron deposits shorten T2 relaxation times on T2-weighted MRI. We used regional T2* SI to estimate regional T2-values. A T2-change ratio was calculated for each region of interest relative to the reference regions. We did not find significant differences in any of the investigated brain regions. In addition, serum measures involved in iron metabolism did not correlate with T2 SI values. We could not replicate earlier findings describing reduced regional brain iron concentrations in patients with RLS. Our results do not support the view of substantially impaired regional brain iron in RLS.Keywords: restless legs syndrome, pathophysiology, iron, MRI, substantia nigra

The effect of massage therapy on restless leg syndrome

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Rahim Mirnasuri

2016-02-01

Full Text Available Background: Restless Leg Syndrome (RLS is a kind of mal-movement which is identified by too much movement of the feet during rest. Although a host of scientific resources have pointed to the significant effect of massage on this disease, no well-designed study to date has explored the efficiency of massage on the RLS. Materials and methods: This study adopted a quasi-experimental design with pre-and post-test. Two groups served as the participants of the study. Experimental group received treatment, while control group received no intervention. Both groups were pre- and post-tested. The participants were 300 male and female students (at higher education centers of Lorestan province, whose age ranged from 18 to 30 years. Also, their height ranged from 155-1990, while their weight was 55-85 kg. A researcher-made questionnaire, including multiple-choice questions associated with RLS which show gravity of the mal-movement on a four-point Likert scale from very weak to very strong. T-test was used for data analysis. Results: The results of the study  showed that a period of massage therapy had a significant effect on tingling therapy on the foot, the foot throbbing, burning feet, the sudden jump feet, sleep the sleep quality Conclusion: The current study revealed that performing a massage-therapy protocol have a significant effect on reducing the symptoms of RLS.

Acupuncture for restless legs syndrome.

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Cui, Ye; Wang, Yin; Liu, Zhishun

2008-10-08

Restless legs syndrome (RLS) is a common movement disorder for which patients may seek treatment with acupuncture. However, the benefits of acupuncture in the treatment of RLS are unclear and have not been evaluated in a systematic review until now. To evaluate the efficacy and safety of acupuncture therapy in patients with RLS. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2007), MEDLINE (January 1950 to February 2007), EMBASE (January 1980 to 2007 Week 8), Chinese Biomedical Database (CBM) (1978 to February 2007), China National Knowledge Infrastructure (CNKI) (1979 to February 2007), VIP Database (1989 to February 2007), Japana Centra Revuo Medicina (1983 to 2007) and Korean Medical Database (1986 to 2007). Four Chinese journals, relevant academic conference proceedings and reference lists of articles were handsearched. Randomized controlled trials and quasi-randomized trials comparing acupuncture with no intervention, placebo acupuncture, sham acupuncture, pharmacological treatments, or other non-acupuncture interventions for primary RLS were included. Trials comparing acupuncture plus non-acupuncture treatment with the same non-acupuncture treatment were also included. Trials that only compared different forms of acupuncture or different acupoints were excluded. Two authors independently identified potential articles, assessed methodological quality and extracted data. Relative risk (RR) was used for binary outcomes and weighted mean difference for continuous variables. Results were combined only in the absence of clinical heterogeneity. Fourteen potentially relevant trials were identified initially, but twelve of them did not meet the selection criteria and were excluded. Only two trials with 170 patients met the inclusion criteria. No data could be combined due to clinical heterogeneity between trials. Both trials had methodological and/or reporting shortcomings. No significant difference was detected

Frequency of impulse control behaviours associated with dopaminergic therapy in restless legs syndrome

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Reiff Julia

2011-09-01

Full Text Available Abstract Background Low doses of dopamine agonists (DA and levodopa are effective in the treatment of restless legs syndrome (RLS. A range of impulse control and compulsive behaviours (ICBs have been reported following the use of DAs and levodopa in patients with Parkinson's disease. With this study we sought to assess the cross-sectional prevalence of impulse control behaviours (ICBs in restless legs syndrome (RLS and to determine factors associated with ICBs in a population cohort in Germany. Methods Several questionnaires based on validated and previously used instruments for assessment of ICBs were mailed out to patients being treated for RLS. Final diagnoses of ICBs were based on stringent diagnostic criteria after psychiatric interviews were performed. Results 10/140 RLS patients of a clinical cohort (7.1% were finally diagnosed with ICBs, 8 of 10 on dopamine agonist (DA therapy, 2 of 10 on levodopa. 8 of the 10 affected patients showed more than one type of abnormal behaviour. Among those who responded to the questionnaires 6/140 [4.3%] revealed binge eating, 5/140 [3.6%] compulsive shopping, 3/140 [2.1%] pathological gambling, 3/140 [2.1%] punding, and 2/140 [1.4%] hypersexuality in psychiatric assessments. Among those who did not respond to questionnaires, 32 were randomly selected and interviewed: only 1 patient showed positive criteria of ICBs with compulsive shopping and binge eating. ICBs were associated with higher DA dose (p = 0.001, younger RLS onset (p = 0.04, history of experimental drug use (p = 0.002, female gender (p = 0.04 and a family history of gambling disorders (p = 0.02, which accounted for 52% of the risk variance. Conclusion RLS patients treated with dopaminergic agents and dopamine agonists in particular, should be forewarned of potential side effects. A careful history of risk factors should be taken.

Primary headaches in restless legs syndrome patients

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Ravi Gupta

2012-01-01

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.

Research progress of restless legs syndrome in China: Chinese scholars' reports published abroad

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Chun-yan LIU

2017-09-01

Full Text Available In recent years, Chinese scholars have made some progress in the field of restless legs syndrome (RLS, including epidemiological investigation of prevalence of RLS in some areas of China, the pathogenesis, comorbidities research, drug therapy and non ? drug therapy of RLS, such as repetitive transcranial magnetic stimulation (rTMS, acupuncture and moxibustion treatment, etc. This has laid a solid foundation for understanding and treating the disease in a better way, and also makes some contributions to RLS research for our country. DOI: 10.3969/j.issn.1672-6731.2017.09.003

Restless legs syndrome, pica, and iron status in blood donors.

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Spencer, Bryan R; Kleinman, Steven; Wright, David J; Glynn, Simone A; Rye, David B; Kiss, Joseph E; Mast, Alan E; Cable, Ritchard G

2013-08-01

The association of blood donation-related iron deficiency with pica or restless legs syndrome (RLS) remains poorly elucidated. This study evaluated the prevalence of RLS and pica in blood donors completing the REDS-II Iron Status Evaluation (RISE) study. RISE enrolled 2425 blood donors in a prospective cohort study; 1334 donors provided blood samples to characterize iron status and answered a questionnaire inquiring into symptoms of RLS and pica at a final visit after 15 to 24 months of follow-up. Associations between both conditions and iron status were evaluated. There were 9 and 20% of donors reporting symptoms of probable or probable/possible RLS, respectively. Iron depletion and donation intensity were not predictive of RLS. Pica was reported by 65 donors (5.5%), half of whom reported daily cravings. Prevalence of pica increased with degree of iron depletion in women (2% in iron-replete females, 13% in those with ferritin high prevalence of RLS in frequent blood donors but shows no association with iron status or donation intensity. Low iron stores were associated with higher prevalence of pica, but only in females. Furthermore, the results are incompatible with RLS and pica sharing a common pathophysiology. © 2013 American Association of Blood Banks.

Restless leg syndrome in different types of demyelinating neuropathies: a single-center pilot study.

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Luigetti, Marco; Del Grande, Alessandra; Testani, Elisa; Bisogni, Giulia; Losurdo, Anna; Giannantoni, Nadia Mariagrazia; Mazza, Salvatore; Sabatelli, Mario; Della Marca, Giacomo

2013-09-15

to determine the prevalence of restless legs syndrome (RLS) in a cohort of patients with demyelinating neuropathies. Patients were retrospectively recruited from our cohort of different forms of demyelinating neuropathies, including chronic inflammatory demyelinating neuropathy (CIDP), Charcot-Marie-Tooth 1A (CMT1A), and hereditary neuropathy with liability to pressure palsies (HNPP) referred to our Department of Neurology in a 10-year period. The validated 4-item RLS questionnaire was used for diagnosis of RLS. All patients with RLS who fulfilled criteria underwent a suggested immobilization test to confirm the diagnosis. A group of outpatients referred to the sleep disorders unit and data from published literature were used as controls. Prevalence of RLS in demyelinating neuropathy group was higher than prevalence observed in control population (p = 0.0142) or in the literature data (p = 0.0007). In particular, in comparison with both control population and literature data, prevalence of RLS was higher in CIDP group (p = 0.0266 and p = 0.0063, respectively) and in CMT1A group (p = 0.0312 and p = 0.0105, respectively), but not in HNPP (p = 1.000 and p = 0.9320, respectively). our study confirms a high prevalence of RLS in inflammatory neuropathies as CIDP and, among inherited neuropathies, in CMT1A but not in HNPP. Considering that this is only a small cohort from a single-center retrospective experience, the link between RLS and neuropathy remains uncertain, and larger multicenter studies are probably needed to clarify the real meaning of the association between RLS and neuropathy.

Evaluation of restless legs syndrome in fibromyalgia syndrome: an analysis of quality of sleep and life.

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Civelek, Gul Mete; Ciftkaya, Pinar Oztop; Karatas, Metin

2014-01-01

The aim of this study is to find prevalence and severity of restless legs syndrome (RLS) in patients with fibromyalgia syndrome (FMS) and detect effect of FMS and RLS coexistance on quality of sleep and life. In this study, presence and severity of RLS were detected in patients with FMS and Pitsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Fibromyalgia Impact Questionnaire (FIQ) scores of all patients were measured. One hundred and fifteen female patients with median age 49 (39.0-57.0)[median (25-75{\\%} interquartile range)] were included in the study. In 42.6% of patients RLS coexisting with FMS was found. RLS was classified as moderate in 42.9% of patients and as severe in 49.0% of patients. In patients with FMS ans RLS sleep quality, daytime sleepiness and quality of life were more severely impaired (PSQI scores were 9.0 ± 4.4 vs 7.8 ± 4.3, p=0.003; ESS scores were 5.0(3.0-7.5) vs 3.0(1.0-4.3), p=0.036 and FIQ scores were 68.1 ± 9.8 vs 59.4 ± 16.9, p=0.027) compared to patients with only FMS. Prevalence of RLS was found higher in FMS than normal population and quality of sleep and quality of life were worse in patients with RLS. Presence of RLS should be investigated in every patient with FMS and treatment plans should also cover RLS in case of coexistance with FMS. Prospective cohort studies are needed for better explanation of FMS and RLS coexistance.

Postural control in restless legs syndrome with medication intervention using pramipexole.

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Ahlgrén-Rimpiläinen, Aulikki; Lauerma, Hannu; Kähkönen, Seppo; Aalto, Heikki; Tuisku, Katinka; Holi, Matti; Pyykkö, Ilmari; Rimpiläinen, Ilpo

2014-02-01

Central dopamine regulation is involved in postural control and in the pathophysiology of restless legs syndrome (RLS) and Parkinson's disease (PD). Postural control abnormalities have been detected in PD, but there are no earlier studies with regard to RLS and postural control. Computerized force platform posturography was applied to measure the shift and the velocity (CPFV) of center point of forces (CPF) with eyes open (EO) and eyes closed (EC) in controls (n = 12) and prior and after a single day intervention with pramipexole in RLS subjects (n = 12). CPFV (EO) was significantly lower in the RLS group (p < 0.05) than in controls. After pramipexole intake, the difference disappeared and the subjective symptom severity diminished. Pramipexole did not significantly influence CPFV (EC) or CPF shift direction. Subjects with RLS used extensively visual mechanisms to control vestibule-spinal reflexes to improve or compensate the postural stability. Further research is needed to clarify altered feedback in the central nervous system and involvement of dopamine and vision in the postural control in RLS.

Evaluation of Cardiovascular Risk Factors and Restless Legs Syndrome in Women and Men: A Preliminary Population-Based Study in China.

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Liu, Yuqiong; Liu, Gangqiong; Li, Ling; Yang, Jing; Ma, Shengli

2018-03-15

Many studies have investigated the association between restless legs syndrome (RLS) and cardiovascular risk factors, leading to conflicting results. Therefore, the aim of the current study was to determine whether RLS is associated with cardiovascular risk factors and disease. This cross-sectional study included 5,324 consecutive subjects who visited the Physical Examination Center of The First Affiliated Hospital of Zhengzhou University for their yearly routine physical examination. Participants underwent a face-to-face interview with a neurologist for the assessment of RLS, based on the International Restless Legs Study Group criteria. They also completed a questionnaire related to cardiovascular risk factors and other health-related and demographic information. Logistic regression was used to assess which of the demographic and cardiovascular risk factors increased the odds of RLS. Then, unadjusted and adjusted models were designed to determine whether RLS was associated with increased odds of cardiovascular disease, coronary artery disease, or hypertension. RLS was observed in 9.2% of the participants. Multivariable logistic regression models, which included the covariates age, sex, body mass index, smoking status, hypercholesterolemia, and Pittsburgh Sleep Quality Index score (dichotomized at 5), demonstrated that female sex (odds ratio [OR]: 2.42, 95% confidence interval [CI]: 1.99-2.95), smoking (OR: 1.96, 95% CI: 1.31-2.92), high cholesterol (OR: 1.30, 95% CI: 1.03-1.64), and PSQI score > 5 (OR: 5.61, 95% CI: 2.14-14.69) are significantly associated with RLS. Additionally, RLS was associated with hypertension, after adjusting for age, sex, body mass index, smoking, hypercholesterolemia, Pittsburgh Sleep Quality Index score > 5, diabetes, anemia, and decreased renal function. RLS is associated with the prevalence of hypertension but not with that of cardiovascular disease or coronary artery disease. © 2018 American Academy of Sleep Medicine.

Low Dose of Clonazepam Is Effective in the Treatment of Painless Legs and Moving Toes Syndrome: A Case Report

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Sumihiro Kawajiri

2015-03-01

Full Text Available Introduction: Painless legs and moving toes syndrome (PoLMT is a rare movement disorder characterized by flexion, extension, abduction, adduction, and torsion of toes in the absence of pain. It is considered a variant of painful legs and moving toes syndrome, which is characterized by similar movements but is accompanied by pain. Although neuropathy, spinal cord compression, brain tumor, cerebral infarction, and Wilson's disease have been reported to be associated with PoLMT, the actual cause, trigger, and mechanism remain unclear. Therefore, a standardized treatment for PoLMT is not established yet. Case Presentation: We describe a 64-year-old Japanese woman with no past medical history who presented with nonrhythmic repetitive involuntary toe movement of the left foot in the absence of pain. She was diagnosed with idiopathic PoLMT and treated with a low dose of clonazepam (0.5 mg/day. The involuntary movement disappeared completely several days after treatment. Conclusion: A low dose of clonazepam is effective in the treatment of PoLMT.

Associations of Incident Cardiovascular Events With Restless Legs Syndrome and Periodic Leg Movements of Sleep in Older Men, for the Outcomes of Sleep Disorders in Older Men Study (MrOS Sleep Study).

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Winkelman, John W; Blackwell, Terri; Stone, Katie; Ancoli-Israel, Sonia; Redline, Susan

2017-04-01

Both restless legs syndrome (RLS) and periodic leg movements in sleep (PLMS) may be associated with incident cardiovascular disease (CVD). However, the individual contributions of these factors to adverse CVD outcomes are unknown. During the MrOS Sleep Study, 2823 men (mean age = 76.3 years) participated in a comprehensive sleep assessment from 2000 to 2002. RLS was identified by self-report of a physician diagnosis of RLS. A periodic limb movement of sleep index (PLMI) was derived from unattended in-home polysomnography. Incident cardiovascular events were centrally adjudicated during 8.7 ± 2.6 years of follow-up. The primary outcome was all-cause CVD; secondary outcomes included incident myocardial infarction (MI) and cerebrovascular disease. Cox proportional hazards regression models were adjusted for multiple covariates, including PLMI, to examine if there were independent associations of RLS and PLMI to the outcomes. Physician-diagnosed RLS was reported by 2.2% and a PLMI ≥ 15 was found in 59.6% of men. RLS was not associated with the composite CVD outcome. RLS was significantly associated with incident MI (Hazard ratio [HR] = 2.02, 95% CI, 1.04-3.91) even after adjustment for multiple covariates. Results were only modestly attenuated when PLMI was added to the model. PLMI also was found to predict incident MI (per SD increase in PLMI, HR = 1.14, 95% CI, 1.00-1.30, p = .05), and was materially unchanged after addition of RLS. The independent risk that RLS confers for MI suggests a role for non-PLMS factors such as sleep disturbance, shared genetic factors, or PLM-independent sympathetic hyperactivity. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Restless legs syndrome in adolescents: relationship with sleep quality, cardiorespiratory fitness and body fat

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Christoforos D. Giannaki

Full Text Available Objective: The aim of the current study was to investigate the relationship between restless legs syndrome (RLS and cardiorespiratory fitness, body composition and sleep quality in a sample of adolescents. Methods: One hundred fifty seven volunteer adolescents (16.6 ± 0.7 yrs participated in the study. Sleep quality was assessed by the Pittsburg sleep quality index. Cardiorespiratory fitness was assessed by the 20 m shuttle run test and body composition by bioelectrical impedance analysis. Results: The prevalence of RLS was 5.1%. The adolescents with RLS were found to exhibit significantly higher body fat levels (p=0.019 and poorer sleep quality score (p=0.000 compared with their free-RLS counterparts. Conclusions: Adolescents with RLS are subjects of higher body fat and impaired sleep quality compared with adolescents without RLS. Early diagnosis and appropriate management of RLS is essential in the adolescents.

Restless legs syndrome in Parkinson's disease: clinical characteristics and biochemical correlations

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Tiago Machado Guerreiro

2010-12-01

Full Text Available Restless legs syndrome (RLS is a neurological disorder that responds to dopaminergic drugs, indicating a common pathophysiology with Parkinson's disease (PD. The prevalence of RLS was estimated in a group of PD patients and its clinical and biochemical characteristics were analysed. Forty-eight patients with PD were evaluated into two groups, with and without RLS. Clinical characteristics assessed in both groups were age, gender, duration of PD, Hoehn and Yahr, and Schwab and England scales. Laboratory variables such as hemoglobin, s-iron, s-ferritin and creatinine were obtained. The prevalence of RLS was 18.75%. No significant differences regarding clinical variables and biochemical parameters were observed. The high prevalence of RLS found in PD patients suggests the concept of a common etiological link and it seems that secondary causes did not play a central role in the pathophysiology of RLS in this group of parkinsonian patients.

Deep Vein Thrombosis of the Left Leg: A Case of May-Thurner Syndrome

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Jiten Desai

2018-02-01

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.

Quantitation of stress/rest 201TI SPECT of the legs in the diagnosis of compartment-NT syndromes (CPS)

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Hayes, A.A.; Bower, G.D.; Pitstock, K.L.; Maguire, K.F.

1998-01-01

Full text: Compartment-NT syndrom (CPS) of the legs is considered to have an ischaemic basis related to muscle swelling and pressure increase in a muscle compartment (MC) during isotonic work. We decided to study selected patients where CPS was suspected with exercise 201 TI SPECT of the legs to better define their diagnoses. Eighteen patients with probable CPS reproduced their leg pain(s) during isotonic work, and 100 MBq of 201 TI was given i.v. during continued work and pain. Anterior 300 sec. planar and 360 degree, elliptical SPECT studies were acquired five minutes after stress and again four hours later. Quantitation of whole calf and regional MC uptake was attempted after the first five patients were assessed qualitatively. Ten patients were men and eight were women. The mean age was 30.8 y. Four had localised posterior and three had anterior pain with 11 having mixed and bilateral symptoms. Five patients had had a bone scan in the past and nine had MC pressure studies done within a month of study. Six patients had had previous decompressive surgery and seven patients had surgery after stress/rest studies. Four asymptomatic cardiac patients (''controls'') were imaged after their cardiac 201 TI studies and data used for comparison. Mean age of controls was 33 years. Generally even muscle uptake was seen on stress images with mean washout of 201 TI of 12% (7-23%) being calculated on delayed images of controls. Painful MCs with qualitative reduction in uptake after stress showed a mean increase in 201 TI of 25.7% (6-39%) on delayed imaging. Three patients with dramatic improvement in symptoms after surgery had shown a mean increase of 25.2% in delayed uptake in MCs on pre-operative studies. One patient showed washout of 11 and 15% from posterior MCs and had a poor response to subsequent surgery. Further clinical follow up in a large group of patients will be required to fully identify the place of Stress 201 TI imaging of the legs in this difficult group of

Prevalence and Clinical Characteristics of the Restless Legs Syndrome (RLS in Patients Diagnosed with Attention Deficit Hyperactivity Disorder (ADHD in Antioquia

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Ana Carolina Sierra Montoya

2018-02-01

Full Text Available Introduction: Attention Deficit Hyperactivity Disorder (ADHD is the most common behavioral issue for children. One of the sleeping disorders most frequently related to ADHD is the Restless Legs Syndrome (RLS, characterized by an irresistible urge to move the legs, something that is generally associated with paresthesias and motor restlessness. The prevalence rate of RLS in children diagnosed with ADHD is close to 18%, but in Colombia, these cases have been hardly studied. Objective: To determine the frequency of RLS, in children with ADHD. Methods: A cross-sectional study, filled out by parents of children diagnosed with ADHD, were analyzed. This questionnaire contained clinical criteria for classifying ADHD according to the DSM-IV, as well as diagnostic criteria for RLS by the National Institutes of Health (2003. Results: A predominance rate of 65.6% in combined ADHD was observed in children with RLS criteria. Upon carrying out an exploratory data analysis, it was found that having a family history of RLS and belonging to the middle or low socioeconomic strata are conditions associated with the presence of RLS in children with ADHD, with a significant p (p < 0.000 and a PR of 4.47 (3.16-6.32. Conclusions: The prevalence of RLS was similar to the findings of other clinical investigations. However, it highlights new prevalence values in relation to the comorbidity between ADHD and RLS, suggesting the need for new clinical and therapeutic alternatives amidst the presence of both syndromes.

Is nocturnal eating in restless legs syndrome linked to a specific psychopathological profile? A pilot study.

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Marconi, Sara; Scarlatti, Fabiano; Rizzo, Giovanni; Antelmi, Elena; Innamorati, Marco; Pompili, Maurizio; Brugnoli, Roberto; Belvederi Murri, Martino; Amore, Mario; Provini, Federica

2015-11-01

The purpose of the study was to evaluate psychological comorbidity in drug-naive or drug-free primary restless legs syndrome (p-RLS) patients with nocturnal eating disorder (NED), and to analyze the association of comorbid p-RLS and NED with obsessive-compulsive, mood and anxiety symptoms, and personality. Participants comprised 20 consecutive female outpatients with p-RLS, 10 without NED and 10 with NED, and 10 female controls matched for age. Both patients and controls were evaluated by the Hamilton Depression and the Anxiety Rating Scales, the State-Trait Anxiety Inventory, the Maudsley Obsessive Compulsive Inventory and the temperament and character inventory-revised. Compared to controls, p-RLS patients without and with NED had higher trait anxiety and current anxiety and obsessive-compulsive symptoms. p-RLS patients with NED also had significantly higher doubting compared to p-RLS patients without NED. Furthermore, groups differed for harm avoidance (HA), with p-RLS patients with and without NED having higher scores than controls. Untreated p-RLS patients, particularly those with nocturnal eating, report anxiety and obsessive-compulsive symptoms, perceive stressful situations as dangerous and threatening and tend to respond with anxiety to such situations. They have higher tendency to respond intensely to aversive stimuli, inhibiting behavior to avoid punishment, novelty, and frustrative omission of expected rewards. We hypothesize that higher levels of HA, a biologically determined personality trait, might constitute a diathesis predisposing individuals to display obsessive-compulsive symptoms, namely increasingly severe compulsive nocturnal eating.

Restless legs syndrome: relationship between prevalence and latitude.

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Koo, Brian B

2012-12-01

Restless legs syndrome (RLS) has a broad worldwide prevalence between 0.01% and 18.3%. While differences in RLS definitions and data ascertainment methods account for some variability, other factors likely contribute. The circadian nature of RLS and the fact that RLS symptoms track with endogenous melatonin levels suggest that light or ultraviolet radiation (UVR) may be related to RLS expression. As the amount of UVR decreases with latitude, we considered the potential effect of geography on RLS prevalence with the thought being that RLS prevalence rises with increasing latitude. RLS epidemiologic studies were sought via Pubmed search in the period between January 1, 1992 and November 15, 2010. Prevalence was mapped for each country or specific region studied and examined by continent. Pearson's correlational testing was carried out for RLS prevalence and latitude of the region studied. Global RLS prevalence ranges from 0.01% in Africa, 0.7% to 12.5% in Asia, 2.0% to 18.9% in the Americas, and 3.2% to 18.3% in Europe. Mapping RLS prevalence by country or region in both the Americas and in Europe suggests increasing RLS frequency with greater northern latitude. RLS prevalence is positively correlated with northern latitude in both North America and Europe with correlation coefficients of r = 0.77 (0.15, 0.96; p = 0.02) and r = 0.74 (0.44, 0.89; p = 0.0002), respectively. In Europe, lower latitudinal countries like Greece and Turkey had RLS prevalence (per 1,000 persons) of 38 and 34, respectively, middle latitudinal countries like France and England of 108 and 86, respectively, and high latitudinal countries like Norway and Iceland of 143 and 183, respectively. RLS epidemiology indicates an increase in RLS frequency in northern latitudinal countries as a function of distance from the equator, an effect most evident in Europe. This suggests that factors that track with latitude like UVR may be involved in the expression of RLS.

Review of the Relationship of Restless Legs Syndrome and Periodic Limb Movements in Sleep to Hypertension, Heart Disease, and Stroke

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Walters, Arthur S.; Rye, David B.

2009-01-01

Evidence is reviewed documenting an intimate relationship among restless legs syndrome (RLS) / periodic limb movements in sleep (PLMS) and hypertension and cardiovascular and cerebrovascular disease. Sympathetic overactivity is associated with RLS/PLMS, as manifested by increased pulse rate and blood pressure coincident with PLMS. Causality is far from definitive. Mechanisms are explored as to how RLS/PLMS may lead to high blood pressure, heart disease, and stroke: (a) the sympathetic hyperac...

Diseases in patients coming to a sleep center with symptoms related to restless legs syndrome.

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Shih-Wei Lin

Full Text Available STUDY OBJECTIVE: To explore the profile of patients who visit a sleep center with symptoms that fulfill the four essential criteria for restless legs syndrome (RLS. DESIGN: A prospective study. SETTING: Outpatients from one sleep disorders clinic in Taiwan. PARTICIPANTS: 1,200 consecutive patients visit sleep disorders clinic with any sleep complaints. INTERVENTIONS: After completing a history and physical examination, all participants answered the RLS questionnaire. Subjects who fulfilled the four essential criteria for RLS were referred to a special clinic. A work-up including blood tests, polysomnography, and specialized neurological tests etc. was performed to make the final diagnosis. MEASUREMENTS AND RESULTS: A total of 1,185 participants were enrolled, and, of these, 131(11.1% fulfilled the four essential criteria for RLS, and 121 completed the supplemental work-up. Their mean age was 47.6±13.3 and 52.9% were male. Insomnia and snoring were the most common chief complaints. Obstructive sleep apnea syndrome and other diseases were found in 103 patients. Only 18 (14.9% patients had no comorbid condition and were diagnosed with primary RLS. CONCLUSIONS: Symptoms of RLS are common in patients with sleep complaints. Even in a sleep clinic, using a questionnaire approach for identification of RLS has a low positive predictive value. Clinicians should pay attention to the limitations of the 4-item questionnaire in diagnosis of RLS and also the importance of a careful differential diagnosis to identify possible secondary causes of RLS.

Nerve Decompression and Restless Legs Syndrome: A Retrospective Analysis

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James C. Anderson

2017-07-01

Full Text Available IntroductionRestless legs syndrome (RLS is a prevalent sleep disorder affecting quality of life and is often comorbid with other neurological diseases, including peripheral neuropathy. The mechanisms related to RLS symptoms remain unclear, and treatment options are often aimed at symptom relief rather than etiology. RLS may present in distinct phenotypes often described as “primary” vs. “secondary” RLS. Secondary RLS is often associated with peripheral neuropathy. Nerve decompression surgery of the common and superficial fibular nerves is used to treat peripheral neuropathy. Anecdotally, surgeons sometimes report improved RLS symptoms following nerve decompression for peripheral neuropathy. The purpose of this retrospective analysis was to quantify the change in symptoms commonly associated with RLS using visual analog scales (VAS.MethodsForty-two patients completed VAS scales (0–10 for pain, burning, numbness, tingling, weakness, balance, tightness, aching, pulling, cramping, twitchy/jumpy, uneasy, creepy/crawly, and throbbing, both before and 15 weeks after surgical decompression.ResultsSubjects reported significant improvement among all VAS categories, except for “pulling” (P = 0.14. The change in VAS following surgery was negatively correlated with the pre-surgery VAS for both the summed VAS (r = −0.58, P < 0.001 and the individual VAS scores (all P < 0.01, such that patients who reported the worst symptoms before surgery exhibited relatively greater reductions in symptoms after surgery.ConclusionThis is the first study to suggest improvement in RLS symptoms following surgical decompression of the common and superficial fibular nerves. Further investigation is needed to quantify improvement using RLS-specific metrics and sleep quality assessments.

Plantar reflex excitability is increased in the evening in restless legs syndrome patients.

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Dafkin, Chloe; Green, Andrew; Olivier, Benita; McKinon, Warrick; Kerr, Samantha

2017-11-01

To investigate if diurnal changes in spinal excitability (plantar reflex) occur in restless legs syndrome (RLS) participants compared to healthy matched controls. Thirteen RLS participants and 13 healthy control participants' plantar reflex responses were evaluated in the evening (PM) and the morning (AM). Plantar reflex responses were assessed electromyographically, using motion analysis (kinematically) and by subjective nociception (Visual Analogue Scale). RLS participants showed a circadian variation in plantar reflex responses whilst control participants did not. Evening ankle angle changes were larger and faster in RLS participants compared to morning responses. In addition RLS participants displayed significantly smaller change in ankle angle and significantly slower ankle movements in the evening and the morning as well as significantly lower lateral gastrocnemius maximum amplitude in the compared to control participants. The findings of the current study support the theory of RLS circadian fluctuations in spinal excitability. An unexpected finding was decreased plantar reflex responses in RLS participants compared to healthy control participants. However this finding supports the theory of mechanical hypoesthesia in RLS. The results of this study provide further insight into the pathophysiology of RLS, highlighting that not all sensory processing is affected in the same manner. Copyright © 2017 Elsevier B.V. All rights reserved.

Restless Legs Syndrome in Patients with Hypertension and Diabetes Mellitus.

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Sabic, Adela; Sinanovic, Osman; Sabic, Dzevad; Galic, Gordan

2016-04-01

The aim of this study was to analyze frequency of restless legs syndrome (RLS) in patients with hypertension and diabetes mellitus. It was analyzed 120 subjects (from Health Center Živinice/Family Medicine Department) through a survey conducted in the period from March to June 2015, of which 30 (8 men/22 women). Subjects were 30 patients with longtime hypertension (HT)(18 men/12 women), 30 patients with diabetes mellitus (DM) type I or II (9 men/21 women), 30 patients with long standing DM type I or II and HT (12 men /18 women), and 30 control subjects (12 men/18 women). RLS were evaluated by questionnaire - International RLS Study Group Criteria. The average age of patients in the group with HT was 58.70 ± 9.07, in the group with DM 48.43 ± 15.37, and in the group of patients with HT and DM 63.90 ± 7.49 years. In the control group mean age was 52.76 ± 14.83 years. Statistical data were analyzed in Excel and SSPS statistical program. RLS was identified in 10 (30%) of those with HT; 7 (21%) in patients with DM, and 10 (30%) in patients with HT+DM. In the control group RLS was verified in 4 (12%) patients. Comparing the results, it was observed significant difference between the HT and the control group (p=0.0012) and HT+ DM and control group (p=0.0012). The frequency of RLS between DM and the control group was not significantly significant (p=0.107). RLS is frequent in patients with hypertension (30%), hypertension+ diabetes mellitus (30%), and patients with DM (21%).

Successful Treatment with Clonazepam and Pramipexole of a Patient with Sleep-Related Eating Disorder Associated with Restless Legs Syndrome: A Case Report

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Nobuyuki Kobayashi

2012-01-01

Full Text Available Sleep-related eating disorder (SRED is characterized by recurrent episodes of involuntary eating during sleep period and is often associated with restless legs syndrome (RLS. Although pharmacotherapy is recommended for SRED patients, no drug have shown promising effects so far. The patient, a 48-year-old Japanese housewife, first visited our clinic and complained about nighttime eating. She had a history of hypertension, diabetes mellitus, sleep apnea syndrome, and depression. Insomnia appeared 10 years before the first visit and she often received hypnosedatives; at the same time, she developed nocturnal eating episodes. She had amnesia for these episodes, and she felt urge to move her legs while sleeping. The patient was diagnosed with SRED and RLS. Reduction in the doses of triazolam decreased her nighttime eating frequency, and her complete amnesia changed to vague recall of eating during night. Clonazepam 1.0 mg at bedtime decreased nocturnal eating frequency from 1 to 2 times per month, though sleepwalking remained. Administration of pramipexole 0.125 mg relieved all symptoms including SRED, RLS, and sleepwalking. This is the first paper to report that the combination of clonazepam and pramipexole therapy-reduced SRED episodes and RLS symptoms.

THE EFFECTS OF SINGLE LEG HOP PROGRESSION AND DOUBLE LEGS HOP PROGRESSION EXERCISE TO INCREASE SPEED AND EXPLOSIVE POWER OF LEG MUSCLE

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Nining W. Kusnanik

2015-05-01

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.

Restless Legs Syndrome: From Pathophysiology to Clinical Diagnosis and Management

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Shiyi Guo

2017-06-01

Full Text Available Restless legs syndrome (RLS, a common neurological sensorimotor disorder in western countries, has gained more and more attention in Asian countries. The prevalence of RLS is higher in older people and females. RLS is most commonly related to iron deficiency, pregnancy and uremia. The RLS symptoms show a significant circadian rhythm and a close relationship to periodic limb movements (PLMs in clinical observations, while the pathophysiological pathways are still unknown. The diagnostic criteria have been revised in 2012 to improve the validity of RLS diagnosis. Recent studies have suggested an important role of iron decrease of brain in RLS pathophysiology. Dopaminergic (DA system dysfunction in A11 cell groups has been recognized long ago from clinical treatment and autopsy. Nowadays, it is believed that iron dysfunction can affect DA system from different pathways and opioids have a protective effect on DA system. Several susceptible single nucleotide polymorphisms such as BTBD9 and MEIS1, which are thought to be involved in embryonic neuronal development, have been reported to be associated with RLS. Several pharmacological and non-pharmacological treatment are discussed in this review. First-line treatments of RLS include DA agents and α2δ agonists. Augmentation is very common in long-term treatment of RLS which makes prevention and management of augmentation very important for RLS patients. A combination of different types of medication is effective in preventing and treating augmentation. The knowledge on RLS is still limited, the pathophysiology and better management of RLS remain to be discovered.

A family with Parkinsonism, essential tremor, restless legs syndrome, and depression.

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Puschmann, A; Pfeiffer, R F; Stoessl, A J; Kuriakose, R; Lash, J L; Searcy, J A; Strongosky, A J; Vilariño-Güell, C; Farrer, M J; Ross, O A; Dickson, D W; Wszolek, Z K

2011-05-10

Previous epidemiologic and genetic studies have suggested a link between Parkinson disease (PD), essential tremor (ET), and restless legs syndrome (RLS). We describe the clinical, PET, and pathologic characteristics of an extensive kindred from Arkansas with hereditary PD, ET, and RLS. The pedigree contains 138 individuals. Sixty-five family members were examined neurologically up to 3 times from 2004 to 2010. Clinical data were collected from medical records and questionnaires. Genetic studies were performed. Five family members underwent multitracer PET. Two individuals with PD were examined postmortem. Eleven family members had PD with generally mild and slowly progressive symptoms. Age at onset was between 39 and 74 years (mean 59.1, SD 13.4). All individuals treated with l-dopa responded positively. Postural or action tremor was present in 6 individuals with PD, and in 19 additional family members. Fifteen persons reported symptoms of RLS. PET showed reduced presynaptic dopamine function typical of sporadic PD in a patient with PD and ET, but not in persons with ET or RLS. The inheritance pattern was autosomal dominant for PD and RLS. No known pathogenic mutation in PD-related genes was found. Fourteen of the family members with PD, ET, or RLS had depression. Neuropathologic examination revealed pallidonigral pigment spheroid degeneration with ubiquitin-positive axonal spheroids, TDP43-positive pathology in the basal ganglia, hippocampus, and brainstem, and only sparse Lewy bodies. Familial forms of PD, ET, RLS, and depression occur in this family. The genetic cause remains to be elucidated.

Whole body and local cryotherapy in restless legs syndrome: A randomized, single-blind, controlled parallel group pilot study.

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Happe, Svenja; Evers, Stefan; Thiedemann, Christian; Bunten, Sabine; Siegert, Rudolf

2016-11-15

Treatment of restless legs syndrome (RLS) is primarily based on drugs. Since many patients report improvement of symptoms due to cooling their legs, we examined the efficacy of cryotherapy in RLS. 35 patients (28 women, 60.9±12.5years) with idiopathic RLS and symptoms starting not later than 6pm were randomized into three groups: cold air chamber at -60°C (n=12); cold air chamber at -10°C (n=12); local cryotherapy at -17°C (n=11). After a two week baseline, the different therapies were applied three minutes daily at 6pm over two weeks, followed by a four week observation period. The patients completed several questionnaires regarding RLS symptoms, sleep, and quality of life on a weekly basis (IRLS, ESS), VAS and sleep/morning protocol were completed daily, MOSS/RLS-QLI were completed once in each period. Additionally, the PLM index was measured by a mobile device at the end of baseline, intervention, and follow-up. The IRLS score was chosen as primary efficacy parameter. At the end of follow-up, significant improvement of RLS symptoms and quality of life could be observed only in the -60°C group as compared to baseline (IRLS: p=0.009; RLS-QLI: p=0.006; ESS: p=0.020). Local cryotherapy led to improvement in quality of life (VAS4: p=0.028; RLS-QLI: p=0.014) and sleep quality (MOSS: p=0.020; MOSS2: p=0.022) but not in IRLS and ESS. In the -10°C group, the only significant effect was shortening of number of wake phases per night. Serious side-effects were not reported. Whole body cryotherapy at -60°C and, to a less extent, local cryotherapy seem to be a treatment option for RLS in addition to conventional pharmacological treatment. However, the exact mode of cryotherapy needs to be established. Copyright © 2016. Published by Elsevier B.V.

Hereditary Lymphedema of the Leg – A Case Report

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Birgit Heinig

2017-07-01

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.

When gender matters: restless legs syndrome. Report of the "RLS and woman" workshop endorsed by the European RLS Study Group.

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Manconi, Mauro; Ulfberg, Jan; Berger, Klaus; Ghorayeb, Imad; Wesström, Jan; Fulda, Stephany; Allen, Richard P; Pollmächer, Thomas

2012-08-01

Sleep is an essential human behavior that shows prominent gender differences. Disturbed sleep, in particular, is much more prevalent in females than males. Restless legs syndrome (RLS) as one cause of disturbed sleep was observed to be somewhat more common among women than men in Ekbom's 1945 seminal series of clinical cases with the disease. He, however, reported this gender difference mainly for those with more severe symptoms. Since then numerous studies have reported that women are affected by RLS about twice as often as males for mild as well as moderate to severe RLS. The present review focuses on RLS in females from the perspectives of both epidemiology and pathophysiology. RLS will generally become worse or might appear for the first time during pregnancy. Parity increases the risk of RLS later in life suggesting that pregnancy is a specific behavioral risk factor for developing RLS. Some evidence suggests that dysfunction in iron metabolism and high estrogen levels might contribute to RLS during pregnancy. But, menopause does not lower the incidence of RLS nor does hormone replacement therapy lead to an increase, suggesting a quite complex uncertain role of hormones in the pathophysiology of RLS. Therefore, further, preferably longitudinal studies are needed to unravel the factors causing RLS in women. These studies should include genetic, clinical and polysomnographic variables, as well as hormonal measures and variables assessing iron metabolism. Copyright © 2011 Elsevier Ltd. All rights reserved.

Radiating leg pain and positive straight leg raising in spondylolysis in children.

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Halperin, N; Copeliovitch, L; Schachner, E

1983-09-01

Three children presented with low back pain radiating to the leg and with spasm of the hamstring and paravertebral muscles. Since the pain could not be ascribed to trauma, it was necessary to exclude the presence of infection or tumors. All the signs--localization of the pain, tenderness on one side of the back, X-ray film findings of unilateral or bilateral spondylolysis, and localized positive bone scan--pointed to spondylolysis as the cause of pain. All three children exhibited symptoms resembling those found in the facet syndrome described by Mooney and Robertson.

Are the hamstrings from the drive leg or landing leg more active in baseball pitchers? An electromyographic study.

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Erickson, Brandon J; Zaferiou, Antonia; Chalmers, Peter N; Ruby, Deana; Malloy, Phillip; Luchetti, Timothy J; Verma, Nikhil N; Romeo, Anthony A

2017-11-01

Ulnar collateral ligament reconstruction (UCLR) has become a common procedure among baseball players of all levels. There are several graft choices in performing UCLR, one of which is a hamstring (gracilis or semitendinosus) autograft. It is unclear whether the hamstring muscle from a pitcher's drive leg (ipsilateral side of the UCLR) or landing leg (contralateral side of the UCLR) is more active during the pitching motion. We hypothesized that the landing leg semitendinosus will be more electromyographically active than the drive leg. Healthy, elite male pitchers aged 16-21 years were recruited. Sixteen pitchers (average age, 17.6 ± 1.6 years; 67% threw right handed) underwent electromyographic analysis. Pitchers threw 5 fastballs at 100% effort from the wind-up with electromyographic analysis of every pitch. Activation of the semitendinosus and biceps femoris in both legs was compared within pitchers and between pitchers. Hamstring activity was higher in the drive leg than in the landing leg during each phase and in sum, although the difference was significant only during the double support phase (P = .021). On within-pitcher analysis, 10 of 16 pitchers had significantly more sum hamstring activity in the drive leg than in the landing leg, while only 4 of 16 had more activity in the landing leg (P = .043). During the baseball pitch, muscle activity of the semitendinosus was higher in the drive leg than in the landing leg in most pitchers. Surgeons performing UCLR using hamstring autograft should consider harvesting the graft from the pitcher's landing leg to minimize disruption to the athlete's pitching motion. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Propulsion phase of the single leg triple hop test in women with patellofemoral pain syndrome: a biomechanical study.

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Andre Serra Bley

Full Text Available Asymmetry in the alignment of the lower limbs during weight-bearing activities is associated with patellofemoral pain syndrome (PFPS, caused by an increase in patellofemoral (PF joint stress. High neuromuscular demands are placed on the lower limb during the propulsion phase of the single leg triple hop test (SLTHT, which may influence biomechanical behavior. The aim of the present cross-sectional study was to compare kinematic, kinetic and muscle activity in the trunk and lower limb during propulsion in the SLTHT using women with PFPS and pain free controls. The following measurements were made using 20 women with PFPS and 20 controls during propulsion in the SLTHT: kinematics of the trunk, pelvis, hip, and knee; kinetics of the hip, knee and ankle; and muscle activation of the gluteus maximus (GM, gluteus medius (GMed, biceps femoris (BF and vastus lateralis (VL. Differences between groups were calculated using three separate sets of multivariate analysis of variance for kinematics, kinetics, and electromyographic data. Women with PFPS exhibited ipsilateral trunk lean; greater trunk flexion; greater contralateral pelvic drop; greater hip adduction and internal rotation; greater ankle pronation; greater internal hip abductor and ankle supinator moments; lower internal hip, knee and ankle extensor moments; and greater GM, GMed, BL, and VL muscle activity. The results of the present study are related to abnormal movement patterns in women with PFPS. We speculated that these findings constitute strategies to control a deficient dynamic alignment of the trunk and lower limb and to avoid PF pain. However, the greater BF and VL activity and the extensor pattern found for the hip, knee, and ankle of women with PFPS may contribute to increased PF stress.

Propulsion phase of the single leg triple hop test in women with patellofemoral pain syndrome: a biomechanical study.

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Bley, Andre Serra; Correa, João Carlos Ferrari; Dos Reis, Amir Curcio; Rabelo, Nayra Deise Dos Anjos; Marchetti, Paulo Henrique; Lucareli, Paulo Roberto Garcia

2014-01-01

Asymmetry in the alignment of the lower limbs during weight-bearing activities is associated with patellofemoral pain syndrome (PFPS), caused by an increase in patellofemoral (PF) joint stress. High neuromuscular demands are placed on the lower limb during the propulsion phase of the single leg triple hop test (SLTHT), which may influence biomechanical behavior. The aim of the present cross-sectional study was to compare kinematic, kinetic and muscle activity in the trunk and lower limb during propulsion in the SLTHT using women with PFPS and pain free controls. The following measurements were made using 20 women with PFPS and 20 controls during propulsion in the SLTHT: kinematics of the trunk, pelvis, hip, and knee; kinetics of the hip, knee and ankle; and muscle activation of the gluteus maximus (GM), gluteus medius (GMed), biceps femoris (BF) and vastus lateralis (VL). Differences between groups were calculated using three separate sets of multivariate analysis of variance for kinematics, kinetics, and electromyographic data. Women with PFPS exhibited ipsilateral trunk lean; greater trunk flexion; greater contralateral pelvic drop; greater hip adduction and internal rotation; greater ankle pronation; greater internal hip abductor and ankle supinator moments; lower internal hip, knee and ankle extensor moments; and greater GM, GMed, BL, and VL muscle activity. The results of the present study are related to abnormal movement patterns in women with PFPS. We speculated that these findings constitute strategies to control a deficient dynamic alignment of the trunk and lower limb and to avoid PF pain. However, the greater BF and VL activity and the extensor pattern found for the hip, knee, and ankle of women with PFPS may contribute to increased PF stress.

Painless Legs and Moving Toes as an Initial Presentation of Ischemic Stroke

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Se Mi Oh

2009-05-01

Full Text Available Painless legs and moving toes is an unusual syndrome, which has not previously been reported as an initial presentation of ischemic stroke. We encountered a 78-year-old woman who developed dysarthria and involuntary movement of her left toes that was clinically regarded as painless legs and moving toes. These symptoms appeared abruptly and simultaneously as the initial symptoms of stroke, and improved gradually with conservative management by intravenous hydration for a month. We suggest that, in our case, a cortical brain lesion caused by ischemic stroke might be associated with the development of painless legs and moving toes.

Altered Brain Functional Connectome in Migraine with and without Restless Legs Syndrome: A Resting-State Functional MRI Study

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Fu-Chi Yang

2018-01-01

Full Text Available BackgroundMigraine is frequently comorbid with restless legs syndrome (RLS, both displaying functional connectivity (FC alterations in multiple brain networks, although the neurological basis of this association is unknown.MethodsWe performed resting-state functional magnetic resonance imaging and network-wise analysis of FC in migraine patients with and without RLS and healthy controls (CRL. Network-based statistics (NBS and composite FC matrix analyses were performed to identify the patterns of FC changes. Correlation analyses were performed to identify associations between alterations in FC and clinical profiles.ResultsNBS results revealed that both migraine patients with and without RLS exhibited lower FC than CRL in the dorsal attention, salience, default mode, cingulo-opercular, visual, frontoparietal, auditory, and sensory/somatomotor networks. Further composite FC matrix analyses revealed differences in FC of the salience, default mode to subcortical and frontoparietal, auditory to salience, and memory retrieval networks between migraine patients with and without RLS. There was a trend toward a negative association between RLS severity and cross-network abnormalities in the default mode to subcortical network.DiscussionMigraine patients with and without RLS exhibit disruptions of brain FC. Such findings suggest that these disorders are associated with differential neuropathological mechanisms and may aid in the future development of neuroimaging-driven biomarkers for these conditions.

