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Sample records for limbs comparative study

  1. Liposomal angiogenic peptides for ischemic limb perfusion: comparative study between different administration methods.

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    Hwang, Hyosook; Kim, Hyeon-Soo; Jeong, Hwan-Seok; Rajasaheb, Bagalkot Tarique; Kim, Minjoo; Oh, Phil-Sun; Lim, Seok Tae; Sohn, Myung-Hee; Jeong, Hwan-Jeong

    2016-11-01

    We investigated the therapeutic effectiveness of PEGylated liposomes loaded with angiogenic peptides for treating hindlimb ischemia. Rats received a femoral artery occlusion. Red blood cells collected from the animals were labeled with technetium-99m. Limb perfusion gamma imaging was performed. PEGylated liposomes loaded with angiogenic peptides were administered intra-arterially. Technetium-99m red blood cell imaging was repeated 1 week later. The animals were sacrificed the next day. The expression of angiogenic proteins was studied. Later, changes in limb perfusion after intra-arterial infusion versus intra-muscular injection were also compared to determine the therapeutic effectiveness of different administration methods. Femoral artery occlusion dramatically reduced ischemic limb perfusion (by an average of 69%, compared to contralateral limb). This was not different among groups (p > 0.05). Liposomes loaded with angiogenic peptides significantly improved ischemic limb perfusion, compared to controls (210% of baseline, versus 100% of baseline in control; p perfusion was accompanied by an increased expression of CD 31 (an average of 1.6-fold increase of controls; p perfusion (liposomes alone: 100% of baseline; peptides alone: 120% of baseline; p > 0.05 versus controls, respectively) or the angiogenic response (1.1-fold of controls in liposomes alone; 1.0-fold of controls in peptides alone; p > 0.05 versus controls, respectively). Intra-muscular injection induced similar liposomal treatment effects on ischemic limb perfusion (230% of baseline) as those by intra-arterial infusion (210% of baseline; p perfusion and promoted angiogenic responses. Liposomal angiogenic treatment via intra-arterial infusion resulted in an equally effective therapeutic efficacy compared to that of intra-muscular injection. These results show the therapeutic potential of our liposomal strategy for treating peripheral limb ischemia.

  2. Limb shortening in the course of solitary bone cyst treatment - a comparative study

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    Glowacki, Maciej [Karol Marcinkowski University of Medical Sciences, Department of Paediatric Orthopaedics, Poznan (Poland); Ignys-O' Byrne, Anna [J. Strus City Hospital, Department of Radiology, Poznan (Poland); Ignys, Iwona [Karol Marcinkowski University of Medical Sciences, Department of Paediatric Gastroenterology and Metabolic Diseases, Poznan (Poland); Wroblewska, Katarzyna [Karol Marcinkowski University of Medical Sciences, Department of Radiology, Poznan (Poland)

    2011-02-15

    The aim of this paper is to evaluate the frequency of limb shortening in the course of solitary bone cyst treatment. The correlation between the mode of treatment as well as the occurrence of pathological fracture, cyst location, volume, and locularity were examined. A retrospective analysis was carried out on 135 patients where 80 underwent curettage and bone grafting and 55 were administered methylprednisolone injection with a mean time to follow-up of 12 years. Based on clinical and radiological evaluation, limb shortening was found in ten patients when the data before and after treatment was compared. Limb shortening ranging from 1 to 5 cm during the course of the treatment was observed: six in humerus, two in femur, two in tibia. Those with epiphyseal changes, magnetic resonance imaging to evaluate the degree of growth plate damage was performed. Patients with and without limb shortening did not differ statistically regarding the applied method of treatment. The cyst volume was significantly larger in the group of patients with limb shortening when compared to the group of patients with no limb shortening. In patients treated with curettage and bone grafting, the mode of treatment does not increase the frequency of occurrence of iatrogenic limb shortening. In patients with limb shortening, a statistically significant larger volume of the cyst was observed. (orig.)

  3. [Comparative study of the volume difference vs. healthy limb, morphological and population description in transfemoral amputees].

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    Mendoza-Cruz, Felipe; Rodríguez-Reyes, Gerardo; Galván Duque-Gastélum, Carlos; Alvarez-Camacho, Michelín

    2014-07-01

    Knowledge of the general characteristics and physical condition that keeps the transfemoral amputation stump to select and adapt appropriate type of prosthesis to restore a walking pattern amputee patient acceptable and useful design parameters set to propose new prosthetic systems. In this paper, the degree of difference between the volumes of the limb stump and healthy as well as morphological features occurred more frequently in the stumps of transfemoral amputees who were treated at the Laboratory of Orthotics and Prosthetics (LOP), Instituto Nacional de Rehabilitación (INR) in 2008. It captured all patients with unilateral transfemoral amputation left and right, over 18 years old, both sexes, use of hearing candidates were evaluated clinically and took three measurements of the circumferences at different wavelengths and the limb stump healthy, were calculated volumes of both sides using the mathematical model of the truncated cone and analyzed in three groups according to the level of amputation (proximal, middle and distal third). We obtained 49 patients, 39 men and 10 women, the difference stump volume compared to healthy limb volume per group were: 44.9% proximal third, middle third and distal 26.5%, 21.1%, the frequency of diagnostic data showed a stump right transfemoral amputees, due to metabolic, without use of prostheses, the most common morphological features indicate that the stump has a conical shape and size distal third, whose tissue is semi-flaccid consistency, the scar is not adhered to deep planes and shows a negative tinel, the mattress soft tissue is 2.15 ± 1.3 cm and physically presents a force level 4 in the clinical rating scale Daniels. The data are consistent with other studies comparing the percentage of the volume change with the percentages of reduced diameters transfemoral stump muscle, likewise agrees most amputees incidence of diabetes mellitus with other studies, cataloging it eat first cause amputation. The general description

  4. Randomized, multicenter, comparative study of NEURO versus CIMT in poststroke patients with upper limb hemiparesis: the NEURO-VERIFY Study.

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    Abo, Masahiro; Kakuda, Wataru; Momosaki, Ryo; Harashima, Hiroaki; Kojima, Miki; Watanabe, Shigeto; Sato, Toshihiro; Yokoi, Aki; Umemori, Takuma; Sasanuma, Jinichi

    2014-07-01

    Many poststroke patients suffer functional motor limitation of the affected upper limb, which is associated with diminished health-related quality of life. The aim of this study is to conduct a randomized, multicenter, comparative study of low-frequency repetitive transcranial magnetic stimulation combined with intensive occupational therapy, NEURO (NovEl intervention Using Repetitive TMS and intensive Occupational therapy) versus constraint-induced movement therapy in poststroke patients with upper limb hemiparesis. In this randomized controlled study of NEURO and constraint-induced movement therapy, 66 poststroke patients with upper limb hemiparesis were randomly assigned at 2:1 ratio to low-frequency repetitive transcranial magnetic stimulation plus occupational therapy (NEURO group) or constraint-induced movement therapy (constraint-induced movement therapy group) for 15 days. Fugl-Meyer Assessment and Wolf Motor Function Test and Functional Ability Score of Wolf Motor Function Test were used for assessment. No differences in patients' characteristics were found between the two groups at baseline. The Fugl-Meyer Assessment score was significantly higher in both groups after the 15-day treatment compared with the baseline. Changes in Fugl-Meyer Assessment scores and Functional Ability Score of Wolf Motor Function Test were significantly higher in the NEURO group than in the constraint-induced movement therapy group, whereas the decrease in the Wolf Motor Function Test log performance time was comparable between the two groups (changes in Fugl-Meyer Assessment score, NEURO: 5·39 ± 4·28, constraint-induced movement therapy: 3·09 ± 4·50 points; mean ± standard error of the mean; P < 0·05) (changes in Functional Ability Score of Wolf Motor Function Test, NEURO: 3·98 ± 2·99, constraint-induced movement therapy: 2·09 ± 2·96 points; P < 0·05). The results of the 15-day rehabilitative protocol showed the superiority of NEURO

  5. An experimental comparative study between polypropylene and laminated lower limb prosthetic socket

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    .Haider F. Neama, M.Sc

    2007-01-01

    Full Text Available Most researchers concentrate their studies on the design, stress and pressure distributions of the prosthetic socket. A little attention is considered for the stiffness of the various materials of the prosthetic sockets. Prosthetic laminated sockets in Iraq are costly to be manufactured while polypropylene socket is relatively cheap in comparing with the laminates. Experimental study is conducted to compare the stiffness of five prosthetic sockets made of different materials. Compression, three point flexural and tensile tests are implemented by the Testometric machine. The laminate sockets give better results in compression than polypropylene. Polypropylene gives good results in bending compared with the laminate sockets. When the socket loads are mainly in compression i.e. the low activity level patients, it seems that any of the tested sockets could be used, however, when the load will be not only in compression but in flexion as well i.e. high activity patients, socket No.1 and 5 could be used

  6. A comparative study of gland cells implicated in the nerve dependence of salamander limb regeneration.

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    Kumar, Anoop; Nevill, Graham; Brockes, Jeremy P; Forge, Andrew

    2010-07-01

    Limb regeneration in salamanders proceeds by formation of the blastema, a mound of proliferating mesenchymal cells surrounded by a wound epithelium. Regeneration by the blastema depends on the presence of regenerating nerves and in earlier work it was shown that axons upregulate the expression of newt anterior gradient (nAG) protein first in Schwann cells of the nerve sheath and second in dermal glands underlying the wound epidermis. The expression of nAG protein after plasmid electroporation was shown to rescue a denervated newt blastema and allow regeneration to the digit stage. We have examined the dermal glands by scanning and transmission electron microscopy combined with immunogold labelling of the nAG protein. It is expressed in secretory granules of ductless glands, which apparently discharge by a holocrine mechanism. No external ducts were observed in the wound epithelium of the newt and axolotl. The larval skin of the axolotl has dermal glands but these are absent under the wound epithelium. The nerve sheath was stained post-amputation in innervated but not denervated blastemas with an antibody to axolotl anterior gradient protein. This antibody reacted with axolotl Leydig cells in the wound epithelium and normal epidermis. Staining was markedly decreased in the wound epithelium after denervation but not in the epidermis. Therefore, in both newt and axolotl the regenerating axons induce nAG protein in the nerve sheath and subsequently the protein is expressed by gland cells, under (newt) or within (axolotl) the wound epithelium, which discharge by a holocrine mechanism. These findings serve to unify the nerve dependence of limb regeneration.

  7. COMPARATIVE STUDY BETWEEN EPIDURAL BUPIVACAINE WITH BUPRENORPHINE AND EPIDURAL BUPIVACAINE FOR POST - OPERATIVE ANALGESIA IN ABDOMINAL AND LOWER LIMB SURGERY

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    Nagesh

    2015-02-01

    Full Text Available Epidural administration of various analgesics gained increasing popularity following the discovery of opioid receptors in the spinal cord capable of producing potent analgesia. This effect seems to be greatest when epidural anaesthesia in continued in the post - operative period as epidural analgesia . It is now clear that epidural administration of opioids. Ours was a comparative study between epidural bupivacaine with buprenorphine and epidural bupivacaine for post - operative analgesia in abdominal and lower limb surgery. METHODS: 60 patients undergoing lower abdominal and lower limb surgeries of either sex with ASA grade 1 and 2 a ged between 20 and 60 years for divided into two groups. After completion of the surgery and when the effect of local anaesthetic wears of and the patients complains of pain the intended study drugs were given when visual analogue pain score touched 5 cm m ark. Group – A: Patients received 8ml of 0.25% bupivacaine + 0.15mg of buprenorphine. Group – B: patients received 0.25% of bupivacaine alone. In the post - operative period the following parameters were studied , 1. Onset of analgesia , 2. Duration of analges ia , 3. Vital parameters such as heart beat , blood pressure , respiratory rate , sedation score and visual analogue score were recorded , 4. Side effects like nausea , vomiting , hypotension , respiratory depression , and pruritus allergic reaction were looked for . RESULTS: It is observed that onset of analgesia in Group A (0.25% bupivacaine + 0.15mg buprenorphine was 7.35 min. When compared to Group B which 15.5 min , which is statically significant (P<0.05. Duration of analgesia in Group A is 17.23 hrs compared to Group B , which is 5.2 hrs , this is statically significant (P<0.05. Visual analogue scale was reduced in Group A compared to Group B CONCLUSIONS: Addition of buprenorphine to bupivacaine by epidural injection for post - operative analgesia improves the on set , The duration and the

  8. Comparative study of the effect of taping on scapular stability and upper limb function in recovering hemiplegics with scapular weakness

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    Dhwanit Shah

    2013-01-01

    Full Text Available Background: Hemiplegia is the commonest form of paralysis, involving arm, leg and sometimes the face on one side of the body. Shoulder girdle in chronic hemiplegic suffers from two sorts of problems (a spasticity of elevators and retractors, which pull the scapula into a fixed elevated and retracted position. (b weakness of the opposite group of scapular muscles, i.e., depressors and protectors. This leads to instability of the scapulothoracic joint resulting in impaired functional use of the upper limb, taping is a method of maintaining orientation of the scapula by means of proprioceptive biofeedback to the patient. Aim of this study is to check the effect of taping on scapular stability and upper limb function in recovering hemiplegics. Objectives of the Study: (1 To study the effect of taping on functional performance of the hemiplegic upper extremity. (2 To compare the effect of taping combined with physiotherapeutic exercises v/s physiotherapeutic exercises alone on functional independence of the hemiplegic upper extremity. Subjects: All the 37 chronic hemiplegic patients with scapular weakness were taken and divided into two groups: Group A (Experimental group and Group B (Control group. Materials and Methods: All the 37 chronic hemiplegic patients were evaluated by Fugl Meyer Physical Performance Assessment Scale for hemiplegic upper extremity before starting the treatment. Group A patients received scapular taping combined with physiotherapeutic exercises and Group B patients received only physiotherapeutic exercises for the period of 2 weeks. After 2 weeks both Group A and B patients were re-evaluated on Fugl Meyer Physical Performance Assessment Scale for hemiplegic upper extremity. Results: There was a significant improvement between the pre- and post-treatment scores of Group A patients on the Fugl Meyer Physical Performance Assessment Scale of hemiplegic upper extremity, whereas Group B patients score on the same scale was

  9. A COMPARATIVE STUDY OF DEXMEDETOMIDINE AND FENTANYL COMBINED WITH ROPIVACAINE FOR EPIDURAL ANAESTHESIA IN LOWER LIMB ORTHOPAEDIC SURGERIES

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    Ravi Vasupalli

    2016-09-01

    Full Text Available BACKGROUND Intrathecal anaesthesia and epidural anaesthesia are the most popular regional anaesthesia techniques used for lower limb surgeries. Intrathecal anaesthesia also called as subarachnoid block. It has few limitations like short duration of anaesthesia, extension of anaesthesia cannot be made for prolonged surgeries, rapid onset of sympathetic blockade, shorter duration of postoperative analgesia and troublesome complication of Post-Dural Puncture Headache (PDPH. Hence, epidural anaesthesia is the most preferred anaesthetic technique for lower limb surgeries these days. METHODS TIME FRAME The study was conducted during period spanning December 2013 to November 2014. STUDY POPULATION Patients who met all inclusion criteria were randomly selected. No distinction is made between males and females. STUDY DESIGN A prospective, randomised, double blind, case control, observational, interventional comparative study is designed after getting the informed written consent was obtained from the patient. RANDOMISATION Randomisation was done using a computer generated random number table. One hundred patients scheduled for various elective lower limb surgical procedures belonging to ASA class I and II were included in the study. 1. Group RD (n=50 15 mL of 0.75% ropivacaine + 0.6 µg/kg of dexmedetomidine (Inj. DEXTOMID-1 mL=100 mcg, 1 mL ampoule; 2. Group RF (n=50 15 mL of 0.75% ropivacaine (ropivacaine 0.75% preservative free-ROPIN 0.75%, 20 mL ampoules-Neon Laboratories, India, fentanyl 1 µg/kg Inj. FENTANYL-1 mL=50 mcg, 2 mL ampoule. The patients were premedicated with tablet alprazolam 0.5 mg and tablet ranitidine 150 mg orally at bedtime on the previous night before surgery. They were kept nil orally 10 p.m. onwards on the previous night. On the day of surgery, patient’s basal pulse rate and blood pressure were recorded. A peripheral intravenous line with 18 gauge cannula after local anaesthesia was secured in one of the upper limbs. All the

  10. A comparative study of intrathecal ropivacaine with fentanyl and L-bupivacaine with fentanyl in lower abdominal and lower limb surgeries

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    Prem Swarup Vampugalla

    2015-12-01

    Conclusion: This study revealed that the intrathecal ropivacaine with fentanyl provided adequate anesthesia for lower abdominal and lower limb surgeries. Ropivacaine achieved a shorter duration of sensory and motor blockade, and a lesser degree of motor blockade when compared to L-bupivacaine. Thus, ropivacaine was justified for short duration ambulatory surgeries of lower abdominal and lower limb surgeries. Furthermore, fentanyl as an adjuvant to both ropivacaine and L-bupivacaine enhanced the duration of the sensory block. Hence, ropivacaine with fentanyl in spinal anesthesia for lower abdominal and lower limb surgeries is a better alternative compared to L-bupivacaine with fentanyl favoring day care ambulatory surgeries. [Int J Basic Clin Pharmacol 2015; 4(6.000: 1147-1155

  11. Comparative study of the two types of limb remote ischemic per-conditioning on the brain protection

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    ZENG Xian-wei

    2013-04-01

    Full Text Available Background Limb remote ischemic per-conditioning (LRPC has been recognized as an applicable strategy in protecting against cerebral ischemia- reperfusion injury. However, widely used invasive limb remote ischemic per-conditioning (LRPC-I is traumatic, limiting the possibility of long-term application and making it more difficult to achieve the conversion from basic research to clinical practice. Because of this, if non-invasive limb remote ischemic per-conditioning (LRPC-N has the same effect of brain protection as LRPC-I, it may be more beneficial to clinical practice. Methods The middle cerebral artery occlusion (MCAO ischemia-reperfusion injury model was established by the suture method in mice. In the beginning of the ischemia, the LRPC-I and LRPC-N were respectively carried out by three cycles of 10 min distal airbag pressurization or clamping the distant limb artery (ischemia /10min reperfusion. Neurological functional deficits after procedure were evaluated, and the cerebral infarct volumes and the degree of cerebral edema were quantified by TTC staining. Results Compared with the control group, the neurological functional outcomes of LRPC-N group and LRPC-I group were improved significantly ( P = 0.041, 0.035; the edema volumes were much smaller ( P = 0.040, 0.028; the infarct volumes reduced significantly ( P = 0.001, 0.019. However, there were no significant differences between LRPC-N group and LRPC-I group on the functional neurological outcomes, edema volumes and the infarct volumes (P = 0.754, 0.946, 0.667. Conclusion Both the LRPC-N and LRPC-I have protective effects on animal models of cerebral ischemia-reperfusion injury, and there is no obvious difference between each other.

  12. Comparative study of the results of compound tibial shaft fractures treated by Ilizarov ring fixators and limb reconstruction system fixators

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    Chandra Prakash Pal; Harish Kumar; Deepak Kumar; K.S.Dinkar; Vivek Mittal; Naveen Kumar Singh

    2015-01-01

    Purpose: Ilizarov ring fixator and limb reconstruction system (LRS) fixators have been used in the management of complex tibial fractures with severe soft tissue injuries, compound tibial fractures, and infected tibial nonunion for which conventional internal fixation cannot be contemplated.Fracture union and distraction osteogenesis can be done simultaneously with these external fixators, allowing early weight bearing.Several previous studies have shown almost equal results of rail and ring fixators for the compound tibial shaft fractures.Thus we performed a prospective study to evaluate the union rate, functional outcome and amount of limb lengthening after the treatment of compound tibial shaft fractures with or without infected nonunion by ring or LRS fixators.Methods: This prospective study was done at Sarojini Naidu Medical College and Hospital, Agra, India and included 32 patients of compound tibial shaft fractures with or without infected nonunion.There were 26 males and 6 females and the average age was 40 years.Patients were randomly divided into two groups (n =16 for each): one underwent Ilizarov fixation and the other received LRS fixation.Cases were followed up for 3-24 months, 6 months on average from September 2012 to October 2014.Functional and radiological outcomes were assessed using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria for both rail and ring fixators.Results: Union was achieved in all cases.Radiological outcome was found excellent in 68.75%, good in 18.75% and fair in 12.50% of cases treated by rail fixators whereas it was excellent in 56.25%, good in 18.75%, fair in 12.50% and poor in 12.50% of cases treated by ring fixators.Functional result was satisfactory in 75.00% of cases treated by rail fixator and 68.75% of cases treated by ring fixators whereas the corresponding rate of unsatisfactory was 25.00% vs.31.25%.Conclusion: In our short-term assessment, LRS fixators show a

  13. COMPARATIVE STUDY BETWEEN TASK SPECIFIC MOTOR IMAGERY WITH MENTAL PRACTICE VERSUS TASK SPECIFIC MIRROR THERAPY ON UPPER LIMB FUNCTIONS FOR SUB ACUTE HEMIPLEGIA

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    Thara. N

    2015-10-01

    Full Text Available Background: Task specific training of upper limb may result in learning of new motor task through transfer after repeated practice. Mirror therapy and motor imagery are effective emerging techniques used as an adjunct in rehabilitation of upper limb function in hemiplegia. The purpose of the study is to find comparative effects of task specific motor imagery with mental practice over task specific mirror therapy on upper limb functional activities for subjects with sub acute hemiplegia. Method: An experimental study design with two groups conducted on 30 subjects with sub-acute hemiplegic. Thirty subjects randomised, 15 subjects into group A and 15 into group B. Group A subjects received task specific motor imagery with mental practice thrice a week for 10 weeks and Group B received task specific mirror therapy thrice a week for 10 weeks. In both groups, each session consisted of 60 minutes. The outcome measure such as Action Research Arm Test (ARAT was measured before and after 10 weeks of intervention. Results: Comparison of post intervention means of ARAT using Independent t test and Mann-Whitney Test showed that there is no statistically significant difference in grasp and gross movement between the groups and there is a statistically significant difference in grip, pinch and total score between the groups. Conclusion: The present study concludes that 10 weeks of task specific motor imagery with mental practice and task specific mirror therapy both shown significant effect on improvement of upper extremity function. However, greater percentage of improvement was found using task specific motor imagery with mental practice in hand function when compared to task specific mirror therapy.

  14. Comparative effectiveness of peripheral vascular intervention versus surgical bypass for critical limb ischemia in the Vascular Study Group of Greater New York.

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    Meltzer, Andrew J; Sedrakyan, Art; Isaacs, Abby; Connolly, Peter H; Schneider, Darren B

    2016-11-01

    In this study, the effectiveness of peripheral vascular intervention (PVI) was compared with surgical bypass grafting (BPG) for critical limb ischemia (CLI) in the Vascular Study Group of Greater New York (VSGGNY). Patients undergoing BPG or PVI for CLI at VSGGNY centers (2011-2013) were included. The Society for Vascular Surgery objective performance goals for CLI were used to directly compare the safety and effectiveness of PVI and BPG. Propensity score matching was used for risk-adjusted comparisons of PVI with BPG. A total of 414 patients (268 PVI, 146 BPG) were treated for tissue loss (69%) or rest pain (31%). Patients undergoing PVI were more likely to have tissue loss (74.6% vs 57.5%; P PVI was associated with improved freedom from major adverse limb events and postoperative death at 1 year (95.6% vs 88.5%; P PVI. However, risk-adjusted comparison underscores the safety and effectiveness of PVI in the treatment of CLI. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  15. The effects of selective breeding on the architectural properties of the pelvic limb in broiler chickens: a comparative study across modern and ancestral populations.

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    Paxton, Heather; Anthony, Nicolas B; Corr, Sandra A; Hutchinson, John R

    2010-08-01

    Intensive artificial selection has led to the production of the modern broiler chicken, which over the last few decades has undergone a dramatic increase in growth rate and noticeable changes in body conformation. Unfortunately, this has been associated with musculoskeletal abnormalities which have altered the walking ability of these birds, raising obvious welfare concerns, as well as causing economic losses. Here we present a comparative study of ancestral and derived muscle anatomy in chickens to begin to tease apart how evolutionary alterations of muscle form in chickens have influenced their locomotor function and perhaps contributed to lameness. We measured the muscle architectural properties of the right pelvic limb in 50 birds, including the Giant Junglefowl, a commercial strain broiler and four pureline commercial broiler breeder lines (from which the broiler populations are derived) to identify which features of the broiler's architectural design have diverged the most from the ancestral condition. We report a decline in pelvic limb muscle mass in the commercial line birds that may compromise their locomotor abilities because they carry a larger body mass. This greater demand on the pelvic limb muscles has mostly led to changes in support at the hip joint, revealing significantly larger abductors and additionally much larger medial rotators in the broiler population. Differences were seen within the commercial line bird populations, which are likely attributed to different selection pressures and may reflect differences in the walking ability of these birds. In addition, Junglefowl seem to have both greater force-generating capabilities and longer, presumably faster contracting muscles, indicative of superior musculoskeletal/locomotor function. We have provided baseline data for generating hypotheses to investigate in greater depth the specific biomechanical constraints that compromise the modern broiler's walking ability and propose that these factors

  16. A comparative study of dexmedetomidine and fentanyl as adjuvants to levobupivacaine for caudal analgesia in children undergoing lower limb orthopedic surgery

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    Elfawal, SM; Abdelaal, WA; Hosny, MR

    2016-01-01

    Background: Levobupivacaine is an effective local anesthetic agent with less systemic toxicity than racemic bupivacaine, but it has short postoperative analgesic duration. Dexmedetomidine and fentanyl are promising adjuncts to provide excellent and prolonged postoperative caudal analgesia. This study compared the effects of caudal levobupivacaine plus dexmedetomidine and levobupivacaine plus fentanyl for postoperative analgesia and sedation in children undergoing lower limb orthopedic surgery. Patients and Methods: Ninety children, whose age ranged from 1 to 7 years, American Society of Anesthesiologists I-II, undergoing orthopedic lower limb surgery under general anesthesia received caudal block for postoperative analgesia. The children were randomly allocated into three groups: Group L (control) received 0.75 ml/kg levobupivacaine 0.25% diluted in saline; Group LD received 0.75 ml/kg levobupivacaine 0.25% with dexmedetomidine 1 μg/kg; and Group LF received 0.75 ml/kg levobupivacaine 0.25% with fentanyl 1 μg/kg. Following the administration of the drugs; hemodynamic variables, the total anesthesia time, sedation score, Face, Legs, Activity, Cry, Consolability score, duration of analgesia, and side effects were recorded. Results: Demographically, all the groups were comparable, both the baseline and the intraoperative hemodynamic profile were similar in all groups. The mean duration of analgesia and the mean sedation score in the Group LD were significantly greater as compared to both the other groups. Conclusion: Dexmedetomidine may be a better additive to levobupivacaine than fentanyl for caudal postoperative analgesia, arousable sedation with comparable hemodynamic and side effect profile in children. PMID:27833486

  17. A pilot study to compare the cerebral hemodynamics between patients with obstructive sleep apnea syndrome (OSA) and periodic limb movement syndrome (PLMS) during nocturnal sleep with near-infrared spectroscopy (NIRS)

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    Zhang, Zhongxing; Schneider, Maja; Laures, Marco; Fritschi, Ursula; Hügli, Gordana; Lehner, Isabella; Qi, Ming; Khatami, Ramin

    2014-03-01

    Obstructive sleep apnea syndrome (OSA) and periodic limb movement in sleep syndrome (PLMS) are two common sleep disorders. Previous studies showed that OSA and PLMS share common features, such as increased cardio-vascular risk, both apnea events and limb movements occur periodically, they are usually associated with cortical arousals, and both of them can induce declines in peripheral oxygen saturation measured with pulse oximetry. However, the question whether apnea events and limb movements also show similar characteristics in cerebral hemodynamic and oxygenation has never been addressed. In this pilot study, we will first time compare the cerebral hemodynamic changes induced by apnea events and limb movements in patients with OSA (n=4) and PLMS (n=4) with NIRS. In patients with OSA, we found periodic oscillations in HbO2, HHb, and blood volume induced by apnea/hypopnea events, HbO2 and HHb showed reverse changing trends. By contrast, the periodic oscillations linked to limb movements were only found in HbO2 and blood volume in patients with PLMS. These findings of different cerebral hemodynamics patterns between apnea events and limb movements may indicate different regulations of nervous system between these two sleep disorders.

  18. Randomized controlled comparative study on effect of training to improve lower limb motor paralysis in convalescent patients with post-stroke hemiplegia

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    Kawakami, Kenji; Miyasaka, Hiroyuki; Nonoyama, Sayaka; HAYASHI, Kazuya; Tonogai, Yusuke; Tanino, Genichi; Wada, Yosuke; Narukawa, Akihisa; Okuyama, Yuko; Tomita, Yutaka; ,; Sonoda, Shigeru

    2015-01-01

    [Purpose] The motor paralysis-improving effect on the hemiplegic lower limb was compared among mirror therapy, integrated volitional-control electrical stimulation, therapeutic electrical stimulation, repetitive facilitative exercises, and the standard training method in post-stroke hemiplegia patients. [Subjects and Methods] Eighty one stroke patients admitted to a convalescent rehabilitation ward were randomly allocated to the above 5 treatment groups. Each patient performed functional trai...

  19. Specialize or risk disappearance - empirical evidence of anisomerism based on comparative and developmental studies of gnathostome head and limb musculature.

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    Diogo, Rui; Ziermann, Janine M; Linde-Medina, Marta

    2015-08-01

    William K. Gregory was one of the most influential authors defending the existence of an evolutionary trend in vertebrates from a higher degree of polyisomerism (more polyisomeric or 'serial' anatomical structures arranged along any body axis) to cases of anisomerism (specialization or loss of at least some original polyisomeric structures). Anisomerism was the subject of much interest during the 19th and the beginning of the 20th centuries, particularly due to the influence of the Romantic German School and the notion of 'primitive archetype' and because it was conceptually linked to other crucial biological issues (e.g. complexity, scala naturae, progress, modularity or phenotypic integration). However, discussions on anisomerism and related issues (e.g. Williston's law) have been almost exclusively based on hard tissues. Here we provide the first detailed empirical test, and discussion, of anisomerism based on quantitative data obtained from phylogenetic and comparative analyses of the head and forelimb muscles of gnathostomes. Our results strongly support the existence of such a trend in both forelimb and head musculature. For instance, the last common ancestor (LCA) of extant tetrapods likely had 38 polyisomeric muscles (PMs) out of a total of 70 forelimb muscles (i.e. 54%), whereas in the LCAs of extant amniotes and of mammals these numbers were 38/73 (52%) and 21/67 (31%), and in humans are 11/59 (19%). Interestingly, the number of PMs that became specialized during the forelimb evolutionary transition from the LCA of extant tetrapods to humans (13) is very similar to the number of PMs that became lost (14), indicating that both specialization and loss contributed equally to the trend towards anisomerism. By contrast, during the evolution of the head musculature from the LCA of gnathostomes to humans a total of 27 PMs were lost whereas only one muscle became specialized. Importantly, the evolutionary trend towards anisomerism is not related to a general

  20. A COMPARATIVE STUDY OF EFFECT OF 0.5% AND 0.75% ISOBARIC ROPIVACAINE IN SPINAL ANAESTHESIA IN PATIENTS UNDERGOING ELECTIVE LOWER LIMB SURGERIES

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    Tridip Jyoti

    2016-04-01

    Full Text Available OBJECTIVES The study was conducted to compare the differences in the onset, duration of action and complications of intrathecal isobaric ropivacaine 0.5% (Group I and intrathecal isobaric ropivacaine 0.75% (Group II in elective lower limb surgeries. METHODS We enrolled 60 patients of ASA (American Society of Anaesthesiologists Grade I-II scheduled for lower limb surgeries under spinal anaesthesia for this prospective randomized control trial. The patients were randomized to receive either 15 mg of 0.5% isobaric ropivacaine or 22.5 mg of 0.75% isobaric ropivacaine intrathecally. The time of onset of sensory and motor block, haemodynamic status, time for regression of sensory level to T10 dermatome, time of first request of analgesics and adverse effects were compared in both the groups. RESULTS The time of onset of sensory and motor block was significantly longer in Group-I than Group-II (P0.05. The onset of analgesia was faster in Group II (2.13±0.50 mins. than Group I (2.6±0.93 mins.. The time for regression of sensory level to T10 dermatome (Group-I 150±28.9 minutes and Group-II 180±32.07 were statistically longer in Group II (P<0.001. The time of first request of analgesics by the patient in Group-I was 197±31.20 minutes and in Group II was 219±31.66 minutes, which was statistically significant (P<0.001. The onset of motor block was quicker (P˂0.05 and the total duration of motor block was longer (P˂0.05 in Group II. No unexpected adverse events were registered. CONCLUSION The subarachnoid injection of glucose-free isobaric ropivacaine 0.5% and 0.75% solutions results in a variable spread of analgesia, accompanied by a good quality of motor block. Ropivacaine 0.75% produces a better quality of analgesia and longer duration of analgesia than the 0.5% solution.

  1. Randomized controlled comparative study on effect of training to improve lower limb motor paralysis in convalescent patients with post-stroke hemiplegia.

    Science.gov (United States)

    Kawakami, Kenji; Miyasaka, Hiroyuki; Nonoyama, Sayaka; Hayashi, Kazuya; Tonogai, Yusuke; Tanino, Genichi; Wada, Yosuke; Narukawa, Akihisa; Okuyama, Yuko; Tomita, Yutaka; Sonoda, Shigeru

    2015-09-01

    [Purpose] The motor paralysis-improving effect on the hemiplegic lower limb was compared among mirror therapy, integrated volitional-control electrical stimulation, therapeutic electrical stimulation, repetitive facilitative exercises, and the standard training method in post-stroke hemiplegia patients. [Subjects and Methods] Eighty one stroke patients admitted to a convalescent rehabilitation ward were randomly allocated to the above 5 treatment groups. Each patient performed functional training of the paralytic lower limb for 20 minutes a day for 4 weeks, and changes in the lower limb function were investigated using the Stroke Impairment Assessment Set. [Results] The hip and knee joint functions did not significantly improve in the standard training control group, but significant improvements were observed after 4 weeks in the other intervention groups. Significant improvement was noted in the ankle joint function in all groups. [Conclusion] Although the results were influenced by spontaneous recovery and the standard training in the control group, the hip and knee joints were more markedly improved by the interventions in the other 4 groups of patients with moderate paralysis, compared to the control group.

  2. INTRATHECAL BUPRENORPHINE, CLONIDINE AND FENTANYL AS ADJUVANTS TO 0.5% HYPERBARIC BUPIVACAINE IN LOWER ABDOMINAL AND LOWER LIMB SURGERIES: A PROSPECTIVE, RANDOMIZED AND COMPARATIVE STUDY

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    Rashmi

    2015-06-01

    Full Text Available BACKGROUND: Among all the spinal adjuvants, clonidine, an alpha - 2 agonist has the ability to alleviate both the somatic and visceral pain and is more potent at spinal site, favoring its neuraxial administration. OBJECTIVE: This study was done to compare the onset and duration of sensory and motor blocks, duration of analgesia, haemodynamic and adverse effects of Clonidine, buprenorhine and fentanyl used intrathecally with hyperbaric 0.5% bupuvacaine. SETTINGS & DESIGN: This prospective, randomized and comparative study included 90 ASA class 1 & 2 patients undergoing lower abdominal and lower limb surgeries under spinal anesthesia after approval from hospital ethics committee with written i nformed consent of patients. MATERIALS AND METHOD S: Patients were randomly allocated into three groups (n=30 and received 50μg of clonidine, 25μg of fentanyl and 75μg of buprenorphine respectively in group BC,BF and BB as adjuvants to 15mg of 0.5% hyperba ric bupivacaine (3.0ml. The onset time and duration of sensory and motor block, duration of analgesia, haemodynamic changes and side effects were recorded. RESULTS: The onset time of motor block and durations of sensory, motor blockade and analgesia were prolonged in - group BC as compared to group BF and BB (P.05. Group BC had lower heart rate and mean blood pressure and higher sedation score. CONCLUSION: Intr athecal Clonidine in a dose of 50μg is an effective adjuvant to local anesthetics in neuraxial blocks despite mild sedation and haemodynamic variations.

  3. EFFECT OF ADDITION OF DEXMEDETOMIDINE TO ROPIVACAINE HYDROCHLORIDE (0.75% IN BRACHIAL PLEXUS BLOCK THROUGH SUPRACLAVICULAR ROUTE IN UPPER LIMB SURGERIES: A CLINICAL COMPARATIVE STUDY

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    Neelesh

    2014-10-01

    Full Text Available Brachial plexus block is a popular and widely employed regional nerve block of upper extremity which avoids the unwanted effect of anesthetic drugs used during general anesthesia, there complication and the stress of laryngoscopy and tracheal intubation. Patients also have a post-operative period free from nausea, vomiting, cerebral depression and immediate post-operative pain. The brachial plexus via supraclavicular approach block provide safe, effective, low cost complete anesthesia or analgesia of the upper extremity and is carried out at the level of the distal trunks/divisions of the brachial plexus, where it is in its tightest formation thus allowing for rapid and completed anesthesia or analgesia of the upper limb. The present single Centre, prospective, randomized, double blind study was undertaken to compare the effects of Ropivacaine and Ropivacaine-Dexmedetomidine combination in brachial plexus block via supraclavicular route with respect to its onset, duration of action. A total of 60 patients of ASA grading I &II and age ranging 18-50 year of either sex underwent various elective upper limb surgeries were divided in two equal groups Group A (n=30: Received brachial plexus block with 30 ml Ropivacaine (0.75%. Group B (n=30: Received brachial plexus block with 29 ml Ropivacaine (0.75% + 1 ml Dexmedetomidine (50μg. After performing supraclavicular block the following observations were made: 1. Onset of sensory blockade. 2. Duration of sensory blockade. 3. Onset of motor blockade. 4. Duration of motor blockade. 5. Duration of analgesia. The onset and duration of sensory blockade was assessed by pin prick response on area of all four nerves of upper limbs. The onset and duration of motor blockade was assessed by Modified Bromage Scale. The onset and duration of analgesia was assessed by response to pin prick and time of first request of analgesic dose. The observations were as follow: - The average time of onset of sensory blockade was

  4. A COMPARATIVE STUDY OF EPIDURAL BUTORPHANOL AND EPIDURAL FENTANYL FOR THE RELIEF OF POST-OPERATIVE PAIN IN LOWER ABDOMINAL AND LOWER LIMB SURGERIES

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    Ashwini

    2014-11-01

    Full Text Available BACKGROUND: Epidural anaesthesia is used extensively for both intra-operative and post-operative analgesia. This prospective randomized study was conducted using opioids epidurally for post-operative analgesia. Fentanyl is a pure opioid agonist. Butorphanol tartarate which is an agonist antagonist opioid is considered safer than pure opioid agonist. Hence, we compared epidural 4mg butorphanol and epidural 100 µg fentanyl for the relief of post-operative pain. AIMS AND OBJECTIVES: To compare the onset, duration, quality of analgesia, hemodynamic effects and side effects between the 2 study drugs. MATERIALS AND METHODS: 60 patients of either sex posted for elective lower abdominal and lower limb surgeries were randomly divided into 2 groups of 30 each. Group A received butorphanol 4mg epidurally. Group B received fentanyl 100 µg epidurally. All surgeries were done under lumbar epidural anaesthesia with catheter in situ. Post-operatively when patients complained of pain, intensity of pain was assessed using visual analogue scale [VAS]. When the VAS score was > 5, Group A received butorphanol 4mg diluted to 10 ml with NS or Group B received 100 µg fentanyl epidurally diluted to 10 ml with NS. Onset, duration, quality of analgesia, hemodynamic effects and incidence of side effects were compared between the two groups and treated accordingly. RESULTS: Demographic profile was comparable in both groups. Mean time of onset of analgesia was rapid (3.22 ±0.9 (S.D min in group B compared to group A (6.38± 1.26 (S.D min. Duration of analgesia was longer in group A (344.00 ±63.39 min compared to group B (227±38.12 min. Quality of analgesia was better with group A compared to group B. There was no significant difference in hemodynamic parameters in both groups. Sedation was the main side effect in group A. Incidence of pruritis, vomiting, hypotension and respiratory depression was more in group B. CONCLUSION: Epidural Butorphanol though has a delayed

  5. MAGNESIUM SULPHATE VS CLONIDINE AS AN ADJUVANT TO 0.5% BUPIVACAINE IN EPIDURAL ANAESTHESIA FOR PATIENTS UNDERGOING LOWER LIMB SURGERIES: A COMPARATIVE STUDY

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    Anand Masih

    2015-09-01

    Full Text Available Epidural anesthesia is a safe and inexpensive technique with the advantage of providing surgical anesthesia and prolonged postoperative pain relief. To address the problems of limited duration of action and to improve the quality of analgesia intra - operatively and postoperatively, various adjuvants have been added to bupivacaine. The present study is designed to evaluate the effect of magnesium sulphate vs clonidine as an adjunct to 0.5% Bupivacaine in epidural anesthesia for patients undergoing lower limb surgeries in terms of onset, duration and degree of sensory and motor block, sedation and pain. 90 patients of age group 18 - 60 years of ASA grade I & II of either sex undergoing lower limb surgeries were included in this prospective study who were randomly allocated into three groups . Group A received bupivacaine 0.5%(19ml +normal saline 0.9% (1.0ml, Group B received bupivacaine 0.5%(19ml+magnesium sulphate 50mg dissolved in 0.9% normal saline (1.0ml and Group C received bupivacaine 0.5%(19ml +clonidine 150μgm(1.0ml. Assessments of sensory block were performed at 5, 10, 15, 20, 25, 30 min and then every 10 min until the return of normal sensation. . Assessment of motor block were performed immediately after the assessment of sensory block until the return of normal motor function. The onset and end of all degrees of motor blocks were assessed bilaterally according to the Modified Bromage scale. Duration of analgesia, patient’s satisfaction, duration of motor block and adverse effects were assessed and recorded. We concluded that co - administration of epidural magnesium sulphate 50 MG with bupivacaine 0.5% produces predictable rapid onset of surgical anesthesia without any side - effects, and addi tion of clonidine 150μgmto epidural bupivacaine 0.5% produces prolonged duration of anesthesia with sedation. The results of our study suggest that magnesium may be a useful alternative as an adjuvant to epidural bupivacaine as clonidine .

  6. Comparative Study of Motor Performance of Deaf and Hard of Hearing Students in Reaction Time, Visual-Motor Control and Upper Limb Speed and Dexterity Abilities

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    Gkouvatzi, Anastasia N.; Mantis, Konstantinos; Kambas, Antonis

    2010-01-01

    Using the Bruininks-Oseretsky Test the motor performance of 34 deaf--hard-of-hearing pupils, 6-14 year, was evaluated in reaction time, visual-motor control and upper limb speed and dexterity. The two-way ANOVA variance analysis for two independent variables, group, age, and the Post Hoc (Scheffe test) for multiple comparisons were used. The…

  7. Polarization data from SCIAMACHY limb backscatter observations compared to vector radiative transfer model simulations

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    P. Liebing

    2012-03-01

    Full Text Available SCIAMACHY is a passive imaging spectrometer onboard ENVISAT, designed to obtain trace gas abundances from measured radiances and irradiances in the UV to SWIR range in nadir, limb and occultation viewing modes. Its grating spectrometer introduces a substantial sensitivity to the polarization of the incoming light with nonnegligible effects on the radiometric calibration. To be able to correct for the polarization sensitivity, SCIAMACHY utilizes broadband Polarization Measurement Devices (PMDs. While for the nadir viewing mode the measured atmospheric polarization has been validated against POLDER data (Tilstra and Stammes, 2007, 2010, a similar validation study regarding the limb viewing mode has not yet been performed. This paper aims at an assessment of the quality of the SCIAMACHY limb polarization data. Since limb polarization measurements by other air- or spaceborne instruments in the spectral range of SCIAMACHY are not available, a comparison with radiative transfer simulations by SCIATRAN V3.1(Rozanov et al., 2012 using a wide range of atmospheric parameters is performed. SCIATRAN is a vector radiative transfer model (VRTM capable of performing calculations of the multiply scattered radiance in a~spherically symmetric atmosphere.

    The study shows that the limb polarization data exhibit a large systematic bias which is decreasing with wavelength. The most likely reason for this bias is an instrumental phase shift which changes the relative contributions of different Stokes vector components to the PMD signal as compared to on-ground calibration measurements. It is also shown that it is in principle feasible to recalibrate the polarization sensitivity using the in-flight data and the VRTM simulations, enabling also the monitoring of its degradation. Together with an optimization of the algorithm used to calculate the in-flight polarization data an improved polarization correction can increase the radiometric accuracy of SCIAMACHY

  8. Comparative anatomy and muscle architecture of selected hind limb muscles in the Quarter Horse and Arab.

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    Crook, T C; Cruickshank, S E; McGowan, C M; Stubbs, N; Wakeling, J M; Wilson, A M; Payne, R C

    2008-02-01

    The Quarter Horse (bred for acceleration) and the Arab (bred for endurance) are situated at either end of the equine athletic spectrum. Studies into the form and function of the leg muscles in human sprint and endurance runners have demonstrated that differences exist in their muscle architecture. It is not known whether similar differences exist in the horse. Six Quarter Horse and six Arab fresh hind limb cadavers were dissected to gain information on the muscle mass and architecture of the following muscles: gluteus medius; biceps femoris; semitendinosus; vastus lateralis; gastrocnemius; tibialis cranialis and extensor digitorum longus. Specifically, muscle mass, fascicle length and pennation angle were quantified and physiological cross-sectional area (PCSA) and maximum isometric force were estimated. The hind limb muscles of the Quarter Horse were of a significantly greater mass, but had similar fascicle lengths and pennation angles when compared with those of the Arab; this resulted in the Quarter Horse hind limb muscles having greater PCSAs and hence greater isometric force potential. This study suggests that Quarter Horses as a breed inherently possess large strong hind limb muscles, with the potential to accelerate their body mass more rapidly than those of the Arab.

  9. 威利坦消除四肢骨折后早期肿胀疗效的对照研究%Efficacy of venostan eliminating early post-traumatic swelling of the limbs: a comparative study

    Institute of Scientific and Technical Information of China (English)

    公茂琪; 查晔军; 蒋协远; 李庭; 何大炜

    2012-01-01

    Objective To analysis the efficacy of venostan to eliminate the early post-traumatic limb swelling with a comparative study. Methods From January 2011 to Ottober 2011, two hundred patients of limb fractures with limb swelling were analyzed and randomly divided into two groups, 100 cases of treatment group were treated with oral venostan tablet combined with conventional physical therapy (such as cold therapy and limb elevation), and 100 cases of control group were treated through conventional physical therapy only. No other medications were applied in each group. The circumference of the swelling limbs were recorded respectively at admission and 3, 4, 5, 7, 10, 14 days after admission, to evaluate the severity of swelling, the duration for eliminating swelling, the clinical efficacy and adverse drug reaction. Results Comparing with control group, treatment group had the earlier onset of eliminating swelling (the first 3 days vs. 5 days). Within 7 days after the injury, the efficacy of eliminating swelling between the two groups had significant difference (P0.05). Moreover there was no significant difference in the efficiency rates (P>0. 05). Conclusion Venostan can eliminate the post-traumatic limb swelling in early stage(7 days), which contribute to early surgery and physical rehabilitation.%目的 对照研究威利坦(venostan)在消除四肢骨折后早期肢体肿胀中的临床疗效.方法 自2011年1月至2011年10月,将200例四肢骨折后肢体肿胀患者随机分为实验组和对照组,每组100例.实验组给予威利坦片剂口服结合冷疗、肢体抬高等常规物理疗法,对照组仅给予冷疗、肢体抬高等常规物理疗法,两组均禁用其他消肿药物.于入院时、入院后第3、4、5、7、10、14天测量肿胀肢体周径并作记录,观察消肿程度、消肿时间、临床疗效及不良反应.结果 实验组起效更快,第3天即开始起效,对照组第5天才能起效.受伤后7d内,两组间消

  10. Anxiety and depression in patients with amputated limbs suffering from phantom pain: A comparative study with non-phantom chronic pain

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    Hadi Kazemi

    2013-01-01

    Conclusion : Our results indicate that depression and anxiety are not more common in PLP patients, whereas they are more prevalent in subjects with non-phantom chronic pain. These lower levels of anxiety and depression in PLP compared with chronic pain is a new finding that needs to be evaluated further, which may lead to new insights into the pathogenesis of phantom pain in further studies.

  11. Comparative Analysis of Cartilage Marker Gene Expression Patterns during Axolotl and Xenopus Limb Regeneration.

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    Kazumasa Mitogawa

    Full Text Available Axolotls (Ambystoma mexicanum can completely regenerate lost limbs, whereas Xenopus laevis frogs cannot. During limb regeneration, a blastema is first formed at the amputation plane. It is thought that this regeneration blastema forms a limb by mechanisms similar to those of a developing embryonic limb bud. Furthermore, Xenopus laevis frogs can form a blastema after amputation; however, the blastema results in a terminal cone-shaped cartilaginous structure called a "spike." The causes of this patterning defect in Xenopus frog limb regeneration were explored. We hypothesized that differences in chondrogenesis may underlie the patterning defect. Thus, we focused on chondrogenesis. Chondrogenesis marker genes, type I and type II collagen, were compared in regenerative and nonregenerative environments. There were marked differences between axolotls and Xenopus in the expression pattern of these chondrogenesis-associated genes. The relative deficit in the chondrogenic capacity of Xenopus blastema cells may account for the absence of total limb regenerative capacity.

  12. Comparative Analysis of Cartilage Marker Gene Expression Patterns during Axolotl and Xenopus Limb Regeneration.

    Science.gov (United States)

    Mitogawa, Kazumasa; Makanae, Aki; Satoh, Ayano; Satoh, Akira

    2015-01-01

    Axolotls (Ambystoma mexicanum) can completely regenerate lost limbs, whereas Xenopus laevis frogs cannot. During limb regeneration, a blastema is first formed at the amputation plane. It is thought that this regeneration blastema forms a limb by mechanisms similar to those of a developing embryonic limb bud. Furthermore, Xenopus laevis frogs can form a blastema after amputation; however, the blastema results in a terminal cone-shaped cartilaginous structure called a "spike." The causes of this patterning defect in Xenopus frog limb regeneration were explored. We hypothesized that differences in chondrogenesis may underlie the patterning defect. Thus, we focused on chondrogenesis. Chondrogenesis marker genes, type I and type II collagen, were compared in regenerative and nonregenerative environments. There were marked differences between axolotls and Xenopus in the expression pattern of these chondrogenesis-associated genes. The relative deficit in the chondrogenic capacity of Xenopus blastema cells may account for the absence of total limb regenerative capacity.

  13. COMPARATIVE STUDY ON POST - OPERATIVE ANALGESIA IN LOWER LIMB ARTHROPLASTIES WITH CONTINUOUS EPIDURAL INFUSION OF 0.125% BUPIVACAINE AND TWO DIFFERENT NARCOTIC ANALGESICS FENTANYL AND SUFENTANIL

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    Rajeev

    2015-02-01

    Full Text Available Present study was carried out to compare and evaluate the effect of fentany and sufentanil in combination of bupivacaine on postoperative pain relief and possible side effects if any in patients operated for hip and knee arthroplasties. We randomly selected sixty patients of ASA grade I - III of age 18 to 75 years divided in to two groups. Group – I Received2.5 μg/ml fentanyl along with 0.125% bupivacaine as a continuous epidural infusion at the rate of 5 ml/hr up to 48 hr after the surgery. Group - II Received 0.25 μg/ml sufentanil along with 0.125% bupivacaine as a continuous epidural infusion at the rate of 5 ml/hr up to 48 hr after the surgery. Analgesia was assessed by Visual analogue scale and motor block if any by Bromage scale. Haemodynamics and respiratory parameters were recorded and side effects if any were noted. In group I mean VAS score during rest was 27.0 +/ - 4.8 and mean VAS score during movement was 33.5+/ - 4.9 in group II mean VAS score during rest was 20.8+/ - 4.9 and mean VAS score during movement was 27.7+/ - 5.2. T he dynamic pain VAS score showed a statistically significant difference between two groups . haemodynamics parameters were similar in both groups. Thus group II patients received sufentanil along with 0.125% bupivacaine had better post - operative analgesia d uring movement as well as at rest without respiratory depression or significant side effects.

  14. The i-LIMB hand and the DMC plus hand compared : A case report

    NARCIS (Netherlands)

    Niet Van Der, Olga; Reinders-Messelink, Heleen A.; Bongers, Raoul M.; Bouwsema, Hanneke; Van Der Sluis, Corry K.; Otr, O.V.

    2010-01-01

    The i-LIMB hand is a novel upper limb myoelectric prosthetic hand with several joints in the fingers and thumb. This study aimed to determine whether this new device had more functionality than a more conventional myoelectric prosthetic hand with only a single joint between the thumb and two fingers

  15. The efficacy of epidural ropivacaine 0.75% and levobupivacaine 0.5% in abdominal and lower limb surgeries- a comparative study

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    Kiran Kumar S.

    2016-09-01

    Conclusions: The present study concludes that 0.5% levobupivacaine and 0.75% ropivacaine were clinically similar with respect to sensory block characteristics and duration of analgesia, quality of motor blockade with minimal side effects in both the groups. Both drugs could be better alternatives to bupivacaine in epidural anaesthesia. [Int J Res Med Sci 2016; 4(9.000: 4101-4107

  16. Tibial torsion in non-arthritic Indian adults: A computer tomography study of 100 limbs

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    Mullaji Arun

    2008-01-01

    Full Text Available Background: Knowledge of normal tibial torsion is mandatory during total knee replacement (TKR, deformity correction and fracture management of tibia. Different values of tibial torsion have been found in different races due to biological and mechanical factors. Value of normal tibial torsion in Indian limbs is not known, hence this study to determine the norm of tibial torsional value in normal Indian population. Materials and Methods: Computer tomography (CT scans were performed in 100 non-arthritic limbs of 50 Indian adults (42 males, eight females; age 26-40 years. Value of tibial torsion was measured using dorsal tangent to tibial condyles proximally and bimalleolar axis distally. Results: Normal tibial torsion was found to be 21.6 ± 7.6 (range 4.8 to 39.5 with none of the values in internal rotation. Right tibia was externally rotated by 2 degrees as compared to the left side ( P 0.029. No significant difference was found in male and female subjects. Value of tibial torsion was less than in Caucasian limbs, but was comparable to Japanese limbs when studies using similar measurement technique were compared. Conclusions: Indian limbs have less tibial torsion than Caucasian limbs but the value of tibial torsion is comparable to Japanese limbs.

  17. Kinect One-based biomechanical assessment of upper-limb performance compared to clinical scales in post-stroke patients.

    Science.gov (United States)

    Scano, Alessandro; Caimmi, Marco; Chiavenna, Andrea; Malosio, Matteo; Tosatti, Lorenzo Molinari

    2015-08-01

    This paper presents a Kinect One sensor-based protocol for the evaluation of the motor-performances of the upper limb of neurological patients during rehabilitative sessions. The assessment provides evaluations of kinematic, dynamic, motor and postural control variables. A pilot study was conducted on three post-stroke neurological patients, comparing Kinect-One biomechanical assessment with the outcomes of some of the most common clinical scales for the evaluation of the upper-limb functionality. Preliminary results indicate coherency between the clinical and instrumental evaluation. Moreover, the Kinect-One assessment seems to provide some complementary quantitative information, consistently integrating the clinical assessment.

  18. Pilot Study: The Role of the Hemispheric Lateralization in Mental Disorders by Use of the Limb (Eye, Hand, Foot) Dominance

    OpenAIRE

    Goodarzi, Naser; Dabbaghi, Parviz; Valipour, Habib; Vafadari, Behnam

    2015-01-01

    Introduction: Based on the previous studies, we know that the hemispheric lateralization defects, increase the probability of psychological disorders. We also know that dominant limb is controlled by dominant hemisphere and limb preference is used as an indicator for hemisphere dominance. In this study we attempted to explore the hemispheric dominance by the use of three limbs (hand, foot and eye). Methods: We performed this survey on two samples, psychiatric patients compared with normal pop...

  19. A COMPARATIVE STUDY OF THE EFFECT OF EPIDURAL BUPIVACAINE (0.125% VERSUS EPIDURAL BUPIVACAINE (0.125% AND BUTORPHANOL (2mg FOR POST-OPERATIVE PAIN RELIEF IN LOWER ABDOMINAL AND LOWER LIMB SURGERIES

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    Krishna

    2014-08-01

    Full Text Available BACKGROUND: Postoperative pain gives rise to various physiological and psychological phenomenons. Epidural analgesia with combination of local anesthetics and opioids provides better pain relief than local anesthetics alone in the postoperative period. Epidural opioids acting through the spinal cord receptors improve the quality and duration of analgesia along with dose-sparing effect with the local anesthetics. AIMS: The study was conducted to evaluate the efficacy of addition of opioids to local anesthetics for postoperative pain relief. METHODS: Fifty patients of American society of anesthesiology grade and physical status undergoing lower abdominal surgeries & lower limb surgeries in narayana general hospital, Nellore, were divided into two groups B and BB. Group B was given 0.125% bupivacaine alone and Group BB was given 0.125% bupivacaine plus 2mg of butorphanol postoperatively when the patients first complained of pain. Onset of Analgesia, duration of analgesia, visual analog scores and side effects were compared. RESULTS: The onset of analgesia in group B patients (10ml of 0.125% Bupivacaine was varied from 4-8 minutes (mean 5.2 minutes and duration of analgesia lasted for 2-4 hours (mean 2.98(p<0.0001 where as in group BB patients (2mg butorphanol + 0.125% bupivacaine the onset was 2-4 minutes (mean 2.69 and duration of analgesia lasted for 6-8 hours (mean 6.98 (p<0.0001.The Visual Analog Scores of Group B were in the range of 7 to 9 and Group BB were in the range of 5 to 6 (P<0.0001. CONCLUSION: This study concludes that addition of butorphanol (2mg to bupivacaine (0.125% gives more effective and prolonged duration of postoperative pain relief when administered epidurally, without significant side effects.

  20. Vocational reintegration after a lower limb amputation : a qualitative study

    NARCIS (Netherlands)

    Bruins, M.; Geertzen, J.H.; Groothoff, J.W.; Schoppen, T.

    2003-01-01

    The objectives of this study were to describe the process of job reintegration, to obtain more detailed information about workplace adjustments, and to assess the positive and negative experiences of amputees (in the Netherlands) who returned to paid work after their lower limb amputation. The study

  1. Vocational reintegration after a lower limb amputation: A qualitative study

    NARCIS (Netherlands)

    Bruins, Ria; Bruins, M.; Geertzen, J.H.B.; Groothoff, J.W.; Schoppen, T.

    2003-01-01

    The objectives of this study were to describe the process of job reintegration, to obtain more detailed information about workplace adjustments, and to assess the positive and negative experiences of amputees (in the Netherlands) who returned to paid work after their lower limb amputation. The study

  2. Vocational reintegration after a lower limb amputation : a qualitative study

    NARCIS (Netherlands)

    Bruins, M.; Geertzen, J.H.; Groothoff, J.W.; Schoppen, T.

    The objectives of this study were to describe the process of job reintegration, to obtain more detailed information about workplace adjustments, and to assess the positive and negative experiences of amputees (in the Netherlands) who returned to paid work after their lower limb amputation. The study

  3. Effects of joint contracture on the contralateral unoperated limb in a rabbit knee contracture model: a biomechanical and genetic study.

    Science.gov (United States)

    Abdel, Matthew P; Morrey, Mark E; Grill, Diane E; Kolbert, Christopher P; An, Kai-Nan; Steinmann, Scott P; Sanchez-Sotelo, Joaquin; Morrey, Bernard F

    2012-10-01

    In most animal models, unoperated contralateral limbs are used as controls. However, in some experimental circumstances, the contralateral limb may represent a skewed control. The main purpose of this study was to determine if the unoperated contralateral limb could be used as a control, or if a different unoperated animal's limb should be used instead. Seventeen rabbits were divided into two groups. Group 1 rabbits (n = 12) underwent surgery on their right limbs to induce a contracture. Group 2 rabbits (n = 5) underwent no surgery. The left non-operated limbs of rabbits in group 1 were biomechanically and genetically compared to the limbs of unoperated rabbits in group 2 with the use of a validated joint measuring device and custom microarray, respectively. After 8 weeks of immobilization, there was a statistically greater flexion contracture in the unoperated contralateral limbs compared to the limbs of animals that received no surgery(8.4 ± 8.9° vs. 0 ± 0°; p-value = 0.03). When animals were remobilized for an additional 16 weeks, the significance between groups was lost (11.9 ± 21.4° vs. 8.9 ± 9.5°; p = 0.38). Similarly, there was a statistically significant increase in nine genes at 8 weeks (p contracture at 8 weeks. After 16 weeks of remobilization, there is no biomechanical or genetic difference between contralateral non-operated limbs and limbs of animals not undergoing any surgical intervention. Given the biomechanical and genetic findings, the contralateral non-operated limb can be used as a valid control. Copyright © 2012 Orthopaedic Research Society.

  4. Geriatric rehabilitation of lower limb amputees: a multicenter study.

    NARCIS (Netherlands)

    Eijk, M.S. van; Linde, H. van der; Buijck, B.I.; Zuidema, S.U.; Koopmans, R.T.C.M.

    2012-01-01

    PURPOSE: The aim of this study was to determine factors independently associated with successful rehabilitation of patients with lower limb amputation in skilled nursing facilities (SNFs). METHODS: All patients admitted to one of the 11 participating SNFs were eligible. Multidisciplinary teams colle

  5. Geriatric rehabilitation of lower limb amputees : a multicenter study

    NARCIS (Netherlands)

    Eijk, Monica Spruit-van; van der Linde, Harmen; Buijck, Bianca I; Zuidema, Sytse U; Koopmans, Raymond T C M

    2012-01-01

    PURPOSE: The aim of this study was to determine factors independently associated with successful rehabilitation of patients with lower limb amputation in skilled nursing facilities (SNFs). METHODS: All patients admitted to one of the 11 participating SNFs were eligible. Multidisciplinary teams colle

  6. Robot training of upper limb in multiple sclerosis: comparing protocols with or without manipulative task components.

    Science.gov (United States)

    Carpinella, Ilaria; Cattaneo, Davide; Bertoni, Rita; Ferrarin, Maurizio

    2012-05-01

    In this pilot study, we compared two protocols for robot-based rehabilitation of upper limb in multiple sclerosis (MS): a protocol involving reaching tasks (RT) requiring arm transport only and a protocol requiring both objects' reaching and manipulation (RMT). Twenty-two MS subjects were assigned to RT or RMT group. Both protocols consisted of eight sessions. During RT training, subjects moved the handle of a planar robotic manipulandum toward circular targets displayed on a screen. RMT protocol required patients to reach and manipulate real objects, by moving the robotic arm equipped with a handle which left the hand free for distal tasks. In both trainings, the robot generated resistive and perturbing forces. Subjects were evaluated with clinical and instrumental tests. The results confirmed that MS patients maintained the ability to adapt to the robot-generated forces and that the rate of motor learning increased across sessions. Robot-therapy significantly reduced arm tremor and improved arm kinematics and functional ability. Compared to RT, RMT protocol induced a significantly larger improvement in movements involving grasp (improvement in Grasp ARAT sub-score: RMT 77.4%, RT 29.5%, p=0.035) but not precision grip. Future studies are needed to evaluate if longer trainings and the use of robotic handles would significantly improve also fine manipulation.

  7. Influence of Immediate and Delayed Lower-Limb Amputation Compared with Lower-Limb Salvage on Functional and Mental Health Outcomes Post-Rehabilitation in the U.K. Military.

    Science.gov (United States)

    Ladlow, Peter; Phillip, Rhodri; Coppack, Russell; Etherington, John; Bilzon, James; McGuigan, M Polly; Bennett, Alexander N

    2016-12-07

    Medical practitioners face difficult decisions over whether to amputate or to salvage a lower limb that has undergone trauma. To our knowledge, there has been little evidence reporting the impact of different surgical decisions on functional and mental health outcomes following intensive rehabilitation that might inform decision-making. This study is a retrospective, independent-group comparison of rehabilitation outcomes from a U.K. military complex trauma rehabilitation center. There were 100 procedures examined: 36 unilateral amputations (11 immediate-below-the-knee amputations, 15 delayed below-the-knee amputations, and 10 immediate above-the-knee amputations), 43 bilateral amputations, and 21 single-limb salvages (including 13 below-the-knee limb salvages); the patients had a mean age (and standard deviation) of 29 ± 6 years and a mean New Injury Severity Score of 34 ± 15 points. The outcome measures at completion of rehabilitation included a 6-minute walk test (6MWT), Defence Medical Rehabilitation Centre mobility and activities of daily living scores, screening for depression (Patient Health Questionnaire [PHQ-9]) and general anxiety disorder (General Anxiety Disorder 7-item scale [GAD-7]), mental health support, and pain scores. On completion of their rehabilitation, the unilateral amputation group walked significantly farther in 6 minutes (564 ± 92 m) than the limb-salvage group (483 ± 108 m; p amputation group (409 ± 106 m; p amputation group (595 ± 89 m) walked significantly farther than the group with limb salvage below the knee (472 ± 110 m; p amputation and the group with immediate below-the-knee amputation (598 ± 63 m; p > 0.05). The limb-salvage group was less capable of running independently compared with all amputee groups. No significant differences (p > 0.05) were reported in mean mental health outcomes between the below-the-knee injury groups, and depression and anxiety scores were comparable with population norms. At discharge, 97% of

  8. Antagonist muscle co-activation of limbs in human infant crawling: A pilot study.

    Science.gov (United States)

    Xiong, Qi L; Wu, Xiao Y; Xiao, Nong; Zeng, Si Y; Wan, Xiao P; Zheng, Xiao L; Hou, Wen S

    2015-01-01

    Muscle Co-activation (MCo) is the simultaneous muscular activation of agonist and antagonist muscle groups, which provides adequate joint stability, movement accuracy during movement. Infant crawling is an important stage of motor function development that manifests non-synchronization growth and development of upper and lower limbs due to the well-known gross motor development principle of head to toe. However, the effect of MCo level for agonist and antagonist muscle groups on motor function development of limbs has not been previously reported. In this paper, sEMG signals were collected from triceps brachii (TB) and biceps brachii (BB), quadriceps femoris (QF) and hamstrings (HS) of limbs when fourteen infants were crawling at their self-selected speed. Antagonist muscle co-activation was evaluated by measuring two common indexes (co-activation index and Pearson's correlation coefficient).A significant difference was observed between upper limbs and lower limbs, but the relationship between MCo and speed of crawling was poor. This study is an opening for further investigation including a longitudinal study and compare against infant with CNS disorders.

  9. A randomized controlled double-blinded prospective study of the efficacy of clonidine added to bupivacaine as compared with bupivacaine alone used in supraclavicular brachial plexus block for upper limb surgeries

    Directory of Open Access Journals (Sweden)

    Shivinder Singh

    2010-01-01

    Full Text Available We compared the effects of clonidine added to bupivacaine with bupivacaine alone on supraclavicular brachial plexus block and observed the side-effects of both the groups. In this prospective, randomized,double-blinded, controlled trial, two groups of 25 patients each were investigated using (i 40 ml of bupivacaine 0.25% plus 0.150 mg of clonidine and (ii 40 ml of bupivacaine 0.25% plus 1 ml of NaCl 0.9, respectively. The onset of motor and sensory block and duration of sensory block were recorded along with monitoring of heart rate, non-invasive blood pressure, oxygen saturation and sedation. It was observed that addition of clonidine to bupivacaine resulted in faster onset of sensory block, longer duration of analgesia (as assessed by visual analogue score, prolongation of the motor block (as assessed by modified Lovett Rating Scale, prolongation of the duration of recovery of sensation and no association with any haemodynamic changes (heart rate and blood pressure, sedation or any other adverse effects. These findings suggest that clonidine added to bupivacaine is an attractive option for improving the quality and duration of supraclavicular brachial plexus block in upper limb surgeries.

  10. Incorporation of another person's limb into body image relieves phantom limb pain: a case study.

    Science.gov (United States)

    Weeks, Sharon R; Tsao, Jack W

    2010-12-01

    Phantom limb phenomena are well characterized, but the underlying mechanisms remain unclear. Here we report a patient who relieves his phantom sensations and pain, experienced as itching and cramping, through scratching or massaging his prosthesis or the leg of another person. This pain relief occurs only when phantom limb sensations are present. We hypothesize that symptom relief results from incorporation of the foreign limb into the patient's body image, mediated by the sensory mirror neuron system, relieving pain by restoring concordance between sensory systems.

  11. The Military Extremity Trauma Amputation/Limb Salvage (METALS) study: outcomes of amputation versus limb salvage following major lower-extremity trauma.

    Science.gov (United States)

    Doukas, William C; Hayda, Roman A; Frisch, H Michael; Andersen, Romney C; Mazurek, Michael T; Ficke, James R; Keeling, John J; Pasquina, Paul F; Wain, Harold J; Carlini, Anthony R; MacKenzie, Ellen J

    2013-01-16

    The study was performed to examine the hypothesis that functional outcomes following major lower-extremity trauma sustained in the military would be similar between patients treated with amputation and those who underwent limb salvage. This is a retrospective cohort study of 324 service members deployed to Afghanistan or Iraq who sustained a lower-limb injury requiring either amputation or limb salvage involving revascularization, bone graft/bone transport, local/free flap coverage, repair of a major nerve injury, or a complete compartment injury/compartment syndrome. The Short Musculoskeletal Function Assessment (SMFA) questionnaire was used to measure overall function. Standard instruments were used to measure depression (the Center for Epidemiologic Studies Depression Scale), posttraumatic stress disorder (PTSD Checklist-military version), chronic pain (Chronic Pain Grade Scale), and engagement in sports and leisure activities (Paffenbarger Physical Activity Questionnaire). The outcomes of amputation and salvage were compared by using regression analysis with adjustment for age, time until the interview, military rank, upper-limb and bilateral injuries, social support, and intensity of combat experiences. Overall response rates were modest (59.2%) and significantly different between those who underwent amputation (64.5%) and those treated with limb salvage (55.4%) (p = 0.02). In all SMFA domains except arm/hand function, the patients scored significantly worse than population norms. Also, 38.3% screened positive for depressive symptoms and 17.9%, for posttraumatic stress disorder (PTSD). One-third (34.0%) were not working, on active duty, or in school. After adjustment for covariates, participants with an amputation had better scores in all SMFA domains compared with those whose limbs had been salvaged (p depressive symptoms, pain interfering with daily activities (pain interference), or work/school status. Major lower-limb trauma sustained in the military

  12. A study of technical changes to lower limb prostheses after initial fitting

    NARCIS (Netherlands)

    Rommers, GM; Vos, LDW; Klein, L; Groothoff, JW; Eisma, W H

    There is little published material in recent years about the use of lower limb prostheses in an elderly amputee population. In this study the authors were interested in the technical changes to lower limb prostheses after a first limb fitting procedure in a post-rehabilitation population in the

  13. A study of technical changes to lower limb prostheses after initial fitting

    NARCIS (Netherlands)

    Rommers, GM; Vos, LDW; Klein, L; Groothoff, JW; Eisma, W H

    2000-01-01

    There is little published material in recent years about the use of lower limb prostheses in an elderly amputee population. In this study the authors were interested in the technical changes to lower limb prostheses after a first limb fitting procedure in a post-rehabilitation population in the Neth

  14. Comparative evaluation of dexmedetomidine and fentanyl for epidural analgesia in lower limb orthopedic surgeries

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2011-01-01

    Full Text Available Background and Aims: Opioids as epidural adjunct to local anesthetics (LA have been in use since long and α-2 agonists are being increasingly used for similar purpose. The present study aims at comparing the hemodynamic, sedative, and analgesia potentiating effects of epidurally administered fentanyl and dexmedetomidine when combined with ropivacaine. Methods: A total of one hundred patients of both gender aged 21-56 years, American Society of Anaesthesiologist (ASA physical status I and II who underwent lower limb orthopedic surgery were enrolled into the present study. Patients were randomly divided into two groups: Ropivacaine + Dexmedetomidine (RD and Ropivacaine + Fentanyl (RF, comprising 50 patie nts each. Inj. Ropivacaine, 15 ml of 0.75%, was administered epidurally in both the groups with addition of 1 μg/kg of dexmedetomidine in RD group and 1 μg/kg of fentanyl in RF group. Besides cardio-respiratory parameters and sedation scores, various block characteristics were also observed which included time to onset of analgesia at T10, maximum sensory analgesic level, time to complete motor blockade, time to two segmental dermatomal regressions, and time to first rescue analgesic. At the end of study, data was compiled systematically and analyzed using ANOVA with post-hoc significance, Chi-square test and Fisher′s exact test. Value of P<0.05 is considered significant and P<0.001 as highly significant. Results: The demographic profile of patients was comparable in both the groups. Onset of sensory analgesia at T10 (7.12±2.44 vs 9.14±2.94 and establishment of complete motor blockade (18.16±4.52 vs 22.98±4.78 was significantly earlier in the RD group. Postoperative analgesia was prolonged significantly in the RD group (366.62±24.42 and consequently low dose consumption of local anaesthetic LA (76.82±14.28 vs 104.35±18.96 during epidural top-ups postoperatively. Sedation scores were much better in the RD group and highly significant on

  15. A “ COMPARATIVE STUDY BETWEEN BUPIVACAINE 0.5% AND ROPIVACAINE 0.75% IN EPIDURAL ANALGESIA IN PATIENTS U NDERGOING ELECTIVE LOWER ABDOMINAL AND LOWER LIMB SURGERIES ”

    Directory of Open Access Journals (Sweden)

    Sachidanand

    2015-09-01

    Full Text Available BACKGROUND : Regional anaesthesia is noted for its simplic ity, safety and effectiveness. Though spinal anaesthesia provides an efficient block it has some limitations. Epidural anaesthesia is one of regional techniques for lower abdominal and lower limb surgeries. Bupivacaine is the drug of choice for providing e ffective epidural analgesia. Ropivacaine is new long acting local anaesthetic with similar chemical structure but with less cardio toxicity and CNS toxicity. We did a Prospective Randomised control study to c o m p a r e between t wo g r o u ps - 20 m l o f 0.75% R op i v ac a i ne ( I sob ar i c a nd 20 m l 0. 5 % B up i v a ca i ne ( I sob ar i c f o r e p i du ra l a n ae s t h e s i a i n l ow e r a bdo mi n a l a nd l ow e r li m b su r g er i e s i n a du lt s a g e d 1 8 t o 60 y e ar s. AIM : To compare in two groups - 20 m l o f 0.75% R op i v aca i ne ( I sob ar i c a nd 20 m l 0. 5 % B up i v a ca i ne ( i sob ar i c f o r e p i du ra l a n ae s t h e s i a i n l ow e r a bdo mi n a l a nd l ow e r li m b su r g er i e s i n a du lt s DESIGN : A Prospective randomized control study . METHODS : Th e s t ud y p o p ul a t i on w as r a nd o m l y di v id e d in t o 2 g r o up s w i t h 30 p a t i e n t s i n e a c h g r o up . S t ud y g r o u p R - rece i v e d 20 m l of 0.75% Ro pi v a c a in e ( I so b a r i c b y e pidu r al r o u t e S t ud y g r o u p B - rece i v e d 20 m l of 0.5% B upi v a c a in e ( i so b a r i c b y e pidu r al r o u t e and compared 1. Ons e t of s e nso r y a nd m o t or b l o c k, 2. H i g h e st l e v e l of s e nso r y b l o c k, 3. D e g r e e of m o t or b l o c k a d e ( U s i ng Mod i f i e d B r o m a g e s c a l e 4. Du ra ti on of m o t or b l o c k a de. 5. Du ra ti on of s e nso r y a n a l g e s i a. 6. Haemodynamic changes heart rate, blood pressure, respiratory rate. 7. S ide effects if any . R ESULTS : 0.75% R op i v aca i ne h a s a sho r t e r du ra ti on of m o t o r b l o c k

  16. Coaptive film versus subcuticular suture: comparing skin closure time following identical, single-session, bilateral limb surgery in children.

    Science.gov (United States)

    Rebello, Gleeson; Parikh, Ravi; Grottkau, Brian

    2009-09-01

    This study is a randomized controlled trial comparing skin closure time between coaptive film and subcuticular monocryl sutures in children undergoing identical single session, bilateral limb multiple soft tissue releases. Eight children less than 18 years of age (mean 14.5) with cerebral palsy underwent identical, single session bilateral multiple soft tissue releases in the lower limb from August 2005 to March 2007. There were 50 incisions in all in which 25 incisions were closed with 4-0 intracuticular monocryl sutures and 25 were closed with coaptive film (Steri Strip S; 3M company). Time taken for closure using either technique was recorded. A blinded plastic surgeon used a visual analog scale to assess the cosmetic results at the end of a 3 month follow-up. The average length of incisions closed with coaptive film was almost identical to the corresponding incision on the contralateral limb that was closed with subcuticular monocryl suture (4.45 and 4.81 cm, P=0.66). The average time for skin closure using monocryl sutures was 167.04 seconds compared with the average time of 79.36 seconds when using coaptive film (P <0.0001). There was no significant difference in the cosmetic results or the number of wound complications using either technique. Coaptive film is an attractive and cost-effective option for skin closure after pediatric surgery. The time saved, comparable cosmetic results and lack of complications makes coaptive film an attractive option for skin closure in the pediatric age group.

  17. The role of limb perfusion studies in the paediatric ischaemic limb

    African Journals Online (AJOL)

    Transmission images of the upper limbs of the same patient as in Figs. 1, 2 and 3. ... specificity of 99%, sensitivity of 96% and positive predictive value of 92%. Normal or .... Huang DB, Price M, Pokorny J, Gabriel KR, Lynch R, Paletta CE.

  18. [A clinical and experimental study of the role of long-lasting perioperative epidural anesthesia in the prevention of phantom limb pain].

    Science.gov (United States)

    Ovechkin, A M; Kukushkin, M L; Gnezdilov, A V; Reshetniak, V K

    1994-01-01

    The aim of this study was to investigate the possible onset of phantom limb pain (PLP) and its development depending on preoperative limb pain and type of anesthesia during limb amputation. It was experimentally proved that preliminary local anesthesia of rat sciatic nerve slowed down the development of pain syndrome after the operation as well as reduced the number of rats with pain syndrome, as compared to the group subjected to preliminary painful electrical stimulation of the operated on limb. The clinical data presented reveal a significant reduction in the incidence of PLP after perioperative epidural anesthesia, as compared to patients with preoperative pain operated on under general anesthesia.

  19. A comparative study on proprioception between lower limbs of unaffected side of hemiplegic patients after stroke and lower limbs of normal person%脑卒中偏瘫患者非瘫痪侧下肢与正常人下肢本体感觉比较

    Institute of Scientific and Technical Information of China (English)

    宋建霞; 倪朝民; 张科; 陈进; 范文祥; 穆景颂; 邹坤

    2013-01-01

    目的:定量分析脑卒中偏瘫患者非瘫痪侧下肢与正常人下肢本体感觉之间的差异.方法:选用意大利Tecnobody公司Pro-Kin254P型本体感觉定量测试系统,采集28例脑卒中偏瘫患者非瘫痪侧下肢和30例正常人双下肢的本体感觉测试参数,主要观察指标为平均轨迹误差(ATE)、测试执行时间(TTE)和稳定指数(SI).结果:①脑卒中偏瘫患者患侧下肢平均轨迹误差、测试执行时间及稳定指数与正常组相应侧下肢比较,差异具有显著性(P<0.01);②右半球损伤患者同侧下肢本体感觉差于左半球损伤者,除测试执行时间指标外差异具有显著性意义(P<0.05);③正常组左下肢本体感觉参数优于右下肢,但差异无显著性意义(P>0.05);④平均轨迹误差与测试执行时间呈中度负相关(r=-0.550,P=0.002).结论:脑卒中偏瘫患者不仅患侧下肢存在功能障碍,其非瘫痪侧下肢与正常人相比也存在差异,且右半球损伤患者下肢本体感觉差于左半球损伤者,因此脑卒中后健侧下肢功能状况不容忽视.%Objective:To make quantitative comparision on proprioception between the unaffected lower limbs of hemiplegte patients after stroke and lower limbs of normal person.Method: The lower limbs of 28 hemiplegic patients after stroke and 30 normal person were measured by using a computerized proprioceptive foot-board(Pro-Kin system,Tecnbody,Italy).Main outcome measures included average trace error(ATE)、test't time execution(TTE) and stability index(SI).Result: ①The affected lower limbs of hemiplegie patients after stroke and lower limbs of normal person were significant different on the three parameters ATE、TTE and SI(P0.05);④Moder-ate negative correlation was found between ATE and TTE(r=-0.550,P=0.002).Conclusion: In hemiplegic patients, not only the affected lower limbs had proprioception deficits, but also there were some differences between the unaffected lower limbs of

  20. Comparative lower limb hemodynamics using neuromuscular electrical stimulation (NMES) versus intermittent pneumatic compression (IPC).

    Science.gov (United States)

    Broderick, Barry J; O'Connell, Sandra; Moloney, Shelly; O'Halloran, Kevin; Sheehan, James; Quondamatteo, Fabio; Quinlan, Leo R; OLaighin, Gearoid

    2014-09-01

    Deep Vein Thrombosis (DVT) is a life threatening condition and a serious concern among hospitalised patients, with death occurring in approximately 6% of cases. Intermittent pneumatic compression (IPC) is commonly used for DVT prevention, however suffers from low compliance and issues of usability and portability. Neuromuscular electrical stimulation (NMES) has been shown to improve lower limb hemodynamics but direct comparison with IPC in terms of hemodynamics is rare but very important to determine the potential effectiveness of NMES in DVT prevention.Lower limb IPC was compared to calf NMES, in 30 healthy volunteers (18-23 years). Each intervention was carried out on each leg, on the popliteal vein measured using Doppler ultrasound. All interventions produced significantly greater haemodynamic responses compared to baseline. Calf-IPC and NMES produced significant increases in venous blood velocity (cm/s) and volume of blood ejected per cycle (1 cycle of NMES expels 23.22 ml compared to the baseline ejected volume of 2.52 ml, measured over 1 s (p IPC (x3 greater than foot-IPC and x1.7 greater than calf-IPC) more effectively emptying the veins and soleal sinuses. This is an important finding as DVT occurs predominantly in the soleal sinuses. NMES is silent and portable and thus does not suffer many of the issues associated with IPC. This work supports the potential widespread application of NMES in hospital and home settings where the risk of DVT formation is high.

  1. Study on upper limb rehabilitation system based on surface EMG.

    Science.gov (United States)

    Wang, Lan; Li, Hailong; Wang, Zhengyu; Meng, Fandong

    2015-01-01

    During the rehabilitation process, it is essential to accurately judge a patient's recovery in a timely manner. A reasonable and matched training program is significant in the development of rehabilitation system. This paper presents a new upper limb rehabilitation training system, which consists of an upper limb rehabilitation training device, a current detection circuit, a motor speed test circuit, a surface EMG (sEMG) sensor, and a dSPACE HIL simulation platform. The real-time output torque of the servo motor is calculated by using the motor's real-time current and speed, in order to monitor the patient's training situation. The signal of sEMG is collected in real time and is processed with root mean square (RMS) to characterize the degree of muscle activation. Based on this rehabilitation system, maximum voluntary contraction (MVC) experiments, passive training experiments under different speeds, and active training experiments under different damping are studied. The results show that this new system performs real-time and accurate monitoring of a patient's training situation. It can also assess a patient's recovery through muscle activation. To a certain extent, this system provides a platform for research and development of rehabilitation medical engineering.

  2. Effects of elevated vacuum on in-socket residual limb fluid volume: Case study results using bioimpedance analysis

    Directory of Open Access Journals (Sweden)

    Joan E. Sanders, PhD

    2011-12-01

    Full Text Available Bioimpedance analysis was used to measure the residual limb fluid volume of seven transtibial amputee subjects using elevated vacuum sockets and nonelevated vacuum sockets. Fluid volume changes were assessed during sessions with the subjects sitting, standing, and walking. In general, fluid volume losses during 3 or 5 min walks and losses over the course of the 30 min test session were less for elevated vacuum than for suction. Numerous variables, including the time of day that data were collected, soft tissue consistency, socket-to-limb size and shape differences, and subject health, may have affected the results and had an equivalent or greater effect on limb fluid volume compared with elevated vacuum. Researchers should well consider these variables in the study design of future investigations on the effects of elevated vacuum on residual limb volume.

  3. Effects of elevated vacuum on in-socket residual limb fluid volume: Case study results using bioimpedance analysis

    Science.gov (United States)

    Sanders, JE; Harrison, DS; Myers, TR; Allyn, KJ

    2015-01-01

    Bioimpedance analysis was used to measure residual limb fluid volume on seven trans-tibial amputee subjects using elevated vacuum sockets and non-elevated vacuum sockets. Fluid volume changes were assessed during sessions with the subjects sitting, standing, and walking. In general, fluid volume losses during 3 or 5 min walks and losses over the course of the 30-min test session were less for elevated vacuum than for suction. A number of variables including the time of day data were collected, soft tissue consistency, socket-to-limb size differences and shape differences, and subject health may have affected the results and had an equivalent or greater impact on limb fluid volume compared with elevated vacuum. Researchers should well consider these variables in study design of future investigations on the effects of elevated vacuum on residual limb volume. PMID:22234667

  4. Upper limb injury in rugby union football: results of a cohort study.

    Science.gov (United States)

    Usman, Juliana; McIntosh, Andrew Stuart

    2013-04-01

    There have been few in-depth studies of upper limb injury epidemiology in rugby union football, despite reports that they accounted for between 14% and 28% of all rugby injuries. To report on upper limb injury incidence, injury severity and to identify the risk factors associated with upper limb injuries, for example, level of play, season (years) and playing position. Prospective cohort study across five rugby seasons from 2004 to 2008. Formal rugby competitions-suburban, provincial and international. 1475 adult male rugby players in Colts, Grade and Elite competitions. An upper limb injury resulting in a missed game and its characteristics. A total of 61 598 athletic exposures (AE) and 606 upper limb injuries were recorded. About 66% of the injuries were to the shoulder. The overall upper limb injury incidence rate (IIR) was 9.84 injuries/1000 AE (95% CI 9.06 to 10.62). Statistically significant associations were found between upper limb injuries and level of play; and between shoulder injuries and playing position (p<0.05). No association was found between upper limb and shoulder injuries and study year. The overall upper limb IIR decreased as the level of play increased; 10.74 upper limb injuries/1000 AE (95% CI 9.93 to 11.56) in Colts to 6.07 upper limb injuries/1000 AE (95% CI 5.46 to 6.69) in Elite. The upper limb IIR decreased as the level of play increased indicating that age, level of skill and playing experience may be risk factors for upper limb injury.

  5. A prospective study of short-term functional outcome after dysvascular major lower limb amputation.

    Science.gov (United States)

    Madsen, Ulla Riis; Bååth, Carina; Berthelsen, Connie Bøttcher; Hommel, Ami

    2017-08-12

    This study investigates functional status on Day 21 after dysvascular major lower limb amputation compared with one month pre-amputation and evaluates factors potentially influencing outcome. A prospective cohort study design was used. Data were collected via in-person interviews using structured instruments and covered functional level (Barthel index 100) one month pre-amputation and on Day 21. Out of a consecutive sample of patients having major lower limb amputation (tibia, knee or femoral) (n = 105), 51 participated on Day 21 follow-up. Clinical, demographic, body function and environmental data were analysed as factors potentially influencing outcome. From pre-amputation to Day 21, participants' functional level decreased significantly in all ten activities of daily living activities as measured by the Barthel Index. Almost 60% of participants were independent in bed-chair transfer on Day 21. Being independent in transfer on Day 21 was positively associated with younger age and attending physiotherapy after discharge. The findings indicate that short-term functional outcome is modifiable by quality of the postoperative care provided and thus highlights the need for increased focus on postoperative care to maintain basic function as well as establish and provide everyday rehabilitation in the general population of patients who have dysvascular lower limb amputations. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Comparative transcriptional profiling of the axolotl limb identifies a tripartite regeneration-specific gene program.

    Directory of Open Access Journals (Sweden)

    Dunja Knapp

    Full Text Available Understanding how the limb blastema is established after the initial wound healing response is an important aspect of regeneration research. Here we performed parallel expression profile time courses of healing lateral wounds versus amputated limbs in axolotl. This comparison between wound healing and regeneration allowed us to identify amputation-specific genes. By clustering the expression profiles of these samples, we could detect three distinguishable phases of gene expression - early wound healing followed by a transition-phase leading to establishment of the limb development program, which correspond to the three phases of limb regeneration that had been defined by morphological criteria. By focusing on the transition-phase, we identified 93 strictly amputation-associated genes many of which are implicated in oxidative-stress response, chromatin modification, epithelial development or limb development. We further classified the genes based on whether they were or were not significantly expressed in the developing limb bud. The specific localization of 53 selected candidates within the blastema was investigated by in situ hybridization. In summary, we identified a set of genes that are expressed specifically during regeneration and are therefore, likely candidates for the regulation of blastema formation.

  7. The Characteristics of Acute Rejection after Limb Allotransplantation in Rats-An Experimental Study

    Institute of Scientific and Technical Information of China (English)

    康皓; 洪光祥; 王发斌; 陈振兵; 黄启顺; 翁雨雄

    2003-01-01

    To study the characteristics of acute rejection after limb allotransplantation, 29 male Sprague-Dawley rats were randomly divided into 2 groups, with 15 rats in control group and 14 rats in experimental group. Each rat in control group underwent limb replantation. Each rat in experimental group received limb transplantation from Wistar rat. No immnosuppressive drugs were used after operation. The circulation of the transplanted limb, time and signs of rejection, histopathological changes in the tissues of the limb graft when rejected and survival time of limb grafts were evaluated. In the control group, no signs of rejection were observed, the circulation of each replanted limb was normal, it could survive for a longer time. The experimental group showed clinical signs of rejection (sub dermal edema and erythema) after a mean time of 3. 36±1.15 days, and the mean survival time of the allografts was only 7±0.78 days. Histopathological examination showed most violent rejection reaction in skin. It is concluded that with Wistar-to-SD limb transplantation without use of immunosuppression, rejection of the grafts would occur after a mean time of 3.36 ±1.15days; the earliest signs of rejection were edema and erythema of the skin, skin being the most representative component of limb graft rejection.

  8. Factors associated with phantom limb pain : a 31/2-year prospective study

    NARCIS (Netherlands)

    Bosmans, J.C.; Geertzen, J.H.B.; Post, W.J.; van der Schans, C.P.; Dijkstra, P.U.

    2010-01-01

    Objective: To analyse the prevalence of phantom (limb) pain over time and to analyse factors associated with phantom (limb) pain in a prospective cohort of amputees. Design: A multicentre longitudinal study. Patients: One hundred and thirty-four patients scheduled for amputation were included. Metho

  9. Decrease of physical activity level in adolescents with limb fractures: an accelerometry-based activity monitor study

    Directory of Open Access Journals (Sweden)

    Delhumeau Cécile

    2011-05-01

    Full Text Available Abstract Background Immobilization and associated periods of inactivity can cause osteopenia, the physiological response of the bone to disuse. Mechanical loading plays an essential role in maintaining bone integrity. Skeletal fractures represent one cause of reduction of the physical activity (PA level in adolescents. The purpose of this study was to quantify the reduction of PA in adolescents with limb fractures during the cast immobilization period compared with healthy controls. Methods Two hundred twenty adolescents were divided into three groups: those with upper limb fractures (50 cases; lower limb fractures (50 cases; and healthy cases (120 cases. Patients and their healthy peers were matched for gender, age, and seasonal assessment of PA. PA level was assessed during cast immobilization by accelerometer. Time spent in PA in each of the different intensity levels - sedentary, light, moderate, and vigorous - was determined for each participant and expressed in minutes and as a percentage of total valid time. Results Reduction in PA during cast immobilization was statistically significant in patients with limb fractures compared to healthy controls. The total PA count (total number of counts/min was significantly lower in those with upper and lower limb fractures (-30.1% and -62.4%, respectively compared with healthy controls (p p = 0.0003 and 76.6% (p p = 0.0008 and 84.4% (p Conclusions PA measured by accelerometer is a useful and valid tool to assess the decrease of PA level in adolescents with limb fractures. As cast immobilization and reduced PA are known to induce bone mineral loss, this study provides important information to quantify the decrease of skeletal loading in this patient population. The observed reduction of high intensity skeletal loading due to the decrease in vigorous PA may explain osteopenia due to disuse, and these data should be kept in mind by trauma practitioners to avoid any unnecessary prolongation of the cast

  10. A study of solar photospheric temperature gradient variation using limb darkening measurements

    CERN Document Server

    Criscuoli, Serena

    2016-01-01

    The variation in area of quiet magnetic network measured over the sunspot cycle should modulate the spatially averaged photospheric temperature gradient, since temperature declines with optical depth more gradually in magnetic flux tube atmospheres. Yet, limb darkening measurements show no dependence upon activity level, even at an rms precision of 0.04%. We study the sensitivity of limb darkening to changes in area filling factor using a 3D MHD model of the magnetized photosphere. The limb darkening change expected from the measured 11 yr area variation lies below the level of measured limb darkening variations, for a reasonable range of magnetic flux in quiet network and internetwork regions. So the remarkably constant limb darkening observed over the solar activity cycle is not inconsistent with the measured 11 year change in area of quiet magnetic network. Our findings offer an independent constraint on photospheric temperature gradient changes reported from measurements of the solar spectral irradiance f...

  11. ultrastructural study of limb bud development in green turtles chelonia mydas

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    morphological changes during the embryonic development of limbs of the green turtle,chelonia mydas,were studied during the entire period of incubation,using transmission and scanning electron microscopy (tem and sem).limb buds were first observed at stage 2.at that stage,the tip was covered with an apical ectodermal ridge (aer) which began to regress at stage 6.associated with aer was the presence of the mesenchymal cells which,consequently,differentiated into muscles,cartilage and bones.the gross features of the skeletal development appeared as a condensation of the cartilaginous structures in the proximal distal region of the limbs.the primordial digits were gradually enclosed by hard keratinized webbed skin.the increase in rate of ossification and skin pigmentation was correlated with the growth of the limbs.the development of the limbs was closely related to the transitional appearance of mucus secretion from the epidermis.

  12. A study on limb reduction defects in six European regions

    NARCIS (Netherlands)

    Stoll, C; Calzolari, E; Cornel, M; GarciaMinaur, S; Garne, E; Nevin, N

    1996-01-01

    Limb reduction defects (LRD) gained especial attention after the thalidomide tragedy in 1962, LRD are common congenital malformations which present as obvious congenital anomalies recognized at birth, Therefore it might be assumed that they are well documented, However classification of LRDs is disp

  13. A study on limb reduction defects in six European regions

    NARCIS (Netherlands)

    Stoll, C; Calzolari, E; Cornel, M; GarciaMinaur, S; Garne, E; Nevin, N

    1996-01-01

    Limb reduction defects (LRD) gained especial attention after the thalidomide tragedy in 1962, LRD are common congenital malformations which present as obvious congenital anomalies recognized at birth, Therefore it might be assumed that they are well documented, However classification of LRDs is disp

  14. Remote Effect of Lower Limb Acupuncture on Latent Myofascial Trigger Point of Upper Trapezius Muscle: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Kai-Hua Chen

    2013-01-01

    Full Text Available Objectives. To demonstrate the use of acupuncture in the lower limbs to treat myofascial pain of the upper trapezius muscles via a remote effect. Methods. Five adults with latent myofascial trigger points (MTrPs of bilateral upper trapezius muscles received acupuncture at Weizhong (UB40 and Yanglingquan (GB34 points in the lower limbs. Modified acupuncture was applied at these points on a randomly selected ipsilateral lower limb (experimental side versus sham needling on the contralateral lower limb (control side in each subject. Each subject received two treatments within a one-week interval. To evaluate the remote effect of acupuncture, the range of motion (ROM upon bending the contralateral side of the cervical spine was assessed before and after each treatment. Results. There was significant improvement in cervical ROM after the second treatment (P=0.03 in the experimental group, and the increased ROM on the modified acupuncture side was greater compared to the sham needling side (P=0.036. Conclusions. A remote effect of acupuncture was demonstrated in this pilot study. Using modified acupuncture needling at remote acupuncture points in the ipsilateral lower limb, our treatments released tightness due to latent MTrPs of the upper trapezius muscle.

  15. Nerve conduction studies in lower limb of elite Nepalese football players: an insight into neural adaptations.

    Science.gov (United States)

    Sharma, Deepak; Paudel, Bishnu H; Khadka, Rita; Thakur, Dilip; Shah, Dev K; Sapkota, Niraj K; Yadav, Ram L; Yadav, Prakash K

    2017-03-01

    The study was aimed to assess somatic neural alterations in lower limbs of elite Nepalese football players by comparing their nerve conduction parameters with non-athletic controls. Players (N.=27, age 22.74±2.52 yrs.) with excellent cardio-respiratory fitness and presenting no signs of injuries, and sedentary controls (N.=29, age 23.41±2.95 yrs.) were recruited for the study. Standard nerve conduction techniques were applied to evaluate posterior tibial and sural nerves in the dominant and non-dominant limbs of each individual. Conduction velocity, onset latency, amplitude and duration of the motor and sensory evoked responses were recorded. The players had significantly lower resting mean heart rate, systolic and diastolic blood pressure than controls. Tibial compound muscle action potential (CMAP) showed higher amplitude as compared to controls; tibial proximal CMAP amplitude [(13.624±4.57) vs. (10.810±4.62) mV, P=0.035] of dominant leg, tibial proximal [(13.893±4.60) vs. (11.083±4.51) mV, P=0.045] and distal [(16.388±3.62) vs. (13.958±4.65) mV, P=0.049] amplitude of non-dominant leg. Likewise, players had significantly shorter tibial CMAPs duration of each lower limb compared with corresponding limb of controls. Sural nerve of non-dominant leg revealed shortened sensory nerve action potential duration [(1.729±0.25) vs. (1.904±0.289) ms, P=0.018]. Increased tibial CMAP amplitude and decreased CMAP duration in players suggest excitation of more number of motor units and higher synchronicity of muscle fibers' discharge than in controls respectively. Higher amplitude can also be attributed to increase in muscle fiber size and/or efficiency of neuromuscular transmission. Increased synchronicity indirectly reflects narrow range of conduction velocity among tibial neurons. The adaptive changes in somatic nerves need more crucial research for exact identification of sites and the structures responsible.

  16. Comparative Packaging Study

    Science.gov (United States)

    Perchonok, Michele; Antonini, David

    2008-01-01

    This viewgraph presentation describes a comparative packaging study for use on long duration space missions. The topics include: 1) Purpose; 2) Deliverables; 3) Food Sample Selection; 4) Experimental Design Matrix; 5) Permeation Rate Comparison; and 6) Packaging Material Information.

  17. Vibrotactile sense in patients with different upper limb disorders compared with a control group

    DEFF Research Database (Denmark)

    Laursen, Lise Hedegaard; Jepsen, Jørgen Riis; Sjøgaard, Gisela

    2006-01-01

    BACKGROUND: Upper limb disorders (ULDs) are common, and so are the difficulties with regard to their specific diagnoses. According to diagnostic consensus criteria, specific diagnoses include neuropathy and muscular- and connective-tissue disorders (MCDs). There is a need for valid objective...... diagnostic tools to reveal underlying mechanisms for specific diagnoses. OBJECTIVE: To investigate the possible differences in vibration perception threshold (VPT) and tolerance to suprathreshold stimulation (STS) between controls and specific diagnostic ULD patient groups with uni- and bilateral neuropathy...

  18. A review of nerve conduction studies in cases of suspected compression neuropathies of the upper limb.

    LENUS (Irish Health Repository)

    Neligan, A

    2010-01-01

    Entrapment neuropathies, particularly those affecting upper limbs, are common reasons for referral for nerve conduction studies (NCS). However, concordance between clinical findings and NCS findings, especially in patients being considered for intervention including decompressive surgery, has not been assessed.

  19. Studying the flow dynamics in an aortic endograft with crossed-limbs.

    Science.gov (United States)

    Georgakarakos, Efstratios; Xenakis, Antonios; Manopoulos, Christos; Georgiadis, George S; Argyriou, Christos; Tsangaris, Sokrates; Lazarides, Miltos K

    2014-01-01

    To evaluate the flow phenomena within an aortic endograft with crossed-limbs, comparing to an endograft with the ordinary limb bifurcation. An endograft model with crossed-limbs was computationally reconstructed based on Computed Tomography patient-specific data, using commercially available software. Accordingly, its analogue model was reconstructed in the ordinary fashion (ordinary bifurcation). Computational fluid dynamics analysis was performed to determine and compare the flow fields, velocity profiles, pressure and shear stress distribution throughout the different parts of both endograft configurations, in different phases of the cardiac cycle. The flow patterns between the "Ballerina" and the classic endograft were similar, with flow disturbance near the inlet zone at late diastole and smooth flow patterns during the systolic phase. Both configurations presented similar pressure distribution patterns throughout the cardiac cycle. The highest and lowest pressures were demonstrated in the inlet-main body area and the iliac limbs, respectively. Marked differences were observed in the velocity profiles of the proximal limb segments between the two configurations, mostly in the peak- and end-systolic phase. The regions of lower velocities correlated well to low shear values. Differences in the shear stress distribution were noted between the two configurations in the systolic and, predominantly, in the diastolic phase. There are differences in the velocity profiles and shear distribution between the limbs of the two endograft configurations. The pathophysiologic implication of our findings and their possible association with clinical events, such as thrombus apposition, deserves further investigation.

  20. A COMPARATIVE EVALUATION OF DEXMEDETOMIDINE AND CLONIDINE AS ADJUVANTS TO LEVOBUPIVACAINE IN EPIDURAL ANAESTHESIA FOR LOWER LIMB ORTHOPAEDIC SURGERIES

    Directory of Open Access Journals (Sweden)

    Karthik

    2015-02-01

    Full Text Available BACKGROUND: There are always efforts to find a better and safer local anaesthetic along with adjuvants in epidural anaesthesia. Bupivacaine is a long acting , effective local anaesthetic that is commonly administered in anaesthesia practice. Despite its undoubted efficacy, bupivacaine is associated with cardiotoxicity and neurotoxicity. Central nervous system (CNS and cardiovascular adverse reactions reported after inadvertent intravascular or intravenous regional anesthesia have been linked to R (+ isomer of bupivacaine. So Levobupivacaine, the pure S ( - – enantiomer of racemic bupivacaine, was developed as an alternative to bupivacaine. Levobupivacaine is increasingly used in the clinical practice because of its safer pharmacological profile and faster protein binding rate AIM: This study was conducted to evaluate the onset and duration of analgesia, extent and duration of sensory and motor block, sedation and side effects of Dexmedetomidine and Clonidine when used as adjuvants to Levobupivacaine in epidural anaesthesia for lower limb orthopaedic surgeries. MATERIALS AND METHODS: A prospective randomized study was carried out in the department of Anaesthesia at Rajarajeswari Medical College and Hospital which included 50 adult patients between the ages of 21 and 60 years (o f ASA I/II grade who underwent lower limb orthopaedic surgeries. The patients were randomly allocated into two groups; levobupivacaine + dexmedetomidine (LD and levobupivacaine + clonidine (LC, comprising of 25 patients each. Group LD was administered 18 ml of 0.5% epidural levobupivacaine and 1.5 μg/kg of dexmedetomidine, while group LC received admixture of 18 ml of 0.5% levobupivacaine and 2 μg/kg of Clonidine . Onset of analgesia, sensory and motor block levels, sedation, duration of analgesia and side effects were observed. STATISTICAL ANALYSIS: The data obtained was subjected to statistical analysis using analysis of variance, student t test, chi - square test

  1. Prevalence of phantom limb pain, stump pain, and phantom limb sensation among the amputated cancer patients in India: A prospective, observational study

    Directory of Open Access Journals (Sweden)

    Arif Ahmed

    2017-01-01

    Full Text Available Introduction: The phantom limb pain (PLP and phantom limb sensation (PLS are very common among amputated cancer patients, and they lead to considerable morbidity. In spite of this, there is a lack of epidemiological data of this phenomenon among the Asian population. This study was done to provide the data from Indian population. Methods: The prevalence of PLP, stump pain (SP, and PLS was prospectively analyzed from the amputated cancer patients over a period of 2 years in Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi. The risk factors and the impact of phantom phenomenon on patients were also noted. Results: The prevalence of PLP was 41% at 3 and 12 months and 45.3% at 6 months, whereas that of SP and PLS was 14.4% and 71.2% at 3 months, 18.75% and 37.1% at 6 months, 15.8% and 32.4% at 12 months, respectively. There was higher prevalence of PLP and PLS among the patients with history of preamputation pain, smoking with proximal level of amputation, receiving general anesthesia, receiving intravenous (IV opioid postoperative analgesia, and developing neuroma or infection. Conclusion: The prevalence of PLP and PLS was higher among the cancer amputees as compared to SP, and a few risk factors responsible for their higher prevalence were found in our study. The PLP and PLS lead to considerable morbidity in terms of sleep disturbance and depression.

  2. Phantom pain and phantom sensations in upper limb amputees: an epidemiological study

    OpenAIRE

    Kooijman, CM; Dijkstra, PU; Geertzen, JHB; Elzinga, A; Van Der Schans, CP

    2000-01-01

    Phantom pain in subjects with an amputated limb is a well-known problem. However, estimates of the prevalence of phantom pain differ considerably in the literature. Various factors associated with phantom pain have been described including pain before the amputation, gender, dominance, and time elapsed since the amputation. The purposes of this study were to determine prevalence and factors associated with phantom pain and phantom sensations in upper limb amputees in The Netherlands. Addition...

  3. Comparative analysis of phenotypes features in two common genetic variants of limb-girdle muscular dystrophy

    Directory of Open Access Journals (Sweden)

    I. V. Sharkova

    2015-01-01

    Full Text Available The algorithm of differential diagnosis of the two most common genetic variants the limb-girdle muscular dystrophy (LGMD2A and DMD, developed on the basis of a comprehensive survey of 85 patients with a diagnosis specification using techniques of DNA analysis. It is shown that the accurate diagnosis of LGMD genetic types should be based on the results of the clinical and genealogical, biochemical and molecular genetic analysis. The proposed algorithm will significantly reduces the economic and time costs with expensive DNA testing.

  4. The effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture: A retrospective case-control study.

    Science.gov (United States)

    Yang, Si-Dong; Ning, Sheng-Hua; Zhang, Li-Hong; Zhang, Ying-Ze; Ding, Wen-Yuan; Yang, Da-Long

    2016-08-01

    The purpose of this study was to explore the effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture after undergoing intramedullary nail fixation surgery.We collected medical records of elderly patients aged ≥ 60 years with femoral shaft fracture between 03/2010 and 03/2015 in Longyao County Hospital. Totally, 160 patients were identified and divided into the intervention group (n = 80) and the control group (n = 80). During the postoperative period, the intervention group received lower limb rehabilitation gymnastics treatment for 3 months, but the control group did not. All patients were routinely asked to return hospital for a check in the 1st postoperative week, as well as the 2nd week, the 1st month, and the 3rd month, after surgery. The clinical rehabilitation effect was evaluated by checking lower limb action ability, detecting the lower limb deep venous thrombosis (DVT), scoring muscle strength of quadriceps and visual analog scale (VAS) score, and performing satisfaction survey.At the 1st week and 2nd week after surgery, the clinical rehabilitation effect in the intervention group was better regarding lower limb action ability, lower limb DVT, muscle strength of quadriceps, VAS score, and patient satisfaction, as compared with the control group. However, there was no significant difference at the 1st month and the 3rd month after surgery when comparing the intervention group to the control group.In the early postoperative stage, lower limb rehabilitation gymnastics can effectively improve the recovery of lower limb function, beneficial to reducing postoperative complications such as lower limb DVT and muscle atrophy, and increasing patient satisfaction rate.