Crossed Leg Sign Is Associated With Severity of Unilateral Spatial Neglect After Stroke

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Gustavo José Luvizutto

2018-04-01

Full Text Available BackgroundThe crossed leg sign in patients with right hemisphere stroke is thought to be associated with perceptual disorders, such as unilateral spatial neglect (USN. The aim of this study was to compare the crossed leg sign with the severity of USN during the acute phase of stroke.Experimental proceduresThis was an observational and prospective clinical study of individuals with a diagnosis of right parietal stroke, as confirmed by neuroimaging. The occurrence of the crossed leg sign, the time at which this occurred after the stroke, and a clinical diagnosis of USN were measured and recorded. The patients’ age, sex, and lesion severity, as determined by the National Institutes of Health Stroke Scale and Glasgow coma scale, were included in the analyses as confounding variables. The outcome of interest was the degree of USN, as measured by the cancellation and bisection tests. Binary logistic regression was used to analyze the effect of crossed leg syndrome on the severity of USN. In the adjusted multiple regression model, a p-value of <0.05 was considered statistically significant.ResultsOverall, 60 patients were included in this study. There were no associations between patient demographics and the presence of the crossed leg sign. There was, however, an association between the crossed leg sign and the absolute value of the deviation in the line bisection test (B = −0.234; p = 0.039. The crossed leg sign was not associated with other measures of USN.ConclusionBased on the results of our study, we can conclude that a crossed leg sign in the acute phase of stroke is associated with USN severity, specifically the misinterpretation of the midline.

Mapping the changed hubs and corresponding functional connectivity in idiopathic restless legs syndrome.

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Liu, Chunyan; Wang, Jiaojian; Hou, Yue; Qi, Zhigang; Wang, Li; Zhan, Shuqin; Wang, Rong; Wang, Yuping

2018-05-01

The hubs of the brain network play a key role in integrating and transferring information between different functional modules. However, whether the changed pattern in functional network hubs contributes to the onset of leg discomfort symptoms in restless legs syndrome (RLS) patients remains unclear. Using resting-state functional magnetic resonance imaging (rs-fMRI) and graph theory methods, we investigated whether alterations of hubs can be detected in RLS. First, we constructed the whole-brain voxelwise functional connectivity and calculated a functional connectivity strength (FCS) map in each of 16 drug-naive idiopathic RLS patients and 26 gender- and age-matched healthy control (HC) subjects. Next, a two-sample t test was applied to compare the FCS maps between HC and RLS patients, and to identify significant changes in FCS in RLS patients. To further elucidate the corresponding changes in the functional connectivity patterns of the aberrant hubs in RLS patients, whole-brain resting-state functional connectivity analyses for the hub areas were performed. The hub analysis revealed decreased FCS in the cuneus, fusiform gyrus, paracentral lobe, and precuneus, and increased FCS in the superior frontal gyrus and thalamus in idiopathic drug-naive RLS patients. Subsequent functional connectivity analyses revealed decreased functional connectivity in sensorimotor and visual processing networks and increased functional connectivity in the affective cognitive network and cerebellar-thalamic circuit. Furthermore, the mean FCS value in the superior frontal gyrus was significantly correlated with Hamilton Anxiety Rating Scale scores in RLS patients, and the mean FCS value in the fusiform gyrus was significantly correlated with Hamilton Depression Rating Scale scores. These findings may provide novel insight into the pathophysiology of RLS. Copyright © 2018 Elsevier B.V. All rights reserved.

The Relationship among Leg Strength, Leg Power and Alpine Skiing Success.

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Gettman, Larry R.; Huckel, Jack R.

The purpose of this study was to relate leg strength and power to alpine skiing success as measured by FIS points. Isometric leg strength was represented by the knee extension test described by Clarke. Leg power was measured by the vertical jump test and the Margaria-Kalamen stair run. Results in the strength and power tests were correlated with…

Task driven optimal leg trajectories in insect-scale legged microrobots

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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.

Intrinsic factors associated with medial tibial stress syndrome in ...

African Journals Online (AJOL)

Intrinsic factors associated with medial tibial stress syndrome in athletes: A large case-control study. ... Medial tibial stress syndrome (MTSS) is the most common lower-leg injury in athletes, and is thought to be caused by ... from 32 Countries:.

Efficacy of vitamins C, E, and their combination for treatment of restless legs syndrome in hemodialysis patients: a randomized, double-blind, placebo-controlled trial.

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Sagheb, Mohammad Mahdi; Dormanesh, Banafshe; Fallahzadeh, Mohammad Kazem; Akbari, Hamideh; Sohrabi Nazari, Sahar; Heydari, Seyed Taghi; Behzadi, Saeed

2012-05-01

Restless legs syndrome (RLS) is a common disorder in hemodialysis patients that leads to insomnia and impaired quality of life. Because high oxidative stress has been implicated in the pathogenesis of RLS, we sought to evaluate the efficacy of vitamins C and E and their combination in reducing the severity of RLS symptoms in hemodialysis patients in this randomized, double-blind, placebo-controlled, four-arm parallel trial. Sixty stable hemodialysis patients who had all four diagnostic criteria for RLS developed by the International Restless Legs Syndrome Group with no acute illness or history of renal stone were randomly allocated to four fifteen-patient parallel groups to receive vitamin C (200 mg) and vitamin E (400 mg), vitamin C (200 mg) and placebo, vitamin E (400 mg) and placebo, and double placebo daily for eight weeks. International Restless Legs Scale (IRLS) scores were measured for all patients at baseline and at the end of treatment phase. The primary outcome was absolute change in IRLS sum score from baseline to the end of treatment phase. Means of IRLS sum score decreased significantly in the vitamins C and E (10.3 ± 5.3, 95% CI: 7.4-13.3), vitamin C and placebo (10 ± 3.5, 95% CI: 8.1-11.9), and vitamin E and placebo groups (10.1 ± 6, 95% CI: 6.8-13.5) compared with the double placebo group (3.1 ± 3, 95% CI: 1.5-4.8), (PVitamins C and E and their combination are safe and effective treatments for reducing the severity of RLS in hemodialysis patients over the short-term. Copyright © 2012 Elsevier B.V. All rights reserved.

The prevalence and related factors of restless leg syndrome in the community dwelling elderly; in Kayseri, Turkey: A cross-sectional study.

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Safak, Elif Deniz; Gocer, Semsinur; Mucuk, Salime; Ozturk, Ahmet; Akin, Sibel; Arguvanli, Sibel; Mazicioglu, Mumtaz M

2016-01-01

The aim of this study is to determine the prevalence and related factors of restless leg syndrome (RLS) in the community-dwelling elderly living in Kayseri. This is a cross-sectional population based study in 960 community-dwelling elderly living in an urban area. We sampled 1/100 of elderly people aged 60 years and older. The diagnosis of RLS was made according to the criteria of the International RLS Study Group. The demographic data were collected by face-to-face interviews. Additionally, the Mini-Mental State Examination, Geriatric Depression Scale and anthropometric measurements were used. Logistic regression analyses were performed to define risk factors for RLS. We excluded elderly people with cognitive impairment (295). One hundred and five (15.8%) of the remaining 665 elderly subjects met the criteria to diagnose RLS. There was female predominance (3/1). Gender, length of education, employment status, smoking, hypertension, diabetes mellitus, depressive mood, high body mass index, and high waist circumferences, sleep quality, sleep duration, and difficulty in falling asleep in the first 30min were all detected as risk factors for RLS. However in logistic regression analysis, being a housewife, sleeping less than 6h a day and having diabetes was found as significantly related risk factors for RLS. This is the first epidemiologic study of RLS conducted in the Turkish community-dwelling elderly in an urban area. RLS is a common but underestimated disease in the elderly. Although RLS is prevalent we found very few risk factors for RLS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The one-leg standing radiograph

OpenAIRE

Pinsornsak, P.; Naratrikun, K.; Kanitnate, S.; Sangkomkamhang, T.

2016-01-01

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...

Restless Legs Syndrome and Poor Sleep Quality in Obese Children and Adolescents

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Baran, Rıza Taner; Atar, Müge; Pirgon, Özgür; Filiz, Serkan; Filiz, Meral

2018-01-01

Objective: Adult epidemiological studies suggest that the rate of Restless Legs syndrome (RLS) in the general population may range from 5% to 15%. The aim of this study was to investigate the frequency of RLS in a community sample of obese adolescents aged 10-16 years and to assess the association with sleep quality and health-related glucose metabolism markers. Methods: The study group comprised 144 obese and overweight children aged 10-16 yearsand the control group consisted of 66 age-matched healthy children. The RLS Questionnaire devised by the International RLS Study and the Pittsburgh Sleep Quality Index (PSQI), where a score >5 indicates poor sleep quality, was used to assess sleep quality. Results: Mean body mass index (BMI) of the overweight/obese and control groups were 30.5±0.5 and 18.7±0.2, respectively. The frequency of RLS was higher in the obese group (21.7%) than the overweight (3.4%) and control (1.5%) (p<0.001) groups. The frequency of a poor PSQI score was significantly higher (p<0.001) in the obese group (37.3%) than the control group (24.2%). The obese with RLS group also had poorer sleep quality scores than the non-RLS obese group. Many symptoms of sleep disruption were more common in obese patients with RLS and RLS was independently correlated with a high PSQI score [odds ratio (OR): 2.25, confidence interval (Cl): 0.96-5.28, p<0.001)] and an increased BMI z-score (OR: 8.87, Cl: 2.04-38.61, p<0.001). Conclusion: RLS is common in obese children and may be associated with altered sleep quality. Obese children with RLS need to be assessed since they may need support to improve their sleep quality. PMID:29175807

Sleep improvement for restless legs syndrome patients. Part IV: meta-analysis comparison of effect sizes of vibratory stimulation sham pads and placebo pills

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Burbank F

2014-02-01

Full Text Available Fred Burbank Salt Creek International Women's Health Foundation, San Clemente, CA, USA Purpose: To determine whether sham pads used as controls in randomized clinical trials of vibratory stimulation to treat patients with sleep loss associated with restless legs syndrome perform differently than placebo pills used in comparable restless legs syndrome drug trials. Patients and methods: Sham pad effect sizes from 66 control patients in two randomized clinical trials of vibratory stimulation were compared with placebo responses from 1,024 control patients in 12 randomized clinical drug trials reporting subjective sleep measurement scales. Control patient responses were measured as the standardized difference in means corrected for correlation between beginning and ending scores and for small sample sizes. Results: For parallel randomized clinical trials, sham effects in vibratory stimulation trials were not significantly different from placebo effects in drug trials (0.37 and 0.31, respectively, Qbetween subgroups =0.25, PQ≥0.62. Placebo effect sizes were significantly smaller in crossover drug trials than sham effect sizes in parallel vibratory stimulation trials (0.07 versus 0.37, respectively, Qbetween subgroups =4.59, PQ≤0.03 and placebo effect sizes in parallel drug trials (0.07 versus 0.31, respectively, Qbetween subgroups =5.50, PQ≤0.02. Conclusion: For subjective sleep loss assessments in parallel trials, sham pads in vibratory stimulation trials performed similarly to placebo pills in drug trials. Trial design (parallel versus crossover had a large influence on control effect sizes. Placebo pills in crossover drug trials had significantly smaller effect sizes than sham pads in parallel vibratory stimulation trials or placebo pills in parallel drug trials. Keywords: sham effect, placebo effect, trial design, crossover study, parallel study, counterstimulation

Report of a man with heterotopic ossification of the legs.

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García-Arpa, Mónica; Flores-Terry, Miguel A; Franco-Muñoz, Monserrat; Villasanti-Rivas, Natalia; González-Ruiz, Lucía; Banegas-Illescas, M Eugenia

2018-05-21

Heterotopic ossification is an uncommon disorder that consists of deposition of ectopic bone outside the extraskeletal tissues. In the skin, it can be primary, in association with genetic syndromes, or be secondary to different disorders. The latter include subcutaneous ossification of the legs in chronic venousinsufficiency, an infrequent and unrecognized complication. We report the case of a patient with subcutaneous ossification of both legs secondary to venous insufficiency and review the literature. Copyright © 2018 Sociedad Española de Reumatologña y Colegio Mexicano de Reumatologña. Publicado por Elsevier España, S.L.U. All rights reserved.

The medial tibial stress syndrome. A cause of shin splints.

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Mubarak, S J; Gould, R N; Lee, Y F; Schmidt, D A; Hargens, A R

1982-01-01

The medial tibial stress syndrome is a symptom complex seen in athletes who complain of exercise-induced pain along the distal posterior-medial aspect of the tibia. Intramuscular pressures within the posterior compartments of the leg were measured in 12 patients with this disorder. These pressures were not elevated and therefore this syndrome is a not a compartment syndrome. Available information suggests that the medial tibial stress syndrome most likely represents a periostitis at this location of the leg.

Does structural leg-length discrepancy affect postural control? Preliminary study.

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Eliks, Małgorzata; Ostiak-Tomaszewska, Wioleta; Lisiński, Przemysław; Koczewski, Paweł

2017-08-09

Leg-length inequality results in an altered position of the spine and pelvis. Previous studies on the influence of leg asymmetry on postural control have been inconclusive. The purpose of this paper was to investigate the effect of structural leg-length discrepancy (LLD) on the control of posture. We studied 38 individuals (19 patients with structural LLD, 19 healthy subjects). The examination included measurement of the length of the lower limbs and weight distribution as well as a static posturography. All statistical analyses were performed with Statistica software version 10.0. Non-parametrical Kruskal-Wallis with Dunn's post test and Spearman test were used. Differences between the groups and correlation between mean COP sway velocity and the value of LLD as well as the value of LLD and weight distribution were assumed as statistically significant at p  0.05). Meaningful differences in mean COP velocity in mediolateral direction between tandem stance with eyes open and closed were detected in both groups (in controls p = 0.000134, in patients both with the shorter leg in a front and rear position, p = 0.029, p = 0.026 respectively). There was a positive moderate correlation between the value of LLD and the value of mean COP velocity in normal standing in mediolateral direction with eyes open (r = 0.47) and closed (r = 0.54) and in anterioposterior plane with eyes closed (r = 0.05). The fact that there were no significant differences in posturography between the groups might indicate compensations to the altered posture and neuromuscular adaptations in patients with structural leg-length inequality. LLD causes an increased asymmetry of weight distribution. This study confirmed a fundamental role of the sight in postural control, especially in unstable conditions. The analysis of mean COP sway velocity may suggest a proportional deterioration of postural control with the increase of the value of leg-length asymmetry. Trial registry: Clinical

Síndrome das pernas inquietas: diagnóstico e tratamento. Opinião de especialistas brasileiros Restless legs syndrome: diagnosis and treatment. Opinion of Brazilian experts

Directory of Open Access Journals (Sweden)

2007-09-01

Full Text Available Este artigo contém as conclusões de reunião de 17-18 de novembro de 2006 do Grupo Brasileiro de Estudo em Síndrome das Pernas Inquietas (GBE-SPI sobre diagnóstico e tratamento de SPI. Reiterou-se que se trata de condição de diagnóstico exclusivamente clínico, caracterizada por sensação anormal localizada, sobretudo, mas não exclusivamente, em membros inferiores, com piora noturna e alívio por movimentação da parte envolvida. Agentes terapêuticos com eficácia comprovada por estudos classe I são agonistas dopaminérgicos, levodopa e gabapentina enquanto que ácido valpróico de liberação lenta, clonazepam, oxicodona e reposição de ferro têm eficácia sugerida por estudos classe II. As recomendações do GBE-SPI para manejo de SPI primária são medidas de higiene do sono, suspensão de agentes agravantes de SPI, tratamento de comorbidades e agentes farmacológicos. Para estes as drogas de primeira escolha são agentes dopaminérgicos; segunda escolha são gabapentina ou oxicodona; e terceira escolha são clonazepam ou ácido valpróico de liberação lenta.This article contains the conclusions of the November 17-18, 2006 meeting of the Brazilian Study Group of Restless Legs Syndrome (GBE-SPI about diagnosis and management of restless legs syndrome (RLS. RLS is characterized by abnormal sensations mostly but not exclusively in the legs which worsen in the evening and are improved by motion of the affected body part. Its diagnosis is solely based on clinical findings. Therapeutic agents with efficacy supported by Class I studies are dopamine agonists, levodopa and gabapentine. Class II studies support the use of slow release valproic acid, clonazepan and oxycodone. The GBE-SPI recommendations for management of SPI are sleep hygiene, withdrawal of medications capable of worsening the condition, treatment of comorbidities and pharmacological agents. The first choice agents are dopaminergic drugs, second choice are gabapentine or

Single-leg squats can predict leg alignment in dancers performing ballet movements in "turnout".

Science.gov (United States)

Hopper, Luke S; Sato, Nahoko; Weidemann, Andries L

2016-01-01

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.

Biomechanical study on axillary crutches during single-leg swing-through gait.

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Goh, J C; Toh, S L; Bose, K

1986-08-01

This paper describes a kinetic and kinematic study on axillary crutches during one-leg swing-through gait. The primary objective is to evaluate the interplay of forces at the crutch and body interfaces and to relate them in the understanding of problems associated with the use of axillary crutches. Ten normal adult male subjects with simulated left leg impairment participated in the study. For data acquisition, the VICON kinematic system, a Kistler force plate and an instrumented crutch (with force transducers at the two upper struts close to the axillary bar and one near the crutch tip) were used. Results showed that the peak ground reaction force on the weight-bearing leg during lower limb stance increased by 21.6 percent bodyweight. The peak reaction force transmitted to the arm during crutch stance was 44.4 percent bodyweight. These increased loadings could be detrimental to patients with unsound weight-bearing leg and upper extremities respectively. When the crutches were used incorrectly, 34 percent bodyweight was carried by the underarm. This could cause undue pressure over the neurovascular structures at the axillary region.

TREATMENT OF EXTENSIVE PURULENT-NECROTIC LESIONS OF THE LEG IN PATIENTS WITH NEUROPATHIC FORM OF DIABETIC FOOT SYNDROME

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V. T. Krivikhin

2014-01-01

Full Text Available Background: The development of purulent-necrotic complications in patients with diabetic foot syndrome (DFS is a cause of high amputations, early disablement, resulting in development of metabolic syndrome and progression of cardiovascular complications. Today, the methods of treatment of purulent-necrotic lesions in DFS are aimed at preserving the supporting function of an extremity. The presence of extensive purulent-necrotic leg wounds is a risk factor of urgent indications for amputation. Aim: To develop an algorithm of treatment of extensive purulent-necrotic leg wounds in patients with neuropathic form of DFS. Materials and methods:  At the Regional Center “Diabetic foot” on the basis of Vidnoe regional clinical hospital, during a period of 2009 to 2013, the treatment results were analyzed in 62 patients with neuropathic form of DFS and extensive purulent-necrotic leg wounds. All patients underwent an active surgical intervention together with the complex conservative therapy. Treatment consisted of several stages: wound cleansing up to the appearance of granulation tissue – autodermoplasty – stimulation of epithelization. The efficiency of treatment was assessed depending on the time needed for wound cleansing, granulation, epithelization, and on the number of high amputations. Results: All patients underwent primary radical surgery to cross the pathways of purulent infection spreading in the proximal direction followed by an open management of the wound. Subsequently, the staged necrectomies were carried out along with a conservative therapy aimed at wound cleansing. The average time of wound cleansing was 10.6±1.2 days. Formation of granulation tissue took 8.4±0.8 days after the first surgery. When the purified granulation tissue was obtained, the patients underwent autodermoplasty with a free split tissue flap to stimulate epithelization. The process of epithelization started on the 10.2±0.6 day. At the admission to the

Two Pilot Studies of the Effect of Bicycling on Balance and Leg Strength among Older Adults

OpenAIRE

Rissel, Chris; Passmore, Erin; Mason, Chloe; Merom, Dafna

2013-01-01

Objectives. Study 1 examines whether age-related declines in balance are moderated by bicycling. Study 2 tests whether regular cycling can increase leg strength and improve balance. Methods. Study 1: a cross-sectional survey of 43 adults aged 44–79 was conducted. Leg strength was measured, and Balance was measured using the choice stepping reaction time (CSRT) test (decision time and response time), leg strength and timed single leg standing. Study 2: 18 older adults aged 49–72 were recruited...

Management of treatment failure in restless legs syndrome (Willis-Ekbom disease).

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Garcia-Borreguero, Diego; Cano-Pumarega, Irene; Marulanda, Rafael

2018-01-09

Dopaminergic drugs have been widely used over the last decades for the treatment of restless legs syndrome (RLS)/Willis-Ekbom disease (WED). While the majority of studies show an initial improvement in symptoms, longer studies and clinical experience show that either treatment efficacy decreases with time, and/or augmentation develops: dopaminergic augmentation has been reported to be the main reason for treatment discontinuation and treatment failure in RLS/WED. The current review discusses the main reasons for treatment failure in RLS/WED and outlines the most recent expert-based strategies to prevent and manage it. The main strategy for preventing augmentation is to consider non-dopaminergic medications such as α2δ ligands for initial RLS/WED treatment; these effective drugs have been shown to have little risk of augmentation. Alternatively, should dopaminergic drugs be elected as initial treatment, then the daily dose should be kept low and not exceed maximum recommended doses, however, it should be kept in mind that even low dose dopaminergics can cause augmentation. Patients with low iron stores should be given appropriate iron supplementation. Daily treatment should start only when symptoms significantly impact quality of life in terms of frequency and severity; while 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 continue by dividing or advancing the dose, or increasing the dose if there are breakthrough nighttime symptoms. Alternatively, the patient can be switched to an α2δ ligand or rotigotine. For severe augmentation, the patient can be switched to an α2δ ligand or rotigotine, noting that rotigotine may produce augmentation at higher doses with long-term use. In more severe cases

Single-leg squats can predict leg alignment in dancers performing ballet movements in “turnout”

Science.gov (United States)

Hopper, Luke S; Sato, Nahoko; Weidemann, Andries L

2016-01-01

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. PMID:27895518

Anatomical variations within the deep posterior compartment of the leg and important clinical consequences.

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Hislop, M; Tierney, P

2004-09-01

The management of musculoskeletal conditions makes up a large part of a sports medicine practitioner's practice. A thorough knowledge of anatomy is an essential component of the armament necessary to decipher the large number of potential conditions that may confront these practitioners. To cloud the issue further, anatomical variations may be present, such as supernumerary muscles, thickened fascial bands or variant courses of nerves and blood vessels, which can themselves manifest as acute or chronic conditions that lead to significant morbidity or limitation of activity. There are a number of contentious areas within the literature surrounding the anatomy of the leg, particularly involving the deep posterior compartment. Conditions such as chronic exertional compartment syndrome, tibial periostitis (shin splints), peripheral nerve entrapment and tarsal tunnel syndrome may all be affected by subtle anatomical variations. This paper primarily focuses on the deep posterior compartment of the leg and uses the gross dissection of cadaveric specimens to describe definitively the anatomy of the deep posterior compartment. Variant fascial attachments of flexor digitorum longus are documented and potential clinical sequelae such as chronic exertional compartment syndrome and tarsal tunnel syndrome are discussed.

Kinematic Differences During Single-Leg Step-Down Between Individuals With Femoroacetabular Impingement Syndrome and Individuals Without Hip Pain.

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Lewis, Cara L; Loverro, Kari L; Khuu, Anne

2018-04-01

Study Design Controlled laboratory study, case-control design. Background Despite recognition that femoroacetabular impingement syndrome (FAIS) is a movement-related disorder, few studies have examined dynamic unilateral tasks in individuals with FAIS. Objectives To determine whether movements of the pelvis and lower extremities in individuals with FAIS differ from those in individuals without hip pain during a single-leg step-down, and to analyze kinematic differences between male and female participants within groups. Methods Individuals with FAIS and individuals without hip pain performed a single-leg step-down while kinematic data were collected. Kinematics were evaluated at 60° of knee flexion. A linear regression analysis assessed the main effects of group, sex, and side, and the interaction of sex by group. Results Twenty individuals with FAIS and 40 individuals without hip pain participated. Individuals with FAIS performed the step-down with greater hip flexion (4.9°; 95% confidence interval [CI]: 0.5°, 9.2°) and anterior pelvic tilt (4.1°; 95% CI: 0.9°, 7.3°) than individuals without hip pain. Across groups, female participants performed the task with more hip flexion (6.1°; 95% CI: 1.7°, 10.4°), hip adduction (4.8°; 95% CI: 2.2°, 7.4°), anterior pelvic tilt (5.8°; 95% CI: 2.6°, 9.0°), pelvic drop (1.4°; 95% CI: 0.3°, 2.5°), and thigh adduction (2.7°; 95% CI: 1.3°, 4.2°) than male participants. Conclusion The results of this study suggest that individuals with FAIS have alterations in pelvic motion during a dynamic unilateral task. The noted altered movement patterns in the FAIS group may contribute to the development of hip pain and may be due to impairments that are modifiable through rehabilitation. J Orthop Sports Phys Ther 2018;48(4):270-279. Epub 6 Mar 2018. doi:10.2519/jospt.2018.7794.

Reproducibility and day time bias correction of optoelectronic leg volumetry: a prospective cohort study.

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Engelberger, Rolf P; Blazek, Claudia; Amsler, Felix; Keo, Hong H; Baumann, Frédéric; Blättler, Werner; Baumgartner, Iris; Willenberg, Torsten

2011-10-05

Leg edema is a common manifestation of various underlying pathologies. Reliable measurement tools are required to quantify edema and monitor therapeutic interventions. Aim of the present work was to investigate the reproducibility of optoelectronic leg volumetry over 3 weeks' time period and to eliminate daytime related within-individual variability. Optoelectronic leg volumetry was performed in 63 hairdressers (mean age 45 ± 16 years, 85.7% female) in standing position twice within a minute for each leg and repeated after 3 weeks. Both lower leg (legBD) and whole limb (limbBF) volumetry were analysed. Reproducibility was expressed as analytical and within-individual coefficients of variance (CVA, CVW), and as intra-class correlation coefficients (ICC). A total of 492 leg volume measurements were analysed. Both legBD and limbBF volumetry were highly reproducible with CVA of 0.5% and 0.7%, respectively. Within-individual reproducibility of legBD and limbBF volumetry over a three weeks' period was high (CVW 1.3% for both; ICC 0.99 for both). At both visits, the second measurement revealed a significantly higher volume compared to the first measurement with a mean increase of 7.3 ml ± 14.1 (0.33% ± 0.58%) for legBD and 30.1 ml ± 48.5 ml (0.52% ± 0.79%) for limbBF volume. A significant linear correlation between absolute and relative leg volume differences and the difference of exact day time of measurement between the two study visits was found (P correction formula permitted further improvement of CVW. Leg volume changes can be reliably assessed by optoelectronic leg volumetry at a single time point and over a 3 weeks' time period. However, volumetry results are biased by orthostatic and daytime-related volume changes. The bias for day-time related volume changes can be minimized by a time-correction formula.

Reproducibility and day time bias correction of optoelectronic leg volumetry: a prospective cohort study

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Baumgartner Iris

2011-10-01

Full Text Available Abstract Background Leg edema is a common manifestation of various underlying pathologies. Reliable measurement tools are required to quantify edema and monitor therapeutic interventions. Aim of the present work was to investigate the reproducibility of optoelectronic leg volumetry over 3 weeks' time period and to eliminate daytime related within-individual variability. Methods Optoelectronic leg volumetry was performed in 63 hairdressers (mean age 45 ± 16 years, 85.7% female in standing position twice within a minute for each leg and repeated after 3 weeks. Both lower leg (legBD and whole limb (limbBF volumetry were analysed. Reproducibility was expressed as analytical and within-individual coefficients of variance (CVA, CVW, and as intra-class correlation coefficients (ICC. Results A total of 492 leg volume measurements were analysed. Both legBD and limbBF volumetry were highly reproducible with CVA of 0.5% and 0.7%, respectively. Within-individual reproducibility of legBD and limbBF volumetry over a three weeks' period was high (CVW 1.3% for both; ICC 0.99 for both. At both visits, the second measurement revealed a significantly higher volume compared to the first measurement with a mean increase of 7.3 ml ± 14.1 (0.33% ± 0.58% for legBD and 30.1 ml ± 48.5 ml (0.52% ± 0.79% for limbBF volume. A significant linear correlation between absolute and relative leg volume differences and the difference of exact day time of measurement between the two study visits was found (P W. Conclusions Leg volume changes can be reliably assessed by optoelectronic leg volumetry at a single time point and over a 3 weeks' time period. However, volumetry results are biased by orthostatic and daytime-related volume changes. The bias for day-time related volume changes can be minimized by a time-correction formula.

Genetic parameters for claw and leg health, foot and leg conformation, and locomotion in Danish Holsteins

DEFF Research Database (Denmark)

Laursen, M. V.; Boelling, D.; Mark, Thomas

2009-01-01

was defined as absence of hock infection, swollen hock, and bruising. The potential indicators were locomotion and foot and leg conformation, represented by rear leg side view, rear leg rear view, foot angle, and apparent hock quality and bone structure. The study was conducted using records from 429......,877 Danish Holstein cows in first lactation. Binary health traits were divided into 3 subcategories: claw health, leg health, and absence of all claw and leg disorders. Genetic (r(g)) and phenotypic correlations were estimated using a bivariate linear sire model and REML. Estimated heritabilities were 0.......01 for all 3 combined claw and leg health traits (on the observed binary scale), 0.09 for locomotion, 0.14 for rear leg rear view, 0.19 for rear leg side view, 0.13 for foot angle, 0.22 for apparent hock quality, and 0.27 for apparent bone structure. Heritabilities were 0.06 and 0.01 for claw health and leg...

Periodic limb movements and restless legs syndrome in children with a history of prematurity.

Science.gov (United States)

Cielo, Christopher M; DelRosso, Lourdes M; Tapia, Ignacio E; Biggs, Sarah N; Nixon, Gillian M; Meltzer, Lisa J; Traylor, Joel; Kim, Ji Young; Marcus, Carole L

2017-02-01

Little is known about the pediatric population at an increased risk of restless legs syndrome (RLS) and periodic limb movement disorder (PLMD). Polysomnographic data from the Caffeine for Apnea of Prematurity-Sleep (CAPS) study showed a high prevalence of elevated periodic limb movement index (PLMI) in a cohort of ex-preterm children, but the clinical importance of this finding, such as association with RLS, is unknown. We hypothesized that ex-preterm children would have a high prevalence of RLS and PLMD. Ex-preterm children enrolled in CAPS, now aged 5-12 years, completed home polysomnography (PSG) and standardized questionnaires. A diagnosis of RLS or PLMD was established by participants meeting the International Classification of Sleep Disorders, 3rd edition, criteria based on questionnaires and polysomnograms. The clinically available serum ferritin levels were assessed. In total, 167 participants underwent polysomnography and completed all questionnaires. The overall prevalence of RLS was 14/167 (8.4%). An additional 13 subjects (7.8%) were found to have PLMD. Of the 26 participants who had PLMI > 5/h, seven (26.9%) had RLS and 13 (50%) had PLMD. The serum ferritin levels were prematurity have a high prevalence of RLS, particularly those with elevated periodic limb movements. Iron deficiency likely contributes to RLS and PLMD symptoms in this population. Clinicians evaluating ex-preterm children with sleep disturbances should evaluate for RLS and PLMD. Further studies including serum ferritin evaluation are required to confirm these findings. Copyright © 2016 Elsevier B.V. All rights reserved.

Sleep apnea in patients reporting insomnia or restless legs symptoms.

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Bianchi, M T; Goparaju, B; Moro, M

2016-01-01

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.

Leg Movement Activity During Sleep in Adults With Attention-Deficit/Hyperactivity Disorder

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Corrado Garbazza

2018-05-01

Full Text Available Objectives: To conduct a first detailed analysis of the pattern of leg movement (LM activity during sleep in adult subjects with Attention-Deficit/Hyperactivity Disorder (ADHD compared to healthy controls.Methods: Fifteen ADHD patients and 18 control subjects underwent an in-lab polysomnographic sleep study. The periodic character of LMs was evaluated with established markers of “periodicity,” i.e., the periodicity index, intermovement intervals, and time distribution of LM during sleep, in addition to standard parameters such as the periodic leg movement during sleep index (PLMSI and the periodic leg movement during sleep arousal index (PLMSAI. Subjective sleep and psychiatric symptoms were assessed using several, self-administered, screening questionnaires.Results: Objective sleep parameters from the baseline night did not significantly differ between ADHD and control subjects, except for a longer sleep latency (SL, a longer duration of the periodic leg movements during sleep (PLMS in REM sleep and a higher PLMSI also in REM sleep. Data from the sleep questionnaires showed perception of poor sleep quality in ADHD patients.Conclusions: Leg movements during sleep in ADHD adults are not significantly more frequent than in healthy controls and the nocturnal motor events do not show an increased periodicity in these patients. The non-periodic character of LMs in ADHD has already been shown in children and seems to differentiate ADHD from other pathophysiological related conditions like restless legs syndrome (RLS or periodic limb movement disorder (PLMD. The reduced subjective sleep quality reported by ADHD adults contrasted with the normal objective polysomnographic parameters, which could suggest a sleep-state misperception in these individuals or more subtle sleep abnormalities not picked up by the traditional sleep staging.

An MRI volumetric study for leg muscles in congenital clubfoot.

Science.gov (United States)

Ippolito, Ernesto; Dragoni, Massimiliano; Antonicoli, Marco; Farsetti, Pasquale; Simonetti, Giovanni; Masala, Salvatore

2012-10-01

To investigate both volume and length of the three muscle compartments of the normal and the affected leg in unilateral congenital clubfoot. Volumetric magnetic resonance imaging (VMRI) of the anterior, lateral and postero-medial muscular compartments of both the normal and the clubfoot leg was obtained in three groups of seven patients each, whose mean age was, respectively, 4.8 months, 11.1 months and 4.7 years. At diagnosis, all the unilateral congenital clubfeet had a Pirani score ranging from 4.5 to 5.5 points, and all of them had been treated according to a strict Ponseti protocol. All the feet had percutaneous lengthening of the Achilles tendon. A mean difference in both volume and length was found between the three muscular compartments of the leg, with the muscles of the clubfoot side being thinner and shorter than those of the normal side. The distal tendon of the tibialis anterior, peroneus longus and triceps surae (Achilles tendon) were longer than normal on the clubfoot side. Our study shows that the three muscle compartments of the clubfoot leg are thinner and shorter than normal in the patients of the three groups. The difference in the musculature volume of the postero-medial compartment between the normal and the affected side increased nine-fold from age group 2 to 3, while the difference in length increased by 20 %, thus, showing that the muscles of the postero-medial compartment tend to grow in both thickness and length much less than the muscles of the other leg compartments.

A Data-Driven Analysis of the Rules Defining Bilateral Leg Movements during Sleep.

Science.gov (United States)

Ferri, Raffaele; Manconi, Mauro; Rundo, Francesco; Zucconi, Marco; Aricò, Debora; Bruni, Oliviero; Ferini-Strambi, Luigi; Fulda, Stephany

2016-02-01

The aim of this study was to describe and analyze the association between bilateral leg movements (LMs) during sleep in subjects with restless legs syndrome (RLS), in order to eventually support or challenge the current scoring rules defining bilateral LMs. Polysomnographic recordings of 100 untreated patients with RLS (57 women and 43 males, mean age 57 y) were included. In each recording, we selected as reference all LMs that occurred during sleep and that were separated from another ipsilateral LM by at least 10 sec of EMG inactivity. For each reference LM and an evaluation interval from 5 sec before the onset to 5 sec after the offset of the reference LM, we evaluated (1) the presence or absence of contralateral leg movement activity and (2) the distribution of the onset-to-onset and (3) the offset-to-onset differences between bilateral LMs. We selected a mean of 368 (± 222 standard deviation [SD]) reference LMs per subject. For 42% (± 22%) of the reference LMs no contralateral leg movement activity was observed within the evaluation interval. In 55% (± 22%) exactly one and in 3% (± 2%) more than one contralateral LM was observed. A further evaluation of events where exactly one contralateral LM was observed showed that in most (1) the two LMs were overlapping (93% ± 9% SD) and (2) were classified as bilateral according to the World Association of Sleep Medicine and the International Restless Legs Syndrome Study Group (WASM/ IRLSSG) (96% ± 6% SD) and (3) the American Academy of Sleep Medicine scoring rules (99% ± 2% SD). Although there was a systematic and statistically significant difference in standard LM indices during sleep based on the two different definitions of bilateral LMs, the size of the difference was not clinically meaningful (maximum individual, absolute difference in LM indices ± 2.5). In addition, we found that the duration of LMs within bilateral LM pairs was longer compared to monolateral LMs and that the duration of the single LMs in

Prevalence of restless legs syndrome in Ankara, Turkey: an analysis of diagnostic criteria and awareness.

Science.gov (United States)

Yilmaz, Nesrin Helvaci; Akbostanci, Muhittin Cenk; Oto, Aycan; Aykac, Ozlem

2013-09-01

The aim of this study was threefold: (1) to investigate the prevalence of restless legs syndrome (RLS), in Ankara, Turkey; (2) to determine the predictive values of diagnostic criteria; and (3) to determine the frequency of physician referrals and the frequency of getting the correct diagnosis. A total of 815 individuals, from randomly selected addresses, above the age of 15, were reached using the questionnaire composed of the four diagnostic criteria. Individuals who responded by answering 'yes' for at least one question were interviewed by neurologists for the diagnosis of RLS. Frequency of physician referrals and frequency of getting the correct diagnosis of RLS were also determined for patients getting the final diagnoses of RLS. Prevalence of RLS in Ankara was 5.52 %; 41.0 % of the individuals diagnosed with RLS had replied 'yes' to either one, two or three questions asked by interviewers. However, only 21.3 % of individuals who replied 'yes' to all four questions received the diagnosis of RLS. Among the patients who had the final diagnosis of RLS, 25.7 % had referred to a physician for the symptoms and 22.2 % got the correct diagnosis. The RLS prevalence in Ankara was somewhere between Western and Far East countries compatible with the geographical location. Diagnostic criteria may not be fully predictive when applied by non-physician pollsters. Physician's probability of correctly diagnosing RLS is still low.

Two Pilot Studies of the Effect of Bicycling on Balance and Leg Strength among Older Adults

Directory of Open Access Journals (Sweden)

Chris Rissel

2013-01-01

Full Text Available Objectives. Study 1 examines whether age-related declines in balance are moderated by bicycling. Study 2 tests whether regular cycling can increase leg strength and improve balance. Methods. Study 1: a cross-sectional survey of 43 adults aged 44–79 was conducted. Leg strength was measured, and Balance was measured using the choice stepping reaction time (CSRT test (decision time and response time, leg strength and timed single leg standing. Study 2: 18 older adults aged 49–72 were recruited into a 12-week cycling program. The same pre- and postmeasures as used in Study 1 were collected. Results. Study 1: participants who had cycled in the last month performed significantly better on measures of decision time and response time. Study 2: cycling at least one hour a week was associated with significant improvements in balance (decision time and response time and timed single leg standing. Conclusions. Cycling by healthy older adults appears promising for improving risk factors for falls.

Two Pilot Studies of the Effect of Bicycling on Balance and Leg Strength among Older Adults

Science.gov (United States)

Rissel, Chris; Passmore, Erin; Mason, Chloe; Merom, Dafna

2013-01-01

Objectives. Study 1 examines whether age-related declines in balance are moderated by bicycling. Study 2 tests whether regular cycling can increase leg strength and improve balance. Methods. Study 1: a cross-sectional survey of 43 adults aged 44–79 was conducted. Leg strength was measured, and Balance was measured using the choice stepping reaction time (CSRT) test (decision time and response time), leg strength and timed single leg standing. Study 2: 18 older adults aged 49–72 were recruited into a 12-week cycling program. The same pre- and postmeasures as used in Study 1 were collected. Results. Study 1: participants who had cycled in the last month performed significantly better on measures of decision time and response time. Study 2: cycling at least one hour a week was associated with significant improvements in balance (decision time and response time) and timed single leg standing. Conclusions. Cycling by healthy older adults appears promising for improving risk factors for falls. PMID:23690805

Immediate effects of the trunk stabilizing exercise on static balance parameters in double-leg and one-leg stances

OpenAIRE

Kim, Jwa-jun; Park, Se-yeon

2016-01-01

[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...

Possible association between vitamin D deficiency and restless legs syndrome

Directory of Open Access Journals (Sweden)

Oran M

2014-05-01

Full Text Available Mustafa Oran,1 Cuneyt Unsal,2 Yakup Albayrak,2 Feti Tulubas,3 Keriman Oguz,4 Okan Avci,1 Nilda Turgut,4 Recep Alp,4 Ahmet Gurel3 1Department of Internal Medicine, 2Department of Psychiatry, 3Department of Biochemistry, 4Department of Neurology, Namik Kemal University, Faculty of Medicine, Tekirdağ, Turkey Background and aim: Restless legs syndrome (RLS is a distressing sleep disorder that occurs worldwide. Although there have been recent developments in understanding the pathophysiology of RLS, the exact mechanism of the disease has not been well elucidated. An increased prevalence of neurologic and psychiatric diseases involving dopaminergic dysfunction in vitamin D-deficient patients led us to hypothesize that vitamin D deficiency might result in dopaminergic dysfunction and consequently, the development of RLS (in which dopaminergic dysfunction plays a pivotal role. Thus, the aim of this study was to evaluate the relationship between vitamin D deficiency and RLS. Methods: One hundred and fifty-five consecutive patients, 18–65 years of age, who were admitted to the Department of Internal Medicine with musculoskeletal symptoms and who subsequently underwent neurological and electromyography (EMG examination by the same senior neurologist, were included in this study. The patients were divided into two groups according to serum 25-hydroxyvitamin D (25(OHD (a vitamin D metabolite used as a measure of vitamin D status level: 36 patients with serum 25(OHD levels ≥20 ng/mL comprised the normal vitamin D group, and 119 patients with serum 25(OHD levels <20 ng/mL comprised the vitamin D deficiency group. The two groups were compared for the presence of RLS and associated factors. Results: The two groups were similar in terms of mean age, sex, mean body mass index (BMI, and serum levels of calcium, phosphate, alkaline phosphatase (ALP, and ferritin. The presence of RLS was significantly higher in the vitamin D deficiency group (χ2=12.87, P<0

Single-leg squats can predict leg alignment in dancers performing ballet movements in “turnout”

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Hopper LS

2016-11-01

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

Restless legs syndrome: a new entity of neuropathic pain? Treatment with prolonged release oxycodone/naloxone combination

Directory of Open Access Journals (Sweden)

Gemignani F

2016-04-01

Full Text Available Franco Gemignani,1 Andrea Melpignano,1,2 Giulia Milioli,1,2 Silvia Riccardi,1,2 Liborio Parrino1,2 1Neurology Unit, Department of Neurosciences, University of Parma, Parma, Italy; 2Sleep Disorders Center, Department of Neurosciences, University of Parma, Parma, Italy Abstract: Restless legs syndrome (RLS is a disorder of sensorimotor integration characterized by an urge to move the legs when at rest, especially at night or in the evening, which is relieved by movement. Sensory symptoms may be prominent, often exhibiting features consistent with neuropathic pain. Iron deficiency and genetic factors are implicated in RLS causation in most patients. The pathogenetic model of impaired circadian dopaminergic modulation of sensorimotor integration circuitry at the spinal level is fitting with the co-occurrence of movement disorders, sensory symptoms, and sleep disruption in RLS. Accordingly, levodopa and dopamine agonists are effective for RLS symptoms, which compensate for the impaired descending control by diencephalo-spinal dopa(minergic pathway. Dopamine agonists are usually indicated as the first-line therapy, but their use in long-term treatment is often complicated by augmentation and impulse control disorder, thus alpha-2-delta ligands also are now considered the first line of treatment. It has been recognized that endogenous opioid system is also involved in the mechanisms generating RLS, possibly through an impaired modulation of pain pathways. Opioids can be considered as an alternative therapy, particularly in patients with augmentation and/or refractory to other treatments. Recently introduced prolonged-release oxycodone–naloxone was efficacious for short-term treatment of patients with severe RLS inadequately controlled with previous treatment. It will be important to assess whether opioids, as well as other drugs, are especially effective in definite RLS subtypes such as the painful phenotype. Keywords: small fiber neuropathy

Venous leg ulcers

Science.gov (United States)

2008-01-01

Introduction 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. Methods and outcomes 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 interventions to prevent recurrence of venous leg ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2007 (BMJ 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). Results We found 80 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions 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, thromboxane alpha2 antagonists, zinc), peri

Transdermal rotigotine causes impulse control disorders in patients with restless legs syndrome.

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Schreglmann, S R; Gantenbein, A R; Eisele, G; Baumann, C R

2012-02-01

Dopaminergic drugs are the mainstay of treatment for restless legs syndrome (RLS). We analyzed the frequency and clinical characteristics of impulse control disorders (ICD) in patients with RLS on transdermal rotigotine treatment. Retrospective case series at a university movement disorder clinic (n = 28, 17 women). Symptoms of ICD were assessed via detailed history taking and scoring with the Zurich Screening Questionnaire for ICD (ZICD) prior to and after initiation of treatment. None of the patients had a history of ICD prior to treatment. Baseline mean scores for patients who did (8.0 ± 2.5) and did not (6.2 ± 2.7) develop ICD under treatment did not differ. Six male patients (21%) developed various symptoms of ICD (mean ZICD scores 20.7 ± 10.2) on rotigotine treatment (mean dose: 3.8 mg/d), including binge eating, hypersexuality, compulsive shopping, pathological gambling, and punding, equaling a prevalence rate of 21%. Also in the non-ICD group, ZICD scores increased (7.5 ± 2.8). This is the first report of ICD in patients treated with transdermal rotigotine for RLS. In contrast to literature, even low doses of rotigotine (mean 3.8 mg/d) can cause ICD. Therefore every prescribing physician should be aware that ICD may emerge in both RLS and PD patients on any dopaminergic treatment, and should actively ask for such symptoms. The ZICD questionnaire not only replicated the findings of detailed history taking but also showed an increased tendency towards impulsive behaviour in subjects that did not develop ICD. Copyright © 2011 Elsevier Ltd. All rights reserved.

Restless Legs Syndrome and Depression: Effect Mediation by Disturbed Sleep and Periodic Limb Movements.

Science.gov (United States)

Koo, Brian B; Blackwell, Terri; Lee, Hochang B; Stone, Katie L; Louis, Elan D; Redline, Susan

2016-11-01

To investigate an association between restless legs syndrome (RLS) and depression and to what extent sleep disturbance, periodic limb movements during sleep (PLMS), and antidepressant medication mediate this relationship. A cross-sectional analysis was conducted of the Osteoporotic Fractures in Older Men Study data in 982 men assessed for RLS (International RLS Study Group scale [IRLSS]) and depression (Geriatric Depression Scale [GDS]), who underwent actigraphy (for sleep latency/efficiency) and polysomnography (for PLMS). Men were split into three groups: no RLS (N = 815), mild RLS (IRLSS ≤ 12, N = 85), moderate-to-severe RLS (IRLSS > 12, N = 82). Depression was defined as GDS score ≥ 6. Logistic and linear regression assessed associations of RLS and depression or number depressive symptoms, respectively. Models were adjusted for age, site, race, education, body mass index, personal habits, benzodiazepine/dopaminergic medication, physical activity, cardiovascular risk factors, and apnea-hypopnea index. Of 982 men, 167 (17.0%) had RLS. Depression was significantly associated with moderate-to-severe RLS after adjustment (versus no RLS: OR [95% CI] 2.85 [1.23, 6.64]). Further adjustment for potential mediators attenuated effect size modestly, most for sleep efficiency (OR: 2.85-2.55). Compared with no RLS, moderate-to-severe RLS was associated with the number of depressive symptoms after adjustment (adjusted means [95% CI]; no RLS: 1.14 [1.05, 1.24] versus IRLSS > 12: 1.69 [1.32, 2.11]). Further adjustment for potential mediators did not alter effect size. For men with PLMS index at least median, number of depressive symptoms significantly increased as RLS category became more severe. Depression is more common as RLS severity worsens. The RLS-depression relationship is modestly explained by sleep disturbance and PLMS. Published by Elsevier Inc.