  5. No effects of dioxin singly on limb malformations in macaque monkeys through epidemiological and treated studies

    Energy Technology Data Exchange (ETDEWEB)

    Asaoka, Kazuo; Iida, Hiroko [Kyoto Univ. (Japan). Primate Research Insitute, Dept. of Molecular and Cellular Biochemistry; Watanabe, Kunio [Kyoto Univ. (Japan). Primate Research Institute, Field Research Center; Goda, Hiroshi [Towa Kagaku Co., Ltd. (Japan); Ihara, Toshio; Nagata, Ryoichi [Shin Nippon Biomedical Laboratories, Ltd. (Japan). Safety Research Facility; Yasuda, Mineo [Hiroshima International Univ. (Japan). Fac. of Health Sciences, Dept. of Clinical Engineering; Kubata, Shunichiro [Tokyo Univ. (Japan). Dept. of Life Science, Graduate School of Arts and Sciences

    2004-09-15

    Human populations exposed with highly dioxin were suspected to be caused immunological dysfunctions, carcinogenesis, and developmental and reproductive dysfunctions. Because of species resemblances, the dioxin effects have been investigating using monkeys as a model for assessment of dioxin exposure on human health. Since 1957 the limb malformations of monkeys in Japan have been reported. The higher frequency of them was found in provisional groups of monkeys who were given the same kind of food for human. The chromosomal abnormalities are excluded from the factor for the congenital limb malformations that are still producing in Japan. In this study, the relations between dioxin and the limb malformations of macaque monkeys were estimated by the epidemiological and administered researches. The dioxin levels in monkeys were measured at two districts that one has the provisional groups including monkeys with limb malformations and the other has breeding groups never seeing the malformations for a long time. TEQ was calculated by the levels of dioxin isomers in the monkeys and the values show no difference between the two places and between the individuals with and without the limb malformations. 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) was administered via subcutaneous to pregnant rhesus monkeys from the day 20 of gestation to the day 90 after birth. The exposed babies, including the offspring and died in neonatal, had observed normal limbs in the range of 30-300 ng TCDD /kg of body weight.

  6. Comparing unilateral and bilateral upper limb training: The ULTRA-stroke program design

    Directory of Open Access Journals (Sweden)

    Koppe Peter

    2009-11-01

    Full Text Available Abstract Background About 80% of all stroke survivors have an upper limb paresis immediately after stroke, only about a third of whom (30 to 40% regain some dexterity within six months following conventional treatment programs. Of late, however, two recently developed interventions - constraint-induced movement therapy (CIMT and bilateral arm training with rhythmic auditory cueing (BATRAC - have shown promising results in the treatment of upper limb paresis in chronic stroke patients. The ULTRA-stroke (acronym for Upper Limb TRaining After stroke program was conceived to assess the effectiveness of these interventions in subacute stroke patients and to examine how the observed changes in sensori-motor functioning relate to changes in stroke recovery mechanisms associated with peripheral stiffness, interlimb interactions, and cortical inter- and intrahemispheric networks. The present paper describes the design of this single-blinded randomized clinical trial (RCT, which has recently started and will take several years to complete. Methods/Design Sixty patients with a first ever stroke will be recruited. Patients will be stratified in terms of their remaining motor ability at the distal part of the arm (i.e., wrist and finger movements and randomized over three intervention groups receiving modified CIMT, modified BATRAC, or an equally intensive (i.e., dose-matched conventional treatment program for 6 weeks. Primary outcome variable is the score on the Action Research Arm test (ARAT, which will be assessed before, directly after, and 6 weeks after the intervention. During those test sessions all patients will also undergo measurements aimed at investigating the associated recovery mechanisms using haptic robots and magneto-encephalography (MEG. Discussion ULTRA-stroke is a 3-year translational research program which aims (1 to assess the relative effectiveness of the three interventions, on a group level but also as a function of patient

  7. Energy flow analysis of amputee walking shows a proximally-directed transfer of energy in intact limbs, compared to a distally-directed transfer in prosthetic limbs at push-off.

    Science.gov (United States)

    Weinert-Aplin, R A; Howard, D; Twiste, M; Jarvis, H L; Bennett, A N; Baker, R J

    2017-01-01

    Reduced capacity and increased metabolic cost of walking occurs in amputees, despite advances in prosthetic componentry. Joint powers can quantify deficiencies in prosthetic gait, but do not reveal how energy is exchanged between limb segments. This study aimed to quantify these energy exchanges during amputee walking. Optical motion and forceplate data collected during walking at a self-selected speed for cohorts of 10 controls, 10 unilateral trans-tibial, 10 unilateral trans-femoral and 10 bilateral trans-femoral amputees were used to determine the energy exchanges between lower limb segments. At push-off, consistent thigh and shank segment powers were observed between amputee groups (1.12W/kg vs. 1.05W/kg for intact limbs and 0.97W/kg vs. 0.99W/kg for prosthetic limbs), and reduced prosthetic ankle power, particularly in trans-femoral amputees (3.12W/kg vs. 0.87W/kg). Proximally-directed energy exchange was observed in the intact limbs of amputees and controls, while prosthetic limbs displayed distally-directed energy exchanges at the knee and hip. This study used energy flow analysis to show a reversal in the direction in which energy is exchanged between prosthetic limb segments at push-off. This reversal was required to provide sufficient energy to propel the limb segments and is likely a direct result of the lack of push-off power at the prosthetic ankle, particularly in trans-femoral amputees, and leads to their increased metabolic cost of walking.

  8. Suicidal mercury injection into the upper limb: a case study.

    Science.gov (United States)

    Wong, F; Hung, L K; Wong, C H; Ho, P C

    2004-12-01

    We report a rare case of self-injection of mercury into the subcutaneous tissue of the upper limb. A multi-disciplinary management approach was adopted including cooperation between toxicologists, orthopaedic surgeons, radiologists and environment safety personnel. Surgical removal of mercury under radiological screening and systemic intoxication treated by chelating agents, namely dimercaprol and succimer. Serial serum and urine mercury levels showed an initial rise despite surgical removal and returned to normal after a prolonged period of time. Safety precautions were taken during surgery to avoid inadvertent intoxication of staff. Contamination of the operation theatre was monitored by the amount of mercury vapour released into the air. All personnels involved in the management of the patient did not show any evidence of mercury intoxication.

  9. A Pilot Study of Botulinum Toxin for Jerky, Position-Specific, Upper Limb Action Tremor

    Science.gov (United States)

    Saifee, Tabish A.; Teodoro, Tiago; Erro, Roberto; Edwards, Mark J.; Cordivari, Carla

    2016-01-01

    Background We aimed to investigate the efficacy and safety of botulinum toxin (BT) injections for jerky action tremor of the upper limb. Methods We performed an uncontrolled, prospective study of electromyography (EMG)-guided BT injections for jerky, position-specific, upper limb action tremor. The primary outcome was clinical global impression at 3–6 weeks after baseline. Results Eight patients with jerky, position-specific action tremor involving the upper limb were consecutively recruited. After a median follow-up of 4.4 weeks (interquartile range [IQR] 3.6–6 weeks), four of them rated themselves as “improved” and two as “much improved.” Five of these six subjects reported improvements in specific activities of daily living (bringing liquids to mouth, feeding, shaving, and dressing). Upper limb subscore of the Fahn–Tolosa–Marin Tremor Rating Scale (FTM) significantly decreased from 4.5 (4–6) to 3 (2–5) (p = 0.01). Discussion This pilot, prospective cohort study suggests that EMG-guided BT injections may improve jerky, position-specific, upper limb action tremor. Placebo-controlled studies evaluating larger samples of patients are warranted to confirm these findings. PMID:27818844

  10. Prosthetic fitting, use, and satisfaction following lower-limb amputation: A prospective study

    Directory of Open Access Journals (Sweden)

    Joseph B. Webster, MD

    2013-01-01

    Full Text Available Providing a satisfactory, functional prosthesis following lower-limb amputation is a primary goal of rehabilitation. The objectives of this study were to describe the rate of successful prosthetic fitting over a 12 mo period; describe prosthetic use after amputation; and determine factors associated with greater prosthetic fitting, function, and satisfaction. The study design was a multicenter prospective cohort study of individuals undergoing their first major lower-limb amputation because of vascular disease and/or diabetes. At 4 mo, unsuccessful prosthetic fitting was significantly associated with depression, prior arterial reconstruction, diabetes, and pain in the residual limb. At 12 mo, 92% of all subjects were fit with a prosthetic limb and individuals with transfemoral amputation were significantly less likely to have a prosthesis fit. Age older than 55 yr, diagnosis of a major depressive episode, and history of renal dialysis were associated with fewer hours of prosthetic walking. Subjects who were older, had experienced a major depressive episode, and/or were diagnosed with chronic obstructive pulmonary disease had greater functional restriction. Thus, while most individuals achieve successful prosthetic fitting by 1 yr following a first major nontraumatic lower-limb amputation, a number of medical variables and psychosocial factors are associated with prosthetic fitting, utilization, and function.

  11. Operations dashboard: comparative study

    Science.gov (United States)

    Ramly, Noor Nashriq; Ismail, Ahmad Zuhairi; Aziz, Mohd Haris; Ahmad, Nurul Haszeli

    2011-10-01

    In this present days and age, there are increasing needs for companies to monitor application and infrastructure health. Apart from having proactive measures to secure their application and infrastructure, many see monitoring dashboards as crucial investment in disaster preparedness. As companies struggle to find the best solution to cater for their needs and interest for monitoring their application and infrastructure's health, this paper summarizes the studies made on several known off-the-shelf operations dashboard and in-house developed dashboard. A few criteria of good dashboard are collected from previous studies carried out by several researchers and rank them according to importance and business needs. The finalized criteria that will be discussed in later sections are data visualization, performance indicator, dashboard personalization, audit capability and alert/ notification. Comparative studies between several popular dashboards were then carried out to determine whether they met these criteria that we derived from the first exercise. The findings hopefully can be used to educate and provide an overview of selecting the best IT application and infrastructure operations dashboard that suit business needs, thus become the main contribution of this paper.

  12. Robot Assisted Training for the Upper Limb after Stroke (RATULS): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Rodgers, Helen; Shaw, Lisa; Bosomworth, Helen; Aird, Lydia; Alvarado, Natasha; Andole, Sreeman; Cohen, David L; Dawson, Jesse; Eyre, Janet; Finch, Tracy; Ford, Gary A; Hislop, Jennifer; Hogg, Steven; Howel, Denise; Hughes, Niall; Krebs, Hermano Igo; Price, Christopher; Rochester, Lynn; Stamp, Elaine; Ternent, Laura; Turner, Duncan; Vale, Luke; Warburton, Elizabeth; van Wijck, Frederike; Wilkes, Scott

    2017-07-20

    Loss of arm function is a common and distressing consequence of stroke. We describe the protocol for a pragmatic, multicentre randomised controlled trial to determine whether robot-assisted training improves upper limb function following stroke. Study design: a pragmatic, three-arm, multicentre randomised controlled trial, economic analysis and process evaluation. NHS stroke services. adults with acute or chronic first-ever stroke (1 week to 5 years post stroke) causing moderate to severe upper limb functional limitation. Randomisation groups: 1. Robot-assisted training using the InMotion robotic gym system for 45 min, three times/week for 12 weeks 2. Enhanced upper limb therapy for 45 min, three times/week for 12 weeks 3. Usual NHS care in accordance with local clinical practice Randomisation: individual participant randomisation stratified by centre, time since stroke, and severity of upper limb impairment. upper limb function measured by the Action Research Arm Test (ARAT) at 3 months post randomisation. upper limb impairment (Fugl-Meyer Test), activities of daily living (Barthel ADL Index), quality of life (Stroke Impact Scale, EQ-5D-5L), resource use, cost per quality-adjusted life year and adverse events, at 3 and 6 months. Blinding: outcomes are undertaken by blinded assessors. Economic analysis: micro-costing and economic evaluation of interventions compared to usual NHS care. A within-trial analysis, with an economic model will be used to extrapolate longer-term costs and outcomes. Process evaluation: semi-structured interviews with participants and professionals to seek their views and experiences of the rehabilitation that they have received or provided, and factors affecting the implementation of the trial. allowing for 10% attrition, 720 participants provide 80% power to detect a 15% difference in successful outcome between each of the treatment pairs. Successful outcome definition: baseline ARAT 0-7 must improve by 3 or more points; baseline

  13. An augmented reality system for upper-limb post-stroke motor rehabilitation: a feasibility study.

    Science.gov (United States)

    Assis, Gilda Aparecida de; Corrêa, Ana Grasielle Dionísio; Martins, Maria Bernardete Rodrigues; Pedrozo, Wendel Goes; Lopes, Roseli de Deus

    2016-08-01

    To determine the clinical feasibility of a system based on augmented reality for upper-limb (UL) motor rehabilitation of stroke participants. A physiotherapist instructed the participants to accomplish tasks in augmented reality environment, where they could see themselves and their surroundings, as in a mirror. Two case studies were conducted. Participants were evaluated pre- and post-intervention. The first study evaluated the UL motor function using Fugl-Meyer scale. Data were compared using non-parametric sign tests and effect size. The second study used the gain of motion range of shoulder flexion and abduction assessed by computerized biophotogrammetry. At a significance level of 5%, Fugl-Meyer scores suggested a trend for greater UL motor improvement in the augmented reality group than in the other. Moreover, effect size value 0.86 suggested high practical significance for UL motor rehabilitation using the augmented reality system. System provided promising results for UL motor rehabilitation, since enhancements have been observed in the shoulder range of motion and speed. Implications for Rehabilitation Gain of range of motion of flexion and abduction of the shoulder of post-stroke patients can be achieved through an augmented reality system containing exercises to promote the mental practice. NeuroR system provides a mental practice method combined with visual feedback for motor rehabilitation of chronic stroke patients, giving the illusion of injured upper-limb (UL) movements while the affected UL is resting. Its application is feasible and safe. This system can be used to improve UL rehabilitation, an additional treatment past the traditional period of the stroke patient hospitalization and rehabilitation.

  14. A Study of Solar Photospheric Temperature Gradient Variation Using Limb Darkening Measurements

    Science.gov (United States)

    Criscuoli, Serena; Foukal, Peter

    2017-01-01

    The variation in area of quiet magnetic network measured over the sunspot cycle should modulate the spatially averaged photospheric temperature gradient, since temperature declines with optical depth more gradually in magnetic flux tube atmospheres. Yet, limb darkening measurements show no dependence upon activity level, even at an rms precision of 0.04%. We study the sensitivity of limb darkening to changes in area filling factor using a 3D MHD model of the magnetized photosphere. The limb darkening change expected from the measured 11-year area variation lies below the level of measured limb darkening variations, for a reasonable range of magnetic flux in quiet network and internetwork regions. So the remarkably constant limb darkening observed over the solar activity cycle is not inconsistent with the measured 11-year change in area of quiet magnetic network. Our findings offer an independent constraint on photospheric temperature gradient changes reported from measurements of the solar spectral irradiance from the Spectral Irradiance Monitor, and recently, from wavelength-differential spectrophotometry using the Solar Optical Telescope aboard the HINODE spacecraft.

  15. Comparing nadir and limb observations of polar mesospheric clouds: The effect of the assumed particle size distribution

    Science.gov (United States)

    Bailey, Scott M.; Thomas, Gary E.; Hervig, Mark E.; Lumpe, Jerry D.; Randall, Cora E.; Carstens, Justin N.; Thurairajah, Brentha; Rusch, David W.; Russell, James M.; Gordley, Larry L.

    2015-05-01

    Nadir viewing observations of Polar Mesospheric Clouds (PMCs) from the Cloud Imaging and Particle Size (CIPS) instrument on the Aeronomy of Ice in the Mesosphere (AIM) spacecraft are compared to Common Volume (CV), limb-viewing observations by the Solar Occultation For Ice Experiment (SOFIE) also on AIM. CIPS makes multiple observations of PMC-scattered UV sunlight from a given location at a variety of geometries and uses the variation of the radiance with scattering angle to determine a cloud albedo, particle size distribution, and Ice Water Content (IWC). SOFIE uses IR solar occultation in 16 channels (0.3-5 μm) to obtain altitude profiles of ice properties including the particle size distribution and IWC in addition to temperature, water vapor abundance, and other environmental parameters. CIPS and SOFIE made CV observations from 2007 to 2009. In order to compare the CV observations from the two instruments, SOFIE observations are used to predict the mean PMC properties observed by CIPS. Initial agreement is poor with SOFIE predicting particle size distributions with systematically smaller mean radii and a factor of two more albedo and IWC than observed by CIPS. We show that significantly improved agreement is obtained if the PMC ice is assumed to contain 0.5% meteoric smoke by mass, in agreement with previous studies. We show that the comparison is further improved if an adjustment is made in the CIPS data processing regarding the removal of Rayleigh scattered sunlight below the clouds. This change has an effect on the CV PMC, but is negligible for most of the observed clouds outside the CV. Finally, we examine the role of the assumed shape of the ice particle size distribution. Both experiments nominally assume the shape is Gaussian with a width parameter roughly half of the mean radius. We analyze modeled ice particle distributions and show that, for the column integrated ice distribution, Log-normal and Exponential distributions better represent the range

  16. Global cloud top height retrieval using SCIAMACHY limb spectra: model studies and first results

    Science.gov (United States)

    Eichmann, Kai-Uwe; Lelli, Luca; von Savigny, Christian; Sembhi, Harjinder; Burrows, John P.

    2016-03-01

    Cloud top heights (CTHs) are retrieved for the period 1 January 2003 to 7 April 2012 using height-resolved limb spectra measured with the SCanning Imaging Absorption SpectroMeter for Atmospheric CHartographY (SCIAMACHY) on board ENVISAT (ENVIronmental SATellite). In this study, we present the retrieval code SCODA (SCIAMACHY cloud detection algorithm) based on a colour index method and test the accuracy of the retrieved CTHs in comparison to other methods. Sensitivity studies using the radiative transfer model SCIATRAN show that the method is capable of detecting cloud tops down to about 5 km and very thin cirrus clouds up to the tropopause. Volcanic particles can be detected that occasionally reach the lower stratosphere. Upper tropospheric ice clouds are observable for a nadir cloud optical thickness (COT) ≥ 0.01, which is in the subvisual range. This detection sensitivity decreases towards the lowermost troposphere. The COT detection limit for a water cloud top height of 5 km is roughly 0.1. This value is much lower than thresholds reported for passive cloud detection methods in nadir-viewing direction. Low clouds at 2 to 3 km can only be retrieved under very clean atmospheric conditions, as light scattering of aerosol particles interferes with the cloud particle scattering. We compare co-located SCIAMACHY limb and nadir cloud parameters that are retrieved with the Semi-Analytical CloUd Retrieval Algorithm (SACURA). Only opaque clouds (τN,c > 5) are detected with the nadir passive retrieval technique in the UV-visible and infrared wavelength ranges. Thus, due to the frequent occurrence of thin clouds and subvisual cirrus clouds in the tropics, larger CTH deviations are detected between both viewing geometries. Zonal mean CTH differences can be as high as 4 km in the tropics. The agreement in global cloud fields is sufficiently good. However, the land-sea contrast, as seen in nadir cloud occurrence frequency distributions, is not observed in limb geometry. Co

  17. A COMPARATIVE EVALUATION OF INTRAVENOUS DEXMEDETOMIDINE AND CLONIDINE AS PREMEDIC ATION FOR PROLONGATION OF BUPIVA CAINE SUBARACHNOID BLOCK FOR LOWER LIMB ORTHOPAEDIC SURGERY

    Directory of Open Access Journals (Sweden)

    Chavi

    2015-06-01

    Full Text Available BACKGROUND : Addition of α2 adrenergic agonists with local anaesthetics in bupivacaine spinal anaesthesia prolongs the duration of sensory and motor blockade and postoperative analgesia with minimal haemod ynamic alterations. AIM AND OBJECTIVES: To compare and evaluate the efficacy of intravenous dexmedetomidine and clonidine as premedication on subarachnoid blockade duration, postoperative analgesia, and sedation score in patients undergoing lower limb orthopaedic surgeries in bupivacaine (0.5% heavy intrathecal block. MATERIALS AND METHOD S: We carried out a prospective, randomized, double blind study in which 60 patients of ASA status I or II, scheduled for orthopaedic lower limb surgery under spinal a naesthesia, were randomly allocated into two groups of 30 each group A and group B. Group A received dexmedetomidine 0.5μg/kg IV and group B received clonidine 1μg/kg in 10 ml of normal saline intravenously as premedication over 10 min., before subarachnoi d blockade with 3.0 ml. of 0.5% hyperbaric bupivacaine. Onset time and regression times of both sensory and motor blockade, haemodynamic parameters were recorded. Duration of postoperative analgesia and sedation score with adverse effects were also recorde d. RESULTS: The sensory block level was higher (T5 - T7 and earlier in onset (1.81±1.75min. in dexmedetomidine group than clonidine with level (T6 - T8 and onset (2.56±1.62min.. Dexmedetomidine also increased the onset (3.54±3.07min. and duration (265.45± 41.50min. of motor block achieved as compared to clonidine. The Ramsay sedation score was also greater in dexmedetomidine group than clonidine group (P<0.0001. CONCLUSION: Single dose of premedication with intravenous dexmedetomidine is better than intrav enous clonidine during bupivacaine spinal anaesthesia in orthopaedic lower limb surgeries for prolongation of sensory and motor blockade.

  18. Prevalence of Hypertension in HIV/AIDS Patients on Highly Active Antiretroviral Therapy (HAART Compared with HAART-Naive Patients at the Limbe Regional Hospital, Cameroon.

    Directory of Open Access Journals (Sweden)

    Christian Akem Dimala

    Full Text Available Highly active antiretroviral therapy (HAART has greatly reduced the morbidity and mortality of HIV/AIDS patients but has also been associated with increased metabolic complications and cardiovascular diseases. Data on the association between HAART and hypertension (HTN in Africa are scarce.Primarily to compare the prevalence of HTN in HIV/AIDS patients on HAART and HAART-naïve patients in Limbe, Cameroon; and secondarily to assess other socio-demographic and clinical factors associated with HTN in this population.A cross-sectional study was conducted at the Limbe Regional Hospital HIV treatment center between April and June 2013, involving 200 HIV/AIDS patients (100 on first-line HAART regimens for at least 12 months matched by age and sex to 100 HAART-naïve patients. HTN was defined as a systolic blood pressure (BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg.The prevalence of HTN in patients on HAART was twice (38%; 95% CI: 28.5-48.3 that of the HAART-naïve patients (19%; 95% CI, 11.8-28.1, p = 0.003. In multivariate analyses adjusted for age, gender, smoking, family history of HTN, and BMI-defined overweight, HAART was associated with HTN, the adjusted odds ratio of the HAART-treated versus HAART-naïve group was 2.20 (95% CI: 1.07-4.52, p = 0.032. HTN was associated with older age and male gender, in the HAART group and with BMI-defined overweight in the HAART-naïve group.The prevalence of hypertension in HIV/AIDS patients in Limbe stands out to be elevated, higher in patients on HAART compared to those not on treatment. Blood pressure and cardiovascular risk factors should be routinely monitored. Other factors such as diet, weight control and physical exercise should also be considered.

  19. Anatomical, radiographical and computed tomographic study of the limbs skeleton of the Euphrates soft shell turtle (Rafetus euphraticus).

    Science.gov (United States)

    Asadi Ahranjani, Behnaz; Shojaei, Bahador; Tootian, Zahra; Masoudifard, Madjid; Rostami, Amir

    2016-01-01

    Euphrates turtle is the only soft shell turtle of Iran, and unfortunately is in danger of extinction due to multiple reasons. Imaging techniques, in addition to their importance in diagnosis of injuries to animals, have been used as non-invasive methods to provide normal anatomic views. A few studies have been conducted to understand body structure of the Euphrates turtle. Since there is only general information about the anatomy of turtle limbs, the normal skeleton of the Euphrates limbs was studied. For this purpose four adult Euphrates turtles were used. Digital radiographic examination was performed by computed radiographic (CR) in dorsoventral (DV) and lateral (L) positions. Spiral CT-scanning was done and 3D images of the bones were reconstructed for anatomical evaluation. For skeletal preparation, the skeleton was cleaned by a combination of boiling and mealworm methods and limbs' bones were examined anatomically. In the present study, simultaneous anatomic, radiographic and CT studies of bones in individual turtles made us possible to describe bones anatomically and provided comparable and complementary conditions to represent the abilities of the radiography and CT for better understanding of the anatomy. Arrangement and the number of carpal and tarsal bones are used in turtles' classification. Among the studied species, Euphrates turtle carpal and tarsal bones show the most similarities to the Apolone spinifera.

  20. Biomechanical study of patient positioning: influence of lower limb positioning on spinal geometry.

    Science.gov (United States)

    Driscoll, Christopher; Aubin, Carl-Eric; Canet, Fanny; Labelle, Hubert; Horton, William; Dansereau, Jean

    2012-04-01

    The objective of this study was to use finite element model (FEM) simulations and experimental testing to study the relationship between lower limb positioning for surgeries of the spine and changes in sagittal curves. Four volunteers underwent lower limb flexibility and range of motion testing before being placed prone on a new surgical frame where lateral radiographs of their spines were taken in positions of hip flexion (average 48 degrees) and extension (average 13 degrees). Personalized FEMs were created representing each volunteer's spine, rib cage, pelvis, and lower limbs. Optimization of model behavior was performed by adjustment of lower limb muscle initial strains. The FEMs were exploited to examine the impact of more extreme and intermediate lower limb positions; 30 degrees of hip extension to 90 degrees of flexion at intervals of 20 degrees. With increased hip flexion, lordosis and kyphosis decreased to an average of 52% (35 degrees) and 16% (6 degrees), respectively. Personalization of the 4 FEMs allowed reproduction of the experimental results within 5 degrees and their subsequent exploitation showed the linear changes in lordosis and kyphosis between extreme positions decreasing an average of 84% (59 degrees) and 34% (13 degrees) with increased hip flexion. A strong correlation was found between experimental change in lordosis and individual hamstring flexibilities (R=-0.93) which allowed for the development of a predictive equation for lordosis in terms of hip flexion which factors straight leg raise test results. Knowledge gained through this study can be used to improve intraoperative control of sagittal curves through lower limb positioning.

  1. HST observations of the limb polarization of Titan

    CERN Document Server

    Bazzon, Andreas; Buenzli, Esther

    2014-01-01

    Titan is an excellent test case for detailed studies of the scattering polarization from thick hazy atmospheres. We present the first limb polarization measurements of Titan, which are compared as a test to our limb polarization models. Previously unpublished imaging polarimetry from the HST archive is presented which resolves the disk of Titan. We determine flux-weighted averages of the limb polarization and radial limb polarization profiles, and investigate the degradation and cancelation effects in the polarization signal due to the limited spatial resolution of our observations. Taking this into account we derive corrected values for the limb polarization in Titan. The results are compared with limb polarization models, using atmosphere and haze scattering parameters from the literature. In the wavelength bands between 250 nm and 2000 nm a strong limb polarization of about 2-7 % is detected with a position angle perpendicular to the limb. The fractional polarization is highest around 1 micron. As a first ...

  2. Central representation of phantom limb phenomenon in amputees studied with single photon emission computerized tomography.

    Science.gov (United States)

    Liaw, M Y; You, D L; Cheng, P T; Kao, P F; Wong, A M

    1998-01-01

    To explore the possible mechanisms of phantom limb discomfort after amputation, three amputees with phantom limb pain were studied. This study examined the change of regional cerebral blood flow using technetium-99m hexamethylpropyleneamine oxime-single photon emission computerized tomography, which was arranged at the time of severe phantom limb discomfort and after the discomfort subsided or was completely relieved. Nine representative transverse slices parallel to the orbitomeatal line were selected for quantification. The cortical ribbon (2-cm thickness) was equally subdivided into 12 symmetrical pairs of sector regions of interest in each slice. The irregularly shaped regions of interest were drawn manually around the right thalamus and basal ganglion and then mirrored to the left thalamus and basal ganglion. The contralateral to ipsilateral ratio of regional cerebral blood flow for each area was calculated. The intensity of phantom limb pain was evaluated on a 0 to 10 visual analog scale. In Cases 1 and 2, the contralateral to ipsilateral regional cerebral blood flow ratios of multiple areas of the frontal, temporal, or parietal lobes were increased at the time of more severe phantom limb pain, and the ratios were normalized or even decreased when the phantom limb pain subsided. In Case 3, increased contralateral to ipsilateral regional cerebral blood flow ratios were also found over the frontal, temporal, and parietal lobe. However, most of the increased regional cerebral blood flow ratios of regions of interest in the first study persisted in the follow-up study. Also, the regional cerebral blood flow ratios of greater number of regions of interest of the same gyrus and new gyrus were increased. There was no significant right-left difference of regional cerebral blood flow over bilateral thalami and basal ganglia in all three cases. The results suggested that phantom limb pain might be associated with cortical activation involving the frontal, temporal, or

  3. Skin problems of the stump and hand function in lower limb amputees : A historic cohort study

    NARCIS (Netherlands)

    Baars, E. C. T.; Dijkstra, P. U.; Geertzen, J. H. B.

    2008-01-01

    The aim of this study was to investigate the relationship between liner-related skin problems of the stump in patients with a lower limb amputation and impaired hand function. Sixty patients who were treated in a rehabilitation hospital from 1998-2006 were included in an historic cohort study. Data

  4. [The results in chronic ischemia of the lower limbs. The Granada-90 Geriatric Angiology Study (2)].

    Science.gov (United States)

    Peñafiel Marfil, R; García Rospide, V; Moreno Padilla, F; González Ríos, F J; Ros Die, E

    1992-01-01

    Results of a study about the chronic ischaemia of the lower limbs and its correlation with age, sex and previous diagnosis, are presented. Also, a comparison between previous diagnosis and results following the methodology exposed, was made. Study group included 433 older patients, randomizadely selected and permanent residents of some geriatric centers of the Oriental Andalucy.

  5. Deviation in the recovery of the lower limb and respiratory muscles of patients with polymyositis: a preliminary clinical study

    Science.gov (United States)

    Nishikawa, Yuichi; Hosomi, Naohisa; Ueno, Hiroki; Kurashige, Takashi; Ochi, Kazuhide; Takahashi, Tetsuya; Orita, Naoya; Ueda,, Kazuyuki; Maruyama, Hirofumi; Kimura, Hiroaki; Matsumoto, Masayasu

    2016-01-01

    [Purpose] The purposes of this study were to quantify the serial changes in lower limb and respiratory muscle strengths and to evaluate the acute effects of physiotherapy in polymyositis patients. [Subjects and Methods] Five patients (57.6 ± 9.0 years, 50 to 72; four females) received physiotherapy five days a week for four weeks. The lower limb and respiratory muscle strength, the % vital capacity, and the Barthel index were evaluated at baseline and after the intervention. [Results] The patient’s symptoms and creatine kinase values did not change, and after four weeks, all of the patients exhibited significantly increased outcomes compared with the baseline. However, the inspiratory muscle strength of the patients presented smaller improvements than the expiratory muscle strength. [Conclusion] Differential changes in inspiratory and expiratory muscle strength were observed following physiotherapy, and an unbalanced muscle distribution may explain the pathological and therapeutic effects. PMID:27799713

  6. Comparative waste forms study

    Energy Technology Data Exchange (ETDEWEB)

    Wald, J.W.; Lokken, R.O.; Shade, J.W.; Rusin, J.M.

    1980-12-01

    A number of alternative process and waste form options exist for the immobilization of nuclear wastes. Although data exists on the characterization of these alternative waste forms, a straightforward comparison of product properties is difficult, due to the lack of standardized testing procedures. The characterization study described in this report involved the application of the same volatility, mechanical strength and leach tests to ten alternative waste forms, to assess product durability. Bulk property, phase analysis and microstructural examination of the simulated products, whose waste loading varied from 5% to 100% was also conducted. The specific waste forms investigated were as follows: Cold Pressed and Sintered PW-9 Calcine; Hot Pressed PW-9 Calcine; Hot Isostatic Pressed PW-9 Calcine; Cold Pressed and Sintered SPC-5B Supercalcine; Hot Isostatic pressed SPC-5B Supercalcine; Sintered PW-9 and 50% Glass Frit; Glass 76-68; Celsian Glass Ceramic; Type II Portland Cement and 10% PW-9 Calcine; and Type II Portland Cement and 10% SPC-5B Supercalcine. Bulk property data were used to calculate and compare the relative quantities of waste form volume produced at a spent fuel processing rate of 5 metric ton uranium/day. This quantity ranged from 3173 L/day (5280 Kg/day) for 10% SPC-5B supercalcine in cement to 83 L/day (294 Kg/day) for 100% calcine. Mechanical strength, volatility, and leach resistance tests provide data related to waste form durability. Glass, glass-ceramic and supercalcine ranked high in waste form durability where as the 100% PW-9 calcine ranked low. All other materials ranked between these two groupings.

  7. Spinal cord stimulation or prostacyclin in unrevascularizable arteriopathy of lower limbs (SPINAL study: interim analysis results

    Directory of Open Access Journals (Sweden)

    Pedrini L

    2014-04-01

    Full Text Available Luciano Pedrini,1 Maria Sandra Ballestrazzi,1 Fabio Chierichetti,2 Luigi Comandatore,3 Filippo Magnoni,1 Reinhold Perkmann,4 Tommaso Castrucci,5 Domenico Palombo6On behalf of the SPINAL Study Group1Operative Unit of Vascular Surgery, Maggiore Hospital of Bologna, Bologna, Italy; 2Operative Unit of Vascular Surgery, Circle Hospital of Busto Arsizio, Busto Arsizio, Italy; 3Operative Unit of Vascular Surgery, AEO Morelli of Sondalo, Sondalo, Italy; 4Operative Unit of Vascular and Thoracic Surgery, Hospital of Bolzano, Bolzano, Italy; 5Operative Unit of Vascular Surgery of Sant'Eugenio Hospital, Rome, Italy; 6Operative Unit of Vascular and Endovascular Surgery, IRCCS San Martino, Genoa, ItalyObjective: The aim of this study was to compare the clinical efficacy and the safety of spinal cord stimulation (SCS plus medical treatment versus iloprost plus medical treatment in patients with severe unrevascularizable ischemia of the lower limbs due to atherosclerotic disease of the limbs and to identify predictive parameters for a positive outcome of SCS.Methods: A multicenter randomized controlled trial (RCT with central randomization and core laboratory evaluation of angiography, subdivided into two treatment arms (SCS and iloprost and two subgroups (rest pain and ulcer/gangrene. After the 15-day clinical efficacy evaluation, responder patients continued follow-up in their arm, while nonresponders could change arms or decline participation. The primary endpoint was 1-year limb salvage. Principal secondary endpoints were: survival rate; minor amputations and stump healing; ulcer healing; pain relief and analgesic intake; and predictive criteria for SCS treatment.Results: The trial was stopped at 35.6% of the expected sample due to low accrual rate. Fifty-two patients (55 legs entered the study. At the 15-day efficacy evaluation, responders (reduced pain, no increase of ulcer area comprised 74% of the SCS arm and 26% of the iloprost arm, (P=0.003. Nine

  8. A cross sectional study of the prevalence, risk factors and population attributable fractions for limb and body lesions in lactating sows on commercial farms in England

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    Gillman Claire E

    2009-08-01

    Full Text Available Abstract Background Lesions on sows' limbs and bodies are an abnormality that might impact on their welfare. The prevalence of and risks for limb and body lesions on lactating sows on commercial English pig farms were investigated using direct observation of the sows and their housing. Results The prevalence of lesions on the limbs and body were 93% (260/279 and 20% (57/288 respectively. The prevalence of limb and body lesions was significantly lower in outdoor-housed sows compared with indoor-housed sows. Indoor-housed sows had an increased risk of wounds (OR 6.8, calluses (OR 8.8 and capped hock (OR 3.8 on their limbs when housed on fully slatted floors compared with solid concrete floors. In addition, there was an increased risk of bursitis (OR 2.7, capped hock (OR 2.3 and shoulder lesions (OR 4.8 in sows that were unwilling to rise to their feet. There was a decreased risk of shoulder lesions (OR 0.3 and lesions elsewhere on the body (OR 0.2 in sows with more than 20 cm between their tail and the back of the crate compared with sows with less than 10 cm. Conclusion The sample of outdoor housed sows in this study had the lowest prevalence of limb and body lesions. In lactating sows housed indoors there was a general trend for an increased risk of limb and body lesions in sows housed on slatted floors compared with those housed on solid concrete floors with bedding. Sows that were less responsive to human presence and sows that had the least space to move within their crates had an additional increased risk of lesions.

  9. The application of accelerometers to measure movements of upper limbs: Pilot study

    Directory of Open Access Journals (Sweden)

    Patrik Kutilek

    2017-03-01

    Full Text Available Background: Even though inertial measurement units (IMU are already being used experimentally for evaluating movements of segment of the axial skeleton, no studies have been found which have used IMUs to measure the behavior of the segments of upper limbs during quiet stance. Objective: The objective is to design a suitable application of IMUs to measure movements of the upper extremities in Romberg's test and analyze spontaneous arm movements. Second aim is to identify possible discrepancies between the dominant and non-dominant arm movements. Methods: The dominant and non-dominant upper limb of each participant was identified. Then, the movements of both upper limbs were measured by the Xsens system equipped with MTx motion trackers during the quiet stance on a firm surface with eyes open (EO and eyes closed (EC. The measured data was used to calculate the medians and maximums of the superior-inferior, medio-lateral and anterior-posterior acceleration. Also, tremor intensity was calculated to quantitatively evaluate the measured data. Results: The comparison of values of maximal accelerations of the dominant and non-dominant arms showed significant difference between the arms during EC conditions. The comparison of values of median accelerations of the dominant and non-dominant arms showed significant differences between the acceleration of arms in medio-lateral direction during EO and EC conditions. In all cases, values of maximal and median accelerations and values of tremor intensity of the dominant limb strongly correlated with values on the non-dominant limb. Conclusions: Findings suggest possible usefulness of the designed application of IMUs and evaluation methods for their use in Romberg's test in clinical practice for evaluation of upper limb movements.

  10. Single element ultrasonic imaging of limb geometry: an in-vivo study with comparison to MRI

    Science.gov (United States)

    Zhang, Xiang; Fincke, Jonathan R.; Anthony, Brian W.

    2016-04-01

    Despite advancements in medical imaging, current prosthetic fitting methods remain subjective, operator dependent, and non-repeatable. The standard plaster casting method relies on prosthetist experience and tactile feel of the limb to design the prosthetic socket. Often times, many fitting iterations are required to achieve an acceptable fit. Use of improper socket fittings can lead to painful pathologies including neuromas, inflammation, soft tissue calcification, and pressure sores, often forcing the wearer to into a wheelchair and reducing mobility and quality of life. Computer software along with MRI/CT imaging has already been explored to aid the socket design process. In this paper, we explore the use of ultrasound instead of MRI/CT to accurately obtain the underlying limb geometry to assist the prosthetic socket design process. Using a single element ultrasound system, multiple subjects' proximal limbs were imaged using 1, 2.25, and 5 MHz single element transducers. Each ultrasound transducer was calibrated to ensure acoustic exposure within the limits defined by the FDA. To validate image quality, each patient was also imaged in an MRI. Fiducial markers visible in both MRI and ultrasound were used to compare the same limb cross-sectional image for each patient. After applying a migration algorithm, B-mode ultrasound cross-sections showed sufficiently high image resolution to characterize the skin and bone boundaries along with the underlying tissue structures.

  11. Pilot Study: The Role of the Hemispheric Lateralization in Mental Disorders by Use of the Limb (Eye, Hand, Foot) Dominance.

    Science.gov (United States)

    Goodarzi, Naser; Dabbaghi, Parviz; Valipour, Habib; Vafadari, Behnam

    2015-04-01

    Based on the previous studies, we know that the hemispheric lateralization defects, increase the probability of psychological disorders. We also know that dominant limb is controlled by dominant hemisphere and limb preference is used as an indicator for hemisphere dominance. In this study we attempted to explore the hemispheric dominance by the use of three limbs (hand, foot and eye). We performed this survey on two samples, psychiatric patients compared with normal population. For this purpose, knowing that the organ dominance is stabilized in adolescence, and age has no effect on the people above 15, we used 48 high school girls and 65 boys as the final samples of normal population. The patient group included 57 male and 26 female who were chronic psychiatric patients. The result shows that left-eye dominance is more in patients than the normal group (P=0.000) but the handedness and footedness differences are not significance. In psychotic, bipolar and depressive disorders, eye dominance had significant difference (P=0.018). But this is not true about hand and foot dominance. Our findings proved that generally in psychiatric patients, left-eye dominance is more common, left-eye dominance is also more in psychotic and depressive disorders. It is less common in bipolar disorders.

  12. A large Italian observational multicentre study on vascular ulcers of the lower limbs (Studio Ulcere Vascolari).

    Science.gov (United States)

    Apollonio, Alessandro; Antignani, Pier L; Di Salvo, Michelangelo; Failla, Giacomo; Guarnera, Giorgio; Mosti, Giovanni; Ricci, Elia

    2016-02-01

    An observational study of 2 years was promoted by the Italian Association for Cutaneous Ulcers (AIUC) in order to monitor the epidemiology of leg ulcers, the trend of healing and the more frequent therapeutic approaches in lower limb ulcers. Fifty-nine sites in 14 different Italian regions involved in the study, with 1333 enrolled patients (1163 patients fully evaluated and followed up for 9 months). A prevalence of females (62%) was observed with a mean age of 70 years and a high rate of hypertension (62%), diabetes (38%) and obesity (29%). Venous ulcer was most frequent (55%), followed by mixed (25%) and diabetic (8·3%) ulcers. Basically, all patients received a local therapy (LT) (compression and advanced local therapies), while 63% of patients have an associated systemic pharmaceutical treatment. Ulcer healing rates progressively increased throughout the study and despite the type of observational study does not allow conclusions on the treatment, it was observed that the patients receiving additional systemic drugs were associated with a more rapid acceleration of healing rates of ulcers compared to LT alone (3 months: 39·7% versus 29·2%; 6 months: 62·0% versus 47·0%; 9 months: 74·7% versus 63·8%). In particular, the Studio Ulcere Vascolari (SUV) study showed that a combination treatment with sulodexide and compression therapy allows for a greater increase in the healing rates in venous ulcers.

  13. A Study of Correlations within the Dimensions of Lower Limb Parts for Personal Identification in a Sudanese Population

    Directory of Open Access Journals (Sweden)

    Altayeb Abdalla Ahmed

    2014-01-01

    Full Text Available The presence of an isolated limb or limb parts from different individuals presents a major challenge for medicolegal investigators in establishing identification in cases of wars, mass disasters, and criminal assaults because different populations have different sizes and proportions. The measurement of lower limb dimensions showed a high success rate in establishing individual identity in terms of sex and stature in various populations. However, there is a paucity of data concerning the correlation within the lower limb parts. This study aims to assess the existence of relationships within lower limb parts and to develop regression formulae to reconstruct limb parts from one another. The tibial length, bimalleolar breadth, foot length, and foot breadth of 376 right-handed Sudanese adults were measured. The results showed that all variables were significantly larger in males than in females. A significant positive correlation (P<0.001 was found within the lower limb parts. Sex-specific linear equations and multiple regression equations were developed to reconstruct the lower limb parts in the presence of single dimension or multiple dimensions from the same limb. The use of multiple regression equations provided a better reconstruction than simple regression equations. These results are significant in forensics and orthopedic reconstructive surgery.

  14. Redox regulation of ischemic limb neovascularization – What we have learned from animal studies

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    Reiko Matsui

    2017-08-01

    Full Text Available Mouse hindlimb ischemia has been widely used as a model to study peripheral artery disease. Genetic modulation of the enzymatic source of oxidants or components of the antioxidant system reveal that physiological levels of oxidants are essential to promote the process of arteriogenesis and angiogenesis after femoral artery occlusion, although mice with diabetes or atherosclerosis may have higher deleterious levels of oxidants. Therefore, fine control of oxidants is required to stimulate vascularization in the limb muscle. Oxidants transduce cellular signaling through oxidative modifications of redox sensitive cysteine thiols. Of particular importance, the reversible modification with abundant glutathione, called S-glutathionylation (or GSH adducts, is relatively stable and alters protein function including signaling, transcription, and cytoskeletal arrangement. Glutaredoxin-1 (Glrx is an enzyme which catalyzes reversal of GSH adducts, and does not scavenge oxidants itself. Glrx may control redox signaling under fluctuation of oxidants levels. In ischemic muscle increased GSH adducts through Glrx deletion improves in vivo limb revascularization, indicating endogenous Glrx has anti-angiogenic roles. In accordance, Glrx overexpression attenuates VEGF signaling in vitro and ischemic vascularization in vivo. There are several Glrx targets including HIF-1α which may contribute to inhibition of vascularization by reducing GSH adducts. These animal studies provide a caution that excess antioxidants may be counter-productive for treatment of ischemic limbs, and highlights Glrx as a potential therapeutic target to improve ischemic limb vascularization.

  15. Trends in Major Lower Limb Amputation Related to Peripheral Arterial Disease in Hungary: A Nationwide Study (2004-2012).

    Science.gov (United States)

    Kolossváry, E; Ferenci, T; Kováts, T; Kovács, L; Járai, Z; Menyhei, G; Farkas, K

    2015-07-01

    To assess the trends of peripheral arterial disease associated major lower limb amputation in Hungary over a 9 year period (2004-2012) in the whole Hungarian population. This was a retrospective cohort study employing administrative health care data. Major amputations were identified in the entire Hungarian population during a 9 year period (2004-2012) using the health care administrative data. Direct standardization was used to eliminate the potential bias induced by the different age and sex structure of the compared populations. For external direct standardization, the ESP 2013 was chosen as reference. 76,798 lower limb amputations were performed. The number of major amputations was 38,200; these procedures affected 32,084 patients. According to case detection, 50.4% of the amputees were diabetic. The overall primary amputation rate was 71.5%. The annual crude and age adjusted major amputation rates exhibited no significant long-term pattern over the observation period. The major lower limb amputation incidence for the overall period was 42.3/10(5) in the total population and 317.9/10(5) in diabetic population. According to this whole population based study from Hungary, the incidence of lower limb major amputation is high with no change over the past 9 years. An explanation for this remains to be determined, as the traditional risk factors in Hungary do not account for it. The characteristics of major amputation (the rate of primary amputation, the ratio of below to above knee amputation and the age of the affected population) underline the importance of screening, early detection, improved vascular care and an optimal revascularization policy. Standardization and validation of amputation detection methods and reporting is essential. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  16. Recovery of physical activity levels in adolescents after lower limb fractures: a longitudinal, accelerometry-based activity monitor study

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    Ceroni Dimitri

    2012-07-01

    Full Text Available Abstract Background In adolescents, loss of bone mineral mass usually occurs during phases of reduced physical activity (PA, such as when an injured extremity spends several weeks in a cast. We recorded the PA of adolescents with lower limb fractures during the cast immobilization, at 6 and at 18 months after the fracture, and we compared these values with those of healthy controls. Methods Fifty adolescents with a first episode of limb fracture and a control group of 50 healthy cases were recruited for the study through an advertisement placed at the University Children’s Hospital of Geneva, Switzerland. PA was assessed during cast immobilization and at 6- and 18-month follow-up by accelerometer measurement (Actigraph® 7164, MTI, Fort Walton Beach, FL, USA. Patients and their healthy peers were matched for gender and age. Time spent in PA at each level of intensity was determined for each participant and expressed in minutes and as a percentage of total valid time. Results From the 50 initial teenagers with fractures, 44 sustained functional evaluations at 6 months follow-up, whereas only 38 patients were studied at 18 months. The total PA count (total number of counts/min was lower in patients with lower limb fractures (-62.4% compared with healthy controls (ppp Importantly, we observed that time spent in vigorous PA, which reflects high-intensity forces beneficial to skeletal health, returned to similar values between both groups from the six month follow-up in adolescents who sustained a fracture. However, a definitive reduction in time spent in moderate PA was observed among patients with a lower limb fracture at 18 months, when comparing with healthy controls values (p = 0.0174. Conclusions As cast immobilization and reduced PA are known to induce bone mineral loss, this study provides important information to quantify the decrease of skeletal loading in adolescents with limb fractures. The results of this study demonstrate

  17. A Tunable Silk Hydrogel Device for Studying Limb Regeneration in Adult Xenopus Laevis.

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    Anne Golding

    Full Text Available In certain amphibian models limb regeneration can be promoted or inhibited by the local wound bed environment. This research introduces a device that can be utilized as an experimental tool to characterize the conditions that promotes limb regeneration in the adult frog (Xenopus laevis model. In particular, this device was designed to manipulate the local wound environment via a hydrogel insert. Initial characterization of the hydrogel insert revealed that this interaction had a significant influence on mechanical forces to the animal, due to the contraction of the hydrogel. The material and mechanical properties of the hydrogel insert were a factor in the device design in relation to the comfort of the animal and the ability to effectively manipulate the amputation site. The tunable features of the hydrogel were important in determining the pro-regenerative effects in limb regeneration, which was measured by cartilage spike formation and quantified by micro-computed tomography. The hydrogel insert was a factor in the observed morphological outcomes following amputation. Future work will focus on characterizing and optimizing the device's observed capability to manipulate biological pathways that are essential for limb regeneration. However, the present work provides a framework for the role of a hydrogel in the device and a path forward for more systematic studies.

  18. Barriers and Facilitators of Participation in Sports : A Qualitative Study on Dutch Individuals with Lower Limb Amputation

    NARCIS (Netherlands)

    Bragaru, Mihai; van Wilgen, C. P.; Geertzen, Jan H. B.; Ruijs, Suzette G. J. B.; Dijkstra, Pieter U.; Dekker, Rienk

    2013-01-01

    Introduction: Although individuals with lower limb amputation may benefit from participation in sports, less than 40% do so. Aim: To identify the barriers and facilitators that influence participation in sports for individuals with lower limb amputation. Design: Qualitative study. Participants: Twen

  19. Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review.

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    Leire Santisteban

    Full Text Available Establishing which upper limb outcome measures are most commonly used in stroke studies may help in improving consensus among scientists and clinicians.In this study we aimed to identify the most commonly used upper limb outcome measures in intervention studies after stroke and to describe domains covered according to ICF, how measures are combined, and how their use varies geographically and over time.Pubmed, CinHAL, and PeDRO databases were searched for upper limb intervention studies in stroke according to PRISMA guidelines and477 studies were included.In studies 48different outcome measures were found. Only 15 of these outcome measures were used in more than 5% of the studies. The Fugl-Meyer Test (FMTwas the most commonly used measure (in 36% of studies. Commonly used measures covered ICF domains of body function and activity to varying extents. Most studies (72% combined multiple outcome measures: the FMT was often combined with the Motor Activity Log (MAL, the Wolf Motor Function Test and the Action Research Arm Test, but infrequently combined with the Motor Assessment Scale or the Nine Hole Peg Test. Key components of manual dexterity such as selective finger movements were rarely measured. Frequency of use increased over a twelve-year period for the FMT and for assessments of kinematics, whereas other measures, such as the MAL and the Jebsen Taylor Hand Test showed decreased use over time. Use varied largely between countries showing low international consensus.The results showed a large diversity of outcome measures used across studies. However, a growing number of studies used the FMT, a neurological test with good psychometric properties. For thorough assessment the FMT needs to be combined with functional measures. These findings illustrate the need for strategies to build international consensus on appropriate outcome measures for upper limb function after stroke.

  20. Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review

    Science.gov (United States)

    Santisteban, Leire; Térémetz, Maxime; Bleton, Jean-Pierre; Baron, Jean-Claude; Maier, Marc A.; Lindberg, Påvel G.

    2016-01-01

    Background Establishing which upper limb outcome measures are most commonly used in stroke studies may help in improving consensus among scientists and clinicians. Objective In this study we aimed to identify the most commonly used upper limb outcome measures in intervention studies after stroke and to describe domains covered according to ICF, how measures are combined, and how their use varies geographically and over time. Methods Pubmed, CinHAL, and PeDRO databases were searched for upper limb intervention studies in stroke according to PRISMA guidelines and477 studies were included. Results In studies 48different outcome measures were found. Only 15 of these outcome measures were used in more than 5% of the studies. The Fugl-Meyer Test (FMT)was the most commonly used measure (in 36% of studies). Commonly used measures covered ICF domains of body function and activity to varying extents. Most studies (72%) combined multiple outcome measures: the FMT was often combined with the Motor Activity Log (MAL), the Wolf Motor Function Test and the Action Research Arm Test, but infrequently combined with the Motor Assessment Scale or the Nine Hole Peg Test. Key components of manual dexterity such as selective finger movements were rarely measured. Frequency of use increased over a twelve-year period for the FMT and for assessments of kinematics, whereas other measures, such as the MAL and the Jebsen Taylor Hand Test showed decreased use over time. Use varied largely between countries showing low international consensus. Conclusions The results showed a large diversity of outcome measures used across studies. However, a growing number of studies used the FMT, a neurological test with good psychometric properties. For thorough assessment the FMT needs to be combined with functional measures. These findings illustrate the need for strategies to build international consensus on appropriate outcome measures for upper limb function after stroke. PMID:27152853

  1. A Comparative Study of Teaching Comparative Education

    OpenAIRE

    2007-01-01

    The purpose of this paper is to characterize the comparative education subjects offered in different programs in different foreign universities. As a subject, comparative education has not been firmly institutionalized in education programs in Japanese universities. There was a movement which aimed at making comparative education as one of the mandatory subjects in the teacher training program, however it was not successful. To date, comparative education subject has been offered in various p...

  2. Intermittent pneumatic compression in intractable critical ischemia of lower limb - a pilot study

    DEFF Research Database (Denmark)

    Feuerhake, Ingrid Luise; Henneberg, Eskild Winther; Høgh, Annette Langager

    Posters på "Forskningens Dag" 1. Intermittent pneumatic compression in intractable critical ischemia of the lower limb - a pilot study Feuerhake IL1 , Henneberg E1 , Høgh A1 1 Department of Vascular Surgery, Viborg Regional Hospital Aim: Patients with chronic ischemic wounds or rest pain in the l......Posters på "Forskningens Dag" 1. Intermittent pneumatic compression in intractable critical ischemia of the lower limb - a pilot study Feuerhake IL1 , Henneberg E1 , Høgh A1 1 Department of Vascular Surgery, Viborg Regional Hospital Aim: Patients with chronic ischemic wounds or rest pain...... in the lower extremity (CLI), without the possibility for vascular reconstruction, represent a high selected patient population with high comorbidity and mortality. The aim of this case-study was to investigate the use of intermittent pneumatic compression (IPC) among these patients, as a tool to lower pain...

  3. Visual appearance of a virtual upper limb modulates the temperature of the real hand: a thermal imaging study in Immersive Virtual Reality.

    Science.gov (United States)

    Tieri, Gaetano; Gioia, Annamaria; Scandola, Michele; Pavone, Enea F; Aglioti, Salvatore M

    2017-05-01

    To explore the link between Sense of Embodiment (SoE) over a virtual hand and physiological regulation of skin temperature, 24 healthy participants were immersed in virtual reality through a Head Mounted Display and had their real limb temperature recorded by means of a high-sensitivity infrared camera. Participants observed a virtual right upper limb (appearing either normally, or with the hand detached from the forearm) or limb-shaped non-corporeal control objects (continuous or discontinuous wooden blocks) from a first-person perspective. Subjective ratings of SoE were collected in each observation condition, as well as temperatures of the right and left hand, wrist and forearm. The observation of these complex, body and body-related virtual scenes resulted in increased real hand temperature when compared to a baseline condition in which a 3d virtual ball was presented. Crucially, observation of non-natural appearances of the virtual limb (discontinuous limb) and limb-shaped non-corporeal objects elicited high increase in real hand temperature and low SoE. In contrast, observation of the full virtual limb caused high SoE and low temperature changes in the real hand with respect to the other conditions. Interestingly, the temperature difference across the different conditions occurred according to a topographic rule that included both hands. Our study sheds new light on the role of an external hand's visual appearance and suggests a tight link between higher-order bodily self-representations and topographic regulation of skin temperature. © 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  4. COMPARATIVE CLINICAL EVALUATION OF 0.5% ROPIVACAINE AND 0.5% BUPIVACAINE FOR BRACHIAL PLEXUS BLOCK VIA SUPRACLAVICULAR APPROACH FOR UPPER LIMB SURGERIES.

    Directory of Open Access Journals (Sweden)

    Surendra

    2013-11-01

    Full Text Available ABSTRACT: Ropivacaine, a local anesthetic agent with similar pharmacological profile to that of bupivacaine has lower potential for toxic effect. The aim of our study is to compare the anesthetic characteristics of ropivacaine and bupivacaine when used for supraclavicular brachial plexus blockade in upper limb surgeries. Fifty patients was grouped equally and one group R received 0.5% ropivacaine (100mg 20ml and another group B received 0.5% bupivacaine (100mg 20ml. onset & durat ion of sensory and motor blockade, duration of analgesia and associated complications & side effects were recorded. It was found that there were no significant differences in duration of sensory & motor blockade, in complications or any other side effects in both the groups. But ropivacaine provided rapid onset of action and better quality of surgical anesthesia than bupivacaine when used in supraclavicular brachial plexus blockade.

  5. Risk of upper limb complaints due to computer use in older persons: a randomized study

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    Jolles Jelle

    2007-08-01

    Full Text Available Abstract Background We studied whether the twelve-month use of a standard computer would induce complaints of upper limb pain or functional limitations in older novice computer users. Methods Participants between 64 and 76 of age were randomly assigned to an Intervention group (n = 62, whose members received a personal computer and fast Internet access at their homes, or a No Intervention control group (n = 61, whose members refrained from computer use during the twelve month study period. Results Difference scores between baseline and twelve months assessments on both complaint (SFS and functional health scales (SF-36 did not differ between groups (all p > .05. Conclusion Prolonged, self-paced use of a standard computer interface does not put older persons at a risk of upper limb complaints or reduce functional health in older adults.

  6. Cross-sectional study of alteration of phantom limb pain with visceral stimulation in military personnel with amputation.

    Science.gov (United States)

    Rafferty, Michael; Bennett Britton, Thomas M; Drew, Benjamin T; Phillip, Rhodri D

    2015-01-01

    While phantom limb pain is a well-recognized phenomenon, clinical experience has suggested that the augmentation of phantom limb pain with visceral stimulation is an issue for many military personnel with amputation (visceral stimulation being the sensation of the bowel or bladder either filling or evacuating). However, the prevalence of this phenomenon is not known. The aim of this study was to investigate the prevalence of the alteration in phantom limb pain and the effect that visceral stimulation has on phantom limb pain intensity. A cross-sectional study of 75 military personnel who have lost one or both lower limbs completed a questionnaire to assess the prevalence of the alteration of phantom limb pain with visceral stimulation. Included in the questionnaire was a pain visual analog scale (VAS) graded from 0 to 10. Patients recorded the presence and intensity of phantom limb pain. They also recorded whether and how this pain altered with a need to micturate or micturition, and/or a need to defecate or defecation, again using a pain VAS. Time since amputation, level of amputation, and medications were also recorded. Patients reported a phantom limb pain prevalence of 85% with a mean VAS of 3.6. In all, 56% of patients reported a change in the severity of phantom limb pain with visceral stimuli. The mean increase in VAS for visceral stimulation was 2.5 +/- 1.6 for bladder stimulation and 2.9 +/- 2.0 for bowel stimulation. Of the patients questioned, 65% reported an improvement in symptoms over time. VAS scores were highest in the subgroup less than 6 mo postamputation. An increase in phantom limb pain with visceral stimulation is a common problem for military personnel with amputation.

  7. Normal inter-limb differences during the straight leg raise neurodynamic test: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Boyd Benjamin S

    2012-12-01

    Full Text Available Abstract Background The straight leg raise (SLR neurodynamic test is commonly used to examine the sensitivity of the lower quarter nervous system to movement. Range of motion during the SLR varies considerably, due to factors such as age, sex and activity level. Knowing intra-individual, inter-limb differences may provide a normative measure that is not influenced by such demographic characteristics. This study aimed to determine normal asymmetries between limbs in healthy, asymptomatic individuals during SLR testing and the relationship of various demographic characteristics. Methods The limb elevation angle was measured using an inclinometer during SLR neurodynamic testing that involved pre-positioning the ankle in plantar flexion (PF/SLR and neutral dorsiflexion (DF/SLR. Phase 1 of the study included 20 participants where the ankle was positioned using an ankle brace replicating research testing conditions. Phase 2 included 20 additional participants where the ankle was manually positioned to replicate clinical testing conditions. Results The group average range of motion during PF/SLR was 57.1 degrees (SD: 16.8 degrees on the left and 56.7 degrees (SD: 17.2 degrees on the right while during DF/SLR the group average was 48.5 degrees (SD: 16.1 degrees on the left and 48.9 degrees (SD: 16.4 degrees on the right. The range of motion during SLR was moderately correlated to weight (−0.40 to −0.52, body mass index (−0.41 to −0.52, sex (0.40 to 0.42 and self-reported activity level (0.50 to 0.57. Intra-individual differences between limbs for range of motion during PF/SLR averaged 5.0 degrees (SD: 3.5 degrees (95% CI: 3.8 degrees, 6.1 degrees and during DF/SLR averaged 4.1 degrees (SD: 3.2 degrees (95% CI: 3.1 degrees, 5.1 degrees but were not correlated with any demographic characteristic. There were no significant differences between Phase 1 and Phase 2. Conclusions Overall range of motion during SLR was related to sex, weight, BMI and

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

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    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

  9. Mechanics of dog walking compared with a passive, stiff-limbed, 4-bar linkage model, and their collisional implications.

    Science.gov (United States)

    Usherwood, James R; Williams, Sarah B; Wilson, Alan M

    2007-02-01

    Here, we present a simple stiff-limbed passive model of quadrupedal walking, compare mechanics predicted from the model with those observed from forceplate measurements of walking dogs and consider the implications of deviation from model predictions, especially with reference to collision mechanics. The model is based on the geometry of a 4-bar linkage consisting of a stiff hindleg, back, foreleg and the ground between the hind and front feet. It uses empirical morphological and kinematic inputs to determine the fluctuations in potential and kinetic energy, vertical and horizontal forces and energy losses associated with inelastic collisions at each foot placement. Using forceplate measurements to calculate centre of mass motions of walking dogs, we find that (1) dogs may, but are not required to, spend periods of double support (one hind- and one forefoot) agreeing with the passive model; (2) legs are somewhat compliant, and mechanical energy fluctuates during triple support, with mechanical energy being lost directly after hindfoot placement and replaced following forefoot placement. Footfall timings and timing of mechanical energy fluctuations are consistent with strategies to reduce collisional forces, analogous to the suggested role of ankle extension as an efficient powering mechanism in human walking.

  10. Limb regeneration: a new development?

    Science.gov (United States)

    Nacu, Eugen; Tanaka, Elly M

    2011-01-01

    Salamander limb regeneration is a classical model of tissue morphogenesis and patterning. Through recent advances in cell labeling and molecular analysis, a more precise, mechanistic understanding of this process has started to emerge. Long-standing questions include to what extent limb regeneration recapitulates the events observed in mammalian limb development and to what extent are adult- or salamander- specific aspects deployed. Historically, researchers studying limb development and limb regeneration have proposed different models of pattern formation. Here we discuss recent data on limb regeneration and limb development to argue that although patterning mechanisms are likely to be similar, cell plasticity and signaling from nerves play regeneration-specific roles.

  11. "Functional outcome of lower limb following anterior cruciate ligament reconstruction; a prospective clinical study"

    Directory of Open Access Journals (Sweden)

    Olyaei G.R

    2007-06-01

    Full Text Available Background: Both isokinetic testing and functional tests are commonly used to evaluate anterior cruciate ligament reconstructed (ACLR patients. The object of this study was to evaluate motor performance of the knee and determine the relationship of isokinetic test scores to scores on a variety of lower extremity functional tests. Methods: Ten healthy subjects and eleven ACLR patients at least six months after surgery performed the following: knee isokinetic tests at 60 and 180 deg/sec; three functional tests including leg vertical jump, single hop, and triple cross-over hop for distance. The International Knee Document Committee Subjective Knee Evaluation Form (IKDCSKEF was used to score the self-assessment of each study participant. Paired T-test was used to compare the involved and uninvolved knee. Pearson correlation coefficients were used to determine the relationship between the scores on the isokinetic test and functional tests. Significance was determined by P<0.05. Results: IKDCSKEF score was significantly lower in patients than control subjects. Quadriceps peak torque and functional test scores were significantly lower in the involved knee of the ACLR subjects compared to the uninvolved knee. Correlation coefficients of isokinetic peak torque to body weight and functional testing were not significant in patients or control subjects, whi1e the limb symmetry index (LSI of the quadriceps isokinetics peak torque to body weight and the LSI of the functional tests were significant (r = 0.54 to 0.97. Conclusion: These results indicate a significant relationship between the LSI of various functional tests and the LSI of isokinetic testing among ACLR patients. Thus, in situations where an isokinetic dynamometer is not available, the LSI of functional tests can be used to estimate quadriceps deficiency for ACLR patients.

  12. A sensitivity study for far infrared balloon-borne limb emission sounding of stratospheric trace gases

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    J. Xu

    2013-05-01

    Full Text Available This paper presents a sensitivity study performed for trace gases retrieval from synthetic observations by TELIS (TErahertz and submillimeter LImb Sounder which is a stratospheric balloon-borne cryogenic heterodyne spectrometer. Issues pertaining to hydroxyl radical (OH retrieval from the far infrared measurements by the 1.8 THz channel are addressed. The study is conducted by a retrieval code PILS (Profile Inversion for Limb Sounding developed to solve the nonlinear inverse problems arising in the analysis of infrared/microwave limb sounding measurements. PILS combines a line-by-line forward model with automatic differentiation for computing Jacobians and employs regularized nonlinear least squares inversion. We examine the application of direct and iterative regularization methods and evaluate the performance of single- and multi-profile retrievals. Sensitivities to expected errors in calibration procedure, instrumental knowledge and atmospheric profiles have been analyzed. Nonlinearity effect, inaccurate sideband ratio, and pointing error turned out to be the dominant error sources. Furthermore, the capability of multi-channel simultaneous retrieval from the far infrared and submillimeter data has been investigated. The errors and averaging kernels infer that the quality of the obtained hydrogen chloride (HCl can be improved by significantly better exploitation of information from the observations.

  13. The developing Xenopus limb as a model for studies on the balance between inflammation and regeneration.

    Science.gov (United States)

    King, Michael W; Neff, Anton W; Mescher, Anthony L

    2012-10-01

    The roles of inflammation and immune cell reactivity triggered by amputation have only recently begun to be addressed in investigations of epimorphic regeneration, although studies of tissue repair in mammals clearly show the importance of the immune system in determining the quality of the repair process. Here, we first review inflammation-related work in non-mammalian systems of epimorphic regeneration which suggests that regeneration of an amputated appendage requires continuous modulation of the local immune response, from the first hours after amputation through the period of blastema patterning. We then present data on the effects of anti-inflammatory and proinflammatory agents on regeneration of larval Xenopus hindlimbs. Treatment with the glucocorticoid beclomethasone immediately after amputation inhibits regeneration in regeneration-complete stage 53 limbs. Other anti-inflammatory agents, including the inhibitors of cyclooxygenase-2 (COX-2) activity celecoxib and diclofenac, applied similarly to larvae amputated at stage 55, when the capacity for limb regeneration is normally being lost, restore regenerative capacity. This suggests that although injury-related events sensitive to glucocorticoids are necessary for regeneration, resolution of the inflammatory response may also be required to allow the complete regenerative response and normal blastema patterning. Conversely, if resolution of inflammation is prevented by local treatment of amputated limbs with beryllium, a strong immunoadjuvant, regeneration is inhibited, and gene expression data suggest that this inhibition results from a failure of normal blastema patterning. Both positive and negative effects of immune- or inflammation-related activities occur during anuran limb regeneration and this underscores the importance of considering immune cells in studies of epimorphic regeneration.

  14. Using data from the Microsoft Kinect 2 to quantify upper limb behavior: a feasibility study.

    Science.gov (United States)

    Dehbandi, Behdad; Barachant, Alexandre; Harary, David; Long, John; Tsagaris, K Zoe; Bumanlag, Silverio; He, Victor; Putrino, David

    2016-09-05

    The objective of this study was to assess whether the novel application of a machine learning approach to data collected from the Microsoft Kinect 2 (MK2) could be used to classify differing levels of upper limb impairment. twenty-four healthy subjects completed items of the Wolf Motor Function Test (WMFT), which is a clinically validated metric of upper limb function for stroke survivors. Subjects completed the WMFT 3 times: 1) as a healthy individual, 2) emulating mild impairment, and 3) emulating moderate impairment. A MK2 was positioned in front of participants, and collected kinematic data as they completed the WMFT. A classification framework, based on Riemannian geometry and the use of covariance matrices as feature representation of the MK2 data, was developed for these data, and its ability to successfully classify subjects as either "healthy", "mildly impaired" or "moderately impaired" was assessed. Mean accuracy for our classifier was 91.7%, with a specific accuracy breakdown of 100%, 83.3% and 91.7% for the "healthy", "mildly impaired" and "moderately impaired" conditions, respectively. We conclude that data from the MK2 is of sufficient quality to perform objective motor behavior classification in individuals with upper limb impairment. The data collection and analysis framework that we have developed has the potential to disrupt the field of clinical assessment. Future studies will focus on validating this protocol on large populations of individuals with actual upper limb impairments in order to create a toolkit that is clinically validated and available to the clinical community.

  15. An EEG-based study of discrete isometric and isotonic human lower limb muscle contractions

    Directory of Open Access Journals (Sweden)

    Gwin Joseph T

    2012-06-01

    Full Text Available Abstract Background Electroencephalography (EEG combined with independent component analysis enables functional neuroimaging in dynamic environments including during human locomotion. This type of functional neuroimaging could be a powerful tool for neurological rehabilitation. It could enable clinicians to monitor changes in motor control related cortical dynamics associated with a therapeutic intervention, and it could facilitate noninvasive electrocortical control of devices for assisting limb movement to stimulate activity dependent plasticity. Understanding the relationship between electrocortical dynamics and muscle activity will be helpful for incorporating EEG-based functional neuroimaging into clinical practice. The goal of this study was to use independent component analysis of high-density EEG to test whether we could relate electrocortical dynamics to lower limb muscle activation in a constrained motor task. A secondary goal was to assess the trial-by-trial consistency of the electrocortical dynamics by decoding the type of muscle action. Methods We recorded 264-channel EEG while 8 neurologically intact subjects performed isometric and isotonic, knee and ankle exercises at two different effort levels. Adaptive mixture independent component analysis (AMICA parsed EEG into models of underlying source signals. We generated spectrograms for all electrocortical source signals and used a naïve Bayesian classifier to decode exercise type from trial-by-trial time-frequency data. Results AMICA captured different electrocortical source distributions for ankle and knee tasks. The fit of single-trial EEG to these models distinguished knee from ankle tasks with 80% accuracy. Electrocortical spectral modulations in the supplementary motor area were significantly different for isometric and isotonic tasks (p  Conclusions Independent component analysis of EEG reveals unique spatial and spectro-temporal electrocortical properties for different

  16. Gesture recognition in upper-limb prosthetics: a viability study using dynamic time warping and gyroscopes.

    Science.gov (United States)

    Dermitzakis, Konstantinos; Arieta, Alejandro Hernandez; Pfeifer, Rolf

    2011-01-01

    One of the significant challenges in the upper-limb-prosthetics research field is to identify appropriate interfaces that utilize the full potential of current state-of-the-art neuroprostheses. As the new generation of such prostheses paces towards approximating the human physiological performance in terms of movement dexterity and sensory feedback, it is clear that current non-invasive interfaces are still severely limited. Surface electromyography, the interface ubiquitously used in the field, is riddled with several shortcomings. Gesture recognition, an interface pervasively used in wearables and mobile devices, shows a strong potential as a non-invasive upper-limb prosthetic interface. This study aims at showcasing its potential in the field by using gyroscope sensors. To this end, we (1) explore the viability of Dynamic Time Warping as a classification method for upper-limb prosthetics and (2) look for appropriate sensor locations on the body. Results indicate an optimal classification rate of 97.53%, σ = 8.74 using a sensor located proximal to the endpoint performing a gesture.

  17. Relationship between structural brainstem and brain plasticity and lower-limb training in spinal cord injury: a longitudinal pilot study

    Directory of Open Access Journals (Sweden)

    Michael eVilliger

    2015-05-01

    Full Text Available Rehabilitative training has shown to improve significantly motor outcomes and functional walking capacity in patients with incomplete spinal cord injury (iSCI. However, whether performance improvements during rehabilitation relate to brain plasticity or whether it is based on functional adaptation of movement strategies remain uncertain. This study assessed training improvement-induced structural brain plasticity in chronic iSCI patients using longitudinal MRI.We used tensor-based morphometry (TBM to analyze longitudinal brain volume changes associated with intensive virtual reality (VR-augmented lower limb training in nine traumatic iSCI patients. The MRI data was acquired before and after a 4-week training period (16-20 training sessions. Before training, voxel-based morphometry (VBM and voxel-based cortical thickness (VBCT assessed baseline morphometric differences in nine iSCI patients compared to 14 healthy controls. The intense VR-augmented training of limb control improved significantly balance, walking speed, ambulation, and muscle strength in patients. Retention of clinical improvements was confirmed by the 3-4 months follow-up. In patients relative to controls, reductions in VBM of white matter volume within the brainstem and cerebellum and VBCT showed cortical thinning in the primary motor cortex. Over time, TBM revealed significant improvement-induced increases in the left middle temporal and occipital gyrus, left temporal pole and fusiform gyrus, both hippocampi, cerebellum, corpus callosum, and brainstem in iSCI patients. This study demonstrates structural plasticity at the cortical and brainstem level as a consequence of VR-augmented training in iSCI patients. These structural changes may serve as neuroimaging biomarkers of VR-augmented lower limb neurorehabilitation in addition to performance measures to detect improvements in rehabilitative training.

  18. Medicine and Design Investigate Residual Limb Volume Fluctuations: Three case studies

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    Molly Staker

    2009-11-01

    Full Text Available BackgroundVolume fluctuations dramatically affect the daily fit andfunction of amputees’ prosthetic limbs. Prosthetists haveexperiential knowledge of patient volume fluctuations;however they rarely have access to quantitative evidence.Information regarding volume fluctuations is crucial whendetermining prosthetic socket design, component selection,and rehabilitation regimens. A collaboration between theHuman Dimensioning© Lab (HDL and Dan Rowe andAssociates, a community prosthetic and orthotic providerquantified volume data of individual residuum anatomy.MethodThe project used a 3-dimensional optical body scanner andpoint cloud digitizing technology, currently used for appareldesign, to quantify the daily residuum volume fluctuations inthree lower limb amputees. Utilizing the HDL designresources, three amputees were scanned three times at fourintervals over a six-hour period. The scans were analyzedusing Polyworks® software. Each group of three scans wasmeshed into an average and each of the four averaged scanswas compared to the amputee’s remaining three averagedscans.ResultsThe results document the changes in volume of the subjects’residuum over the six-hour period. The subjects experienceda range of volume fluctuations from 0.5% to 7.5% of totalvolume. To validate the method, scanned volumemeasurements were compared to a simple waterdisplacement measurement. The results from the scanningmethod and displacement method differed between .71%and 1.16%. The magnitude and period of fluctuation werenot consistent between the subjects.ConclusionPresently, little is known of the magnitude of short-termvolume fluctuations, nor is it known if shape changesaccompany short-term volume changes. This design andmedicine collaboration provides a platform for compilingaccurate and consistent residuum volume data and shapecharacterization. The method has the potential to affectprosthetic limb design and fit.

  19. LDTk: Limb Darkening Toolkit

    CERN Document Server

    Parviainen, Hannu

    2015-01-01

    We present a Python package LDTk that automates the calculation of custom stellar limb darkening (LD) profiles and model-specific limb darkening coefficients (LDC) using the library of PHOENIX-generated specific intensity spectra by Husser et al. (2013). The aim of the package is to facilitate analyses requiring custom generated limb darkening profiles, such as the studies of exoplanet transits--especially transmission spectroscopy, where the transit modelling is carried out for custom narrow passbands--eclipsing binaries (EBs), interferometry, and microlensing events. First, LDTk can be used to compute custom limb darkening profiles with uncertainties propagated from the uncertainties in the stellar parameter estimates. Second, LDTk can be used to estimate the limb-darkening-model specific coefficients with uncertainties for the most common limb-darkening models. Third, LDTk can be directly integrated into the log posterior computation of any pre-existing modelling code with minimal modifications. The last a...

  20. THE EFFICACY OF CLONIDINE ADDED TO BUPIVACAINE AS COMPARED WITH BUPIVACAINE ALONE USED IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB SURGERIES

    Directory of Open Access Journals (Sweden)

    Suchismita

    2014-09-01

    Full Text Available : INTRODUCTION: Clonidine when added to local anesthetic solutions improved peripheral nerve blocks by reducing the onset time, improving the efficacy of the block during surgery and extending postoperative analgesia. MATERIALS AND METHODS: Sixty patients aged 18 to 60 years, scheduled for elective orthopedic operations in the upper limb, of ASA Grade I or II were included in the study. We conducted the study with 2 groups consisting of 30 patients each to compare the effects of Clonidine added to Bupivacaine with Bupivacaine alone in supraclavicular brachial plexus block. First group received 40 ml of Bupivacaine 0.25% plus 0.15mg (1ml of Clonidine, second group had 40 ml of Bupivacaine 0.25% plus 1 ml 0.9% Saline respectively. The onset as well as duration of sensory and motor block along with monitoring of heart rate, NIBP, oxygen saturation were recorded. The level of sedation and side effects were also noted. RESULTS: In this study the addition of Clonidine to Bupivacaine resulted in faster onset (study group 15.2±1.44, control group 20.4±1.12, p˂0.001 and longer duration of sensory block (study group 544±31.2, control group 302±34.4, p=0.0363 as well as analgesia (study group 561.2±30.96, control group 324.4±34.08, p=0.0001 without any adverse hemodynamic changes.

  1. Clinico-microbiological study of diabetic limb amputations in a tertiary care hospital in North India

    Directory of Open Access Journals (Sweden)

    Rajpal Singh Punia

    2015-04-01

    Full Text Available The diabetic population faces 80% increased risk of cellulitis, 4-fold increased risk of osteomyelitis and 2-fold risk of both sepsis and death caused by infections.Study objectives.The present study was carried out to assess the clinical aspects and microbiological profile of organisms isolated from 25 patients undergoing diabetic limb amputations.Materials and Methods. In 25 diabetes persons who underwent limb amputation, grading of ulcers was done according to Wagner system. Material was stained with Gram stain. Potassium hydroxide wet mounts were also studied. Culture was done in blood agar, MacConkey agar, Sabouraud dextrose agar tube slants and brain heart infusion broth and examined for growth. The histopathology sections were also studied and special stains were done.Results. Of 25 cases, 16 were males and 9 were females. The age ranged from 30 to 90 years (mean: 58±10.91. Majority of ulcers were grade 3. Osteomyelitis was seen in 13 (52% cases; acute in 2 (8%, chronic in 3 (12% and acute exacerbation of chronic osteomyelitis in 8 (32% cases. On culture Proteus mirabilis was isolated in majority of cases followed by Escherichia coli. In 20 cases more than one bacterium were isolated. Candida was cultured in 8 cases followed by Trichosporon in 2 and Fusarium in one case. On histopathology Candida was seen in 3 cases, while one case showed spores of Trichosporon. 80% cases with osteomyelitis had polymicrobial infection.Conclusions. The isolation of etiologic agent helps in administering appropriate antibiotic regimens, thus reducing the problem of multidrug resistance, morbidity and surgical limb amputations in patients suffering from diabetes mellitus.

  2. Abnormal thalamocortical dynamics may be altered by deep brain stimulation: using magnetoencephalography to study phantom limb pain.

    Science.gov (United States)

    Ray, N J; Jenkinson, N; Kringelbach, M L; Hansen, P C; Pereira, E A; Brittain, J S; Holland, P; Holliday, I E; Owen, S; Stein, J; Aziz, T

    2009-01-01

    Deep brain stimulation (DBS) is used to alleviate chronic pain. Using magnetoencephalography (MEG) to study the mechanisms of DBS for pain is difficult because of the artefact caused by the stimulator. We were able to record activity over the occipital lobe of a patient using DBS for phantom limb pain during presentation of a visual stimulus. This demonstrates that MEG can be used to study patients undergoing DBS provided control stimuli are used to check the reliability of the data. We then asked the patient to rate his pain during and off DBS. Correlations were found between these ratings and power in theta (6-9) and beta bands (12-30). Further, there was a tendency for frequencies under 25 Hz to correlate with each other after a period off stimulation compared with immediately after DBS. The results are interpreted as reflecting abnormal thalamocortical dynamics, previously implicated in painful syndromes.

  3. Upper Limb Neurodynamic Test 1 and symptoms reproduction in carpal tunnel syndrome. A validity study.

    Science.gov (United States)

    Vanti, Carla; Bonfiglioli, Roberta; Calabrese, Monica; Marinelli, Francesco; Guccione, Andrew; Violante, Francesco Saverio; Pillastrini, Paolo

    2011-06-01

    The aim of this study was to estimate the validity of the Upper Limb Neurodynamic Test 1 (ULNT1) for the diagnosis of Carpal Tunnel Syndrome (CTS) with blind comparison to a reference criterion of a compatible clinical presentation and abnormal nerve conduction. 47 subjects with suspected CTS were enrolled. All patients were tested with nerve conduction studies and ULNT1. Considering results as positive in the presence of reproduction of symptoms on affected upper limb, or side-to-side differences in elbow extension, or symptoms modified by lateral neck side-bending, we estimated sensitivity as 91.67%, specificity as 15%, positive likelihood ratio as 1.0784, negative likelihood ratio as 0.5556, and post-test probability for negative test as 40%. Using a new criterion, i.e. the reproduction of symptoms only in the first three digits of the affected hand, we estimated sensitivity as 54.17%, specificity as 70%, positive and negative likelihood ratios as 1.8056 and 0.6548, respectively, and post-test probability for positive test as 68%. Our investigation suggests that the reproduction of the typical current CTS symptoms in the affected hand during ULNT1 testing, improves estimation of the probability of the presence of this condition, even if this test alone cannot be used to diagnose CTS.

  4. [Limb-girdle muscular dystrophy: clinical, hereditary and histological features: study of a family (author's transl)].

    Science.gov (United States)

    Pennisi, G; Russo, S; Ammatuna, A; Falsaperla, A

    1982-01-01

    The family of an "affected" subject with limb girdle dystrophy has been studied in order to assess the clinical-hereditary characteristics of the disease and to contribute to its definite genetic features (phenotypical expressiveness of the pathologic gene). The diagnosis of certitude was based on the anamnestic-clinical criteria and instrumental investigations, supported by histological and histochemical studies of the muscles. The clinical, electromyographic and biochemical data made it possible to distinguish the "affected" from the "subclinical" and the healthy subjects. The subjects that, without noticeable symptoms of neuromuscular disorders, showed a slight clinical expressiveness which didn't alter the normal social and working activities, have been defined "subclinical". The modalities of hereditary transmission of this form of muscular dystrophy are considered in the light of the genetics most present trends that are tending to overcome the dominant-recessive dualism. The possibility of a modality of transmission definable as "intermediate inheritance" is proposed. In the case of the examined family the hypothesis that a pathologic recessive autosomic gene gives rise to a clinical expressiveness in heterozygote subjects seems tenable. This situation definable as "incomplete recessive" is rarely found in the limb girdle dystrophy.

  5. Trajectory of phantom limb pain relief using mirror therapy: Retrospective analysis of two studies.

    Science.gov (United States)

    Griffin, Sarah C; Curran, Sean; Chan, Annie W Y; Finn, Sacha B; Baker, Chris I; Pasquina, Paul F; Tsao, Jack W

    2017-04-01

    Research indicates that mirror therapy reduces phantom limb pain (PLP). Objectives were to determine when mirror therapy works in those who respond to treatment, the relevance of baseline PLP to when pain relief occurs, and what pain symptoms respond to mirror therapy. Data from two independent cohorts with unilateral lower limb amputation were analyzed for this study (n=33). Mirror therapy consisted of 15-min sessions in which amputees performed synchronous movements of the phantom and intact legs/feet. PLP was measured using a visual analogue scale and the Short-Form McGill Pain Questionnaire. The severity of PLP at the beginning of treatment predicted when pain relief occurred. Those with low baseline PLP experienced a reduction (pMirror therapy reduced throbbing, shooting, stabbing, sharp, cramping, aching, tender, splitting, tiring/exhausting, and punishing-cruel pain symptoms. The degree of PLP at baseline predicts when mirror therapy relieves pain. This article indicates that the degree of baseline PLP affects when mirror therapy relieves pain: relief occurs by session 7 in patients with low PLP but by session 21 in patients with high PLP. Clinicians should anticipate slower pain relief in patients who begin treatment with high levels of pain. ClinicalTrials.gov numbers:NCT00623818 and NCT00662415. Copyright © 2017 Scandinavian Association for the Study of Pain. All rights reserved.

  6. Comparative Anatomy of the Hind Limb Vessels of the Bearded Capuchins (Sapajus libidinosus with Apes, Baboons, and Cebus capucinus: With Comments on the Vessels' Role in Bipedalism

    Directory of Open Access Journals (Sweden)

    Roqueline A. G. M. F. Aversi-Ferreira

    2013-01-01

    Full Text Available Capuchin monkeys are known to exhibit sporadic bipedalism while performing specific tasks, such as cracking nuts. The bipedal posture and locomotion cause an increase in the metabolic cost and therefore increased blood supply to lower limbs is necessary. Here, we present a detailed anatomical description of the capuchin arteries and veins of the pelvic limb of Sapajus libidinosus in comparison with other primates. The arterial pattern of the bearded capuchin hind limb is more similar to other quadrupedal Cebus species. Similarities were also found to the pattern observed in the quadruped Papio, which is probably due to a comparable pelvis and the presence of the tail. Sapajus' traits show fewer similarities when compared to great apes and modern humans. Moreover, the bearded capuchin showed unique patterns for the femoral and the short saphenous veins. Although this species switches easily from quadrupedal to bipedal postures, our results indicate that the bearded capuchin has no specific or differential features that support extended bipedal posture and locomotion. Thus, the explanation for the behavioral differences found among capuchin genera probably includes other aspects of their physiology.

  7. A 3-year follow-up study of inpatients with lower limb ulcers: evidence of an obesity paradox?

    Directory of Open Access Journals (Sweden)

    Miller M

    2012-08-01

    Full Text Available Michelle Miller,1 Christopher Delaney,2 Deanna Penna,1 Lilian Liang,1 Jolene Thomas,1 Phillip Puckridge,2 James I Spark21Department of Nutrition and Dietetics, Flinders University, Adelaide, Australia; 2Department of Vascular Surgery, Southern Adelaide Health Service, Adelaide, AustraliaObjectives: To determine whether body composition is related to long-term outcomes amongst vascular inpatients with lower limb ulcers.Design: Prospective study with 3 years follow-up.Materials and methods: Body mass index (BMI, fat, and fat-free mass were measured and associations with readmission to hospital (number, cause, length of stay and all-cause mortality were explored.Results: Thirty patients (22 men, 8 women participated in the study. Ten patients (33% had a BMI ≥ 30 kg/m2. 18/20 (90% patients with a BMI < 30 kg/m2 and 9/10 (90% patients with a BMI ≥ 30 kg/m2 were admitted to hospital in the 3 years of follow-up. Patients with a BMI < 30 kg/m2 were admitted more frequently, earlier and for longer compared to those with BMI ≥ 30 kg/m2 but these did not reach statistical significance. The 3 year mortality rate for patients with BMI ≥ 30 kg/m2 was 20% (n = 2/10 compared to 70% (n = 14/20 with a BMI <30 kg/m2, P = 0.019.Conclusion: This preliminary study suggests that higher BMI may have a protective effect against mortality in vascular patients with lower limb ulcers. These findings contradict the universal acceptance that obesity leads to poor health outcomes. Further work is required to confirm these findings and explore some of the potential mechanisms for this effect.Keywords: body mass index, fat mass, obesity, overweight, vascular, ulcers

  8. Can Orthopedic Oncologists Predict Functional Outcome in Patients with Sarcoma after Limb Salvage Surgery in the Lower Limb? A Nationwide Study

    Directory of Open Access Journals (Sweden)

    Sjoerd Kolk

    2014-01-01

    Full Text Available Accurate predictions of functional outcome after limb salvage surgery (LSS in the lower limb are important for several reasons, including informing the patient preoperatively and, in some cases, deciding between amputation and LSS. This study aimed to elucidate the correlation between surgeon-predicted and patient-reported functional outcome of LSS in the Netherlands. Twenty-three patients (between six months and ten years after surgery and five independent orthopedic oncologists completed the Toronto Extremity Salvage Score (TESS and the RAND-36 physical functioning subscale (RAND-36 PFS. The orthopedic oncologists made their predictions based on case descriptions (including MRI scans that reflected the preoperative status. The correlation between patient-reported and surgeon-predicted functional outcome was “very poor” to “poor” on both scores (r2 values ranged from 0.014 to 0.354. Patient-reported functional outcome was generally underestimated, by 8.7% on the TESS and 8.3% on the RAND-36 PFS. The most difficult and least difficult tasks on the RAND-36 PFS were also the most difficult and least difficult to predict, respectively. Most questions had a “poor” intersurgeon agreement. It was difficult to accurately predict the patient-reported functional outcome of LSS. Surgeons’ ability to predict functional scores can be improved the most by focusing on accurately predicting more demanding tasks.

  9. Controlled study of conventional surgery and ultrasound guided foam sclerotherapy for the treatment of primary SVI of lower limbs

    Institute of Scientific and Technical Information of China (English)

    Raguram Ganesamoni; Mazda Turel; Sunil Agarwalt; Edwin Stephen; Vinu Moses; Thomas Mam-men

    2009-01-01

    Objective: To compare conventional surgery and ultrasound guided foam sclerotherapy for primary superficial venous insufficiency(SVI) with respect to obliteration of superficial venous system, clinical outcome and cost. Methods: The study was conducted between September 2005 and March 2006, in Surgery department of Christian Medical College Hospital, Vellore. All patients with symptomatic primary venous insufficiency of lower limbs requiring definitive management were randomized to conventional surgery (n = 30) or ultrasound guided foam scleretherapy (n = 30). Obliteration of superficial venous system at 3 months, clinical outcome and costs were registered. Results: Superficial venous system was obliterated in all the patients of both the groups at 3 months. Improvement in clinical scores and complication rates was similar in both the groups. The foam scleretherapy group had less analgesic requirement, earlier return to work and lower cost. Conclusion: Foam sclerotherapy is a cheaper alternative to surgery for primary venous insufficiency with respect to early measures of clinical outcome.

  10. Real-time Classification of Non-Weight Bearing Lower-Limb Movements Using EMG to Facilitate Phantom Motor Execution: Engineering and Case Study Application on Phantom Limb Pain

    Directory of Open Access Journals (Sweden)

    Eva Lendaro

    2017-09-01

    Full Text Available Phantom motor execution (PME, facilitated by myoelectric pattern recognition (MPR and virtual reality (VR, is positioned to be a viable option to treat phantom limb pain (PLP. A recent clinical trial using PME on upper-limb amputees with chronic intractable PLP yielded promising results. However, further work in the area of signal acquisition is needed if such technology is to be used on subjects with lower-limb amputation. We propose two alternative electrode configurations to conventional, bipolar, targeted recordings for acquiring surface electromyography. We evaluated their performance in a real-time MPR task for non-weight-bearing, lower-limb movements. We found that monopolar recordings using a circumferential electrode of conductive fabric, performed similarly to classical bipolar recordings, but were easier to use in a clinical setting. In addition, we present the first case study of a lower-limb amputee with chronic, intractable PLP treated with PME. The patient’s Pain Rating Index dropped by 22 points (from 32 to 10, 68% after 23 PME sessions. These results represent a methodological advancement and a positive proof-of-concept of PME in lower limbs. Further work remains to be conducted for a high-evidence level clinical validation of PME as a treatment of PLP in lower-limb amputees.

  11. Body Structures and Physical Complaints in Upper Limb Reduction Deficiency : A 24-Year Follow-Up Study

    NARCIS (Netherlands)

    Postema, Sietke G.; van der Sluis, Corry K.; Waldenlov, Kristina; Hermansson, Liselotte M. Norling

    2012-01-01

    Objective: To describe upper body structures associated with upper limb reduction deficiency and the development of these structures over time, to examine the presence of physical complaints in this population, and to compare body structures and complaints between groups based on prosthesis use. Des

  12. Medial knee joint contact force in the intact limb during walking in recently ambulatory service members with unilateral limb loss: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Ross H. Miller

    2017-02-01

    Full Text Available Background Individuals with unilateral lower limb amputation have a high risk of developing knee osteoarthritis (OA in their intact limb as they age. This risk may be related to joint loading experienced earlier in life. We hypothesized that loading during walking would be greater in the intact limb of young US military service members with limb loss than in controls with no limb loss. Methods Cross-sectional instrumented gait analysis at self-selected walking speeds with a limb loss group (N = 10, age 27 ± 5 years, 170 ± 36 days since last surgery including five service members with transtibial limb loss and five with transfemoral limb loss, all walking independently with their first prosthesis for approximately two months. Controls (N = 10, age 30 ± 4 years were service members with no overt demographical risk factors for knee OA. 3D inverse dynamics modeling was performed to calculate joint moments and medial knee joint contact forces (JCF were calculated using a reduction-based musculoskeletal modeling method and expressed relative to body weight (BW. Results Peak JCF and maximum JCF loading rate were significantly greater in limb loss (184% BW, 2,469% BW/s vs. controls (157% BW, 1,985% BW/s, with large effect sizes. Results were robust to probabilistic perturbations to the knee model parameters. Discussion Assuming these data are reflective of joint loading experienced in daily life, they support a “mechanical overloading” hypothesis for the risk of developing knee OA in the intact limb of limb loss subjects. Examination of the evolution of gait mechanics, joint loading, and joint health over time, as well as interventions to reduce load or strengthen the ability of the joint to withstand loads, is warranted.

  13. Measuring the motor output of the pontomedullary reticular formation in the monkey: do stimulus-triggered averaging and stimulus trains produce comparable results in the upper limbs?

    Science.gov (United States)

    Herbert, Wendy J; Davidson, Adam G; Buford, John A

    2010-06-01

    The pontomedullary reticular formation (PMRF) of the monkey produces motor outputs to both upper limbs. EMG effects evoked from stimulus-triggered averaging (StimulusTA) were compared with effects from stimulus trains to determine whether both stimulation methods produced comparable results. Flexor and extensor muscles of scapulothoracic, shoulder, elbow, and wrist joints were studied bilaterally in two male M. fascicularis monkeys trained to perform a bilateral reaching task. The frequency of facilitation versus suppression responses evoked in the muscles was compared between methods. Stimulus trains were more efficient (94% of PMRF sites) in producing responses than StimulusTA (55%), and stimulus trains evoked responses from more muscles per site than from StimulusTA. Facilitation (72%) was more common from stimulus trains than StimulusTA (39%). In the overall results, a bilateral reciprocal activation pattern of ipsilateral flexor and contralateral extensor facilitation was evident for StimulusTA and stimulus trains. When the comparison was restricted to cases where both methods produced a response in a given muscle from the same site, agreement was very high, at 80%. For the remaining 20%, discrepancies were accounted for mainly by facilitation from stimulus trains when StimulusTA produced suppression, which was in agreement with the under-representation of suppression in the stimulus train data as a whole. To the extent that the stimulus train method may favor transmission through polysynaptic pathways, these results suggest that polysynaptic pathways from the PMRF more often produce facilitation in muscles that would typically demonstrate suppression with StimulusTA.

  14. Postcoital Sperm Assessment Comparative Study.

    Science.gov (United States)

    Pelekanos, Michael J

    2015-11-01

    This postcoital sperm assessment study was performed over a 10 month time period (November 2014-August 2015). Fifteen couples enrolled in the study. The study was a non-blinded, non-randomized, single-center comparison study comparing The Stork® OTC (Rinovum Women's Health, Monroeville, PA) to natural intercourse (NI), using the subjects as their own control/baseline. This was an efficacy study designed to compare the number of sperm in the cervical mucus following the use of The Stork OTC conception aid with the number of sperm in the cervical mucus following natural intercourse. Subjects used both The Stork OTC conception system and the natural intercourse method to evaluate concentrations of sperm in the cervical mucus. Post-coital test (PCT) data was collected demonstrating higher concentrations of sperm within the cervical mucus with The Stork OTC conception system versus natural intercourse for 85% of test subjects in this study. Of the 15 couples enrolled in the study, 2 were lost to follow-up. Mean age for male subjects was 31.7 +/ 5.4 years of age and mean age for female subjects was 29.7+/- 5.4. The average sperm score value of the 85% of test subjects with higher sperm concentrations from The Stork OTC was 3.23 times the score value of sperm concentration compared to natural intercourse. The remaining 15% of test subjects showed no change in sperm score value between The Stork OTC and natural intercourse.

  15. The use of wearable inertial motion sensors in human lower limb biomechanics studies: a systematic review.

    Science.gov (United States)

    Fong, Daniel Tik-Pui; Chan, Yue-Yan

    2010-01-01

    Wearable motion sensors consisting of accelerometers, gyroscopes and magnetic sensors are readily available nowadays. The small size and low production costs of motion sensors make them a very good tool for human motions analysis. However, data processing and accuracy of the collected data are important issues for research purposes. In this paper, we aim to review the literature related to usage of inertial sensors in human lower limb biomechanics studies. A systematic search was done in the following search engines: ISI Web of Knowledge, Medline, SportDiscus and IEEE Xplore. Thirty nine full papers and conference abstracts with related topics were included in this review. The type of sensor involved, data collection methods, study design, validation methods and its applications were reviewed.

  16. The Use of Wearable Inertial Motion Sensors in Human Lower Limb Biomechanics Studies: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Yue-Yan Chan

    2010-12-01

    Full Text Available Wearable motion sensors consisting of accelerometers, gyroscopes and magnetic sensors are readily available nowadays. The small size and low production costs of motion sensors make them a very good tool for human motions analysis. However, data processing and accuracy of the collected data are important issues for research purposes. In this paper, we aim to review the literature related to usage of inertial sensors in human lower limb biomechanics studies. A systematic search was done in the following search engines: ISI Web of Knowledge, Medline, SportDiscus and IEEE Xplore. Thirty nine full papers and conference abstracts with related topics were included in this review. The type of sensor involved, data collection methods, study design, validation methods and its applications were reviewed.

  17. The comparative efficacy of angiosome-directed and indirect revascularisation strategies to aid healing of chronic foot wounds in patients with co-morbid diabetes mellitus and critical limb ischaemia: a literature review.

    Science.gov (United States)

    Khor, Benedictine Y C; Price, Pamela

    2017-01-01

    Ischaemic ulcerations have been reported to persist and/or deteriorate despite technically successful revascularisations; a higher incidence of which affects patients with diabetes and critical limb ischaemia. In the context of wound healing, it is unclear if applications of the angiosome concept in 'direct revascularisation' (DR) would be able to aid the healing of chronic foot ulcerations better than the current 'best vessel' or 'indirect revascularisation' (IR) strategy in patients with co-morbid diabetes and critical limb ischaemia. A literature search was conducted in eight electronic databases, namely AMED, CINAHL, The Cochrane Library, ProQuest Health & Medicine Complete, ProQuest Nursing & Allied Health Source, PubMed, ScienceDirect and TRIP database. Articles were initially screened against a pre-established inclusion and exclusion criteria to determine eligibility and subsequently appraised using the Newcastle-Ottawa Scale. Five retrospective studies of varying methodological quality were eligible for inclusion in this review. Critical analysis of an aggregated population (n = 280) from methodologically stronger studies indicates better wound healing outcomes in subjects who had undergone DR as compared to IR (p < 0.001; p = 0.04). DR also appears to result in a nearly twofold increase in probability of wound healing within 12 months (hazard ratio, 1.97; 95% CI, 1.34-2.90). This suggests that achieving direct arterial perfusion to the site of ulceration may be important for the healing of chronic diabetic foot ulcerations. Incorporating an angiosome-directed approach in the lower limb revascularisation strategy could be a very useful adjunct to a solely indirect approach, which could increase the likelihood of wound healing. With the limited data currently available, findings appear promising and merit from further investigation. Additional research to form a solid evidence base for this revised strategy in patients with co-morbid diabetes and

  18. A comparative study on the effect of stretch stockings and 3M elastic bandage on prevention of deep vein thrombosis in patients with fracture of lower limb after operation%3M自粘弹性绷带与弹力袜预防下肢骨折术后患者深静脉血栓的效果比较

    Institute of Scientific and Technical Information of China (English)

    姜雪晶; 顾群

    2013-01-01

    Objective To explore the effect of stretch stockings and 3M elastic bandage on prevention of deep vein thrombosis in patients with fracture of lower hmb after operation.Methods During the period from January 2011 to December 2012,108 patients were divided into two groups according their sex and age.The control group was treated by the stretch stockings and routine nursing,while the experimental group was treated by 3M elastic bandage and routine nursing.The incidence of deep vein thrombosis and the average of hospital days were compared and analyzed between two groups after fracture.Results No lower limbs necrosis and pulmonary embolism happened in all patients.The average of hospital days were (31.0 ± 2.7) d in the control group,and longer than (22.0 ±3.1) d in the experimental group,and the difference was statistically significant (t =3.68,P =0.012).The incidence of deep vein thrombosis was 20.3% (11 cases) in the control group,and 5.5% (3 cases) in the experimental group,and the differences were statistically significant (x2 =3.68,5.25,respectively; P =0.012,0.042,respectively).Conclusions Compared with the traditional method using stretch stockings,the new method using 3M elastic bandage can decrease the incidence of deep vein thrombosis and reduce the average of hospital days in patients with fracture.Its clinical application is worth promoting.%目的 对比研究3M弹性绷带与弹力袜对预防下肢骨折术后深静脉血栓发生情况的影响.方法 选取2011年1月到2012年12月的108例下肢骨折患者按年龄、性别配对分为两组,对照组是常规护理加弹力袜护理(54例),干预组是常规护理加3M弹力袜护理组(54例),比较两组护理方法在骨折后深静脉血栓的发生率和平均住院天数.结果 两组均无肢体坏死及肺栓塞发生,对照组的平均住院日为(31.02.7)d,干预组的平均住院日为(22.03.1)d,干预组组的住院日明显缩短,两组比较,差异有统计学意义(t=3.68,P=0

  19. An investigation of somatosensory profiles in work related upper limb disorders: a case-control observational study protocol.

    LENUS (Irish Health Repository)

    Moloney, Niamh

    2010-01-01

    BACKGROUND: Work related upper limb disorders constitute 45% of all occupational diseases and are a significant public health problem. A subgroup, non specific arm pain (NSAP), remains elusive in terms of understanding its pathophysiological mechanisms with its diagnosis based on the absence of specific clinical findings. One commonly proposed theory is that a neural tissue disorder is the primary dysfunction in NSAP and findings from previous studies lend some support to this theory. However, it is not clear if changes identified are simply a consequence of ongoing pain rather than due to specific neural changes. The presence of neuropathic pain has been investigated in several other musculoskeletal conditions but currently, there is no specific diagnostic tool or gold standard which permits an unequivocal diagnosis of neuropathic pain. The purpose of this study is to further describe the somatosensory profiles in patients with NSAP and to compare these profiles to a group of patients with MRI confirmed cervical radiculopathy who have been previously classified as having neuropathic pain. METHODS\\/DESIGN: Three groups of participants will be investigated: Groups 1 and 2 will be office workers with either NSAP or cervical radiculopathy and Group 3 will be a control group of non office workers without upper limb pain. Participants will undergo a clinical assessment, pain questionnaires (LANSS, Short Form McGill, DASH and TSK) and quantitative sensory testing comprising thermal detection and pain thresholds, vibration thresholds and pressure pain thresholds. DISCUSSION: The spectrum of clinically suspected neuropathic pain ranges from more obvious conditions such as trigeminal neuralgia to those with vague signs of nerve disorder such as NSAP. A thorough description of the somatosensory profiles of NSAP patients and a comparison with a more defined group of patients with evidence of neuropathic pain will help in the understanding of underlying neurophysiology in

  20. Upper-limb thrombo-embolectomy: national cohort study in Denmark

    DEFF Research Database (Denmark)

    Andersen, L V; Mortensen, L S; Lindholt, Jes S.;

    2010-01-01

    We investigated the incidence of thrombo-embolectomy in upper-limb and prognosis with respect to arm amputation, stroke and death.......We investigated the incidence of thrombo-embolectomy in upper-limb and prognosis with respect to arm amputation, stroke and death....

  1. Ideomotor limb apraxia in Huntington's disease: a case-control study.

    Science.gov (United States)

    Hödl, Anna K; Hödl, Elfriede; Otti, Daniela V; Herranhof, Brigitte; Ille, Rottraut; Bonelli, Raphael M

    2008-03-01

    Ideomotor limb apraxia is the disturbance of planning and of execution of motor activity,which is not caused by a dysfunction of the motor or sensory nervous system. Apraxia is a diagnostic criterion in dementialike Alzheimer's disease. However, this symptom may also occur in dementia with subcortical lesions like Huntington's disease (HD), a hereditary, devastating neurodegenerative disease leading to neurological and psychiatric dysfunction. The aim of our study is to determine the correlation between the occurrence of ideomotor limb apraxia and neuropsychological deficits in HD. To assess the correlation between apraxia and neuropsychological abilities in HD, 41 patients with HD and 33 age- and sex-matched controls were examined. The De Renzi test for apraxia and an apraxia test battery containing tests of i) imitation of meaningless gestures of hands, ii) imitation of meaningless gestures of fingers, iii) performance of meaningful gestures on demand, and iv) pantomime of tool use were used to assess apraxia. Moreover, neuropsychological function was rated by the Mini Mental State Examination (MMSE), the Rey Complex Figure Memory Test, the Trail Making Test A and B, the California Verbal Learning Test (German version), the Stroop Color and Word Test, the Controlled Oral Word Association Test, and the Mehrfachwahl- Wortschatz-Intelligenztest for measuring verbal intelligence. Motor function was assessed in all HD patients by the Unified HD Rating Scale (UHDRS), rating oculomotor and orolingual function, fine motor tasks, parkinsonism, dystonia, chorea and statics and gait. Apraxic HD patients showed worse results than non-apraxic HD patients in three items of the Rey Complex Figure Memory Test (Organisation, short-term and longterm memory), but not in other assessed neuropsychological tests. In assessment of meaningful gestures on demand 39.3% of HD patients were apraxic, in assessment of pantomime of tool use 67.9% of HD patients showed apraxia. Patients with HD

  2. Lower limb force, power and performance in skateboarding: an exploratory study

    Directory of Open Access Journals (Sweden)

    Cláudia Tarragô Candotti

    2012-09-01

    Full Text Available The purpose of this study was to identify the relationship between the height reached when performing the Ollie maneuver and the muscle force and power of the lower limbs required by beginner level skateboarders. Ten practitioners of Street category, with at least two years experience and who participate in competitions in Beginner, Amateur II or Amateur I categories were submitted to three tests: (1 maximal voluntary contraction of the knee and hip extensor muscles; (2 vertical jump tests, Counter Movement Jump (CJ and Squat Jump (SJ; and (3 the maximum height achieved during the Ollie maneuver. The results demonstrate that the variance of the Ollie maneuver (p<0.05 is explained by the power estimated with the CJ (76.3%; and the maximal force of the knee extensor muscle (50.6%. These results suggest that the variable power is strongly associated with the performance of the Ollie maneuver.

  3. Slacklining and stroke: A rehabilitation case study considering balance and lower limb weakness.

    Science.gov (United States)

    Gabel, Charles P; Rando, Natalie; Melloh, Markus

    2016-08-18

    To ascertain the effectiveness of slacklining as a supplementary therapy for elderly stroke patients who are functionally non-progressing. This case study involved an 18-mo prospective observation of the management of an 87-year-old female stroke-patient of the left hemisphere with reduced balance, reduced lower limb muscular activation, hypertonia, and concurrent postural deficits. This entailed the initial acute care phase through to discharge to home and 18-mo final status in her original independent living setting. The introduction of slacklining as an adjunct therapy was made 12 mo post incident. Slacklining involves balance retention on a tightened band where external environmental changes cause a whole-body dynamic response to retain equilibrium. It is a complex neuromechanical task enabling individualized self-developed response strategies to be learned and adapted. This facilitates the innate process of balance retention, lower-limb and core muscle activation, and stable posture through a combination of learned motor skills and neurological system down regulation. Individuals adopt and follow established sequential motor learning stages where the acquired balance skills are achieved in a challenging composite-chain activity. Slacklining could be considered an adjunct therapy for lower limb stroke rehabilitation where function is compromised due to decreased muscle recruitment, decreased postural control and compromised balance. Initial inpatient rehabilitation involved one-month acute-care, one-month rehabilitation, and one-month transitional care prior to home discharge. A further six months of intensive outpatient rehabilitation was provided with five hourly sessions per week including:supervised and self-managed hydrotherapy, plus one individual and two group falls' prevention sessions. These were supported by daily home exercises. At 12 mo post incident, recovery plateaued, then regressed following three falls. Rehabilitation was subsequently modified

  4. Study on 3D printer production of auxiliary device for upper limb for medical imaging test

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyeong Gyun [Dept. of Radiological Science, Far East University, Eumsung (Korea, Republic of); Yoon, Jae Ho [Jukwang Precision Co., Ltd., Gumi (Korea, Republic of); Choi, Seong Dae [Dept. of Mechanical system engineering, Kumoh Institute of Technology, Gumi (Korea, Republic of)

    2015-12-15

    There is a progressive development in the medical imaging technology, especially of descriptive capability for anatomical structure of human body thanks to advancement of information technology and medical devices. But however maintenance of correct posture is essential for the medical imaging checkup on the shoulder joint requiring rotation of the upper limb due to the complexity of human body. In the cases of MRI examination, long duration and fixed posture are critical, as failure to comply with them leads to minimal possibility of reproducibility only with the efforts of the examiner and will of the patient. Thus, this study aimed to develop an auxiliary device that enables rotation of the upper limb as well as fixing it at quantitative angles for medical imaging examination capable of providing diagnostic values. An auxiliary device has been developed based on the results of precedent studies, by designing a 3D model with the CATIA software, an engineering application, and producing it with the 3D printer. The printer is Objet350 Connex from Stratasys, and acrylonitrile- butadiene-styrene(ABS) is used as the material of the device. Dimensions are 120 X 150 X 190 mm, with the inner diameter of the handle being 125.9 mm. The auxiliary device has 4 components including the body (outside), handle (inside), fixture terminal and the connection part. The body and handle have the gap of 2.1 mm for smooth rotation, while the 360 degree of scales have been etched on the handle so that the angle required for observation may be recorded per patient for traceability and dual examination.