Decompressive L5 Transverse Processectomy for Bertolotti's Syndrome: A Preliminary Study.

Science.gov (United States)

Ju, Chang Il; Kim, Seok Won; Kim, Jong Gyue; Lee, Seung Myung; Shin, Ho; Lee, Hyeun Young

2017-09-01

Bertolotti's syndrome is a spinal disorder characterized by abnormal enlargement of the transverse process of the most caudal lumbar vertebra. The L5 transverse process may be enlarged either unilaterally or bilaterally and may articulate or fuse with the sacrum or ilium. Pseudoarticulation between the transverse process of the L5 and the alar of the sacrum can cause buttock pain and leg pain. In addition, the L4 exiting nerve root could be compressed by an enlarged L5 transverse process. The authors could have obtained satisfactory results from the selected cases of Bertolotti's syndrome by applying a selective transverse processectomy of the L5. The objective of this study is to determine the effectiveness of L5 transverse processectomy for symptomatic Bertolotti's syndrome. A retrospective study. A total of 256 patients with Bertolotti's syndrome who had severe buttock pain and unilateral or bilateral radiating leg pain were selected. The correct diagnosis was made based on imaging studies which included computed tomography (CT), plain x-rays, and magnetic resonance imaging (MRI). The final diagnosis was made by confirming pain relief from anesthetic block. A total of 87 patients were classified into 2 groups: group A included 50 patients whose pain was relieved by block into the pseudoarticulation and group B included 37 patients whose pain was relieved by block into the L4 exiting nerve root. A total of 61 cases (group A: 39 cases, group B: 22 cases) were selected as pure L5 transverse processectomy. The primary outcome measures were reduction in pain scores and improvement in quality of life. Among 61 patients, there were 19 men and 42 women. The mean age of the patients was 53.2 ± 12 years (group A: 57.8 ± 14 years [16 - 86 years], group B: 53.4 ± 14 years [27 - 77 years]). The mean follow-up period was 6.5 months. The patients' mean visual analog scale (VAS) prior to surgery was 7.54 ± 0.81 (group A: 7.59 ± 0.93, group B: 7.50 ± 0.86), and the mean

Muscle stiffness of posterior lower leg in runners with a history of medial tibial stress syndrome.

Science.gov (United States)

Saeki, J; Nakamura, M; Nakao, S; Fujita, K; Yanase, K; Ichihashi, N

2018-01-01

Previous history of medial tibial stress syndrome (MTSS) is a risk factor for MTSS relapse, which suggests that there might be some physical factors that are related to MTSS development in runners with a history of MTSS. The relationship between MTSS and muscle stiffness can be assessed in a cross-sectional study that measures muscle stiffness in subjects with a history of MTSS, who do not have pain at the time of measurement, and in those without a history of MTSS. The purpose of this study was to compare the shear elastic modulus, which is an index of muscle stiffness, of all posterior lower leg muscles of subjects with a history of MTSS and those with no history and investigate which muscles could be related to MTSS. Twenty-four male collegiate runners (age, 20.0±1.7 years; height, 172.7±4.8 cm; weight, 57.3±3.7 kg) participated in this study; 14 had a history of MTSS, and 10 did not. The shear elastic moduli of the lateral gastrocnemius, medial gastrocnemius, soleus, peroneus longus, peroneus brevis, flexor hallucis longus, flexor digitorum longus, and tibialis posterior were measured using shear wave elastography. The shear elastic moduli of the flexor digitorum longus and tibialis posterior were significantly higher in subjects with a history of MTSS than in those with no history. However, there was no significant difference in the shear elastic moduli of other muscles. The results of this study suggest that flexor digitorum longus and tibialis posterior stiffness could be related to MTSS. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A study on the temperature distribution in the hot leg pipe

International Nuclear Information System (INIS)

Choe, Yoon-Jae; Baik, Se-Jin; Jang, Ho-Cheol; Lee, Byung-Jin; Im, In-Young; Ro, Tae-Sun

2003-01-01

In the hot leg pipes of reactor coolant system of the Korean Standard Nuclear Power Plant (KSNP), a non-uniform distribution in temperature has been observed across the cross-section, which is attributed to the non-uniformity of power distribution in the reactor core usually having a peak in the center region, and to the colder coolant bypass flow through the reactor vessel outlet nozzle clearances. As a result, the arithmetic mean temperature of four Resistance Temperature Detectors (RTDs) installed in each hot leg - two in the upper region and two in the lower region around the pipe wall may not correctly represent the actual coolant bulk temperature. It is also believed that there is a skewness in the velocity profile in the hot leg pipe due to the sudden changes in the flow direction and area from the core to the hot leg pipe, through the reactor vessel outlet plenum. These temperature non-uniformity and velocity skewness affect the measurement of the plant parameter such as the reactor coolant flow rate which is calculated by using the bulk temperature of hot leg pipes. A computational analysis has been performed to simulate the temperature and velocity distributions and to evaluate the uncertainty of temperature correction offset in the hot leg pipe. A commercial CFD code, FLUENT, is used for this analysis. The analysis results are compared with the operational data of KSNP and the scaled-down model test data for System 80. From the comparisons, an uncertainty of correction offset is obtained to measure the bulk temperature of hot leg more accurately, which can be also applied to the operating plants, leading to the reduction of temperature measurement uncertainty. Since the uncertainty of temperature in the hot leg pipe is one of major parameters to calculate the uncertainty of the reactor coolant flow rate, the analysis results can contribute to the improvement of the plant performance and safety by reducing the uncertainty of temperature measurement

Allocating provider resources to diagnose and treat restless legs syndrome: a cost-utility analysis.

Science.gov (United States)

Padula, William V; Phelps, Charles E; Moran, Dane; Earley, Christopher

2017-10-01

Restless legs syndrome (RLS) is a neurological disorder that is frequently misdiagnosed, resulting in delays in proper treatment. The objective of this study was to analyze the cost-utility of training primary care providers (PCP) in early and accurate diagnosis of RLS. We used a Markov model to compare two strategies: one where PCPs received training to diagnose RLS (informed care) and one where PCPs did not receive training (standard care). This analysis was conducted from the US societal and health sector perspectives over one-year, five-year, and lifetime (50-year) horizons. Costs were adjusted to 2016 USD, utilities measured as quality-adjusted life-years (QALYs), and both measures were discounted annually at 3%. Cost, utilities, and probabilities for the model were obtained through a comprehensive review of literature. An incremental cost-effectiveness ratio (ICER) was calculated to interpret our findings at a willingness-to-pay threshold of $100,000/QALY. Univariate and multivariate analyses were conducted to test model uncertainty, in addition to calculating the expected value of perfect information. Providing training to PCPs to correctly diagnose RLS was cost-effective since it cost $2021 more and gained 0.44 QALYs per patient over the course of a lifetime, resulting in an ICER of $4593/QALY. The model was sensitive to the utility for treated and untreated RLS. The probabilistic sensitivity analysis revealed that at $100,000/QALY, informed care had a 65.5% probability of being cost-effective. A program to train PCPs to better diagnose RLS appears to be a cost-effective strategy for improving outcomes for RLS patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Topography of sensory symptoms in patients with drug-naïve restless legs syndrome.

Science.gov (United States)

Koo, Yong Seo; Lee, Gwan-Taek; Lee, Seo Young; Cho, Yong Won; Jung, Ki-Young

2013-12-01

We aimed to describe the sensory topography of restless legs syndrome (RLS) sensory symptoms and to identify the relationship between topography and clinical variables. Eighty adult patients with drug-naïve RLS who had symptoms for more than 1year were consecutively recruited. During face-to-face interviews using a structured paper and pencil questionnaire with all participants, we obtained clinical information and also marked the topography of RLS sensory symptoms on a specified body template, all of which were subsequently inputted into our in-house software. The RLS sensory topography patterns were classified according to localization, lateralization, and symmetry. We investigated if these sensory topography patterns differed according to various clinical variables. The lower extremities only (LE) were the most common location (72.5%), and 76.3% of participants exhibited symmetric sensory topography. Late-onset RLS showed more asymmetric sensory distribution compared with early-onset RLS (P=.024). Patients whose sensory symptoms involved the lower extremities in addition to other body parts (LE-PLUS) showed more severe RLS compared with those involving the LE (P=.037). RLS sensory symptoms typically were symmetrically located in the lower extremities. LE-PLUS or an asymmetric distribution more often occurred in patients with more severe RLS symptoms or late-onset RLS. Copyright © 2013 Elsevier B.V. All rights reserved.

A prospective study of gait related risk factors for exercise-related lower leg pain.

Science.gov (United States)

Willems, T M; De Clercq, D; Delbaere, K; Vanderstraeten, G; De Cock, A; Witvrouw, E

2006-01-01

The purpose of this study was to determine prospectively gait related risk factors for exercise-related lower leg pain (ERLLP) in 400 physical education students. Static lower leg alignment was determined, and 3D gait kinematics combined with plantar pressure profiles were collected. After this evaluation, all sports injuries were registered by the same sports physician during the duration of the study. Forty six subjects developed ERLLP and 29 of them developed bilateral symptoms thus giving 75 symptomatic lower legs. Bilateral lower legs of 167 subjects who developed no injuries in the lower extremities served as controls. Cox regression analysis revealed that subjects who developed ERLLP had an altered running pattern before the injury compared to the controls and included (1) a significantly more central heel-strike, (2) a significantly increased pronation, accompanied with more pressure underneath the medial side of the foot, and (3) a significantly more lateral roll-off. These findings suggest that altered biomechanics play a role in the genesis of ERLLP and thus should be considered in prevention and rehabilitation.

Lower Leg Anterior and Lateral Intracompartmental Pressure Changes Before and After Classic Versus Skate Nordic Rollerskiing.

Science.gov (United States)

Woods, Katherine M; Petron, David J; Shultz, Barry B; Hicks-Little, Charlie A

2015-08-01

Chronic exertional compartment syndrome (CECS) is a debilitating condition resulting in loss of function and a decrease in athletic performance. Cases of CECS are increasing among Nordic skiers; therefore, analysis of intracompartmental pressures (ICPs) before and after Nordic skiing is warranted. To determine if lower leg anterior and lateral ICPs and subjective lower leg pain levels increased after a 20-minute Nordic rollerskiing time trial and to examine if differences existed between postexercise ICPs for the 2 Nordic rollerskiing techniques, classic and skate. Crossover study. Outdoor paved loop. Seven healthy Division I Nordic skiers (3 men, 4 women; age = 22.71 ± 1.38 y, height = 175.36 ± 6.33 cm, mass = 70.71 ± 6.58 kg). Participants completed two 20-minute rollerskiing time trials using the classic and skate technique in random order. The time trials were completed 7 days apart. Anterior and lateral ICPs and lower leg pain scores were obtained at baseline and at minutes 1 and 5 after rollerskiing. Anterior and lateral ICPs (mm Hg) were measured using a Stryker Quic STIC handheld monitor. Subjective measures of lower leg pain were recorded using the 11-point Numeric Rating Scale. Increases in both anterior (P = .000) and lateral compartment (P = .002) ICPs were observed, regardless of rollerskiing technique used. Subjective lower leg pain increased after the classic technique for the men from baseline to 1 minute postexercise and after the skate technique for the women. Significant 3-way interactions (technique × time × sex) were observed for the anterior (P = .002) and lateral (P = .009) compartment ICPs and lower leg pain (P = .005). Postexercise anterior and lateral ICPs increased compared with preexercise ICPs after both classic and skate rollerskiing techniques. Lower leg pain is a primary symptom of CECS. The subjective lower leg pain 11-point Numeric Rating Scale results indicate that increases in lower leg ICPs sustained during Nordic

Leg Length, Body Proportion, and Health: A Review with a Note on Beauty

Science.gov (United States)

Bogin, Barry; Varela-Silva, Maria Inês

2010-01-01

Decomposing stature into its major components is proving to be a useful strategy to assess the antecedents of disease, morbidity and death in adulthood. Human leg length (femur + tibia), sitting height (trunk length + head length) and their proportions, for example, (leg length/stature), or the sitting height ratio (sitting height/stature × 100), among others) are associated with epidemiological risk for overweight (fatness), coronary heart disease, diabetes, liver dysfunction and certain cancers. There is also wide support for the use of relative leg length as an indicator of the quality of the environment for growth during infancy, childhood and the juvenile years of development. Human beings follow a cephalo-caudal gradient of growth, the pattern of growth common to all mammals. A special feature of the human pattern is that between birth and puberty the legs grow relatively faster than other post-cranial body segments. For groups of children and youth, short stature due to relatively short legs (i.e., a high sitting height ratio) is generally a marker of an adverse environment. The development of human body proportions is the product of environmental x genomic interactions, although few if any specific genes are known. The HOXd and the short stature homeobox-containing gene (SHOX) are genomic regions that may be relevant to human body proportions. For example, one of the SHOX related disorders is Turner syndrome. However, research with non-pathological populations indicates that the environment is a more powerful force influencing leg length and body proportions than genes. Leg length and proportion are important in the perception of human beauty, which is often considered a sign of health and fertility. PMID:20617018

Congenital varicella syndrome

Directory of Open Access Journals (Sweden)

Atul Chaudhary

2016-01-01

Full Text Available A 7 month old female presented with localized scarring over right buttock and right leg with hypoplasia of right lower limb. Mother had history of chicken pox at tenth week of pregnancy. We confirm the diagnosis of varicella zoster syndrome clinically.

Patellofemoral Pain Syndrome

Science.gov (United States)

... But do this slowly, increasing the amount of time you do the sports activity a little at a time. Talk to ... 20 seconds. Do the exercise 6 to 10 times and then switch legs. Citations Management of Patellofemoral Pain Syndrome by S Dixit, M.D., ...

Foot, leg, and ankle swelling

Science.gov (United States)

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 ...

Compartment syndrome without pain!

LENUS (Irish Health Repository)

O'Sullivan, M J

2012-02-03

We report the case of a young male patient who underwent intra-medullary nailing for a closed, displaced mid-shaft fracture of tibia and fibula. He was commenced on patient controlled analgesia post-operatively. A diagnosis of compartment syndrome in the patient\\'s leg was delayed because he did not exhibit a pain response. This ultimately resulted in a below-knee amputation of the patient\\'s leg. We caution against the use of patient controlled analgesia in any traumatised limb distal to the hip or the shoulder.

Effect of squatting velocity on hip muscle latency in women with patellofemoral pain syndrome.

Science.gov (United States)

Orozco-Chavez, Ignacio; Mendez-Rebolledo, Guillermo

2018-03-01

[Purpose] Neuromuscular activity has been evaluated in patellofemoral pain syndrome but movement velocity has not been considered. The aim was to determine differences in onset latency of hip and knee muscles between individuals with and without patellofemoral pain syndrome during a single leg squat, and whether any differences are dependent on movement velocity. [Subjects and Methods] Twenty-four females with patellofemoral pain syndrome and 24 healthy females participated. Onset latency of gluteus maximus, anterior and posterior gluteus medius, rectus femoris, vastus medialis, vastus lateralis and biceps femoris during a single leg squat at high and low velocity were evaluated. [Results] There was an interaction between velocity and diagnosis for posterior gluteus medius. Healthy subjects showed a later posterior gluteus medius onset latency at low velocity than high velocity; and also later than patellofemoral pain syndrome subjects at low velocity and high velocity. [Conclusion] Patellofemoral pain syndrome subjects presented an altered latency of posterior gluteus medius during a single leg squat and did not generate adaptations to velocity variation, while healthy subjects presented an earlier onset latency in response to velocity increase.

[Risk factors associated with leg erysipelas (cellulitis) in sub-Saharan Africa: A multicentre case-control study].

Science.gov (United States)

Pitché, P; Diatta, B; Faye, O; Diané, B-F; Sangaré, A; Niamba, P; Mandengue, C; Kobengue, L; Saka, B; Diop, A; Ly, F; Dieng, M-T; Dicko, A; Soumah, M-M; Cissé, M; Kourouma, S-H; Kouassi, Y-I; Boukari, T; Akakpo, S; Tchangaï-Walla, K

2015-11-01

Acute bacterial cellulitis of the leg (erysipelas) is a common problem involving considerable morbidity in dermatology practice in Africa. Previous studies conducted in Europe and North Africa have highlighted lymphoedema and toe-web intertrigo as independent factors associated with leg erysipelas. The aim of this case-control study was to identify risk factors associated with leg erysipelas in sub-Saharan Africa, within a different socio-economic and culture context. We conducted a prospective case-control study in hospital dermatology departments in 8 sub-Saharan African countries over a 12-month period (October 2013 to September 2014). Each case of acute leg cellulitis was matched with 2 controls for age (±5 years) and sex. We analysed the general and local factors. During the study period, 364 cases (223 female, 141 male) were matched with 728 controls. The mean age was 42.15±15.15 years for patients and 42.11±36 years for controls. Multivariate analysis showed the following to be independent risk factors associated with leg erysipelas in our study: obesity (odds ratio [OR]=2.82 ; 95% confidence interval: 2.11-3.76), lymphoedema (OR=3.87, 95%CI: 2.17-6.89), voluntary cosmetic depigmentation (OR=4.29, 95%CI: 2.35-7.83), neglected traumatic wound (OR=37.2, 95%CI: 24.9-57.72) and toe-web intertrigo (OR=37.86, 95%CI: 22.27-64.5). The results of this study confirms the major role of local risk factors (toe-web intertrigo, lymphoedema) previously identified in other geographical settings. However, the originality of our study consists of the identification of voluntary cosmetic depigmentation as a risk factor for leg erysipelas in sub-Saharan Africa. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Comparative study of quality of life and psychosocial characteristics in patients with psoriasis and leg ulcers.

Science.gov (United States)

Kouris, Anargyros; Christodoulou, Christos; Efstathiou, Vasiliki; Tsatovidou, Revekka; Torlidi-Kordera, Evangelia; Zouridaki, Eftychia; Kontochristopoulos, George

2016-03-01

Psoriasis and leg ulcers have a marked impact on the patient's quality of life and represent a life-long burden for affected patients. The aim of this study is to compare the quality of life, anxiety and depression, self-esteem, and loneliness in patients with psoriasis and leg-ulcer patients. Eighty patients with leg ulcers, eighty patients with psoriasis, and eighty healthy controls were included in this study. The quality of life, depression and anxiety, loneliness of the patient, and self-esteem were assessed using the Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), the UCLA loneliness Scale (UCLA-Version 3), and the Rosenberg's Self-esteem Scale (RSES), respectively. The DLQI score among patients with psoriasis was 12.74 ± 4.89 and leg ulcer patients was 13.28 ± 2.57. The patients with psoriasis presented statistically significant higher anxiety (9.87 ± 4.56) than both leg ulcer patients (8.26 ± 2.82) and controls (6.45 ± 1.89), while leg ulcer patients also presented higher anxiety than controls. Regarding self-esteem, although there were no significant differences between the patients with psoriasis (15.25 ± 3.20) and the ones with leg ulcers (15.89 ± 2.93), they both presented statistically significant lower self-esteem scores than control group (18.53 ± 3.04). The patients with psoriasis presented statistically significant higher levels of loneliness and social isolation (46.18 ± 6.63) compared to leg ulcer patients (43.73 ± 5.68) than controls (42.49 ± 3.41). Psoriasis and leg ulcers are long-term skin diseases associated with significant impairment of the patient's quality of life, anxiety, and self-esteem, which are frequently under-recognized. © 2016 by the Wound Healing Society.

Assessing health-related quality of life in patients with restless legs syndrome in Korea: comparison with other chronic medical diseases.

Science.gov (United States)

Cho, Yong Won; Kim, Do Hyung; Allen, Richard P; Earley, Christopher J

2012-10-01

There have been few quality of life (QoL) studies of patients with restless legs syndrome (RLS) in Asian countries. We studied the QoL of patients with RLS and compared it to normal controls and patients with hypertension, type 2 diabetes, or osteoarthritis in Korea. A total of 215 RLS patients (141 female; mean age 51.7 ± 13.5) were enrolled. All patients completed the questionnaires, including all the Korean versions of SF-36, RLS QoL, the International RLS Severity scale (IRLS), the Pittsburgh Sleep Quality Index (PSQI), and the Beck Depression Inventory-2 (BDI-2). These results were compared with the scores from normal controls (N=214) and from patients with hypertension (196), uncomplicated type 2 diabetes (185), or osteoarthritis of the knee (177). The SF-36 QoL in patients with RLS was lower than that of the normal controls, and even lower than patients with hypertension or diabetes, but higher than those with osteoarthritis. The SF-36 Qol of RLS patients showed a significantly negative correlation with the severity of RLS symptoms(r=-0.430, pwestern countries. The QoL impairment relates to the degree of depression with RLS for Koreans. Copyright © 2012 Elsevier B.V. All rights reserved.

Patients suffering from restless legs syndrome have low internal locus of control and poor psychological functioning compared to healthy controls.

Science.gov (United States)

Brand, Serge; Beck, Johannes; Hatzinger, Martin; Holsboer-Trachsler, Edith

2013-01-01

Restless legs syndrome (RLS) is a disturbing sensorimotor disorder negatively influencing both sleep and psychological functioning. The aim of the present study was to assess RLS patients with respect to locus of control, sleep-related personality traits, quality of life, and sleep as compared to healthy controls. Thirty-eight patients (18 females and 20 males; mean age: 56.06 years) diagnosed with RLS and an age- and gender-matched control group (n = 42) were recruited. Participants completed a series of questionnaires related to locus of control, personality traits, quality of life, and sleep. Compared to healthy controls, RLS patients had a lower internal locus of control, unfavourable sleep-related personality traits such as low self-confidence and higher mental arousal, poorer quality of life, and more depressive symptoms. Sleep was also affected. Multiple regression analyses showed that a low internal and a high external locus of control were predicted by RLS. The pattern of results suggests that RLS is associated with a low locus of control, negative personality traits, and poor quality of life as compared to healthy controls. Copyright © 2013 S. Karger AG, Basel.

Assessment of the vibration on the foam legged and sheet metal-legged passenger seat

Directory of Open Access Journals (Sweden)

L. Dahil

2015-10-01

Full Text Available In this study, it was aim ed to decrease the vibration reaching to passenger from the legs of vehicle seats. In order to determine the levels of vibrations reaching at passengers, a test pad placed under the passenger seat was used, and HVM100 device was used for digitizing the information obtained. By transferring the vibration data to system by using HVM100 device, the acceleration graphics were prepared with Blaze software. As a result, it was determined that the acceleration values of seat legs made of foam material were lower than that of seat legs made of 2 mm thick sheet metal, so they damped the vibration better.

A study on the strength of leg extention and leg curl exercise measured with the "Tremax System" and the "ADR" (Aero Dynamic Resistance System)

OpenAIRE

安藤, 勝英

1995-01-01

This is a study on the nature of the extensor and flexor muscles by the leg extention and leg curl exercise. The strength of the static muscles were measured with the "Tremax system" and for the strength of the dynamic muscles the "ADR" was used. Measuring the strength of the extensor muscles at bar no.1 to 4 of the Tremax System，it comes to a maximum at bar no.2 (extention 60°) but it declines radically when approaching extention 0°. Compared to the extensor muscles, the flexor muscules show...

Complex Regional Pain Syndrome

Science.gov (United States)

Complex regional pain syndrome (CRPS) is a chronic pain condition. It causes intense pain, usually in the arms, hands, legs, or feet. It may happen ... move the affected body part The cause of CRPS is unknown. There is no specific diagnostic test. ...

Robust and efficient walking with spring-like legs

Energy Technology Data Exchange (ETDEWEB)

Rummel, J; Blum, Y; Seyfarth, A, E-mail: juergen.rummel@uni-jena.d, E-mail: andre.seyfarth@uni-jena.d [Lauflabor Locomotion Laboratory, University of Jena, Dornburger Strasse 23, 07743 Jena (Germany)

2010-12-15

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.

Robust and efficient walking with spring-like legs

International Nuclear Information System (INIS)

Rummel, J; Blum, Y; Seyfarth, A

2010-01-01

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.

Restless legs syndrome in patients with sequelae of poliomyelitis.

Science.gov (United States)

Kumru, Hatice; Portell, Enric; Barrio, Manuela; Santamaria, Joan

2014-10-01

No studies have examined the association between RLS and the sequelae of poliomyelitis (PM). We studied the frequency and severity of RLS in a group of consecutive patients with the sequelae of poliomyelitis (PM) and the effect of treatment with dopaminergic drugs. A diagnosis of RLS was made according to the criteria of the International RLS Study Group, and severity was assessed by the RLS rating scale. Information on sex, age, age at onset, site affected by PM, disease duration of PM, and history of post-polio syndrome (pPS) was obtained in a cohort of 52 PM patients. The mean age was 55.9 ± 6.5 years; 39 patients had post-polio syndrome (75%). RLS was diagnosed in 21 (40.4%) patients. Sixteen of the 21 patients (76.2%) with RLS had pPS, which was similar to the non-RLS group (74.2% patients with pPS). RLS symptoms were very severe in 5 patients, severe in 13, moderate in 2 and mild in 1. Nineteen of the 21 patients with RLS had symptoms predominantly in the more affected lower limb (90% of patients). Sixteen patients received dopaminergic agonist treatment with a significant reduction in their scores on the RLS severity scale from 28.3 ± 4.7 to 6.9 ± 7.3 (p < 0.001). RLS occurs frequently in patients with PM, both in those with and without pPS, and responds well to treatment with dopaminergic drugs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Stable walking with asymmetric legs

International Nuclear Information System (INIS)

Merker, Andreas; Rummel, Juergen; Seyfarth, Andre

2011-01-01

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.

Restless legs syndrome after high-risk TIA and minor stroke: association with reduced quality of life.

Science.gov (United States)

Boulos, Mark I; Wan, Anthony; Black, Sandra E; Lim, Andrew S; Swartz, Richard H; Murray, Brian J

2017-09-01

Restless legs syndrome (RLS) is a movement disorder that is associated with poor quality of life and depressive symptoms in the general population. Emerging evidence suggests that RLS is closely associated with cerebrovascular disease. We assessed the effect of RLS on quality of life after stroke and transient ischemic attack (TIA). In this single-center prospective study, we recruited patients within 14 days of high-risk TIA or minor stroke. Patients were diagnosed with RLS using a questionnaire based on the 2003 International RLS Study Group criteria, and diagnoses were confirmed by a sleep neurologist. Follow-up assessments were conducted within 2-6 months of recruitment. The outcome of quality of life was measured using the Stroke-specific Quality of Life (SS-QoL). Of the 94 patients recruited into the study, 23 (24.4%) were diagnosed with RLS: 11 were newly diagnosed with RLS and 12 had RLS preceding the index stroke/TIA. There were no significant differences in baseline characteristics between those with or without RLS. Median SS-QoL in patients with RLS was lower at baseline (p = 0.008) and at follow-up (p = 0.002). RLS patients had more depressive symptoms at follow-up (p = 0.007). Ordinal logistic regression demonstrated that RLS was negatively associated with quality of life at baseline (OR = 0.28; p = 0.010) and at follow-up (OR = 0.14; p = 0.029), independent of functional outcome and depressive symptoms. RLS is common after stroke or TIA and negatively affects the quality of life. Screening for RLS after cerebrovascular events may be warranted, and future research should assess whether treatment of RLS can improve post-stroke quality of life. Copyright © 2017 Elsevier B.V. All rights reserved.

The study of dynamic force acted on water strider leg departing from water surface

Science.gov (United States)

Sun, Peiyuan; Zhao, Meirong; Jiang, Jile; Zheng, Yelong

2018-01-01

Water-walking insects such as water striders can skate on the water surface easily with the help of the hierarchical structure on legs. Numerous theoretical and experimental studies show that the hierarchical structure would help water strider in quasi-static case such as load-bearing capacity. However, the advantage of the hierarchical structure in the dynamic stage has not been reported yet. In this paper, the function of super hydrophobicity and the hierarchical structure was investigated by measuring the adhesion force of legs departing from the water surface at different lifting speed by a dynamic force sensor. The results show that the adhesion force decreased with the increase of lifting speed from 0.02 m/s to 0.4 m/s, whose mechanic is investigated by Energy analysis. In addition, it can be found that the needle shape setae on water strider leg can help them depart from water surface easily. Thus, it can serve as a starting point to understand how the hierarchical structure on the legs help water-walking insects to jump upward rapidly to avoid preying by other insects.

Novel Surgical Treatment for Refractory Heel Ulcers in Werner’s Syndrome

Directory of Open Access Journals (Sweden)

Keisuke Oe

2013-01-01

Full Text Available Patients with Werner’s syndrome frequently develop chronic leg ulcers that heal poorly. We present a patient who suffered from this rare syndrome and developed typical heel ulcers. Treatment of the ulcer is challenging, as flap options are limited over the lower third of the leg and skin grafting is not easy as there is a lack of healthy granulations. We successfully treated the ulcer with osteomyelitis by drilling the bone and applying an ultrathin split thickness skin graft with the thigh skin as the donor site.

Evaluation of arm-leg coordination in flat breaststroke.

Science.gov (United States)

Chollet, D; Seifert, L; Leblanc, H; Boulesteix, L; Carter, M

2004-10-01

This study proposes a new method to evaluate arm-leg coordination in flat breaststroke. Five arm and leg stroke phases were defined with a velocity-video system. Five time gaps quantified the time between arm and leg actions during three paces of a race (200 m, 100 m and 50 m) in 16 top level swimmers. Based on these time gaps, effective glide, effective propulsion, effective leg insweep and effective recovery were used to identify the different stroke phases of the body. A faster pace corresponded to increased stroke rate, decreased stroke length, increased propulsive phases, shorter glide phases, and a shorter T1 time gap, which measured the effective body glide. The top level swimmers showed short time gaps (T2, T3, T4, measuring the timing of arm-leg recoveries), which reflected the continuity in arm and leg actions. The measurement of these time gaps thus provides a pertinent evaluation of swimmers' skill in adapting their arm-leg coordination to biomechanical constraints.

Erysipelas of the leg (cellulitis in sub-Saharan Africa: A multicentric study of 562 cases

Directory of Open Access Journals (Sweden)

Bayaki Saka

2017-01-01

Full Text Available Introduction: Erysipelas of the leg is a common and serious infection. We carried out this study aiming at describing the epidemiological and clinical characteristics, and assessing the risks factors associated with the local complications of erysipelas of the leg in sub-Saharan Africa. Methods: This was a prospective multicentric study carried out in the dermatology units of Hospitals located in seven sub-Saharan African countries during a period of 12 months. Patients aged 15 and above with a first episode of erysipelas of the leg were recruited. Results: In this study, 562 patients were recruited, having a mean age of 43.7±16.9 years and a sex-ratio (M/F of 0.67. Patients infected on one leg were 562 while those infected with two were 27. Bullous forms of the disease were observed in 95 patients, while purpuric forms were observed in 167 patients. The existence of a point of entry (485 cases, obesity (230, lymph edema (130 and the use of bleaching agents (97 were the mains risk factors. Complications during the course of the infection such as necrotizing fasciitis (34 cases and abscesses (63 cases were observed. They were due to the use of antibiotics and non-steroidal anti-inflammatory treatments, and the use of cataplasm. Conclusion: This study reveals that existence of a point of entry, obesity and lymph edema, and the use of bleaching agents were the mains risk factors influencing the local complications of erysipelas of the leg. Necrotizing fasciitis and abscesses were influenced by the use of antibiotics and non-steroidal anti-inflammatory treatments, and the use of cataplasm.

Relationship between Leg Mass, Leg Composition and Foot Velocity on Kicking Accuracy in Australian Football.

Science.gov (United States)

Hart, Nicolas H; Nimphius, Sophia; Spiteri, Tania; Cochrane, Jodie L; Newton, Robert U

2016-06-01

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

Lyden-af-Leg

DEFF Research Database (Denmark)

Toft, Herdis

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....

Acute compartment syndrome after medial gastrocnemius tear.

Science.gov (United States)

Sit, Yan Kit; Lui, Tun Hing

2015-02-01

Acute compartment syndrome after medial gastrocnemius tear is very rare. It can involve the superficial posterior compartment alone or progress to involve all the 4 compartments of the lower legs. Those patients with high pain tolerance and minor trauma can lead to delayed presentation. Immediate fasciotomy is the treatment of choice. Therapeutic Level IV, Case Study. © 2014 The Author(s).

A Study on Temperature Distribution in the Hot Leg Pipes considering the Variation of Flow Rate in RCS

Energy Technology Data Exchange (ETDEWEB)

Cho, Hyuksu; Yi, Kunwoo; Choe, Yoonjae; Jang, Hocheol; Yune, Seokjeong; Park, Seongchan [KEPCO Engineering and Construction, Daejeon (Korea, Republic of)

2016-10-15

In this study, a computational analysis is performed to predict the deviation in the temperature distribution in the hot leg pipe according to the flow rate variation in RCS. In the hot leg pipes of Reactor Coolant System (RCS) of APR1400, four Resistance Temperature Detectors (RTDs), to obtain the average hot leg temperature, are installed at each hot leg pipe (two in the upper region and the other two in the lower region around the wall of the hot leg pipe). There is a deviation in temperature distribution in the hot leg pipe due to the sudden changes in the flow direction and area from the reactor core exit to the hot leg pipe. The non-uniform temperature distribution in the hot leg pipe can affect the measurement of the plant parameters such as the reactor power and the reactor coolant flow rate. The following conclusions are reached 1) The non-uniform temperature distribution in the core exit is sustained to some extent through the entire region of hot leg pipe. 2) The temperature ranges having a uniform pattern are 45 - 120° and 240 - 315°. The sensor positions of RTDs are located in this interval (45 - 120° and 240 - 315°) and this sensor positions of RTDs show the appropriate temperature measurement. Also, the temperature distribution shows the similar pattern without reference to the flow rate variation in RCS.

Increasing trunk flexion transforms human leg function into that of birds despite different leg morphology.

Science.gov (United States)

Aminiaghdam, Soran; Rode, Christian; Müller, Roy; Blickhan, Reinhard

2017-02-01

Pronograde trunk orientation in small birds causes prominent intra-limb asymmetries in the leg function. As yet, it is not clear whether these asymmetries induced by the trunk reflect general constraints on the leg function regardless of the specific leg architecture or size of the species. To address this, we instructed 12 human volunteers to walk at a self-selected velocity with four postures: regular erect, or with 30 deg, 50 deg and maximal trunk flexion. In addition, we simulated the axial leg force (along the line connecting hip and centre of pressure) using two simple models: spring and damper in series, and parallel spring and damper. As trunk flexion increases, lower limb joints become more flexed during stance. Similar to birds, the associated posterior shift of the hip relative to the centre of mass leads to a shorter leg at toe-off than at touchdown, and to a flatter angle of attack and a steeper leg angle at toe-off. Furthermore, walking with maximal trunk flexion induces right-skewed vertical and horizontal ground reaction force profiles comparable to those in birds. Interestingly, the spring and damper in series model provides a superior prediction of the axial leg force across trunk-flexed gaits compared with the parallel spring and damper model; in regular erect gait, the damper does not substantially improve the reproduction of the human axial leg force. In conclusion, mimicking the pronograde locomotion of birds by bending the trunk forward in humans causes a leg function similar to that of birds despite the different morphology of the segmented legs. © 2017. Published by The Company of Biologists Ltd.

The study of dynamic force acted on water strider leg departing from water surface

Directory of Open Access Journals (Sweden)

Peiyuan Sun

2018-01-01

Full Text Available Water-walking insects such as water striders can skate on the water surface easily with the help of the hierarchical structure on legs. Numerous theoretical and experimental studies show that the hierarchical structure would help water strider in quasi-static case such as load-bearing capacity. However, the advantage of the hierarchical structure in the dynamic stage has not been reported yet. In this paper, the function of super hydrophobicity and the hierarchical structure was investigated by measuring the adhesion force of legs departing from the water surface at different lifting speed by a dynamic force sensor. The results show that the adhesion force decreased with the increase of lifting speed from 0.02 m/s to 0.4 m/s, whose mechanic is investigated by Energy analysis. In addition, it can be found that the needle shape setae on water strider leg can help them depart from water surface easily. Thus, it can serve as a starting point to understand how the hierarchical structure on the legs help water-walking insects to jump upward rapidly to avoid preying by other insects.

Study on improvement of energy efficiency of walking robots by spring -installed leg design

International Nuclear Information System (INIS)

Shin, Eung Soo; Song, Heuy Gap

1993-01-01

Although a walking robot is potentially useful in nuclear industry, its application has not been successful so far due to poor energy efficiency. In this paper, dynamic spring balancing of a swinging leg is proposed for improving energy efficiency. Since the fluctuation of internal energy is unavoidable due to leg oscillation, springs can be used for storing energy that is otherwise dissipated at the end of the return phase of the leg. Based of approximation to harmonic oscillation, an optimum trajectory and spring parameters are simultaneously synthesized for the leg in the return phase. (Author)

INTRA-RATER RELIABILITY OF THE MULTIPLE SINGLE-LEG HOP-STABILIZATION TEST AND RELATIONSHIPS WITH AGE, LEG DOMINANCE AND TRAINING.

Science.gov (United States)

Sawle, Leanne; Freeman, Jennifer; Marsden, Jonathan

2017-04-01

Balance is a complex construct, affected by multiple components such as strength and co-ordination. However, whilst assessing an athlete's dynamic balance is an important part of clinical examination, there is no gold standard measure. The multiple single-leg hop-stabilization test is a functional test which may offer a method of evaluating the dynamic attributes of balance, but it needs to show adequate intra-tester reliability. The purpose of this study was to assess the intra-rater reliability of a dynamic balance test, the multiple single-leg hop-stabilization test on the dominant and non-dominant legs. Intra-rater reliability study. Fifteen active participants were tested twice with a 10-minute break between tests. The outcome measure was the multiple single-leg hop-stabilization test score, based on a clinically assessed numerical scoring system. Results were analysed using an Intraclass Correlations Coefficient (ICC 2,1 ) and Bland-Altman plots. Regression analyses explored relationships between test scores, leg dominance, age and training (an alpha level of p = 0.05 was selected). ICCs for intra-rater reliability were 0.85 for the dominant and non-dominant legs (confidence intervals = 0.62-0.95 and 0.61-0.95 respectively). Bland-Altman plots showed scores within two standard deviations. A significant correlation was observed between the dominant and non-dominant leg on balance scores (R 2 =0.49, ptest demonstrated strong intra-tester reliability with active participants. Younger participants who trained more, have better balance scores. This test may be a useful measure for evaluating the dynamic attributes of balance. 3.

Laterality of the legs in young female soccer players

Directory of Open Access Journals (Sweden)

Antosiak-Cyrak Katarzyna Z.

2015-12-01

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.

Acute compartment syndrome after muscle rupture in a non-athlete.

OpenAIRE

Thennavan, A S; Funk, L; Volans, A P

1999-01-01

Acute compartment syndrome after muscle rupture, although rare, is a limb threatening condition, which warrants emergency treatment. The case of acute compartment syndrome secondary to a gastrocnemius muscle tear of the right lower leg, in a non-athlete is reported. To our knowledge, this is the only description of acute compartment syndrome due to muscle rupture in a non-athlete.

Leg Injuries and Disorders

Science.gov (United States)

... are important for motion and standing. Playing sports, running, falling, or having an accident can damage your legs. Common leg injuries include sprains and strains, joint dislocations, and fractures. ...

Leg ulcers due to hyperhomocysteinemia

Directory of Open Access Journals (Sweden)

Krupa Shankar D

2006-01-01

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.

Effect of a patella support brace on myoelectric activity of knee joint muscles during single leg landing

Directory of Open Access Journals (Sweden)

Fatemeh Salariesker

2013-06-01

Full Text Available Introduction: Patellfemoral pain syndrome is one of the most common knee joint problems that affect athletes and non-athletes. Knee brace is often used as a treatment method for patellar realignment. The aim of the present study was to determine the effects of a patella support brace on myoelectric activity of selected knee muscles during single leg landing in healthy females. Materials and Methods: 19 healthy female students (Mean age: 23.6±1.98 years, height: 163.5±5.88 cm, weight: 62.3±3.6 kg participated in this study. Myoelectric activity of biceps femoris, semitendinosus, vastus medialis and vastus lateralis were collected during single leg landing in with and without using the patella support brace conditions.Results: Use of the patella support brace had no significant effect on myoelectric activity for the semitendinosus (p=0.668, vastus medialis (VM (p=0.915 and vastus lateralis (VL (P=0.134, while myoelectric activity for biceps femoris (p=0.005 and ratio of VM/VL myoelectric activity significantly increased (p=0.045. Conclusion: Our results revealed that biceps femoris activity and vastus medialis/vastus lateralis ratio increased after using patella support brace during single leg landing. Further studies on kinematic and kinetic variables are needed to describe these changes in muscular activity when using the patella support brace.

Distal muscle activity alterations during the stance phase of gait in restless leg syndrome (RLS) patients.

Science.gov (United States)

Dafkin, Chloe; Green, Andrew; Olivier, Benita; McKinon, Warrick; Kerr, Samantha

2018-05-01

To assess if there is a circadian variation in electromyographical (EMG) muscle activity during gait in restless legs syndrome (RLS) patients and healthy control participants. Gait assessment was done in 14 RLS patients and 13 healthy control participants in the evening (PM) and the morning (AM). Muscle activity was recorded bilaterally from the tibialis anterior (TA), lateral gastrocnemius (GL), rectus femoris (RF) and biceps femoris (BF) muscles. A circadian variation during the stance phase in only TA (PM > AM, p  Controls, p < 0.05) during early stance and decreased GL activity (RLS < Controls, p < 0.01) during terminal stance in comparison to control participants in the evening. No other significant differences were noted between RLS patients and control participants. Activation of GL during the swing phase was noted in 79% of RLS patients and in 23% of control participants in the morning compared to 71% and 38% in the evening, respectively. EMG muscle activity shows no circadian variation in RLS patients. Evening differences in gait muscle activation patterns between RLS patients and control participants are evident. These results extend our knowledge about alterations in spinal processing during gait in RLS. A possible explanation for these findings is central pattern generator sensitization caused by increased sensitivity in cutaneous afferents in RLS patients. Copyright © 2018 Elsevier B.V. All rights reserved.

The Numerical Sensitivity Study of Cold Leg Top Slot Break for ATLAS

Energy Technology Data Exchange (ETDEWEB)

Sung, Hae Jung; Lee, Sang Ik; Park, Ju hyun; Choi, Tong Soo [KEPCO, Daejeon (Korea, Republic of)

2016-05-15

In this study, cold leg top slot break calculations are performed by RELAP5/MOD3.3 Patch04 for the ATLAS test which is the scaled down experimental facility for the APR1400. The test condition for base case is selected as 0.1016 m (4 in.) based on the break size of the APR1400. In addition, sensitivity studies about break size, break distance from vessel, and pressurizer location are performed until the initiation of simultaneous injection of 2.5 hours. The loop seal reformation occurs early, and the duration of final loop seal reformation is longer as the break is close to vessel. Nonetheless, PCT increased by loop seal reformation is not identified since core uncovery does not occur. In this study, it is confirmed through RELAP5 simulation of the ATLAS test that cold leg top slot break for the APR1400 is not a safety issue in perspective of the loop seal reformation.

[The concept and definition of locomotive syndrome in a super-aged society].

Science.gov (United States)

Nakamura, Kozo; Yoshimura, Noriko; Akune, Toru; Ogata, Toru; Tanaka, Sakae

2014-10-01

The population of elderly individuals who need nursing care is rapidly increasing in Japan. Locomotive syndrome involves a decrease in mobility due to locomotive organ dysfunction, and increases risk for dependency on nursing care service. Because gait speed and chair stand time are correlated with such risks, patients with locomotive syndrome are assessed using brief methods such as the two-step test, which involves dividing the maximum stride length by the height of the patient, and the stand-up test, which involves standing on one or both legs at different heights. One leg standing and squatting are recommended as beneficial locomotive home exercises. Locomotive syndrome has been recognized widely in Japan, and included in the National Health Promotion Movement (2013-2022).

Limb symmetry during double-leg squats and single-leg squats on land and in water in adults with long-standing unilateral anterior knee pain; a cross sectional study.

Science.gov (United States)

Severin, Anna C; Burkett, Brendan J; McKean, Mark R; Wiegand, Aaron N; Sayers, Mark G L

2017-01-01

The presence of pain during movement typically results in changes in technique. However, the physical properties of water, such as flotation, means that water-based exercise may not only reduce compensatory movement patterns but also allow pain sufferers to complete exercises that they are unable to perform on land. The purpose of this study was to assess bilateral kinematics during double-leg squats and single-leg squats on land and in water in individuals with unilateral anterior knee pain. A secondary aim was to quantify bilateral asymmetry in both environments in affected and unaffected individuals using a symmetry index. Twenty individuals with unilateral knee pain and twenty healthy, matched controls performed body weight double- and single-leg squats in both environments while inertial sensors (100 Hz) recorded trunk and lower body kinematics. Repeated-measures statistics tested for environmental effects on movement depths and peak angles within the anterior knee pain group. Differences in their inter-limb symmetry in each environments was compared to the control group using analysis of variance tests. Water immersion allowed for greater movement depths during both exercises (double-leg squat: +7 cm, p  = 0.032, single-leg squat: +9 cm, p  = 0.002) for the knee pain group. The double-leg squat was symmetrical on land but water immersion revealed asymmetries in the lower body frontal plane movements. The single-leg squat revealed decreased hip flexion and frontal plane shank motions on the affected limb in both environments. Water immersion also affected the degree of lower limb asymmetry in both groups, with differences also showing between groups. Individuals with anterior knee pain achieved increased squat depth during both exercises whilst in water. Kinematic differences between the affected and unaffected limbs were often increased in water. Individuals with unilateral anterior knee pain appear to utilise different kinematics in the affected

Limb symmetry during double-leg squats and single-leg squats on land and in water in adults with long-standing unilateral anterior knee pain; a cross sectional study

OpenAIRE

Severin, Anna C.; Burkett, Brendan J.; McKean, Mark R.; Wiegand, Aaron N.; Sayers, Mark G. L.

2017-01-01

Background The presence of pain during movement typically results in changes in technique. However, the physical properties of water, such as flotation, means that water-based exercise may not only reduce compensatory movement patterns but also allow pain sufferers to complete exercises that they are unable to perform on land. The purpose of this study was to assess bilateral kinematics during double-leg squats and single-leg squats on land and in water in individuals with unilateral anterior...

Happle-tinschert syndrome: Report of a case with hemimegalencephaly

Energy Technology Data Exchange (ETDEWEB)

Oezgur, Anil; Cabuk, Gonca; Arpaci, Rabia; Baz, Kiymet; Katar, Demet [Mersin University Faculty of Medicine, Mersin (Turkmenistan)

2014-08-15

Happle-Tinschert syndrome is a disorder causing unilateral segmentally arranged basaloid follicular hamartomas of the skin associated with ipsilateral osseous, dental and cerebral abnormalities including tumors. Although a case with hemimegalencephaly was previously described, this is the first report of Happle-Tinschert syndrome with discrepant short left leg, ipsilateral skin lesions, hemimegalencephaly and frontal polymicrogyria.

Happle-tinschert syndrome: Report of a case with hemimegalencephaly

International Nuclear Information System (INIS)

Oezgur, Anil; Cabuk, Gonca; Arpaci, Rabia; Baz, Kiymet; Katar, Demet

2014-01-01

Happle-Tinschert syndrome is a disorder causing unilateral segmentally arranged basaloid follicular hamartomas of the skin associated with ipsilateral osseous, dental and cerebral abnormalities including tumors. Although a case with hemimegalencephaly was previously described, this is the first report of Happle-Tinschert syndrome with discrepant short left leg, ipsilateral skin lesions, hemimegalencephaly and frontal polymicrogyria.