  5. A comparative study of two computer-aided measurement methods

    OpenAIRE

    Gronau, Franziska

    2010-01-01

    Growth and developmental disorders of the elbow joint are frequent causes of lameness of the thoracic limb of the dog. Golden Retriever is one of the mainly affected breeds. Two different computer-aided methods of measurement will be compared in this study. The aim is to find out whether one of these measurement methods is more suitable to distinguish affected from unaffected joints and to recognize a possible predisposition for elbow dysplasia (ED). X-Rays of the elbow joints in the medio-la...

  6. How Depressive Levels Are Related to the Adults' Experiences of Lower-Limb Amputation: A Mixed Methods Pilot Study

    Science.gov (United States)

    Senra, Hugo

    2013-01-01

    The current pilot study aims to explore whether different adults' experiences of lower-limb amputation could be associated with different levels of depression. To achieve these study objectives, a convergent parallel mixed methods design was used in a convenience sample of 42 adult amputees (mean age of 61 years; SD = 13.5). All of them had…

  7. How Depressive Levels Are Related to the Adults' Experiences of Lower-Limb Amputation: A Mixed Methods Pilot Study

    Science.gov (United States)

    Senra, Hugo

    2013-01-01

    The current pilot study aims to explore whether different adults' experiences of lower-limb amputation could be associated with different levels of depression. To achieve these study objectives, a convergent parallel mixed methods design was used in a convenience sample of 42 adult amputees (mean age of 61 years; SD = 13.5). All of them had…

  8. Limb anomalies

    DEFF Research Database (Denmark)

    Gurrieri, Fiorella; Kjær, Klaus Wilbrandt; Sangiorgi, Eugenio

    2002-01-01

    In this review we describe the developmental mechanisms involved in the making of a limb, by focusing on the nature and types of interactions of the molecules that play a part in the regulation of limb patterning and characterizing clinical conditions that are known to result from the abnormal...... function of these molecules. The latter subject is divided into sections dealing with syndromal and nonsyndromal deficiencies, polydactylies, and brachydactylies. Conditions caused by mutations in homeobox genes and fibroblast growth factors and their receptor genes are listed separately. Since the process...... of limb development has been conserved for more than 300 millions years, with all the necessary adaptive modifications occurring throughout evolution, we also take into consideration the evolutionary aspects of limb development in terms of genetic repertoire, molecular pathways, and morphogenetic events....

  9. Artificial Limbs

    Science.gov (United States)

    ... diabetes. They may cause you to need an amputation. Traumatic injuries, including from traffic accidents and military combat Cancer Birth defects If you are missing an arm or leg, an artificial limb can sometimes replace it. The device, which is ...

  10. Fifteen years of experience with Integral-Leg-Prosthesis: Cohort study of artificial limb attachment system.

    Science.gov (United States)

    Juhnke, Dora-Lisa; Beck, James P; Jeyapalina, Sujee; Aschoff, Horst H

    2015-01-01

    Integral-Leg-Prosthesis (ILP) is a comparatively new attachment system that allows direct skeletal docking of artificial limbs. Between January 1999 and December 2013, 69 patients with transfemoral amputation were fitted with ILPs by a single German surgeon. Device design iterations and surgical techniques evolved during these years. For the purposes of comparison, patients receiving the first two designs and procedure iterations were placed in group 1 and the patients fitted with the final design were placed in group 2. Infection rate and planned and unplanned surgical interventions were statistically compared using Fisher exact test. Data demonstrated that the high rate of stoma-associated infections seen in group 1 was dramatically reduced in group 2. Of the 39 patients with 42 implants in group 2, none had operative interventions secondary to infection. All group 2 patients remained infection-free without the use of antibiotics by following a simple but defined wound-hygiene protocol. We concluded that the final iteration of the osseointegrated intramedullary device with a low energy surface at the soft tissue and prosthesis interface allowed a biologically stable skin stoma that remained infection-free without chronic use of antibiotics. The reduction in the infection rate was attributed to the clinically based, empirically driven changes in design and surgical techniques.

  11. Fifteen years of experience with Integral-Leg-Prosthesis: Cohort study of artificial limb attachment system

    Directory of Open Access Journals (Sweden)

    Dora-Lisa Juhnke, MD

    2015-08-01

    Full Text Available Integral-Leg-Prosthesis (ILP is a comparatively new attachment system that allows direct skeletal docking of artificial limbs. Between January 1999 and December 2013, 69 patients with transfemoral amputation were fitted with ILPs by a single German surgeon. Device design iterations and surgical techniques evolved during these years. For the purposes of comparison, patients receiving the first two designs and procedure iterations were placed in group 1 and the patients fitted with the final design were placed in group 2. Infection rate and planned and unplanned surgical interventions were statistically compared using Fisher exact test. Data demonstrated that the high rate of stoma-associated infections seen in group 1 was dramatically reduced in group 2. Of the 39 patients with 42 implants in group 2, none had operative interventions secondary to infection. All group 2 patients remained infection-free without the use of antibiotics by following a simple but defined wound-hygiene protocol. We concluded that the final iteration of the osseointegrated intramedullary device with a low energy surface at the soft tissue and prosthesis interface allowed a biologically stable skin stoma that remained infection-free without chronic use of antibiotics. The reduction in the infection rate was attributed to the clinically based, empirically driven changes in design and surgical techniques.

  12. [Comparative studies of face recognition].

    Science.gov (United States)

    Kawai, Nobuyuki

    2012-07-01

    Every human being is proficient in face recognition. However, the reason for and the manner in which humans have attained such an ability remain unknown. These questions can be best answered-through comparative studies of face recognition in non-human animals. Studies in both primates and non-primates show that not only primates, but also non-primates possess the ability to extract information from their conspecifics and from human experimenters. Neural specialization for face recognition is shared with mammals in distant taxa, suggesting that face recognition evolved earlier than the emergence of mammals. A recent study indicated that a social insect, the golden paper wasp, can distinguish their conspecific faces, whereas a closely related species, which has a less complex social lifestyle with just one queen ruling a nest of underlings, did not show strong face recognition for their conspecifics. Social complexity and the need to differentiate between one another likely led humans to evolve their face recognition abilities.

  13. [Preliminary study on autologous bone marrow mononuclear cells transplantation for lower limb chronic venous ulcer].

    Science.gov (United States)

    Huang, Wen; Wang, Liwei; Tan, Bin; Zhang, Guozhen; Zhao, Yu; Ren, Guosheng

    2011-05-01

    To investigate the effectiveness of autologous bone marrow mononuclear cells transplantation on lower limb chronic venous ulcer. Between May 2009 and September 2010, 17 patients with lower limb chronic venous ulcer were treated with autologous bone marrow mononuclear cells transplantation (transplantation group) and 10 patients treated without cells transplantation served as control group. In the transplantation group, there were 9 males and 8 females with age of (33.3 +/- 6.1) years, including 11 cases of simple great saphenous vein varicosity and 6 cases of chronic venous insufficiency; the area of ulcer was (4.39 +/- 2.46) cm2; and the duration of ulcer ranged from 3 months to 6 years. In the control group, there were 4 males and 6 females with age of (39.2 +/- 10.3) years, including 7 cases of simple great saphenous vein varicosity and 3 cases of chronic venous insufficiency; and the area of ulcer was (5.51 +/- 2.63) cm2; and the duration of ulcer ranged from 3 months to 2 years. All patients in both groups were classified as C6 according to clinical etiology anatomy pathophysiology (CEAP) classification. No significant difference was found in the general data between 2 groups (P > 0.05). The healing process of ulcer was observed. The granulation tissue was harvested for HE staining before operation and at 3 days after operation in the transplantation group. The microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression of ulcer granulation tissue were observed. In the transplantation group, ulcer healing was accelerated; complete healing was observed in 15 cases, partial healing in 1 case, and no healing in 1 case with the median healing time of 22 days. However, in the control group, the healing process was slower; complete healing of ulcer was observed in 7 cases and no healing in 3 cases with the median healing time of 57.5 days. There was significant difference in the healing time between 2 groups (Z = 0.001 4, P = 0.0027). HE

  14. Effect of lower limb preference on local muscular and vascular function.

    Science.gov (United States)

    Fahs, Christopher A; Thiebaud, Robert S; Rossow, Lindy M; Loenneke, Jeremy P; Kim, Daeyeol; Abe, Takashi; Bemben, Michael G

    2014-01-01

    Unilateral physical training can enhance muscular size and function as well as vascular function in the trained limb. In non-athletes, the preferred arm for use during unilateral tasks may exhibit greater muscular strength compared to the non-preferred arm. It is unclear if lower limb preference affects lower limb vascular function or muscular endurance and power in recreationally active adults. To examine the effect of lower limb preference on quadriceps muscle size and function and on lower limb vascular function in middle-aged adults. Twenty (13 men, 7 women) recreationally-active middle-aged (55 ± 7 yrs) adults underwent measurements of quadriceps muscle thickness, strength, mean power, endurance, and arterial stiffness, calf venous compliance, and calf blood flow in the preferred and non-preferred lower limb. The preferred limb exhibited greater calf vascular conductance (31.6 ± 15.5 versus 25.8 ± 13.0 units flow/mmHg; p = 0.011) compared to the non-preferred limb. The interlimb difference in calf vascular conductance was negatively related to weekly aerobic activity (hrs/week) (r = -0.521; p = 0.019). Lower limb preference affects calf blood flow but not quadriceps muscle size or function. Studies involving unilateral lower limb testing procedures in middle-aged individuals should consider standardizing the testing to either the preferred or non-preferred limb rather than the right or left limb.

  15. Prevalence and Characteristics of Phantom Limb Pain and Residual Limb Pain in the Long Term after Upper Limb Amputation

    Science.gov (United States)

    Desmond, Deirdre M.; MacLachlan, Malcolm

    2010-01-01

    This study aims to describe the prevalence and characteristics of phantom limb pain and residual limb pain after upper limb amputation. One-hundred and forty-one participants (139 males; mean age 74.8 years; mean time since amputation 50.1 years) completed a self-report questionnaire assessing residual and phantom limb pain experience. Prevalence…

  16. Prevalence and Characteristics of Phantom Limb Pain and Residual Limb Pain in the Long Term after Upper Limb Amputation

    Science.gov (United States)

    Desmond, Deirdre M.; MacLachlan, Malcolm

    2010-01-01

    This study aims to describe the prevalence and characteristics of phantom limb pain and residual limb pain after upper limb amputation. One-hundred and forty-one participants (139 males; mean age 74.8 years; mean time since amputation 50.1 years) completed a self-report questionnaire assessing residual and phantom limb pain experience. Prevalence…

  17. Intermanual Transfer in Training With an Upper-Limb Myoelectric Prosthesis Simulator : A Mechanistic, Randomized, Pretest-Posttest Study

    NARCIS (Netherlands)

    Romkema, Sietske; Bongers, Raoul M.; van der Sluis, Corry K.

    2013-01-01

    Background. Intermanual transfer may improve prosthetic handling and acceptance if used in training soon after an amputation. Objective. The purpose of this study was to determine whether intermanual transfer effects can be detected after training with a myoelectric upper-limb prosthesis simulator.

  18. Combining levodopa and virtual reality-based therapy for the rehabilitation of upper limb after acute stroke: pilot study part II.

    Science.gov (United States)

    Samuel, Geoffrey Sithamparapillai; Oey, Nicodemus Eldrick; Choo, Min; Ju, Han; Chan, Wai Yin; Kok, Stanley; Ge, Yu; Van Dongen, Antonius M; Ng, Yee Sien

    2016-06-17

    This study aimed to evaluate the safety and efficacy of a combination of levodopa and virtual reality (VR)-based therapy for the enhancement of upper limb recovery following acute stroke. This was a pilot single-blinded case series of acute stroke patients with upper extremity hemiparesis randomised to standard care with concomitant administration of either levodopa alone (conventional therapy or control group) or combination therapy consisting of VR-based motivational visuomotor feedback training coupled with levodopa neuromodulation (combination therapy or VR group). Main clinical outcome measures were the Fugl-Meyer-Upper Extremity (FM-UE) assessment and Action Research Arm Test (ARAT). Kinematic measurements of the affected upper limb movement were evaluated as a secondary measure of improvement. Of 42 patients screened, four were enrolled in the VR group and four in the control group, from which two patients dropped out during the trial. Patients receiving combination therapy had clinically significant improvements in FM-UE assessment scores of 16.5 points compared to a 3.0-points improvement among control patients. Similarly, ARAT scores of VR group patients improved by 15.3 points compared to a 10.0-points improvement in the control group. Corresponding improvements were noted in kinematic measures, including hand-path ratio, demonstrating improved quality of upper limb movement in the VR group. Our results suggest that VR-based therapy and pharmacotherapy may be combined for acute stroke rehabilitation. The bedside acquisition of kinematic measurements allows for an accurate assessment of the quality of limb movement, offering a sensitive clinical tool for quantifying motor recovery during the rehabilitation process after acute stroke.

  19. Growing blood vessels to treat limb ischemia : studie in mice and man

    NARCIS (Netherlands)

    Weel, Vincent van

    2008-01-01

    Summary This thesis describes the efforts of increasing our knowledge and insights into cellular and molecular mechanisms of vascular growth, especially collateral artery growth (arteriogenesis), in limb ischemia with the aim of developing new strategies for therapeutic angiogenesis and arteriogenes

  20. Links between nurses' organisational work environment and upper limb musculoskeletal symptoms: independently of effort-reward imbalance! The ORSOSA study.

    Science.gov (United States)

    Herin, Fabrice; Paris, Christophe; Levant, Aude; Vignaud, Marie-Chantal; Sobaszek, Annie; Soulat, Jean-Marc

    2011-09-01

    The role of psychosocial factors in the development of upper limb musculoskeletal disorders has now been clearly demonstrated. However, only a few studies have analysed the association between the organisational work environment and musculoskeletal disorders in health care workers. The main goal of this study was to test the hypothesis that some specific organisational constraints may be related to upper limb musculoskeletal symptoms experienced by registered nurses, independently of the effort/reward imbalance model and major confounding factors. In 2006, 2194 female registered nurses in 7 French teaching hospitals, recruited from the baseline screening of an epidemiological cohort study (the ORSOSA study), responded to valid self-report questionnaires (ERI [effort-reward imbalance], Nordic-style questionnaire). The organisational work environment was assessed by the self-rated Nursing Work Index-Extended Organisation scale. Multilevel models were used for analyses. We found that 2 organisational health care constraints: low level of shared values about work between members in the unit and lack of support from the administration were significantly associated with upper limb symptoms, independently of ERI perceptions. This study identified and quantified specific health care organisational factors that have an impact on nurses' upper limb symptoms, sometimes independently of ERI perception. A prospective study is needed to clarify the causal role of psychosocial and organisational work factors in upper limb injury in nurses. Organisational approaches may be more effective in improving health at work and may also have a longer-lasting impact than individual approaches. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  1. Bilateral upper limb amputations in victims of high tension electrical injuries: Three case studies

    Directory of Open Access Journals (Sweden)

    Cajetan Nwadinigwe

    2015-02-01

    Full Text Available Bilateral upper limb amputations result in severe disability. High voltage electrical injury is a rare cause of such an outcome and injuries often occur as occupational hazards. We present three case reports of accidental high voltage injuries that occurred in a non-occupational setting. Victims were all initially managed at other centres before referral to our hospital and all subsequently had bilateral upper limb amputations. The high cost of treatment, importance of prevention, and need for rehabilitation are highlighted.

  2. Evaluation of changes in equine care and limb-related abnormalities in working horses in Jaipur, India, as part of a two year participatory intervention study.

    Directory of Open Access Journals (Sweden)

    Helen R Whay

    Full Text Available Previous studies have found the prevalence of lameness in working horses to be 90-100%. Risk factors for lameness in this important equine population, together with risk-reduction strategies adopted by their owners, are poorly understood. The objective was to uncover risk factors for lameness and limb abnormalities in working horses, by associating clinical lameness examination findings on three occasions over two years with owner reported changes in equine management and work practices over this period.Twenty-one communities of horse owners in Jaipur, India, took part in a participatory intervention (PI project aiming to reduce risk factors for poor welfare, particularly lameness and limb problems. Associations between quantitative measures of equine lameness/limb abnormalities and reported changes in management and work practices were compared with 21 control (C communities of owners where no intervention had taken place. Key findings from 'complete cases', where the same horse stayed with the same owner for the whole study period (PI group = 73 owners of 83 horses, C group = 58 owners of 66 horses, were that more positive statements of change in equine management and work practices were made by PI group owners than C group owners. A mixed picture of potential risk factors emerged: some reported management improvements, for example reducing the weight of the load for cart animals, were associated with improved limbs and lameness, and others, such as making improvements in shoeing and increasing the age at which their animals started work, with negative outcomes.This study illustrates the complexity and interacting nature of risk factors for lameness in working horses, and highlights the importance of longitudinal investigations that recognise and address this. PI group owners found the project useful and requested similar inputs in future. Our findings demonstrate the value of exploratory and participatory research methodology in the field of

  3. Prospective clinical study of surgical management of varicose veins of lower limb and its complications

    Directory of Open Access Journals (Sweden)

    Nagaraj H.

    2014-02-01

    Methods: Two years prospective study was conducted in our institution from May 2007 to April 2009. During this period 62 cases of varicose veins of lower limbs were admitted to our hospital of which 50 cases were selected and were studies in detail. After thorough clinical examination and relevant investigation they are all subjected to surgical management. Results: Out of 50 cases studied, 21 (42% had only long saphenous vein involvement, 7 (14% had short saphenous vein involvement and in 5 (10% cases both short and long saphenous system were involved. In addition to long saphenous vein involvement, incompetent perforators were present in 17 (34% cases. Among them prominent veins and pain were the main complain in 38 (78% patients. Itching and pigmentation were present in 4 (8% patients. Ankle edema was present in 6 (12% patients. Pain and ulceration of lower leg were present in 2 (4% patients. After clinical assessment appropriate surgical procedures were followed for each of patients. These cases were followed for 3 year durations. Out of 50 patients 7 (14% patients had recurrence of varicose vein. 7 (14% patient complained of recurrence of pain after 2 years of surgery but no appearance of varicose vein. One patient (2% complained of persistence of pigmentation after surgery. 2 (4% patients complained of persistence of ankle edema and there was complete healing of ulcer which was present earlier. Conclusions: Commonest age group of varicose vein of lower limb was 20 to 40 years. Definite relationship exists between the occupation and the incidence of varicose veins. The patients were in the occupation which required standing for long time had the higher chances of varicose vein. Severity of the symptoms is not proportional to the duration of varicose veins. The involvement of long saphenous vein is more common than the short saphenous vein. Since our study shows very low percentage of recurrence and symptoms related to varicose vein the surgical line of

  4. Relationship between lower limb position and pelvic floor muscle surface electromyography activity in menopausal women: a prospective observational study

    Science.gov (United States)

    Halski, Tomasz; Ptaszkowski, Kuba; Słupska, Lucyna; Dymarek, Robert; Paprocka-Borowicz, Małgorzata

    2017-01-01

    Objectives In physiotherapeutic practice, special attention is being given to the reciprocal anatomical, physiological, and biomechanical relationship of the pelvis and the structures connected to it. However, the scientific literature shows mainly the theoretical information about their mutual connections. The lack of information about these relations from a practical aspect coupled with the paucity of scientific papers on the impact of posture changes on the pelvic floor led the authors to conduct this study. The primary aim of this study was to compare the resting and functional bioelectrical activities of pelvic floor muscles (PFMs) depending on three different positions of the lower limbs (positions A, B, and C) in the supine position. Materials and methods This was a prospective observational study evaluating resting and functional activities of the PFM depending on the position of the lower limbs. The study was carried out at the Department and Clinic of Urology, University Hospital in Wroclaw, Poland and the target group were women in the menopausal period. Bioelectrical activity of PFM was recorded using a surface electromyographic instrument in the supine position. Results of the values obtained in A, B, and C positions were compared using a one-way analysis of variance. Results In position A, the average resting surface electromyography (sEMG) activity of PFM was 6.9±2.6 µV; in position B, the result was 6.9±2.5 µV and in position C, the resting sEMG activity was 5.7±1.8 µV (P=0.0102). The results of the functional bioelectrical activity of PFM were as follows: position A – 20.3±11.8 µV, position B – 19.9±10.6 µV, and position C – 25.3±10.9 µV (P=0.0104). Conclusion The results showed that in the supine position, the PFM achieved the lowest resting activity and the highest functional activity. Therefore, the supine position can be recommended for the diagnosis and therapy of weakened PFM. PMID:28115836

  5. Relationship between lower limb position and pelvic floor muscle surface electromyography activity in menopausal women: a prospective observational study

    Directory of Open Access Journals (Sweden)

    Halski T

    2017-01-01

    Full Text Available Tomasz Halski,1 Kuba Ptaszkowski,2 Lucyna Słupska,1 Robert Dymarek,3 Małgorzata Paprocka-Borowicz2 1Department of Physiotherapy, Opole Medical School, Opole, 2Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, 3Department of Nervous System Diseases, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland Objectives: In physiotherapeutic practice, special attention is being given to the reciprocal anatomical, physiological, and biomechanical relationship of the pelvis and the structures connected to it. However, the scientific literature shows mainly the theoretical information about their mutual connections. The lack of information about these relations from a practical aspect coupled with the paucity of scientific papers on the impact of posture changes on the pelvic floor led the authors to conduct this study. The primary aim of this study was to compare the resting and functional bioelectrical activities of pelvic floor muscles (PFMs depending on three different positions of the lower limbs (positions A, B, and C in the supine position.Materials and methods: This was a prospective observational study evaluating resting and functional activities of the PFM depending on the position of the lower limbs. The study was carried out at the Department and Clinic of Urology, University Hospital in Wroclaw, Poland and the target group were women in the menopausal period. Bioelectrical activity of PFM was recorded using a surface electromyographic instrument in the supine position. Results of the values obtained in A, B, and C positions were compared using a one-way analysis of variance.Results: In position A, the average resting surface electromyography (sEMG activity of PFM was 6.9±2.6 µV; in position B, the result was 6.9±2.5 µV and in position C, the resting sEMG activity was 5.7±1.8 µV (P=0.0102. The results of the functional bioelectrical activity of PFM were as follows: position A – 20.3

  6. Association between walking ability and trunk and lower-limb muscle atrophy in institutionalized elderly women: a longitudinal pilot study.

    Science.gov (United States)

    Ikezoe, Tome; Nakamura, Masatoshi; Shima, Hiroto; Asakawa, Yasuyoshi; Ichihashi, Noriaki

    2015-08-28

    The aim of this study was to investigate the association between walking ability and muscle atrophy in the trunk and lower limbs. Subjects in this longitudinal study were 21 elderly women who resided in nursing homes. The thicknesses of the following trunk and lower-limb muscles were measured using B-mode ultrasound: rectus abdominis, external oblique, internal oblique, transversus abdominis, erector spinae, lumbar multifidus, psoas major, gluteus maximus, gluteus medius, gluteus minimus, rectus femoris, vastus lateralis, vastus intermedius, biceps femoris, gastrocnemius, soleus, and tibialis anterior. Maximum walking speed was used to represent walking ability. Maximum walking speed and muscle thickness were assessed before and after a 12-month period. Of the 17 measured muscles of the trunk and lower limbs, age-related muscle atrophy in elderly women was greatest in the erector spinae, rectus femoris, vastus lateralis, vastus intermedius, and tibialis anterior muscles. Correlation coefficient analyses showed that only the rate of thinning of the vastus lateralis was significantly associated with the rate of decline in maximum walking speed (r = 0.518, p muscle atrophy in the trunk and lower limbs, especially in the vastus lateralis muscle, among frail elderly women.

  7. Angiographic study of upper limb vascularization in a large cohort of hemodialysis patients with critical hand ischemia.

    Science.gov (United States)

    Ferraresi, Roberto; Acuña-Valerio, Jorge; Ferraris, Matteo; Fresa, Marco; Hamade, Meneme; Danzi, Gian B; Gandini, Roberto; Mauri, Giovanni

    2016-12-01

    Critical hand ischemia (CHI) is a not rare condition in patients with end-stage-renal-disease on hemodialysis (HD), and presents devastating consequences due to its impact on life quality. In HD patients CHI may be related to three main conditions: obstruction of the big upper limb arteries, obstruction of the small hand and finger arteries, and the steal effect of a hemodialysis access. The aim of this study was to describe the angiographic pattern of upper limb vascularization and associated cardiovascular risk factors, in a large cohort of consecutive HD patients with CHI studied in our center. In our center 114 HD consecutive patients (age 64±10 years) with a total of 132 upper limbs affected by CHI (21 with rest pain and 93 with tissue loss) underwent angiography in our center. The majority of them were diabetic males. We computed the prevalence of obstructive disease for each vascular segment of the upper limb. Above-the-elbow arteries were mostly spared, while below-the-elbow and hand arteries were extensively affected. We found a stenosis or occlusion in humeral artery (2.3%), radial (61.4%) or ulnar (90.1%) arteries, deep palmar arch (51.5%), superficial palmar arch (58.3%) and digital arteries (72.4%). In 42.4% of cases an ipsilateral functioning arteriovenous fistula was present. CHI in HD patients is a result of below-the-elbow and hand vessel obstruction and is not primarily related to dialysis access.

  8. Simulation study for the Stratospheric Inferred Wind (SIW) sub-millimeter limb sounder

    Science.gov (United States)

    Baron, Philippe; Murtagh, Donal; Eriksson, Patrick; Ochiai, Satoshi

    2017-04-01

    The Stratospheric Inferred Wind is a micro satellite mission studied within the Swedish Innosat program. The objective of the Innosat program is to launch a scientific satellite every two years [1]. SIW has been selected together with two other missions as a candidate for the 2nd launch planned in 2020. If realized, SIW will be the first sub-millimetre (SMM) satellite mission designed for measuring horizontal wind between 30-80 km. It has been shown that such systems can provide relevant wind information in this altitude range where other satellite techniques lack sensitivity [2,3]. The other objective of the mission will be to continue the stratospheric monitoring at a time in which the current observing systems will probably be ended. SIW is equipped with a small payload (40x40x44 cm3, 17 kg and power of 47 W) consisting of a radiometer cooled to 70 K, an auto-correlator spectrometer (8 GHz bandwidth, 1 MHz resolution), and an antenna of 30 cm. The atmospheric limb will be scanned from 10 to 80 km at two perpendicular directions in order to reconstruct the horizontal wind vectors from the measured line-of-sight winds. Those are obtained from the small Doppler shift of molecular lines contained in two spectral bands simultaneously measured with the double-side band radiometer. One of the bands is centred at 655 GHz to measure a cluster of strong O3 lines. It is the best spectral band for wind measurements [4]. The second band is centred near 625 GHz, and together with the first band, it will allow us to measure a large number of molecules relevant for studying the stratospheric dynamics and chemistry (N2O, H2O, ClO, HCl, BrO, NO, HNO3,...). The 655 GHz O3 lines also provide temperature between 10-80 km with similar performances as those obtained if an oxygen line would have been used instead. In this presentation we will introduce SIW and discuss the measurement performances derived from simulations studies. [1] http://www.ohb.de/press-releases-details/ohb-sweden

  9. The ArtAssist Device in chronic lower limb ischemia. A pilot study.

    Science.gov (United States)

    Louridas, G; Saadia, R; Spelay, J; Abdoh, A; Weighell, W; Arneja, A S; Tanner, J; Guzman, R

    2002-03-01

    Patients with chronic critical limb ischemia following a failed bypass graft or with non-reconstructable distal disease diagnosed angiographically, have a very poor prognosis. This is a prospective pilot study to assess the influence of the ArtAssist Device on pedal blood flow and amputation rate. Thirty-three legs in 25 patients were evaluated. Ten legs presented with rest pain, and 23 legs with tissue loss. Nine legs had previously undergone bypass surgery. At a mean follow-up of 3 months, 14 (42%) legs were amputated, and 19 (58%) were saved. Eleven of the amputated legs were in patients with chronic renal failure, a known risk factor. The amputation rate, excluding this group, was 13.6% (3/22). Toe pressures measured initially and after 3 months on the pump showed a significant improvement (p=0.03). Forty percent of patients presenting with rest pain improved, while 26% of foot ulcers healed on the pump. Mortality rate was 12%. The results from this prospective study are encouraging but need to be validated in a larger prospective randomized study.

  10. Study of trace gases in the Martian atmosphere: Groundbased observation using SUBARU/IRCS and development of radiative transfer model for MEX/PFS limb observation

    Science.gov (United States)

    Aoki, S.; Nakagawa, H.; Kasaba, Y.; Giuranna, M.; Geminale, A.; Sindoni, G.; Sagawa, H.; Mendrok, J.; Kasai, Y.; Formisano, V.

    2012-09-01

    We observed Martian atmosphere to investigate CH4, H2O, and HDO on 30 November 2011, 4-5 January 2012, and 12 April 2012 using SUBARU/ IRCS. This observation aims to verify CH4 on Mars, constrain its source, and investigate the distribution of H2O/HDO ratio. Our observation covered possible source areas of CH4, i.e. the areas where the extend plumes of CH4 were detected by previous groundbased and MEX/PFS observations [1,2] and the potential mud volcanism areas [3,4]. This paper will show some preliminary results. Vertical profiles of these trace gases are crucial for understanding their chemistry and transportation. Limb observations by MEX/PFS are a powerful tool to retrieve vertical profiles of H2O, CO, and CH4. For this purpose, we adapted the SARTre model, a radiative transfer code which includes multiple scattering for limb geometry observations developed for the terrestrial atmosphere [5], to the Martian atmosphere. In order to validate our model, SARTre model for Martian limb, we first compared of our synthetic spectra in nadir geometry with the result from ARS [6] which has been widely used for previous studies of MEX/PFS nadir-observation. We concluded that the difference between them is small offset (below 3%) in the spectral range between 3000 and 3030 cm-1.

  11. Muscle precursor cells in the developing limbs of two isopods (Crustacea, Peracarida): an immunohistochemical study using a novel monoclonal antibody against myosin heavy chain.

    Science.gov (United States)

    Kreissl, S; Uber, A; Harzsch, S

    2008-05-01

    In the hot debate on arthropod relationships, Crustaceans and the morphology of their appendages play a pivotal role. To gain new insights into how arthropod appendages evolved, developmental biologists recently have begun to examine the expression and function of Drosophila appendage genes in Crustaceans. However, cellular aspects of Crustacean limb development such as myogenesis are poorly understood in Crustaceans so that the interpretative context in which to analyse gene functions is still fragmentary. The goal of the present project was to analyse muscle development in Crustacean appendages, and to that end, monoclonal antibodies against arthropod muscle proteins were generated. One of these antibodies recognises certain isoforms of myosin heavy chain and strongly binds to muscle precursor cells in malacostracan Crustacea. We used this antibody to study myogenesis in two isopods, Porcellio scaber and Idotea balthica (Crustacea, Malacostraca, Peracarida), by immunohistochemistry. In these animals, muscles in the limbs originate from single muscle precursor cells, which subsequently grow to form multinucleated muscle precursors. The pattern of primordial muscles in the thoracic limbs was mapped, and results compared to muscle development in other Crustaceans and in insects.

  12. Barriers and Facilitators of Participation in Sports: A Qualitative Study on Dutch Individuals with Lower Limb Amputation

    Science.gov (United States)

    Bragaru, Mihai; van Wilgen, C. P.; Geertzen, Jan H. B.; Ruijs, Suzette G. J. B.; Dijkstra, Pieter U.; Dekker, Rienk

    2013-01-01

    Introduction Although individuals with lower limb amputation may benefit from participation in sports, less than 40% do so. Aim To identify the barriers and facilitators that influence participation in sports for individuals with lower limb amputation. Design Qualitative study. Participants Twenty six individuals with lower limb amputation, all originating from the Dutch provinces of Groningen and Drenthe, of which 13 athletes. Methods Semi-structured interviews were used to gather information. Following thematic analysis, emerging themes were organized in three categories Technical, Social and Personal. Results Sport was perceived as enjoyable activity that would help participants to become and stay healthy, improve the number of social contacts, reduce phantom pain and decrease daily tension. Inadequate facilities, problematic transportation, trivialization from others, poor health and lack of motivation or the lack of a sports partner were barriers commonly mentioned by non-athletes. Remarkably, while all athletes were successful prosthetic users, the majority chose to participate in sports for which prosthesis was neither required nor needed. Conclusions Each individual with lower limb amputation needs to be counselled according to the barriers and facilitators he/she personally experiences. Athletes appeared to be more proactive in searching for a solution and also appeared less discouraged by failing. PMID:23533655

  13. Bihemispheric repetitive transcranial magnetic stimulation combined with intensive occupational therapy for upper limb hemiparesis after stroke: a preliminary study.

    Science.gov (United States)

    Yamada, Naoki; Kakuda, Wataru; Kondo, Takahiro; Shimizu, Masato; Mitani, Sugao; Abo, Masahiro

    2013-12-01

    We investigated the safety, feasibility, and efficacy of the combination of bihemispheric repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) for upper limb hemiparesis in poststroke patients. The study participants were eight poststroke patients with upper limb hemiparesis (age at intervention: 62.8±4.9 years, time after stroke: 84.3±87.2 months, mean±SD). During 15 days of hospitalization, each patient received 10 sessions of 40-min bihemispheric rTMS and 240-min intensive OT (120-min one-to-one training and 120-min self-training). One session of bihemispheric rTMS comprised the application of both 1 and 10 Hz rTMS (2000 stimuli for each hemisphere). The Fugl-Meyer Assessment, Wolf Motor Function Test, and the Modified Ashworth Scale were administered on the day of admission and at discharge. All patients completed the treatment without any adverse effects. Motor function of the affected upper limb improved significantly, on the basis of changes in Fugl-Meyer Assessment and Wolf Motor Function Test (Ptherapy for poststroke hemiparetic patients, and improved motor function of the hemiparetic upper limb in poststroke patients. The findings provide a new avenue for the treatment of patients with poststroke hemiparesis.

  14. Barriers and facilitators of participation in sports: a qualitative study on Dutch individuals with lower limb amputation.

    Directory of Open Access Journals (Sweden)

    Mihai Bragaru

    Full Text Available INTRODUCTION: Although individuals with lower limb amputation may benefit from participation in sports, less than 40% do so. AIM: To identify the barriers and facilitators that influence participation in sports for individuals with lower limb amputation. DESIGN: Qualitative study. PARTICIPANTS: Twenty six individuals with lower limb amputation, all originating from the Dutch provinces of Groningen and Drenthe, of which 13 athletes. METHODS: Semi-structured interviews were used to gather information. Following thematic analysis, emerging themes were organized in three categories Technical, Social and Personal. RESULTS: Sport was perceived as enjoyable activity that would help participants to become and stay healthy, improve the number of social contacts, reduce phantom pain and decrease daily tension. Inadequate facilities, problematic transportation, trivialization from others, poor health and lack of motivation or the lack of a sports partner were barriers commonly mentioned by non-athletes. Remarkably, while all athletes were successful prosthetic users, the majority chose to participate in sports for which prosthesis was neither required nor needed. CONCLUSIONS: Each individual with lower limb amputation needs to be counselled according to the barriers and facilitators he/she personally experiences. Athletes appeared to be more proactive in searching for a solution and also appeared less discouraged by failing.

  15. Multimodal optical measurement for study of lower limb tissue viability in patients with diabetes mellitus

    Science.gov (United States)

    Dremin, Viktor V.; Zherebtsov, Evgeny A.; Sidorov, Victor V.; Krupatkin, Alexander I.; Makovik, Irina N.; Zherebtsova, Angelina I.; Zharkikh, Elena V.; Potapova, Elena V.; Dunaev, Andrey V.; Doronin, Alexander A.; Bykov, Alexander V.; Rafailov, Ilya E.; Litvinova, Karina S.; Sokolovski, Sergei G.; Rafailov, Edik U.

    2017-08-01

    According to the International Diabetes Federation, the challenge of early stage diagnosis and treatment effectiveness monitoring in diabetes is currently one of the highest priorities in modern healthcare. The potential of combined measurements of skin fluorescence and blood perfusion by the laser Doppler flowmetry method in diagnostics of low limb diabetes complications was evaluated. Using Monte Carlo probabilistic modeling, the diagnostic volume and depth of the diagnosis were evaluated. The experimental study involved 76 patients with type 2 diabetes mellitus. These patients were divided into two groups depending on the degree of complications. The control group consisted of 48 healthy volunteers. The local thermal stimulation was selected as a stimulus on the blood microcirculation system. The experimental studies have shown that diabetic patients have elevated values of normalized fluorescence amplitudes, as well as a lower perfusion response to local heating. In the group of people with diabetes with trophic ulcers, these parameters also significantly differ from the control and diabetes only groups. Thus, the intensity of skin fluorescence and level of tissue blood perfusion can act as markers for various degrees of complications from the beginning of diabetes to the formation of trophic ulcers.

  16. In vivo longitudinal micro-CT study of bent long limb bones in rat offspring.

    Science.gov (United States)

    De Schaepdrijver, Luc; Delille, Peter; Geys, Helena; Boehringer-Shahidi, Christian; Vanhove, Christian

    2014-07-01

    Micro-computed X-ray tomography (micro-CT) has been reported as a reliable method to assess ex vivo rat and rabbit fetal skeletons in embryo-fetal developmental toxicity studies. Since micro-CT is a non-invasive imaging modality it has the potential for longitudinal, in vivo investigation of postnatal skeletal development. This is the first paper using micro-CT to assess the reversibility of drug-induced bent long bones in a longitudinal study from birth to early adulthood in rat offspring. Analysis of the scans obtained on postnatal Day 0, 7, 21 and 80 showed complete recovery or repair of the bent long limb bones (including the scapula) within the first 3 weeks. When assessing risk the ability to demonstrate recovery is highly advantageous when interpreting such transient skeletal change. In summary, in vivo micro-CT of small laboratory animals can aid in non-clinical safety assessment, particularly for specific mechanistic purposes or to address a particular concern in developmental biology.

  17. A feasibility study of an upper limb rehabilitation system using Kinect and computer games.

    Science.gov (United States)

    Pastor, Isaac; Hayes, Heather A; Bamberg, Stacy J M

    2012-01-01

    A new low-cost system for rehabilitation of the impaired upper limb for stroke survivors is presented. A computer game was developed specifically for this purpose and the user's impaired upper extremity is tracked using a downward-pointed Kinect, an inexpensive motion capture system commercially available from Microsoft. A Kalman filter was implemented to reduce data jittering. Patients are required to move their impaired arm, sliding it on top of a transparent support, in order to play the game. The game is personalized to the patient through specific settings that adapt to the patient's range of motion and motor control at the start of the game as well as performance during the game. The final score is proportional to the arm's movement speed. A feasibility study was carried out with one stroke survivor. The game was played for ten days and usability surveys were answered before and after the study. The patient was engaged with the game, found it easy to understand and reported willingness to use it in the home environment and enjoyment of the use in the clinic.

  18. A cross sectional study of prevalence, risk factors, population attributable fractions and pathology for foot and limb lesions in preweaning piglets on commercial farms in England

    Directory of Open Access Journals (Sweden)

    Ossent Pete

    2009-08-01

    Full Text Available Abstract Background In a cross sectional study of 88 indoor and outdoor English pig farms, the prevalence of foot and limb lesions in 2843 preweaning piglets aged 1–4 weeks from 304 litters was recorded. The environmental risks for the prevalence of lesions and population attributable fractions were calculated. The risks for lesions in piglets were compared with those for limb and body lesions in their mothers. A small number of piglets with each type of lesion were examined post mortem to elucidate the pathology of the clinical lesions observed. Results The prevalence of sole bruising, sole erosion, skin abrasion and swollen joints or claws in 2843 piglets was 49.4% (1404, 15.5% (441, 43.6% (1240 and 4.7% (143 respectively. The prevalence of all foot and limb lesions was higher in indoor housed piglets than in outdoor housed piglets. The prevalence of sole bruising (OR 0.3 and skin abrasion (OR 0.6 decreased with each week of age from 1–4 weeks, but there was no significant association between piglet age and the prevalence of sole erosion or swollen joints and claws. There was an increased prevalence of sole bruising (OR 3.0 and swollen joints or claws (OR 3.0 and a decreased prevalence of skin abrasion (OR 0.3, piglets ≤ 1-week old, in piglets housed on slatted floors, compared with those on solid concrete floors with bedding. There was an increased risk of sole erosion associated with piglets housed on partly slatted floors with no bedding (OR 2.4 and partly slatted floors with small amounts of bedding (OR 2.9 compared with piglets housed on solid concrete floors with bedding in all areas of the pen. Post mortem examination of feet with lesions indicated that internal pathological changes were frequently more severe than the degree of external damage suggested. Conclusion Piglets housed outdoors had a very low prevalence of foot and limb injuries. Indoors, no one floor type was ideal to minimise all piglet foot and limb injuries and the

  19. Observational retrospective study on the effectiveness of sequential graduated intermittent pneumatic compression therapy of lower limbs edema

    Directory of Open Access Journals (Sweden)

    Elena Toma

    2016-09-01

    Full Text Available The main aim of the study is to evaluate the effectiveness of sequential graduated intermittent pneumatic compression (SGIPC therapy of lower limbs edema, regardless of its etiology. A retrospective observational study is conducted to determine the effectiveness of a regimen of sequential gradient SGIPC in treating edema of lower limbs. The study is carried out on 90 patients affected by different stages of edema and evaluated at a Wound Care Clinic for one month. Medical records data have been collected after the first, the third, and the fifth hour-long treatment session. The inclusion criteria are: (1 presence of edema to one limb, at least, regardless of etiology, (2 presence of both pain and feeling of heaviness (or tiredness of the limb, (3 non-use of bandages or elastic stocking/knee socks, and (4 availability of complete data about the edema size monitoring. The exclusion criteria are: (1 presence of infected wounds, (2 severe arteriosclerosis or other ischemic vascular diseases, (3 severe congestive cardiac failure, (4 known or suspected acute deep vein thrombosis (DVT, (5 thrombophlebitis or Pulmonary Embolism (PE, and (6 hypertension (Systolic Pressure greater than 170mmHg. The following parameters are considered as grade of improvement: the decrease of the limb circumference in at least two measurement points between the foot, ankle, and calf; the disappearance of at least one of the symptoms of pain and feeling of heaviness of the limb; improved mobility. A Flowtron ACS 900 system is used, for the treatment, consisting of a pump, connected to two (calf and thigh brace with individual tubes, applying a pneumatic compression, graduated in the air chamber, with sequential cycle in three compartments (one at the calf level and two at the thigh level, at a pressure of 45mmHg, with inflation cycles intermittent alternating. Inflation time 12s, time of deflation 48s. In addition, braces corresponding to limb size have been used

  20. 169 patients with postoperative breast cancer on exercising the function of limbs and investigating quality of life:a clinical study

    Institute of Scientific and Technical Information of China (English)

    Xiaodong Xie; Zhaozhe Liu; Shuxian Qu; Fang Guo; Zhendong Zheng; Yongye Liu; Min Song; Xue Bai

    2010-01-01

    Objective:The aim of this study was to observe the physical training influence on the limbs of postoperative breast cancer patients with adjuvant chemotherapy and do dual-response quality of life(QOL)according to clinical characteristics of patients.Methods:from February 2007 to December 2008,169 patients with postoperative breast cancer were included.We put all the patients into two groups randomly,including 80 patients in the treatment group and 89 patients in the control group.When the cycle of chemotherapy has been completed or on the 28th day postoperatively,all the patients need to be measured the function of upper limbs.The patients in the treatment group perform the rehabilitative training by our rehabilitation gymnastics,and the patients in the control group perform the rehabilitative training by themselves.When 6 cycles of adjuvant chemotherapy have been completed,we evaluated the differences of the function of upper limbs in patients.At the same time,we hand out the QOL questionnaire to patients and their doctors for doing the two-way assessment.Results:Compared with patients in control group,patients in treatment group have better in the abductive angle of shoulders and myodynamia(P= 0.000).By analysis on 156(92.3%)questionnaires,we found that the match rate of doctors and patients with physiological functions and physical symptoms were better than mentation and relationships.The better match rate between doctors and patients in QOL questionnaires suggested that the QOL of patients would be improved in the higher rate.Conclusion:Exercising the function of limbs in early could be beneficial to the patients with postoperative breast cancer and effectively improve patient's QOL.Meanwhile,we put doctors' questionnaires in the assessment of patients' QOL,and the results show that the assessment of patients' QOL is more objective and complete.

  1. Preliminary study of laser doppler perfusion signal by wavelet transform in patients with critical limb ischemia before and after revascularization.

    Science.gov (United States)

    Ticcinelli, Valentina; Martini, Romeo; Bagno, Andrea

    2014-01-01

    The haemodynamics of skin microcirculation can be quantitatively evaluated by Laser Doppler Fluxmetry (LDF). LDF signal in human skin shows periodic oscillations. Spectral analysis by wavelet transform displays six characteristic frequency intervals (FI) from 0.005 to 2 Hz, related to distinct vascular structures activities: heart (0.6-2 Hz), sympathetic respiratory (0.145-0.6 Hz), myogenic (0.052-0.145 Hz), local sympathetic nerve (0.021-0.052 Hz) and endothelial cells NO dependent (0.0095-0.021 Hz) and NO independent (0.005-0.0095 Hz). The most advanced stage of peripheral arterial obstructive disease is the critical limb ischemia (CLI), which causes the reduction of blood perfusion threatening limb viability. Besides macrocirculatory alterations, many studies have shown microvascular misdistribution of skin blood flow as the main factor that leads patients to CLI. Revascularization can save limb and patient's life, too. In the present study, LDF signals have been recorded on the skin of the foot dorsum in 15 patients suffering from CLI. LDF signals have been analyzed before and after limb revascularization by means of the wavelet analysis. Significant changes in frequency distribution before and after limb revascularization have been detected: the median normalized values of spectral power increases for 49.8% (p = 0.0341) in the frequency range 0.050328-0.053707 Hz, whereas spectral power decreases for 77.1% (p = 0.0179) in the frequency range 0.018988-0.029284 Hz. We can conclude that changes in the frequency intervals occur after revascularization, shifting from a prevailing endothelial activity toward a prevailing sympathetic activity.

  2. The Armeo Spring as training tool to improve upper limb functionality in multiple sclerosis: a pilot study

    Directory of Open Access Journals (Sweden)

    Kerkhofs Lore

    2011-01-01

    Full Text Available Abstract Background Few research in multiple sclerosis (MS has focused on physical rehabilitation of upper limb dysfunction, though the latter strongly influences independent performance of activities of daily living. Upper limb rehabilitation technology could hold promise for complementing traditional MS therapy. Consequently, this pilot study aimed to examine the feasibility of an 8-week mechanical-assisted training program for improving upper limb muscle strength and functional capacity in MS patients with evident paresis. Methods A case series was applied, with provision of a training program (3×/week, 30 minutes/session, supplementary on the customary maintaining care, by employing a gravity-supporting exoskeleton apparatus (Armeo Spring. Ten high-level disability MS patients (Expanded Disability Status Scale 7.0-8.5 actively performed task-oriented movements in a virtual real-life-like learning environment with the affected upper limb. Tests were administered before and after training, and at 2-month follow-up. Muscle strength was determined through the Motricity Index and Jamar hand-held dynamometer. Functional capacity was assessed using the TEMPA, Action Research Arm Test (ARAT and 9-Hole Peg Test (9HPT. Results Muscle strength did not change significantly. Significant gains were particularly found in functional capacity tests. After training completion, TEMPA scores improved (p = 0.02, while a trend towards significance was found for the 9HPT (p = 0.05. At follow-up, the TEMPA as well as ARAT showed greater improvement relative to baseline than after the 8-week intervention period (p = 0.01, p = 0.02 respectively. Conclusions The results of present pilot study suggest that upper limb functionality of high-level disability MS patients can be positively influenced by means of a technology-enhanced physical rehabilitation program.

  3. Transverse limb reduction defects after chorion villus sampling: a retrospective cohort study. GIDEF--Gruppo Italiano Diagnosi Embrio-Fetali.

    Science.gov (United States)

    Mastroiacovo, P; Tozzi, A E; Agosti, S; Bocchino, G; Bovicelli, L; Dalprà, L; Carbone, L D; Lituania, M; Luttichau, A; Mantegazza, F

    1993-11-01

    A retrospective cohort study was performed in five Italian obstetrical centres from 1984 to 1991 in order to verify the association between chorionic villus sampling (CVS) and transverse limb reduction defects (TLRDs). TLRD rates by period of gestation at CVS were calculated, and the study's results were compared with data from the general population. Of the 3430 pregnancies for which CVS was performed, 2759 had a known outcome. The overall rate for TLRDs was 1 in 1143 CVS pregnancies, four times higher than that of the general population in Italy (1 in 4458). The rate of TLRDs was 2.9/1000 for CVS performed at 9 weeks' gestation and 1.0/1000 for CVS at 10 weeks' gestation. A scalp defect was detected in a pregnancy in which CVS was performed at 10 weeks. A high proportion of pregnancies lost to follow-up and the poor quality of the data may have affected the results. Nevertheless, our results suggest an association between CVS carried out at less than 10 weeks' gestation and TLRDs which is consistent with the findings of other studies. CVS should not be prepared at less than 10 weeks' gestation until additional evidence is obtained.

  4. Study design and methods of the BoTULS trial: a randomised controlled trial to evaluate the clinical effect and cost effectiveness of treating upper limb spasticity due to stroke with botulinum toxin type A

    Directory of Open Access Journals (Sweden)

    Graham Laura

    2008-10-01

    Full Text Available Abstract Background Following a stroke, 55–75% of patients experience upper limb problems in the longer term. Upper limb spasticity may cause pain, deformity and reduced function, affecting mood and independence. Botulinum toxin is used increasingly to treat focal spasticity, but its impact on upper limb function after stroke is unclear. The aim of this study is to evaluate the clinical and cost effectiveness of botulinum toxin type A plus an upper limb therapy programme in the treatment of post stroke upper limb spasticity. Methods Trial design : A multi-centre open label parallel group randomised controlled trial and economic evaluation. Participants : Adults with upper limb spasticity at the shoulder, elbow, wrist or hand and reduced upper limb function due to stroke more than 1 month previously. Interventions : Botulinum toxin type A plus upper limb therapy (intervention group or upper limb therapy alone (control group. Outcomes : Outcome assessments are undertaken at 1, 3 and 12 months. The primary outcome is upper limb function one month after study entry measured by the Action Research Arm Test (ARAT. Secondary outcomes include: spasticity (Modified Ashworth Scale; grip strength; dexterity (Nine Hole Peg Test; disability (Barthel Activities of Daily Living Index; quality of life (Stroke Impact Scale, Euroqol EQ-5D and attainment of patient-selected goals (Canadian Occupational Performance Measure. Health and social services resource use, adverse events, use of other antispasticity treatments and patient views on the treatment will be compared. Participants are clinically reassessed at 3, 6 and 9 months to determine the need for repeat botulinum toxin type A and/or therapy. Randomisation : A web based central independent randomisation service. Blinding : Outcome assessments are undertaken by an assessor who is blinded to the randomisation group. Sample size : 332 participants provide 80% power to detect a 15% difference in treatment

  5. 连续腰麻与腰-硬联合麻醉用于下肢手术的临床对比研究%Clinical comparative study of continuous spinal anesthesia and combined epidural-spinal anesthesia used for lower limb surgery

    Institute of Scientific and Technical Information of China (English)

    浦鹏飞; 阎位明; 桑达; 艾莎杜

    2012-01-01

    Objective To explore the clinical anesthetic effect, postoperative complications of continuous spinal anesthesia, through the continuous spinal anesthesia (CSA) and combined epidural-spinal anesthesia (CESA) used for lower limb surgery. Methods 70 patients who underwent lower limb surgery were collected and randomly divided into CSA group and CESA group, with 35 cases in each group. Both groups were punctured at L2_3 or L3_4 vertebral gap, after the success of the CSA group, spinocath tube were placed 1-2 cm to subarachnoid and then injected 0.5% Levobupivacaine 1.2 mL, for the CESA group injected 0.5% Levobupivacaine 2 mL through the needle who within the needle of combined epidural-spinal anesthesia, then placed a catheter 3-4 cm to the head-end epidural through the needle. The changes of blood pressure and heart rate parameters, sensory and motor block parameters, the Bromage score, plus the adjuvant drugs, adverse reactions and complications of patients before anesthesia and after anesthesia between the two groups were observed and recorded. Results Between two groups, the minimum value of mean arterial pressure after anesthesia was significantly decreased than preoperative (P 0.05); the adverse reactions and auxiliary medicine dosage in CESA group were significantly more than those in CSA group (P < 0.05). Conclusion Continuous spinal anesthesia applied in lower limb operation has good effects of anesthesia, hemodynamic stability, strong controllability and less adverse reactions, etc, especially for elderly patients with lower limb operation.%目的 旨在通过应用连续腰麻(CSA)和腰-硬联合麻醉(CESA)行下肢手术的对比,探讨CSA的临床麻醉效果、术后并发症等情况.方法 收集拟行骨科下肢手术的患者70例,随机分为CSA组和CESA组,各35例.两组患者均选择L2~3或L3~4椎间隙穿刺,成功后CSA组向蛛网膜下腔置入Spinocath管1~2 cm并注入0.5%左旋布比卡因1.2 mL,CESA组通过腰-硬联合麻

  6. Analysis of voluntary opening Ottobock Hook and Hosmer Hook for upper limb prosthetics: a preliminary study.

    Science.gov (United States)

    Hashim, Nur Afiqah; Abd Razak, Nasrul Anuar Bin; Gholizadeh, Hossein; Osman, Noor Azuan Abu

    2016-11-19

    There are a number of prosthetic terminal devices which offer functional restoration to individuals with upper limb deficiencies. Hosmer and Ottobock are major commercial hook providers for prosthetic terminal devices. The concern of this paper is to analyse the voluntary opening (VO) Ottobock model 10A18 and Hosmer model 99P hooks (one band) during opening operation and to find out favourable features in the design. Two tests were conducted to analyse the performance of both hooks. The first test used a simple bench tool to investigate cable excursion and hook opening angle and the second test used force sensor to find out the force supplied at a different hook opening angle. The study found that the average cable excursion for both hooks is approximately 30% less than the hook's opening span with the force at the hook's tip section being inversely proportional to the force at the lateral section. Ottobock 10A18 has a better control for grasping larger objects, while Hosmer 99P has the highest average force at the tip section but yet less efficient in generating adequate force for activities of daily living. Favourable features identified are low cable excursion per hook opening span and balance lateral to hook tip pinch force.

  7. Study on development of active-passive rehabilitation system for upper limbs: Hybrid-PLEMO

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, T; Jin, Y; Fukushima, K; Akai, H; Furusho, J [Department of Mechanical Engineering, Graduate School of Engineering, Osaka University, Osaka (Japan)], E-mail: kikuchi@mech.eng.osaka-u.ac.jp

    2009-02-01

    In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. Active-type (motor-driven) haptic devices can realize a lot of varieties of haptics. But they basically require high-cost safety system. On the other hand, passive-type (brake-based) haptic devices have inherent safety. However, the passive robot system has strong limitation on varieties of haptics. There are not sufficient evidences to clarify how the passive/active haptics effect to the rehabilitation of motor skills. In this paper, we developed an active-passive-switchable rehabilitation system with ER clutch/brake device named 'Hybrid-PLEMO' in order to address these problems. In this paper, basic structures and haptic control methods of the Hybrid-PLEMO are described.

  8. Four cases of trisomy 18 syndrome with limb reduction malformations.

    OpenAIRE

    Christianson, A L; Nelson, M. M.

    1984-01-01

    Limb reduction malformations of the arms are well documented in the trisomy 18 syndrome. Four cases of trisomy 18 syndrome with limb reduction malformations of the legs are described and compared with the upper limb malformations.

  9. Effect of position feedback during task-oriented upper-limb training after stroke: Five-case pilot study

    Directory of Open Access Journals (Sweden)

    Birgit I. Molier, MSc

    2011-11-01

    Full Text Available Feedback is an important element in motor learning during rehabilitation therapy following stroke. The objective of this pilot study was to better understand the effect of position feedback during task-oriented reach training of the upper limb in people with chronic stroke. Five subjects participated in the training for 30 minutes three times a week for 6 weeks. During training, subjects performed reaching movements over a predefined path. When deviation from this path occurred, shoulder and elbow joints received position feedback using restraining forces. We recorded the amount of position feedback used by each subject. During pre- and posttraining assessments, we collected data from clinical scales, isometric strength, and workspace of the arm. All subjects showed improvement on one or several kinematic variables during a circular motion task after training. One subject showed improvement on all clinical scales. Subjects required position feedback between 7.4% and 14.7% of training time. Although augmented feedback use was limited, kinematic outcome measures and movement performance during training increased in all subjects, which was comparable with other studies. Emphasis on movement errors at the moment they occur may possibly stimulate motor learning when movement tasks with sufficiently high levels of difficulty are applied.

  10. Biofuel: a comparative case study

    OpenAIRE

    Siddiqui, Aamir; Kading, Christopher; Carter, Kasey

    2013-01-01

    Approved for public release; distribution is unlimited This project analyzes the governments role in the commercialization of biofuel by comparing biofuel commercialization efforts to those of nuclear power and nanotechnology commercialization. The PESTEL framework is applied to nuclear power and nanotechnology to identify key factors relevant to successful commercialization. These success factors are compared to current government biofuel policies to infer the likelihood of successful bio...

  11. Brain Function and Upper Limb Outcome in Stroke: A Cross-Sectional fMRI Study.

    Directory of Open Access Journals (Sweden)

    Floor E Buma

    Full Text Available The nature of changes in brain activation related to good recovery of arm function after stroke is still unclear. While the notion that this is a reflection of neuronal plasticity has gained much support, confounding by compensatory strategies cannot be ruled out. We address this issue by comparing brain activity in recovered patients 6 months after stroke with healthy controls.We included 20 patients with upper limb paresis due to ischemic stroke and 15 controls. We measured brain activation during a finger flexion-extension task with functional MRI, and the relationship between brain activation and hand function. Patients exhibited various levels of recovery, but all were able to perform the task.Comparison between patients and controls with voxel-wise whole-brain analysis failed to reveal significant differences in brain activation. Equally, a region of interest analysis constrained to the motor network to optimize statistical power, failed to yield any differences. Finally, no significant relationship between brain activation and hand function was found in patients. Patients and controls performed scanner task equally well.Brain activation and behavioral performance during finger flexion-extensions in (moderately well recovered patients seems normal. The absence of significant differences in brain activity even in patients with a residual impairment may suggest that infarcts do not necessarily induce reorganization of motor function. While brain activity could be abnormal with higher task demands, this may also introduce performance confounds. It is thus still uncertain to what extent capacity for true neuronal repair after stroke exists.

  12. A prospective study on the immunophenotypic characterization of limb girdle muscular dystrophies 2 in India

    Directory of Open Access Journals (Sweden)

    Atchayaram Nalini

    2015-01-01

    Full Text Available Objective: In this prospective study conducted over 2 years, 300 nonconsecutive cases of autosomal recessive limb girdle muscular dystrophies (AR-LGMD were characterized, based on phenotypic features, biochemical findings, electrophysiological studies, muscle immunohistochemistry (IHC, and western blot (WB analysis. Methods: Muscle biopsy was performed in 280 index cases. 226 biopsies were subjected for IHC, and, 176 of these for WB analysis. Results: A total of 246 patients were finally analyzed. This figure included 20 affected siblings. LGMD2B was the most common form and comprised of 33.3% (n = 82 of the entire cohort. This was followed by alpha-dystroglycanopathies with 61 (24.79% patients (LGMD2I in 15, 2K in 10 and combined deficiency of both in the remaining. LGMD 2C-F was present in 35 (14.23% cases and LGMD2A in 22 (10.2% cases, and were identified by routine WB, densitometry method and autocatalytic assay. LGMD2G was present in 8 patients (3.25%, and LGMD2H and 2J in 2 cases each, respectively. Conclusions: For the first time, we have identified patients with LGMD2G, 2H, 2I, and 2K by the WB technique. These may be the common forms of autosomal recessive (AR-LGMD′s among Indian patients and need identification for prognostication and appropriate counseling. Although not a nationwide study, our data is sufficient to provide information about the relative proportions of various LGMD2 subtypes in India. Diagnosing LGMD2 based on classical clinical features, IHC and WB is fairly sensitive and specific; however, further genetic studies are required to confirm the diagnosis.

  13. A study of computer-related upper limb discomfort and computer vision syndrome.

    Science.gov (United States)

    Sen, A; Richardson, Stanley

    2007-12-01

    Personal computers are one of the commonest office tools in Malaysia today. Their usage, even for three hours per day, leads to a health risk of developing Occupational Overuse Syndrome (OOS), Computer Vision Syndrome (CVS), low back pain, tension headaches and psychosocial stress. The study was conducted to investigate how a multiethnic society in Malaysia is coping with these problems that are increasing at a phenomenal rate in the west. This study investigated computer usage, awareness of ergonomic modifications of computer furniture and peripherals, symptoms of CVS and risk of developing OOS. A cross-sectional questionnaire study of 136 computer users was conducted on a sample population of university students and office staff. A 'Modified Rapid Upper Limb Assessment (RULA) for office work' technique was used for evaluation of OOS. The prevalence of CVS was surveyed incorporating a 10-point scoring system for each of its various symptoms. It was found that many were using standard keyboard and mouse without any ergonomic modifications. Around 50% of those with some low back pain did not have an adjustable backrest. Many users had higher RULA scores of the wrist and neck suggesting increased risk of developing OOS, which needed further intervention. Many (64%) were using refractive corrections and still had high scores of CVS commonly including eye fatigue, headache and burning sensation. The increase of CVS scores (suggesting more subjective symptoms) correlated with increase in computer usage spells. It was concluded that further onsite studies are needed, to follow up this survey to decrease the risks of developing CVS and OOS amongst young computer users.

  14. Critical evaluation of endovascular surgery for limb salvage.

    Science.gov (United States)

    Lucas, Layla C; Mills, Joseph L

    2011-01-01

    Rest pain, tissue loss, and gangrene are manifestations of critical limb ischemia caused by peripheral arterial disease and define a patient subgroup at highest risk for major limb amputation. Patients with nonhealing lower extremity wounds should be screened for the risk factors for peripheral arterial disease and offered noninvasive vascular testing. The diagnosis of critical limb ischemia mandates prompt institution of medical and surgical management to achieve the best chance of limb salvage. Surgical intervention has evolved from primary amputation to open bypass to the present era of endovascular therapy. The goals of surgical bypass and endovascular therapy are to improve perfusion sufficiently to permit healing. Despite poorer patency rates and the more frequent need for reintervention, endovascular therapy has been shown in multiple retrospective studies to achieve limb salvage similar to open bypass. Only one large, prospective, randomized controlled trial exists comparing open bypass with endovascular therapy: The Bypass versus Angioplasty in Severe Limb Ischemia of the Leg (BASIL) trial. Close clinical surveillance and serial monitoring of limb perfusion by means of noninvasive arterial studies are needed to determine the need for further vascular intervention. Limb salvage patients suffer from multiple comorbidities and benefit from a multidisciplinary, team approach to care.

  15. Experimental investigation of crustacean swimming with variation of limb structures

    Science.gov (United States)

    Lai, Hong Kuan; Samaee, Milad; Donnell, Geoffrey; Santhanakrishnan, Arvind; Guy, Robert; Lewis, Timothy

    2015-11-01

    Crustaceans such as crayfish and krill swim by rhythmically paddling a set of four to five limbs (known as swimmerets or pleopods) originating from their abdomen. The limb motion in these animals has been observed to follow tail-to-head metachronal wave pattern with an approximate quarter-period inter-limb phase difference. The goal of this study is to investigate the hydrodynamics of this swimming mechanism as a function of inter-limb phase difference, inclusion of hinges in the limbs, and Reynolds number (Re). 2D PIV measurements were conducted on a scaled robotic model of metachronal paddling, consisting of a rectangular tank fitted with stepper motors coupled to a four-bar linkage that actuated four paddles immersed in water-glycerin fluid medium. The inter-limb phase difference was varied from 0% (synchronous paddling) through 50% across Re range of O(10-1000). Two types of limb models were used, including a simple flat plate and a `split-paddle' structure with two flat plates connected halfway with hinges. The results of the study show that limb models with hinges generated increased horizontal (thrust-producing direction) fluid velocity compared to the simple flat plate paddles, suggesting that asymmetry between power and return strokes is important to augment thrust.

  16. Tailor-made rehabilitation approach using multiple types of hybrid assistive limb robots for acute stroke patients: A pilot study.

    Science.gov (United States)

    Fukuda, Hiroyuki; Morishita, Takashi; Ogata, Toshiyasu; Saita, Kazuya; Hyakutake, Koichi; Watanabe, Junko; Shiota, Etsuji; Inoue, Tooru

    2016-01-01

    This article investigated the feasibility of a tailor-made neurorehabilitation approach using multiple types of hybrid assistive limb (HAL) robots for acute stroke patients. We investigated the clinical outcomes of patients who underwent rehabilitation using the HAL robots. The Brunnstrom stage, Barthel index (BI), and functional independence measure (FIM) were evaluated at baseline and when patients were transferred to a rehabilitation facility. Scores were compared between the multiple-robot rehabilitation and single-robot rehabilitation groups. Nine hemiplegic acute stroke patients (five men and four women; mean age 59.4 ± 12.5 years; four hemorrhagic stroke and five ischemic stroke) underwent rehabilitation using multiple types of HAL robots for 19.4 ± 12.5 days, and 14 patients (six men and eight women; mean age 63.2 ± 13.9 years; nine hemorrhagic stroke and five ischemic stroke) underwent rehabilitation using a single type of HAL robot for 14.9 ± 8.9 days. The multiple-robot rehabilitation group showed significantly better outcomes in the Brunnstrom stage of the upper extremity, BI, and FIM scores. To the best of the authors' knowledge, this is the first pilot study demonstrating the feasibility of rehabilitation using multiple exoskeleton robots. The tailor-made rehabilitation approach may be useful for the treatment of acute stroke.

  17. Comparing low-dose intravenous ketamine-midazolam with intravenous morphine with respect to pain control in patients with closed limb fracture

    Science.gov (United States)

    Ahmadi, Omid; Isfahani, Mehdi Nasr; Feizi, Awat

    2014-01-01

    Background: We assessed the effects of low-dose IV ketamine-midazolam versus morphine on pain control in patients with closed limb fracture(s); and also compared the incidence of adverse events (cardio-pulmonary) between two groups. Materials and Methods: This prospective, single-blind, non-inferiority trial randomized consecutive emergency department (ED) patients aged 18-60 years to two groups: Receiving 300-500 mcg/kg ketamine plus 0.03 mg/kg midazolam, or 0.05-0.1 mg/kg morphine. Visual analogue score (VAS) and adverse events were verified during an interval of 30 minutes. Results: Two hundred and thirty — six patients were selected, among whom 207 were males (87.3%). The average age was 29 ± 2, (range, 18-60 years). The VAS score at T30 (i.e., 30 minutes after initial analgesic dose) was significantly decreased compared with VAS score at T0, in both groups. No statistically significant difference, however, was observed between the two groups (–6.1 ± 1.1 versus –6.2 ± 1.0; P = 0.16). With regard to systolic blood pressure and respiratory rate, however, a meaningful difference was noted between the two groups (1.5 ± 6.4 versus –2.1 ± 6.6; P = 0.000 for SBP, and –0.2 ± 1.1 versus –1.1 ± 6.1; P = 0.048 for RR). Conclusion: Low-dose intravenous ketamine plus midazolam has the same analgesic effects as morphine on pain control in trauma patients with closed limb fracture(s), in addition to less respiratory adverse events. PMID:25197290

  18. Comparing low-dose intravenous ketamine-midazolam with intravenous morphine with respect to pain control in patients with closed limb fracture

    Directory of Open Access Journals (Sweden)

    Omid Ahmadi

    2014-01-01

    Full Text Available Background: We assessed the effects of low-dose IV ketamine-midazolam versus morphine on pain control in patients with closed limb fracture(s; and also compared the incidence of adverse events (cardio-pulmonary between two groups. Materials and Methods: This prospective, single-blind, non-inferiority trial randomized consecutive emergency department (ED patients aged 18-60 years to two groups: Receiving 300-500 mcg/kg ketamine plus 0.03 mg/kg midazolam, or 0.05-0.1 mg/kg morphine. Visual analogue score (VAS and adverse events were verified during an interval of 30 minutes. Results: Two hundred and thirty - six patients were selected, among whom 207 were males (87.3%. The average age was 29 ± 2, (range, 18-60 years. The VAS score at T30 (i.e., 30 minutes after initial analgesic dose was significantly decreased compared with VAS score at T0, in both groups. No statistically significant difference, however, was observed between the two groups (-6.1 ± 1.1 versus -6.2 ± 1.0; P = 0.16. With regard to systolic blood pressure and respiratory rate, however, a meaningful difference was noted between the two groups (1.5 ± 6.4 versus -2.1 ± 6.6; P = 0.000 for SBP, and -0.2 ± 1.1 versus -1.1 ± 6.1; P = 0.048 for RR. Conclusion: "Low-dose" intravenous ketamine plus midazolam has the same analgesic effects as morphine on pain control in trauma patients with closed limb fracture(s, in addition to less respiratory adverse events.

  19. Studying Upper-Limb Amputee Prosthesis Use to Inform Device Design

    Science.gov (United States)

    2016-10-01

    taxonomy was applied to classification of the recorded videos via custom tagging software with midi controller interface. The software creates...TERMS Upper Limb Prosthetics, Amputee, Assistive Technology , Motion Capture 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF...we expect to identify shortcomings in current terminal devices and implementations that will inform improvements to existing designs and inspire new

  20. An Experimental Study of the Effect of Periosteal Stripping on Limb Length in Rabbits

    Directory of Open Access Journals (Sweden)

    Ramesh Narula

    2014-04-01

    Conclusion: Circumferential periosteal division with stripping is an ideal procedure for minor length discrepancies or for those with limb inequality undergoing other procedures. It is simple and safe and would not require more than a short period in the hospital. [Arch Clin Exp Surg 2014; 3(2.000: 94-101

  1. The biomechanical interaction between vertebral column and limbs in the horse: a kinematical study

    NARCIS (Netherlands)

    Gómez Álvarez, C.B.

    2007-01-01

    Nowadays, horses have to train and perform in high-level sportive and leisure activities. Injuries of the locomotor system with a decreased functionality or pain of the back are often seen in equine hospitals. In general, the relationship between limb and vertebral column function in mammals is comp

  2. The biomechanical interaction between vertebral column and limbs in the horse: a kinematical study

    NARCIS (Netherlands)

    Gómez Álvarez, C.B.

    2007-01-01

    Nowadays, horses have to train and perform in high-level sportive and leisure activities. Injuries of the locomotor system with a decreased functionality or pain of the back are often seen in equine hospitals. In general, the relationship between limb and vertebral column function in mammals is

  3. Phantom pain and phantom sensations in upper limb amputees : an epidemiological study

    NARCIS (Netherlands)

    Kooijman, CM; Dijkstra, PU; Geertzen, JHB; Elzinga, A; van der Schans, CP

    2000-01-01

    Phantom pain in subjects with an amputated limb is a well-known problem. However, estimates of the prevalence of phantom pain differ considerably in the literature. Various factors associated with phantom pain have been described including pain before the amputation, gender, dominance, and time elap

  4. Mobility of people with lower limb amputations: scales and questionnaires: a review

    OpenAIRE

    Rommers, G. M.; Groothoff, J. W.; Eisma, W.H.

    2001-01-01

    Objective and design: A systematic literature review to compare mobility scales used for lower limb amputees. A literature search was carried out by computerized search of biomedical literature including Medline and Embase. The studies included were published between 1978 and 1998 and including the following keywords: amputation, artificial limbs, prosthesis, lower limb, activities of daily living, mobility. Results: Thirty-five studies were identified; 19 had a measurement of separate levels...

  5. A pilot feasibility study of daily rTMS to modify corticospinal excitability during lower limb immobilization.

    Science.gov (United States)

    Ricci, Raffaella; Ramsey, Dave; Johnson, Kevin; Borckardt, Jeffrey J; Vallejo, Matthew; Roberts, Donna R; George, Mark S

    2008-10-01

    Short term immobilization of the lower limb is associated with increased corticospinal excitability at 24 hours post cast removal. We wondered whether daily stimulation of the motor cortex might decrease brain reorganization during casting. We tested the feasibility of this approach. Using transcranial magnetic stimulation (TMS), resting motor threshold and recruitment curves were obtained at baseline in 6 healthy participants who then had leg casts placed for 10 days. On 7 of the 10 days subjects received 20 minutes of 1 Hz repetitive TMS (rTMS). TMS measures were then recorded immediately after and 24 hours post cast removal. Four of 6 subjects completed the study. At the group level there were no changes in excitability following cast removal. At the individual level, two participants did not show any change, 1 participant had higher and one lower excitability 24 hours after cast removal. Daily rTMS over motor cortex is feasible during casting and may modify neuroplastic changes occurring during limb disuse. A prospective double blind study is warranted to test whether daily rTMS might improve outcome in subjects undergoing casting, and perhaps in other forms of limb disuse such as those following brain injury or weightlessness in space flight.

  6. Continuous theta-burst stimulation combined with occupational therapy for upper limb hemiparesis after stroke: a preliminary study.

    Science.gov (United States)

    Yamada, Naoki; Kakuda, Wataru; Kondo, Takahiro; Shimizu, Masato; Sageshima, Masashi; Mitani, Sugao; Abo, Masahiro

    2014-12-01

    The purpose of this study was to assess the safety, feasibility and efficacy of continuous theta-burst stimulation (cTBS) combined with intensive occupational therapy (OT) for upper limb hemiparesis after stroke. Ten patients with history of stroke and upper limb hemiparesis (age 62.0 ± 11.1 years, time since stroke 95.7 ± 70.2 months, mean ± SD) were studied. Each patient received 13 sessions, each comprising 160 s of cTBS applied to the skull on the area of the non-lesional hemisphere (using a 70-mm figure-8 coil, three pulse bursts at 50 Hz, repeated every 200 ms, i.e., 5 Hz, with total stimulation of 2,400 pulses), followed by intensive OT (comprising 120-min one-to-one training and 120-min self-training) during 15-day hospitalization. The motor function of the affected upper limb was evaluated by Fugl-Meyer Assessment (FMA) and Wolf Motor Function Test (WMFT) on the days of admission and discharge. All patients completed the 15-day protocol without any adverse effects. Treatment significantly increased the FMA score (from 46.6 ± 8.7 to 51.6 ± 8.2 points, p < 0.01) and shortened the log performance time of WMFT (from 2.5 ± 1.1 to 2.2 ± 1.2 s, p < 0.01). The 15-day protocol of cTBS combined with intensive OT is a safe and potentially useful therapeutic modality for upper limb hemiparesis after stroke.

  7. Benchmarked Library Websites Comparative Study

    KAUST Repository

    Ramli, Rindra M.

    2015-01-01

    This presentation provides an analysis of services provided by the benchmarked library websites. The exploratory study includes comparison of these websites against a list of criterion and presents a list of services that are most commonly deployed by the selected websites. In addition to that, the investigators proposed a list of services that could be provided via the KAUST library website.

  8. How could robotic training and botolinum toxin be combined in chronic post stroke upper limb spasticity? A pilot study.

    Science.gov (United States)

    Pennati, G V; Da Re, C; Messineo, I; Bonaiuti, D

    2015-08-01

    Spasticity has a role of primary importance in functional motor recovery of upper limb after a stroke. The widespread intervention is the botulinum toxin neurolysis, however robotic training could have a role as useful addition to this conventional therapy. The aim of this study was to verify how the combination of a short robotic training and chemical neurolysis reduces spasticity and improves function in chronic post-stroke patients. Prospective single blind randomized controlled clinical trial. Post-stroke outpatients. Fifteen chronic post-stroke outpatients with severe upper limb spastic paresis. Two experimental groups underwent ten sessions of robotic training, alone (Group A) or with Botulinum toxin neurolysis (Group B). Evaluation of motor function with Fugl Meyer Upper Limb Assessment Scale (FMA) and Box & Block Test (B&B), disability with Functional Indipendence Measure (FIM), spasticity with Modified Ashworth Scale (MAS), and the Quality of Life (Euro-Qol) and muscular recruitment pattern with dynamic surface electromyography were carried out before and after the interventions. Both groups showed improvement in FMA (Group A 8.25 and Group B 5.29). Higher improvement in B&B was detected in the group A (2.62 versus 0,14 in Group B). MAS was improved more in the Group B (-0,86 versus -0,14 in Group A). In both groups, sEMG showed a reduction of co-contractions and an increase of agonist muscles recruitment during the reaching movement and the robotic exercises. The demonstrated improvement in motor function and in muscular activation pattern suggests how a short robotic training could be effective in chronic post-stroke spasticity of upper limb and in less severe spasticity the only robotic treatment could be effective. With the limits of small sample, the results showed some equivalence between these two approaches with respect to motor recovery and spasticity reduction suggesting that the cost effectiveness of each treatment may have an important role in

  9. Study of the different types of actuators and mechanisms for upper limb prostheses.

    Science.gov (United States)

    Cura, Vanderlei O Del; Cunha, Fransérgio L; Aguiar, Manoel L; Cliquet, Alberto

    2003-06-01

    Research in the area of actuators and mechanisms has shown steadily growing technological advances in externally activated upper limb prostheses. From among the actuators, advances include the use of piezoelectric materials, special metal alloys, polymers, and new motor applications, while the advances in mechanisms include mechanical designs based on the anatomy of the human hand and improvements in the way these components are combined. These efforts are aimed at meeting the need for anthropomorphic and functional prosthetic devices that enable patients to carry out basic daily tasks more easily and reduce the rejection rate of prostheses. This article technically discusses the several types of actuators and mechanisms, listing their main characteristics, applications, and advantages and disadvantages, and the current state of research in the area of rehabilitation of upper limb functions through the use of active prostheses. Comparisons of these devices are made with regard to the main criteria of construction and operation required to achieve optimal prosthetic performance.

  10. A prospective feasibility study of duplex ultrasound arterial mapping, digital-subtraction angiography, and magnetic resonance angiography in management of critical lower limb ischemia by endovascular revascularization.

    Science.gov (United States)

    Lowery, A J; Hynes, N; Manning, B J; Mahendran, M; Tawfik, S; Sultan, S

    2007-07-01

    total number of target lesions for revascularization; however, MRA overestimated it. Our results indicate that DUAM is outstanding when compared with other available modalities as a preoperative imaging tool in a successful EvR program. DUAM is a minimally invasive preoperative evaluation for EvR and offers precise consecutive data with patency and limb salvage rates comparable to EvR based on DSA and superior to MRA. We believe that our feasibility study has established DUAM as an economically proficient primary modality for investigating patients with CLI that significantly shortens length of hospital stay.

  11. Spina bifida and lower limb amputation in Northern Ireland: A retrospective study of demographics and outcome.

    Science.gov (United States)

    Graham, Lorraine

    2017-01-01

    Spina bifida is an uncommon cause for lower limb amputation. The causes and level of amputation and mobility outcome for these patients have not been reported previously. To identify the causes and level of amputation and the mobility outcome for amputee patients with spina bifida. Retrospective case series. Chart review of patients identified by computer as having an amputation secondary to neurological or congenital cause. Additional patients identified from the Regional Spina Bifida Medical Clinic. Demographics, cause and level of mobility pre- and post-amputation recorded from the prosthetic notes. In total, 16 patients were identified who had a diagnosis of spina bifida and a lower limb amputation. Mean age at the time of amputation was 28.5 years. In total, 15 patients had a transtibial amputation. In total, 14 patients post-amputation were able to maintain their mobility, wheelchair or walking, without any change in type of aid needed. Patients with spina bifida appear to require lower limb amputation at a younger age than patients with peripheral vascular disease. Almost all patients had prior chronic skin infection/osteomyelitis as precursors for amputation. The most common level for amputation was transtibial. Mobility was maintained for all patients, albeit for two in a more supported way. Clinical relevance Spina bifida is an uncommon reason for amputation. Patients, are often younger and medically complicated. Chronic skin ulceration, was the most common indication for amputation. Wheelchair or walking ambulance was maintained at the same level for most patients.

  12. A Framework to Automate Assessment of Upper-Limb Motor Function Impairment: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    Paul Otten

    2015-08-01

    Full Text Available Standard upper-limb motor function impairment assessments, such as the Fugl-Meyer Assessment (FMA, are a critical aspect of rehabilitation after neurological disorders. These assessments typically take a long time (about 30 min for the FMA for a clinician to perform on a patient, which is a severe burden in a clinical environment. In this paper, we propose a framework for automating upper-limb motor assessments that uses low-cost sensors to collect movement data. The sensor data is then processed through a machine learning algorithm to determine a score for a patient’s upper-limb functionality. To demonstrate the feasibility of the proposed approach, we implemented a system based on the proposed framework that can automate most of the FMA. Our experiment shows that the system provides similar FMA scores to clinician scores, and reduces the time spent evaluating each patient by 82%. Moreover, the proposed framework can be used to implement customized tests or tests specified in other existing standard assessment methods.

  13. Study of L-arginine-nitric oxide pathway in ischemia-reperfusion injured limbs in rats

    Institute of Scientific and Technical Information of China (English)

    朱立军; 黄耀添; 裴国献

    2002-01-01

    Objective: To observe the change of nitric oxide (NO) levels in the blood and the morphological change of the muscles in the limbs of rats during the (IR) injury and after being intervened by L-arginine (L-Arg) and L-nitroarginine (L-NNA).   Methods: Sixty-six male Sprague-Dawley (SD) rats were used and grouped into the normal controls, the sham injury controls, the IR injury group and the intervention groups (L-Arg group and L-NNA group). After 6 hours of ischemia, followed by reperfusion for 3, 12 or 24 hours, the samples in the IR injury group were obtained. The rats in the intervention groups were given L-Arg (100 mmol/L) and L-NNA (10 mmol/L), respectively, through the abdominal cavity. Then the anterior tibial muscle in the right limb was obtained for histological examination, the anterior tibial muscle in the left limb for ultrastructure observation and the blood for assay of NO in all the rats. NO was assayed by indirect measurement of NO2/NO3 with Griess method.   Results: There was no significant difference of NO between the normal controls and the sham injury controls (P>0.05). But NO significantly decreased in the IR injury group (P0.05). In the L-NNA group, NO decreased to the undetectable level (P<0.01). Histological examination and ultrastructure observation showed the muscles were normal in the control groups. After 6 hours of ischemia, the skeletal muscles displayed injuries, and they were most severely injured after 12 hours of reperfusion. In the L-Arg group, the skeletal muscles were less injured, while in the L-NNA group, the injury was similar to that in the IR injury group.   Conclusions: When the limbs of the rats sustain IR, NO in the blood decreases. Meanwhile, the muscles in the limbs are injured. When L-Arg is given, NO in the blood is restored and the muscles are protected. When L-NNA completely inhibits NO, no protection of the muscles is shown.

  14. [Case-control study on methods of limb length control in hip arthroplasty].

    Science.gov (United States)

    Zhang, Yang-yang; Zuo, Jian-lin; Gao, Zhong-li

    2016-02-01

    To introduce a new measuring tool for measuring postoperative limb length exactly, and to provide a convenient and effective method to control limb length after total hip replacement. From January 2013 to September 2014, 102 patients undergoing primary unilateral hip replacement were divided into two groups: experimental group and control group. There were 51 patients in the experimental group, including 25 males and 26 females, ranging in age from 37 to 92 years old, with an average of 60.41 years old. The patients in experimental group were treated with new method to control limb length. Other 51 patients in the control group, including 27 males and 24 females, ranging in age from 35 to 87 years old, with an average of 61.00 years old. The patients in the control group were treated with normal methods such as shuck test or limb touching. All the patients were operated by the same experienced surgeon. In the experimental group,total hip arthroplasties (THA) were performed on 35 patients with avascular necrosis of the femoral head or femoral neck fracture, and 16 patients were treated with hemiarthroplasty (HA). In the control group, 38 patients received THA and 13 patients received HA. On the anterior-posterior X-ray radiograph, several indexes were measured as follows: the distance of bilateral femoral offset (a), the height from tip of great trochanter to the rotation center of the femoral head (b) and the vertical distance between the top of the minor trochanter and the two tear drops line (c). The leg length discrepancy can be assessed with three parameters as follows: d1, the absolute value of the difference between the bilateral a values; d2, the difference between the bilateral b values; d3, the difference between the bilateral c values. The SPSS 21.0 was applied for the statistical analysis. In the experimental and control groups, d1 were 4.49 mm and 7.32 mm (P = 0.013); d2 were 2.37 mm and 4.32 mm (P = 0.033); d3 were 3.32 mm and 6.08 mm (P = 0.031). The

  15. Gene expression patterns specific to the regenerating limb of the Mexican axolotl

    Directory of Open Access Journals (Sweden)

    James R. Monaghan

    2012-07-01

    Salamander limb regeneration is dependent upon tissue interactions that are local to the amputation site. Communication among limb epidermis, peripheral nerves, and mesenchyme coordinate cell migration, cell proliferation, and tissue patterning to generate a blastema, which will form missing limb structures. An outstanding question is how cross-talk between these tissues gives rise to the regeneration blastema. To identify genes associated with epidermis-nerve-mesenchymal interactions during limb regeneration, we examined histological and transcriptional changes during the first week following injury in the wound epidermis and subjacent cells between three injury types; 1 a flank wound on the side of the animal that will not regenerate a limb, 2 a denervated limb that will not regenerate a limb, and 3 an innervated limb that will regenerate a limb. Early, histological and transcriptional changes were similar between the injury types, presumably because a common wound-healing program is employed across anatomical locations. However, some transcripts were enriched in limbs compared to the flank and are associated with vertebrate limb development. Many of these genes were activated before blastema outgrowth and expressed in specific tissue types including the epidermis, peripheral nerve, and mesenchyme. We also identified a relatively small group of transcripts that were more highly expressed in innervated limbs versus denervated limbs. These transcripts encode for proteins involved in myelination of peripheral nerves, epidermal cell function, and proliferation of mesenchymal cells. Overall, our study identifies limb-specific and nerve-dependent genes that are upstream of regenerative growth, and thus promising candidates for the regulation of blastema formation.

  16. MR imaging in the evaluation of isolated limb perfusion: a prospective study of 18 cases

    Energy Technology Data Exchange (ETDEWEB)

    Vanel, Daniel; Petrow, Peter; Dromain, Clarisse; Caillet, Hubert [Department of Radiology, Institut Gustave-Roussy, 39 rue Camille Desmoulins, 94805, Villejuif Cedex (France); Bonvalot, Sylvie [Department of Surgery, Institut Gustave-Roussy, 39 rue Camille Desmoulins, 94805, Villejuif Cedex (France); Guinebretiere, Jean Marc [Department of Pathology, Centre Rene-Huguenin, 35 rue Dailly, 92210, Saint-Cloud (France)

    2004-03-01

    To prospectively evaluate the use of MRI with dynamic sequences during isolated limb perfusion (ILP) for soft tissue sarcomas, an aggressive local treatment using very high-dose chemotherapy and tumor necrosis factor aimed at avoiding limb amputation. Twenty-six patients were referred for ILP over one and a half years; eight were excluded as the lesions were either too proximal or suspicious inflammatory changes without tumor were found on the initial MRI, or the vascular status was poor. The indications for ILP were: vessel nerve involvement (13), multiple lesions (8), tumor size (4) or the presence of pulmonary metastases (2). MRI was performed 1 and 2 months after ILP, immediately prior to surgery and histological analysis. The MR examinations included T1-weighted SE and fast SE T2-weighted fat-saturated sequences, as well as dynamic sequences (T1-weighted SE repeated six times every 40 s), displaying the maximum intensity slope in each pixel. The tumor had disappeared in three patients. One patient still had histologically proven isolated widespread tumor cells without a mass. The tumor size had increased in two patients. In six patients, the size of the tumor had not changed but it had become completely necrotic, with a thin wall.In three patients, after an initially good result MRI demonstrated that the tumor wall had become thickened from 1 to 2 months after ILP. Dynamic MRI was mainly useful during the initial examination, demonstrating two patients with inflammatory changes without tumor. Three amputations and a second ILP were proposed based on poor results. Conservative limb-sparing surgery was successful in the other cases. MRI proved valuable in demonstrating the variable responses to ILP. (orig.)

  17. Optic ataxia affects the lower limbs: evidence from a single case study.

    Science.gov (United States)

    Evans, Carys; Milner, A David; Humphreys, Glyn W; Cavina-Pratesi, Cristiana

    2013-05-01

    Optic ataxia represents a spatial impairment of visually guided reaching following bilateral or unilateral damage to the posterior parietal cortex that is independent of purely motor or visual deficits. Research to date has focused on reaching actions performed with the upper limbs but has neglected to explore whether or not optic ataxia affects the lower limbs, that is, whether it is effector-specific. We asked patient M.H., who suffers from unilateral optic ataxia from left hemispheric damage, and eight age-matched controls, to perform leg movements by stepping down from a wooden block towards a visually presented target. Steps were performed using the left or the right leg, in conditions of central fixation or free viewing. Patient M.H. performed significantly worse than controls. His errors in step accuracy were most pronounced when stepping into the visual periphery (during central fixation), particularly while using the contralesional right foot towards the contralesional right hemispace. This behaviour is consistent with M.H.'s impairments in optic ataxia previously recorded for reaching and grasping actions with the upper limbs. The lesion affecting M.H.'s brain is quite large, encompassing functional areas associated with visuomotor transformations performed with different effectors such as arm and eye (superior parietal-occipital cortex and medial intraparietal sulcus). Our data suggest that optic ataxia is not completely effector-specific, and that neurons encoding visuomotor transformations for both arm and leg are probably both affected by the damage. Our results support the notion that lesions affecting the medial portion of the left posterior parietal cortex similarly affect different effectors (arm and leg) when visually guided actions are directed towards the same contralesional hemispace. In addition they may help explain why patients with optic ataxia have been reported to have difficulties in certain aspects of visually guided locomotion

  18. Limb girdle muscular dystrophies

    DEFF Research Database (Denmark)

    Vissing, John

    2016-01-01

    PURPOSE OF REVIEW: The aim of the study was to describe the clinical spectrum of limb girdle muscular dystrophies (LGMDs), the pitfalls of the current classification system for LGMDs, and emerging therapies for these conditions. RECENT FINDINGS: Close to half of all LGMD subtypes have been...

  19. Effects of shock waves on the microcirculation in critical limb ischemia (CLI) (8-week study).

    Science.gov (United States)

    De Sanctis, M T; Belcaro, G; Nicolaides, A N; Cesarone, M R; Incandela, L; Marlinghaus, E; Griffin, M; Capodanno, S; Ciccarelli, R

    2000-08-01

    Shock waves (SWs) are used to control and decrease pain in several clinical conditions (e.g., painful elbow and shoulder, etc). This clinical effect may be due to cellular stunning of the tissues (particularly nervous components) in the area treated with SW. It may also be the consequence of unknown metabolic actions on tissues, which may include changes in cellular permeability and the liberation of proteins and mediators locally acting on pain and nerve endings. The aim of this study was to evaluate the reduction in pain and the microcirculation improvement induced by SWs treatment in an 8-week study in patients with chronic limb ischemia (CLI). Patients with CLI (15 with rest pain only and 15 with rest pain and limited distal necrosis) were included. The treatment was based on a 30-minute SWs session, three times weekly for 2 weeks. Clinical and microcirculatory evaluation were performed with laser Doppler Po2 and Pco2 measurements. Pain was measured with an analogue scale line. A Minilith SL1 (Storz Medical, Switzerland) litotriptor was used. The parabolic reflector is coupled to the skin with a silicon water cushion. Focal pressure was adjusted between 6 and 70 Mpa in eight steps. The energy flux density was variable from 0.03 to 0.5 mJ/mm2. Focal diameter and distance were defined (depth of target within the patient's foot of about 70 mm). The coded intensity used in this study was between 6 and 8 and the application time was 20 min (at four impulses per second). Twenty-eight of the 30 patients with CLI (15 with rest pain only and 13 with necrosis) completed the study. The treatment was well tolerated. Blood pressure was unchanged after 8 weeks while the increase in laser Doppler flux was significant (p<0.05) (at all measurements after treatment). The ORACLE score at 1 and 8 weeks was decreased (p<0.05). The same trend was observed with the analogue scale line for pain (p<0.05). PO2 increased (p<0.05) and Pco2 decreased (p<0.05). Tibial pressure did not

  20. Birth prevalence for congenital limb defects in the northern Netherlands: a 30-year population-based study

    Science.gov (United States)

    2013-01-01

    Background Reported birth prevalences of congenital limb defects (CLD) vary between countries: from 13/10,000 in Finland for the period 1964–1977 to 30.4/10,000 births in Scotland from 1964–1968. Epidemiological studies permit the timely detection of trends in CLD and of associations with other birth defects. The aim of this study is to describe the birth prevalence of CLD in the northern Netherlands. Methods In a population-based, epidemiological study we investigated the birth prevalences of CLD for 1981–2010. Data were collected by the European Surveillance of Congenital Anomalies in the northern Netherlands (EUROCAT-NNL). We excluded malpositions, club foot, and dislocation/dysplasia of hips or knees. Trends were analysed for the 19-year period 1992–2010 using χ2 tests, as well as CLD association with anomalies affecting other organs. Results The birth prevalence of CLD was 21.1/10,000 births for 1981–2010. There was an overall decrease in non-syndromic limb defects (P = 0.023) caused by a decrease in the prevalence of non-syndromic syndactyly (P congenital anomalies (MCA), and 30% had a recognised syndrome. The upper:lower limb ratio was 2:1, and the left:right side ratio was 1.2:1. Cardiovascular and urinary tract anomalies were common in combination with CLD (37% and 25% of cases with MCA). Digestive-tract anomalies were significantly associated with CLD (P = 0.016). Conclusions The birth prevalence of CLD in the northern Netherlands was 21.1/10,000 births. The birth prevalence of non-syndromic syndactyly dropped from 5.2/10,000 to 1.1/10,000 in 1992–2010. PMID:24237863

  1. Study of a Vuilleumier cycle cryogenic refrigerator for detector cooling on the limb scanning infrared radiometer

    Science.gov (United States)

    Russo, S. C.

    1976-01-01

    A program to detect and monitor the presence of trace constituents in the earth's atmosphere by using the Limb Scanning Infrared Radiometer (LSIR) is reported. The LSIR, which makes radiometric measurements of the earth's limb radiance profile from a space platform, contains a detector assembly that must be cooled to a temperature of 65 + or - 2 K. The feasibility of cooling the NASA-type detector package with Vuilleumier (VM) cryogenic refrigerator was investigated to develop a preliminary conceptual design of a VM refrigerator that is compatible with a flight-type LSIR instrument. The scope of the LSIR program consists of analytical and design work to establish the size, weight, power consumption, interface requirements, and other important characteristics of a cryogenic cooler that would meet the requirements of the LSIR. The cryogenic cooling requirements under the conditions that NASA specified were defined. Following this, a parametric performance analysis was performed to define the interrelationships between refrigeration characteristics and mission requirements. This effort led to the selection of an optimum refrigerator design for the LSIR mission.

  2. Preliminary diffusion tensor imaging studies in limb-girdle muscular dystrophies

    Science.gov (United States)

    Hidalgo-Tobon, S.; Hernandez-Salazar, G.; Vargas-Cañas, S.; Marrufo-Melendez, O.; Solis-Najera, S.; Taboada-Barajas, J.; Rodriguez, A. O.; Delgado-Hernandez, R.

    2012-10-01

    Limb-girdle muscular dystrophies (LGMD) are a group of autosomal dominantly or recessively inherited muscular dystrophies that also present with primary proximal (limb-girdle) muscle weakness. This type of dystrophy involves the shoulder and pelvic girdles, distinct phenotypic or clinical characteristics are recognized. Imaging experiments were conducted on a 1.5T GE scanner (General Electric Medical Systems. Milwaukee. USA), using a combination of two eight-channel coil array. Diffusion Tensor Imaging (DTI) data were acquired using a SE-EPI sequence, diffusion weighted gradients were applied along 30 non-collinear directions with a b-value=550 s/mm2. The connective tissue content does not appear to have a significant effect on the directionality of the diffusion, as assessed by fractional anisotropy. The fibers of the Sartorius muscle and gracilis showed decreased number of tracts, secondary to fatty infiltration and replacement of connective tissue and muscle mass loss characteristic of the underlying pathology. Our results demonstrated the utility of non-invasive MRI techniques to characterize the muscle pathology, through quantitative and qualitative methods such as the FA values and tractrography.

  3. Field study of hind limb claw lesions and claw measures in sows.

    Science.gov (United States)

    Sasaki, Yosuke; Ushijima, Ruri; Sueyoshi, Masuo

    2015-03-01

    We investigated the associations of hind limb claw lesions with claw measures and reproductive performance of sows on a commercial breeding farm. We used a five-point scale (score of 0-4) for each hind limb claw region to generate a claw lesion score (CLS). Of 110 sows, 1.8% had no hind claw lesions, and the remaining 98.2% had at least one. The proportions of sows with a CLS of 2 and 3 were 49.1% and 3.6%, respectively. The junction region had the highest frequency of a CLS of ≥ 2 (P Sows with the highest CLS of ≥ 2 in the lateral claw had longer sole dimensions than did sows with the highest CLS of ≤ 1 (P sows with the highest CLS of ≥ 2 and ≤ 1. There was also no difference in reproductive performance between sows with the highest CLS of ≥ 2 and ≤ 1. In conclusion, most sows had hind claw lesions. The association between CLS and claw measures indicates that the sole length can be used as an indicator of claw lesions. © 2014 Japanese Society of Animal Science.

  4. Defocused Shock Wave Therapy for Chronic Soft Tissue Wounds in the Lower Limbs: A Pilot Study.

    Science.gov (United States)

    Porso, Manuela; Loreti, Simona; Nusca, Sveva Maria; Luziatelli, Sara; Caccia, Donatella; Taborri, Giulia; Trischitta, Donatella; Taurino, Maurizio; Padua, Luca; Saraceni, Vincenzo Maria; Vulpiani, Maria Chiara; Vetrano, Mario

    2017-01-01

    Chronic soft tissue wounds of the lower limbs are debilitating, painful and often unresponsive to advanced dressing treatments. Extracorporeal shock wave therapy (ESWT) could represent an alternative treatment. Ten patients with chronic soft tissue wounds of the legs, unresponsive to advanced dressing treatments for more than 3 mo, underwent three defocused ESWT sessions at 72-h intervals. In every session, the sum of 300 standard pulses + 100 pulses per square centimeter was applied at 0.15 mJ/mm(2) and 4 Hz over the edge of the wound. The wound size in square centimeters, Bates-Jensen Wound Assessment Tool and visual analogue scale were used as outcome measures. A significant reduction in wound size and Bates-Jensen Wound Assessment Tool and visual analogue scale values from pre-treatment to 90 d was observed. Seven of ten ulcers healed completely and nine of ten patients reported complete pain relief. Defocused ESWT represents a non-invasive, feasible strategy for difficult-to-treat soft tissue wounds of the lower limbs. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  5. [Limb apraxia].

    Science.gov (United States)

    Hödl, Anna K; Bonelli, Raphael M; Kapfhammer, Hans-Peter

    2006-01-15

    Apraxia is the disturbance of planning and of execution of motor activity. It is not caused by a lesion or a disturbance of the motor or sensory nervous system, it is elicited by a dysfunction of an area in the left cortex of the brain. This area in the left fronto-parietotemporal hemisphere is located right beside the area for speech. Therefore it is not unusual that patients with apraxia suffer from aphasia as well. The two different types of limb apraxia are ideomotor apraxia and ideational apraxia. Ideomotor apraxia is apraxia without tool use, it includes imitation of positions of hands and fingers, performance of gestures on demand, and pantomime of object use. Ideational apraxia is apraxia with tool use like cutting with a knife or utilizing a pencil.

  6. Treprostinil sodium (Remodulin), a prostacyclin analog, in the treatment of critical limb ischemia: open-label study.

    Science.gov (United States)

    Berman, Scott; Quick, Rhonda; Yoder, Pam; Voigt, Sonia; Strootman, Deborah; Wade, Michael

    2006-01-01

    The purpose of this study was to assess the safety of continuous subcutaneous therapy with treprostinil sodium (Remodulin), a prostacyclin analog, and its effect on ischemic rest pain and ischemic wound healing in subjects with critical limb ischemia (CLI) and no planned revascularization procedure. This was a 12-week, open-label, single-center pilot study enrolling 10 subjects (mean age 82.4 years) with Fontaine stage III to IV (Rutherford class 4-6) peripheral arterial disease and ankle brachial indices less than 0.55. The primary end point was safety, and the secondary end points were the effects of treatment on ischemic rest pain, limb salvage, and wound healing. There was a 62% reduction in mean worst rest pain and a 57% reduction in mean average rest pain at week 12, with most subjects using less pain medication. Three subjects experienced complete healing of their wounds. No subject developed a new wound during the trial. Treprostinil was generally well tolerated. Subcutaneous infusion-site pain was the most frequently reported side effect, with one subject withdrawing from the study as a result. Jaw pain was reported by two subjects. One subject experienced two serious adverse events considered unrelated to treprostinil (cholecystitis and congestive heart failure). This study demonstrates that chronic, continuous subcutaneous treprostinil is safe and can be useful in the treatment of ischemic pain and wounds in subjects with CLI. Future controlled studies are needed to evaluate these effects and determine appropriate patient selection.

  7. Individual limb mechanical analysis of gait following stroke.

    Science.gov (United States)

    Mahon, Caitlin E; Farris, Dominic J; Sawicki, Gregory S; Lewek, Michael D

    2015-04-13

    The step-to-step transition of walking requires significant mechanical and metabolic energy to redirect the center of mass. Inter-limb mechanical asymmetries during the step-to-step transition may increase overall energy demands and require compensation during single-support. The purpose of this study was to compare individual limb mechanical gait asymmetries during the step-to-step transitions, single-support and over a complete stride between two groups of individuals following stroke stratified by gait speed (≥0.8 m/s or phases of a stride, as well as over a complete stride. Robust inter-limb asymmetries in mechanical power existed during walking after stroke; for both groups, the non-paretic limb produced significantly more positive net mechanical power than the paretic limb during all phases of a stride and over a complete stride. Interestingly, no differences in inter-limb mechanical power asymmetry were noted between groups based on walking speed, during any phase or over a complete stride. Paretic propulsion, however, was different between speed-based groups. The fact that paretic propulsion (calculated from anterior-posterior forces) is different between groups, but our measure of mechanical work (calculated from all three directions) is not, suggests that limb power output may be dominated by vertical components, which are required for upright support.

  8. Brain network involved in visual processing of movement stimuli used in upper limb robotic training: an fMRI study.

    Science.gov (United States)

    Nocchi, Federico; Gazzellini, Simone; Grisolia, Carmela; Petrarca, Maurizio; Cannatà, Vittorio; Cappa, Paolo; D'Alessio, Tommaso; Castelli, Enrico

    2012-07-24

    The potential of robot-mediated therapy and virtual reality in neurorehabilitation is becoming of increasing importance. However, there is limited information, using neuroimaging, on the neural networks involved in training with these technologies. This study was intended to detect the brain network involved in the visual processing of movement during robotic training. The main aim was to investigate the existence of a common cerebral network able to assimilate biological (human upper limb) and non-biological (abstract object) movements, hence testing the suitability of the visual non-biological feedback provided by the InMotion2 Robot. A visual functional Magnetic Resonance Imaging (fMRI) task was administered to 22 healthy subjects. The task required observation and retrieval of motor gestures and of the visual feedback used in robotic training. Functional activations of both biological and non-biological movements were examined to identify areas activated in both conditions, along with differential activity in upper limb vs. abstract object trials. Control of response was also tested by administering trials with congruent and incongruent reaching movements. The observation of upper limb and abstract object movements elicited similar patterns of activations according to a caudo-rostral pathway for the visual processing of movements (including specific areas of the occipital, temporal, parietal, and frontal lobes). Similarly, overlapping activations were found for the subsequent retrieval of the observed movement. Furthermore, activations of frontal cortical areas were associated with congruent trials more than with the incongruent ones. This study identified the neural pathway associated with visual processing of movement stimuli used in upper limb robot-mediated training and investigated the brain's ability to assimilate abstract object movements with human motor gestures. In both conditions, activations were elicited in cerebral areas involved in visual

  9. Brain network involved in visual processing of movement stimuli used in upper limb robotic training: an fMRI study

    Directory of Open Access Journals (Sweden)

    Nocchi Federico

    2012-07-01

    Full Text Available Abstract Background The potential of robot-mediated therapy and virtual reality in neurorehabilitation is becoming of increasing importance. However, there is limited information, using neuroimaging, on the neural networks involved in training with these technologies. This study was intended to detect the brain network involved in the visual processing of movement during robotic training. The main aim was to investigate the existence of a common cerebral network able to assimilate biological (human upper limb and non-biological (abstract object movements, hence testing the suitability of the visual non-biological feedback provided by the InMotion2 Robot. Methods A visual functional Magnetic Resonance Imaging (fMRI task was administered to 22 healthy subjects. The task required observation and retrieval of motor gestures and of the visual feedback used in robotic training. Functional activations of both biological and non-biological movements were examined to identify areas activated in both conditions, along with differential activity in upper limb vs. abstract object trials. Control of response was also tested by administering trials with congruent and incongruent reaching movements. Results The observation of upper limb and abstract object movements elicited similar patterns of activations according to a caudo-rostral pathway for the visual processing of movements (including specific areas of the occipital, temporal, parietal, and frontal lobes. Similarly, overlapping activations were found for the subsequent retrieval of the observed movement. Furthermore, activations of frontal cortical areas were associated with congruent trials more than with the incongruent ones. Conclusions This study identified the neural pathway associated with visual processing of movement stimuli used in upper limb robot-mediated training and investigated the brain’s ability to assimilate abstract object movements with human motor gestures. In both conditions

  10. Electromyographic Analysis of the Lower Limb Muscles in Low- and High-Handicap Golfers

    Science.gov (United States)

    Marta, Sérgio; Silva, Luís; Vaz, João R.; Castro, Maria António; Reinaldo, Gustavo; Pezarat-Correia, Pedro

    2016-01-01

    Purpose: The aim of this study was to compare the electromyographic patterns of the lower limb muscles during a golf swing performed by low- and high-handicap golfers. Method: Ten golfers (5 low- and 5 high-handicap) performed 8 swings using a 7-iron. Surface electromyography (EMG) was recorded for the following lower limb muscles on both sides:…

  11. COMPARATIVE EFFECTIVENESS OF AN ADJUSTABLE TRANSFEMORAL PROSTHETIC INTERFACE ACCOMMODATING VOLUME FLUCTUATION: CASE STUDY

    OpenAIRE

    Kahle, Jason T.; Klenow, Tyler D.; Highsmith, M. Jason

    2016-01-01

    The socket-limb interface is vital for functionality and provides stability and mobility for the amputee. Volume fluctuation can lead to compromised fit and function. Current socket technology does not accommodate for volume fluctuation. An adjustable interface may improve function and comfort by filling this technology gap. The purpose of this study was to compare the effectiveness of the standard of care (SOC) ischial ramus containment to an adjustable transfemoral prosthetic interface sock...

  12. Functional outcome after endoprosthetic limb-salvage therapy of primary bone tumours--a comparative analysis using the MSTS score, the TESS and the RNL index.