[Economy class syndrome].

Science.gov (United States)

Morio, Hiroshi

2003-10-01

Economy class syndrome is venous thromboembolism following air travel. This syndrome was firstly reported in 1946, and many cases have been reported since 1990s. Low air pressure and low humidity in the aircraft cabin may contribute to the mechanism of this syndrome. Risk factors for venous thrombosis in the plane were old age, small height, obesity, hormonal therapy, malignancy, smoking, pregnancy or recent parturition, recent trauma or operation, chronic disease and history of venous thrombosis. In Japan, the feminine gender is also risk factor though reason was not well known. For prophylaxis, adequate fluid intake and leg exercise are recommended to all passengers. For passengers with high risk, prophylactic measures such as compression stockings, aspirin or low molecular weight heparin should be considered.

Ulcer-related problems and health care needs in patients with venous leg ulceration: a descriptive, cross-sectional study.

NARCIS (Netherlands)

Heinen, M.M.; Persoon, J.W.B.; Kerkhof, P.C.M. van de; Kooijmans-Otero, M.E.; Achterberg, T. van

2007-01-01

BACKGROUND: Patients with leg ulceration often have long lasting and recurrent wounds. The treatment exists mainly of wound-care and compression therapy. International literature shows several indications of problems in relation to leg ulceration, but no studies were performed to give a

Extension and customization of self-stability control in compliant legged systems

International Nuclear Information System (INIS)

Ernst, M; Blickhan, R; Geyer, H

2012-01-01

Several recent studies on the control of legged locomotion in animal and robot running focus on the influence of different leg parameters on gait stability. In a preceding investigation self-stability controls showing deadbeat behavior could be obtained by studying the dynamics of the system in dependence of the leg orientation carefully adjusted during the flight phase. Such controls allow to accommodate disturbances of the ground level without having to detect them. Here we further this method in two ways. Besides the leg orientation, we allow changes in leg stiffness during flight and show that this extension substantially improves the rejection of ground disturbances. In a human like example the tolerance of random variation in ground level over many steps increased from 3.5% to 35% of leg length. In single steps changes of about 70% leg length (either up or down) could be negotiated. The variable leg stiffness not only allows to start with flat leg orientations maximizing step tolerances but also increase the control subspace. This allows to customize self-stability controls and to consider physical and technical limitations found in animals and robots. (paper)

Refeeding syndrome in Southeastern Taiwan: our experience with 11 cases.

Science.gov (United States)

Chen, Li-Ju; Chen, Huan-Lin; Bair, Ming-Jong; Wu, Chia-Hsien; Lin, I-Tsung; Lee, Yuan-Kai; Chu, Cheng-Hsin

2014-08-14

To present our experience with refeeding syndrome in southeastern Taiwan. We conducted a retrospective study during a 2-year period at the Mackay Memorial Hospital, Taitung Branch. We enrolled patients with very little or no nutrition intake for more than 10 d, a high risk group of refeeding syndrome, including those suffering from alcohol abuse, cancerous cachexia, chronic malnutrition, and prolonged starvation. A total of 11 patients (7 males, 4 females) with nasogastric feeding were included as having refeeding syndrome. Most of them had the symptoms of diarrhea, lethargy, and leg edema. The initial nutritional supplement was found to be relatively high in calories (1355.1 ± 296.2 kcal/d), high in protein (47.3 ± 10.4 gm/d), low in vitamin B1 (2.0 ± 0.5 mg/d), low in potassium (1260.4 ± 297.7 mg/d), and low in phosphorus (660.1 ± 151.8 mg/d). Furthermore, hypophosphatemia (2.4 ± 0.9 mg/dL) was noted during follow-up. Based on the suggestions of a dietician and a gastroenterologist, the clinical disorders of diarrhea, malaise and leg edema were significantly improved. The level of phosphate was also increased (3.3 ± 0.6 mg/dL). Refeeding syndrome is an overlooked and risky disorder that has some potentially fatal complications. Nasogastric feeding in nursing homes is an important risk factor for patients and deserves greater attention based on the initial results of this study.

Pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis: a cross-sectional study.

Science.gov (United States)

Kierkegaard, Signe; Jørgensen, Peter Bo; Dalgas, Ulrik; Søballe, Kjeld; Mechlenburg, Inger

2015-09-01

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 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. 57 patients (mean age 65.6 years) scheduled for medial uni-compartmental knee arthroplasty, and 29 age and gender matched controls were included in this cross-sectional study. Leg extension power was tested with the Nottingham Leg Extension Power-Rig. Pelvic range of motion was derived from an inertia-based measurement unit placed over the sacrum bone during walking, stair climbing and stepping. Patients had lower leg extension power than controls (20-39 %, P 0.06). Furthermore, an inverse association (coefficient: -0.03 to -0.04; R (2) = 13-22 %) between leg extension power and pelvic range of motion during stair and step descending was found in the patients. Compared to controls, patients with medial 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 for the patients.

Sodium Hypochlorite-Modified Hemosorbents in the Treatment of Limb Ischemia-Reperfusion Syndrome: Experimental Study

Directory of Open Access Journals (Sweden)

V. I. Sergiyenko

2007-01-01

Full Text Available Objective: to enhance the efficiency of treatment for limb ischemia-reperfusion syndrome in an experiment, by using the modified hemosorbents that have oxidative properties.Materials and methods. The investigation was conducted on 94 mongrel male dogs divided into 3 groups: 1 intact animals (n=20; 2 animals treated with hemocarboperfusion on the standard sorbent CKH-1K (n=36; 3 animals received hemocarboperfusion on sodium hypochloride-modified sorbent CKH-1K (n=38. A model of acute ischemia-reperfusion syndrome was created by the method of V. D. Pasechnikov et al. Partial oxygen tension (pO2 was determined by pin polarography. The levels of vasoactive eicosanoids were measured by enzyme immunoassay.Results. In the animals with leg ischemia syndrome, there is a significant pO2 reduction in the muscles of the hip and shin, which does not completely recover after reperfusion. Standard CKN-1K sorbent hemocarboperfusion reduces pO2 as compared with the reperfusion period while the use of modified CKH-1K hemosorbent increased pO2 in the study hind limb muscles to the level observed in intact animals. The development of ischemia and reperfusion is accompanied by the elevated levels of inflammatory mediators that have vasoconstrictive properties (thromboxane B2, endothelin-1, leukotrienes C4/D4/E4 and the lower concentration of the vasodilator prostacyclin. Standard CKN-1K sorbent hemocarboperfusion results in a further increase in the concentrations of thromboxane B2 and leukotrienes C4/D4/E4, a decrease in the concentration of endothelin-1, and an elevation of the levels of prostacyclin and prostaglandin E2. When sodium hypochlorite-modified CKN-1K sorbent hemocarboperfusion is employed, the concentrations of thromboxane B2, endothelin-1, and leukotrienes C4/D4/E4 decrease, and the level of prostacyclin increases.Conclusion. Hemocarboperfusion used in the treatment of leg ischemia-reperfusion syndrome leads to restoration of tissue oxygenation and

Can Wound Exudate from Venous Leg Ulcers Measure Wound Pain Status?: A Pilot Study.

Directory of Open Access Journals (Sweden)

Taichi Goto

Full Text Available We investigated the associations between the self-evaluated pain status and two pain biomarker candidates, nerve growth factor and S100A8/A9, in exudate from venous leg ulcer to finally develop an objective pain evaluation method. Patients with venous leg ulcer participated in this cross-sectional observational study conducted between April and October 2014 at two medical facilities. During routine wound care, each participant self-evaluated their pain status at each examination using the 10-point numerical rating scale (present pain intensity and the short-form McGill Pain Questionnaire 2 (continuous pain, intermittent pain, neuropathic pain, affective descriptors, and total score. Venous leg ulcer exudate sample was collected after wound cleansing. The nerve growth factor and S100A8/A9 concentrations in the venous leg ulcer exudate were measured by enzyme-linked immunosorbent assay and standardized according to the wound area. The association between each pain status and the two standardized protein concentrations was evaluated using Spearman's correlation coefficient. In 30 sample collected from 13 participants, the standardized nerve growth factor concentration was negatively correlated with continuous pain (ρ = -0.47, P = 0.01, intermittent pain (ρ = -0.48, P = 0.01, neuropathic pain (ρ = -0.51, P = 0.01, and total score (ρ = -0.46, P = 0.01. The standardized S100A8/A9 concentration was positively correlated with present pain intensity (ρ = 0.46, P = 0.03 and continuous pain (ρ = 0.48, P = 0.03. Thus, these two proteins may be useful for objective evaluation of wound pain in venous leg ulcer patients.

Radiologic features of preteus syndrome: A case report

Energy Technology Data Exchange (ETDEWEB)

Kim, Ok Hwa [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

2014-04-15

Proteus syndrome is a rare congenital hamartomatous condition that is characterized by a wide range of malformations with overgrowth of various tissues. The author reports the case of a Proteus syndrome in a 14-year-old girl who had the unique features of this syndrome including megaspondylodysplasia with resultant scoliosis, leg discrepancy, macrodactyly, clinodactyly, hyperostosis in external auditory meatus, asymmetric megalencephaly, splenomegaly, cystic lung changes, asymmetric soft tissue fat infiltrations and a long, asymmetric face, with descriptions of the radiological features.

A prospective study of the cumulative incidence and course of restless legs syndrome in de novo patients with Parkinson's disease during chronic dopaminergic therapy.

Science.gov (United States)

Marchesi, Elena; Negrotti, Anna; Angelini, Monica; Goldoni, Matteo; Abrignani, Giorgia; Calzetti, Stefano

2016-03-01

The authors report the cumulative incidence of Restless Legs Syndrome (RLS) over a 3 years follow-up period in 92 de novo Parkinson's disease patients under chronic dopaminergic therapy and the clinical course of the sensory-motor disorder over 12 months as from its onset. The overall cumulative incidence of RLS was found by 15.3%, i.e. 14 incident cases, and by 11.9%, i.e. 11 incident cases, after the exclusion of possible "secondary" forms of the disorder. These figures are higher than those reported in general population in Germany (Study of Health in Pomerania), confirming our previous findings of incidence rate of the disorder. At the end of the 3 years follow-up period the prevalence of "current" RLS was significantly higher than that previously found in drug naïve Parkinson's disease patients and in controls, supporting the view that RLS emerging in the course of chronic dopaminergic therapy is the main determinant of the co-morbid association with Parkinson's disease. During the 12 months period of observation the RLS showed a frequency of occurrence of 6.08 episodes per month on average and a remittent clinical course was prevailing in the 11 incident cases, with a significant frequency decrease in the second as compared to the first 6 months, i.e. 3.26 versus 8.9 episodes per month, and none of the patients developed augmentation in the same period. It is hypothesized that the remittent course could be due to long-term adaptation (downregulation) of the hypersensitive post-synaptic dopamine receptors in the spinal cord to a continuous dopaminergic stimulation, possibly coupled with compensatory up-regulation of pre-synaptic dopamine re-uptake mechanism, in the patients in which the hypothalamic A11 area, site of origin of the dopamine-mediated diencephalo-spinal pathway, is involved in the neurodegenerative process.

An unusual case of calcineurine inhibitor pain syndrome.

Science.gov (United States)

Nickavar, Azar; Mehrazma, Mitra; Hallaji, Farideh

2014-09-01

Cyclosporine induced pain syndrome (CIPS) is a newly diagnosed complication of calcineurine inhibitors, mainly observed in solid organ and hematopoetic transplantations. The present case is a male child with steroid resistant nephrotic syndrome on low therapeutic level cyclosporine treatment. He presented with intractable and debilitating leg pain, with no reported history of previous injury or trauma. The pain was reluctant to antimicrobial and sedative treatment. MRI revealed bone marrow and soft tissue edema in the mid shaft of patient's right leg. Inspite of unusual manifestations, CIPS was suggested and cyclosporine discontinued. However, the pain did not improve and was resistant to calcium blocker. Subsequently, core decompression was performed as an unusual treatment of CIPS, revealing normal bone morphology. The pain improved rapidly and the patient was discharged a few days later.

Exocrine glands in the legs of the social wasp Vespula vulgaris.

Science.gov (United States)

Nijs, Catherine; Billen, Johan

2015-09-01

This study brings a survey of the exocrine glands in the legs of Vespula vulgaris wasps. We studied workers, males, virgin queens as well as mated queens. A variety of 17 glands is found in the different leg segments. Among these, five glands are novel exocrine structures for social insects (trochanter-femur gland, ventrodistal tibial gland, distal tibial sac gland, ventral tibial gland, and ventral tarsomere gland). Most leg glands are present in the three leg pairs of all castes. This may indicate a mechanical function. This is likely for the numerous glands that occur near the articulation between the various leg segments, where lubricant production may be expected. Other possible functions include antenna cleaning, acting as a hydraulic system, or pheromonal. Further research including leg-related behavioural observations and chemical analyses may help to clarify the functions of these glandular structures in the legs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Atypical Presentation of Sjögren-Larsson Syndrome

Directory of Open Access Journals (Sweden)

D. Papathemeli

2017-01-01

Full Text Available Sjögren-Larsson syndrome is a rare neurocutaneous disorder characterized by ichthyosis, spastic diplegia or tetraplegia, and intellectual disability. Herein, we describe a case of a Greek patient with ichthyosis and spasticity of the legs but with normal intelligence (IQ 95. This syndrome should be suspected when a child presents with ichthyosis and spastic diplegia or tetraplegia, even if intelligence is normal.

Pulmonary hypertension in patients with Martorell hypertensive leg ulcer: a case control study

Science.gov (United States)

2012-01-01

Background Martorell hypertensive ischemic leg ulcer (Martorell ulcer) is characterized by distinct alterations in the arteriolar wall of subcutaneous vessels, leading to progressive narrowing of the vascular lumen and increase of vascular resistance. These changes are similar to the alterations observed in pulmonary arterioles in patients with chronic pulmonary hypertension (PH). This study was aimed to assess an association between the two disorders. Methods In this case–control study, 14 patients with Martorell ulcer were clinically assessed for the presence of pulmonary hypertension using transthoracic Doppler echocardiography. Data from patients were compared to 28 matched hypertensive controls. Results Systolic pulmonary arterial pressure (sPAP) in patients with Martorell ulcer was significantly higher than in the control group (33.8 ± 16.9 vs 25.3 ± 6.5 mmHg, p = 0.023); the prevalence of pulmonary hypertension was 31% (5/14) in patients and 7% (2/28) in controls (p = 0.031). No differences were seen in left heart size and function between patients and controls. Conclusion This study provides first evidence that subcutaneous arteriolosclerosis, the hallmark of Martorell ulcer, is associated with PH. These findings suggest that patients with Martorell leg ulcer might be at significant risk to develop elevated pulmonary arterial pressure. Patients with leg ulcers who present with dyspnea should be evaluated by echocardiography for the presence of pulmonary hypertension. PMID:22686459

Analysis of large break loss of coolant accident with simultaneous injection into cold leg and hot leg

International Nuclear Information System (INIS)

Luo Bangqi

1997-01-01

When a large break loss of coolant accident occurs, the most part of the safety injection water injected into the cold leg by the safety injection system will flow through the channel between the pressure vessel and the barrel out of the break into the containment, only a little part of the safety injection water can flow into the reactor core. If the safety injection can inject into both the cold leg and the hot leg simultaneously, the safety injection water injected from the cold leg will flow into the core more easily, because the safety injection water injected from the hot leg will carry out more heat from the upper plenum and the core, so the upper plenum and the core is depressed. In addition, a small part of the safety injection water injected from the hot leg will flow down in the core after impinging the guide tubes in the upper plenum, so the core will get more safety injection water than only cold leg injection, and the core will be much safer

Running over unknown rough terrain with a one-legged planar robot

International Nuclear Information System (INIS)

Andrews, Ben; Miller, Bruce; Clark, Jonathan E; Schmitt, John

2011-01-01

The ability to traverse unknown, rough terrain is an advantage that legged locomoters have over their wheeled counterparts. However, due to the complexity of multi-legged systems, research in legged robotics has not yet been able to reproduce the agility found in the animal kingdom. In an effort to reduce the complexity of the problem, researchers have developed single-legged models to gain insight into the fundamental dynamics of legged running. Inspired by studies of animal locomotion, researchers have proposed numerous control strategies to achieve stable, one-legged running over unknown, rough terrain. One such control strategy incorporates energy variations into the system during the stance phase by changing the force-free leg length as a sinusoidal function of time. In this research, a one-legged planar robot capable of implementing this and other state-of-the-art control strategies was designed and built. Both simulated and experimental results were used to determine and compare the stability of the proposed controllers as the robot was subjected to unknown drop and raised step perturbations equal to 25% of the nominal leg length. This study illustrates the relative advantages of utilizing a minimal-sensing, active energy removal control scheme to stabilize running over rough terrain.

Bio-Inspired Design and Kinematic Analysis of Dung Beetle-Like Legs

DEFF Research Database (Denmark)

Aditya, Sai Krishna Venkata; Ignasov, Jevgeni; Filonenko, Konstantin

2017-01-01

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...... performed to identify its workspace as well as to design its trajectory. To this end, the study contributes not only novel multifunctional robotic legs but also the methodology of the bio-inspired leg design....

Factors influencing the implementation of a lifestyle counseling program in patients with venous leg ulcers: a multiple case study

Directory of Open Access Journals (Sweden)

van de Glind Irene M

2012-10-01

Full Text Available Abstract Background Implementation of lifestyle interventions in patient care is a major challenge. Understanding factors that influence implementation is a first step in programs to enhance uptake of these interventions. A lifestyle-counseling intervention, Lively Legs, delivered by trained nurses, can effectively improve the lifestyle in patients with venous leg ulcers. The aim of this study was to identify factors that hindered or facilitated implementation of this intervention in outpatient dermatology clinics and in home care. Methods A mixed-methods multiple case study in five purposefully selected healthcare settings in the Netherlands was conducted. Measurements to identify influencing factors before and after implementation of Lively Legs included interviews, focus groups, questionnaires, and nurses’ registration. Analyses focused on qualitative data as the main data source. All data were compared across multiple cases to draw conclusions from the study as a whole. Results A total of 53 patients enrolled in the Lively Legs program, which was delivered by 12 trained nurses. Barriers for implementation were mainly organizational. It was difficult to effectively organize reaching and recruiting patients for the program, especially in home care. Main barriers were a lack of a standardized healthcare delivery process, insufficient nursing time, and a lack of motivated nurses to deliver the program. Facilitating factors were nurse-driven coordination of care and a standardized care process to tie Lively Legs into, as this resulted in better patient recruitment and better program implementation. Conclusions This study identified a range of factors influencing the implementation of a lifestyle-counseling program, mainly related to the organization of healthcare. Using a case study method proved valuable in obtaining insight into influencing factors for implementation. This study also shed light on a more general issue, which is that leg ulcer

Leg og dannelse

DEFF Research Database (Denmark)

Skovbjerg, Helle Marie

2017-01-01

lederen i det pædagogiske tidskrift Asterisk: ”Leg i skolen, leg i klasserummet, ja legende læring i skolen udgør derimod en enorm, seriøs og ubrugt læringsressource – ikke alene med effekter på kreativiteten, men også på den faglige læring” (Holm, 2015, p. 2). Legens værdi gøres altså først og fremmest...

The Motor and the Brake of the Trailing Leg in Human Walking: Leg Force Control Through Ankle Modulation and Knee Covariance

Science.gov (United States)

Toney, Megan E.; Chang, Young-Hui

2016-01-01

Human walking is a complex task, and we lack a complete understanding of how the neuromuscular system organizes its numerous muscles and joints to achieve consistent and efficient walking mechanics. Focused control of select influential task-level variables may simplify the higher-level control of steady state walking and reduce demand on the neuromuscular system. As trailing leg power generation and force application can affect the mechanical efficiency of step-to-step transitions, we investigated how joint torques are organized to control leg force and leg power during human walking. We tested whether timing of trailing leg force control corresponded with timing of peak leg power generation. We also applied a modified uncontrolled manifold analysis to test whether individual or coordinated joint torque strategies most contributed to leg force control. We found that leg force magnitude was adjusted from step-to-step to maintain consistent leg power generation. Leg force modulation was primarily determined by adjustments in the timing of peak ankle plantar-flexion torque, while knee torque was simultaneously covaried to dampen the effect of ankle torque on leg force. We propose a coordinated joint torque control strategy in which the trailing leg ankle acts as a motor to drive leg power production while trailing leg knee torque acts as a brake to refine leg power production. PMID:27334888

Quality of life psychosocial characteristics in Greek patients with leg ulcers: a case control study.

Science.gov (United States)

Kouris, Anargyros; Armyra, Kalliopi; Christodoulou, Christos; Sgontzou, Themis; Karypidis, Dimitrios; Kontochristopoulos, George; Liordou, Fotini; Zakopoulou, Nikoletta; Zouridaki, Eftychia

2016-10-01

Chronic leg ulcers are a public health problem that can have a significant impact on the patient's physical, socioeconomic and psychological status. The aim of this study is to evaluate the quality of life, anxiety and depression, self-esteem and loneliness in patients suffering from leg ulcers. A total of 102 patients were enrolled in the study. The quality of life, anxiety and depression, self-esteem and loneliness of the patient were assessed using the Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), Rosenberg's Self-esteem Scale (RSES) and the UCLA Loneliness Scale (UCLA-Version 3), respectively. The mean DLQI score was 13·38 ± 2·59, suggesting a serious effect on the quality of life of patients. Those with leg ulcers had statistically significant higher scores according to the HADS-total scale (P = 0·031) and HADS-anxiety subscale (P = 0·015) compared with healthy volunteers. Moreover, a statistically significant difference was found between the two groups concerning the UCLA-scale (P = 0·029). Female patients presented with a higher score of anxiety (P = 0·027) and social isolation (P = 0·048), and worse quality of life (P = 0·018) than male patients. A severe quality of life impairment was documented, reflecting a significant psychosocial impact on patients with leg ulcers. © 2014 The Authors. International Wound Journal © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

A Hydroxyurea-induced Leg Ulcer

OpenAIRE

Hwang, Seon-Wook; Hong, Soon-Kwon; Kim, Sang-Hyun; Seo, Jong-Keun; Lee, Deborah; Sung, Ho-Suk

2009-01-01

Hydroxyurea is a cytostatic agent that has recently become the drug of choice in the treatment of various myeloproliferative diseases. The cutaneous side effects of hydroxyurea include xerosis, hyperpigmentation, nail discoloration, and scaling. Leg ulcers have only rarely been reported in association with hydroxyurea treatment. A 75-year-old woman presented with leg ulcers, nail discoloration, and xerosis. The leg ulcers were refractory to conventional treatment. She had been taking oral hyd...

Prevalence and risk factors of restless legs syndrome among Chinese adults in a rural community of Shanghai in China.

Directory of Open Access Journals (Sweden)

Yunbo Shi

Full Text Available The primary objective of this study was to investigate the prevalence and risk factors of restless legs syndrome (RLS in an adult Chinese population living in a rural community. We also aimed to determine the predictive diagnostic value of the 4-item screening questionnaire for RLS in this population.This study was designed as a 2-phase survey. In phase 1 we performed a face-to-face interview of eligible individuals living in a rural community in Shanghai using a 4-item screening questionnaire. In phase 2, sleep specialists performed a phone interview of the individuals who screened positive to diagnosis RLS.Forty-one RLS cases were confirmed among 2941 eligible individuals 18 years of age or older in the study community. The prevalence of RLS was 1.4% (95% confidence interval (CI = 1.0-1.9%, with a significantly higher rate observed in females (1.9% [95%CI =1.3-2.7%] than that in males (0.9% [95%CI = 0.5-1.5%], p = 0.019. The prevalence rate increased significantly with age, from 0.2% (95% CI = 0.08-0.6% in those 18-39 years old to 4.1% (95% CI = 2.1-7.9% in those ≥ 70 years old (p < 0.001. The multivariate logistic regression analysis indicated that gastritis, anemia and hypertension were risk factors for RLS. The sensitivity and specificity of the 4-item screening questionnaire used in this study were 63.4% and 97.5%, respectively.RLS prevalence is relatively low among Chinese adults living in rural Shanghai. Furthermore, population-based studies with a larger sample size and a longitudinal follow-up may help to determine the risk factors of RLS and potential interventions for RLS.

Valid measures of periodic leg movements (PLMs) during a suggested immobilization test using the PAM-RL leg activity monitors require adjusting detection parameters for noise and signal in each recording.

Science.gov (United States)

Yang, Myung Sung; Montplaisir, Jacques; Desautels, Alex; Winkelman, John W; Cramer Bornemann, Michel A; Earley, Christopher J; Allen, Richard P

2014-01-01

Individuals with restless legs syndrome (RLS) (Willis-Ekbom disease [WED]) usually have periodic leg movements (PLMs). The suggested immobilization test (SIT) measures sensory and motor features of WED during wakefulness. Surface electromyogram (EMG) recordings of the anterior tibialis (AT) are used as the standard for counting PLMs. However, due to several limitations, leg activity meters such as the PAM-RL were advanced as a potential substitute. In our study, we assessed the validity of the measurements of PLM during wakefulness (PLMW) in the SIT for PAM-RL using both default and custom detection threshold parameters compared to AT EMG. Data were obtained from 39 participants who were diagnosed with primary WED and who were on stable medication as part of another study using the SIT to repeatedly evaluate WED symptoms over 6-12 months. EMG recordings and PAM-RL, when available, were used to detect PLMW for each SIT. Complete PAM-RL and polysomnography (PSG) EMG data were available for 253 SITs from that study. The default PAM-RL (dPAM-RL) detected leg movements based on manufacturer's noise (resting) and signal (movement) amplitude criteria developed to accurately detect PLM during sleep (PLMS). The custom PAM-RL (cPAM-RL) similarly detected leg movements except the noise and movement detection parameters were adjusted to match the PAM-RL data for each SIT. The distributions of the differences between either dPAM-RL or cPAM-RL and EMG PLMW were strongly leptokurtic (Kurtosis >2) with many small differences and a few unusually large differences. These distributions are better described by median and quartile ranges than mean and standard deviation. Despite an adequate correlation (r=0.66) between the dPAM-RL and EMG recordings, the dPAM-RL on average significantly underscored the number of PLMW (median: quartiles=-13: -51.2, 0.0) and on Bland-Altman plots had a significant magnitude bias with greater underscoring for larger average PLMW/h. There also was an

Deep vein thrombosis of the leg

Energy Technology Data Exchange (ETDEWEB)

Lee, Eun Hee; Rhee, Kwang Woo; Jeon, Suk Chul; Joo, Kyung Bin; Lee, Seung Ro; Seo, Heung Suk; Hahm, Chang Kok [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

1987-04-15

Ascending contrast venography is the definitive standard method for the diagnosis of deep vein thrombosis (DVT) of the lower extremities. Authors analysed 22 cases of DVT clinically and radiographically. 1.The patients ranged in age from 15 to 70 yrs and the most prevalent age group was 7th decade (31%). There was an equal distribution of males and females. 2.In 11 cases of 22 cases, variable etiologic factors were recognized, such as abdominal surgery, chronic bedridden state, local trauma on the leg, pregnancy, postpartum, Behcet's syndrome, iliac artery aneurysm, and chronic medication of estrogen. 3.Nineteen cases out of 22 cases showed primary venographic signs of DVT, such as well-defined filling defect in opacified veins and narrowed, irregularly filled venous lumen. In only 3 cases, the diagnosis of DVT was base upon the segmental nonvisualization of deep veins with good opacification of proximal and distal veins and presence of collaterals. 4.Extent of thrombosis: 3 cases were confined to calf vein, 4 cases extended to femoral vein, and 15 cases had involvement above iliac vein. 5.In 17 cases involving relatively long segment of deep veins, propagation pattern of thrombus was evaluated by its radiologic morphology according to the age of thrombus: 9 cases suggested central or antegrade propagation pattern and 8 cases, peripheral or retrograde pattern. 6.None of 22 cases showed clinical evidence of pulmonary embolism. The cause of the rarity of pulmonary embolism in Korean in presumed to be related to the difference in major involving site and propagation pattern of DVT in the leg.

Deep vein thrombosis of the leg

International Nuclear Information System (INIS)

Lee, Eun Hee; Rhee, Kwang Woo; Jeon, Suk Chul; Joo, Kyung Bin; Lee, Seung Ro; Seo, Heung Suk; Hahm, Chang Kok

1987-01-01

Ascending contrast venography is the definitive standard method for the diagnosis of deep vein thrombosis (DVT) of the lower extremities. Authors analysed 22 cases of DVT clinically and radiographically. 1.The patients ranged in age from 15 to 70 yrs and the most prevalent age group was 7th decade (31%). There was an equal distribution of males and females. 2.In 11 cases of 22 cases, variable etiologic factors were recognized, such as abdominal surgery, chronic bedridden state, local trauma on the leg, pregnancy, postpartum, Behcet's syndrome, iliac artery aneurysm, and chronic medication of estrogen. 3.Nineteen cases out of 22 cases showed primary venographic signs of DVT, such as well-defined filling defect in opacified veins and narrowed, irregularly filled venous lumen. In only 3 cases, the diagnosis of DVT was base upon the segmental nonvisualization of deep veins with good opacification of proximal and distal veins and presence of collaterals. 4.Extent of thrombosis: 3 cases were confined to calf vein, 4 cases extended to femoral vein, and 15 cases had involvement above iliac vein. 5.In 17 cases involving relatively long segment of deep veins, propagation pattern of thrombus was evaluated by its radiologic morphology according to the age of thrombus: 9 cases suggested central or antegrade propagation pattern and 8 cases, peripheral or retrograde pattern. 6.None of 22 cases showed clinical evidence of pulmonary embolism. The cause of the rarity of pulmonary embolism in Korean in presumed to be related to the difference in major involving site and propagation pattern of DVT in the leg

Thomas de Quincey and his restless legs symptoms as depicted in "Confessions of an English Opium-Eater".

Science.gov (United States)

Miranda, Marcelo; Williams, Anne-Marie; Garcia-Borreguero, Diego

2010-10-15

Thomas de Quincey, a British writer of 19th century, suffered insomnia from the age of 17 years. In his famous "Confessions of an English-Opium Eater" (1822), he described a symptomatology that could concord with restless legs syndrome long before he became addicted to opium. In this report, we analyze his clinical description and the circumstances leading to his opium addiction.

Lower Limb Symmetry: Comparison of Muscular Power Between Dominant and Nondominant Legs in Healthy Young Adults Associated With Single-Leg-Dominant Sports.

Science.gov (United States)

Vaisman, Alex; Guiloff, Rodrigo; Rojas, Juan; Delgado, Iris; Figueroa, David; Calvo, Rafael

2017-12-01

Achieving a symmetrical power performance (difference power between the dominant and nondominant legs in healthy young adults, (2) evaluate the effect of a single-leg-dominant sport activity performed at the professional level, and (3) propose a parameter of normality for maximal power difference in the lower limbs of this young adult population. Controlled laboratory study. A total of 78 healthy, male, young adults were divided into 2 groups according to sport activity level. Group 1 consisted of 51 nonathletes (mean ± SD age, 20.8 ± 1.5 years; weight, 71.9 ± 10.5 kg) who participated in less than 8 hours a week of recreational physical activity with nonspecific training; group 2 consisted of 27 single-leg-dominant professional soccer players (age, 18.4 ± 0.6 years; weight, 70.1 ± 7.5 kg) who specifically trained and competed at their particular activity 8 hours or more a week. For assessment of maximal leg power, both groups completed the single-leg squat jump test. Dominance was determined when participants completed 2 of 3 specific tests with the same extremity. Statistical analysis included the Student t test. No statistical difference was found for maximal power between dominant and nondominant legs for nonathletes ( t = -1.01, P = .316) or single-leg-dominant professional soccer players ( t = -1.10, P = .281). A majority (95%) of participants studied showed a power difference of less than 15% between their lower extremities. Among young healthy adults, symmetrical power performance is expected between lower extremities independent of the existence of dominance and difference in sport activity level. A less than 15% difference in power seems to be a proper parameter to define symmetrical power performance assessed by vertical single-leg jump tests.

Case study: survey of patient satisfaction with prosthesis quality and design among below-knee prosthetic leg socket users.

Science.gov (United States)

Mohd Hawari, Nurhanisah; Jawaid, Mohammad; Md Tahir, Paridah; Azmeer, Raja Ahmad

2017-11-01

The aim of this case study was to explore patient satisfaction with the quality of prosthetic leg sockets intended for persons with lower limb amputations. A qualitative study based on in-depth interviews, preceded by a questionnaire session, was carried out with patients from the Rehabilitation Center and Hospital in Malaysia. Twelve out-patient and in-patient amputees with lower limb amputations, specifically below-knee amputations, were chosen randomly. The analysis of patients' narratives aimed to identify the functional and esthetic characteristics of currently used prosthetic leg sockets and any problems related to them. The obtained results indicated that out of the 12 participants, 41.7% and 25% were satisfied and somewhat satisfied with their current prosthetic sockets. Durability and comfort were rated by the participants as the most important characteristics of prosthetic sockets, with 83.3%. As regards the esthetic appearance of the socket, 66.7% of the respondents considered that the most important feature was the material from which the socket was fabricated. Thus, we conclude that current satisfaction levels with the quality of prosthetic sockets among amputees in Malaysia are suitable, prosthesis being preferred by many amputees. The results can be used to direct future research on cosmesis and functionality of prosthetic socket design. Implications for Rehabilitation Case study will help participants to get cost effective prosthetic leg socket. Develop prosthetic leg socket comfortable as comparative to existing one. Help Malaysian government to make policy to develop local prosthetic leg socket at affordable price.

Stewart-Bluefarb acroangiodermatitis in a case of Parkes-Weber syndrome

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Deepti H Ghia

2014-01-01

Full Text Available Stewart-Bluefarb acroangiodermatitis is the occurrence of pseudo-kaposiform changes with an underlying arterio-venous malformation. Parkes-Weber syndrome is a triad of arterio-venous malformation with varicose veins with bony and soft-tissue hypertrophy involving the extremity. A 13 year-old-female presented with ulcerated growth with bleeding episodes on right leg since past four years. A reddish discoloration over right leg was noticed at four years of age which remained unchanged until nine years of age, after which it showed rapid increase in size along with disproportionate increase in length and girth of right lower limb. Examination revealed hyperpigmented soft verrucous plaque over the right lower one-third of leg, along with presence of ulcers and dilated tortuous veins in the right lower leg with thrill and bruit over the right popliteal and inguinal region. A differential diagnosis of verrucous hemangioma and arterio-venous malformation with pseudo-kaposiform change was considered. Skin biopsy showed multiple fenestrated capillaries with perivascular lymphocyte infiltrate suggestive of capillary malformations. X-ray showed osteolytic defect in right tibia. Duplex ultrasound and magnetic resonance imaging of right leg showed multiple fast flowing small and medium sized arterio-venous malformations of small to moderate size. Thus, on the basis of clinical and radiological features, we made a diagnosis of Stewart-Bluefarb type of acroangiodermatitis with Parkes-Weber syndrome. She was managed conservatively with compression stockings.

Relationship between Leg Mass, Leg Composition and Foot Velocity on Kicking Accuracy in Australian Football

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Nicolas H. Hart, Jodie L. Cochrane, Tania Spiteri, Sophia Nimphius, Robert U. Newton

2016-06-01

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.

Pipe crawler with extendable legs

International Nuclear Information System (INIS)

Zollinger, W.T.

1992-01-01

A pipe crawler for moving through a pipe in inchworm fashion having front and rear leg assemblies separated by air cylinders to increase and decrease the spacing between assemblies. Each leg of the four legs of an assembly is moved between a wall-engaging, extended position and a retracted position by a separate air cylinder. The air cylinders of the leg assemblies are preferably arranged in pairs of oppositely directed cylinders with no pair lying in the same axial plane as another pair. Therefore, the cylinders can be as long as a leg assembly is wide and the crawler can crawl through sections of pipes where the diameter is twice that of other sections. The crawler carries a valving system, a manifold to distribute air supplied by a single umbilical air hose to the various air cylinders in a sequence controlled electrically by a controller. The crawler also utilizes a rolling mechanism, casters in this case, to reduce friction between the crawler and pipe wall thereby further extending the range of the pipe crawler. 8 figs

Pipe crawler with extendable legs

Science.gov (United States)

Zollinger, W.T.

1992-06-16

A pipe crawler for moving through a pipe in inchworm fashion having front and rear leg assemblies separated by air cylinders to increase and decrease the spacing between assemblies. Each leg of the four legs of an assembly is moved between a wall-engaging, extended position and a retracted position by a separate air cylinder. The air cylinders of the leg assemblies are preferably arranged in pairs of oppositely directed cylinders with no pair lying in the same axial plane as another pair. Therefore, the cylinders can be as long as a leg assembly is wide and the crawler can crawl through sections of pipes where the diameter is twice that of other sections. The crawler carries a valving system, a manifold to distribute air supplied by a single umbilical air hose to the various air cylinders in a sequence controlled electrically by a controller. The crawler also utilizes a rolling mechanism, casters in this case, to reduce friction between the crawler and pipe wall thereby further extending the range of the pipe crawler. 8 figs.

Sensitivity of sensor-based sit-to-stand peak power to the effects of training leg strength, leg power and balance in older adults.

Science.gov (United States)

Regterschot, G Ruben H; Folkersma, Marjanne; Zhang, Wei; Baldus, Heribert; Stevens, Martin; Zijlstra, Wiebren

2014-01-01

Increasing leg strength, leg power and overall balance can improve mobility and reduce fall risk. Sensor-based assessment of peak power during the sit-to-stand (STS) transfer may be useful for detecting changes in mobility and fall risk. Therefore, this study investigated whether sensor-based STS peak power and related measures are sensitive to the effects of increasing leg strength, leg power and overall balance in older adults. A further aim was to compare sensitivity between sensor-based STS measures and standard clinical measures of leg strength, leg power, balance, mobility and fall risk, following an exercise-based intervention. To achieve these aims, 26 older adults (age: 70-84 years) participated in an eight-week exercise program aimed at improving leg strength, leg power and balance. Before and after the intervention, performance on normal and fast STS transfers was evaluated with a hybrid motion sensor worn on the hip. In addition, standard clinical tests (isometric quadriceps strength, Timed Up and Go test, Berg Balance Scale) were performed. Standard clinical tests as well as sensor-based measures of peak power, maximal velocity and duration of normal and fast STS showed significant improvements. Sensor-based measurement of peak power, maximal velocity and duration of normal STS demonstrated a higher sensitivity (absolute standardized response mean (SRM): ≥ 0.69) to the effects of training leg strength, leg power and balance than standard clinical measures (absolute SRM: ≤ 0.61). Therefore, the presented sensor-based method appears to be useful for detecting changes in mobility and fall risk. Copyright © 2013 Elsevier B.V. All rights reserved.

Ubx regulates differential enlargement and diversification of insect hind legs.

Directory of Open Access Journals (Sweden)

Najmus Mahfooz

2007-09-01

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.

Differential glucose uptake in quadriceps and other leg muscles during one-legged dynamic submaximal knee-extension exercise

DEFF Research Database (Denmark)

Kalliokoski, Kari K; Boushel, Robert; Langberg, Henning

2011-01-01

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...

Leg som ustyrlig deltagelseskultur

DEFF Research Database (Denmark)

Toft, Herdis

2017-01-01

- og spilteoretikere Johan Huizinga og Roger Caillois. Deres teorier og begrebsdannelser har været brugt til at påpege leg dels som et æstetisk baseret betydningssystem, dels som et affektivt og stemningsbaseret oplevelsessystem samt endelig som et socialt baseret relationssystem. I artiklen vælger vi...... at fokusere på leg som et socialt baseret relationssystem og yderligere zoome ind på et af legens systemiske væsenstræk, nemlig brugen af regulerbare regelsæt, som legerne uden ’politi’ forhandler sig frem til før, under og efter legen. Fælles for Huizinga og Caillois er, at de knytter leg uløseligt sammen...

Restless Legs Symptoms and Pregnancy and Neonatal Outcomes.

Science.gov (United States)

Oyieng'o, D Onentia; Kirwa, Kipruto; Tong, Iris; Martin, Susan; Antonio Rojas-Suarez, José; Bourjeily, Ghada

2016-02-01

Restless legs syndrome (RLS) is a commonly occurring neurologic disorder that affects up to one third of women during pregnancy. RLS has been associated with increased sympathetic tone in the nonpregnant population. We examined whether a RLS surrogate is associated with a higher prevalence of pregnancy and neonatal outcomes. Data were analyzed from a cross-sectional survey of 1000 women interviewed soon after delivery by using an RLS surrogate question. Women were asked how frequently (0 = none, 1 = rarely [pregnancy. Clinical charts were reviewed to obtain relevant demographic and clinical data, including the presence of gestational hypertensive disorders and neonatal outcomes at birth. Subjects who "always" experienced RLS were compared with subjects experiencing symptoms less frequently or not at all with respect to prevalence of gestational hypertensive disorder. The mean ([SD]) age, prepregnancy body mass index (BMI), and BMI at delivery were 29.0 (6.1) years, 26.1 (6.2) kg/m(2), and 32.0 (6.3) kg/m(2), respectively. The overall prevalence of the RLS surrogate (jumpy or jerky leg movements) was 35.5% with the following distribution on a Likert scale: score 1 = 6.4%; score 2 = 10.2%; score 3 = 8.1%; and score 4 = 10.8%. Chronic hypertension was present in 2.1%, pregnancy-induced hypertension in 9.5%, and preeclampsia in 4.5% of respondents. Subjects who reported "always" having sensations of jumpy or jerky legs were more likely to have gestational hypertensive disorders compared with those who reported less frequent occurrence of the symptoms. Adjusted odds ratios were 3.74 (95% CI, 1.31-10.72; P = 0.014) for chronic hypertension; 1.26 (95% CI, 0.65-2.46; P = 0.487) for pregnancy-induced hypertension; and 2.15 (95% CI, 0.97-4.75; P = 0.060) for preeclampsia. There was a significant association between leg movement score and neonatal birth weight (coefficient, -149.5 g [95% CI, -276.9 to -22.5]; P = 0.005) and gestational age at birth (-0.7 week [95% CI, -1.1 to

Analytical Study of Active Prosthetic Legs

Science.gov (United States)

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.

A randomised clinical trial of the efficacy of drop squats or leg extension/leg curl exercises to treat clinically diagnosed jumper's knee in athletes: pilot study

Science.gov (United States)

Cannell, L; Taunton, J; Clement, D; Smith, C; Khan, K

2001-01-01

Objectives—To compare the therapeutic effect of two different exercise protocols in athletes with jumper's knee. Methods—Randomised clinical trial comparing a 12 week programme of either drop squat exercises or leg extension/leg curl exercises. Measurement was performed at baseline and after six and 12 weeks. Primary outcome measures were pain (visual analogue scale 1–10) and return to sport. Secondary outcome measures included quadriceps and hamstring moment of force using a Cybex II isokinetic dynamometer at 30°/second. Differences in pain response between the drop squat and leg extension/curl treatment groups were assessed by 2 (group) x 3 (time) analysis of variance. Two by two contingency tables were used to test differences in rates of return to sport. Analysis of variance (2 (injured versus non-injured leg) x 2 (group) x 3 (time)) was also used to determine differences for secondary outcome measures. Results—Over the 12 week intervention, pain diminished by 2.3 points (36%) in the leg extension/curl group and 3.2 points (57%) in the squat group. There was a significant main effect of both exercise protocols on pain (psquat group returned to sporting activity by 12 weeks, but five of those subjects still had low level pain. Six of nine of the leg extension/curl group returned to sporting activity by 12 weeks and four patients had low level pain. There was no significant difference between groups in numbers returning to sporting activity. There were no differences in the change in quadriceps or hamstring muscle moment of force between groups. Conclusions—Progressive drop squats and leg extension/curl exercises can reduce the pain of jumper's knee in a 12 week period and permit a high proportion of patients to return to sport. Not all patients, however, return to sport by that time. Key Words: knee; patellar tendon; tendinopathy; tendinosis; eccentric strengthening; strength training PMID:11157465

Legāti

OpenAIRE

Segliņa, Aiga

2010-01-01

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...

Dipoles on a Two-leg Ladder

DEFF Research Database (Denmark)

Gammelmark, Søren; Zinner, Nikolaj Thomas

2013-01-01

We study polar molecules with long-range dipole-dipole interactions confined to move on a two-leg ladder for different orientations of the molecular dipole moments with respect to the ladder. Matrix product states are employed to calculate the many-body ground state of the system as function...... that there is a critical angle at which ordering disappears. This angle is slightly larger than the angle at which the dipoles are non-interacting along a single leg. This behavior should be observable using current experimental techniques....

Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke.

Science.gov (United States)

Walters, Arthur S; Rye, David B

2009-05-01

Evidence is reviewed documenting an intimate relationship among restless legs syndrome (RLS) / periodic limb movements in sleep (PLMS) and hypertension and cardiovascular and cerebrovascular disease. Sympathetic overactivity is associated with RLS/PLMS, as manifested by increased pulse rate and blood pressure coincident with PLMS. Causality is far from definitive. Mechanisms are explored as to how RLS/PLMS may lead to high blood pressure, heart disease, and stroke: (a) the sympathetic hyperactivity associated with RLS/PLMS may lead to daytime hypertension that in turn leads to heart disease and stroke; (b) in the absence of daytime hypertension, this sympathetic hyperactivity may predispose to heart disease and stroke either directly or indirectly via atherosclerotic plaque formation and rupture; and (c) comorbidities associated with RLS/PLMS, such as renal failure, diabetes, iron deficiency, and insomnia, may predispose to heart disease and stroke. One theoretical cause for sympathetic hyperactivity is insufficient All diencephalospinal dopaminergic neuron inhibition of sympathetic preganglionic neurons residing in the intermediolateral cell columns of the spinal cord. We cannot exclude the possibility that peripheral vascular, cardiovascular, and cerebrovascular disease may also contribute to RLS/PLMS, and mechanisms for these possibilities are also discussed.

Periodic Limb Movement Disorder (PLMD) and Restless Legs Syndrome (RLS)

Science.gov (United States)

... the syndrome. Risk factors include the following: A sedentary lifestyle Smoking Obesity Many people with narcolepsy or ... kidney and liver disorders. Treatment Changes in the diet Drugs used to treat Parkinson disease and other ...

Artificial Leg Design and Control Research of a Biped Robot with Heterogeneous Legs Based on PID Control Algorithm

Directory of Open Access Journals (Sweden)

Hualong Xie

2015-04-01

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.

Numerical study of hot-leg ECC injection into the upper plenum of a pressurized water reactor

International Nuclear Information System (INIS)

Daly, B.J.; Torrey, M.D.; Rivard, W.C.

1981-01-01

In certain pressurized water reactor (PWR) designs, emergency core coolant (ECC) is injected through the hot legs into the upper plenum. The condensation of steam on this subcooled liquid stream reduces the pressure in the hot legs and upper plenum and thereby affects flow conditions throughout the reactor. In the present study, we examine countercurrent steam-water flow in the hot leg to determine the deceleration of the ECC flow that results from an adverse pressure gradient and from momentum exchange from the steam by interfacial drag and condensation. For the parameters examined in the study, water flow reversal is observed for a pressure drop of 22 to 32 mBar over the 1.5 m hot leg. We have also performed a three-dimensional study of subcooled water injection into air and steam environments of the upper plenum. The ECC water is deflected by an array of cylindrical guide tubes in its passage through the upper plenum. Comparisons of the air-water results with data obtained in a full scale experiment shows reasonable agreement, but indicates that there may be too much resistance to horizontal flow about the columns because of the use of a stair-step representation of the cylindrical guide tube cross section. Calculations of flow past single columns of stair-step, square and circular cross section do indicate excessive water deeentrainment by the noncircular column. This has prompted the use of an arbitrary mesh computational procedure to more accuratey represent the circular cross-section guide tubes. 15 figures

A prospective study on gait-related intrinsic risk factors for lower leg overuse injuries.