    Science.gov (United States)

    Tunn, P U; Pomraenke, D; Goerling, U; Hohenberger, P

    2008-10-01

    Limb-saving therapy for primary bone tumours is the treatment of choice. We aimed at analysing the quality of life of this group of patients by combining three different tools. Eighty-seven patients (46 females, 41 males) with a primary bone tumour of the extremity who had undergone endoprosthetic reconstruction between 1982 and 2000 were included in this retrospective study. The median age at the time of evaluation was 30 (12-73) years. The Toronto Extremity Salvage Score (TESS) and the Reintegration to Normal Living index (RNL) were recorded an average of 5.8 years after reconstruction and the Musculoskeletal Tumour Society Score (MSTS) after an average of 6.5 years. The mean MSTS score was 77% (13-93%). The mean TESS was 82% (22-99%), and the mean RNL index was 87% (32-98%). The subjective satisfaction and acceptance of physical impairment were significantly higher than the objective score (p TESS was 88% in patients aged 12-25 years, 81% in those aged 26-40 years and 57% in those aged 41-73 years. Parallel recording of the MSTS score, TESS and RNL index provides a better measure reflecting the complex situation of the patients by combining objective and subjective parameters.

  13. Evaluation of EEG oscillatory patterns and cognitive process during simple and compound limb motor imagery.

    Directory of Open Access Journals (Sweden)

    Weibo Yi

    Full Text Available Motor imagery (MI, sharing similar neural representations to motor execution, is regarded as a window to investigate the cognitive motor processes. However, in comparison to simple limb motor imagery, significantly less work has been reported on brain oscillatory patterns induced by compound limb motor imagery which involves several parts of limbs. This study aims to investigate differences of the electroencephalogram (EEG patterns as well as cognitive process between simple limb motor imagery and compound limb motor imagery. Ten subjects participated in the experiment involving three tasks of simple limb motor imagery (left hand, right hand, feet and three tasks of compound limb motor imagery (both hands, left hand combined with right foot, right hand combined with left foot. Simultaneous imagination of different limbs contributes to the activation of larger cortical areas as well as two estimated sources located at corresponding motor areas within beta rhythm. Compared with simple limb motor imagery, compound limb motor imagery presents a network with more effective interactions overlying larger brain regions, additionally shows significantly larger causal flow over sensorimotor areas and larger causal density over both sensorimotor areas and neighboring regions. On the other hand, compound limb motor imagery also shows significantly larger 10-11 Hz alpha desynchronization at occipital areas and central theta synchronization. Furthermore, the phase-locking value (PLV between central and occipital areas of left/right hand combined with contralateral foot imagery is significantly larger than that of simple limb motor imagery. All these findings imply that there exist apparent intrinsic distinctions of neural mechanism between simple and compound limb motor imagery, which presents a more complex effective connectivity network and may involve a more complex cognitive process during information processing.

  14. Reasonable classical concepts in human lower limb anatomy from the viewpoint of the primitive persistent sciatic artery and twisting human lower limb.

    Science.gov (United States)

    Kawashima, Tomokazu; Sasaki, Hiroshi

    2010-11-01

    The main aim of this review is (1) to introduce the two previous studies we published human lower limb anatomy based on the conventional macroscopic anatomical [corrected] criteria with hazardous recognition of this description, (2) to activate the discussion whether the limb homology exists, and (3) to contribute to future study filling the gap between the gross anatomy and embryology. One of the topics we discussed was the human persistent sciatic artery. To date, numerous human cases of persistent sciatic artery have been reported in which the anomalous artery was present in the posterior compartment of the thigh alongside the sciatic nerve. As one of the important criteria for assessing the human primitive sciatic artery, its ventral arterial position with respect to the sciatic nerve is reasonable based on the initial positional relationship between ventral arterial and dorsal nervous systems and comparative anatomical findings. We also discuss ways of considering the topography of muscles of the lower limb and their innervations compared to those of the upper limb. We propose a schema of the complex anatomical characteristics of the lower limb based on the vertebrate body plan. According to this reasonable schema, the twisted anatomy of the lower limb can be understood more easily. These two main ideas discussed in this paper will be useful for further understanding of the anatomy of the lower limb and as a first step for future. We hope that the future study in lower limb will be further developed by both viewpoints of the classical gross anatomy and recent embryology.

  15. Patient Experience, Pain, and Quality of Life after Lower Limb Angioplasty: A Multisite Prospective Cohort Study

    Energy Technology Data Exchange (ETDEWEB)

    Culverwell, A. D., E-mail: adamculverwell@doctors.net.uk [Leeds General Infirmary (United Kingdom); Tapping, C. R.; Ettles, D. F. [Hull Royal Infirmary (United Kingdom); Kessel, D. [Leeds General Infirmary (United Kingdom)

    2012-08-15

    Purpose: To explore the experience of patients undergoing endovascular lower limb angioplasty and evaluate the improvements in quality of life and disease-related symptoms after the procedure. Methods: Patients completed a questionnaire before treatment and three questionnaires after the procedure (immediately after the procedure, and again 4 weeks and 3 months later). Anxiety, patient understanding, procedure-related pain, and disease-related pain were assessed by a visual analog score (VAS). Complications, analgesic requirements, and satisfaction were recorded. Changes to quality of life were assessed by the validated SF36 questionnaire. Results: A total of 88 patients (41%) responded. Overall, disease-related pain decreased over 3 months after the procedure. Smokers had more pain both before and after the procedure (P < 0.05). Explanation was considered better if provided by radiologist (P < 0.05). Sixty-nine percent of patients found the procedures less painful (mean VAS 2.5) than they had anticipated (VAS 5.5). Fifty percent of patients experienced adverse effects related to their puncture site, but this was highest among patients who had undergone the procedure before and smokers. The greatest quality-of-life improvements were in emotional and general health. Higher levels of disease-related pain were associated with worse general, emotional, and physical health (P < 0.05). Conclusion: Lower limb angioplasty provides symptomatic and quality-of-life improvements. Implementation of simple measures could improve patient satisfaction-for example, treatment should be explained by the radiologist in advance. Routine prescription of analgesics with particular attention to smokers and those undergoing repeat interventions is suggested.

  16. Lower limb strength in sports-active transtibial amputees.

    Science.gov (United States)

    Nolan, Lee

    2009-09-01

    The aim of this study was to compare hip strength in sports-active transtibial (TT) amputees, sedentary TT amputees and sports-active non-amputees. Three 'active' (exercising recreationally at least three times per week) TT amputees, four 'inactive' or sedentary TT amputees and nine 'active' able-bodied persons (AB) underwent concentric and eccentric hip flexion and extension strength testing on both limbs on an isokinetic dynamometer at 60 and 120 degrees /s. Little strength asymmetry was noted between the limbs of the active TT amputees (8% and 14% at 60 and 120 degrees /s, respectively), their residual limb being slightly stronger. Inactive TT amputees demonstrated up to 49% strength asymmetry, their intact limb being the stronger. Active TT amputees demonstrated greater peak hip torques (Nm/kg) for all conditions and speeds compared to inactive TT amputees. Peak hip torques (Nm/kg), were greater in the active TT amputees' residual limb compared to AB. While inactive TT amputees and AB had similar flexion/extension ratios, active TT amputees exhibited a lower ratio indicating overdeveloped hip extensors with respect to their hip flexors. It is not known whether this is due to the demands of sport or exercise with a prosthetic limb, or remaining residual thigh atrophy.

  17. High Intensity Physical Exercise and Pain in the Neck and Upper Limb among Slaughterhouse Workers: Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Emil Sundstrup

    2014-01-01

    Full Text Available Slaughterhouse work involves a high degree of repetitive and forceful upper limb movements and thus implies an elevated risk of work-related musculoskeletal disorders. High intensity strength training effectively rehabilitates musculoskeletal disorders among sedentary employees, but less is known about the effect among workers with repetitive and forceful work demands. Before performing randomized controlled trials it may be beneficial to assess the cross-sectional connection between exercise and musculoskeletal pain. We investigated the association between high intensity physical exercise and pain among 595 slaughterhouse workers in Denmark, Europe. Using logistic regression analyses, odds ratios for pain and work disability as a function of physical exercise, gender, age, BMI, smoking, and job position were estimated. The prevalence of pain in the neck, shoulder, elbow, and hand/wrist was 48%, 60%, 40%, and 52%, respectively. The odds for experiencing neck pain were significantly lower among slaughterhouse workers performing physical exercise (OR = 0.70, CI: 0.49–0.997, whereas the odds for pain in the shoulders, elbow, or hand/wrist were not associated with exercise. The present study can be used as general reference of pain in the neck and upper extremity among slaughterhouse workers. Future studies should investigate the effect of high intensity physical exercise on neck and upper limb pain in slaughterhouse workers.

  18. Reperfusion injury in skeletal muscle: a prospective study in patients with acute limb ischaemia and claudicants treated by revascularization.

    Science.gov (United States)

    Adiseshiah, M; Round, J M; Jones, D A

    1992-10-01

    A study was carried out to document the occurrence of rhabdomyolysis and renal complications in patients undergoing vascular reconstruction. Indices of muscle damage and renal function were monitored before, during and for up to 10 days after vascular reconstruction for a variety of conditions ranging from intermittent claudication to acute ischaemia. Seven patients with acute limb ischaemia (group 1) and nine with intermittent claudication (group 2) were studied prospectively. In group 1, median creatine kinase (CK) and myoglobin levels were markedly raised 24-48 h after surgery (CK, 29,370 units/l; myoglobin, 8.17 mg/l). Myoglobin reached its peak concentration and declined more quickly than CK, but both indices gave similar information about the extent of muscle damage. In contrast, patients undergoing elective surgery for claudication showed no significant departure from reference values for myoglobin or CK. All patients in group 1 underwent fasciotomy to relieve raised compartmental pressures and five were treated with alkali and mannitol to produce diuresis. Despite these measures, two patients suffered renal failure (peak creatinine levels 611 and 590 mumol/l) after successful revascularization and subsequently required haemodialysis; these patients did not have diuresis. One of these patients died following a stroke 8 days after surgery; the other survived and was discharged with a normal limb and restored renal function. There was no evidence of muscle damage or renal complications in group 2.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Physics studies in Europe; a comparative study

    NARCIS (Netherlands)

    Steenstrup, S; dalle Rose, LFD; Jones, WG; Tugulea, L; van Steenwijk, FJ

    What are the differences and similarities between physics studies at different universities across Europe (here the definition of Europe is broad)? How much does a student have to work to obtain a degree in physics? Questions like those prompted EUPEN (European Physics Education Network) to make a

  20. Psychophysical correlates of phantom limb experience.

    Science.gov (United States)

    Katz, J

    1992-09-01

    Phantom limb phenomena were correlated with psychophysiological measures of peripheral sympathetic nervous system activity measured at the amputation stump and contralateral limb. Amputees were assigned to one of three groups depending on whether they reported phantom limb pain, non-painful phantom limb sensations, or no phantom limb at all. Skin conductance and skin temperature were recorded continuously during two 30 minute sessions while subjects continuously monitored and rated the intensity of any phantom limb sensation or pain they experienced. The results from both sessions showed that mean skin temperature was significantly lower at the stump than the contralateral limb in the groups with phantom limb pain and non-painful phantom limb sensations, but not among subjects with no phantom limb at all. In addition, stump skin conductance responses correlated significantly with the intensity of non-painful phantom limb paresthesiae but not other qualities of sensation or pain. Between-limb measures of pressure sensitivity were not significantly different in any group. The results suggest that the presence of a phantom limb, whether painful or painless, is related to the sympathetic-efferent outflow of cutaneous vasoconstrictor fibres in the stump and stump neuromas. The hypothesis of a sympathetic-efferent somatic-afferent mechanism involving both sudomotor and vasoconstrictor fibres is proposed to explain the relationship between stump skin conductance responses and non-painful phantom limb paresthesiae. It is suggested that increases in the intensity of phantom limb paresthesiae follow bursts of sympathetic activity due to neurotransmitter release onto apposing sprouts of large diameter primary afferents located in stump neuromas, and decreases correspond to periods of relative sympathetic inactivity. The results of the study agree with recent suggestions that phantom limb pain is not a unitary syndrome, but a symptom class with each class subserved by

  1. Neuromuscular taping for the upper limb in Cerebral Palsy: A case study in a patient with hemiplegia.

    Science.gov (United States)

    Camerota, Filippo; Galli, Manuela; Cimolin, Veronica; Celletti, Claudia; Ancillao, Andrea; Blow, David; Albertini, Giorgio

    2014-12-01

    To assess quantitatively the effects of Neuromuscular Taping (NMT) on the upper limb in a female child with left hemiplegia, due to Cerebral Palsy (CP). The patient underwent NMT on cervical level, shoulder and hand only of the plegic upper limb, followed by physical therapy. Kinematic data of upper limbs during reaching task were collected before (PRE) and after 2 weeks of treatment (POST). After the intervention, the affected limb improved in terms of movement duration, Average Jerk and Number of Unit Movements indices, indicating a faster, smoother and less segmented movement. Improvements appeared at the ranges of motion of the upper limb joints, both at shoulder and elbow joints. No significant changes were globally displayed for the unaffected arm. NMT seems to be a promising intervention for improving upper limb movement in patients with CP. Further investigations are certainly needed to assess effectively the effects of the intervention in this pathological state.

  2. Comparative anatomy, homologies and evolution of the pectoral and forelimb musculature of tetrapods with special attention to extant limbed amphibians and reptiles.

    Science.gov (United States)

    Abdala, Virginia; Diogo, Rui

    2010-11-01

    The main aim of the present work is to synthesize the information obtained from our dissections of the pectoral and forelimb muscles of representative members of the major extant taxa of limbed amphibians and reptiles and from our review of the literature, in order to provide an account of the comparative anatomy, homologies and evolution of these muscles in the Tetrapoda. The pectoral and forelimb musculature of all these major taxa conform to a general pattern that seems to have been acquired very early in the evolutionary history of tetrapods. Although some muscles are missing in certain taxa, and a clear departure from this general pattern is obviously present in derived groups such as birds, the same overall configuration is easily distinguishable in these taxa. Among the most notable anatomical differences between the groups, one that seems to have relevant evolutionary and functional implications, concerns the distal insertion points of the forearm musculature. In tetrapods, the muscles of the radial and ulnar complexes of the forearm are pleisomorphically mainly inserted onto the radius/ulna or onto the more proximal carpal bones, but in mammals some of these muscles insert more distally onto bones such as the metacarpals. Interestingly, a similar trend towards a more distal insertion of these muscles is also found in some non-mammalian tetrapod taxa, such as some anurans (e.g. Phyllomedusa). This may be correlated with the acquisition of more subtle digital movement abilities in these latter taxa. © 2010 The Authors. Journal of Anatomy © 2010 Anatomical Society of Great Britain and Ireland.

  3. Cutaneous chemical burns in children - a comparative study.

    Science.gov (United States)

    Hardwicke, Joseph; Bechar, Janak; Bella, Husam; Moiemen, Naiem

    2013-12-01

    Exposure to chemicals is an unusual causation of cutaneous burns in children. The aim of this study is to look at childhood chemical burns and compare this to adult chemical burns from the same population. A total of 2054 patients were referred to the pediatric burns unit during the study period. This included 24 cutaneous chemical burns, equating to an incidence of 1.1%. Over half of the injuries occurred in the domestic setting. The mean total body surface area (TBSA) affected was 1.9%. When compared to a cohort of adult patients from the same population with cutaneous chemical burns, the TBSA affected was identical (1.9%) but distribution favored the buttock and perineum in children, rather than the distal lower limb in adults. Children presented earlier, had lower rates of surgical intervention and had a shorter length of stay in hospital (p Chemical burns in children are rare, but are becoming more common in our region. It is important to be aware of the characteristic distribution, etiology and need to identify children at risk of child protection issues.

  4. A basic study on variable-gain Kalman filter based on angle error calculated from acceleration signals for lower limb angle measurement with inertial sensors.

    Science.gov (United States)

    Teruyama, Yuta; Watanabe, Takashi

    2013-01-01

    In this study, development of wearable motion measurement system using inertial sensors has been focused with the aim of rehabilitation support. For measurement of lower limb joint angles with inertial sensors, Kalman-filtering-based angle measurement method was developed. However, it was required to reduce variation of measurement errors that depended on movement speeds or subjects. In this report, variable-gain Kalman filter based on the difference between the estimated angle by the Kalman filter and the angle calculated from acceleration signals was tested. From angle measurement during treadmill walking with healthy subjects, it was shown that measurement accuracy of the foot inclination angle was significantly improved with the proposed method compared to the method of fixed parameter value.

  5. Agency over a phantom limb and electromyographic activity on the stump depend on visuomotor synchrony: a case study

    OpenAIRE

    Imaizumi, Shu; Asai, Tomohisa; Kanayama, Noriaki; Kawamura, Mitsuru; Koyama, Shinichi

    2014-01-01

    Most patients, post-amputation, report the experience of a phantom limb. Some even sense voluntary movements when viewing a mirror image of the intact limb superimposed onto the phantom limb. While delayed visual feedback of an action is known to reduce a sense of agency, the effect of delayed visual feedback on phantom motor sensation (i.e., sense of controlling a phantom limb) has not been examined. Using a video-projection system, we examined the effect of delayed visual feedback on phanto...

  6. The Influence Studies in Comparative Literature

    Institute of Scientific and Technical Information of China (English)

    张宏莹

    2010-01-01

    Comparative literature arose in the 19th century,the approach adopted for its influence study has been developed and diversified in different eras,in this article,the influence study in comparative literature through a reading culture is discussed in order to reveal in what aspects the reading culture may cut across the regional border of influence study.

  7. A longitudinal study of functional magnetic resonance imaging in upper-limb hemiplegia after stroke treated with constraint-induced movement therapy.

    Science.gov (United States)

    Sheng, Bi; Lin, Ma

    2009-01-01

    To investigate the correlation of cerebral function reorganization and functional recovery by using functional magnetic resonance imaging (fMRI) with constraint-induced movement therapy (CIMT) for chronic upper-limb hemiparesis in one subject with stroke. The patient was treated with 2 weeks of CIMT and the unaffected upper-limb was restricted by a splint for 2 weeks. Clinical measures and functional magnetic resonance imaging (fMRI) tests were performed 1 day before the treatment, the day of after the treatment and 2 weeks after the treatment. Compared with the baseline, Upper Extremity Function Test (UEFT) of the patient's upper limb increased by 29.1% and Simple Test for Evaluating Hand Function (STEF) increased by 18.4%. Before, after and 2 weeks after the treatment, changes of activation in brain by using fMRI were found during the movement of the affected and unaffected hand. CIMT could significantly improve the upper limb movement function of stroke patients and fMRI proved that this kind of change was related with the plasticity change of the cerebrum. The motor function of the unaffected limb could not be affected when it was restricted and the change of the cerebrum excitation area was a transient change.

  8. The Effectiveness of Intravenous Morphine Infusion as Preemptive Analgesia in Preventing Phantom Limb Pain Following Lower Limb Amputation

    Directory of Open Access Journals (Sweden)

    KC Chong

    2010-11-01

    Full Text Available hantom limb pain may reduce ambulation and mobility in amputees, resulting in diminished quality of life. We conducted a prospective study to compare the perioperative analgesic use of intravenous morphine infusion in 27 patients (Group A and intramuscular diclofenac sodium in 28 patients (Group B in patients undergoing lower limb amputation. All patients underwent amputation under spinal anaesthesia and reported a Modified Verbal Numerical Pain Score of less than two prior to the procedure. Presence of phantom pain was assessed on the first, second, third and seventh day as well as at the third month and sixth month post-operatively. Twelve (44 % patients from group A and 21 patients (75 % from group B developed phantom limb pain following amputation, a statistically significant difference between groups (p<0.05. We conclude that intravenous morphine infusion is more effective than intramuscular diclofenac sodium in preventing the occurrence of phantom limb pain following amputation.

  9. Pharmacologically induced/exacerbated restless legs syndrome, periodic limb movements of sleep, and REM behavior disorder/REM sleep without atonia: literature review, qualitative scoring, and comparative analysis.

    Science.gov (United States)

    Hoque, Romy; Chesson, Andrew L

    2010-02-15

    Pharmacologically induced/exacerbated restless legs syndrome (RLS), periodic limb movements in sleep (PLMS), and REM behavior disorder/REM sleep without atonia (RSWA) are increasingly recognized in clinical sleep medicine. A scoring system to evaluate the literature was created and implemented. The aim was to identify the evidence with the least amount of confound, allowing for more reliable determinations of iatrogenic etiology. Points were provided for the following criteria: manuscript type (abstract, peer-reviewed paper); population size studied (large retrospective study, small case series, case report); explicitly stated dosage timing; identification of peak symptoms related to time of medication administration (i.e., medication was ingested in the evening or at bedtime); initiation of a treatment plan; symptoms subsided or ceased with decreased dosage or drug discontinuation (for RLS articles only); negative personal history for RLS prior to use of the medication; exclusion of tobacco/alcohol/excessive caffeine use; exclusion of sleep disordered breathing by polysomnography (PSG); and PSG documentation of presence or absence of PLMS. For RLS and PLMS articles were also given points for the following criteria: each 2003 National Institutes of Health (NIH) RLS criteria met; exclusion of low serum ferritin; and exclusion of peripheral neuropathy by neurological examination. Thirty-two articles on drug-induced RLS, 6 articles on drug-induced PLMS, and 15 articles on drug-induced RBD/ RSWA were analyzed. Based on scores or = 10 are for the following drugs: bupropion, citalopram, fluoxetine, paroxetine, sertraline, and venlafaxine. Based on scores > or = 10 and/or trials of medication cessation, the strongest evidence for drug induced RBD/ RSWA is for the following drugs: clomipramine, selegiline, and phenelzine.

  10. Treatment with intramuscular vascular endothelial growth factor gene compared with placebo for patients with diabetes mellitus and critical limb ischemia : A double-blind randomized trial

    NARCIS (Netherlands)

    Kusumanto, YH; Van Weel, [No Value; Mulder, NH; Smit, AJ; Van den Dungen, JJAM; Hooymans, JMM; Sluiter, WJ; Tio, RA; Quax, PHA; Gans, ROB; Dullaart, RPF; Hospers, GAP

    2006-01-01

    Despite advances in revascularization techniques, limb salvage and relief of pain cannot be achieved in many diabetic patients with diffuse peripheral vascular disease. Our objective was to determine the effect of intramuscular administration of phVEGF(165) (vascular endothelial growth factor gene-c

  11. Change in health-related quality of life in the first 18 months after lower limb amputation : A prospective, longitudinal study

    NARCIS (Netherlands)

    Fortington, L.V.; Dijkstra, P.U.; Bosmans, J.C.; Post, W.J.; Geertzen, J.H.B.

    2013-01-01

    Objective: To describe changes in health-related quality of life in people with lower limb amputation, from time of amputation to 18 months, taking into consideration the influence of age and walking distance. In addition, quality of life for people with amputation is compared with the Dutch populat

  12. Change in health-related quality of life in the first 18 months after lower limb amputation : A prospective, longitudinal study

    NARCIS (Netherlands)

    Fortington, L.V.; Dijkstra, P.U.; Bosmans, J.C.; Post, W.J.; Geertzen, J.H.B.

    Objective: To describe changes in health-related quality of life in people with lower limb amputation, from time of amputation to 18 months, taking into consideration the influence of age and walking distance. In addition, quality of life for people with amputation is compared with the Dutch

  13. Research Priorities in Limb and Task-Specific Dystonias

    Directory of Open Access Journals (Sweden)

    Sarah Pirio Richardson

    2017-05-01

    Full Text Available Dystonia, which causes intermittent or sustained abnormal postures and movements, can present in a focal or a generalized manner. In the limbs, focal dystonia can occur in either the upper or lower limbs and may be task-specific causing abnormal motor performance for only a specific task, such as in writer’s cramp, runner’s dystonia, or musician’s dystonia. Focal limb dystonia can be non-task-specific and may, in some circumstances, be associated with parkinsonian disorders. The true prevalence of focal limb dystonia is not known and is likely currently underestimated, leaving a knowledge gap and an opportunity for future research. The pathophysiology of focal limb dystonia shares some commonalities with other dystonias with a loss of inhibition in the central nervous system and a loss of the normal regulation of plasticity, called homeostatic plasticity. Functional imaging studies revealed abnormalities in several anatomical networks that involve the cortex, basal ganglia, and cerebellum. Further studies should focus on distinguishing cause from effect in both physiology and imaging studies to permit focus on most relevant biological correlates of dystonia. There is no specific therapy for the treatment of limb dystonia given the variability in presentation, but off-label botulinum toxin therapy is often applied to focal limb and task-specific dystonia. Various rehabilitation techniques have been applied and rehabilitation interventions may improve outcomes, but small sample size and lack of direct comparisons between methods to evaluate comparative efficacy limit conclusions. Finally, non-invasive and invasive therapeutic modalities have been explored in small studies with design limitations that do not yet clearly provide direction for larger clinical trials that could support new clinical therapies. Given these gaps in our clinical, pathophysiologic, and therapeutic knowledge, we have identified priorities for future research including

  14. The Comparisons of Cerebral Hemodynamics Induced by Obstructive Sleep Apnea with Arousal and Periodic Limb Movement with Arousal: A Pilot NIRS Study

    Science.gov (United States)

    Zhang, Zhongxing; Schneider, Maja; Laures, Marco; Qi, Ming; Khatami, Ramin

    2016-01-01

    Obstructive sleep apnea syndrome (OSA) and restless legs syndrome (RLS) with periodic limb movement during sleep (PLMS) are two sleep disorders characterized by repetitive respiratory or movement events associated with cortical arousals. We compared the cerebral hemodynamic changes linked to periodic apneas/hypopneas with arousals (AHA) in four OSA-patients with periodic limb movements (PLMA) with arousals in four patients with RLS-PLMS using near-infrared spectroscopy (NIRS). AHA induced homogenous pattern of periodic fluctuations in oxygenated (HbO2) and deoxygenated (HHb) hemoglobin, i.e., the decrease of HbO2 was accompanied by an increase of HHb during the respiratory event and resolved to reverse pattern when cortical arousal started. Blood volume (BV) showed the same pattern as HHb but with relative smaller amplitude in most of the AHA events.These changing patterns were significant as Wilcoxon signed-rank tests gave p < 0.001 when comparing the area under the curve of these hemodynamic parameters to zero. By contrast, in PLMA limb movements induced periodic increments in HbO2 and BV (Wilcoxon signed-rank tests, p < 0.001), but HHb changed more heterogeneously even during the events coming from the same patient. Heart rate (HR) also showed different patterns between AHA and PLMA. It significantly decreased during the respiratory event (Wilcoxon signed-rank test, p < 0.001) and then increased after the occurrence of cortical arousal (Wilcoxon signed-rank test, p < 0.001); while in PLMA HR first increased preceding the occurrence of cortical arousal (Wilcoxon signed-rank test, p < 0.001) and then decreased. The results of this preliminary study show that both AHA and PLMA induce changes in cerebral hemodynamics. The occurrence of cortical arousal is accompanied by increased HR in both events, but by different BV changes (i.e., decreased/increased BV in AHA/PLMA, respectively). HR changes may partially account for the increased cerebral hemodynamics during PLMA

  15. Agency over a phantom limb and electromyographic activity on the stump depend on visuomotor synchrony: a case study

    Directory of Open Access Journals (Sweden)

    Shu eImaizumi

    2014-07-01

    Full Text Available Most patients, post-amputation, report the experience of a phantom limb. Some even sense voluntary movements when viewing a mirror image of the intact limb superimposed onto the phantom limb. While delayed visual feedback of an action is known to reduce a sense of agency, the effect of delayed visual feedback on phantom motor sensation (i.e., sense of controlling a phantom limb has not been examined. Using a video-projection system, we examined the effect of delayed visual feedback on phantom motor sensation in an upper-limb amputee (male; left upper-limb amputation. He was instructed to view mirrored video images of his intact hand clasping and unclasping during a phantom limb movement. He then rated the intensity of the phantom motor sensation. Three types of hand movement images were presented as follows: synchronous, asynchronous with a 250-ms delay, and asynchronous with a 500-ms delay. Results showed that phantom motor sensation decreased when the image was delayed by 250 and 500 ms. However, when we instructed the patient to adjust the phase of phantom limb movement to that of the image with a 500-ms delay, phantom motor sensation increased. There was also a positive correlation between intensity of phantom motor sensation and electromyographic activity on deltoids at the patient’s stump. These results suggest that phantom motor sensation and electromyographic activity on the stump depend on visuomotor synchrony and top-down effects.

  16. Agency over a phantom limb and electromyographic activity on the stump depend on visuomotor synchrony: a case study.

    Science.gov (United States)

    Imaizumi, Shu; Asai, Tomohisa; Kanayama, Noriaki; Kawamura, Mitsuru; Koyama, Shinichi

    2014-01-01

    Most patients, post-amputation, report the experience of a phantom limb. Some even sense voluntary movements when viewing a mirror image of the intact limb superimposed onto the phantom limb. While delayed visual feedback of an action is known to reduce a sense of agency, the effect of delayed visual feedback on phantom motor sensation (i.e., sense of controlling a phantom limb) has not been examined. Using a video-projection system, we examined the effect of delayed visual feedback on phantom motor sensation in an upper-limb amputee (male; left upper-limb amputation). He was instructed to view mirrored video images of his intact hand clasping and unclasping during a phantom limb movement. He then rated the intensity of the phantom motor sensation. Three types of hand movement images were presented as follows: synchronous, asynchronous with a 250-ms delay, and asynchronous with a 500-ms delay. Results showed that phantom motor sensation decreased when the image was delayed by 250 and 500 ms. However, when we instructed the patient to adjust the phase of phantom limb movement to that of the image with a 500-ms delay, phantom motor sensation increased. There was also a positive correlation between intensity of phantom motor sensation and electromyographic (EMG) activity on deltoids at the patient's stump. These results suggest that phantom motor sensation and EMG activity on the stump depend on visuomotor synchrony and top-down effects.

  17. Spatial Coupling Affects Both Homologous and Non-Homologous Limbs

    Science.gov (United States)

    Huh, Carey Y.

    2004-01-01

    The present study examined the interaction between limb movements in space. The amount of interaction was measured by how much moving one limb affected the movement of another limb. Participants were 24 right-handed university students (19 female, mean AGE=19 years). The task was to draw lines with the right hand while moving another limb in lines…

  18. Feasibility study of a wearable exoskeleton for children: is the gait altered by adding masses on lower limbs?

    Directory of Open Access Journals (Sweden)

    Stefano Rossi

    Full Text Available We are designing a pediatric exoskeletal ankle robot (pediatric Anklebot to promote gait habilitation in children with Cerebral Palsy (CP. Few studies have evaluated how much or whether the unilateral loading of a wearable exoskeleton may have the unwanted effect of altering significantly the gait. The purpose of this study was to evaluate whether adding masses up to 2.5 kg, the estimated overall added mass of the mentioned device, at the knee level alters the gait kinematics. Ten healthy children and eight children with CP, with light or mild gait impairment, walked wearing a knee brace with several masses. Gait parameters and lower-limb joint kinematics were analyzed with an optoelectronic system under six conditions: without brace (natural gait and with masses placed at the knee level (0.5, 1.0, 1.5, 2.0, 2.5 kg. T-tests and repeated measures ANOVA tests were conducted in order to find noteworthy differences among the trial conditions and between loaded and unloaded legs. No statistically significant differences in gait parameters for both healthy children and children with CP were observed in the five "with added mass" conditions. We found significant differences among "natural gait" and "with added masses" conditions in knee flexion and hip extension angles for healthy children and in knee flexion angle for children with CP. This result can be interpreted as an effect of the mechanical constraint induced by the knee brace rather than the effect associated with load increase. The study demonstrates that the mechanical constraint induced by the brace has a measurable effect on the gait of healthy children and children with CP and that the added mass up to 2.5 kg does not alter the lower limb kinematics. This suggests that wearable devices weighing 25 N or less will not noticeably modify the gait patterns of the population examined here.

  19. Influence of Total Knee Arthroplasty on Gait Mechanics of the Replaced and Non-Replaced Limb During Stair Negotiation.

    Science.gov (United States)

    Standifird, Tyler W; Saxton, Arnold M; Coe, Dawn P; Cates, Harold E; Reinbolt, Jeffrey A; Zhang, Songning

    2016-01-01

    This study compared biomechanics during stair ascent in replaced and non-replaced limbs of total knee arthroplasty (TKA) patients with control limbs of healthy participants. Thirteen TKA patients and fifteen controls performed stair ascent. Replaced and non-replaced knees of TKA patients were less flexed at contact compared to controls. The loading response peak knee extension moment was greater in control and non-replaced knees compared with replaced. The push-off peak knee abduction moment was elevated in replaced limbs compared to controls. Loading and push-off peak hip abduction moments were greater in replaced limbs compared to controls. The push-off peak hip abduction moment was greater in non-replaced limbs compared to controls. Future rehabilitation protocols should consider the replaced knee and also the non-replaced knee and surrounding joints.

  20. Periodic limb movements during sleep and prevalent hypertension in the multi-ethnic study of atherosclerosis.

    Science.gov (United States)

    Koo, Brian B; Sillau, Stefan; Dean, Dennis A; Lutsey, Pamela L; Redline, Susan

    2015-01-01

    Periodic limb movements during sleep (PLMS) are associated with immediate increases in blood pressure. Both PLMS and hypertension have different distributions across racial/ethnic groups. We sought to determine whether PLMS is associated with hypertension among various racial/ethnic groups. A total of 1740 men and women underwent measurement of blood pressure and polysomnography with quantification of PLMS. Hypertension was defined as systolic blood pressure (SBP) ≥140, diastolic BP ≥90, or taking antihypertensive medication. For those taking antihypertensives, an estimated pretreatment SBP value was derived based on observed SBP and medication type/dose. Measures of PLMS, PLMS index, and PLMS arousal index were the main explanatory variables. Hypertension and SBP were modeled with logistic and multivariable regression adjusted for age, sex, body mass index, cardiovascular risk factors, lifestyle/habitual factors, apnea-hypopnea index, and race/ethnicity. In the overall cohort, prevalent hypertension was modestly associated with PLMS index (10 U; odds ratio, 1.05; 95% confidence interval, 1.00-1.10) and PLMS arousal index (1 U; 1.05; 1.01-1.09) after adjusting for confounders. Association in the overall cohort was influenced by large effect sizes in blacks, in whom the odds of prevalent hypertension increased by 21% (1%-45%) for 10 U PLMS index increase and 20% (2%-42%) for 1-U PLMS arousal index increase. In blacks, every 1-U PLMS arousal index increase was associated with SBP 1.01 mm Hg higher (1.01; 0.04-1.98). Associations between PLMS and blood pressure outcomes were also suggested among Chinese-Americans but not in whites or Hispanics. In a multiethnic cohort of community-dwelling men and women, prevalent hypertension and SBP are associated with PLMS frequency in blacks.

  1. Can orthotic insoles prevent lower limb overuse injuries? A randomized-controlled trial of 228 subjects.

    Science.gov (United States)

    Mattila, V M; Sillanpää, P J; Salo, T; Laine, H-J; Mäenpää, H; Pihlajamäki, H

    2011-12-01

    Lower limb overuse injuries are common among people who are exposed to physical stress. Orthotic shoe insoles are widely used to prevent lower limb overuse injuries. Here, we conducted a randomized-controlled study to examine whether the use of orthotic insoles prevents lower limb overuse injuries. Participants (n=228) were randomly assigned to use (n=73) or not to use (n=147) orthotic insoles. The insoles were molded to the shape of the foot to provide support during physical activity. The main outcome measure in the present study was the physician-diagnosed lower limb overuse injury. Thirty-four (46.6%) subjects in the insole group were diagnosed with a lower limb overuse injury compared with 56 (38.1%) in the control group (P=0.29) during the 6-month study period. When body mass index and the results of a 12-min running test and muscle strength were adjusted in a Cox's regression model, the hazard ratio for lower limb overuse injury in the insole group was 1.3 (95% confidence intervals: 0.8-2.1) compared with the control group. Use of orthotic insoles was not associated with a decrease in lower limb overuse injuries. Our findings suggest that routine use of orthotic insoles does not prevent physical-stress-related lower limb injuries in healthy young male adults.

  2. Lower limb landmine injuries.

    Science.gov (United States)

    Necmioglu, S; Subasi, M; Kayikci, C; Young, D B

    2004-04-01

    The medical records of 186 patients seeking treatment for landmine injuries in the authors' region between 1993 and 2001 were evaluated. Of these patients 13 died of accompanying complications. Ten (10) patients with general body trauma and upper limb trauma were excluded from the study. Of 163 patients with lower-limb injuries included in the study, 21 with traumatic amputation underwent surgical amputation at different levels. Patients without traumatic amputation were divided into 2 groups. There were 41 patients (29%) in Group I who were treated by limb salvage procedures. Treatments used in Group I including wound debridement, tendon repair, skin approximation, minimal osteosynthesis, external fixation of long bones and secondary wound coverage. In Group II, there were 101 patients (71%) with primary amputation. Trans-tibial amputation was performed in 52 cases (51.4%), ankle disarticulation in 24 (23.7%), trans-femoral amputation in 9 (8.9%), partial foot amputation in 8 (7.9%), knee disarticulation in 7 (6.9%) and hip disarticulation in 1 case. In Group I, there was infection in 21 patients (51.2%), revision in 27 (65.8%), and amputation in 15 (36.5%). In Group II, there was infection in 28 patients (27.7%), revision in 17 (16.8%), and amputation at a higher level in 8 (7%). In crush injuries such as those resulting from landmines, soft tissue, vascular, and neurological assessment must be performed with utmost care. Even so, the desired success in interventions intended to save a limb is complicated by a high infection rate, soft tissue complications, and high revision amputation rates. Therefore, a decision to amputate in the early term based on an accurate preoperative assessment is crucial.

  3. Adjustments to amputation and an artificial limb in lower limb amputees

    NARCIS (Netherlands)

    Sinha, Richa; van den Heuvel, Wim J. A.; Arokiasamy, Perianayagam

    2014-01-01

    Background: Positive adjustments to amputation and an artificial limb play important roles in the rehabilitation process. Objectives: To study the different facets of adjustments to amputation and an artificial limb in lower limb amputees and to assess the possible role of different background and a

  4. Adjustments to amputation and an artificial limb in lower limb amputees

    NARCIS (Netherlands)

    Sinha, Richa; van den Heuvel, Wim J. A.; Arokiasamy, Perianayagam

    Background: Positive adjustments to amputation and an artificial limb play important roles in the rehabilitation process. Objectives: To study the different facets of adjustments to amputation and an artificial limb in lower limb amputees and to assess the possible role of different background and

  5. Development of lower limb range of motion from early childhood to adolescence in cerebral palsy: a population-based study

    Directory of Open Access Journals (Sweden)

    Lauge-Pedersen Henrik

    2009-10-01

    Full Text Available Abstract Background The decreasing range of joint motion caused by insufficient muscle length is a common problem in children with cerebral palsy (CP, often worsening with age. In 1994 a CP register and health care programme for children with CP was initiated in southern Sweden. The aim of this study was to analyse the development of the passive range of motion (ROM in the lower limbs during all the growth periods in relation to gross motor function and CP subtype in the total population of children with CP. Methods In total, 359 children with CP born during 1990-1999, living in the southernmost part of Sweden in the year during which they reached their third birthday and still living in the area in the year of their seventh birthday were analysed. The programme includes a continuous standardized follow-up with goniometric measurements of ROM in the lower limbs. The assessments are made by each child's local physiotherapist twice a year until 6 years of age, then once a year. In total, 5075 assessments from the CPUP database from 1994 to 1 January 2007 were analysed. Results The study showed a decreasing mean range of motion over the period 2-14 years of age in all joints or muscles measured. The development of ROM varied according to GMFCS level and CP subtype. Conclusion We found a decreasing ROM in children with CP from 2-14 years of age. This information is important for both the treatment and follow-up planning of the individual child as well as for the planning of health care programmes for all children with CP.

  6. The effect of limb crossing and limb congruency on multisensory integration in peripersonal space for the upper and lower extremities

    NARCIS (Netherlands)

    van Elk, M.; Forget, J.; Blanke, O.

    2013-01-01

    The present study investigated how multisensory integration in peripersonal space is modulated by limb posture (i.e. whether the limbs are crossed or uncrossed) and limb congruency (i.e. whether the observed body part matches the actual position of one’s limb). This was done separately for the upper

  7. Factors Influencing Goal Attainment in Patients with Post-Stroke Upper Limb Spasticity Following Treatment with Botulinum Toxin A in Real-Life Clinical Practice: Sub-Analyses from the Upper Limb International Spasticity (ULIS)-II Study

    OpenAIRE

    Fheodoroff, Klemens; Ashford, Stephen; Jacinto, Jorge; Maisonobe, Pascal; Balcaitiene, Jovita; Turner-Stokes, Lynne

    2015-01-01

    In this post-hoc analysis of the ULIS-II study, we investigated factors influencing person-centred goal setting and achievement following botulinum toxin-A (BoNT-A) treatment in 456 adults with post-stroke upper limb spasticity (ULS). Patients with primary goals categorised as passive function had greater motor impairment (p < 0.001), contractures (soft tissue shortening [STS]) (p = 0.006) and spasticity (p = 0.02) than those setting other goal types. Patients with goals categorised as active...

  8. Factors Influencing Goal Attainment in Patients with Post-Stroke Upper Limb Spasticity Following Treatment with Botulinum Toxin A in Real-Life Clinical Practice: Sub-Analyses from the Upper Limb International Spasticity (ULIS)-II Study

    OpenAIRE

    Klemens Fheodoroff; Stephen Ashford; Jorge Jacinto; Pascal Maisonobe; Jovita Balcaitiene; Lynne Turner-Stokes

    2015-01-01

    In this post-hoc analysis of the ULIS-II study, we investigated factors influencing person-centred goal setting and achievement following botulinum toxin-A (BoNT-A) treatment in 456 adults with post-stroke upper limb spasticity (ULS). Patients with primary goals categorised as passive function had greater motor impairment (p < 0.001), contractures (soft tissue shortening [STS]) (p = 0.006) and spasticity (p = 0.02) than those setting other goal types. Patients with goals categorised as act...

  9. Low-Frequency Repetitive Transcranial Magnetic Stimulation and Intensive Occupational Therapy for Poststroke Patients with Upper Limb Hemiparesis: Preliminary Study of a 15-Day Protocol

    Science.gov (United States)

    Kakuda, Wataru; Abo, Masahiro; Kobayashi, Kazushige; Momosaki, Ryo; Yokoi, Aki; Fukuda, Akiko; Ishikawa, Atsushi; Ito, Hiroshi; Tominaga, Ayumi

    2010-01-01

    The purpose of the study was to determine the safety and feasibility of a 15-day protocol of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with intensive occupational therapy (OT) on motor function and spasticity in hemiparetic upper limbs in poststroke patients. Fifteen poststroke patients (age at study entry 55 [plus…

  10. How Depressive Levels Are Related to the Adults' Experiences of Lower-Limb Amputation: A Mixed Methods Pilot Study

    Science.gov (United States)

    Senra, Hugo

    2013-01-01

    The current pilot study aims to explore whether different adults' experiences of lower-limb amputation could be associated with different levels of depression. To achieve these study objectives, a convergent parallel mixed methods design was used in a convenience sample of 42 adult amputees (mean age of 61 years; SD = 13.5). All of them had…

  11. [Phantom limb pain].

    Science.gov (United States)

    Steffen, Peter

    2006-06-01

    Almost everyone who has amputated a limb will experience a phantom limb. They have the vivid impression, that the limb is still present. 60 to 70% of these amputees will suffer from phantom limb pain. The present paper gives an overview of the incidence and the characteristics of the so called "post amputation syndrome". Possible mechanism of this phenomena are presented, including peripheral, spinal, and central theories. Treatment of phantom limb pain is sometimes very difficult. It includes drug therapy, psychological therapy, physiotherapy as well as the prevention of phantom limb pain with regional analgesia techniques.

  12. A Comparative Study of Whitman and Frost

    Institute of Scientific and Technical Information of China (English)

    田寨耕

    2014-01-01

    Walt Whitman and Robert Frost are both famous poets in American literary history. They share a great deal in common. This paper attempts to make a study of the two poets by means of comparing their similarities and differences.

  13. Assessment of Lower Limb Muscle Strength and Power Using Hand-Held and Fixed Dynamometry: A Reliability and Validity Study.

    Science.gov (United States)

    Mentiplay, Benjamin F; Perraton, Luke G; Bower, Kelly J; Adair, Brooke; Pua, Yong-Hao; Williams, Gavin P; McGaw, Rebekah; Clark, Ross A

    2015-01-01

    Hand-held dynamometry (HHD) has never previously been used to examine isometric muscle power. Rate of force development (RFD) is often used for muscle power assessment, however no consensus currently exists on the most appropriate method of calculation. The aim of this study was to examine the reliability of different algorithms for RFD calculation and to examine the intra-rater, inter-rater, and inter-device reliability of HHD as well as the concurrent validity of HHD for the assessment of isometric lower limb muscle strength and power. 30 healthy young adults (age: 23±5 yrs, male: 15) were assessed on two sessions. Isometric muscle strength and power were measured using peak force and RFD respectively using two HHDs (Lafayette Model-01165 and Hoggan microFET2) and a criterion-reference KinCom dynamometer. Statistical analysis of reliability and validity comprised intraclass correlation coefficients (ICC), Pearson correlations, concordance correlations, standard error of measurement, and minimal detectable change. Comparison of RFD methods revealed that a peak 200 ms moving window algorithm provided optimal reliability results. Intra-rater, inter-rater, and inter-device reliability analysis of peak force and RFD revealed mostly good to excellent reliability (coefficients ≥ 0.70) for all muscle groups. Concurrent validity analysis showed moderate to excellent relationships between HHD and fixed dynamometry for the hip and knee (ICCs ≥ 0.70) for both peak force and RFD, with mostly poor to good results shown for the ankle muscles (ICCs = 0.31-0.79). Hand-held dynamometry has good to excellent reliability and validity for most measures of isometric lower limb strength and power in a healthy population, particularly for proximal muscle groups. To aid implementation we have created freely available software to extract these variables from data stored on the Lafayette device. Future research should examine the reliability and validity of these variables in clinical

  14. Assessment of Lower Limb Muscle Strength and Power Using Hand-Held and Fixed Dynamometry: A Reliability and Validity Study.

    Directory of Open Access Journals (Sweden)

    Benjamin F Mentiplay

    Full Text Available Hand-held dynamometry (HHD has never previously been used to examine isometric muscle power. Rate of force development (RFD is often used for muscle power assessment, however no consensus currently exists on the most appropriate method of calculation. The aim of this study was to examine the reliability of different algorithms for RFD calculation and to examine the intra-rater, inter-rater, and inter-device reliability of HHD as well as the concurrent validity of HHD for the assessment of isometric lower limb muscle strength and power.30 healthy young adults (age: 23±5 yrs, male: 15 were assessed on two sessions. Isometric muscle strength and power were measured using peak force and RFD respectively using two HHDs (Lafayette Model-01165 and Hoggan microFET2 and a criterion-reference KinCom dynamometer. Statistical analysis of reliability and validity comprised intraclass correlation coefficients (ICC, Pearson correlations, concordance correlations, standard error of measurement, and minimal detectable change.Comparison of RFD methods revealed that a peak 200 ms moving window algorithm provided optimal reliability results. Intra-rater, inter-rater, and inter-device reliability analysis of peak force and RFD revealed mostly good to excellent reliability (coefficients ≥ 0.70 for all muscle groups. Concurrent validity analysis showed moderate to excellent relationships between HHD and fixed dynamometry for the hip and knee (ICCs ≥ 0.70 for both peak force and RFD, with mostly poor to good results shown for the ankle muscles (ICCs = 0.31-0.79.Hand-held dynamometry has good to excellent reliability and validity for most measures of isometric lower limb strength and power in a healthy population, particularly for proximal muscle groups. To aid implementation we have created freely available software to extract these variables from data stored on the Lafayette device. Future research should examine the reliability and validity of these variables in

  15. Retrieval of stratospheric ozone profiles from MIPAS/ENVISAT limb emission spectra: a sensitivity study

    Directory of Open Access Journals (Sweden)

    N. Glatthor

    2005-11-01

    Full Text Available We report on the dependance of ozone volume mixing ratio profiles, retrieved from spectra of the Michelson Interferometer for Passive Atmospheric Sounding (MIPAS, on different retrieval setups such as different a-priori profiles, regularization strengths and spectral regions used for analysis. MIPAS is a spaceborne limb-viewing Fourier transform infrared (FTIR emission spectrometer, by which vertical profiles of various trace gases can be measured simultaneously. Purpose of this investigation is to check and to optimize the current retrieval setup. The choice of different a-priori profiles, of a different approach to retrieve the continuum radiation, and of a weaker regularization than in the reference data version (V2_O3_2 causes only small to moderate deviations of up to ±0.2, −0.3 and ±0.5 ppmv, respectively, in the retrieved ozone volume mixing ratios below 60 km altitude. Use of different microwindow sets optimized for polar, mid-latitude and tropical conditions results in deviations of up to ±1.5 ppmv in the altitude region of the ozone maximum, exceeding the total estimated retrieval error of 0.65 ppmv (polar regions – 1.2 ppmv (tropics in this height region. Therefore, to avoid latitudinal artefacts, one fixed set of microwindows is considered more appropriate for retrieval of a whole orbit rather than a latitude-dependent microwindow selection. For this task the microwindow set optimized for the polar atmosphere was found to be better suitable than its midlatitude and tropical counterparts. The results from the different microwindow sets, which variably cover MIPAS spectral bands A (685–970 cm−1 and AB (1020–1170 cm−1, indicated a positive bias of up to 1ppmv between the ozone maxima retrieved from the ozone emission in MIPAS band AB only and from combined analysis of MIPAS bands A and AB. Further investigations showed that this discrepancy can be caused by a bias between the radiance calibration of

  16. Treatment of phantom limb pain (PLP based on augmented reality and gaming controlled by myoelectric pattern recognition: a case study of a chronic PLP patient

    Directory of Open Access Journals (Sweden)

    Max eOrtiz-Catalan

    2014-02-01

    Full Text Available A variety of treatments have been historically used to alleviate phantom limb pain (PLP with varying efficacy. Recently, virtual reality (VR has been employed as a more sophisticated mirror therapy. Despite the advantages of VR over a conventional mirror, this approach has retained the use of the contralateral limb and is therefore restricted to unilateral amputees. Moreover, this strategy disregards the actual effort made by the patient to produce phantom motions. In this work, we investigate a treatment in which the virtual limb responds directly to myoelectric activity at the stump, while the illusion of a restored limb is enhanced through augmented reality (AR. Further, phantom motions are facilitated and encouraged through gaming.The proposed set of technologies was administered to a chronic PLP patient who has shown resistance to a variety of treatments (including mirror therapy for 48 years. Individual and simultaneous phantom movements were predicted using myoelectric pattern recognition and were then used as input for VR and AR environments, as well as for a racing game.The sustained level of pain reported by the patient was gradually reduced to complete pain-free periods. The phantom posture initially reported as a strongly closed fist was gradually relaxed, interestingly resembling the neutral posture displayed by the virtual limb. The patient acquired the ability to freely move his phantom limb and a telescopic effect was observed where the position of the phantom hand was restored to the anatomically correct distance. More importantly, the effect of the interventions was positively and noticeably perceived by the patient and his relatives.Despite the limitation of a single case study, the successful results of the proposed system in a patient for whom other medical and non-medical treatments have been ineffective justifies and motivates further investigation in a wider study.

  17. Treatment of phantom limb pain (PLP) based on augmented reality and gaming controlled by myoelectric pattern recognition: a case study of a chronic PLP patient.

    Science.gov (United States)

    Ortiz-Catalan, Max; Sander, Nichlas; Kristoffersen, Morten B; Håkansson, Bo; Brånemark, Rickard

    2014-01-01

    A variety of treatments have been historically used to alleviate phantom limb pain (PLP) with varying efficacy. Recently, virtual reality (VR) has been employed as a more sophisticated mirror therapy. Despite the advantages of VR over a conventional mirror, this approach has retained the use of the contralateral limb and is therefore restricted to unilateral amputees. Moreover, this strategy disregards the actual effort made by the patient to produce phantom motions. In this work, we investigate a treatment in which the virtual limb responds directly to myoelectric activity at the stump, while the illusion of a restored limb is enhanced through augmented reality (AR). Further, phantom motions are facilitated and encouraged through gaming. The proposed set of technologies was administered to a chronic PLP patient who has shown resistance to a variety of treatments (including mirror therapy) for 48 years. Individual and simultaneous phantom movements were predicted using myoelectric pattern recognition and were then used as input for VR and AR environments, as well as for a racing game. The sustained level of pain reported by the patient was gradually reduced to complete pain-free periods. The phantom posture initially reported as a strongly closed fist was gradually relaxed, interestingly resembling the neutral posture displayed by the virtual limb. The patient acquired the ability to freely move his phantom limb, and a telescopic effect was observed where the position of the phantom hand was restored to the anatomically correct distance. More importantly, the effect of the interventions was positively and noticeably perceived by the patient and his relatives. Despite the limitation of a single case study, the successful results of the proposed system in a patient for whom other medical and non-medical treatments have been ineffective justifies and motivates further investigation in a wider study.

  18. CURRICULAR OFFER INFLUENCING STUDENTS’ SATISFACTION: COMPARATIVE STUDY

    OpenAIRE

    Oana DUMITRASCU; Constantin Manuel HILA

    2014-01-01

    The main objective of the study is the determination of students’ satisfaction regarding curricular activities. The study has been accomplished using the qualitative and quantitative research, using the bibliographic study, various secondary sources and different primary sources. The study is developed with a marketing research and accomplished using the survey method. 699 students from four universities have been questioned. Due to a comparative study the University of Applied Sciences Worms...

  19. A Comparative Study on Error Analysis

    DEFF Research Database (Denmark)

    Wu, Xiaoli; Zhang, Chun

    2015-01-01

    Title: A Comparative Study on Error Analysis Subtitle: - Belgian (L1) and Danish (L1) learners’ use of Chinese (L2) comparative sentences in written production Xiaoli Wu, Chun Zhang Abstract: Making errors is an inevitable and necessary part of learning. The collection, classification and analysis...... the occurrence of errors either in linguistic or pedagogical terms. The purpose of the current study is to demonstrate the theoretical and practical relevance of error analysis approach in CFL by investigating two cases - (1) Belgian (L1) learners’ use of Chinese (L2) comparative sentences in written production....... Finally, pedagogical implication of CFL is discussed and future research is suggested. Keywords: error analysis, comparative sentences, comparative structure ‘‘bǐ - 比’, Chinese as a foreign language (CFL), written production...