Science.gov (United States)

Ghani Zadeh Hesar, N; Van Ginckel, A; Cools, A; Peersman, W; Roosen, P; De Clercq, D; Witvrouw, E

2009-12-01

To determine prospectively gait-related risk factors for lower leg overuse injury (LLOI). A prospective cohort study. Male and female recruits from a start-to-run (STR) programme during a 10-week training period. 131 healthy subjects (20 men and 111 women), without a history of any lower leg complaint, participated in the study. Before the start of the 10-week STR programme, plantar force measurements during running were performed. During STR, lower leg injuries were diagnosed and registered by a sports physician. Plantar force measurements during running were performed using a footscan pressure plate. During the STR, 27 subjects (five men and 22 women) developed a LLOI. Logistic regression analysis revealed that subjects who developed a LLOI had a significantly more laterally directed force distribution at first metatarsal contact and forefoot flat, a more laterally directed force displacement in the forefoot contact phase, foot flat phase and at heel-off. These subjects also had a delayed change of the centre of force (COF) at forefoot flat, a higher force and loading underneath the lateral border of the foot, and a significantly higher directed force displacement of the COF at forefoot flat. These findings suggest that a less pronated heel strike and a more laterally directed roll-off can be considered as risk factors for LLOI. Clinically, the results of this study can be considered important in identifying individuals at risk of LLOI.

The emergence of devastating impulse control disorders during dopamine agonist therapy of the restless legs syndrome.

Science.gov (United States)

Dang, Dien; Cunnington, David; Swieca, John

2011-01-01

The Restless Legs Syndrome is a common sensorimotor disorder, typically amenable to treatment with dopamine agonist therapy. Dopamine agonists have been associated with emergent impulse control disorders (ICDs) when used in patients with Parkinson disease, and ICDs have now been reported in individuals with RLS on dopamine agonist therapy. Our aim was to characterize cases of emergent ICDs in Australian patients with focus on the dopamine agonists implicated and the social significance of ICDs. A series of RLS patients on dopamine agonist therapy were identified with ICDs over a 2-year period. Additional cases of ICDs were found using a mailout questionnaire designed to capture those with high impulsivity. These patients were assessed using the Barratt Impulsiveness Scale, Version 11, and a modified Minnesota Impulse Disorders Interview. Case records and medication schedules were evaluated. Twelve cases of patients with de novo ICDs were found with a range of impulsive behaviors including pathological gambling, kleptomania, compulsive shopping, and hypersexuality. Criminality, suicidality, and marital discord also were featured. These occurred over a wide range of latencies and l-dopa exposures. This group of Australian RLS patients with ICDs display high levels of impulsivity and is the first to use the BIS-11 questionnaire in this setting. Impulse control disorders can occur over a wide range of dopamine agonist therapy types and dose exposures. Impulse control disorder tendencies may persist, despite withdrawal of dopamine agonists. The emergence of ICDs needs careful consideration in light of their potentially devastating financial, social, and marital consequences.

Iliac Vein Compression Syndrome due to Bladder Distention Caused by Urethral Calculi

Directory of Open Access Journals (Sweden)

Akiko Ikegami

2015-01-01

Full Text Available We report a rare case of iliac vein compression syndrome caused by urethral calculus. A 71-year-old man had a history of urethral stenosis. He complained of bilateral leg edema and dysuria for 1 week. Physical examination revealed bilateral distention of the superficial epigastric veins, so obstruction of both common iliac veins or the inferior vena cava was suspected. Plain abdominal computed tomography showed a calculus in the pendulous urethra, distention of the bladder (as well as the right renal pelvis and ureter, and compression of the bilateral common iliac veins by the distended bladder. Iliac vein compression syndrome was diagnosed. Bilateral iliac vein compression due to bladder distention (secondary to neurogenic bladder, benign prostatic hyperplasia, or urethral calculus as in this case is an infrequent cause of acute bilateral leg edema. Detecting distention of the superficial epigastric veins provides a clue for diagnosis of this syndrome.

Understanding the Active Straight Leg Raise (ASLR): An electromyographic study in healthy subjects

NARCIS (Netherlands)

Hu, H.; Meijer, O.G.; Bruijn, S.M.; Strijers, R.L.M.; Nanayakkara, P.W.B.; van Royen, B.J.; Wu, W; Xia, C.; van Dieen, J.H.

2012-01-01

The Active Straight Leg Raise (ASLR) is an important test in diagnosing pelvic girdle pain (PGP). It is difficult to understand what happens normally during the ASLR, let alone why it would be impaired in PGP. In the present study, healthy subjects performed the ASLR under normal conditions, with

Does a crouched leg posture enhance running stability and robustness?

Science.gov (United States)

Blum, Yvonne; Birn-Jeffery, Aleksandra; Daley, Monica A; Seyfarth, Andre

2011-07-21

Humans and birds both walk and run bipedally on compliant legs. However, differences in leg architecture may result in species-specific leg control strategies as indicated by the observed gait patterns. In this work, control strategies for stable running are derived based on a conceptual model and compared with experimental data on running humans and pheasants (Phasianus colchicus). From a model perspective, running with compliant legs can be represented by the planar spring mass model and stabilized by applying swing leg control. Here, linear adaptations of the three leg parameters, leg angle, leg length and leg stiffness during late swing phase are assumed. Experimentally observed kinematic control parameters (leg rotation and leg length change) of human and avian running are compared, and interpreted within the context of this model, with specific focus on stability and robustness characteristics. The results suggest differences in stability characteristics and applied control strategies of human and avian running, which may relate to differences in leg posture (straight leg posture in humans, and crouched leg posture in birds). It has been suggested that crouched leg postures may improve stability. However, as the system of control strategies is overdetermined, our model findings suggest that a crouched leg posture does not necessarily enhance running stability. The model also predicts different leg stiffness adaptation rates for human and avian running, and suggests that a crouched avian leg posture, which is capable of both leg shortening and lengthening, allows for stable running without adjusting leg stiffness. In contrast, in straight-legged human running, the preparation of the ground contact seems to be more critical, requiring leg stiffness adjustment to remain stable. Finally, analysis of a simple robustness measure, the normalized maximum drop, suggests that the crouched leg posture may provide greater robustness to changes in terrain height

Don't break a leg: running birds from quail to ostrich prioritise leg safety and economy on uneven terrain.

Science.gov (United States)

Birn-Jeffery, Aleksandra V; Hubicki, Christian M; Blum, Yvonne; Renjewski, Daniel; Hurst, Jonathan W; Daley, Monica A

2014-11-01

Cursorial ground birds are paragons of bipedal running that span a 500-fold mass range from quail to ostrich. Here we investigate the task-level control priorities of cursorial birds by analysing how they negotiate single-step obstacles that create a conflict between body stability (attenuating deviations in body motion) and consistent leg force-length dynamics (for economy and leg safety). We also test the hypothesis that control priorities shift between body stability and leg safety with increasing body size, reflecting use of active control to overcome size-related challenges. Weight-support demands lead to a shift towards straighter legs and stiffer steady gait with increasing body size, but it remains unknown whether non-steady locomotor priorities diverge with size. We found that all measured species used a consistent obstacle negotiation strategy, involving unsteady body dynamics to minimise fluctuations in leg posture and loading across multiple steps, not directly prioritising body stability. Peak leg forces remained remarkably consistent across obstacle terrain, within 0.35 body weights of level running for obstacle heights from 0.1 to 0.5 times leg length. All species used similar stance leg actuation patterns, involving asymmetric force-length trajectories and posture-dependent actuation to add or remove energy depending on landing conditions. We present a simple stance leg model that explains key features of avian bipedal locomotion, and suggests economy as a key priority on both level and uneven terrain. We suggest that running ground birds target the closely coupled priorities of economy and leg safety as the direct imperatives of control, with adequate stability achieved through appropriately tuned intrinsic dynamics. © 2014. Published by The Company of Biologists Ltd.

Evaluation of Thermoelectric Performance and Durability of Functionalized Skutterudite Legs

Science.gov (United States)

Skomedal, Gunstein; Kristiansen, Nils R.; Sottong, Reinhard; Middleton, Hugh

2017-04-01

Thermoelectric generators are a promising technology for waste heat recovery. As new materials and devices enter a market penetration stage, it is of interest to employ fast and efficient measurement methods to evaluate the long-term stability of thermoelectric materials in combination with metallization and coating (functionalized thermoelectric legs). We have investigated a method for measuring several thermoelectric legs simultaneously. The legs are put under a common temperature gradient, and the electrical characteristics of each leg are measured individually during thermal cycling. Using this method, one can test different types of metallization and coating applied to skutterudite thermoelectric legs and look at the relative changes over time. Postcharacterization of these initial tests with skutterudite legs using a potential Seebeck microprobe and an electron microscope showed that oxidation and interlayer diffusion are the main reasons for the gradual increase in internal resistance and the decrease in open-circuit voltage. Although we only tested skutterudite material in this work, the method is fully capable of testing all kinds of material, metallization, and coating. It is thus a promising method for studying the relationship between failure modes and mechanisms of functionalized thermoelectric legs.

Autoerythrocyte Sensitization Syndrome: A Case Report

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Pinar Ozuguz

2014-04-01

Full Text Available Autoerythrocyte sensitization syndrome or Gardner-Diamond syndrome is a rare syndrome, characterized by recurrent, spontaneous, painful ecchymosis. The lesions occur particularly after emotional stress or mild trauma. Psychiatric problems are commonly observed in these patients. The lower limbs and the trunk are the most often localizations; however, lesions can appear on any other skin area. It is thought to be a sensitivity to intradermally injected autoerythrocyte. The diagnosis is usually based on typical anamnesis, clinical presentation, absence of specific laboratory changes and positive intradermal test. This syndrome should be considered in the differential diagnosis of purpura, especially in patients with psychiatric problems and without any coagulopathy. Herein, a case of 38 year-old-female who has recurrent ecchymoses on her legs, fatigue, headache and sleeping problems is presented.

Leg intravenous pressure during head-up tilt.

NARCIS (Netherlands)

Groothuis, J.T.; Poelkens, F.; Wouters, C.W.; Kooijman, H.M.; Hopman, M.T.E.

2008-01-01

Leg vascular resistance is calculated as the arterial-venous pressure gradient divided by blood flow. During orthostatic challenges it is assumed that the hydrostatic pressure contributes equally to leg arterial, as well as to leg venous pressure. Because of venous valves, one may question whether,

Sensitivity of sensor-based sit-to-stand peak power to the effects of training leg strength, leg power and balance in older adults

NARCIS (Netherlands)

Regterschot, G Ruben H; Folkersma, Marjanne; Zhang, Wei; Baldus, Heribert; Stevens, Martin; Zijlstra, Wiebren

Increasing leg strength, leg power and overall balance can improve mobility and reduce fall risk. Sensor-based assessment of peak power during the sit-to-stand (STS) transfer may be useful for detecting changes in mobility and fall risk. Therefore, this study investigated whether sensor-based STS

Antiphospholipid antibody syndrome complicated by Grave's disease.

Science.gov (United States)

Takahashi, Ayumi; Tamura, Atsushi; Ishikawa, Osamu

2002-12-01

The report describes a woman with primary antiphospholipid antibody syndrome complicated with Grave's disease. Developing symptoms included a small cutaneous nodule on her finger and subsequently ecchymotic purpura on the cheeks, ears, buttocks and lower legs. Histological examinations showed thrombosed vessels in the dermis without or with hemorrhage, respectively. Laboratory investigation revealed positive lupus anticoagulant and immunogenic hyperthyroidism due to Grave's disease. There is a close relationship between the cutaneous manifestation of antiphospholipid antibody syndrome and the activities of Grave's disease and a possible link of antiphospholipid antibody syndrome with Grave's disease was suggested both by the etiology of the disease as well as the disease activity.

Doppler ultrasound exam of an arm or leg

Science.gov (United States)

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 ...

Perforated peptic ulcer associated with abdominal compartment syndrome.

Science.gov (United States)

Lynn, Jiun-Jen; Weng, Yi-Ming; Weng, Chia-Sui

2008-11-01

Abdominal compartment syndrome (ACS) is defined as an increased intra-abdominal pressure with adverse physiologic consequences. Abdominal compartment syndrome caused by perforated peptic ulcer is rare owing to early diagnosis and management. Delayed recognition of perforated peptic ulcer with pneumoperitoneum, bowel distension, and decreased abdominal wall compliance can make up a vicious circle and lead to ACS. We report a case of perforated peptic ulcer associated with ACS. A 74-year-old man with old stroke and dementia history was found to have distended abdomen, edema of bilateral legs, and cyanosis. Laboratory tests revealed deterioration of liver and kidney function. Abdominal compartment syndrome was suspected, and image study was arranged to find the cause. The study showed pneumoperitoneum, contrast stasis in heart with decreased caliber of vessels below the abdominal aortic level, and diffuse lymphedema at the abdominal walls. Emergent laparotomy was performed. Perforated peptic ulcer was noted and the gastrorrhaphy was done. The symptoms, and liver and kidney function improved right after emergent operation.

Pyloric atresia epidermolysis bullosa aplasia cutis syndrome: a case ...

African Journals Online (AJOL)

Pyloric atresia epidermolysis bullosa aplasia cutis syndrome: a case report and literature ... skin over the right leg from the knee joint up to the middle of the right foot. ... Examination indicated no signs of child abuse; the parents refused an ...

Long-Term Course of Failed Back Surgery Syndrome (FBSS Patients Receiving Integrative Korean Medicine Treatment: A 1 Year Prospective Observational Multicenter Study.

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Jinho Lee

Full Text Available With increase of spine surgeries, failed back surgery syndrome (FBSS prevalence is also rising. While complementary and alternative medicine (CAM is commonly used for low back pain (LBP, there are no studies reporting use of integrative Korean medicine in FBSS patients.Patients with pain continuing after back surgery or recurring within 1 year and visual analogue scale (VAS of LBP or leg pain of ≥6 (total n = 120 were recruited at 2 hospital sites from November 2011 to September 2014. Weekly sessions of integrative Korean medicine treatment were conducted for 16 weeks (herbal medicine, acupuncture/electroacupuncture, pharmacopuncture/bee venom pharmacopuncture, and Chuna manual therapy with additional follow-ups at 24 weeks and 1 year. Outcome measures included VAS of LBP and leg pain (primary outcome, Oswestry Disability Index (ODI, Short-Form 36 (SF-36, medical use, and patient global impression of change (PGIC.VAS of LBP and leg pain improved at 6 months (LBP from 6.1±2.0 at baseline to 2.9±2.3; and leg pain from 5.4±2.6 to 2.4±2.5, respectively. Eighty patients (66.7% showed improvement of 50% or more in main pain of LBP or leg pain from baseline. Disability and quality of life also improved at 6 months (ODI from 41.3±12.3 at baseline to 23.6±13.6; and SF-36 from 42.8±14.5 to 62.7±16.8. At 1 year follow-up, conventional medical management use decreased, improvement in pain and disability was maintained, and 79.2% reported improvement of PGIC.Despite limitations as an observational study, integrative Korean medicine treatment showed positive results in pain, function, and quality of life of FBSS patients.

Straight leg elevation to rule out pelvic injury.

Science.gov (United States)

Bolt, Caroline; O'Keeffe, Francis; Finnegan, Pete; Dickson, Kristofer; Smit, De Villiers; Fitzgerald, Mark C; Mitra, Biswadev

2018-02-01

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.

Frustrated S = 1/2 Two-Leg Ladder with Different Leg Interactions

Science.gov (United States)

Tonegawa, Takashi; Okamoto, Kiyomi; Hikihara, Toshiya; Sakai, Tôru

2017-04-01

We explore the ground-state phase diagram of the S = 1/2 two-leg ladder. The isotropic leg interactions J1,a and J1,b between nearest neighbor spins in the legs a and b, respectively, are different from each other. The xy and z components of the uniform rung interactions are denoted by Jr and ΔJr, respectively, where Δ is the XXZ anisotropy parameter. This system has a frustration when J1,aJ1,b employ the physical consideration, the level spectroscopy analysis of the results obtained by the exact diagonalization method and also the density-matrix renormalization-group method. It is found that the non-collinear ferrimagnetic (NCFR) state appears as the ground state in the frustrated region of the parameters. Furthermore, the direct-product triplet-dimer (TD) state in which all rungs form the TD pair is the exact ground state, when J1,a + J1,b = 0 and 0≤ Δ ≲ 0.83. The obtained phase diagrams consist of the TD, XY and Haldane phases as well as the NCFR phase.

The effect of spinal manipulation on imbalances in leg strength.

Science.gov (United States)

Chilibeck, Philip D; Cornish, Stephen M; Schulte, Al; Jantz, Nathan; Magnus, Charlene R A; Schwanbeck, Shane; Juurlink, Bernhard H J

2011-09-01

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.

Marfan syndrome: Report of two cases with review of literature

African Journals Online (AJOL)

2011-06-10

Jun 10, 2011 ... Marfan syndrome is a variable autosomal dominant disorder with characteristic cardiovascular, eye and skeletal features. Progressive aortic ... Outward bowing of the legs was noticed along with dry scaly skin. The first toe was ...

Approach to leg edema

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Fulvio Pomero

2017-09-01

Full Text Available Edema is defined as a palpable swelling caused by an increase in interstitial fluid volume. Leg edema is a common problem with a wide range of possible causes and is the result of an imbalance in the filtration system between the capillary and interstitial spaces. Major causes of edema include venous obstruction, increased capillary permeability and increased plasma volume secondary to sodium and water retention. In both hospital and general practice, the patient with a swollen leg presents a common dilemma in diagnosis and treatment. The cause may be trivial or life-threatening and it is often difficult to determine the clinical pathway. The diagnosis can be narrowed by categorizing the edema according to its duration, distribution (unilateral or bilateral and accompanying symptoms. This work provides clinically oriented recommendations for the management of leg edema in adults.

Restless Legs Syndrome/Willis-Ekbom Disease Is Prevalent in Working Nurses, but Seems Not to Be Associated with Shift Work Schedules.

Science.gov (United States)

Waage, Siri; Pallesen, Ståle; Moen, Bente Elisabeth; Bjorvatn, Bjørn

2018-01-01

Insomnia and excessive sleepiness are among the most commonly reported sleep problems related to shift work. Sleep-related movement disorders have, however, received far less attention in relation to such work schedules. The objective of this study was to investigate the association between different shift work schedules and the prevalence of Restless legs syndrome/Willis-Ekbom disease (RLS/WED) in a large sample of Norwegian nurses. Our hypothesis was that shift working nurses would report higher prevalence of RLS/WED compared to day workers. A total of 1,788 nurses with different work schedules (day work, two-shift rotation, night work, three shift rotation) participated in a cohort study, started in 2008/2009. Four questions about RLS/WED based on the diagnostic criteria were included in wave 4 (2012). RLS/WED prevalence rates across different shift schedules were explored by the Pearson chi-square test. Logistic regression analysis was used to assess the association between RLS/WED and work schedules and shift work disorder (SWD) with adjustment for sex, age, marital status, smoking, and caffeine use. In total, 90.0% of the nurses were females, mean age 36.5 years (SD = 8.6, range 25-67). The overall prevalence of RLS/WED was 26.8%. We found no significant differences between the prevalence of RLS/WED across the different shift schedules, ranging from 23.3% (day work) to 29.4% (night work). There was a significant difference ( p  shift work also are sensitive to other complaints related to a misalignment of the biological clock.

Medial tibial stress syndrome: a critical review

NARCIS (Netherlands)

Moen, Maarten H.; Tol, Johannes L.; Weir, Adam; Steunebrink, Miriam; de Winter, Theodorus C.

2009-01-01

Medial tibial stress syndrome (MTSS) is one of the most common leg injuries in athletes and soldiers. The incidence of MTSS is reported as being between 4% and 35% in military personnel and athletes. The name given to this condition refers to pain on the posteromedial tibial border during exercise,

PELATIHAN PLIOMETRIK ALTERNATE LEG BOUND DAN DOUBLE LEG BOUND MENINGKATKAN DAYA LEDAK OTOT TUNGKAI PADA SISWA PUTRA KELAS VII SMP NEGERI 3 SUKAWATI TAHUN PELAJARAN 2012/2013

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Komang Ayu Tri Widhiyanti

2013-11-01

Full Text Available This study was conducted to know the improvement the explosive power of leg muscle. It was done through 5 set 12 repetitions during 6 weeks in the field of SMP Negeri 3 Sukawati started from 4 p.m. until 6 p.m. There were 3 groups applied in this study such as group 1 (control group that was instructed to kick a ball, group 2 (plyometric training of alternate leg bound, and group 3 (plyometric training of double leg bound. The sample was 14 male students who were in the seventh grade class of SMP Negeri 3 Sukawati in the academic year 2012/2013. The data was gained by doing the movement of alternate leg bound and double leg bound that each movement was done three times before and after the training. The hypothesis was examined by using independent t-test with the result 0.05 (p<0.05. Based on the different result of analysis test in each group, the gain score of the group 2 with the group 1 about 0,51 that shows the significant differences p = 0,00, the gain score of the group 2 with the group 3 about 0,31 that shows the significant differences p = 0,00, the gain score of the group 3 with the group 1 about 0,20 that shows the significant differences p = 0,00. Thus, alternate leg bound plyometric training is more effective than double leg bound. It is expected that the coach and the gym teacher to apply alternate leg bound plyometric training as an alternative to improve the explosive power of leg muscle.

Evolution of non-treated restless legs syndrome Síndrome das pernas inquietas: evolução após um ano sem tratamento

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Raimundo Nonato Delgado Rodrigues

2009-03-01

Full Text Available PURPOSE: The primary concern of this study is to evaluate the clinical course of restless legs syndrome (RLS in a group of patients who refused treatment. METHOD: This study compares the outcome of a group of RLS patients after one year without any specific treatment. The International Restless Legs Syndrome Scale (IRLS was applied at baseline (irls_1 and after one year (irls_2. The patients answered a simple questionnaire for the evaluation of possible environmental or life habit changes after one-year evolution. Serum ferritin was determined at baseline. An improvement index (%improvement was established through the formula: irls_1- irls_2/irls_1 ' 100. Results were compared and a correlation analysis performed. RESULTS: A negative significant correlation was found between the patientsí age and irls_2 (r= -0.9 p=0.0018 and between %improvement and irls_2 (r= -0.88 p=0.0039. A positive and significant correlation was determined between %improvement and age. There was only a marginally significant correlation between serum ferritin and ilrs_2 (r= -0.7 p=0.052. No significant changes were found in the other elements analyzed. CONCLUSION: A favorable outcome was found in this group of RLS patients after one year evolution without treatment. The outcome was positively influenced by the patientsí age.OBJETIVO: O objetivo deste estudo é avaliar a evolução de oito pacientes com diagnóstico de síndrome das pernas inquietas (SPI após doze meses sem tratamento. MÉTODO: Estudo de coorte, retrospectivo, consistindo na aplicação da escala de gravidade da SPI (IRLS, de questionário para avaliação de mudanças ambientais ou de hábitos de vida e dosagem de ferritina sérica. Realizada comparação da pontuação IRLS obtida na consulta inicial (irls_1 e após doze meses de evolução (irls_2 e estabelecido um índice de melhora percentual (%melhora=irls_1 - irls_2 / irls_1 ' 100. Análise de correlação dos dados obtidos. RESULTADOS: Foi

Water displacement leg volumetry in clinical studies - A discussion of error sources

Science.gov (United States)

2010-01-01

Background Water displacement leg volumetry is a highly reproducible method, allowing the confirmation of efficacy of vasoactive substances. Nevertheless errors of its execution and the selection of unsuitable patients are likely to negatively affect the outcome of clinical studies in chronic venous insufficiency (CVI). Discussion Placebo controlled double-blind drug studies in CVI were searched (Cochrane Review 2005, MedLine Search until December 2007) and assessed with regard to efficacy (volume reduction of the leg), patient characteristics, and potential methodological error sources. Almost every second study reported only small drug effects (≤ 30 mL volume reduction). As the most relevant error source the conduct of volumetry was identified. Because the practical use of available equipment varies, volume differences of more than 300 mL - which is a multifold of a potential treatment effect - have been reported between consecutive measurements. Other potential error sources were insufficient patient guidance or difficulties with the transition from the Widmer CVI classification to the CEAP (Clinical Etiological Anatomical Pathophysiological) grading. Summary Patients should be properly diagnosed with CVI and selected for stable oedema and further clinical symptoms relevant for the specific study. Centres require a thorough training on the use of the volumeter and on patient guidance. Volumetry should be performed under constant conditions. The reproducibility of short term repeat measurements has to be ensured. PMID:20070899

Budd-Chiari Syndrome: Two Cases with Different Courses

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Shinjiro Inomata

2008-08-01

Full Text Available We report two cases of Budd-Chiari syndrome. Case 1: A 57-year-old man presented with leg edema and esophageal varices. Cavography showed obstruction of the inferior vena cava with antiphospholipid syndrome. Further, the patient showed positive serology for hepatitis C virus and consumed large quantities of alcohol. Percutaneous transluminal angioplasty was performed on this patient and anticoagulants administered; leg edema and esophageal varices were ameliorated although liver biopsy showed cirrhosis without evident congestion. More than 9 months since the diagnosis, restenosis of the inferior vena cava has not occurred. Case 2: A 73-year-old woman presented abdominal pain but no edema or varices. Cavography showed membranous obstruction of the inferior vena cava which required no therapy. Manifestation of portal hypertension was not present and liver function was maintained although liver biopsy showed obvious congestion. These cases showed untypical features against histopathology, and careful observation will be required for emergence of hepatocellular carcinoma.

Crossover study of amputee stair ascent and descent biomechanics using Genium and C-Leg prostheses with comparison to non-amputee control.

Science.gov (United States)

Lura, Derek J; Wernke, Matthew W; Carey, Stephanie L; Kahle, Jason T; Miro, Rebecca M; Highsmith, M Jason

2017-10-01

This study was a randomized crossover of stair ambulation of Transfemoral Amputees (TFAs) using the Genium and C-Leg prosthetic knees. TFAs typically have difficulty ascending and descending stairs, limiting community mobility. The objective of this study was to determine the relative efficacy of the Genium and C-Leg prostheses for stair ascent and descent, and their absolute efficacy relative to non-amputees. Twenty TFAs, and five non-amputees participated in the study. TFAs were randomized to begin the study with the Genium or C-Leg prosthesis. Informed consent was obtained from all participants prior to data collection and the study was listed on clinicaltrials.gov (#NCT01473662). After fitting, accommodation, and training, participants were asked to demonstrate their preferred gait pattern for stair ascent and descent and a step-over-step pattern if able. TFAs then switched prosthetic legs and repeated fitting, accommodation, training, and testing. An eight camera Vicon optical motion analysis system, and two AMTI force plates were used to track and analyze the participants' gait patterns, knee flexion angles, knee moment normalized by body weight, and swing time. For stair descent, no significant differences were found between prostheses. For stair ascent, Genium use resulted in: increased ability to use a step-over-step gait pattern (p=0.03), increased prosthetic side peak knee flexion (pstair ascent relative to the C-Leg, by enabling gait patterns that more closely resembled non-amputees. Copyright © 2017 Elsevier B.V. All rights reserved.

Leg stiffness during phases of countermovement and take-off in vertical jump.

Science.gov (United States)

Struzik, Artur; Zawadzki, Jerzy

2013-01-01

With respect to cyclic movements such as human gait, running or hopping, leg stiffness is a little variable parameter. The aim of this study was to investigate changes in leg stiffness during the phase of countermovement and take-off when performing a single maximum counter-movement jump. Kistler force plates and a BTS SMART system for comprehensive motion analysis were employed in the study. The study covered a group of 12 athletes from university basketball teams. Leg stiffness was calculated in those parts of countermovement and take-off phases where its level is relatively constant and the relationship F(Δl) is similar to linear one. Mean total stiffness (±SD) in both legs in the countermovement phase amounted to 6.5 ± 1.5 kN/m, whereas during the take-off phase this value was 6.9 ± 1 kN/m. No statistically significant differences were found between leg stiffness during the countermovement phase and takeoff phase in the study group at the level of significance set at α = 0.05. This suggests that the leg stiffness in phase of countermovement and phase of take-off are much similar to each other, despite different function of both phases. Similar to cyclic movements, leg stiffness turned out relatively constant when performing a single vertical jump. There are also reported statistically significant correlations between body mass, body height, length of lower limbs and leg stiffness. The stiffness analysed by the authors should be understood as quasi-stiffness because the measurements of ΔF(Δl) were made during transient states where inertia and dumping forces are likely to affect the final result.

Duplex sonography of the near-surface leg veins

International Nuclear Information System (INIS)

Mendoza, E.

2007-01-01

The book contains the following contributions: The ultrasonograph, selection of the ultrasonic transducer, anatomy of the near-surface vein system, physiology of the near-surface vein system, varicose status classification, systematics of the duplex sonography of near-surface leg veins, provocational maneuver for the duplex sonographic varicose diagnostics, exploration of vena saphena parva, perforans veins, side branches, phlebitis, sonography for varicose therapy, postsurgical sonography, deep leg veins, examination of near-surface leg veins for the pathology of the deep vein system, differential diagnostic clarification of leg oedema from the phlebologic-lymphological view, diagnostic side features along the near-surface leg veins

Increase in Leg Stiffness Reduces Joint Work During Backpack Carriage Running at Slow Velocities.

Science.gov (United States)

Liew, Bernard; Netto, Kevin; Morris, Susan

2017-10-01

Optimal tuning of leg stiffness has been associated with better running economy. Running with a load is energetically expensive, which could have a significant impact on athletic performance where backpack carriage is involved. The purpose of this study was to investigate the impact of load magnitude and velocity on leg stiffness. We also explored the relationship between leg stiffness and running joint work. Thirty-one healthy participants ran overground at 3 velocities (3.0, 4.0, 5.0 m·s -1 ), whilst carrying 3 load magnitudes (0%, 10%, 20% weight). Leg stiffness was derived using the direct kinetic-kinematic method. Joint work data was previously reported in a separate study. Linear models were used to establish relationships between leg stiffness and load magnitude, velocity, and joint work. Our results found that leg stiffness did not increase with load magnitude. Increased leg stiffness was associated with reduced total joint work at 3.0 m·s -1 , but not at faster velocities. The association between leg stiffness and joint work at slower velocities could be due to an optimal covariation between skeletal and muscular components of leg stiffness, and limb attack angle. When running at a relatively comfortable velocity, greater leg stiffness may reflect a more energy efficient running pattern.

OSTEOPATHIC APPROACH: LEG LENGTH DISCREPANCY AND LOW BACK PAIN

Directory of Open Access Journals (Sweden)

Taner AYDIN

2015-12-01

Full Text Available Leg length discrepancy (LLD is a biomechanical impediment, which is a potential factor in affecting musculoskeletal disorders in the rest of life, such as scoliosis, osteoarthritis and muscle tightness, or even tenderness in lumbar and pelvic area. Athletes who have developed LLD have symptoms in gait, running, standing posture. Skeletal regions related to the disorder are the lumbar spine, ilium, hip joint, greater trochanter and knee, or even ankle and plantar region. Muscles involved in these areas are numeous. In osteopathic management, the manual practitioner can use a lot of basic techniques to handle these dysfunctions. To cope with musculoskeletal problems, osteopathic manipulation techniques would be an ideal modality to alleviate the LLD syndrome. An overview of the mentioned topics of concern will be discussed in the review.

Experimental research on pedestrian lower leg impact

Science.gov (United States)

Constantin, B. A.; Iozsa, D. M.; Stan, C.

2017-10-01

The present paper is centred on the research of deceleration measured at the level of the lower leg during a pedestrian impact in multiple load cases. Basically, the used methodology for physical test setup is similar to EuroNCAP and European Union regulatory requirements. Due cost reduction reasons, it was not used a pneumatic system in order to launch the lower leg impactor in the direction of the vehicle front-end. During the test it was used an opposite solution, namely the vehicle being in motion, aiming the standstill lower leg impactor. The impactor has similar specifications to those at EU level, i.e. dimensions, materials, and principle of measurement of the deceleration magnitude. Therefore, all the results obtained during the study comply with the requirements of both EU regulation and EuroNCAP. As a limitation, due to unavailability of proper sensors in the equipment of the lower leg impactor, that could provide precise results, the bending angle, the shearing and the detailed data at the level of knee ligaments were not evaluated. The knee joint should be improved for future studies as some bending angles observed during the post processing of several impact video files were too high comparing to other studies. The paper highlights the first pedestrian impact physical test conducted by the author, following an extensive research in the field. Deceleration at the level of pedestrian knee can be substantially improved by providing enough volume between the bumper fascia and the front-end structure and by using pedestrian friendly materials for shock absorbers, such as foams.

Recovery of atrophic leg muscles in the hemiplegics due to cerebrovascular accidents. Computed tomographic study

Energy Technology Data Exchange (ETDEWEB)

Odajima, Natsu; Ishiai, Sumio; Okiyama, Ryouichi; Furukawa, Tetsuo; Tsukagoshi, Hiroshi.

1988-02-01

Thirty-five patients with hemiplegia due to cerebrovascular accidents were studied with regared to the muscle wastings before and after rehabilitation training. Hemiplegics were composed of 12 improved and 23 non-improved patients. The CT scan was carried out at the midportion of the thigh and largest-diameter section of the calf. Muscle size of each cross-sectional area was measured on CT image and the increase of size (..delta..S) in each muscle after training was calculated. The ..delta..S of quadriceps femoris was correlated with that of whole cross-section of the thigh. The gracilis in non-affected side was not correlated with that of whole muscles. In both legs, there was an increase in leg muscle size after training. These changes were nost marked in the non-affected side of the improved patients. After training the difference between the two limbs remained unchanged. Recovery of muscle wasting in both legs was seen first in the quadriceps in thigh and flexors in calf. Gracilis was relatively unchanged in comparison with other muscles. Remarkable increase of muscle size in non-affected side was worthwhile to note.

Lower leg muscle involvement in Duchenne muscular dystrophy: an MR imaging and spectroscopy study

International Nuclear Information System (INIS)

Torriani, Martin; Townsend, Elise; Thomas, Bijoy J.; Bredella, Miriam A.; Ghomi, Reza H.; Tseng, Brian S.

2012-01-01

To describe the involvement of lower leg muscles in boys with Duchenne muscular dystrophy (DMD) by using MR imaging (MRI) and spectroscopy (MRS) correlated to indices of functional status. Nine boys with DMD (mean age, 11 years) and eight healthy age- and BMI-matched boys (mean age, 13 years) prospectively underwent lower leg MRI, 1H-MRS of tibialis anterior (TA) and soleus (SOL) for lipid fraction measures, and 31P-MRS for pH and high-energy phosphate measures. DMD subjects were evaluated using the Vignos lower extremity functional rating, and tests including 6 min walk test (6MWT) and 10 m walk. DMD subjects had highest fatty infiltration scores in peroneal muscles, followed by medial gastrocnemius and soleus. Compared to controls, DMD boys showed higher intramuscular fat (P = 0.04), lipid fractions of TA and SOL (P = 0.02 and 0.003, respectively), pH of anterior compartment (P = 0.0003), and lower phosphocreatine/inorganic phosphorus ratio of posterior compartment (P = 0.02). The Vignos rating correlated with TA (r = 0.79, P = 0.01) and SOL (r = 0.71, P = 0.03) lipid fractions. The 6MWT correlated with fatty infiltration scores of SOL (r = -0.76, P = 0.046), medial (r = -0.80, P = 0.03) and lateral (r = -0.84, P = 0.02) gastrocnemius, intramuscular fat (r = -0.80, P = 0.03), and SOL lipid fraction (r = -0.89, P = 0.007). Time to walk 10 m correlated with anterior compartment pH (r = 0.78, P = 0.04). Lower leg muscles of boys with DMD show a distinct involvement pattern and increased adiposity that correlates with functional status. Lower leg MRI and 1H-MRS studies may help to noninvasively demonstrate the severity of muscle involvement. (orig.)

Lower leg muscle involvement in Duchenne muscular dystrophy: an MR imaging and spectroscopy study

Energy Technology Data Exchange (ETDEWEB)

Torriani, Martin [Massachusetts General Hospital and Harvard Medical School, Division of Musculoskeletal Imaging and Intervention, Boston, MA (United States); Massachusetts General Hospital, Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Townsend, Elise [MGH Institute of Health Professions and Massachusetts General Hospital, Boston, MA (United States); Thomas, Bijoy J.; Bredella, Miriam A.; Ghomi, Reza H. [Massachusetts General Hospital and Harvard Medical School, Division of Musculoskeletal Imaging and Intervention, Boston, MA (United States); Tseng, Brian S. [Massachusetts General Hospital and Harvard Medical School, Pediatric Neuromuscular Clinic, Boston, MA (United States); Novartis Institute of Biomedical Research, Cambridge, MA (United States)

2012-04-15

To describe the involvement of lower leg muscles in boys with Duchenne muscular dystrophy (DMD) by using MR imaging (MRI) and spectroscopy (MRS) correlated to indices of functional status. Nine boys with DMD (mean age, 11 years) and eight healthy age- and BMI-matched boys (mean age, 13 years) prospectively underwent lower leg MRI, 1H-MRS of tibialis anterior (TA) and soleus (SOL) for lipid fraction measures, and 31P-MRS for pH and high-energy phosphate measures. DMD subjects were evaluated using the Vignos lower extremity functional rating, and tests including 6 min walk test (6MWT) and 10 m walk. DMD subjects had highest fatty infiltration scores in peroneal muscles, followed by medial gastrocnemius and soleus. Compared to controls, DMD boys showed higher intramuscular fat (P = 0.04), lipid fractions of TA and SOL (P = 0.02 and 0.003, respectively), pH of anterior compartment (P = 0.0003), and lower phosphocreatine/inorganic phosphorus ratio of posterior compartment (P = 0.02). The Vignos rating correlated with TA (r = 0.79, P = 0.01) and SOL (r = 0.71, P = 0.03) lipid fractions. The 6MWT correlated with fatty infiltration scores of SOL (r = -0.76, P = 0.046), medial (r = -0.80, P = 0.03) and lateral (r = -0.84, P = 0.02) gastrocnemius, intramuscular fat (r = -0.80, P = 0.03), and SOL lipid fraction (r = -0.89, P = 0.007). Time to walk 10 m correlated with anterior compartment pH (r = 0.78, P = 0.04). Lower leg muscles of boys with DMD show a distinct involvement pattern and increased adiposity that correlates with functional status. Lower leg MRI and 1H-MRS studies may help to noninvasively demonstrate the severity of muscle involvement. (orig.)

Calf Compartment Syndrome associated with the Use of an Intra-osseous Line in an Adult Patient: A Case Report

Directory of Open Access Journals (Sweden)

Malhotra R

2016-11-01

Full Text Available We present a case of a lower limb compartment syndrome associated with the use of an intra-osseous line inserted into the proximal tibia in an adult patient. An unconscious 59-year old male with multiple injuries presented to our Emergency Department after a road traffic accident. Bilateral proximal tibial intra osseous-lines were inserted due to poor venous access. After resuscitation his left leg was noted to be tense and swollen with absent pulses. Acute compartment syndrome was diagnosed both clinically and with compartment pressure measurement. Two incision fasciotomy on his left lower leg was performed. Intra osseous-lines in the proximal tibia are increasingly used in adult patients in the pre-hospital setting by paramedics and emergency physicians. Their use, along with the possible complications of these devices, such as the development of compartment syndrome or osteomyelitis leading to amputation, is well reported in the paediatric literature. To the best of our knowledge, there have not been any previous reports of complications in the adult patient. We present a case of lower leg compartment syndrome developing from the use of an intra-osseous line in the proximal tibia in an adult patient. With the increasing use of intra-osseous lines in adult patients, clinicians should be aware of the possibility of developing compartment syndrome which may lead to disability or amputation in severe cases.

Compartment syndrome and popliteal vascular injury complicating unicompartmental knee arthroplasty

NARCIS (Netherlands)

Kort, Nanne Pieter; Van Raay, Jos J. J. A. M.; van Horn, Jim R.

Popliteal vascular injury and the compartment syndrome of the leg are rare but important complications of knee arthroplasties. Early diagnosis and treatment are of paramount importance in preventing the devastating complications of these conditions. To our knowledge, these complications have not

An under-diagnosed geriatric syndrome: sleep disorders among older adults.

Science.gov (United States)

Tufan, Asli; Ilhan, Birkan; Bahat, Gulistan; Karan, Mehmet Akif

2017-06-01

Sleep disorders are commonly under-diagnosed in the geriatric population. We aimed to determine the prevalence of sleep problems among older adults admitted to the geriatrics out-patient clinic. Two hundred and three patients (136 female) older than 75 years of age were included in the study. Patients underwent comprehensive geriatric assessment, including identification of sleep problems using the Sleep Disturbance Scale, Rapid eye movement (REM) sleep behavior disorder (RBD) Single-Question Screen questionnaire (RBD1Q) and The Johns Hopkins Restless Leg Syndrome Severity Scale. Demographic and clinical data including age, sex, medications, comorbid diseases, body mass index and functional scores was noted. The mean age of the patients was 80.92±4.3 years. 35.5% of the patients had findings of REM-SBD and 32.5% of the patients had restless legs syndrome. Ninety-seven percent of the patients answered 'yes' to at least one of the sleep disturbance scale questions. There was no significant difference between male and female groups. We observed that sleep disorders were common among older adults. For this reason, the course and quality of sleep should be examined in all patients as a routine part of comprehensive geriatric assessment.

Gitelman's syndrome: a rare presentation mimicking cauda equina syndrome.

LENUS (Irish Health Repository)

Quinlan, C S

2012-02-01

We describe a case of bilateral weakness of the lower limbs, sensory disturbance and intermittent urinary incontinence, secondary to untreated Gitelman\\'s syndrome, in a 42-year-old female who was referred with presumed cauda equina syndrome. On examination, the power of both legs was uniformly reduced, and the perianal and lower-limb sensation was altered. However, MRI of the lumbar spine was normal. Measurements of serum and urinary potassium were low and blood gas analysis revealed metabolic alkalosis. Her symptoms resolved following potassium replacement. We emphasise the importance of measurement of the plasma and urinary levels of electrolytes in the investigation of patients with paralysis of the lower limbs and suggest that they, together with blood gas analysis, allow the exclusion of unusual causes of muscle weakness resulting from metabolic disorders such as metabolic alkalosis.

A review of the relationship between leg power and selected chronic disease in older adults

DEFF Research Database (Denmark)

Strollo, S. E.; Caserotti, Paolo; Ward, R. E.

2015-01-01

characterized. Importantly, individuals with these conditions have shown improved leg power with training. METHODS: A search was performed using PubMed to identify original studies published in English from January 1998 to August 2013. Leg power studies, among older adults ≥ 50 years of age, which assessed......OBJECTIVE: This review investigates the relationship between leg muscle power and the chronic conditions of osteoarthritis, diabetes mellitus, and cardiovascular disease among older adults. Current literature assessing the impact of chronic disease on leg power has not yet been comprehensively......), diabetes mellitus (n=5), and cardiovascular disease (n=6). Studies generally supported associations of lower leg power among older adults with chronic disease, although small sample sizes, cross-sectional data, homogenous populations, varied disease definitions, and inconsistent leg power methods limited...

Living with clipped wings—Patients’ experience of losing a leg

Directory of Open Access Journals (Sweden)

Annelise Norlyk

2013-10-01

Full Text Available This study explores the lived experience of losing a leg as described by the patients themselves post-discharge. Studies have documented that regardless of aetiology patients are faced with severe physical as well as psychosocial challenges post-amputation. However, only few studies explore in-depth the patients’ perspective on the various challenges following the loss of a leg. The study uses the phenomenological approach of Reflective Lifeworld Research (RLR. Data were collected from 24 in-depth interviews with 12 Danish patients. Data analysis was performed according to the guidelines given in RLR. The essential meaning of losing a leg is a radical and existential upheaval, which restricts patients’ lifestyle and irretrievably alters their lifeworld. Life after the operation is associated with despair, and a painful sense of loss, but also with the hope of regaining personal independence. The consequences of losing a leg gradually materialize as the patients realize how the loss of mobility limits their freedom. Patients experience the professional help as primarily directed towards physical care and rehabilitation. The findings show that the loss of a leg and, subsequently, the restricted mobility carry with them an existential dimension which refers to limitation of action space and loss of freedom experienced as an exclusion from life. Our findings demonstrate a need for complementary care and stress the importance of an increased awareness of the psychosocial and existential consequences of losing a limb.

Surface Projection of Interosseous Foramen of the Leg: Cadaver Study

Directory of Open Access Journals (Sweden)

Eric Arguello

2016-01-01

Full Text Available Purpose. This study was conducted to identify the surface projection of the interosseous foramen and associated structures of the proximal leg using the average clinician’s thumb width as a quick measurement to assist in differential diagnosis and treatment. Methods. Twelve cadavers (5 males and 7 females, age range = 51–91 years, and mean age = 76.9 were dissected for analysis. Location and size of interosseous foramen, location of anterior tibial artery, location of deep fibular nerve, and corresponding arterial branches were measured and converted into thumb widths. Results. Mean thumb width measured among the cadavers was 17.94±3.9 mm. The interosseous foramen measured was approximately 1 thumb width vertically (18.47±3.0 mm and 1/2 thumb width horizontally (7.32±2.1 mm and was located approximately 1 thumb width distally to the tibial tuberosity (20.81±6.8 mm and 2 thumb widths (37.47±4.7 mm lateral to the tibial ridge. The anterior tibial artery and deep fibular nerve converged approximately 4 thumb widths (74.31±14.8 mm inferior to the tibial tuberosity and 2 thumb widths (33.46±4.9 mm lateral to the tibial ridge. Conclusion. Clinicians may identify anatomical structures of the proximal leg with palpation using the thumb width for measurement.

Congenital constriction ring syndrome of the limbs: A prospective ...

African Journals Online (AJOL)

In the upper limb malformations involved 42 digits; in the lower limb malformations involved 33 toes, one foot and fi ve legs. Four main types of lesions were found: constriction rings, intrauterine amputations, acrosyndactyly, and simple syndactyly. Conclusion: Congenital constriction ring syndrome is of uncertain aetiology ...

Endovascular Therapy Is Effective for Leriche Syndrome with Deep Vein Thrombosis

Directory of Open Access Journals (Sweden)

Tasuku Higashihara

2015-01-01

Full Text Available A 65-year-old man presented to our hospital due to intermittent claudication and swelling in his left leg. He had Leriche syndrome and deep vein thrombosis. We performed endovascular therapy (EVT for Leriche syndrome, and a temporary filter was inserted in the inferior vena cava. He received anticoagulation therapy for deep vein thrombosis. The stenotic lesion in the terminal aorta was stented with an excellent postprocedural angiographic result and dramatic clinical improvement after EVT. This case suggests that EVT can be a treatment for Leriche syndrome.

Leg pain

Science.gov (United States)

... in the blood Medicines (such as diuretics and statins) Muscle fatigue or strain from overuse, too much exercise, or holding a muscle in the same position for a long time An injury can also cause leg pain from: A torn or overstretched muscle ( strain ) Hairline ...

Broken Leg

Science.gov (United States)

... 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 ...

BETHSY ISP-38 flow behaviour in hot leg

International Nuclear Information System (INIS)

Petelin, S.; Jurkovic, M.

1998-01-01

Betsy Test 6.9c OECD ISP-38 RELAP5/MOD3.2 input model was developed and simulation performed for loss of RHR system during mid-loop operation. Initial liquid level in RCS was at horizontal axis of the hot legs. Pressurizer and steam generator manways were opened 1 s after the transient was initiated. Secondary side is full of air and isolated. Results of calculations were satisfied except in surge line and in pressurizer where larger amount of water is presented. Liquid was entrained in that part of the system during bubbly or varies stratified flow in the hot leg. Due to non-physical results in hot leg pipe with connected surge line and pressurizer, RELAP5 horizontal stratification model deficiencies was studied and possible improvements investigated.(author)

[Fractures of the lower leg in professional skiers].

Science.gov (United States)

Mückley, T; Kruis, C; Schütz, T; Brucker, P; Bühren, V

2004-03-01

Fractures of the lower leg due to skiing accidents remain an important concern. Few studies have focussed on the special demands of professional athletes who sustain these injuries. We present our experience with three cases of lower leg fractures in competitive professional downhill skiers and discuss management and treatment concepts. We performed limited reamed compression nailing in all the patients presented because it offers the advantages of high mechanical stability and optimized fragment apposition. Plate osteosynthesis of the fibula is not required in most typical fractures. All patients resumed ski training. Two of them returned to World Cup. Only one achieved her pre-injury World Cup level of performance and success. In conclusion, a successful return for professional skiers with lower leg fractures is feasible using an optimized treatment strategy.

Leg ulcers in older people: a national study addressing variation in diagnosis, pain and sleep disturbance.

Science.gov (United States)

Hellström, Amanda; Nilsson, Camilla; Nilsson, Annina; Fagerström, Cecilia

2016-01-21

Leg ulcers commonly emerge as a symptom of other comorbidities, often in older people. As a consequence of the ulcer, pain and sleep disturbances might occur. Due to the complex illness, the responsibility of treatment is unclear between health caregivers. The interaction between ulcer type, sleep and pain has not previously been investigated. This study aimed to explore pain in older men and women (65 years and older) with different diagnoses of leg ulcers and to investigate the associations of sleep disturbances and pain in people with leg ulcer diagnosis. The study used a cross-sectional design and data from the Swedish Registry of Ulcer Treatment, collected between May 2009 and December 2013. One thousand and eight hundred and twenty four people were included, and 62.9% were women. The mean age was 83.4 years (SD 8.8). For the analyses, the chi-square test, Mann-Whitney U-test, t-test, one-way ANOVA and logistic regression was performed. Pain was measured by the Numeric Rating Scale (NRS), and sleep disturbances was assessed dichotomously. We found the prevalence of pain intensity ≥ 5 on the NRS to be 34.8% in those reporting pain. Additionally, the pain intensity was associated with the number of ulcers (p = 0.003). Sleep disturbances were associated with pain (p pain and scored higher on the NRS, no significant gender difference in sleep disturbances was found (p = 0.606). The mean NRS scores did not differ significantly between the ulcer types; however, arterial and venous-arterial ulcers increased the risk of sleep disturbances, as did higher pain scores. The majority of the participants were of advanced age (>80 years) and frequently suffered from pain and sleep disturbances. Further research is needed regarding pain, sleep and wound healing in the oldest old with leg ulcers. Ulcer pain sometimes appears to receive less attention in ulcer management, as do sleep disturbances, implying that individual needs might not be satisfactorily met

Not letting the left leg know what the right leg is doing: limb-specific locomotor adaptation to sensory-cue conflict.

Science.gov (United States)

Durgin, Frank H; Fox, Laura F; Hoon Kim, Dong

2003-11-01

We investigated the phenomenon of limb-specific locomotor adaptation in order to adjudicate between sensory-cue-conflict theory and motor-adaptation theory. The results were consistent with cue-conflict theory in demonstrating that two different leg-specific hopping aftereffects are modulated by the presence of conflicting estimates of self-motion from visual and nonvisual sources. Experiment 1 shows that leg-specific increases in forward drift during attempts to hop in place on one leg while blindfolded vary according to the relationship between visual information and motor activity during an adaptation to outdoor forward hopping. Experiment 2 shows that leg-specific changes in performance on a blindfolded hopping-to-target task are similarly modulated by the presence of cue conflict during adaptation to hopping on a treadmill. Experiment 3 shows that leg-specific aftereffects from hopping additionally produce inadvertent turning during running in place while blindfolded. The results of these experiments suggest that these leg-specific locomotor aftereffects are produced by sensory-cue conflict rather than simple motor adaptation.

Influence of the Perspectives on the Movement of One-Leg Lifting in an Interactive-Visual Virtual Environment: A Pilot Study.

Directory of Open Access Journals (Sweden)

Chien-Hua Huang

Full Text Available Numerous studies have confirmed the feasibility of active video games for clinical rehabilitation. To maximize training effectiveness, a personal program is necessary; however, little evidence is available to guide individualized game design for rehabilitation. This study assessed the perspectives and kinematic and temporal parameters of a participant's postural control in an interactive-visual virtual environment.Twenty-four healthy participants performed one-leg standing by leg lifting when a posture frame appeared either in a first- or third-person perspective of a virtual environment. A foot force plate was used to detect the displacement of the center of pressure. A three-way mixed factor design was applied, where the perspective was the between-participant factor, and the leg-lifting times (0.7 and 2.7 seconds and leg-lifting angles (30°and 90° were the within-participant factors. The reaction time, accuracy of the movement, and ability to shift weight were the dependent variables.Regarding the reaction time and accuracy of the movement, there were no significant main effects of the perspective, leg-lifting time, or angle. For the ability to shift weight, however, both the perspective and time exerted significant main effects, F(1,22 = 6.429 and F(1,22 = 13.978, respectively.Participants could shift their weight more effectively in the third-person perspective of the virtual environment. The results can serve as a reference for future designs of interactive-visual virtual environment as applied to rehabilitation.

The Interday Measurement Consistency of and Relationships Between Hamstring and Leg Musculo-articular Stiffness.

Science.gov (United States)

Waxman, Justin P; Schmitz, Randy J; Shultz, Sandra J

2015-10-01

Hamstring stiffness (K(HAM)) and leg stiffness (K(LEG)) are commonly examined relative to athletic performance and injury risk. Given these may be modifiable, it is important to understand day-to-day variations inherent in these measures before use in training studies. In addition, the extent to which K(HAM) and K(LEG) measure similar active stiffness characteristics has not been established. We investigated the interday measurement consistency of K(HAM) and K(LEG), and examined the extent to which K(LEG) predicted K(HAM) in 6 males and 9 females. K(HAM) was moderately consistent day-to-day (ICC(2,5) = .71; SEM = 76.3 N·m(-1)), and 95% limits of agreement (95% LOA) revealed a systematic bias with considerable absolute measurement error (95% LOA = 89.6 ± 224.8 N·m(-1)). Day-to-day differences in procedural factors explained 59.4% of the variance in day-to-day differences in K(HAM). Bilateral and unilateral K(LEG) was more consistent (ICC(2,3) range = .87-.94; SEM range = 1.0-2.91 kN·m(-1)) with lower absolute error (95% LOA bilateral= -2.0 ± 10.3; left leg = -0.36 ± 3.82; right leg = -1.05 ± 3.61 kN·m(-1)). K(LEG) explained 44% of the variance in K(HAM) (P consistent and precise K(HAM) measures. The ease and consistency of K(LEG), and moderate correlation with K(HAM), may steer clinicians toward K(LEG) when measuring lower-extremity stiffness for screening studies and monitoring the effectiveness of training interventions over time.

Postural control of typical developing boys during the transition from double-leg stance to single-leg stance.

Science.gov (United States)

Deschamps, Kevin; Staes, Filip; Peerlinck, Kathelijne; Van Geet, Kristel; Hermans, Cedric; Lobet, Sebastien

2017-02-01

Literature is lacking information about postural control performance of typically developing children during a transition task from double-leg stance to single-leg stance. The purpose of the present study was therefore to evaluate the clinical feasibility of a transition task in typical developing age groups as well as to study the correlation between associated balance measures and age.Thirty-three typically developing boys aged 6-20 years performed a standard transition task from DLS to SLS with eyes open (EO) and eyes closed (EC). Balance features derived from the center of pressure displacement captured by a single force platform were correlated with age on the one hand and considered for differences in the perspective of limb dominance on the other hand.All TDB (typically developing boys) were able to perform the transition task with EO. With respect to EC condition, all TDB from the age group 6-7 years and the youngest of the age group 8-12 years (N = 4) were unable to perform the task. No significant differences were observed between the balance measures of the dominant and non-dominant limbs.With respect to EO condition, correlation analyses indicated that time to new stability point (TNSP) as well as the sway measure after this TNSP were correlated with age (p postural balance of typically developing children during walking, running, sit-to-stand, and bipodal and unipodal stance has been well documented in the literature. • These reference data provided not only insight into the maturation process of the postural control system, but also served in diagnosing and managing functional repercussions of neurological and orthopedic pathologies. What is New: • Objective data regarding postural balance of typical developing children during a transition task from double-leg stance to single-leg stance. • Insight into the role of maturation on the postural control system.

Bioinspired template-based control of legged locomotion

OpenAIRE

Ahmad Sharbafi, Maziar

2018-01-01

cient and robust locomotion is a crucial condition for the more extensive use of legged robots in real world applications. In that respect, robots can learn from animals, if the principles underlying locomotion in biological legged systems can be transferred to their artificial counterparts. However, legged locomotion in biological systems is a complex and not fully understood problem. A great progress to simplify understanding locomotion dynamics and control was made by introducing simple mo...

Aetiology, imaging and treatment of medial tibial stress syndrome

NARCIS (Netherlands)

Moen, M.H.

2012-01-01

The work contained is this thesis discusses aetiology, imaging and treatment of a common leg injury: medial tibial stress syndrome (MTSS). Although a common injury, the number of scientific articles on this topic is relatively low as is explained in chapter 1. This chapter also highlights that the

CHRONIC COMPARTMENT SYNDROME OF LOWER LEG. AN UNUSUAL CASE IN NON ATHLETIC PATIENT.

Directory of Open Access Journals (Sweden)

Andrea Schiavone

2016-10-01

Full Text Available Chronic exertional anterior compartment syndrome is debilitating disease of lower limb. The clinical picture is characterised by limited symptomology at rest, pain during sporting activities, tumefaction and contractures of limb as well impotency by pain of the entire forefoot and hypoesthesia. Usually the most affected patients are athletes. We analyse a case of chronic post traumatic compartment syndrome of the anterior tibial muscle in an unsportsmanlike patient.

Six weeks' aerobic retraining after two weeks' immobilization restores leg lean mass and aerobic capacity but does not fully rehabilitate leg strenght in young and older men

DEFF Research Database (Denmark)

Vigelsø Hansen, Andreas; Gram, Martin; Wiuff, Caroline

2015-01-01

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)....

Arm and leg substrate utilization and muscle adaptation after prolonged low-intensity training

DEFF Research Database (Denmark)

Helge, Jørn Wulff

2010-01-01

This review will focus on current data where substrate metabolism in arm and leg muscle is investigated and discuss the presence of higher carbohydrate oxidation and lactate release observed during arm compared with leg exercise. Furthermore, a basis for a possible difference in substrate partiti...... at comparable workloads. Finally, the influence and capacity of low-intensity training to influence metabolic fitness in the face of a limited effect on aerobic fitness will be challenged....... partitioning between endogenous and exogenous substrate during arm and leg exercise will be debated. Moreover the review will probe if differences between arm and leg muscle are merely a result of different training status rather than a qualitative difference in limb substrate regulation. Along this line...... the review will address the available studies on low-intensity training performed separately with arm or legs or as whole-body training to evaluate if this leads to different adaptations in arm and leg muscle resulting in different substrate utilization patterns during separate arm or leg exercise...

Arm to leg coordination in elite butterfly swimmers.

Science.gov (United States)

Chollet, D; Seifert, L; Boulesteix, L; Carter, M

2006-04-01

This study proposed the use of four time gaps to assess arm-to-leg coordination in the butterfly stroke at increasing race paces. Fourteen elite male swimmers swam at four velocities corresponding to the appropriate paces for, respectively, the 400-m, 200-m, 100-m, and 50-m events. The different stroke phases of the arm and leg were identified by video analysis and then used to calculate four time gaps (T1: time gap between entry of the hands in the water and the high break-even point of the first undulation; T2: time gap between the beginning of the hands' backward movement and the low break-even point of the first undulation; T3: time gap between the hands' arrival in a vertical plane to the shoulders and the high break-even point of the second undulation; T4: time gap between the hands' release from the water and the low break-even point of the second undulation), the values of which described the changing relationship of arm to leg movements over an entire stroke cycle. With increases in pace, elite swimmers increased the stroke rate, the relative duration of the arm pull, the recovery and the first downward movement of the legs, and decreased the stroke length, the relative duration of the arm catch phase and the body glide with arms forward (measured by T2), until continuity in the propulsive actions was achieved. Whatever the paces, the T1, T3, and T4 values were close to zero and revealed a high degree of synchronisation at key motor points of the arm and leg actions. This new method to assess butterfly coordination could facilitate learning and coaching by situating the place of the leg undulation in relation with the arm stroke.

Musculo-Skeletal Abnormalities in Patients with Marfan Syndrome

Directory of Open Access Journals (Sweden)

Ali Al Kaissi

2013-01-01

Full Text Available Background A leptosomic body type is tall and thin with long hands. Marfanoid features may be familial in nature or pathological, as occurs in congenital contractual arachnodactyly (Beal's syndrome and Shprintzen-Goldberg syndrome mimicking some of the changes of Marfan syndrome, although not accompanied by luxation of lens and dissecting aneurysm of aorta. Methods In this article we collected eight patients who were consistent with the diagnosis of Marfan syndrome via phenotypic and genotypic characterization. Results Our patients manifested a constellation of variable presentations of musculo-skeletal abnormalities ranging from developmental dysplasia of the hip, protrusio acetabuli, leg length inequality, patellar instability, scoliosis, to early onset osteoarthritis. Each abnormality has been treated accordingly. Conclusion This is the first paper which includes the diagnosis and the management of the associated musculo-skeletal abnormalities in patients with Marfan syndrome, stressing that patients with Marfan syndrome are exhibiting great variability in the natural history and the severity of musculo-skeletal abnormalities.

Acute compartment syndrome caused by uncontrolled hypothyroidism.

Science.gov (United States)

Modi, Anar; Amin, Hari; Salzman, Matthew; Morgan, Farah

2017-06-01

Acute compartment syndrome is increased tissue pressure exceeding perfusion pressure in a closed compartment resulting in nerve and muscle ischemia. Common precipitating causes are crush injuries, burns, substance abuse, osseous or vascular limb trauma. This is a case of 42year old female with history of hypothyroidism who presented to emergency room with acute onset of severe pain and swelling in right lower extremity. Physical examination was concerning for acute compartment syndrome of right leg which was confirmed by demonstration of elevated compartmental pressures. No precipitating causes were readily identified. Further laboratory testing revealed uncontrolled hypothyroidism. Management included emergent fasciotomy and initiating thyroid hormone replacement. This case represents a rare association between acute compartment syndrome and uncontrolled hypothyroidism. We also discuss the pathogenesis of compartment syndrome in hypothyroid patients and emphasize the importance of evaluating for less common causes, particularly in setting of non-traumatic compartment syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

Adaptive leg coordination with a biologically inspired neurocontroller

Science.gov (United States)

Braught, Grant; Thomopoulos, Stelios C.

1996-10-01

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.

An ultrasound study of gestational and postural changes in the deep venous system of the leg in pregnancy.

Science.gov (United States)

Macklon, N S; Greer, I A; Bowman, A W

1997-02-01

To investigate gestational and postural changes in diameter and blood flow in the proximal deep leg veins during pregnancy. A longitudinal, prospective observational study. The ultrasound department of a teaching maternity hospital. Twenty-four healthy women with uncomplicated singleton pregnancies. Real-time and duplex Doppler ultrasound assessments of the vessel diameter, flow velocity and respiratory flow fluctuation in the proximal deep leg veins of women serially measured from the first trimester of pregnancy to six weeks postnatally. The effects of increasing gestation and the adoption of the left lateral position on the above parameters. An increase in vessel diameter and a fall in flow velocity with increasing gestation was observed. However, no change in venous flow variation was observed. Delivery had reverse effects. Flow velocity was slower in the left than right legs, but on adoption of the left lateral position an increase in flow velocity and venous flow variation was observed in both legs during pregnancy. These data are consistent with the observed increase in incidence and pattern of deep venous thrombosis in pregnancy and may aid interpretation of duplex Doppler ultrasound examinations for deep venous thrombosis in pregnancy. Postural changes should be part of this evaluation. The gravid uterus may not be the sole cause for postural changes in deep venous flow velocity.

Leg symptoms associated with sacroiliac joint disorder and related pain.

Science.gov (United States)

Murakami, Eiichi; Aizawa, Toshimi; Kurosawa, Daisuke; Noguchi, Kyoko

2017-06-01

The symptoms of sacroiliac joint (SIJ) disorders are usually detected in the buttock and groin, and occasionally referred to the thigh and leg. However, lumbar disorders also cause symptoms in these same body regions. The presence of a characteristic, symptomatic pattern in the legs would be useful for diagnosing SIJ disorders. This study aimed to identify specific leg symptoms in patients with SIJ pain originating from the posterior sacroiliac ligament and determine the rate of occurrence of these symptoms. The source population consisted of 365 consecutive patients from February 2005 to December 2007. One hundred patients were diagnosed with SIJ pain by a periarticular SIJ injection (42 males and 58 females, average age 46 years, age range, 18-75 years). A leg symptom map was made by subtracting the symptoms after a periarticular SIJ injection from the initial symptoms, and evaluating the rate of each individual symptom by area. Ninety-four patients reported pain at or around the posterior-superior iliac spine (PSIS). Leg symptoms comprised pain and a numbness/tingling sensation; ≥60% of the patients had these symptoms. Pain was mainly detected in the back, buttock, groin, and thigh areas, while numbness/tingling was mainly detected in the lateral to posterior thigh and back of the calf. Leg symptoms associated with SIJ pain originating from the posterior sacroiliac ligament include both pain and numbness, which do not usually correspond to the dermatome. These leg symptoms in addition to pain around the PSIS may indicate SIJ disorders. Copyright © 2017 Elsevier B.V. All rights reserved.

CALCANEAL MINERAL DENSITY IN CHILDREN ATHLETES AND TAKE-OFF LEG

Directory of Open Access Journals (Sweden)

Borislav Obradović

2010-06-01

Full Text Available It is well-known that physical activity has an anabolic effect on the bone tissue. To examine the influence of the take-off lower limb to the bone density we studied a group of prepubertal boys and girls at the initial phase of their peak bone mass acquisition. A sample consisted of 60 subjects ie., 32 soccer players (boys, 10.7±0.5 years old and 28 swimmers (15 girls and 13 boys, 10.8±0.8 years old, who had performed at least one year of high-level sport training (10-15 hours per week for soccer players, 8-12 hours per week for swimmers. The sample was divided into two groups: the first consisted of 40 subjects, with the left take-off leg, while the second consisted of 20 subjects, with the right take-off leg. The bone mineral density (BMD measurements of the left and the right calcaneus were performed using ultrasound densitometer “Sahara” (Hologic, Inc., MA, USA. There were no significant differences between the groups in regard to BUA and SOS of both the left and the right take-off lower legs. Mean BUA of the take-off left leg and the take-off right leg were different, but not significantly (p>0.05. Likewise, mean SOS of the take-off left leg and the take-off right leg were different, but it was not significant (p>0.05. The results do not indicate that the take-off lower limb has an influence on calcaneal bone mineral density.

Børns leg og eksperimenterende virksomhed

DEFF Research Database (Denmark)

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...

Dynamic Leg Exercise Improves Tolerance to Lower Body Negative Pressure

Science.gov (United States)

Watenpaugh, D. E.; Ballard, R. E.; Stout, M. S.; Murthy, G.; Whalen, R. T.; Hargens, A. R.

1994-01-01

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.

Six-legged walking robot for service operations

OpenAIRE

Ihme, T.; Schneider, A.; Schmucker, U.

1998-01-01

This paper presents the control system of a six-legged vehicle including force control. Considered control schemes are control of forces and control of body motion. The experimental result with a six-legged robot is presented.

Sirenomelia (symelia apus) with Potter's syndrome in connection with gestational diabetes mellitus: a case report and literature review.

Science.gov (United States)

Al-Haggar, M; Yahia, S; Abdel-Hadi, D; Grill, F; Al Kaissi, A

2010-12-01

We report one case of a fetus of sirenomelia sequence with Potters syndrome which showed oligohydramnios and symelia apus. The infant showed absent urinary tract and external genitalia, the legs were fused by skin and had separate bones associated with Potter's syndrome. The mother had a history of gestational diabetes mellitus.

A multicenter study on Leigh syndrome

DEFF Research Database (Denmark)

Sofou, Kalliopi; De Coo, Irenaeus F M; Isohanni, Pirjo

2014-01-01

BACKGROUND: Leigh syndrome is a progressive neurodegenerative disorder, associated with primary or secondary dysfunction of the mitochondrial oxidative phosphorylation. Despite the fact that Leigh syndrome is the most common phenotype of mitochondrial disorders in children, longitudinal natural...... history data is missing. This study was undertaken to assess the phenotypic and genotypic spectrum of patients with Leigh syndrome, characterise the clinical course and identify predictors of survival in a large cohort of patients. METHODS: This is a retrospective study of patients with Leigh syndrome...... to thrive, brainstem lesions on neuroimaging and intensive care treatment were significantly associated with poorer survival. CONCLUSIONS: This is a multicenter study performed in a large cohort of patients with Leigh syndrome. Our data help define the natural history of Leigh syndrome and identify novel...

Operation analysis of a Chebyshev-Pantograph leg mechanism for a single DOF biped robot

Science.gov (United States)

Liang, Conghui; Ceccarelli, Marco; Takeda, Yukio

2012-12-01

In this paper, operation analysis of a Chebyshev-Pantograph leg mechanism is presented for a single degree of freedom (DOF) biped robot. The proposed leg mechanism is composed of a Chebyshev four-bar linkage and a pantograph mechanism. In contrast to general fully actuated anthropomorphic leg mechanisms, the proposed leg mechanism has peculiar features like compactness, low-cost, and easy-operation. Kinematic equations of the proposed leg mechanism are formulated for a computer oriented simulation. Simulation results show the operation performance of the proposed leg mechanism with suitable characteristics. A parametric study has been carried out to evaluate the operation performance as function of design parameters. A prototype of a single DOF biped robot equipped with two proposed leg mechanisms has been built at LARM (Laboratory of Robotics and Mechatronics). Experimental test shows practical feasible walking ability of the prototype, as well as drawbacks are discussed for the mechanical design.

Improving venous leg ulcer management

OpenAIRE

Weller, Carolina Dragica

2017-01-01

This thesis reports several different methods to develop and evaluate complex interventions designed to improve venous leg ulcer management. Chronic venous leg ulcers (VLU) are the most common chronic wound problem in the community. Its health and economic burden is predicted to increase due to ageing of the community and increase in prevalence of diabetes and obesity. Although many patients seek health care for VLU, most do not receive the most effective management. Patients with this condi...

Assessing Children's Legs and Feet

OpenAIRE

Wedge, John H.

1985-01-01

Shoes are necessary for protection and warmth. Normal children do not require shoes for support. There is no scientific evidence that shoes—‘orthopedic’ or otherwise—influence or alter the growth or shape of the normal child's foot except, perhaps, adversely if they fit poorly. Family physicians must understand common variations of normal foot and leg development if they are to effectively advise and reassure parents about appropriate footwear. Flat feet, knock knees, bow legs, in-toeing, and...

Cauda Equina Syndrome Secondary to Leptomeningeal Carcinomatosis of Gastroesophageal Junction Cancer

Directory of Open Access Journals (Sweden)

Amal Alkhotani

2016-04-01

Full Text Available Leptomeningeal carcinomatosis (LMC is a diffuse or multifocal malignant infiltration of the pia matter and arachnoid membrane. The most commonly reported cancers associated with LMC are breast, lung, and hematological malignancies. Patients with LMC commonly present with multifocal neurological symptoms. We report a case of LMC secondary to gastroesophageal junction cancer present initially with cauda equina syndrome. A 51-year-old male patient with treated adenocarcinoma of the gastroesophageal junction presented with left leg pain, mild weakness, and saddle area numbness. Initial radiological examinations were unremarkable. Subsequently, he had worsening of his leg weakness, fecal incontinence, and urine retention. Two days later, he developed rapidly progressive cranial neuropathies including facial diplegia, sensorineural hearing loss, dysarthria, and dysphagia. MRI with and without contrast showed diffuse enhancement of leptomeninges surrounding the brain, spinal cord, and cauda equina extending to the nerve roots. Cerebrospinal fluid cytology was positive for malignant cells. The patient died within 10 days from the second presentation. In cancer patients with cauda equina syndrome and absence of structural lesion on imaging, LMC should be considered. To our knowledge, this is the first case of LMC secondary to gastroesophageal cancer presenting with cauda equina syndrome.

Promethus Hot Leg Piping Concept

International Nuclear Information System (INIS)

AM Girbik; PA Dilorenzo

2006-01-01

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

Component level study of an actively lubricated LEG Tilting Pad Bearing: Theory and experiment

DEFF Research Database (Denmark)

Cerda Varela, Alejandro Javier; Santos, Ilmar Ferreira

2018-01-01

portrays the first experimental study for the“proof of concept” of this configuration, as well as a comparison with theoretical results. A simplified setup, featuring a rigid rotor supported by a single pad arrangement is the subject of study. The obtained results prove the viability of the proposed active...... bearing design, validate the available simulation tool and exemplify on a conceptual level the operational benefits from introducing this technology into standard LEG Tilting Pad Bearings....

Bilateral calf chronic compartment syndrome in an elderly male: a case report.

LENUS (Irish Health Repository)

Siau, Keith

2009-01-01

Leg pain is a common presentation to the outpatient department. Bilateral calf chronic compartment syndrome is a rare cause of bilateral calf pain. Although this condition has been well documented in young athletes, it has rarely been reported in the elderly. We present the case of a 68-year-old male bodybuilder with bilateral calf chronic compartment syndrome, describe the presentation and evaluation of the condition, and provide a review of the literature herewith.

The bothersomeness of sciatica: patients' self-report of paresthesia, weakness and leg pain.

Science.gov (United States)

Grøvle, Lars; Haugen, Anne Julsrud; Keller, Anne; Natvig, Bård; Brox, Jens Ivar; Grotle, Margreth

2010-02-01

The objective of the study was to investigate how patients with sciatica due to disc herniation rate the bothersomeness of paresthesia and weakness as compared to leg pain, and how these symptoms are associated with socio-demographic and clinical characteristics. A cross-sectional study was conducted on 411 patients with clinical signs of radiculopathy. Items from the Sciatica Bothersomeness Index (0 = none to 6 = extremely) were used to establish values for paresthesia, weakness and leg pain. Associations with socio-demographic and clinical variables were analyzed by multiple linear regression. Mean scores (SD) were 4.5 (1.5) for leg pain, 3.4 (1.8) for paresthesia and 2.6 (2.0) for weakness. Women reported higher levels of bothersomeness for all three symptoms with mean scores approximately 10% higher than men. In the multivariate models, more severe symptoms were associated with lower physical function and higher emotional distress. Muscular paresis explained 19% of the variability in self-reported weakness, sensory findings explained 10% of the variability in paresthesia, and straight leg raising test explained 9% of the variability in leg pain. In addition to leg pain, paresthesia and weakness should be assessed when measuring symptom severity in sciatica.

Spectral Doppler findings in a rare case of acute compartment syndrome following leg burn

Directory of Open Access Journals (Sweden)

Omer A. Mahmoud

2018-04-01

Full Text Available Acute compartment syndrome (ACS is an orthopedic emergency condition, which is rarely attributed to burns. It occurs when pressure in an enclosed space rises to a point where it reduces blood flow and impairs tissue perfusion. Its consequences often lead to ischemia and possible necrosis within that space. Until now, the use of Doppler assessment to explore different types of compartment syndrome has yielded contradictory findings. Here, we present a significant increase of blood flow velocity in the arteries proximal to the burned area. Thus, the combination of Duplex ultrasound results with clinical findings will help vascular surgeons to make immediate decision to perform fasciotomy. Keywords: Compartment syndrome, Spectral Doppler

Protection against high intravascular pressure in giraffe legs

DEFF Research Database (Denmark)

Petersen, Karin K; Hørlyck, Arne; Østergaard, Kristine Hovkjær

2013-01-01

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....... All three findings can contribute to protection of the capillaries in giraffe legs from a high arterial pressure....... 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...

Skipping on uneven ground: trailing leg adjustments simplify control and enhance robustness.

Science.gov (United States)

Müller, Roy; Andrada, Emanuel

2018-01-01

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.

Cold leg condensation tests. Task C. Steam--water interaction tests

International Nuclear Information System (INIS)

Brodrick, J.R.; Loiselle, V.

1974-03-01

A report is presented of tests to determine the condensation efficiency of ECC water injected into a quality fluid mixture flowing through the cold leg. In particular, a specific objective was to determine if the mixture of ECC water and quality fluid reached thermodynamic equilibrium before exiting the cold leg. Further, the stability of the ECC water/quality fluid interaction would be assessed by interpretation of thermocouple records and utilization of a section of cold leg piping with view ports to film the interaction whenever possible. The cold leg condensation tests showed complete condensation of the 5 lbm/sec steam quality mixtures in the cold leg by the ECC water flows of the test matrix. The cold leg exit fluid temperature remained below the saturation temperature and had good agreement with the predicted cold leg outlet temperature, calculated assuming total condensation. (U.S.)

Parental smoking during pregnancy shortens offspring's legs.

Science.gov (United States)

Żądzińska, E; Kozieł, S; Borowska-Strugińska, B; Rosset, I; Sitek, A; Lorkiewicz, W

2016-12-01

One of the most severe detrimental environmental factors acting during pregnancy is foetal smoke exposure. The aim of this study was to assess the effect of maternal, paternal and parental smoking during pregnancy on relative leg length in 7- to 10-year-old children. The research conducted in the years 2001-2002 included 978 term-born children, 348 boys and 630 girls, at the age of 7-10 years. Information concerning the birth weight of a child was obtained from the health records of the women. Information about the mother's and the father's smoking habits during pregnancy and about the mothers' education level was obtained from a questionnaire. The influence of parental smoking on relative leg length, controlled for age, sex, birth weight and the mother's education, as a proxy measure of socioeconomic status, and controlled for an interaction between sex and birth weight, was assessed by an analysis of covariance, where relative leg length was the dependent variable, smoking and sex were the independent variables, and birth weight as well as the mother's education were the covariates. Three separate analyses were run for the three models of smoking habits during pregnancy: the mother's smoking, the father's smoking and both parents' smoking. Only both parents' smoking showed a significant effect on relative leg length of offspring. It is probable that foetal hypoxia caused by carbon monoxide contained in smoke decelerated the growth of the long bones of foetuses. Copyright © 2016 Elsevier GmbH. All rights reserved.

Leg length, skull circumference, and the incidence of dementia in Latin America and China: A 10/66 population-based cohort study.

Science.gov (United States)

Prince, Martin J; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Jimenez-Velazquez, Ivonne Z; Llibre Rodriguez, Juan J; Salas, Aquiles; Sosa, Ana Luisa; Dewey, Michael E; Guerchet, Maelenn M; Liu, Zhaorui; Llibre Guerra, Jorge J; Prina, A Matthew

2018-01-01

Adult leg length is influenced by nutrition in the first few years of life. Adult head circumference is an indicator of brain growth. Cross-sectional studies indicate inverse associations with dementia risk, but there have been few prospective studies. Population-based cohort studies in urban sites in Cuba, Dominican Republic Puerto Rico and Venezuela, and rural and urban sites in Peru, Mexico and China. Sociodemographic and risk factor questionnaires were administered to all participants, and anthropometric measures taken, with ascertainment of incident dementia, and mortality, three to five years later. Of the original at risk cohort of 13,587 persons aged 65 years and over, 2,443 (18.0%) were lost to follow-up; 10,540 persons with skull circumference assessments were followed up for 40,466 person years, and 10,400 with leg length assessments were followed up for 39,954 person years. There were 1,009 cases of incident dementia, and 1,605 dementia free deaths. The fixed effect pooled meta-analysed adjusted subhazard ratio (ASHR) for leg length (highest vs. lowest quarter) was 0.80 (95% CI, 0.66-0.97) and for skull circumference was 1.02 (95% CI, 0.84-1.25), with no heterogeneity of effect between sites (I2 = 0%). Leg length measurements tended to be shorter at follow-up, particularly for those with baseline cognitive impairment and dementia. However, leg length change was not associated with dementia incidence (ASHR, per cm 1.006, 95% CI 0.992-1.020), and the effect of leg length was little altered after adjusting for baseline frailty (ASHR 0.82, 95% CI 0.67-0.99). A priori hypotheses regarding effect modification by gender or educational level were not supported. However, the effect of skull circumference was modified by gender (M vs F ASHR 0.86, 95% CI 0.75-0.98), but in the opposite direction to that hypothesized with a greater protective effect of larger skull dimensions in men. Consistent findings across settings provide quite strong support for an

A Case of Devic’s Syndrome Presenting with Tonic Spasm: Response to Levetiracetam Treatment

Directory of Open Access Journals (Sweden)

Alev Leventoğlu

2011-03-01

Full Text Available Neuromyelitis optica or Devic’s syndrome is a rare autoimmune disorder which is characterized by inflammatory demyelination of the optic nerves and the spinal cord. Clinically, it causes visual loss in one or both eyes, and numbness or paralysis of the arms and legs. Although tonic spasm is the most frequent movement disorder occuring in MS, it has not been definetely described clinical entity for Devic’s syndrome. We hereby describe a case of Devic’s syndrome with tonic spasms treated with levetiracetam as a new approach and discussed the results of the treatment. A 52-year-old woman with Devic’s syndrome with the complaint of painful tonic spasms primarily affecting the abdomen was given levetiracetam therapy. Levetiracetam therapy resulted in a good response in our patient. Levetiracetam can be a new choice for the treatment of painful tonic spasm with Devic’s syndrome. However, more detailed studies are necessary to investigate efficacy of levetiracetam.

Cervical cord compression presenting with sciatica-like leg pain

OpenAIRE

Chan, Chee Keong; Lee, Ho-Yeon; Choi, Won-Chul; Cho, Ji Young; Lee, Sang-Ho

2010-01-01

Sciatica-like leg pain can be the main presenting symptom in patients with cervical cord compression. It is a false localizing presentation, which may lead to missed or delayed diagnosis, resulting in the wrong plan of management, especially in the presence of concurrent lumbar lesions. Medical history, physical findings and the results of imaging studies were reviewed in two cases of cervical cord compressions, which presented with sciatica-like leg pain. There was multi-level cervical spond...

[Surgical treatment of acute deep leg and pelvic vein trombosis].

Science.gov (United States)

Gall, F; Husfeldt, K J

1977-08-25

In the last 3 years 93 cases of iliofermoral trombosis were treated by surgery. We prefer the method used by Brunner, but under general anaesthesia and using a Bentley-Autotransfusion-System (ATS). The average age of our patients was 55 years (age ranged between 17 and 87 years). No lethal pulmonary embolism was observed. 2, 1 percent of the patients died following apoplex or acute heart failure. Of 67 patients who were operated on 6 months ago or more 70 percent have no further complaints, 28 percent still have some residual edema and only 2 patients have a severe postthrombotic syndrome. 50 percent of 40 control-phlebograms demonstrated patency of all veins. 20 percent had short segmentary occlusions with definite signs of recanalisation, while in 27 percent of the cases occlusions of the lower leg and thigh were found, the iliac veins being free. Only 2 postoperative phlebograms showed a complete iliofemoral venous occlusion. Our results prove, that the operative thrombectomy is a successful method, with which the main complications of the iliofemoral thrombosis-pulmonary embolisation and postthrombotic syndrome-can difinitely be reduced. Also because of better long term results, the operative therapy of acute ilofemoral thrombosis should be generally prefered instead of conservative treatment.

[Anatomical study and clinical application of a leg flap pedicle-included with cutaneous nerve and its concomitant vessels].

Science.gov (United States)

Liu, B; Hao, X; Goan, M

2000-05-01

To investigate the blood supply patterns and the clinical liability of a leg flap pedicle-included with cutaneous nerve and its concomitant vessels. Fresh cadaver legs with thirty-two in infants and two in adults were anatomically examined after the intravenous injection of the red Chlorinated Poly Vingl Choride (CPVC). Five patients with the soft tissue defects were selected for the treatment with the flap pedicle-included with the cutaneous nerve and its concomitant vessels. Four main cutaneous nerves were found in the leg after they perforated the deep fascia out. They were companioned with their concomitant vessels with different blood-supply pateeerns, which the upper part of the leg was in an axial pattern and the lower part was in a "chain-type anastomosing" pattern. Following the above-mentioned findings, five cases were successfully treated with this led flap. The leg flap should be designed along the cutaneous nerve and its concomitant vessels. When the flap is applied in the area of blood supply with "chain-type anastomosing" pattern, the deep fascia should also be included in the flap.

Theoretical study of hydraulic jump during circular horizontal hot leg injection in pressurized water reactor

International Nuclear Information System (INIS)

El Hawary, Shehab; Abu-Elyazeed, Osayed S.M.; Fahmy, Adel Alyan; Meglaa, Khairy

2016-01-01

Highlights: • The model is developed to predict the occurrence of onset hydraulic jump in a circular pipe. • Theoretical results are in agreement with experimental results and theory. • Effects of diameter of the injection pipe, Froude number and injected coolant mass are studied. - Abstract: One important phenomenon occurring during Loss of Coolant Accident (LOCA) is Counter-Current Flow Limitation (CCFL). The incidence of such CCFL is introduced by the onset of hydraulic jump. In the present work, a one dimensional model was modified to fit circular hot channel. The model was used to study the factors affecting the initial Froude number, the location of the occurrence of the hydraulic jump, and the critical coolant flow depth during circular horizontal hot leg injection in US-APWR Mitsubishi Reactor. The results showed good agreement with published experimental data of the Upper Plenum Test Facility (UPTF) at Mannheim, Germany. It was found that higher injected coolant mass flow rate increases the initial Froude number, the location of the occurrence of the hydraulic jump, and the critical injection depth divided by the diameter of the injection pipe. Such behavior is thought to be due to the increase of the inertia force by increasing of the injected coolant mass flow rate and the inverse of the diameter of the injection pipe. It was found also that, the location of the occurrence of hydraulic jump increases with decreasing load effect. Therefore, these results reveal that the avoidance of CCFL as well as hydraulic jump through hot leg at maximum load can be achieved by decreasing the distance between the injection point and the pressure vessel to below 0.3 m, and with diameter of 4 in (10.16 cm) as the design diameter of the injection pipe in US-APWR Mitsubishi Reactor. Moreover, the maximum critical depth (56 cm) is less than the diameter of the hot leg (78.74 cm) at an injected coolant mass flow of 400 kg/s, and with diameter of 4 in (10.16 cm) as the

One-leg balance is an important predictor of injurious falls in older persons.

Science.gov (United States)

Vellas, B J; Wayne, S J; Romero, L; Baumgartner, R N; Rubenstein, L Z; Garry, P J

1997-06-01

To test the hypothesis that one-leg balance is a significant predictor of falls and injurious falls. Analysis of data from a longitudinal cohort study. Healthy, community-living volunteers older than age 60 enrolled in the Albuquerque Falls Study and followed for 3 years (N = 316; mean age 73 years). Falls and injurious falls detected via reports every other month. Baseline measures of demographics, history, physical examination, Iowa Self Assessment Inventory, balance and gait assessment, and one-leg balance (ability to stand unassisted for 5 seconds on one leg). At baseline, 84.5% of subjects could perform one-leg balance. (Impairment was associated with older age and gait abnormalities.) Over the 3-year follow-up, 71% experienced a fall and 22% an injurious fall. The only independent significant predictor of all falls using logistic regression was age greater than 73. However, impaired one-leg balance was the only significant independent predictor of injurious falls (relative risk: 2.13; 95% CI: 1.04, 4.34; P = .03). One-leg balance appears to be a significant and easy-to-administer predictor of injurious falls, but not of all falls. In our study, it was the strongest individual predictor. However, no single factor seems to be accurate enough to be relied on as a sole predictor of fall risk or fall injury risk because so many diverse factors are involved in falling.

Dynamic legged locomotion in robots and animals

Science.gov (United States)

Raibert, Marc; Playter, Robert; Ringrose, Robert; Bailey, Dave; Leeser, Karl

1995-01-01

This report documents our study of active legged systems that balance actively and move dynamically. The purpose of this research is to build a foundation of knowledge that can lead both to the construction of useful legged vehicles and to a better understanding of how animal locomotion works. In this report we provide an update on progress during the past year. Here are the topics covered in this report: (1) Is cockroach locomotion dynamic? To address this question we created three models of cockroaches, each abstracted at a different level. We provided each model with a control system and computer simulation. One set of results suggests that 'Groucho Running,' a type of dynamic walking, seems feasible at cockroach scale. (2) How do bipeds shift weight between the legs? We built a simple planar biped robot specifically to explore this question. It shifts its weight from one curved foot to the other, using a toe-off and toe-on strategy, in conjunction with dynamic tipping. (3) 3D biped gymnastics: The 3D biped robot has done front somersaults in the laboratory. The robot changes its leg length in flight to control rotation rate. This in turn provides a mechanism for controlling the landing attitude of the robot once airborne. (4) Passively stabilized layout somersault: We have found that the passive structure of a gymnast, the configuration of masses and compliances, can stabilize inherently unstable maneuvers. This means that body biomechanics could play a larger role in controlling behavior than is generally thought. We used a physical 'doll' model and computer simulation to illustrate the point. (5) Twisting: Some gymnastic maneuvers require twisting. We are studying how to couple the biomechanics of the system to its control to produce efficient, stable twisting maneuvers.

Bioinspired legged-robot based on large deformation of flexible skeleton

International Nuclear Information System (INIS)

Mayyas, Mohammad

2014-01-01

In this article we present STARbot, a bioinspired legged robot capable of multiple locomotion modalities by using large deformation of its skeleton. We construct STARbot by using origami-style folding of flexible laminates. The long-term goal is to provide a robotic platform with maximum mobility on multiple surfaces. This paper particularly studies the quasistatic model of STARbot’s leg under different conditions. We describe the large elastic deformation of a leg under external force, payload, and friction by using a set of non-dimensional, nonlinear approximate equations. We developed a test mechanism that models the motion of a leg in STARbot. We augmented several foot shapes and then tested them on soft to rough grounds. Both simulation and experimental findings were in good agreement. We utilized the model to develop several scales of tri and quad STARbot. We demonstrated the capability of these robots to locomote by combining their leg deformations with their foot motions. The combination provided a design platform for an active suspension STARbot with controlled foot locomotion. This included the ability of STARbot to change size, run over obstacles, walk and slide. Furthermore, in this paper we discuss a cost effective manufacturing and production method for manufacturing STARbot. (paper)

Bioinspired legged-robot based on large deformation of flexible skeleton.

Science.gov (United States)

Mayyas, Mohammad

2014-11-11

In this article we present STARbot, a bioinspired legged robot capable of multiple locomotion modalities by using large deformation of its skeleton. We construct STARbot by using origami-style folding of flexible laminates. The long-term goal is to provide a robotic platform with maximum mobility on multiple surfaces. This paper particularly studies the quasistatic model of STARbot's leg under different conditions. We describe the large elastic deformation of a leg under external force, payload, and friction by using a set of non-dimensional, nonlinear approximate equations. We developed a test mechanism that models the motion of a leg in STARbot. We augmented several foot shapes and then tested them on soft to rough grounds. Both simulation and experimental findings were in good agreement. We utilized the model to develop several scales of tri and quad STARbot. We demonstrated the capability of these robots to locomote by combining their leg deformations with their foot motions. The combination provided a design platform for an active suspension STARbot with controlled foot locomotion. This included the ability of STARbot to change size, run over obstacles, walk and slide. Furthermore, in this paper we discuss a cost effective manufacturing and production method for manufacturing STARbot.

Stiff-Person Syndrome and Graves’ Disease

Directory of Open Access Journals (Sweden)

Lais Moreira Medeiros MD

2016-12-01

Full Text Available A 9-year-old female child presented with a history of falls, weight loss, diffuse leg pain, and progressive gait disorder, following 1 previous event described as a tonic–clonic seizure. She had increased thyroid volume, brisk symmetric reflexes, abnormal gait, and painful spasms of the paraspinal musculature. Thyroid function tests indicated biochemical hyperthyroidism, and thyrotropin receptor antibodies were positive. Her electromyography showed continuous activation of normal motor units of the paraspinal and proximal lower extremity muscles. The patient had a diagnosis of Graves’ disease with associated stiff-person syndrome, with elevated anti–glutamic acid decarboxylase antibody levels. After intravenous immunoglobulin therapy, her ambulation was substantially improved and the symptoms of stiff-person syndrome decreased dramatically.

Clinical quality indicators of venous leg ulcers

DEFF Research Database (Denmark)

Kjaer, Monica L; Mainz, Jan; Soernsen, Lars T

2005-01-01

In the clinical setting, diagnosis and treatment of venous leg ulcers can vary considerably from patient to patient. The first step to reducing this variation is to document venous leg ulcer care through use of quantitative scientific documentation principles. This requires the development of val...

A tracked robot with novel bio-inspired passive "legs".

Science.gov (United States)

Sun, Bo; Jing, Xingjian

2017-01-01

For track-based robots, an important aspect is the suppression design, which determines the trafficability and comfort of the whole system. The trafficability limits the robot's working capability, and the riding comfort limits the robot's working effectiveness, especially with some sensitive instruments mounted on or operated. To these aims, a track-based robot equipped with a novel passive bio-inspired suspension is designed and studied systematically in this paper. Animal or insects have very special leg or limb structures which are good for motion control and adaptable to different environments. Inspired by this, a new track-based robot is designed with novel "legs" for connecting the loading wheels to the robot body. Each leg is designed with passive structures and can achieve very high loading capacity but low dynamic stiffness such that the robot can move on rough ground similar to a multi-leg animal or insect. Therefore, the trafficability and riding comfort can be significantly improved without losing loading capacity. The new track-based robot can be well applied to various engineering tasks for providing a stable moving platform of high mobility, better trafficability and excellent loading capacity.

Military boot attenuates axial loading to the lower leg.

Science.gov (United States)

Yoganandan, Narayan; Schlick, Michael; Arun, Mike W J; Pintar, Frank A

2014-01-01

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.

MR angiography of the pelvic and lower leg arteries: starting with time-resolved imaging of the lower leg is recommended

International Nuclear Information System (INIS)

Schmitt, R.; Christopoulos, G.; Brunner, S.; Froehner, S.; Dobritz, M.; Fellner, F.

2001-01-01

58 patients suffering from peripheral arterial vascular disease were examined using contrast-enhanced MR angiography with the intention of optimizing the visualization of lower leg arteries. Different from the customary acquisition order, were first the arteries of the lower legs depicted with three time-resolved phases. Afterwards, the iliacal and femoral vessels were imaged by applying the floating-table technique in two steps. In all cases, the lower leg arteries were depicted without overlying veins. By injecting the contrast agent in two phases, imaging quality of the iliofemoral arteries was not significantly reduced. - In conclusion, we would recommend the hybrid technique of peripheral contrast-enhanced MRA with primarily starting the acquisition of the lower legs in cases of foot infections or ulcerations where the transit time is reduced bi- or unilaterally. (orig.) [de

Comparison between Unilateral and Bilateral Plyometric Training on Single and Double Leg Jumping Performance and Strength.

Science.gov (United States)

Bogdanis, Gregory C; Tsoukos, Athanasios; Kaloheri, Olga; Terzis, Gerasimos; Veligekas, Panagiotis; Brown, Lee E

2017-04-18

This study compared the effects of unilateral and bilateral plyometric training on single and double-leg jumping performance, maximal strength and rate of force development (RFD). Fifteen moderately trained subjects were randomly assigned to either a unilateral (U, n=7) or bilateral group (B, n=8). Both groups performed maximal effort plyometric leg exercises two times per week for 6 weeks. The B group performed all exercises with both legs, while the U group performed half the repetitions with each leg, so that total exercise volume was the same. Jumping performance was assessed by countermovement jumps (CMJ) and drop jumps (DJ), while maximal isometric leg press strength and RFD were measured before and after training for each leg separately and both legs together. CMJ improvement with both legs was not significantly different between U (12.1±7.2%) and B (11.0±5.5%) groups. However, the sum of right and left leg CMJ only improved in the U group (19.0±7.1%, pplyometric training was more effective at increasing both single and double-leg jumping performance, isometric leg press maximal force and RFD when compared to bilateral training.

The bothersomeness of sciatica: patients’ self-report of paresthesia, weakness and leg pain

Science.gov (United States)

Haugen, Anne Julsrud; Keller, Anne; Natvig, Bård; Brox, Jens Ivar; Grotle, Margreth

2009-01-01

The objective of the study was to investigate how patients with sciatica due to disc herniation rate the bothersomeness of paresthesia and weakness as compared to leg pain, and how these symptoms are associated with socio-demographic and clinical characteristics. A cross-sectional study was conducted on 411 patients with clinical signs of radiculopathy. Items from the Sciatica Bothersomeness Index (0 = none to 6 = extremely) were used to establish values for paresthesia, weakness and leg pain. Associations with socio-demographic and clinical variables were analyzed by multiple linear regression. Mean scores (SD) were 4.5 (1.5) for leg pain, 3.4 (1.8) for paresthesia and 2.6 (2.0) for weakness. Women reported higher levels of bothersomeness for all three symptoms with mean scores approximately 10% higher than men. In the multivariate models, more severe symptoms were associated with lower physical function and higher emotional distress. Muscular paresis explained 19% of the variability in self-reported weakness, sensory findings explained 10% of the variability in paresthesia, and straight leg raising test explained 9% of the variability in leg pain. In addition to leg pain, paresthesia and weakness should be assessed when measuring symptom severity in sciatica. PMID:19488793

Bowel-associated dermatosis-arthritis syndrome in an adolescent with short bowel syndrome.

Science.gov (United States)

Pereira, Ester; Estanqueiro, Paula; Almeida, Susana; Ferreira, Ricardo; Tellechea, Oscar; Salgado, Manuel

2014-09-01

Bowel-associated dermatosis-arthritis syndrome (BADAS) is a neutrophilic dermatosis, characterized by the occurrence of arthritis and skin lesions related to bowel disease with or without bowel bypass. We report an unusual case of BADAS in a 15-year-old white male with congenital aganglionosis of the colon and hypoganglionosis of the small intestine and multiple bowel surgeries in childhood complicated by short bowel syndrome. He presented with recurrent peripheral polyarthritis, tenosynovitis, and painful erythematous subcutaneous nodules located on the dorsolateral regions of the legs and on the dorsa of the feet. Histological examination disclosed a neutrophilic dermatosis confirming the diagnosis of BADAS.Although an uncommon disease, especially at pediatric age, it is important to evoke the diagnosis of BADAS in children and adolescents with bowel disease, because treatment options and prognosis are distinct from other rheumatologic conditions.

Effectiveness of an Internet-based learning program on venous leg ulcer nursing care in home health care--study protocol.

Science.gov (United States)

Ylönen, Minna; Viljamaa, Jaakko; Isoaho, Hannu; Junttila, Kristiina; Leino-Kilpi, Helena; Suhonen, Riitta

2015-10-01

To describe the study protocol for a study of the effectiveness of an internet-based learning program on venous leg ulcer nursing care (eVLU) in home health care. The prevalence of venous leg ulcers is increasing as population age. The majority of these patients are treated in a municipal home healthcare setting. However, studies show nurses' lack of knowledge of ulcer nursing care. Quasi-experimental study with pre- and postmeasurements and non-equivalent intervention and comparison groups. During the study, nurses taking care of patients with a chronic leg ulcer in home health care in one Finnish municipality will use the eVLU. Nurses working in home health care in another Finnish municipality will not use it providing standard care. Nurses will complete three questionnaires during the study and they will also be observed three times at patients' homes. Nurses' perceived and theoretical knowledge is the primary outcome of the study. Funding for this study was received from the Finnish Foundation for Nursing Education in 2014. Data from this study will provide information about the effectiveness of an internet-based educational program. After completing the program nurses will be accustomed to using internet-based resources that can aid them in the nursing care of patients with a VLU. Nurses will also have better knowledge of VLU nursing care. This study is registered with the International Clinical Trials Registry, identifier NCT02224300. © 2015 John Wiley & Sons Ltd.

Etiologic factors in the development of medial tibial stress syndrome: a review of the literature.

Science.gov (United States)

Tweed, Jo L; Avil, Steven J; Campbell, Jackie A; Barnes, Mike R

2008-01-01

Medial tibial stress syndrome is a type of exercise-induced leg pain that is common in recreational and competitive athletes. Although various studies have attempted to find the exact pathogenesis of this common condition, it remains unknown. Various theories in literature from 1976 to 2006 were reviewed using key words. Until recently, inflammation of the periosteum due to excessive traction was thought to be the most likely cause of medial tibial stress syndrome. This periostitis has been hypothesized by some authors to be caused by the tearing away of the muscle fibers at the muscle-bone interface, although there are several suggestions as to which, if any, muscle is responsible. Recent studies have supported the view that medial tibial stress syndrome is not an inflammatory process of the periosteum but instead a stress reaction of bone that has become painful.

Effects of leg dominance on performance of ballet turns (pirouettes) by experienced and novice dancers.

Science.gov (United States)

Lin, Chia-Wei; Su, Fong-Chin; Wu, Hong-Wen; Lin, Cheng-Feng

2013-01-01

Turns (pirouettes) are an important movement in ballet and may be affected by "lateral bias". This study investigated physiological differences exhibited by experienced and novice dancers, respectively, when performing pirouette with dominant and non-dominant leg supports, respectively. Thirteen novice and 13 experienced dancers performed turns on dominant or non-dominant legs. The maximum ankle plantarflexion, knee extension and hip extension were measured during the single-leg support phase. The inclination angle of rotation axis is the angle between instantaneous rotation axis and global vertical axis in the early single-leg support phase. Both groups exhibited a greater hip extension, knee extension, and ankle plantarflexion when performing a turn on the non-dominant leg. For experienced dancers, the inclination angle of rotation axis during the pre-swing phase was generally smaller for dominant leg support than non-dominant leg. However, no significant difference was found in inclination angle of rotation axis of novice dancers. For experienced dancers, an improved performance is obtained when using the dominant leg for support. By contrast, for novice dancers, the performance is independent of choice of support leg. The significant lateral bias in experienced dancers indicates the possible influence of training. That is, repetitive rehearsal on the preferred leg strengthens the impact of side dominance in experienced dancers.

Diagnosis and management of piriformis syndrome: a rare anatomic variant analyzed by magnetic resonance imaging

Directory of Open Access Journals (Sweden)

Tae Hoon Ro

2018-01-01

Full Text Available Piriformis syndrome is an uncommon condition that causes significant pain in the posterior lower buttocks and leg due to entrapment of the sciatic nerve at the level of the piriformis muscle. In the typical anatomical presentation, the sciatic nerve exits directly ventral and inferior to the piriformis muscle and continues down the posterior leg. Several causes that have been linked to this condition include trauma, differences in leg length, hip arthroplasty, inflammation, neoplastic mass effect, and anatomic variations. A female presented with left-sided lower back and buttock pain with radiation down the posterior leg. After magnetic resonance imaging was performed, an uncommon sciatic anatomical form was identified. Although research is limited, surgical intervention shows promising results for these conditions. Accurate diagnosis and imaging modalities may help in the appropriate management of these patients.

Transcranial direct current stimulation on primary sensorimotor area has no effect in patients with drug-naïve restless legs syndrome: a proof-of-concept clinical trial.

Science.gov (United States)

Koo, Yong Seo; Kim, Sung Min; Lee, Chany; Lee, Byeong Uk; Moon, Ye Ji; Cho, Yong Won; Im, Chang-Hwan; Choi, Jeong Woo; Kim, Kyung Hwan; Jung, Ki-Young

2015-02-01

To evaluate the efficacy of transcranial direct current stimulation (tDCS) in people with drug-naïve restless legs syndrome (RLS). A two-week, double-blind, randomized, sham-controlled trial was performed. Thirty-three females with RLS were recruited. Participants received five sessions of tDCS using cathodal, anodal or sham stimulation. They were assessed at baseline (T0), three days (T1) and 13 days (T2) after the end of tDCS. Primary outcomes included the International RLS Group Rating Scale (IRLS) and the Clinical Global Impressions-Improvement (CGI-I). Secondary outcomes included the Patient Global Impression scale, the Pittsburgh Sleep Quality Index, the Medical Outcome Study sleep subscales, and the Beck Depression Inventory. Objective neurophysiological changes were assessed using event-related desynchronization/synchronization (ERD/ERS) of electroencephalography. The changes in the IRLS scores, as well as the responder rate in the CGI-I scale, did not differ significantly among the groups. There was also no significant difference in any of the secondary outcome measures and ERD/ERS among the groups. Transcranial direct current stimulation with electrodes on the sensorimotor areas showed no significant effect in people with drug-naïve RLS. Copyright © 2014 Elsevier B.V. All rights reserved.

Pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis

DEFF Research Database (Denmark)

Kierkegaard, Signe; Jørgensen, Peter Bo; Dalgas, Ulrik

2015-01-01

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...... patients (mean age 65.6 years) scheduled for medial uni-compartmental knee arthroplasty, and 29 age and gender matched controls were included in this cross-sectional study. Leg extension power was tested with the Nottingham Leg Extension Power-Rig. Pelvic range of motion was derived from an inertia......-based measurement unit placed over the sacrum bone during walking, stair climbing and stepping. RESULTS: Patients had lower leg extension power than controls (20-39 %, P

Effects of combined high intensity arm and leg training on performance and cardio-respiratory measures.

Science.gov (United States)

Zinner, Christoph; Sperlich, Billy; Born, Dennis-Peter; Michels, Guido

2017-01-01

The purpose of this study was to investigate the effects of combined arm and leg high-intensity low-volume interval training (HIITarm+leg) on maximal oxygen uptake, myocardial measures (i.e. stroke volume, cardiac output, ejection fraction), Tissue Oxygenation Index (TOI) of the vastus lateralis and triceps brachii, as well as power output in comparison to leg HIIT (HIITleg) only. The 20 healthy, male and female volunteers completed six sessions of either HIITleg on a cycle ergometer or HIITarm+leg on an arm and leg cycle ergometer. During pre- and post-testing, the volunteers completed a submaximal and incremental test to exhaustion on a cycle ergometer. Magnitude based interference revealed likely to very likely beneficial effects for HIITarm+leg compared to HIITleg in maximal oxygen uptake, cardiac measures as well peak power output. The TOI following HIITarm+leg demonstrated likely to very likely increased oxygenation in the triceps brachii or the vastus lateralis when compared to HIITleg. The results suggest that six sessions of HIITarm+leg may likely to very likely improve maximal oxygen uptake, some inotropy-related cardiac measures with improved tissue oxygenation of the triceps brachii and vastus lateralis muscles resulting in greater leg peak power output.

Aberrant femoral torsion presenting with frog-leg squatting mimicking gluteal muscle contracture.

Science.gov (United States)

Chiang, Chia-Ling; Tsai, Meng-Yuan; Chang, Wei-Ning; Chen, Clement Kuen-Huang

2012-04-01

Patients with frog-leg squatting have restricted internal rotation and adduction of the affected hips during sitting or squatting. In the surgical literature, the cause generally has been presumed to arise from and be pathognomonic for gluteal muscle contracture. However, we have encountered patients with frog-leg squatting but without gluteal muscle contracture. We therefore raised the following questions: What are the imaging features of patients with frog-leg squatting? Do conditions other than gluteal muscle contracture manifest frog-leg squatting? We retrospectively reviewed the MR images of 67 patients presenting with frog-leg squatting from April 1998 to July 2010. There were four females and 63 males; their mean age was 22.2 years (range, 4-50 years). During MRI readout, we observed aberrant axes of some femoral necks and obtained additional CT to measure femoral torsion angles in 59 of the 67 patients. MR images of 27 (40%) patients had signs of gluteal muscle contracture. Twenty-two (33%) patients (40 femora) had aberrant femoral torsion, including diminished anteversion (range, 6°-0°; average, 3.9°) in 11 femora of eight patients and femoral retroversion (range, muscle contracture or aberrant femoral torsion. The observation of aberrant femoral torsion was not anticipated before imaging studies. In addition to gluteal muscle contracture, aberrant femoral torsion can be a cause of frog-leg squatting. Level II, diagnostic study. See the guidelines for Authors for a complete description of levels of evidence.

Early-life nutritional status and metabolic syndrome: gender-specific associations from a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Science.gov (United States)

Briskiewicz, Bruna Lucas; Barreto, Sandhi Maria; do Amaral, Joana Ferreira; Diniz, Maria de Fátima Haueisen Sander; Molina, Maria Del Carmen Bisi; Matos, Sheila Maria Alvim; Cardoso, Letícia de Oliveira; Velasquez-Melendez, Gustavo; Schmidt, Maria Inês; Giatti, Luana

2018-06-01

In the present study we investigated gender-specific associations of low birth weight (LBW) and shorter relative leg length with metabolic syndrome (MetS) after adjusting for sociodemographic characteristics and health-related behaviours. We also investigated whether these associations are independent of age at menarche and BMI at 20 years old. Cross-sectional analysis. Baseline data from 12 602 participants (35-74 years) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), 2008-2010. MetS was defined according to the revised National Cholesterol Education Program Adult Treatment Panel III guidelines. LBW (<2·5 kg) and age- and sex-standardized relative leg length (high, medium and low) were the explanatory variables studied. The strength of the associations between the explanatory variables and MetS was estimated by Poisson regression with robust variance. MetS prevalence was 34·2 %; it was more prevalent in men (36·8 %) than in women (32·2 %). In multivariate analysis, LBW was associated (prevalence ratio; 95 % CI) with MetS only in women (1·28; 1·24, 1·45). Shorter leg length was associated with MetS in both men (1·21; 1·09, 1·35 and 1·46; 1·29, 1·65 for low and medium lengths, respectively) and women (1·12; 1·00, 1·25 and 1·40; 1·22, 1·59 for low and medium lengths, respectively). Additional adjustments for age at menarche and BMI at 20 years old did not change the associations. Poor nutritional status as estimated by LBW and lower leg length in childhood was associated with a higher prevalence of MetS, although LBW was a significant factor only among women.

Genetic association between leg conformation in young pigs and sow reproduction

DEFF Research Database (Denmark)

Le, Thu Hong; Nilsson, Katja; Norberg, Elise

2015-01-01

Lameness is an issue of concern in pig production due both to animal welfare and to economical aspects. Lame sows are believed to suffer from pain and stress which is reported to have a negative influence on reproduction. Leg conformation and locomotion traits in young animals are associated...... with the risk of lameness at higher age. The purpose of this study was to estimate the genetic parameters of leg conformation traits recorded at performance testing (around 5 months of age) and their genetic correlations with reproduction traits. Information on leg conformation traits from 123,307 pigs scored...... and on reproduction traits from 22,204 litters in the first and second parity from Swedish Yorkshire nucleus herds were available for genetic analysis. Eight conformation and locomotion traits, coming from the old or the new scoring system in Sweden, included old movement, old overall leg score, new movement, new...

Growth Curves for Girls with Turner Syndrome

Directory of Open Access Journals (Sweden)

Fabio Bertapelli

2014-01-01

Full Text Available The objective of this study was to review the growth curves for Turner syndrome, evaluate the methodological and statistical quality, and suggest potential growth curves for clinical practice guidelines. The search was carried out in the databases Medline and Embase. Of 1006 references identified, 15 were included. Studies constructed curves for weight, height, weight/height, body mass index, head circumference, height velocity, leg length, and sitting height. The sample ranged between 47 and 1,565 (total = 6,273 girls aged 0 to 24 y, born between 1950 and 2006. The number of measures ranged from 580 to 9,011 (total = 28,915. Most studies showed strengths such as sample size, exclusion of the use of growth hormone and androgen, and analysis of confounding variables. However, the growth curves were restricted to height, lack of information about selection bias, limited distributional properties, and smoothing aspects. In conclusion, we observe the need to construct an international growth reference for girls with Turner syndrome, in order to provide support for clinical practice guidelines.

H:q ratios and bilateral leg strength in college field and court sports players.

Science.gov (United States)

Cheung, Roy T H; Smith, Andrew W; Wong, Del P

2012-06-01

One of the key components in sports injury prevention is the identification of imbalances in leg muscle strength. However, different leg muscle characteristics may occur in large playing area (field) sports and small playing area (court) sports, which should be considered in regular injury prevention assessment. This study examined the isokinetic hamstrings-to-quadriceps (H:Q) ratio and bilateral leg strength balance in 40 male college (age: 23.4 ± 2.5 yrs) team sport players (field sport = 23, soccer players; court sport = 17, volleyball and basketball players). Five repetitions of maximal knee concentric flexion and concentric extension were performed on an isokinetic dynamometer at two speeds (slow: 60°·s(-1) and fast: 300°·s(-1)) with 3 minutes rest between tests. Both legs were measured in counterbalanced order with the dominant leg being determined as the leg used to kick a ball. The highest concentric peak torque values (Nm) of the hamstrings and quadriceps of each leg were analyzed after body mass normalization (Nm·kg(-1)). Court sport players showed significantly weaker dominant leg hamstrings muscles at both contraction speeds (P Sport-specific leg muscle strength was evident in college players from field and court sports. These results suggest the need for different muscle strength training and rehabilitation protocols for college players according to the musculature requirements in their respective sports.

Why do arms extract less oxygen than legs during exercise?

DEFF Research Database (Denmark)

Calbet, J A L; Holmberg, H-C; Rosdahl, H

2005-01-01

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...

[Design and application of medical electric leg-raising machine].

Science.gov (United States)

Liang, Jintang; Chen, Jinyuan; Zhao, Zixian; Lin, Jinfeng; Li, Juanhong; Zhong, Jingliang

2017-08-01

Passive leg raising is widely used in clinic, but it lacks of specialized mechanical raise equipment. It requires medical staff to raise leg by hand or requires a multi-functional bed to raise leg, which takes time and effort. Therefore we have developed a new medical electric leg-raising machine. The equipment has the following characteristics: simple structure, stable performance, easy operation, fast and effective, safe and comfortable. The height range of the lifter is 50-120 cm, the range of the angle of raising leg is 10degree angle-80degree angle, the maximum supporting weight is 40 kg. Because of raising the height of the lower limbs and making precise angle, this equipment can completely replace the traditional manner of lifting leg by hand with multi-functional bed to lift patients' leg and can reduce the physical exhaustion and time consumption of medical staff. It can change the settings at any time to meet the needs of the patient; can be applied to the testing of PLR and dynamically assessing the hemodynamics; can prevent deep vein thrombosis and some related complications of staying in bed; and the machine is easy to be cleaned and disinfected, which can effectively avoid hospital acquired infection and cross infection; and can also be applied to emergency rescue of various disasters and emergencies.

How to determine leg dominance: The agreement between self-reported and observed performance in healthy adults.

Directory of Open Access Journals (Sweden)

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.

Leg-adjustment strategies for stable running in three dimensions

International Nuclear Information System (INIS)

Peuker, Frank; Maufroy, Christophe; Seyfarth, André

2012-01-01

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

Exercise Induced Rhabdomyolysis with Compartment Syndrome and Renal Failure

Directory of Open Access Journals (Sweden)

Mary Colleen Bhalla

2014-01-01

Full Text Available Exertional rhabdomyolysis is sequela that is occasionally seen after strenuous exercise. The progression to compartment syndrome or renal failure is a rare complication that requires prompt recognition and treatment to prevent morbidity (Giannoglou et al. 2007. We present a case of a 22-year-old college football player who presented to the emergency department (ED after a typical leg workout as part of his weight conditioning. He was found to have rhabdomyolysis with evidence of renal insufficiency. His condition progressed to bilateral compartment syndrome and renal failure requiring dialysis. After bilateral fasciotomies were performed he had resolution of his compartment syndrome. He continued to be dialysis dependent and had no return of his renal function at discharge 12 days after admission.

Locally advanced transverse colon cancer with Trousseau’s syndrome

Directory of Open Access Journals (Sweden)

V. A. Aliyev

2012-01-01

Full Text Available Migratory venous thrombosis is a manifestation of the rare paraneoplastic syndrome in patients with malignant neoplasms. The paper describes successful surgical treatment in a young patient with a colon tumor associated with Trousseau’s syndrome. The latter manifesting itself as ischemia forced urgent surgeons to amputate the lower third of the left leg. Locally advanced transverse colon cancer spreading to the great vessels was subsequently diagnosed. All paraneoplastic manifestations disappeared after tumor removal. The patient was professionally given surgical, anesthesiological, and resuscitative aids that not only improved his quality of life, but also gave the chance to prolong it.

TRUNK LEAN DURING A SINGLE-LEG SQUAT IS ASSOCIATED WITH TRUNK LEAN DURING PITCHING.

Science.gov (United States)

Plummer, Hillary A; Oliver, Gretchen D; Powers, Christopher M; Michener, Lori A

2018-02-01

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.

Clinical and electrophysiological impact of repetitive low-frequency transcranial magnetic stimulation on the sensory–motor network in patients with restless legs syndrome

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Cantone, Mariagiovanna; Aricò, Debora; Lanuzza, Bartolo; Cosentino, Filomena Irene Ilaria; Paci, Domenico; Papotto, Maurizio; Pennisi, Manuela; Bella, Rita; Pennisi, Giovanni; Paulus, Walter; Ferri, Raffaele

2018-01-01

Background: Based on the hyperexcitability and disinhibition observed in patients with restless legs syndrome (RLS) following transcranial magnetic stimulation (TMS), we conducted a study with low-frequency repetitive TMS (rTMS) over the primary motor (M1) and somatosensory cortical areas (S1) in patients with RLS. Methods: A total of 13 right-handed patients and 10 age-matched controls were studied using clinical scales and TMS. Measurements included resting motor threshold (rMT), motor-evoked potentials (MEPs), cortical silent period (CSP), and central motor conduction time (CMCT). A single evening session of rTMS (1 Hz, 20 trains, 50 stimuli each) was administered over the left M1, left S1, and sham stimulation over M1 in a random order. Clinical and TMS measures were repeated after each stimulation modality. Results: Baseline CSP was shorter in patients than in controls and remained shorter in patients for both motor and somatosensory stimulation. The patients reported a subjective improvement of both initiating and maintaining sleep the night after the rTMS over S1. Patients exhibited a decrease in rMT after rTMS of S1 only, although the effect was smaller than in controls. MEP latency and CMCT changed only in controls after stimulation. Sham stimulation was without effect on the observed variables. Conclusions: rTMS on S1-M1 connectivity alleviated the sensory–motor complaints of RLS patients. The TMS indexes of excitation and inhibition indicate an intracortical and corticospinal imbalance, mainly involving gamma-aminobutyric acid (GABA)ergic and glutamatergic circuitries, as well as an impairment of the short-term mechanisms of cortical plasticity. The rTMS-induced activation of the dorsal striatum with the consequent increase of dopamine release may have contributed to the clinical and neurophysiological outcome. PMID:29511386

Clinical and electrophysiological impact of repetitive low-frequency transcranial magnetic stimulation on the sensory-motor network in patients with restless legs syndrome.

Science.gov (United States)

Lanza, Giuseppe; Cantone, Mariagiovanna; Aricò, Debora; Lanuzza, Bartolo; Cosentino, Filomena Irene Ilaria; Paci, Domenico; Papotto, Maurizio; Pennisi, Manuela; Bella, Rita; Pennisi, Giovanni; Paulus, Walter; Ferri, Raffaele

2018-01-01

Based on the hyperexcitability and disinhibition observed in patients with restless legs syndrome (RLS) following transcranial magnetic stimulation (TMS), we conducted a study with low-frequency repetitive TMS (rTMS) over the primary motor (M1) and somatosensory cortical areas (S1) in patients with RLS. A total of 13 right-handed patients and 10 age-matched controls were studied using clinical scales and TMS. Measurements included resting motor threshold (rMT), motor-evoked potentials (MEPs), cortical silent period (CSP), and central motor conduction time (CMCT). A single evening session of rTMS (1 Hz, 20 trains, 50 stimuli each) was administered over the left M1, left S1, and sham stimulation over M1 in a random order. Clinical and TMS measures were repeated after each stimulation modality. Baseline CSP was shorter in patients than in controls and remained shorter in patients for both motor and somatosensory stimulation. The patients reported a subjective improvement of both initiating and maintaining sleep the night after the rTMS over S1. Patients exhibited a decrease in rMT after rTMS of S1 only, although the effect was smaller than in controls. MEP latency and CMCT changed only in controls after stimulation. Sham stimulation was without effect on the observed variables. rTMS on S1-M1 connectivity alleviated the sensory-motor complaints of RLS patients. The TMS indexes of excitation and inhibition indicate an intracortical and corticospinal imbalance, mainly involving gamma-aminobutyric acid (GABA)ergic and glutamatergic circuitries, as well as an impairment of the short-term mechanisms of cortical plasticity. The rTMS-induced activation of the dorsal striatum with the consequent increase of dopamine release may have contributed to the clinical and neurophysiological outcome.

Numerical simulation of thermal stratification in cold legs by using openFOAM

International Nuclear Information System (INIS)

Cai, Jiejin; Watanabe, Tadashi

2010-01-01

During a small-break loss-of-coolant accident in pressurized water reactors (PWRs), emergency core cooling system (ECCS) is actuated and cold water is injected into cold legs. Insufficient mixing of injected cold water and hot primary coolant results in thermal stratification, which is a matter of concern for evaluation of pressurized thermal shock (PTS) in view of aging and life extension of nuclear power plants. In this study, an open source CFD software, OpenFOAM, is used to simulate mixing and thermal stratification in the cold leg of ROSA/LSTF, which is the largest thermal-hydraulic integral test facility simulating PWR. One of the cold-leg is numerically simulated from the outlet of primary coolant pump to the inlet of downcomer. ECCS water is injected from injection nozzle connected at the top of the cold leg into the steady-state natural circulation flow under high-pressure and high-temperature conditions. The temperature distribution in the cold leg is compared with experimental and FLUENT's results. Effects of turbulent flow models and secondary flow due to the elbow section of the cold leg are discussed for the case with the single-phase natural circulation. Injection into a two-phase stratified flow is also simulated and predictive and numerical capabilities of OpenFOAM are discussed. (author)

Immobilization increases interleukin-6, but not tumour necrosis factor-a, release from the leg during exercise in humans

DEFF Research Database (Denmark)

Reihmane, Dace; Hansen, Andreas Vigelsø; Jensen, Martin Gram

2013-01-01

have now studied the temporal relationship of leg IL-6 and TNF-a release before and during isolated two-legged exercise after 14 days of one-leg immobilization (IM) while the other leg served as the control (CON) leg. Fifteen healthy male subjects (mean ± SEM age, 23 ± 1 years; body mass index, 23.......6 ± 0.7 kg m; and maximal oxygen uptake, 46.8 ± 1.4 ml kg min) performed 45 min of two-legged dynamic knee-extensor exercise at 19.6 ± 0.8 W. Arterial and femoral venous blood samples from the CON and the IM leg were collected every 15 min during exercise, and leg blood flow was measured with Doppler...

Differences in kinematics of single leg squatting between anterior cruciate ligament-injured patients and healthy controls.

Science.gov (United States)

Yamazaki, J; Muneta, T; Ju, Y J; Sekiya, I

2010-01-01

Seventy to eighty percent of all anterior cruciate ligament (ACL) injuries are due to non-contact injury mechanisms. It has been reported that the majority of injuries due to single leg landing come from valgus positioning of the lower leg. Preventing valgus positioning during single leg landing is expected to help reduce the number of ACL injuries. We found that many ACL-deficient patients cannot perform stable single leg squatting. Therefore, we performed 3D motion analysis of the single-legged half squat for ACL-injured patients to evaluate its significance as a risk factor for ACL injuries. We evaluated the relative angles between the body, thigh, and lower leg using an electromagnetic device during single leg half squatting performed by 63 ACL-injured patients (32 males, 31 females) the day before ACL reconstruction and by 26 healthy control subjects with no knee problems. The uninjured leg of ACL-injured male subjects demonstrated significantly less external knee rotation than that of the dominant leg of the male control. The uninjured leg of ACL-injured female subjects demonstrated significantly more external hip rotation and knee flexion and less hip flexion than that of the dominant leg of the female control. Comparing injured and uninjured legs, the injured leg of male subjects demonstrated significantly less external knee and hip rotation, less knee flexion, and more knee varus than that of the uninjured leg of male subjects. The injured leg of female subjects demonstrated more knee varus than that of the uninjured leg of female subjects. Regarding gender differences, female subjects demonstrated significantly more external hip rotation and knee valgus than male subjects did in both the injured and uninjured legs (P < 0.05). The current kinematic study exhibited biomechanical characteristics of female ACL-injured subjects compared with that of control groups. Kinematic correction during single leg half squat would reduce ACL reinjury in female ACL

Strength, body composition, and functional outcomes in the squat versus leg press exercises.

Science.gov (United States)

Rossi, Fabrício E; Schoenfeld, Brad J; Ocetnik, Skyler; Young, Jonathan; Vigotsky, Andrew; Contreras, Bret; Krieger, James W; Miller, Michael G; Cholewa, Jason

2018-03-01

The purpose of this study was to compare strength, body composition, and functional outcome measures following performance of the back squat, leg press, or a combination of the two exercises. Subjects were pair-matched based on initial strength levels and then randomly assigned to 1 of 3 groups: a squat-only group (SQ) that solely performed squats for the lower body; a leg press-only group (LP) that solely performed leg presses for the lower body, or a combined squat and leg press group (SQ-LP) that performed both squats and leg presses for the lower body. All other RT variables were held constant. The study period lasted 10 weeks with subjects performing 2 lower body workouts per week comprising 6 sets per session at loads corresponding to 8-12 RM with 90- to 120-second rest intervals. Results showed that SQ had greater transfer to maximal squat strength compared to the leg press. Effect sizes favored SQ and SQ-LP versus LP with respect to countermovement jump while greater effect sizes for dynamic balance were noted for SQ-LP and LP compared to SQ, although no statistical differences were noted between conditions. These findings suggest that both free weights and machines can improve functional outcomes, and that the extent of transfer may be specific to the given task.

Flexural characteristics of a stack leg

International Nuclear Information System (INIS)

Cook, J.

1979-06-01

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.)

Multi-Axis Prosthetic Knee Resembles Alpine Skiing Movements of an Intact Leg

Science.gov (United States)

Demšar, Ivan; Duhovnik, Jože; Lešnik, Blaž; Supej, Matej

2015-01-01

The purpose of the study was to analyse the flexion angles of the ski boot, ankle and knee joints of an above-knee prosthesis and to compare them with an intact leg and a control group of skiers. One subject with an above-knee amputation of the right leg and eight healthy subjects simulated the movement of a skiing turn by performing two-leg squats in laboratory conditions. By adding additional loads in proportion to body weight (BW; +1/3 BW, +2/3 BW, +3/3 BW), various skiing regimes were simulated. Change of Flexion Angle (CoFA) and Range of Motion (RoM) in the ski boot, ankle and knee joints were calculated and compared. An average RoM in the skiing boot on the side of prosthesis (4.4 ± 1.1°) was significantly lower compared to an intact leg (5.9 ± 1.8°) and the control group (6.5 ± 2.3°). In the ankle joint, the average RoM was determined to be 13.2±2.9° in the prosthesis, 12.7 ± 2.8° in an intact leg and 14.8±3.6 in the control group. However, the RoM of the knee joint in the prosthesis (42.2 ± 4.2°) was significantly larger than that of the intact leg (34.7 ± 4.4°). The average RoM of the knee joint in the control group was 47.8 ± 5.4°. The influences of additional loads on the kinematics of the lower extremities were different on the side of the prosthesis and on the intact leg. In contrast, additional loads did not produce any significant differences in the control group. Although different CoFAs in the ski boot, ankle and knee joints were used, an above-knee prosthesis with a built-in multi-axis prosthetic knee enables comparable leg kinematics in simulated alpine skiing. Key points The RoM in the ski boot on the side of the prosthetic leg was smaller than the RoM of the intact leg and the control group of healthy subjects. The RoM in the ankle joint of prosthetic leg was comparable to that of the intact leg and the control group of healthy subjects. The RoM in the prosthetic knee joint was greater than the RoM in the knee joint of the

Leg deformation during imaginal ecdysis in the downy emerald, Cordulia aenea (Odonata, Corduliidae).

Science.gov (United States)

Frantsevich, Leonid; Frantsevich, Ludmilla

2018-04-01

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.

Characteristics of patients with chronic exertional compartment syndrome.

Science.gov (United States)

Davis, Daniel E; Raikin, Steven; Garras, David N; Vitanzo, Peter; Labrador, Hallie; Espandar, Ramin

2013-10-01

Chronic exertional compartment syndrome (CECS) is a condition that causes reversible ischemia and lower extremity pain during exercise. To date there are few large studies examining the characteristics of patients with CECS. This study aimed to present these characteristics by examining the largest published series of patients with a confirmed diagnosis of the disorder. An IRB-approved, retrospective review was undertaken of patients with a suspected diagnosis of CECS undergoing pre- and postexercise compartment pressure testing between 2000 and 2012. Patients were evaluated for gender, age, duration of symptoms, pain level, specific compartments involved, compartment pressure measurements, and participation and type of athletics. Two-hundred twenty-six patients (393 legs) underwent compartment pressure testing. A diagnosis of CECS was made in 153 (67.7%) patients and 250 (63.6%) legs with elevated compartment measurements; average age of the patients was 24 years (range, 13-69 years). Female patients accounted for 92 (60.1%) of those with elevated pressures. Anterior and lateral compartment pressures were elevated most frequently, with 200 (42.5%) and 167 (35.5%) compartments, respectively. One hundred forty-one (92.2%) patients reported participation in sports, with running being the most common individual sport and soccer being the most common team sport. Duration of pain prior to diagnosis averaged 28 months. Although there is ample literature pertaining to the diagnostic criteria and treatment algorithm of the condition, few papers have described the type of patient most likely to develop CECS. This is the largest study to date to evaluate the type of patient likely to present with chronic exertional compartment syndrome. Level III, retrospective review.

The relationship between leg preference and knee mechanics during sidestepping in collegiate female footballers.

Science.gov (United States)

Brown, Scott R; Wang, Henry; Dickin, D Clark; Weiss, Kaitlyn J

2014-11-01

This study examined the relationship between leg preference and knee mechanics in females during sidestepping. Three-dimensional data were recorded on 16 female collegiate footballers during a planned 45° sidestep manoeuvre with their preferred and non-preferred kicking leg. Knee kinematics and kinetics during initial contact, weight acceptance, peak push-off, and final push-off phases of sidestepping were analysed in both legs. The preferred leg showed trivial to small increases (ES = 0.19-0.36) in knee flexion angle at initial contact, weight acceptance, and peak push-off, and small increases (ES = 0.21-0.34) in peak power production and peak knee extension velocity. The non-preferred leg showed a trivial increase (ES = 0.10) in knee abduction angle during weight acceptance; small to moderate increases (ES = 0.22-0.64) in knee internal rotation angle at weight acceptance, peak push-off, and final push-off; a small increase (ES = 0.22) in knee abductor moment; and trivial increases (ES = 0.09-0.14) in peak power absorption and peak knee flexion velocity. The results of this study show that differences do exist between the preferred and non-preferred leg in females. The findings of this study will increase the knowledge base of anterior cruciate ligament injury in females and can aid in the design of more appropriate neuromuscular, plyometric, and strength training protocols for injury prevention.

Spider diffraction: a comparison of curved and straight legs

International Nuclear Information System (INIS)

Richter, J.L.

1984-01-01

It has been known for some time that, if curved legs rather than the usual straight ones are used in the spider that supports the secondary optics in certain telescopes, the visible diffraction effect is reduced. Fraunhofer theory is used to calculate the diffraction effects due to the curved leg spider. Calculated and photographic diffraction patterns are compared for straight and curved leg spiders

Computational simulation of passive leg-raising effects on hemodynamics during cardiopulmonary resuscitation.

Science.gov (United States)

Shin, Dong Ah; Park, Jiheum; Lee, Jung Chan; Shin, Sang Do; Kim, Hee Chan

2017-03-01

The passive leg-raising (PLR) maneuver has been used for patients with circulatory failure to improve hemodynamic responsiveness by increasing cardiac output, which should also be beneficial and may exert synergetic effects during cardiopulmonary resuscitation (CPR). However, the impact of the PLR maneuver on CPR remains unclear due to difficulties in monitoring cardiac output in real-time during CPR and a lack of clinical evidence. We developed a computational model that couples hemodynamic behavior during standard CPR and the PLR maneuver, and simulated the model by applying different angles of leg raising from 0° to 90° and compression rates from 80/min to 160/min. The simulation results showed that the PLR maneuver during CPR significantly improves cardiac output (CO), systemic perfusion pressure (SPP) and coronary perfusion pressure (CPP) by ∼40-65% particularly under the recommended range of compression rates between 100/min and 120/min with 45° of leg raise, compared to standard CPR. However, such effects start to wane with further leg lifts, indicating the existence of an optimal angle of leg raise for each person to achieve the best hemodynamic responses. We developed a CPR-PLR model and demonstrated the effects of PLR on hemodynamics by investigating changes in CO, SPP, and CPP under different compression rates and angles of leg raising. Our computational model will facilitate study of PLR effects during CPR and the development of an advanced model combined with circulatory disorders, which will be a valuable asset for further studies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Analysis of the Relationship between Elite Wrestlers’ Leg Strength and Balance Performance, and Injury History

Directory of Open Access Journals (Sweden)

Sezen Çimen Polat

2018-04-01

Full Text Available The purpose of this study is to examine the correlation between leg power and balance performance in elite wrestlers and injury history. In the research group, there are 18 elite freestyle male wrestlers at the ages of 24.27 ± 3.18 years, with a height of 171.86 ± 5.44 cm and a body weight of 79.27 ± 11.16 kg. Information on the injury history of the athletes’ upper legs for the past year was collected via interviews with the club’s physiotherapist. Laboratory tests to measure performance assessed height, body weight, Y balance and isokinetic leg strength. Data obtained from the study are presented as mean and standard deviation. The test of normality was carried out by the Shapiro-Wilk test. The Pearson Correlation Test was performed for all parameters with normal distribution, and significance level was accepted as p < 0.05. It was found that there is a relationship between the wrestlers’ right leg ratio and hamstring strength and injury history. However, there is no statistically significant relationship between left leg hamstring, quadriceps, ratio, right leg quadriceps, or right and left leg balance performance, and injury history. The resulting data shows that the proportioning between hamstring and quadriceps muscles in freestyle wrestlers’ upper leg strength values is not ideal. This finding provides evidence that injury risk increases with the additional impact of loss of strength.

KILT (Kidney and IVC Abnormalities with Leg Thrombosis) Syndrome in a 41-Years-Old Man with Loin Pain and Fever.

Science.gov (United States)

Fung, James Kiujing; Yeung, Victor Hip Wo; Chu, Sau Kwan; Man, Chi Wan

2017-05-01

KILT syndrome is a rare condition composing the triad of kidney and inferior vena cava anomaly and extensive venous thrombosis. We present a case of newly diagnosed KILT syndrome in a 41-years-old gentleman presenting with loin pain and fever. Reviewing previous case reports, KILT syndrome is usually an incidental finding on imaging studies and there is a wide scope of initial clinical presentations. However, recent evidence suggests IVC anomaly may have caused subsequent renal hypoplasia. Identification of the underlying etiology may be helpful in planning early vascular intervention to treat the condition.

GABAergic inhibition of leg motoneurons is required for normal walking behavior in freely moving Drosophila.

Science.gov (United States)

Gowda, Swetha B M; Paranjpe, Pushkar D; Reddy, O Venkateswara; Thiagarajan, Devasena; Palliyil, Sudhir; Reichert, Heinrich; VijayRaghavan, K

2018-02-27

Walking is a complex rhythmic locomotor behavior generated by sequential and periodical contraction of muscles essential for coordinated control of movements of legs and leg joints. Studies of walking in vertebrates and invertebrates have revealed that premotor neural circuitry generates a basic rhythmic pattern that is sculpted by sensory feedback and ultimately controls the amplitude and phase of the motor output to leg muscles. However, the identity and functional roles of the premotor interneurons that directly control leg motoneuron activity are poorly understood. Here we take advantage of the powerful genetic methodology available in Drosophila to investigate the role of premotor inhibition in walking by genetically suppressing inhibitory input to leg motoneurons. For this, we have developed an algorithm for automated analysis of leg motion to characterize the walking parameters of wild-type flies from high-speed video recordings. Further, we use genetic reagents for targeted RNAi knockdown of inhibitory neurotransmitter receptors in leg motoneurons together with quantitative analysis of resulting changes in leg movement parameters in freely walking Drosophila Our findings indicate that targeted down-regulation of the GABA A receptor Rdl (Resistance to Dieldrin) in leg motoneurons results in a dramatic reduction of walking speed and step length without the loss of general leg coordination during locomotion. Genetically restricting the knockdown to the adult stage and subsets of motoneurons yields qualitatively identical results. Taken together, these findings identify GABAergic premotor inhibition of motoneurons as an important determinant of correctly coordinated leg movements and speed of walking in freely behaving Drosophila . Copyright © 2018 the Author(s). Published by PNAS.

Patterns of structural reorganization of the corticospinal tract in children with Sturge-Weber syndrome.

Science.gov (United States)

Kamson, David O; Juhász, Csaba; Shin, Joseph; Behen, Michael E; Guy, William C; Chugani, Harry T; Jeong, Jeong-Won

2014-04-01

Reorganization of the corticospinal tract after early damage can limit motor deficit. In this study, we explored patterns of structural corticospinal tract reorganization in children with Sturge-Weber syndrome. Five children (age 1.5-7 years) with motor deficit resulting from unilateral Sturge-Weber syndrome were studied prospectively and longitudinally (1-2 years follow-up). Corticospinal tract segments belonging to hand and leg movements were separated and their volume was measured by diffusion tensor imaging tractography using a recently validated method. Corticospinal tract segmental volumes were normalized and compared between the Sturge-Weber syndrome children and age-matched healthy controls. Volume changes during follow-up were also compared with clinical motor symptoms. In the Sturge-Weber syndrome children, hand-related (but not leg-related) corticospinal tract volumes were consistently decreased in the affected cerebral hemisphere at baseline. At follow-up, two distinct patterns of hand corticospinal tract volume changes emerged. (1) Two children with extensive frontal lobe damage showed a corticospinal tract volume decrease in the lesional hemisphere and a concomitant increase in the nonlesional (contralateral) hemisphere. These children developed good hand grasp but no fine motor skills. (2) The three other children, with relative sparing of the frontal lobe, showed an interval increase of the normalized hand corticospinal tract volume in the affected hemisphere; these children showed no gross motor deficit at follow-up. Diffusion tensor imaging tractography can detect differential abnormalities in the hand corticospinal tract segment both ipsi- and contralateral to the lesion. Interval increase in the corticospinal tract hand segment suggests structural reorganization, whose pattern may determine clinical motor outcome and could guide strategies for early motor intervention. Copyright © 2014 Elsevier Inc. All rights reserved.

Sympathetic Vasoconstrictor Responsiveness of the Leg Vasculature During Experimental Endotoxemia and Hypoxia in Humans

DEFF Research Database (Denmark)

Brassard, Patrice; Zaar, Morten; Thaning, Pia

2016-01-01

. DESIGN: Prospective descriptive study. SETTING: Hospital research laboratory. SUBJECTS: Ten healthy young men (age [mean ± SD], 31 ± 8 yr; body weight, 83 ± 10 kg) participated in the study. INTERVENTIONS: Leg blood flow and mean arterial pressure were determined, whereas leg vascular conductance...... was calculated during 1) adenosine infusion (vasodilator control), 2) hypoxia (FIO2 = 10%), 3) endotoxemia, and 4) endotoxemia + hypoxia. Leg sympathetic vasoconstrictor responsiveness (reduction in leg vascular conductance) was evaluated by femoral artery tyramine infusion. MEASUREMENTS AND MAIN RESULTS......: Endotoxemia increased body temperature from 36.9 ± 0.4°C to 38.6 ± 0.5°C (p necrosis factor-α from 6 pg/mL (3-8 pg/mL) to 391 pg/mL (128-2258 pg/mL) (p

Six-month exercise training program to treat post-thrombotic syndrome: a randomized controlled two-centre trial

Science.gov (United States)

Kahn, Susan R.; Shrier, Ian; Shapiro, Stan; Houweling, Adrielle H.; Hirsch, Andrew M.; Reid, Robert D.; Kearon, Clive; Rabhi, Khalil; Rodger, Marc A.; Kovacs, Michael J.; Anderson, David R.; Wells, Philip S.

2011-01-01

Background Exercise training may have the potential to improve post-thrombotic syndrome, a frequent, chronic complication of deep venous thrombosis. We conducted a randomized controlled two-centre pilot trial to assess the feasibility of a multicentre-based evaluation of a six-month exercise training program to treat post-thrombotic syndrome and to obtain preliminary data on the effectiveness of such a program. Methods Patients were randomized to receive exercise training (a six-month trainer-supervised program) or control treatment (an education session with monthly phone follow-ups). Levels of eligibility, consent, adherence and retention were used as indicators of study feasibility. Primary outcomes were change from baseline to six months in venous disease-specific quality of life (as measured using the Venous Insufficiency Epidemiological and Economic Study Quality of Life [VEINES-QOL] questionnaire) and severity of post-thrombotic syndrome (as measured by scores on the Villalta scale) in the exercise training group versus the control group, assessed by t tests. Secondary outcomes were change in generic quality of life (as measured using the Short-Form Health Survey-36 [SF-36] questionnaire), category of severity of post-thrombotic syndrome, leg strength, leg flexibility and time on treadmill. Results Of 95 patients with post-thrombotic syndrome, 69 were eligible, 43 consented and were randomized, and 39 completed the study. Exercise training was associated with improvement in VEINES-QOL scores (exercise training mean change 6.0, standard deviation [SD] 5.1 v. control mean change 1.4, SD 7.2; difference 4.6, 95% CI 0.54 to 8.7; p = 0.027) and improvement in scores on the Villalta scale (exercise training mean change −3.6, SD 3.7 v. control mean change −1.6, SD 4.3; difference −2.0, 95% CI −4.6 to 0.6; p = 0.14). Most secondary outcomes also showed greater improvement in the exercise training group. Interpretation Exercise training may improve post

Influence of the cognitive workload on bicycle safety at four-legged intersections

DEFF Research Database (Denmark)

Kveladze, Irma; Agerholm, Niels

2018-01-01

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......-legged intersection. The eye tracking glasses will be used to make video and audio recording of visible field of where or how long bicyclists are allocating their visual attention while riding a bicycle and facing obstacles when crossing the four-legged intersection. On the second phase, a bicycle riding simulator...... riding task. This will allow to understand the allocation of bicyclists attention between primary and secondary tasks, to reveal the limit of the information processing capacity during biking. Results expected: Two experimental results will be incorporated to gain in-depth knowledge on bicycle accidents...

Delivery of compression therapy for venous leg ulcers.

Science.gov (United States)

Zarchi, Kian; Jemec, Gregor B E

2014-07-01

Despite the documented effect of compression therapy in clinical studies and its widespread prescription, treatment of venous leg ulcers is often prolonged and recurrence rates high. Data on provided compression therapy are limited. To assess whether home care nurses achieve adequate subbandage pressure when treating patients with venous leg ulcers and the factors that predict the ability to achieve optimal pressure. We performed a cross-sectional study from March 1, 2011, through March 31, 2012, in home care centers in 2 Danish municipalities. Sixty-eight home care nurses who managed wounds in their everyday practice were included. Participant-masked measurements of subbandage pressure achieved with an elastic, long-stretch, single-component bandage; an inelastic, short-stretch, single-component bandage; and a multilayer, 2-component bandage, as well as, association between achievement of optimal pressure and years in the profession, attendance at wound care educational programs, previous work experience, and confidence in bandaging ability. A substantial variation in the exerted pressure was found: subbandage pressures ranged from 11 mm Hg exerted by an inelastic bandage to 80 mm Hg exerted by a 2-component bandage. The optimal subbandage pressure range, defined as 30 to 50 mm Hg, was achieved by 39 of 62 nurses (63%) applying the 2-component bandage, 28 of 68 nurses (41%) applying the elastic bandage, and 27 of 68 nurses (40%) applying the inelastic bandage. More than half the nurses applying the inelastic (38 [56%]) and elastic (36 [53%]) bandages obtained pressures less than 30 mm Hg. At best, only 17 of 62 nurses (27%) using the 2-component bandage achieved subbandage pressure within the range they aimed for. In this study, none of the investigated factors was associated with the ability to apply a bandage with optimal pressure. This study demonstrates the difficulty of achieving the desired subbandage pressure and indicates that a substantial proportion of

The bacteriology of chronic venous leg ulcer examined by culture-independent molecular methods

DEFF Research Database (Denmark)

Thomsen, Trine R; Aasholm, Martin S; Rudkjøbing, Vibeke B

2010-01-01

The bacterial microbiota plays an important role in the prolonged healing of chronic venous leg ulcers. The present study compared the bacterial diversity within ulcer material from 14 skin graft operations of chronic venous leg ulcers using culture-based methods and molecular biological methods...

A survey of bio-inspired compliant legged robot designs

International Nuclear Information System (INIS)

Zhou Xiaodong; Bi Shusheng

2012-01-01

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)

Asymmetry between the Dominant and Non-Dominant Legs in the Kinematics of the Lower Extremities during a Running Single Leg Jump in Collegiate Basketball Players.

Science.gov (United States)

Sugiyama, Takashi; Kameda, Mai; Kageyama, Masahiro; Kiba, Kazufusa; Kanehisa, Hiroaki; Maeda, Akira

2014-12-01

The present study aimed to clarify the asymmetry between the dominant (DL) and non-dominant takeoff legs (NDL) in terms of lower limb behavior during running single leg jumps (RSJ) in collegiate male basketball players in relation to that of the jump height. Twenty-seven players performed maximal RSJ with a 6 m approach. Three-dimensional kinematics data during RSJ was collected using a 12 Raptor camera infrared motion analysis system (MAC 3D system) at a sampling frequency of 500 Hz. The symmetry index in the jump heights and the kinematics variables were calculated as {2 × (DL - NDL) / (DL + NDL)} × 100. The run-up velocity was similar between the two legs, but the jump height was significantly higher in the DL than in the NDL. During the takeoff phase, the joint angles of the ankle and knee were significantly larger in the DL than the NDL. In addition, the contact time for the DL was significantly shorter than that for the NDL. The symmetry index of the kinematics for the ankle joint was positively correlated with that of jump height, but that for the knee joint was not. The current results indicate that, for collegiate basketball players, the asymmetry in the height of a RSJ can be attributed to that in the joint kinematics of the ankle during the takeoff phase, which may be associated with the ability to effectively transmit run-up velocity to jump height. Key pointsAsymmetry of height during running single leg jump between two legs is due to the behavior of the ankle joint (i.e. stiffer the ankle joint and explosive bounding).The dominant leg can transmit run-up velocity into the vertical velocity at takeoff phase to jump high compared with the non-dominant leg.Basketball players who have a greater asymmetry of the RSJ at the collegiate level could be assessed as non-regulars judging by the magnitude of asymmetry.

Temperature and blood flow distribution in the human leg during passive heat stress.

Science.gov (United States)

Chiesa, Scott T; Trangmar, Steven J; González-Alonso, José

2016-05-01

The influence of temperature on the hemodynamic adjustments to direct passive heat stress within the leg's major arterial and venous vessels and compartments remains unclear. Fifteen healthy young males were tested during exposure to either passive whole body heat stress to levels approaching thermal tolerance [core temperature (Tc) + 2°C; study 1; n = 8] or single leg heat stress (Tc + 0°C; study 2; n = 7). Whole body heat stress increased perfusion and decreased oscillatory shear index in relation to the rise in leg temperature (Tleg) in all three major arteries supplying the leg, plateauing in the common and superficial femoral arteries before reaching severe heat stress levels. Isolated leg heat stress increased arterial blood flows and shear patterns to a level similar to that obtained during moderate core hyperthermia (Tc + 1°C). Despite modest increases in great saphenous venous (GSV) blood flow (0.2 l/min), the deep venous system accounted for the majority of returning flow (common femoral vein 0.7 l/min) during intense to severe levels of heat stress. Rapid cooling of a single leg during severe whole body heat stress resulted in an equivalent blood flow reduction in the major artery supplying the thigh deep tissues only, suggesting central temperature-sensitive mechanisms contribute to skin blood flow alone. These findings further our knowledge of leg hemodynamic responses during direct heat stress and provide evidence of potentially beneficial vascular alterations during isolated limb heat stress that are equivalent to those experienced during exposure to moderate levels of whole body hyperthermia. Copyright © 2016 the American Physiological Society.

Success rate of split-thickness skin grafting of chronic venous leg ulcers depends on the presence of Pseudomonas aeruginosa: a retrospective study

DEFF Research Database (Denmark)

Høgsberg, Trine; Bjarnsholt, Thomas; Thomsen, Jens Schiersing

2011-01-01

that once chronic venous leg ulcers were colonized (weeks or months preoperatively) by P. aeruginosa, the success rate of skin grafting deteriorated despite aggressive treatment. To investigate this, a retrospective study was performed on the clinical outcome of 82 consecutive patients with chronic venous...... regression analysis was carried out leaving P. aeruginosa as the only predictor left in the model (p¿=¿0.001). This study supports our hypothesis that P. aeruginosa in chronic venous leg ulcers, despite treatment, has considerable impact on partial take or rejection of split-thickness skin grafts....

Women's health issues with fibromyalgia syndrome.

Science.gov (United States)

Shaver, Joan L F; Wilbur, Joellen; Robinson, F Patrick; Wang, Edward; Buntin, Mary S

2006-11-01

Fibromyalgia syndrome (FMS) involves multiple sensory, somatic, and cognitive symptoms that are bound to affect or be affected by physical and mental health status and behavioral components of daily life. From a telephone survey of 442 women with and 205 women without FMS as volunteers, data were compared on (1) general health status, (2) reproductive and sleep-related diagnoses, and (3) lifestyle health behaviors. All multiple or logistics regression analyses for group differences were controlled for age, body mass index (BMI), race, employment status, marital status, having a college degree, low household income, and having ever been diagnosed with depression, with a Bonferroni p value correction for multiple indicators. Accordingly, FMS negatively impacted both perceived physical and mental health status, although relatively more so for physical (p < 0.017). Women with FMS were more likely to have had reproductive health or sleep-related diagnoses, including premenstrual syndrome, dysmenorrhea, breast cysts, bladder cystitis, sleep apnea, restless leg syndrome, and abnormal leg movements (p < 0.0125). They were calculated to use less than half as many calories per week as control women (689 +/- 1293 vs. 1499 +/- 1584 kcal/week, p < 0.05) and had more sleep pattern difficulties (p < 0.0125), more negative changes in sexual function (greater odds for 5 of 10 indicators at p < 0.005), and lower alcohol use (odds ratio = 0.39, p < 0.05). Patients with FMS deserve careful assessment for reproductive conditions and sleep-related functional disorders. Besides more research into mechanisms underlying symptoms, intervention testing specifically to alleviate sleep problems, low physical activity levels, and sexual dysfunction should be paramount.

Supporting adherence and healthy lifestyles in leg ulcer patients: systematic development of the Lively Legs program for dermatology outpatient clinics.

Science.gov (United States)

Heinen, Maud M; Bartholomew, L Kay; Wensing, Michel; van de Kerkhof, Peter; van Achterberg, Theo

2006-05-01

The objective of our project was to develop a lifestyle program for leg ulcer patients at outpatient clinics for dermatology. We used the intervention-mapping (IM) framework for systematically developing theory and evidence based health promotion programs. We started with a needs-assessment. A multidisciplinary project group of health care workers and patients was involved in all five IM steps; formulating proximal program objectives, selecting methods and strategies, producing program components, planning for adoption and implementation and planning for evaluation. Several systematic literature reviews and original studies were performed to support this process. Social Cognitive Theory was selected as the main theory behind the program 'Lively Legs' and was combined with elements of Goal-Setting Theory, the precaution adoption model and motivational interviewing. The program is conducted through health counseling by dermatology nurses and was successfully pre-tested. Also, an implementation and evaluation plan were made. Intervention mapping helped us to succeed in developing a lifestyle program with clear goals and methods, operational strategies and materials and clear procedures. Coaching leg ulcer patients towards adherence with compression therapy and healthy lifestyles should be taken on without delay. Systematic development of lifestyle programs for other patient groups should be encouraged.

Development and Physical Control Research on Prototype Artificial Leg

Directory of Open Access Journals (Sweden)

Fei Li

2016-03-01

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.

Seismic response analysis for hinged-leg type port crane

Energy Technology Data Exchange (ETDEWEB)

Kashiwazaki, A.; Kanayama, T.; Arai, K. [Ishikawajima-Harima Heavy Industries Co. Ltd., Tokyo (Japan)

2000-04-01

Container cranes and unloaders in Kobe Pont were severely damaged during the Southern Hyogo Prefecture Earthquake in 1995. Notably, some of the hinged-leg type of cranes with hinges at the end of sea-or land-side of legs were overturned. These damages were derived from the uplifting of their legs. To explain the uplifting and overturning behavior, we carried out nonlinear analyses and shaking table tests using a 1/8-scale model of the container crane. The results of nonlinear response analyses of hinged-leg type of crane, which are in an agreement with the state of damages in the Southern Hyogo Prefecture Earthquake and the result of shaking table tests, are described. (author)

Anatomic and functional leg-length inequality: A review and recommendation for clinical decision-making. Part I, anatomic leg-length inequality: prevalence, magnitude, effects and clinical significance

Directory of Open Access Journals (Sweden)

Knutson Gary A

2005-07-01

Full Text Available Abstract Background Leg-length inequality is most often divided into two groups: anatomic and functional. Part I of this review analyses data collected on anatomic leg-length inequality relative to prevalence, magnitude, effects and clinical significance. Part II examines the functional "short leg" including anatomic-functional relationships, and provides an outline for clinical decision-making. Methods Online database – Medline, CINAHL and MANTIS – and library searches for the time frame of 1970–2005 were done using the term "leg-length inequality". Results and Discussion Using data on leg-length inequality obtained by accurate and reliable x-ray methods, the prevalence of anatomic inequality was found to be 90%, the mean magnitude of anatomic inequality was 5.2 mm (SD 4.1. The evidence suggests that, for most people, anatomic leg-length inequality does not appear to be clinically significant until the magnitude reaches ~ 20 mm (~3/4". Conclusion Anatomic leg-length inequality is near universal, but the average magnitude is small and not likely to be clinically significant.

The role of tendinitis in fibromyalgia syndrome.

Science.gov (United States)

Genç, Hakan; Saracoğlu, Meryem; Duyur, Burcu; Erdem, Hatice Rana

2003-08-30

Fibromyalgia Syndrome (FS) is a common disease characterized by diffuse, widespread pain and multiple tender points. The syndrome has been subclassified as primary (PFS) and secondary (SFS) fibromyalgia. The aim of this study was to evaluate the role of common tendinitis (rotator cuff tendinitis, bicipital tendinitis, lateral epicondylitis, De-Quervain's tendinitis and pes anserinus tendinitis) in FS. Twenty female patients with PFS, 20 with SFS and 20 female controls, matched by age and body mass index, participated in the study. Existence of common tendinitis was evaluated with specific examination methods. Right and left rotator cuff tendinitis, pes anserinus tendinitis and left lateral epicondylitis were significantly more common in patients with PFS and SFS than in control subjects. As a result, considering the central hyperexcitability present in the fibromyalgia patients, concomitant pathologies such as tendinitis which lead to shoulder, arm, and leg pain must be evaluated. Follow up and therapy for the disease must be planned according to these factors which are not only probable symptoms of FS, but also leading causes for the occurrence and continuity of the pain in this disease.

Acute myocardial infarction in young adults with Antiphospholipid syndrome: report of two cases and literature review

Directory of Open Access Journals (Sweden)

Leila Abid

2011-02-01

Full Text Available Acute myocardial infarction (AMI is rarely associated with antiphospholipid syndrome. The treatment of these patients is a clinical challenge. We report the observations of 2 young adults (1 woman and 1 man, admitted in our acute care unit for acute myocardial infarction (AMI. A coagulopathy work-up concludes the existence of antiphospholipid syndrome (APS in the 2 cases. APS syndrome was considered primary in 2 cases. All patients presented an intense inflammatory syndrome (high level of CRP. Anticardiolipine was present in the 2 cases. However, anti B2 glycoprotein I antibodies were detected in only one case. Emergency percutaneous transluminal coronary angioplasty (PTCA with direct stenting had been performed successfully only in the first case, and the follow-up was uncomplicated. Thereafter, long-term oral anticoagulant appeared to be effective. The last patient was admitted because of peripheral acute ischemia of legs. Standard electrocardiogram showed signs of previous silent anteroseptal wall myocardial infarction confirmed by echocardiography. The latter revealed an apical thrombus and a very low left ventricular ejection fraction. Amputation of the right leg was necessary because of consultation occurred too late. However, he died four weeks later. Primary antiphospholipid syndrome should be considered as a cause of acute myocardial infarction in young adults, and PTCA with anticoagulant treatment is effective for initial treatment of this complication

Modeling posture-dependent leg actuation in sagittal plane locomotion

International Nuclear Information System (INIS)

Schmitt, J; Clark, J

2009-01-01

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.

The kinematic differences between off-spin and leg-spin bowling in cricket.

Science.gov (United States)

Beach, Aaron J; Ferdinands, René E D; Sinclair, Peter J

2016-09-01

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.

Biomechanical pole and leg characteristics during uphill diagonal roller skiing.

Science.gov (United States)

Lindinger, Stefan Josef; Göpfert, Caroline; Stöggl, Thomas; Müller, Erich; Holmberg, Hans-Christer

2009-11-01

Diagonal skiing as a major classical technique has hardly been investigated over the last two decades, although technique and racing velocities have developed substantially. The aims of the present study were to 1) analyse pole and leg kinetics and kinematics during submaximal uphill diagonal roller skiing and 2) identify biomechanical factors related to performance. Twelve elite skiers performed a time to exhaustion (performance) test on a treadmill. Joint kinematics and pole/plantar forces were recorded separately during diagonal roller skiing (9 degrees; 11 km/h). Performance was correlated to cycle length (r = 0.77; P Push-off demonstrated performance correlations for impulse of leg force (r = 0.84), relative duration (r= -0.76) and knee flexion (r = 0.73) and extension ROM (r = 0.74). Relative time to peak pole force was associated with performance (r = 0.73). In summary, diagonal roller skiing performance was linked to 1) longer cycle length, 2) greater impulse of force during a shorter push-off with larger flexion/extension ROMs in leg joints, 3) longer leg swing, and 4) later peak pole force, demonstrating the major key characteristics to be emphasised in training.

A Dung Beetle-like Leg and its Adaptive Neural Control

DEFF Research Database (Denmark)

Di Canio, Giuliano; Stoyanov, Stoyan; Larsen, Jørgen Christian

2016-01-01

Dung beetles show fascinating locomotion abilities. They can use their legs to not only walk but also manipulate objects. Furthermore, they can perform their leg movements at a proper frequency with respect to their biomechanical properties and quickly adapt the movements to deal with external pe...... also apply adaptive neural control, based on a central pattern generator (CPG) circuit with synaptic plasticity, to autonomously generate a proper stepping frequency of the leg. The controller can also adapt the leg movement to deal with external perturbations within a few steps....

Numerical simulation of thermal stratification in cold legs by using OpenFOAM

International Nuclear Information System (INIS)

Cai, Jiejin; Watanabe, Tadashi

2011-01-01

During a small-break loss-of-coolant accident in pressurized water reactors (PWRs), emergency core cooling system (ECCS) is actuated and cold water is injected into cold legs. Insufficient mixing of injected cold water and hot primary coolant results in thermal stratification, which is a matter of concern for evaluation of pressurized thermal shock (PTS) in view of aging and life extension of nuclear power plants. In this study, an open source CFD software, OpenFOAM, is used to simulate mixing and thermal stratification in the cold leg of ROSA/LSTF, which is the largest thermal-hydraulic integral test facility simulating PWR. One of the cold-leg is numerically simulated from the outlet of primary coolant pump to the inlet of downcomer. ECCS water is injected from injection nozzle connected at the top of the cold leg into the steady-state natural circulation flow under high-pressure and high-temperature conditions. The temperature distribution in the cold leg is compared with experimental and FLUENT's results. Effects of turbulent flow models and secondary flow due to the elbow section of the cold leg are discussed for the case with the single-phase natural circulation. Injection into a two-phase stratified flow is also simulated and predictive and numerical capabilities of OpenFOAM are discussed. (author)

Genetic correlations between claw health and feet and leg conformation in Norwegian Red cows.

Science.gov (United States)

Ødegård, C; Svendsen, M; Heringstad, B

2014-07-01

The aim of this study was to estimate genetic correlations between claw disorders and feet and leg conformation traits in Norwegian Red cows. A total of 188,928 cows with claw health status recorded at claw trimming from 2004 to September 2013 and 210,789 first-lactation cows with feet and leg conformation scores from 2001 to September 2013 were included in the analyses. Traits describing claw health were corkscrew claw, infectious claw disorders (dermatitis, heel horn erosion, and interdigital phlegmon), and laminitis-related claw disorders (sole ulcer, white line disorder, and hemorrhage of sole and white line). The feet and leg conformation traits were rear leg rear view (new and old definition), rear leg side view, foot angle, and hoof quality. Feet and leg conformation traits were scored linearly from 1 to 9, with optimum scores depending on the trait. Claw disorders were defined as binary (0/1) traits for each lactation. Threshold sire models were used to model claw disorders, whereas the feet and leg conformation traits were described by linear sire models. Three multivariate analyses were performed, each including the 5 feet and leg conformation traits and 1 of the 3 claw disorders at a time. Posterior means of heritability of liability of claw disorders ranged from 0.10 to 0.20 and heritabilities of feet and leg conformation traits ranged from 0.04 to 0.11. Posterior standard deviation of heritability was ≤0.01 for all traits. Genetic correlations between claw disorders and feet and leg conformation traits were all low or moderate, except between corkscrew claw and hoof quality (-0.86), which are supposed to measure the same trait. The genetic correlations between rear leg rear view (new) and infectious claw disorders (-0.20) and laminitis-related claw disorders (0.26), and between hoof quality and laminitis-related claw disorders (-0.33) were moderate. Eight of the 15 genetic correlations between claw disorders and feet and leg conformation traits had 0

Leg loss in Lutzomyia longipalpis (Diptera: Psychodidae) due to pyrethroid exposure: Toxic effect or defense by autotomy?

Science.gov (United States)

Santamaría, E; Cabrera, O L; Avendaño, J; Pardo, R H

2016-01-01

Phlebotomine sandflies lose their legs after exposure to pyrethroids. In some insects leg loss helps to defend them from intoxication and predation, a phenomenon known as autotomy. A field observation has shown that sandflies that have lost some legs are still able to blood-feed. The aims of the study were to determine whether leg loss in sandflies, after exposure to deltamethrin, is due to autotomy and to establish the effect of the leg loss on blood-feeding. Two experiments were carried out with Lutzomyia longipalpis: (i) Females were individually exposed to a sublethal time of deltamethrin and mortality and the number of leg loss were recorded; and (ii) Groups of females with complete legs or with 1-3 legs lost due to pyrethroid exposure were offered a blood meal and percentages of blood-fed and fully-fed females were recorded. Most females lost a median of 1 leg within 1-48 h post-exposure to deltamethrin. Mortality (after 24 h) was significantly higher for exposed females with lost legs (31.1%), compared to exposed females with complete legs (7.3%), and there were no differences in mortality between females with complete legs and the control (unexposed females). There were no differences between the three treatments in the percentages of blood-fed and fully-fed females. Leg loss in sandflies is a toxic effect of pyrethroids and there was no evidence of autotomy. The loss of up to three legs after exposure to pyrethroids does not affect blood-feeding behaviour in laboratory and probably also in wild conditions.

Inverse relationship between the complexity of midfoot kinematics and muscle activation in patients with medial tibial stress syndrome

DEFF Research Database (Denmark)

Rathleff, M S; Samani, Afshin; Olesen, C G

2011-01-01

Medial tibial stress syndrome is a common overuse injury characterized by pain located on the medial side of the lower leg during weight bearing activities such as gait. The purpose of this study was to apply linear and nonlinear methods to compare the structure of variability of midfoot kinematics...... and surface electromyographic (SEMG) signals between patients with medial tibial stress syndrome and healthy controls during gait. Fourteen patients diagnosed with medial tibial stress syndrome and 11 healthy controls were included from an orthopaedic clinic. SEMG from tibialis anterior and the soleus muscles...... as well as midfoot kinematics were recorded during 20 consecutive gait cycles. Permuted sample entropy and permutation entropy were used as a measure of complexity from SEMG signals and kinematics. SEMG signals in patients with medial tibial stress syndrome were characterized by higher structural...

Treatment of vasovagal syncope: pacemaker or crossing legs?

NARCIS (Netherlands)

van Dijk, N.; Harms, M. P.; Linzer, M.; Wieling, W.

2000-01-01

A 50-year-old male patient continued to experience syncope after implantation of a pacemaker. During cardiovascular examination, the patient showed a typical vasovagal response, with normal pacemaker function. Leg crossing, which prohibits the pooling of blood in the legs and abdomen, at the onset

Nisin Z produced by Lactococcus lactis from bullfrog hatchery is active against Citrobacter freundii, a red-leg syndrome related pathogen.

Science.gov (United States)

Quintana, Gabriel; Niederle, Maria V; Minahk, Carlos J; Picariello, Gianluca; Nader-Macías, María E F; Pasteris, Sergio E

2017-09-27

Lactococcus lactis subsp. lactis CRL 1584 isolated from a bullfrog hatchery produces a bacteriocin that inhibits both indigenous Citrobacter freundii (a Red-Leg Syndrome related pathogen) and Lactobacillus plantarum, and Listeria monocytogenes as well. Considering that probiotics requires high cell densities and/or bacteriocin concentrations, the effect of the temperature on L. lactis growth and bacteriocin production was evaluated to find the optimal conditions. Thus, the growth rate was maximal at 36 °C, whereas the highest biomass and bacteriocin activity was achieved between 20 and 30 °C and 20-25 °C, respectively. The bacteriocin synthesis was closely growth associated reaching the maximal values at the end of the exponential phase. Since bacteriocins co-production has been evidenced in bacterial genera, a purification of the bacteriocin/s from L. lactis culture supernatants was carried out. The active fraction was purified by cationic-exchange chromatography and then, a RP-HPLC was carried out. The purified sample was a peptide with a 3353.05 Da, a molecular mass that matches nisin Z, which turned out to be the only bacteriocin produced by L. lactis CRL 1584. Nisin Z showed bactericidal effect on C. freundii and L. monocytogenes, which increased in the presence L-lactic acid + H 2 O 2 . This is the first report on nisin Z production by L. lactis from a bullfrog hatchery that resulted active on a Gram-negative pathogen. This peptide has potential probiotic for raniculture and as food biopreservative for bullfrog meat.

33 CFR 147.809 - Mars Tension Leg Platform safety zone.

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Mars Tension Leg Platform safety... SECURITY (CONTINUED) OUTER CONTINENTAL SHELF ACTIVITIES SAFETY ZONES § 147.809 Mars Tension Leg Platform safety zone. (a) Description. The Mars Tension Leg Platform (Mars TLP) is located at position 28°10′10.29...

Association Between Manual Loading and Newly Developed Carpal Tunnel Syndrome in Subjects With Physical Disabilities: A Follow-Up Study.

Science.gov (United States)

Lin, Yen-Nung; Chiu, Chun-Chieh; Huang, Shih-Wei; Hsu, Wen-Yen; Liou, Tsan-Hon; Chen, Yi-Wen; Chang, Kwang-Hwa

2017-10-01

To identify the association between body composition and newly developed carpal tunnel syndrome (CTS) and to search for the best probabilistic cutoff value of associated factors to predict subjects with physical disabilities developing new CTS. Longitudinal. University-affiliated medical center. Subjects with physical disabilities (N=47; mean age ± SD, 42.1±7.7y). Not applicable. Median and ulnar sensory nerve conduction velocity (SNCV) were measured at the initial and follow-up tests (interval >2y). Total and regional body composition were measured with dual-energy x-ray absorptiometry at the initial test. Leg lean tissue percentage was calculated to delineate each participant's manual loading degree during locomotion. Leg lean tissue percentage is the lean tissue mass of both legs divided by body weight. Based on median SNCV changes, we divided all participants into 3 groups: subjects with bilateral CTS (median SNCV value normative ulnar SNCV value >37.8m/s) in the initial test (n=10), subjects with newly developed CTS in the follow-up test (n=8), and subjects without additional CTS in the follow-up test (n=27). Eight of 35 subjects not having bilateral CTS initially developed new CTS (8.8% per year; mean follow-up period, 2.6y). Leg lean tissue percentage was associated with the probability of newly developed CTS (adjusted odds ratio, .64; P12% were less likely to have developed new CTS at the follow-up test (sensitivity, .75; specificity, .85; area under the curve, .88; Pphysical disabilities. Therefore, a preventive program for those subjects at risk can start early. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Emphysematous Pyelonephritis Presenting as Necrotizing Fasciitis of the Leg

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Yu-Xiong Ye

2009-03-01

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.

Self-Described Differences Between Legs in Ballet Dancers: Do They Relate to Postural Stability and Ground Reaction Force Measures?

Science.gov (United States)

Mertz, Laura; Docherty, Carrie

2012-12-01

Ballet technique classes are designed to train dancers symmetrically, but they may actually create a lateral bias. It is unknown whether dancers in general are functionally asymmetrical, or how an individual dancer's perceived imbalance between legs might manifest itself. The purpose of this study was to examine ballet dancers' lateral preference by analyzing their postural stability and ground reaction forces in fifth position when landing from dance-specific jumps. Thirty university ballet majors volunteered to participate in this study. The subjects wore their own ballet technique shoes and performed fundamental ballet jumps out of fifth position on a force plate. The force plate recorded center of pressure (COP) and ground reaction force (GRF) data. Each subject completed a laterality questionnaire that determined his or her preferred landing leg for ballet jumps, self-identified stronger leg, and self-identified leg with better balance. All statistical comparisons were made between the leg indicated on the laterality questionnaire and the other leg (i.e., if the dancer's response to a question was "left," the comparison was made with the left leg as the "preferred" leg and the right leg as the "non-preferred leg"). No significant differences were identified between the limbs in any of the analyses conducted (all statistical comparisons produced p values > 0.05). The results of this study indicate that a dancer's preferential use of one limb over the other has no bearing on GRFs or balance ability after landing jumps in ballet. Similarly, dancers' opinions of their leg characteristics (such as one leg being stronger than the other) seem not to correlate with the dancers' actual ability to absorb GRFs or to balance when landing from ballet jumps.

A comparison and update of direct kinematic-kinetic models of leg stiffness in human running.

Science.gov (United States)

Liew, Bernard X W; Morris, Susan; Masters, Ashleigh; Netto, Kevin

2017-11-07

Direct kinematic-kinetic modelling currently represents the "Gold-standard" in leg stiffness quantification during three-dimensional (3D) motion capture experiments. However, the medial-lateral components of ground reaction force and leg length have been neglected in current leg stiffness formulations. It is unknown if accounting for all 3D would alter healthy biologic estimates of leg stiffness, compared to present direct modelling methods. This study compared running leg stiffness derived from a new method (multiplanar method) which includes all three Cartesian axes, against current methods which either only include the vertical axis (line method) or only the plane of progression (uniplanar method). Twenty healthy female runners performed shod overground running at 5.0 m/s. Three-dimensional motion capture and synchronised in-ground force plates were used to track the change in length of the leg vector (hip joint centre to centre of pressure) and resultant projected ground reaction force. Leg stiffness was expressed as dimensionless units, as a percentage of an individual's bodyweight divided by standing leg length (BW/LL). Leg stiffness using the line method was larger than the uniplanar method by 15.6%BW/LL (P method by 24.2%BW/LL (P stiffness from the uniplanar method was larger than the multiplanar method by 8.5%BW/LL (6.5 kN/m) (P stiffness estimate with the multiplanar method. Given that limb movements typically occur in 3D, the new multiplanar method provides the most complete accounting of all force and length components in leg stiffness calculation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Secondary hyperparathyroidism: Uncommon cause of a leg ulcer

NARCIS (Netherlands)

van Rijssen, L. B.; Brenninkmeijer, E. E. A.; Nieveen van Dijkum, E. J. M.

2012-01-01

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

Reasonable designing method for fillet welding leg length

Energy Technology Data Exchange (ETDEWEB)

Kiso, T; Michiyuki, T; Nagao, S; Yoshikawa, M; Miyazaki, S

1976-12-01

In VLCC and ULCC vessels, the scantling of structural members, especially the thickness of web plate, increases naturally. The present rule of each classification society generally prescribes that welding leg length should be based on the thickness of the web plate. Welding leg length between this web plate and skin plate such as shell plate, deck plate, etc., or face plate, increases according to increase of the thickness of the web plate. We investigated the method to decide reasonable welding leg length and its programming by using the results of finite element method structural analysis, without adhering to the above rule about welding leg length. As a result of applying this method to actual ships under classification societies' approval, the amount of welding decreased by from about 10 percent to 15 percent compared with that required by the above rule. The rationality of the method has been already confirmed by successful results of the application to several vessels in service.

Theory Analysis and Experiment Research of the Leg Mechanism for the Human-Carrying Walking Chair Robot

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Lingfeng Sang

2014-01-01

Full Text Available For the high carrying capacity of the human-carrying walking chair robot, in this paper, 2-UPS+UP parallel mechanism is selected as the leg mechanism; then kinematics, workspace, control, and experiment of the leg mechanism are researched in detail. Firstly, design of the whole mechanism is described and degrees of freedom of the leg mechanism are analyzed. Second, the forward position, inverse position, and velocity of leg mechanism are studied. Third, based on the kinematics analysis and the structural constraints, the reachable workspace of 2-UPS+UP parallel mechanism is solved, and then the optimal motion workspace is searched in the reachable workspace by choosing the condition number as the evaluation index. Fourth, according to the theory analysis of the parallel leg mechanism, its control system is designed and the compound position control strategy is studied. Finally, in optimal motion workspace, the compound position control strategy is verified by using circular track with the radius 100 mm; the experiment results show that the leg mechanism moves smoothly and does not tremble obviously. Theory analysis and experiment research of the single leg mechanism provide a theoretical foundation for the control of the quadruped human-carrying walking chair robot.

THE ROLE OF LEG AND TRUNK MUSCLES PROPRIOCEPTION ON STATIC AND DYNAMIC POSTURAL CONTROL

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SEYED Hossein Hosseinimehr

2010-04-01

Full Text Available The proprioception information is a prerequisite for balance, body’s navigation system, and the movement coordinator. Due to changes between the angles of ankle, knee, and hip joints the aforementioned information are important in the coordination of the limbs and postural balance. The aim of this study was to investigate therole of leg and trunk muscles proprioception on static and dynamic postural control. Thirty males students of physical education and sport sciences (age =21.23 ± 2.95 years, height = 170.4 ± 5.1 cm, and weight = 70.7 ± 5.6 kg participated in this study volunteered. Vibration (100HZ was used to disturb of proprioception. Vibrationoperated on leg muscle (gasterocnemius and trunk muscles (erector spine muscle, at L1 level. Leg stance time and Star Excursion Balance Test were used for evaluation of static and dynamic postural control respectively.Subjects performed pre and post (with operated vibration leg stance time and star excursion balance test. Paired sample test used for investigation the effect of vibration on leg and trunk muscles in static and dynamic postural control. Result of this study showed in static postural control, there is no significant difference between pre and post test (operated vibration in leg and trunk muscles (p≤0.05. In contrast there is significant difference indynamic postural control between pre and post test in leg muscles in 8 directions of star excursion balance test (p≤0.05 while there is only significant difference in trunk muscle in antrolateral and lateral of star excursion balance test (p≤0.05. During physical training such conditions like fatigue and injury can disturbproprioceptions’ information. Thus, due to the importance of this information we recommend that coaches'additionally specific trainings any sport used specific exercises to enhance the proprioception information

Estimation of peak heat flux onto the targets for CFETR with extended divertor leg

International Nuclear Information System (INIS)

Zhang, Chuanjia; Chen, Bin; Xing, Zhe; Wu, Haosheng; Mao, Shifeng; Luo, Zhengping; Peng, Xuebing; Ye, Minyou

2016-01-01

Highlights: • A hypothetical geometry is assumed to extend the outer divertor leg in CFETR. • Density scan SOLPS simulation is done to study the peak heat flux onto target. • Attached–detached regime transition in out divertor occurs at lower puffing rate. • Unexpected delay of attached–detached regime transition occurs in inner divertor. - Abstract: China Fusion Engineering Test Reactor (CFETR) is now in conceptual design phase. CFETR is proposed as a good complement to ITER for demonstrating of fusion energy. Divertor is a crucial component which faces the plasmas and handles huge heat power for CFETR and future fusion reactor. To explore an effective way for heat exhaust, various methods to reduce the heat flux to divertor target should be considered for CFETR. In this work, the effect of extended out divertor leg on the peak heat flux is studied. The magnetic configuration of the long leg divertor is obtained by EFIT and Tokamak Simulation Code (TSC), while a hypothetical geometry is assumed to extend the out divertor leg as long as possible inside vacuum vessel. A SOLPS simulation is performed to study peak heat flux of the long leg divertor for CFETR. D 2 gas puffing is used and increasing of the puffing rate means increase of plasma density. Both peak heat flux onto inner and outer targets are below 10 MW/m 2 is achieved. A comparison between the peak heat flux between long leg and conventional divertor shows that an attached–detached regime transition of out divertor occurs at lower gas puffing gas puffing rate for long leg divertor. While for the inner divertor, even the configuration is almost the same, the situation is opposite.

Estimation of peak heat flux onto the targets for CFETR with extended divertor leg

Energy Technology Data Exchange (ETDEWEB)

Zhang, Chuanjia; Chen, Bin [School of Nuclear Science and Technology, University of Science and Technology of China, 96 Jinzhai Road, Hefei, Anhui 230026 (China); Xing, Zhe [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031 (China); Wu, Haosheng [School of Nuclear Science and Technology, University of Science and Technology of China, 96 Jinzhai Road, Hefei, Anhui 230026 (China); Mao, Shifeng, E-mail: sfmao@ustc.edu.cn [School of Nuclear Science and Technology, University of Science and Technology of China, 96 Jinzhai Road, Hefei, Anhui 230026 (China); Luo, Zhengping; Peng, Xuebing [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031 (China); Ye, Minyou [School of Nuclear Science and Technology, University of Science and Technology of China, 96 Jinzhai Road, Hefei, Anhui 230026 (China); Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031 (China)

2016-11-01

Highlights: • A hypothetical geometry is assumed to extend the outer divertor leg in CFETR. • Density scan SOLPS simulation is done to study the peak heat flux onto target. • Attached–detached regime transition in out divertor occurs at lower puffing rate. • Unexpected delay of attached–detached regime transition occurs in inner divertor. - Abstract: China Fusion Engineering Test Reactor (CFETR) is now in conceptual design phase. CFETR is proposed as a good complement to ITER for demonstrating of fusion energy. Divertor is a crucial component which faces the plasmas and handles huge heat power for CFETR and future fusion reactor. To explore an effective way for heat exhaust, various methods to reduce the heat flux to divertor target should be considered for CFETR. In this work, the effect of extended out divertor leg on the peak heat flux is studied. The magnetic configuration of the long leg divertor is obtained by EFIT and Tokamak Simulation Code (TSC), while a hypothetical geometry is assumed to extend the out divertor leg as long as possible inside vacuum vessel. A SOLPS simulation is performed to study peak heat flux of the long leg divertor for CFETR. D{sub 2} gas puffing is used and increasing of the puffing rate means increase of plasma density. Both peak heat flux onto inner and outer targets are below 10 MW/m{sup 2} is achieved. A comparison between the peak heat flux between long leg and conventional divertor shows that an attached–detached regime transition of out divertor occurs at lower gas puffing gas puffing rate for long leg divertor. While for the inner divertor, even the configuration is almost the same, the situation is opposite.

Uremic restless legs syndrome (RLS) and sleep quality in patients with end-stage renal disease on hemodialysis: potential role of homocysteine and parathyroid hormone.

Science.gov (United States)

Gade, Katrin; Blaschke, Sabine; Rodenbeck, Andrea; Becker, Andreas; Anderson-Schmidt, Heike; Cohrs, Stefan

2013-01-01

The aetiology of uremic restless legs syndrome (RLS) remains unclear. Our research investigated whether an elevated plasma concentration of the excitatory amino acid homocysteine might be associated with RLS occurrence in patients with chronic renal insufficiency on hemodialysis. Total plasma homocysteine as well as creatinine, urea, folate, parathyroid hormone, hemoglobin, iron, ferritin, phosphate, calcium, magnesium, and albumin levels were compared between 26 RLS-affected (RLSpos) and 26 non-affected (RLSneg) patients on chronic hemodialysis. We further compared subjective sleep quality between RLSpos and RLSneg patients using the Pittsburgh-Sleep-Quality-Index and investigated possible relationships between laboratory parameters and sleep quality. Taking individual albumin concentrations into account, a significant positive correlation between total plasma homocysteine and RLS occurrence was observed (r= 0.246; p=0.045). Sleep quality was significantly more reduced in RLSpos compared to RLSneg patients and RLS severity correlated positively with impairment of sleep quality. Bad sleep quality in all patients was associated with higher concentrations of parathyroid hormone. Our results suggest a possible aetiological role of homocysteine in uremic RLS. They confirm that uremic RLS is an important factor causing sleep impairment in patients on hemodialysis. Higher parathyroid hormone levels might also be associated with bad sleep quality in these patients. © 2013 S. Karger AG, Basel.

Dynamic stability of running: The effects of speed and leg amputations on the maximal Lyapunov exponent

International Nuclear Information System (INIS)

Look, Nicole; Arellano, Christopher J.; Grabowski, Alena M.; Kram, Rodger; McDermott, William J.; Bradley, Elizabeth

2013-01-01

In this paper, we study dynamic stability during running, focusing on the effects of speed, and the use of a leg prosthesis. We compute and compare the maximal Lyapunov exponents of kinematic time-series data from subjects with and without unilateral transtibial amputations running at a wide range of speeds. We find that the dynamics of the affected leg with the running-specific prosthesis are less stable than the dynamics of the unaffected leg and also less stable than the biological legs of the non-amputee runners. Surprisingly, we find that the center-of-mass dynamics of runners with two intact biological legs are slightly less stable than those of runners with amputations. Our results suggest that while leg asymmetries may be associated with instability, runners may compensate for this effect by increased control of their center-of-mass dynamics

A Biological Micro Actuator: Graded and Closed-Loop Control of Insect Leg Motion by Electrical Stimulation of Muscles

Science.gov (United States)

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

2014-01-01

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

A biological micro actuator: graded and closed-loop control of insect leg motion by electrical stimulation of muscles.

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Feng Cao

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.

Leg Regrowth in Blaberus discoidalis (Discoid Cockroach following Limb Autotomy versus Limb Severance and Relevance to Neurophysiology Experiments.

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Timothy C Marzullo

Full Text Available Many insects can regenerate limbs, but less is known about the regrowth process with regard to limb injury type. As part of our neurophysiology education experiments involving the removal of a cockroach leg, 1 the ability of Blaberus discoidalis cockroaches to regenerate a metathoracic leg was examined following autotomy at the femur/trochanter joint versus severance via a transverse coxa-cut, and 2 the neurophysiology of the detached legs with regard to leg removal type was studied by measuring spike firing rate and microstimulation movement thresholds.First appearance of leg regrowth was after 5 weeks in the autotomy group and 12 weeks in the coxa-cut group. Moreover, regenerated legs in the autotomy group were 72% of full size on first appearance, significantly larger (p<0.05 than coxa-cut legs (29% of full size at first appearance. Regenerated legs in both groups grew in size with each subsequent molt; the autotomy-removed legs grew to full size within 18 weeks, whereas coxa-cut legs took longer than 28 weeks to regrow. Removal of the metathoracic leg in both conditions did not have an effect on mortality compared to matched controls with unmolested legs.Autotomy-removed legs had lower spontaneous firing rates, similar marked increased firing rates upon tactile manipulation of tibial barbs, and a 10% higher electrical microstimulation threshold for movement.It is recommended that neurophysiology experiments on cockroach legs remove the limb at autotomy joints instead of coxa cuts, as the leg regenerates significantly faster when autotomized and does not detract from the neurophysiology educational content.

An unusual presentation of Brown-Sequard syndrome.

Science.gov (United States)

Herr, R D; Barrett, J

1987-11-01

We report the case of a man with Brown-Sequard syndrome following a fall in which he sustained fractures of the thoracic and lumbosacral spine. Despite characteristic neurological findings, the diagnosis was delayed due to the absence of history of penetrating spinal trauma and incorrect attribution of unilateral-like weakness and numbness to lumbosacral trauma. A directed history and examination revealed that the patient was stabbed in the back with a penknife while leaving a bus and stepped down onto a paralyzed leg, which collapsed beneath him. The patient was given an antibiotic, underwent a negative peritoneal lavage, and had myelography and nerve conduction velocity confirmatory for Brown-Sequard syndrome. With rehabilitation he became ambulatory with a cane one month after the stabbing.

Leg ulcers associated with Klinefelter’s syndrome: a case report and review of the literature

OpenAIRE

Shanmugam, Victoria K; Tsagaris, Katina C; Attinger, Christopher E

2011-01-01

We present the case of a young man with type II diabetes, stage III chronic kidney disease, hypertension, obstructive sleep apnea and diabetes who presented to the Georgetown University Hospital Center for Wound Healing with refractory lower extremity ulcers. Autoimmune work-up was negative. However, chromosome analysis showed a genetic variant of Klinefelter’s syndrome (48 XXYY). Lower extremity ulceration is a recognised complication of Klinefelter’s syndrome. The pathogenesis of ulcers in ...

COMPARISON OF UNILATERAL SQUAT STRENGTH BETWEEN THE DOMINANT AND NON-DOMINANT LEG IN MEN AND WOMEN

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Kevin McCurdy

2005-06-01

Full Text Available The purpose of this study was to compare unilateral squat strength of the dominant and non-dominant leg in young adult men and women. Seventeen apparently healthy men (mean mass 90.5 ± 20.9 kg and age 21.7 ± 1.8 yrs and 25 women (mean mass 62.2 ± 14.5 kg and age 21.9 ± 1.3 yrs completed the study. To determine unilateral strength, the subjects completed a one repetition maximum (1RM modified unilateral squat (MUS on the dominant and non-dominant leg. The subjects completed the squat to a depth that attained a 90º angle at the knee. This exercise was executed by placing the top of the metatarsophalangeal area of the foot of the uninvolved leg on a support bar behind the subject to isolate the use of the lead leg. Paired samples t-test revealed no significant difference between the men's 1RM mean strength on the dominant (107.0 ± 21.4 kg and non-dominant (106.0 ± 21.4 kg leg with a mean side-to-side difference (comparing the stronger to the weaker leg of 2.8 %. Leg strength symmetry was also found between the women's 1RM mean strength on the dominant (45.3 ± 12.5 kg and non-dominant (45.0 ± 12.4 kg leg with a mean side-to-side difference of 5.0 %. The data indicate that unilateral squat strength, measured in a weight bearing stance, is similar in the dominant and non-dominant leg in apparently healthy young adult men and women

Data report for ROSA-IV LSTF 10% hot leg break experiment Run SB-HL-04

International Nuclear Information System (INIS)

Kukita, Yutaka; Nakamura, Hideo; Saeki, Hiroyuki

1991-03-01

Experimental data for the 10% hot leg break test, Run SB-HL-04, conducted on March 29, 1988 at the ROSA-IV Large Scale Test Facility (LSTF), are presented. This test was conducted as part of test series which studied the effect of break orientation on 10% hot leg break transient, and represented a vertical upward break. Other two tests in this test series represented horizontal break and vertical downward break, respectively. The results of these tests were characterized by asymmetric loop responses, flashing in the cold legs as well as upper downcomer, and condensation depressurization in the cold legs following injection of emergency core coolant (ECC) from accumulators. (author)

Multi-Axis Prosthetic Knee Resembles Alpine Skiing Movements of an Intact Leg

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Ivan Demšar, Jože Duhovnik, Blaž Lešnik, Matej Supej

2015-12-01

Full Text Available The purpose of the study was to analyse the flexion angles of the ski boot, ankle and knee joints of an above-knee prosthesis and to compare them with an intact leg and a control group of skiers. One subject with an above-knee amputation of the right leg and eight healthy subjects simulated the movement of a skiing turn by performing two-leg squats in laboratory conditions. By adding additional loads in proportion to body weight (BW; +1/3 BW, +2/3 BW, +3/3 BW, various skiing regimes were simulated. Change of Flexion Angle (CoFA and Range of Motion (RoM in the ski boot, ankle and knee joints were calculated and compared. An average RoM in the skiing boot on the side of prosthesis (4.4 ± 1.1° was significantly lower compared to an intact leg (5.9 ± 1.8° and the control group (6.5 ± 2.3°. In the ankle joint, the average RoM was determined to be 13.2±2.9° in the prosthesis, 12.7 ± 2.8° in an intact leg and 14.8±3.6 in the control group. However, the RoM of the knee joint in the prosthesis (42.2 ± 4.2° was significantly larger than that of the intact leg (34.7 ± 4.4°. The average RoM of the knee joint in the control group was 47.8 ± 5.4°. The influences of additional loads on the kinematics of the lower extremities were different on the side of the prosthesis and on the intact leg. In contrast, additional loads did not produce any significant differences in the control group. Although different CoFAs in the ski boot, ankle and knee joints were used, an above-knee prosthesis with a built-in multi-axis prosthetic knee enables comparable leg kinematics in simulated alpine skiing.

High performance p-type segmented leg of misfit-layered cobaltite and half-Heusler alloy

International Nuclear Information System (INIS)

Hung, Le Thanh; Van Nong, Ngo; Snyder, G. Jeffrey; Viet, Man Hoang; Balke, Benjamin; Han, Li; Stamate, Eugen; Linderoth, Søren; Pryds, Nini

2015-01-01

Highlights: • p-type segmented leg of oxide and half-Heusler was for the first time demonstrated. • The maximum conversion efficiency reached a value of about 5%. • The results are among the highest reported values so far for oxide-based legs. • Oxide-based segmented leg is very promising for generating electricity. - Abstract: In this study, a segmented p-type leg of doped misfit-layered cobaltite Ca 2.8 Lu 0.15 Ag 0.05 Co 4 O 9+δ and half-Heusler Ti 0.3 Zr 0.35 Hf 0.35 CoSb 0.8 Sn 0.2 alloy was fabricated and characterized. The thermoelectric properties of single components, segmented leg, and the electrical contact resistance of the joint part were measured as a function of temperature. The output power generation characteristics of segmented legs were characterized in air under various temperature gradients, ΔT, with the hot side temperature up to 1153 K. At ΔT ≈ 756 K, the maximum conversion efficiency reached a value of ∼5%, which is about 65% of that expected from the materials without parasitic losses. The long-term stability investigation for two weeks at the hot and cold side temperatures of 1153/397 K shows that the segmented leg has good durability as a result of stable and low electrical resistance contacts