  20. Experimental Study on Seismic Behavior of Exterior Joints of Special-shaped Columns with Different Lengths of Limbs

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Four exterior joints with special-shaped columns which have different lengths of limbs are tested under low cyclic loading. Special-shaped columns adopted are L- and T-shaped in section. It can be concluded that crack pattern, failure mode and shear strength of joints are affected by the length of limb, and that shear strength and ductility increase with the length of limb; the joints with the flexural failure of the beam have better seismic behavior than those with the shear failure of the joint core.

  1. Changes in segmentation and setation along the anterior/posterior axis of the homonomous trunk limbs of a remipede (Crustacea, Arthropoda

    Directory of Open Access Journals (Sweden)

    Viacheslav N. Ivanenko

    2016-08-01

    Full Text Available This study describes the segmentation and setation at different developmental stages of the homonomous trunk limbs of the remipede Speleonectes tulumensis Yager, 1987 collected in anchialine caves of the Yucatan Peninsula. Most homonomous trunk limbs originate ventrolaterally and are composed of two protopodal segments, three exopodal segments and four endopodal segments; contralateral limb pairs are united by a sternal bar. However, the last few posterior limbs originate ventrally, are smaller sized, and have regressively fewer segments, suggesting that limb development passes through several intermediate steps beginning with a limb bud. A terminal stage of development is proposed for specimens on which the posterior somite bears a simple bilobate limb bud, and the adjacent somite bears a limb with a protopod comprised of a coxapod and basipod, and with three exopodal and four endopodal segments. On each trunk limb there are 20 serially homologous groups of setae, and the numbers of setae on different limbs usually varies. These groups of setae are arranged linearly and are identified based on the morphology of the setae and their position on the segments. The number of setae in these groups increases gradually from the anterior homonomous limb to a maximum between limbs 8–12; the number then decreases sharply on the more posterior limbs. Changes in the number of setae, which reach a maximum between trunk limbs 8–12, differ from changes in segmentation which vary only over the last few posterior trunk limbs. Following a vector analysis that identified a spatial pattern for these 20 groups of setae among the different homonomous limbs, the hypothesis was confirmed that the number of setae in any given group and any given limb is correlated with the group, with the position of the somite along the body axis, and with the number of somites present on the specimens. This is the first vector analysis used to analyze a pattern of developmental

  2. EFFICACY OF ADDING FENTANYL TO LIGNOCAINE – ADRENALINE COMBINATION IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB ORTHOPEDIC SURGERIES A MULTI - CENTER STUDY

    Directory of Open Access Journals (Sweden)

    Anish M

    2015-06-01

    Full Text Available BACKGROUND: Brachial plexus block is a suitable alternative to general anesthesia for surgeries of upper limb and it can be performed even in patients who are not adequately fit for general anesthesia. The significance of brachial plexus block has increased in recent years due to renewed interest in day care surgery. Lignocaine hydrochloride has been used extensively for brachial plexus block and it has the disadvantage of having short duration of action. Opioids when added to anesthetic mixtures may improve and prolo ng the action of local anesthetics during peripheral nerve blocks. Such postoperative pain control can reduce both narcotic requirements and narcotic induced side effects. Studies have shown the efficacy of opioids as analgesic adjuvants in prolonging the duration of brachial plexus block. With this background in mind, this study was conducted to compare the onset and duration of sensory and motor block produced by a mixture of lignocaine and adrenaline with that produced by a mixture of fentanyl, lignocain e and adrenaline. Aims: To assess the effectiveness of addition of fentanyl to a mixture of lignocaine and adrenaline in prolonging the duration of analgesia and motor block for upper limb orthopedic surgeries. MATERIALS AND METHODS: This multi - center rand omized control study was conducted in two tertiary care centers in 80 patients underwent elective upper limb orthopedic surgeries and they were allocated into two groups of 40 each group L and group F. the classical approach of supraclavicular brachial ple xus block. Drug used were 30 ml of lignocaine 1.5%+adrenaline 5mcg/ml + 0.5ml normal saline in group L and 30ml of lignocaine 1.5% + adrenaline 5mcg/ml + fentanyl 50 mcg in group F. Adequacy of block was assessed by the pin prick test and temperature test. Motor power was assessed by the modified Lowett scale. Sedation was monitored using the modified Ramsay scale. An assessment was made for onset of analgesia, onset of

  3. A Statistical Perspective on Running with Prosthetic Lower-Limbs: An Advantage or Disadvantage?

    Directory of Open Access Journals (Sweden)

    Hossein Hassani

    2014-11-01

    Full Text Available Technological developments have led to the increased use of carbon fiber and prosthetic lower-limbs in running events at the Paralympic Games. This study aims to exploit a series of statistical techniques in order to prepare a response to the vital question of whether utilizing prosthetic feet can affect an athletes ability when running competitively at the Paralympics Games by comparing both within and between different classifications. The study also considers the differences between running on biological limbs and prosthetic lower-limbs from a mechanical point of view. The results from the male 100 m, 200 m and 400 m at the 2012 London Paralympic Games have been the source of this investigation. The investigation provides statistical evidence to propose that the number of prosthetic limbs used and the structure of such limbs have a significant impact on the outcome of track events at the Paralympic Games.

  4. Adolescents with Intellectual Disability Have Reduced Postural Balance and Muscle Performance in Trunk and Lower Limbs Compared to Peers without Intellectual Disability

    Science.gov (United States)

    Blomqvist, Sven; Olsson, Josefine; Wallin, Louise; Wester, Anita; Rehn, Borje

    2013-01-01

    For adolescent people with ID, falls are more common compared to peers without ID. However, postural balance among this group is not thoroughly investigated. The aim of this study was to compare balance and muscle performance among adolescents aged between 16 and 20 years with a mild to moderate intellectual disability (ID) to age-matched…

  5. Phantom limb pain

    Science.gov (United States)

    Amputation - phantom limb ... Bang MS, Jung SH. Phantom limb pain. In: Frontera, WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation . 3rd ed. Philadelphia, PA: Elsevier ...

  6. Mathematics education and comparative historical studies

    Directory of Open Access Journals (Sweden)

    Wagner RODRIGUES VALENTE

    2013-11-01

    Full Text Available This paper has as its aims: to characterize the area of research «history of mathematics education» and to defend the idea that mathematics education has constituted a privileged research theme within the field of comparative historical studies. To achieve these aims, the text includes references to a review of the literature concerning comparative studies, the analysis of two fundamental moments focused on attempts to internationalize the mathematics curriculum, both of which occurred during the 20th century, and, to end, a case study emanating from an international cooperation between researchers in Brazil and Portugal.

  7. Home-based neurologic music therapy for upper limb rehabilitation with stroke patients at community rehabilitation stage—a feasibility study protocol

    Science.gov (United States)

    Street, Alexander J.; Magee, Wendy L.; Odell-Miller, Helen; Bateman, Andrew; Fachner, Jorg C.

    2015-01-01

    Background: Impairment of upper limb function following stroke is more common than lower limb impairment and is also more resistant to treatment. Several lab-based studies with stroke patients have produced statistically significant gains in upper limb function when using musical instrument playing and techniques where rhythm acts as an external time-keeper for the priming and timing of upper limb movements. Methods: For this feasibility study a small sample size of 14 participants (3–60 months post stroke) has been determined through clinical discussion between the researcher and study host in order to test for management, feasibility and effects, before planning a larger trial determined through power analysis. A cross-over design with five repeated measures will be used, whereby participants will be randomized into either a treatment (n = 7) or wait list control (n = 7) group. Intervention will take place twice weekly over 6 weeks. The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance. A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies. Discussion: Before evaluating the effectiveness of a home-based intervention in a larger scale study, it is important to assess whether implementation of the trial methodology is feasible. This study investigates the feasibility, efficacy and patient experience of a music therapy treatment protocol comprising a chart of 12 different instrumental exercises and variations, which aims at promoting measurable changes in upper limb function in hemiparetic stroke patients. The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes. PMID:26441586

  8. Home-based Neurologic Music Therapy for Upper Limb Rehabilitation with Stroke Patients at Community Rehabilitation Stage - a Feasibility Study Protocol.

    Directory of Open Access Journals (Sweden)

    Alex J Street

    2015-09-01

    Full Text Available Background: Impairment of upper limb function following stroke is more common than lower limb impairment and is also more resistant to treatment. Several lab-based studies with stroke patients have produced statistically significant gains in upper limb function when using musical instrument playing and techniques where rhythm acts as an external time-keeper for the priming and timing of upper limb movements. Methods: For this feasibility study a small sample size of 14 participants (3 – 60 months post stroke has been determined through clinical discussion between the researcher and study host in order to test for management, feasibility and effects, before planning a larger trial determined through power analysis. A cross-over design with five repeated measures will be used, whereby participants will be randomized into either a treatment (n=7 or wait list control (n=7 group. Intervention will take place twice weekly over 6 weeks. The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance. A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies. Discussion: Before evaluating the effectiveness of a home-based intervention in a larger scale study, it is important to assess whether implementation of the trial methodology is feasible. This study investigates the feasibility, efficacy and patient experience of a music therapy treatment protocol comprising a chart of 12 different instrumental exercises and variations, which aims at promoting measurable changes in upper limb function in hemiparetic stroke patients. The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes.

  9. Magnetotactic bacteria and microjets: A comparative study

    NARCIS (Netherlands)

    Khalil, I.S.M.; Magdanz, Veronika; Sanchez, Samuel; Schmidt, Oliver G.; Misra, Sarthak

    2013-01-01

    We provide a comparative study between two self-propelled microrobots, i.e., magnetotactic bacteria and microjets. This study includes characterization of their fluidic properties (linear and rotational drag coefficients) based on their morphologies and characterization of their magnetic properties

  10. The Effect of Additional Virtual Reality Training on Balance in Children with Cerebral Palsy after Lower Limb Surgery: A Feasibility Study.

    Science.gov (United States)

    Meyns, Pieter; Pans, Liene; Plasmans, Kaat; Heyrman, Lieve; Desloovere, Kaat; Molenaers, Guy

    2017-02-01

    Impaired balance is disabling for children with cerebral palsy (CPc), especially for CPc who recently underwent lower limb surgery. Positive results of using virtual reality (VR) in balance rehabilitation have been published in several outpatient populations. We investigated the feasibility of applying additional VR training focused on sitting balance in CP inpatients of a rehabilitation center after lower limb surgery. Additionally, we investigated the rate of enjoyment of VR training compared with conventional physiotherapy. Eleven spastic CPc (4/7 males/females) following rehabilitation after lower limb orthopedic surgery were included (5-18 years). The control group received conventional physiotherapy. The intervention group received additional VR training. Balance was measured using the Trunk Control Measurement Scale every 3 weeks of the rehabilitation period. Enjoyment was analyzed using a 10-point Visual Analog Scale. Providing additional VR training was feasible in terms of recruitment, treatment adherence, and assessment adherence. Both groups improved sitting balance after therapy. The current games were not perceived as more enjoyable than conventional physiotherapy. Including additional VR training to conventional physiotherapy is feasible and might be promising to train sitting balance in CPc after lower limb surgery. Future research should take equal patient allocation and training duration between groups into consideration.

  11. Concurrent assessments of lower limb loading patterns, mechanical muscle strength and functional performance in ACL-patients - A cross-sectional study

    DEFF Research Database (Denmark)

    Holsgaard-Larsen, Anders; Jensen, C; Mortensen, N H M

    2014-01-01

    Full recovery in muscle strength and functional performance may not be achieved after ACL-injury. Aim: The aim of this study is to investigate loading patterns during jumping, muscle function and functional performance in ACL-reconstructed patients and to investigate the origin of between-limb...

  12. Sexual functioning and sexual well-being in people with a limb amputation : a cross-sectional study in the Netherlands

    NARCIS (Netherlands)

    Verschuren, Jesse E A; Geertzen, Jan H.; Enzlin, Paul; Dijkstra, Pieter U; Dekker, Rienk

    2015-01-01

    PURPOSE: This study aimed to: (a) investigate whether, and if so which, sexual problems are present in people with a limb amputation; (b) analyze how they experience their sexuality; and (c) investigate whether sexuality was discussed with them during their rehabilitation process. METHOD: In total,

  13. Sexual functioning and sexual well-being in people with a limb amputation : a cross-sectional study in the Netherlands

    NARCIS (Netherlands)

    Verschuren, Jesse E. A.; Geertzen, Jan H.; Enzlin, Paul; Dijkstra, Pieter U.; Dekker, Rienk

    2016-01-01

    Purpose: This study aimed to: (a) investigate whether, and if so which, sexual problems are present in people with a limb amputation; (b) analyze how they experience their sexuality; and (c) investigate whether sexuality was discussed with them during their rehabilitation process. Method: In total,

  14. Effects of Small-Sided Soccer Games on Internal and External Load and Lower Limb Power: A Pilot Study in Collegiate Players

    Directory of Open Access Journals (Sweden)

    Clemente Filipe Manuel

    2017-03-01

    Full Text Available Purpose. The aim of the study was to examine the influence of small-sided and conditioned games (SSG on the internal load (heart rate [HR] and perceived exertion, external load (Global Positioning System variables, and lower limb power (squat jump [SJ] and countermovement jump [CMJ].

  15. Diagnostic distribution of non-traumatic upper limb disorders

    DEFF Research Database (Denmark)

    Laursen, Lise H; Sjøgaard, Gisela; Hagert, C G

    2007-01-01

    BACKGROUND: Upper limb disorders (ULDs) are common, and so are the difficulties in specific diagnoses of these disorders. Prior studies have shed light on the nerves in the diagnostic approach beside disorders related to muscles, tendons and joints (MCDs). OBJECTIVE: The study aimed to compare th...

  16. Effects of peripheral dynamic movements on the lower-limb circulation assessed by thermography: three one-group studies

    Science.gov (United States)

    Kaerki, Anne; Laehdeniemi, Matti

    2002-03-01

    Peripheral dynamic movements are used as part of postoperative protocols and for preventing vascular complications during bed rest. The effects of peripheral movements have not been studied. The purposes of these studies were to explain the effects of peripheral dynamic movements on lower limb circulation. The aim was also to explain how other factors like sex, age, BMI, medication, smoking, sports activity etc. affect the circulation. Healthy young subjects (N=19), healthy elderly subjects (N=19) and diabetic subjects (N=21) participated in the studies between 1997 and 1999. The study design was the same in each study. Infrared technology and image processing belong to our focus fields of applied research and IR is widely used in our real time industrial applications including also ongoing research of new possibilities. This paper presents the results of our newest application of IR thermography, where it was used to measure the skin temperature over the soleus muscle during and after dynamic ankle movements. The results showed that the skin temperature increased further during the recovery period after movements, and temperature was highest after 3- 5 minutes. Diabetic male subjects were the only subgroup that had immediate decrease during recovery period. The studies showed that smoking had a negative effect on circulation. BMI had also negative correlation (-0,356), showing that subjects with higher BMI had less increase. The results proved that peripheral movements were effective for increasing circulation in the soleus muscle and the effect was still seen after 15 minutes.

  17. A COMPARATIVE STUDY OF BYG SEARCH ENGINES

    Directory of Open Access Journals (Sweden)

    Kailash Kumar

    2013-01-01

    Full Text Available This paper compares the retrieval effectiveness of the Bing, Yahoo and Google (BYG Search Engines. The precision and relative recall of each search engine was considered for evaluating the effectiveness of the search engines. General Queries were tested. Results of the study showed that the precision of Google was high as compared to other two search engines and Yahoo has better precision than Bing

  18. Major limb amputations: A tertiary hospital experience in northwestern Tanzania

    Directory of Open Access Journals (Sweden)

    Chalya Phillipo L

    2012-05-01

    Full Text Available Abstract Background Major limb amputation is reported to be a major but preventable public health problem that is associated with profound economic, social and psychological effects on the patient and family especially in developing countries where the prosthetic services are poor. The purpose of this study was to outline the patterns, indications and short term complications of major limb amputations and to compare our experience with that of other published data. Methods This was a descriptive cross-sectional study that was conducted at Bugando Medical Centre between March 2008 and February 2010. All patients who underwent major limb amputation were, after informed consent for the study, enrolled into the study. Data were collected using a pre-tested, coded questionnaire and analyzed using SPSS version 11.5 computer software. Results A total of 162 patients were entered into the study. Their ages ranged between 2–78 years (mean 28.30 ± 13.72 days. Males outnumbered females by a ratio of 2:1. The majority of patients (76.5% had primary or no formal education. One hundred and twelve (69.1% patients were unemployed. The most common indication for major limb amputation was diabetic foot complications in 41.9%, followed by trauma in 38.4% and vascular disease in 8.6% respectively. Lower limbs were involved in 86.4% of cases and upper limbs in 13.6% of cases giving a lower limb to upper limb ratio of 6.4:1 Below knee amputation was the most common procedure performed in 46.3%. There was no bilateral limb amputation. The most common additional procedures performed were wound debridement, secondary suture and skin grafting in 42.3%, 34.5% and 23.2% respectively. Two-stage operation was required in 45.4% of patients. Revision amputation rate was 29.6%. Post-operative complication rate was 33.3% and surgical site infection was the most common complication accounting for 21.0%. The mean length of hospital stay was 22.4 days and mortality

  19. Comparison of ultrasound-guided supraclavicular, infraclavicular and below-C6 interscalene brachial plexus block for upper limb surgery: a randomised, observer-blinded study.

    Science.gov (United States)

    Bharti, N; Bhardawaj, N; Wig, J

    2015-07-01

    This prospective, randomised, observer-blinded study was conducted to compare the ease of performance and surgical effectiveness of interscalene block below the C6 nerve root with supraclavicular and infraclavicular techniques of brachial plexus block for upper arm and forearm surgery. Sixty adult patients of American Society of Anesthesiologists grade 1 to 3, undergoing upper limb surgery, were randomly allocated into three groups. Group SC received supraclavicular blockade, group IC received infraclavicular blockade and Group IS received interscalene blockade. All blocks were guided by ultrasound with nerve stimulator confirmation. The anaesthetic mixture consisted of 0.5 ml/kg of equal volumes of 0.75% ropivacaine and 2% lignocaine-adrenaline. The imaging and block performance time, onset time, success rate, duration of block, and duration of postoperative analgesia were recorded by a blinded observer. The onset time was significantly longer in the interscalene group as compared with supraclavicular and infraclavicular approaches. The imaging time and block performance time were comparable between groups. No significant differences were observed between the three groups in terms of block-related pain scores, success rates, duration of block or of postoperative analgesia. Two patients in the interscalene group developed clinically detectable phrenic nerve palsy. Our findings indicate that, although interscalene block below the C6 nerve root can provide surgical anaesthesia for forearm and hand surgery, it appears to have a longer onset time than supra- and infraclavicular approaches and an unacceptable incidence of phrenic nerve palsy.

  20. Upper limb arterial thromboembolism

    DEFF Research Database (Denmark)

    Andersen, L V; Lip, Gregory Y.H.; Lindholt, J S;

    2013-01-01

    The aim of this review is to focus on risk factors, risk-modifying drugs and prognosis for upper limb arterial thromboembolism, and the relationship between upper limb arterial thromboembolism and atrial fibrillation (AF).......The aim of this review is to focus on risk factors, risk-modifying drugs and prognosis for upper limb arterial thromboembolism, and the relationship between upper limb arterial thromboembolism and atrial fibrillation (AF)....

  1. GRIN: “GRoup versus INdividual physiotherapy following lower limb intra-muscular Botulinum Toxin-A injections for ambulant children with cerebral palsy: an assessor-masked randomised comparison trial”: study protocol

    Science.gov (United States)

    2014-01-01

    Background Cerebral palsy is the most common cause of physical disability in childhood. Spasticity is a significant contributor to the secondary impairments impacting functional performance and participation. The most common lower limb spasticity management is focal intramuscular injections of Botulinum Toxin-Type A accompanied by individually-delivered (one on one) physiotherapy rehabilitation. With increasing emphasis on improving goal-directed functional activity and participation within a family-centred framework, it is timely to explore whether physiotherapy provided in a group could achieve comparable outcomes, encouraging providers to offer flexible models of physiotherapy delivery. This study aims to compare individual to group-based physiotherapy following intramuscular Botulinum Toxin-A injections to the lower limbs for ambulant children with cerebral palsy aged four to fourteen years. Methods/Design An assessor-masked, block randomised comparison trial will be conducted with random allocation to either group-based or individual physiotherapy. A sample size of 30 (15 in each study arm) will be recruited. Both groups will receive six hours of direct therapy following Botulinum Toxin-A injections in either an individual or group format with additional home programme activities (three exercises to be performed three times a week). Study groups will be compared at baseline (T1), then at 10 weeks (T2, efficacy) and 26 weeks (T3, retention) post Botulinum Toxin-A injections. Primary outcomes will be caregiver/s perception of and satisfaction with their child’s occupational performance goals (Canadian Occupational Performance Measure) and quality of gait (Edinburgh Visual Gait Score) with a range of secondary outcomes across domains of the International Classification of Disability, Functioning and Health. Discussion This paper outlines the study protocol including theoretical basis, study hypotheses and outcome measures for this assessor-masked, randomised

  2. Relationship between lower-limb muscle strength and functional independence among elderly people according to frailty criteria: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Fernanda Sotello Batista

    Full Text Available CONTEXT AND OBJECTIVE: Muscle strength and functional independence are considered to be determinants of frailty levels among elderly people. The aim here was to compare lower-limb muscle strength (LLMS with functional independence in relation to sex, age and number of frailty criteria, and to ascertain the influence of these variables on elderly outpatients' independence.DESIGN AND SETTING: Quantitative cross-sectional study, in a tertiary hospital.METHODS: The study was conducted on 150 elderly outpatients of both sexes who were in a cognitive condition allowing oral communication, between October 2005 and October 2007. The following instruments were used: five-times sit-to-stand test (FTSST, Functional Independence Measurement (FIM and Lawton's Instrumental Activities of Daily Living Scale (IADL. Descriptive, comparative, multivariate, univariate and Cronbach alpha analyses were performed.RESULTS: The mean time taken in the FTSST was 21.7 seconds; the mean score for FIM was 82.2 and for IADL was 21.2; 44.7% of the subjects presented 1-2 frailty criteria and 55.3% > 3 criteria. There was a significant association between LLMS and functional independence in relation to the number of frailty criteria, without homogeneity regarding sex and age. Functional independence showed significant influence from sex and LLMS.CONCLUSION: Elderly individuals with 1 or 2 frailty criteria presented greater independence in all FTSST scores. The subjects with higher LLMS presented better functional independence.

  3. Gait training with Hybrid Assistive Limb enhances the gait functions in subacute stroke patients: A pilot study.

    Science.gov (United States)

    Yoshikawa, Kenichi; Mizukami, Masafumi; Kawamoto, Hiroaki; Sano, Ayumu; Koseki, Kazunori; Sano, Kumiko; Asakawa, Yasutsugu; Kohno, Yutaka; Nakai, Kei; Gosho, Masahiko; Tsurushima, Hideo

    2017-01-01

    The robotic Hybrid Assistive Limb (HAL) provides motion according to the wearer's voluntary activity. HAL training effects on walking speed and capacity have not been clarified in subacute stroke. To determine improvement in walking ability by HAL and the most effective improvement measure for use in future large-scale trials. Sixteen first-ever hemiplegic stroke patients completed at least 20 sessions over 5 weeks. Per session, the experimental group received no more than 20 min of gait training with HAL (HT) and 40 min of conventional physiotherapy, whereas the control group received at least 60 min of conventional physiotherapy. Primary outcome was maximum walking speed (MWS). The change in MWS from baseline at week 5 was 11.6±10.6 m/min (HAL group) and 2.2±4.1 m/min (control group) (adjusted mean difference = 9.24 m/min, 95% confidence interval 0.48-18.01, P = 0.040). In HAL subjects there were significant increases in Self-selected walking speed (SWS; a secondary outcome) and in step length (a secondary outcome) at MWS and SWS compared with controls. HT improved walking speed in hemiplegic sub-acute stroke patients. In future, randomized controlled trials are needed to confirm the utility of HT.

  4. The role of cell transplantation in modifying the course of limb girdle muscular dystrophy: a longitudinal 5-year study

    Directory of Open Access Journals (Sweden)

    Sharma A

    2015-09-01

    Full Text Available Alok Sharma,1 Hemangi Sane,2 Nandini Gokulchandran,1 Sushant Gandhi,3 Pradnya Bhovad,3 Dipti Khopkar,2 Amruta Paranjape,2 Khushboo Bhagwanani,3 Prerna Badhe1 1Department of Medical Services and Clinical Research, 2Department of Research and Development, 3Department of Neurorehabilitation, NeuroGen Brain and Spine Institute, Stemasia Hospital and Research Centre, Nerul, Navi Mumbai, Maharashtra, India Abstract: Limb girdle muscular dystrophy (LGMD, a group of progressive degenerative disorders, causes functional limitation affecting the quality of life. Cell therapy is being widely explored and preliminary studies have shown beneficial effects. Cell therapy induces trophic-factors release, angiogenesis, anti-inflammation, and protein synthesis, which helps in the reparative process at the microcellular level. In this 5-year longitudinal study, the effect of autologous bone marrow mononuclear cells is studied on the natural course of 65 patients with LGMD. Functional Independence Measure and manual muscle testing showed statistically significant improvement, post-cell transplantation. The key finding of this study was demonstration of a plateau phase in the disease progression of the patients. No adverse events were noted. Autologous bone marrow mononuclear cells may be a novel, safe, and effective treatment approach to control the rate of progression of LGMD, thus improving the functional outcomes. Further randomized controlled trials are required. Keywords: cell therapy, autologous, bone marrow

  5. Vasculitis neuropathy mimicking lower limb mono-radiculopathy: a study and follow-up of 8 cases.

    Science.gov (United States)

    Lozeron, Pierre; Lacroix, Catherine; Michon, Mathilde; Theaudin, Marie; Petit Lacour, Marie-Christine; Denier, Christian; Adams, David

    2013-10-01

    The aim of this study was to describe misleading lower limb mono radiculopathy revealing peripheral nerve vasculitis. Retrospective review of eight patients with biopsy confirmed vasculitis presenting as mono-radicululopathy in a tertiary referral centre dedicated to patients with rare peripheral neuropathies. Patients presented with chronic (6/8) or acute (n = 2) radiculopathy in L4, L5 or S1 territories associated with subtle systemic signs. A diagnostic workup was performed because of secondary motor deficit, the absence of clear radicular compression or failure of initial treatment focused on pain relief. In all, nerve conduction studies showed signs of asymmetrical axonal peripheral neuropathy (mononeuritis multiplex). Necrotizing vasculitis was eventually confirmed by peripheral nerve biopsy. Biological markers of inflammation or eosinophilia were present in 5/8 and a progressive motor deficit (7/8) is suggestive of the diagnosis. Under steroid treatment, all patients improved during a mean of 2 years 6 months of follow-up (Mean Rankin score improvement 1.9 point), but five relapsed including three mononeuritis multiplex, and one had acral necrosis. Vasculitis presenting as LL radiculopathy is rare; EMG studies with signs of mononeuritis multiplex and nerve biopsy studies are useful for making the diagnosis.

  6. Effects of Strength Training Combined with Specific Plyometric exercises on body composition, vertical jump height and lower limb strength development in elite male handball players: a case study.

    Science.gov (United States)

    Carvalho, Alberto; Mourão, Paulo; Abade, Eduardo

    2014-06-28

    The purpose of the present study was to identify the effects of a strength training program combined with specific plyometric exercises on body composition, vertical jump (VJ) height and strength development of lower limbs in elite male handball players. A 12-week program with combined strength and specific plyometric exercises was carried out for 7 weeks. Twelve elite male handball players (age: 21.6 ± 1.73) competing in the Portuguese Major League participated in the study. Besides the anthropometric measurements, several standardized jump tests were applied to assess VJ performance together with the strength development of the lower limbs in an isokinetic setting. No significant changes were found in body circumferences and diameters. Body fat content and fat mass decreased by 16.4 and 15.7% respectively, while lean body mass increased by 2.1%. Despite small significance, there was in fact an increase in squat jump (SJ), counter movement jump (CMJ) and 40 consecutive jumps after the training period (6.1, 3.8 and 6.8%, respectively). After the applied protocol, peak torque increased in lower limb extension and flexion in the majority of the movements assessed at 90ºs-1. Consequently, it is possible to conclude that combining general strength-training with plyometric exercises can not only increase lower limb strength and improve VJ performance but also reduce body fat content.

  7. A study of passive weight-bearing lower limb exercise effects on local muscles and whole body oxidative metabolism: a comparison with simulated horse riding, bicycle, and walking exercise.

    Science.gov (United States)

    Shimomura, Kohsuke; Murase, Norio; Osada, Takuya; Kime, Ryotaro; Anjo, Mikiko; Esaki, Kazuki; Shiroishi, Kiyoshi; Hamaoka, Takafumi; Katsumura, Toshihito

    2009-11-10

    We have developed an exercise machine prototype for increasing exercise intensity by means of passively exercising lower limb muscles. The purpose of the present study was to compare the passive exercise intensity of our newly-developed machine with the intensities of different types of exercises. We also attempted to measure muscle activity to study how these forms of exercise affected individual parts of the body. Subjects were 14 healthy men with the following demographics: age 30 years, height 171.5 cm, weight 68.3 kg. They performed 4 types of exercise: Passive weight-bearing lower limb exercise (PWLLE), Simulated horse riding exercise (SHRE), Bicycle exercise, and Walking exercise, as described below at an interval of one week or longer. Oxygen uptake, blood pressure, heart rate, and electromyogram (EMG) were measured or recorded during exercise. At rest prior to exercise and immediately after the end of each exercise intensity, the oxygenated hemoglobin levels of the lower limb muscles were measured by near-infrared spectroscopy to calculate the rate of decline. This rate of decline was obtained immediately after exercise as well as at rest to calculate oxygen consumption of the lower limb muscles as expressed as a ratio of a post-exercise rate of decline to a resting one. The heart rate and oxygen uptake observed in PWLLE during maximal intensity were comparable to that of a 20-watt bicycle exercise or 2 km/hr walking exercise. Maximal intensity PWLLE was found to provoke muscle activity comparable to an 80-watt bicycle or 6 km/hr walking exercise. As was the case with the EMG results, during maximal intensity PWLLE, the rectus femoris muscle consumed oxygen in amounts identical to that of an 80-watt bicycle or a 6 km/hr walking exercise. Passive weight-bearing lower limb exercise using our trial machine could provide approximately 3 MET of exercise and the thigh exhibited muscle activity equivalent to that of 80-watt bicycle or 6 km/hr walking exercise

  8. Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy

    Science.gov (United States)

    Zielinski, Ingar Marie; Steenbergen, Bert; Baas, C. Marjolein; Aarts, Pauline; Jongsma, Marijtje L. A.

    2016-01-01

    Unilateral Cerebral Palsy (CP) is a neurodevelopmental disorder that is a very common cause of disability in childhood. It is characterized by unilateral motor impairments that are frequently dominated in the upper limb. In addition to a reduced movement capacity of the affected upper limb, several children with unilateral CP show a reduced awareness of the remaining movement capacity of that limb. This phenomenon of disregarding the preserved capacity of the affected upper limb is regularly referred to as Developmental Disregard (DD). Different theories have been postulated to explain DD, each suggesting slightly different guidelines for therapy. Still, cognitive processes that might additionally contribute to DD in children with unilateral CP have never been directly studied. The current protocol was developed to study cognitive aspects involved in upper limb control in children with unilateral CP with and without DD. This was done by recording event-related potentials (ERPs) extracted from the ongoing EEG during target-response tasks asking for a hand-movement response. ERPs consist of several components, each of them associated with a well-defined cognitive process (e.g., the N1 with early attention processes, the N2 with cognitive control and the P3 with cognitive load and mental effort). Due to its excellent temporal resolution, the ERP technique enables to study several covert cognitive processes preceding overt motor responses and thus allows insight into the cognitive processes that might contribute to the phenomenon of DD. Using this protocol adds a new level of explanation to existing behavioral studies and opens new avenues to the broader implementation of research on cognitive aspects of developmental movement restrictions in children. PMID:26780483

  9. Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy.

    Science.gov (United States)

    Zielinski, Ingar Marie; Steenbergen, Bert; Baas, C Marjolein; Aarts, Pauline; Jongsma, Marijtje L A

    2016-01-11

    Unilateral Cerebral Palsy (CP) is a neurodevelopmental disorder that is a very common cause of disability in childhood. It is characterized by unilateral motor impairments that are frequently dominated in the upper limb. In addition to a reduced movement capacity of the affected upper limb, several children with unilateral CP show a reduced awareness of the remaining movement capacity of that limb. This phenomenon of disregarding the preserved capacity of the affected upper limb is regularly referred to as Developmental Disregard (DD). Different theories have been postulated to explain DD, each suggesting slightly different guidelines for therapy. Still, cognitive processes that might additionally contribute to DD in children with unilateral CP have never been directly studied. The current protocol was developed to study cognitive aspects involved in upper limb control in children with unilateral CP with and without DD. This was done by recording event-related potentials (ERPs) extracted from the ongoing EEG during target-response tasks asking for a hand-movement response. ERPs consist of several components, each of them associated with a well-defined cognitive process (e.g., the N1 with early attention processes, the N2 with cognitive control and the P3 with cognitive load and mental effort). Due to its excellent temporal resolution, the ERP technique enables to study several covert cognitive processes preceding overt motor responses and thus allows insight into the cognitive processes that might contribute to the phenomenon of DD. Using this protocol adds a new level of explanation to existing behavioral studies and opens new avenues to the broader implementation of research on cognitive aspects of developmental movement restrictions in children.

  10. Species comparative studies and cognitive development.

    Science.gov (United States)

    Gómez, Juan-Carlos

    2005-03-01

    The comparative study of infant development and animal cognition brings to cognitive science the promise of insights into the nature and origins of cognitive skills. In this article, I review a recent wave of comparative studies conducted with similar methodologies and similar theoretical frameworks on how two core components of human cognition--object permanence and gaze following--develop in different species. These comparative findings call for an integration of current competing accounts of developmental change. They further suggest that evolution has produced developmental devices capable at the same time of preserving core adaptive components, and opening themselves up to further adaptive change, not only in interaction with the external environment, but also in interaction with other co-developing cognitive systems.

  11. Comparative study of quantum anharmonic potentials

    Energy Technology Data Exchange (ETDEWEB)

    Amore, Paolo [Facultad de Ciencias, Universidad de Colima, Bernal Diaz del Castillo 340, Colima (Mexico)]. E-mail: paolo@ucol.mx; Aranda, Alfredo [Facultad de Ciencias, Universidad de Colima, Bernal Diaz del Castillo 340, Colima (Mexico); De Pace, Arturo [Istituto Nazionale di Fisica Nucleare, Sezione di Torino, via P. Giuria 1, I-10125 Torino (Italy); Lopez, Jorge A. [Physics Department, University of Texas at El Paso, El Paso, TX (United States)

    2004-09-06

    We perform a study of various anharmonic potentials using a recently developed method. We calculate both the wave functions and the energy eigenvalues for the ground and first excited states of the quartic, sextic and octic potentials with high precision, comparing the results with other techniques available in the literature.

  12. A Comparative Study of Sparse Associative Memories

    Science.gov (United States)

    Gripon, Vincent; Heusel, Judith; Löwe, Matthias; Vermet, Franck

    2016-07-01

    We study various models of associative memories with sparse information, i.e. a pattern to be stored is a random string of 0s and 1s with about log N 1s, only. We compare different synaptic weights, architectures and retrieval mechanisms to shed light on the influence of the various parameters on the storage capacity.

  13. A Comparative Study of Probabilistic Roadmap Planners

    NARCIS (Netherlands)

    Geraerts, R.J.; Overmars, M.H.

    2004-01-01

    The probabilistic roadmap approach is one of the leading motion planning techniques. Over the past eight years the technique has been studied by many different researchers. This has led to a large number of variants of the approach, each with its own merits. It is difficult to compare the different

  14. A comparative study of map use

    DEFF Research Database (Denmark)

    Bouvin, Niels Olof; Brodersen, Ann Christina; Bødker, Susanne

    2006-01-01

    We present a study comparing the handling of three kinds of maps, each on a physical device: a paper map, a tablet-PC based map, and a cellular phone based one. Six groups of users were asked to locate eight landmarks, looking out a window, and using a particular map. We have begun analyzing video...

  15. Residual limb wounds or ulcers heal in transtibial amputees using an active suction socket system. A randomized controlled study.

    Science.gov (United States)

    Traballesi, M; Delussu, A S; Fusco, A; Iosa, M; Averna, T; Pellegrini, R; Brunelli, S

    2012-12-01

    The factors that determine successful rehabilitation after lower limb amputation have been widely investigated in the literature, but little attention has been paid to the type of prosthesis and clinical state of the residual limb, particularly the presence of open ulcers. The aim of this study was to investigate the effects of a vacuum-assisted socket system (VASS) in a sample of trans-tibial amputees with wounds or ulcers on the stump and to evaluate prosthesis use as a primary outcome. Secondary outcome measures were mobility with the prosthesis, pain associated with prosthesis use, and wound/ulcer healing. Randomized controlled study. Inpatient. Twenty dysvascular transtibial amputees suffering from ulcers due to prosthesis use or delayed wound healing post-amputation were enrolled. Participants were separated into two groups: the experimental group was trained to use a VASS prosthesis in the presence of open ulcers/wounds on the stump; and the control group was trained to use a standard suction socket system prosthesis following ulcers/wounds healing. At the end of the 12-week rehabilitation program, all VASS users were able to walk independently with their prosthesis as reflected by a median Locomotor Capability Index (LCI) value of 42, whereas only five participants in the control group were able to walk independently with a median LCI value of 21. At the two-month follow-up, the participants used their VASS prostheses for 62 hours a week (median; range: 0-91), which was significantly longer than the control group using the standard prosthesis for 5 hours per week (range: 0-56, p=0.003). At the six-month follow-up, the difference between VASS-users (80, range: 0-112 hours a weeks) and control-users (59, range: 0-91) was no longer significant (p=0.191). Despite more intense use of the prosthesis, pain and wound healing did not significantly differ between the two groups. These results showed that the VASS prosthesis allowed early fitting with prompt

  16. Comparative study of solar optics for paraboloidal concentrators

    Science.gov (United States)

    Wen, L.; Poon, P.; Carley, W.; Huang, L.

    1979-01-01

    Different analytical methods for computing the flux distribution on the focal plane of a paraboloidal solar concentrator are reviewed. An analytical solution in algebraic form is also derived for an idealized model. The effects resulting from using different assumptions in the definition of optical parameters used in these methodologies are compared and discussed in detail. These parameters include solar irradiance distribution (limb darkening and circumsolar), reflector surface specular spreading, surface slope error, and concentrator pointing inaccuracy. The type of computational method selected for use depends on the maturity of the design and the data available at the time the analysis is made.

  17. Evaluation of CT-angiography of lower limb arteries: a preliminary study; Interet de l'arterio-scanner dans le bilan des arteriopathies des membres inferieurs: etude preliminaire

    Energy Technology Data Exchange (ETDEWEB)

    Walter, F.; Leyder, B.; Fays, J.; Blum, A.; Roland, J. [Hopital Central, Service d' Imagerie Guilloz, 54 - Nancy (France); Bronner, J.F.; Lehalle, B. [Centre Hospitalier Universitaire Nancy-Brabois, 54 - Vandoeuvre-les-Nancy (France)

    2001-04-01

    The purpose of this study was to assess the feasibility of CT Angiography (CTA) with a single row of detectors and to compare it to digital subtraction angiography (DSA) in the evaluation of lower limb peripheral arterial disease. A total of 22 patients underwent 24 lower limb Helical CTA using a Somatom Plus 4A (Siemens) and 24 DSA using an Angiostar unit (Siemens). CT angiography was performed in one acquisition (collimation 3 mm/couch motion 9 mm/ interval 2 mm) with tube rotation time of 0.75 sec from the aortic bifurcation to the calf. DSA was performed after catheterization of a common femoral artery using the Seldinger technique. Arteries were classified in four categories (normal or stenosis <50%, stenosis >50%, occlusion, aneurysm). VRT images and axial source images were assessed by two independent radiologists whereas digital angiographies were read by a vascular radiologist. Global interobserver agreement was good (Kappa=0.71). The degree of agreement between CTA and DSA ranged from low to excellent (0.25 to 0.97) depending on the artery. Lower limb CT angiography is a promising non invasive technique. VRT allows quick evaluation. However, is not accurate enough to replace digital angiography. (authors)

  18. The Use of Functional Electrical Stimulation on the Upper Limb and Interscapular Muscles of Patients with Stroke for the Improvement of Reaching Movements: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    Alicia Cuesta-Gómez

    2017-05-01

    Full Text Available IntroductionReaching movements in stroke patients are characterized by decreased amplitudes at the shoulder and elbow joints and greater displacements of the trunk, compared to healthy subjects. The importance of an appropriate and specific contraction of the interscapular and upper limb (UL muscles is crucial to achieving proper reaching movements. Functional electrical stimulation (FES is used to activate the paretic muscles using short-duration electrical pulses.ObjectiveTo evaluate whether the application of FES in the UL and interscapular muscles of stroke patients with motor impairments of the UL modifies patients’ reaching patterns, measured using instrumental movement analysis systems.DesignA cross-sectional study was carried out.SettingThe VICON Motion System® was used to conduct motion analysis.ParticipantsTwenty-one patients with chronic stroke.InterventionThe Compex® electric stimulator was used to provide muscle stimulation during two conditions: a placebo condition and a FES condition.Main outcome measuresWe analyzed the joint kinematics (trunk, shoulder, and elbow from the starting position until the affected hand reached the glass.ResultsParticipants receiving FES carried out the movement with less trunk flexion, while shoulder flexion elbow extension was increased, compared to placebo conditions.ConclusionThe application of FES to the UL and interscapular muscles of stroke patients with motor impairment of the UL has improved reaching movements.

  19. Myoelectrically driven functional electrical stimulation may increase motor recovery of upper limb in poststroke subjects: A randomized controlled pilot study

    Directory of Open Access Journals (Sweden)

    Rune Thorsen, PhD, MScee

    2013-08-01

    Full Text Available The objective of this randomized controlled pilot study was to assess the feasibility and effectiveness of myoelectrically controlled functional electrical stimulation (MeCFES for rehabilitation of the upper limb in poststroke subjects. Eleven poststroke hemiparetic subjects with residual proximal control of the arm, but impaired volitional opening of the paretic hand, were enrolled and randomized into a treated and a control group. Subjects received 3 to 5 treatment sessions per week until totaling 25 sessions. In the experimental group, myoelectric activity from wrist and finger extensors was used to control stimulation of the same muscles. Patients treated with MeCFES (n = 5 had a significant (p = 0.04 and clinically important improvement in Action Research Arm Test score (median change 9 points, confirmed by an Individually Prioritized Problem Assessment self-evaluation score. This improvement was maintained at follow-up. The control group did not show a significant improvement (p = 0.13. The reduced sample size of participants, together with confounding factors such as spontaneous recovery, calls for larger studies to draw definite conclusions. However, the large and persistent treatment effect seen in our results indicate that MeCFES could play an important role as a clinical tool for stroke rehabilitation.

  20. Cross-Slope and Level Walking Strategies During Swing in Individuals With Lower Limb Amputation.

    Science.gov (United States)

    Villa, Coralie; Loiret, Isabelle; Langlois, Karine; Bonnet, Xavier; Lavaste, François; Fodé, Pascale; Pillet, Hélène

    2017-06-01

    To quantitatively analyze prosthetic limb swing phase gait strategies used to adapt to cross slopes compared with flat surfaces. Cross-sectional study. Gait laboratory. A volunteer sample (N=49) of individuals with transfemoral amputation (n=17), individuals with transtibial amputation (n=15), and able-bodied individuals (n=17). Participants walked on flat and 6° (10%) inclined cross-slope surfaces at a self-selected walking speed. Gait speed, step width, sagittal plane kinematics (ankle, knee, hip) on the prosthetic side during swing (uphill limb) and on the contralateral side during stance (downhill limb), frontal plane pelvic kinematics on the prosthetic side during swing, contralateral side ankle power during stance, and timing of gait events. All groups reduced gait speed and downhill limb knee flexion during the stance phase. Able-bodied participants adjusted their uphill limb ankle flexion during the swing phase. Participants with lower limb amputation used additional adjustments during the swing phase of the prosthetic limb when positioned uphill on cross slopes. Transtibial amputee participants mainly adapted with increased flexion of the residual hip and knee joints. Transfemoral amputee participants primarily compensated using increased pelvic hiking and vaulting gait strategies. The swing phase of the uphill limb during cross-slope walking results in compensatory mechanisms that should be addressed during rehabilitation to gain confidence and reduce avoidance when encountering cross slopes in daily life. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. Early evolution of limb regeneration in tetrapods: evidence from a 300-million-year-old amphibian.

    Science.gov (United States)

    Fröbisch, Nadia B; Bickelmann, Constanze; Witzmann, Florian

    2014-11-07

    Salamanders are the only tetrapods capable of fully regenerating their limbs throughout their entire lives. Much data on the underlying molecular mechanisms of limb regeneration have been gathered in recent years allowing for new comparative studies between salamanders and other tetrapods that lack this unique regenerative potential. By contrast, the evolution of animal regeneration just recently shifted back into focus, despite being highly relevant for research designs aiming to unravel the factors allowing for limb regeneration. We show that the 300-million-year-old temnospondyl amphibian Micromelerpeton, a distant relative of modern amphibians, was already capable of regenerating its limbs. A number of exceptionally well-preserved specimens from fossil deposits show a unique pattern and combination of abnormalities in their limbs that is distinctive of irregular regenerative activity in modern salamanders and does not occur as variants of normal limb development. This demonstrates that the capacity to regenerate limbs is not a derived feature of modern salamanders, but may be an ancient feature of non-amniote tetrapods and possibly even shared by all bony fish. The finding provides a new framework for understanding the evolution of regenerative capacity of paired appendages in vertebrates in the search for conserved versus derived molecular mechanisms of limb regeneration.

  2. The application of precisely controlled functional electrical stimulation to the shoulder, elbow and wrist for upper limb stroke rehabilitation: a feasibility study.

    Science.gov (United States)

    Meadmore, Katie L; Exell, Timothy A; Hallewell, Emma; Hughes, Ann-Marie; Freeman, Chris T; Kutlu, Mustafa; Benson, Valerie; Rogers, Eric; Burridge, Jane H

    2014-06-30

    Functional electrical stimulation (FES) during repetitive practice of everyday tasks can facilitate recovery of upper limb function following stroke. Reduction in impairment is strongly associated with how closely FES assists performance, with advanced iterative learning control (ILC) technology providing precise upper-limb assistance. The aim of this study is to investigate the feasibility of extending ILC technology to control FES of three muscle groups in the upper limb to facilitate functional motor recovery post-stroke. Five stroke participants with established hemiplegia undertook eighteen intervention sessions, each of one hour duration. During each session FES was applied to the anterior deltoid, triceps, and wrist/finger extensors to assist performance of functional tasks with real-objects, including closing a drawer and pressing a light switch. Advanced model-based ILC controllers used kinematic data from previous attempts at each task to update the FES applied to each muscle on the subsequent trial. This produced stimulation profiles that facilitated accurate completion of each task while encouraging voluntary effort by the participant. Kinematic data were collected using a Microsoft Kinect, and mechanical arm support was provided by a SaeboMAS. Participants completed Fugl-Meyer and Action Research Arm Test clinical assessments pre- and post-intervention, as well as FES-unassisted tasks during each intervention session. Fugl-Meyer and Action Research Arm Test scores both significantly improved from pre- to post-intervention by 4.4 points. Improvements were also found in FES-unassisted performance, and the amount of arm support required to successfully perform the tasks was reduced. This feasibility study indicates that technology comprising low-cost hardware fused with advanced FES controllers accurately assists upper limb movement and may reduce upper limb impairments following stroke.

  3. Stump sensibility in children with upper limb reduction deficiency

    NARCIS (Netherlands)

    Reinkingh, Marianne; Reinders-Messelink, Heleen A.; Dijkstra, Pieter U.; Maathuis, Karel G. B.; van der Sluis, Corry K.

    2014-01-01

    Objectives: To compare stump sensibility in children with upper limb reduction deficiency with sensibility of the unaffected arm and hand. In addition, to evaluate the associations between stump sensibility, stump length and activity level. Design: Cross-sectional study. Subjects: Children and young

  4. Obesity and lower limb venous disease - The epidemic of phlebesity.

    Science.gov (United States)

    Davies, Huw Ob; Popplewell, Matthew; Singhal, Rishi; Smith, Neil; Bradbury, Andrew W

    2017-05-01

    Introduction Lower limb venous disease affects up to one half, and obesity up to one quarter, of the adult population. Many people are therefore affected by, and present to health services for the treatment of both conditions. This article reviews the available evidence of pathophysiological and clinical relationship between obesity and varicose veins, chronic venous insufficiency and ulceration and deep vein thrombosis. Methods A literature search of PubMed and Cochrane libraries was performed in accordance with PRISMA statement from 1946 to 2015, with further article identification from following cited references for articles examining the relationship between obesity and venous disease. Search terms included obesity, overweight, thrombosis, varicose veins, CEAP, chronic venous insufficiency, treatment, endovenous, endothermal, sclerotherapy, bariatric surgery and deep vein thrombosis. Results The proportion of the population suffering from lower limb venous disease and obesity is increasing. Obesity is an important risk factor for all types of lower limb venous disease, and obese patients with lower limb venous disease are more likely to be symptomatic as a result of their lower limb venous disease. The clinical diagnosis, investigation, imaging and treatment of lower limb venous disease in obese people present a number of challenges. The evidence base underpinning medical, surgical and endovenous management of lower limb venous disease in obese people is limited and such treatment may be associated with worse outcomes and increased risks when compared to patients with a normal body mass index. Conclusion Lower limb venous disease and obesity are both increasingly common. As such, phlebologists will be treating ever greater numbers of obese patients with lower limb venous disease, and clinicians in many other specialties are going to be treating a wide range of obesity-related health problems in people with or at risk of lower limb venous disease. Unfortunately

  5. Limb lengthening in achondroplasia

    Directory of Open Access Journals (Sweden)

    Sanjay K Chilbule

    2016-01-01

    Full Text Available Background: Stature lengthening in skeletal dysplasia is a contentious issue. Specific guidelines regarding the age and sequence of surgery, methods and extent of lengthening at each stage are not uniform around the world. Despite the need for multiple surgeries, with their attendant complications, parents demanding stature lengthening are not rare, due to the social bias and psychological effects experienced by these patients. This study describes the outcome and complications of extensive stature lengthening performed at our center. Materials and Methods: Eight achondroplasic and one hypochondroplasic patient underwent bilateral transverse lengthening for tibiae, humeri and femora. Tibia lengthening was carried out using a ring fixator and bifocal corticotomy, while a monolateral pediatric limb reconstruction system with unifocal corticotomy was used for the femur and humerus. Lengthening of each bone segment, height gain, healing index and complications were assessed. Subgroup analysis was carried out to assess the effect of age and bone segment on the healing index. Results: Nine patients aged five to 25 years (mean age 10.2 years underwent limb lengthening procedures for 18 tibiae, 10 femora and 8 humeri. Four patients underwent bilateral lengthening of all three segments. The mean length gain for the tibia, femur and humerus was 15.4 cm (100.7%, 9.9 cm (52.8% and 9.6 cm (77.9%, respectively. Healing index was 25.7, 25.6 and 20.6 days/cm, respectively, for the tibia, femur and humerus. An average of 33.3% height gain was attained. Lengthening of both tibia and femur added to projected height achieved as the 3 rd percentile of standard height in three out of four patients. In all, 33 complications were encountered (0.9 complications per segment. Healing index was not affected by age or bone segment. Conclusion: Extensive limb lengthening (more than 50% over initial length carries significant risk and should be undertaken only after due

  6. A Comparative Study on Author's Unreliability

    Institute of Scientific and Technical Information of China (English)

    林映凡

    2016-01-01

    Literature appreciation usually follows a"writer-text-reader" process. The author is an inseparable part in literary discussion. Most literary schools have debate on the author's status, which is mainly sorted into two kinds: reliable author or unreliable author. This paper makes a comparative study on the author's status, which is mainly from the perspectives of New Criticism and Deconstruction. Both of them go for unreliability of the author. They share similarities but also bear differences.

  7. Comparative Study on Richard Ⅲ and Macbeth

    Institute of Scientific and Technical Information of China (English)

    冯丽霞; 闫继苗; 徐婷婷

    2013-01-01

    Shakespeare is one of the most prominent drama writers all over the world. His masterpiece displays vivid, delicate and profound humanity. Richard Ⅲ and Macbeth as the main heroes in his two tragedies of the same theme, share quite a lot of simi⁃larities and differences, yet resulting in sharply different readers’response to their fates. The comparative study on these two char⁃acters is aimed at helping readers better understand the two tragedies.

  8. Survival of participating and nonparticipating limb amputees in prospective study : Consequences for research

    NARCIS (Netherlands)

    Bosmans, J.C.; Geertzen, J.H.B.; Hoekstra, H.J.; Dijkstra, P.U.

    2010-01-01

    This study quantified selection by analyzing the survival rate of the participants and nonparticipants in a 4-year prospective, multicenter cohort study. In addition, the differences between these groups were analyzed. Surgeons of six hospitals in the northern Netherlands referred, in total, 225 pat

  9. Friendship in Latin American Social Comparative Studies

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    Agnaldo Garcia

    2016-06-01

    Full Text Available Friendship has been traditionally investigated in the field of interpersonal relationships using different theoretical frameworks and approaches. This paper discusses the possibility of investigating friendship from a comparative Latin American perspective, based on a wide literature review on the subject. Based on the theoretical proposals of Hinde (1997 for the investigation of interpersonal relationships, the paper considers that friendship involves several levels of complexity and affects and is affected by distinct dimensions of Latin American society. The paper recognizes that comparative studies have placed the importance of friends and friendship in areas such as economy, health, education, and migration, among others. As expected, Latin American comparative studies are more frequent in some disciplines, mainly those based on censuses data, and theoretically related to social-economic and demographic concepts, including social networks and social capital. The possibility of developing a Latin American perspective for the study of friendship requires not only the need of empirical but also theoretical advances, as well as scientific cooperation and innovation. Friendship is seen as relevant for the constitution of the social tissue of Latin American society, being affected and affecting different areas and levels. In the social economic dimension, friends are relevant, specifically in Latin America, to themes such as poverty and social vulnerability. Some future possibilities for investigation are discussed.

  10. Lower limb replantations: indications and a new scoring system.

    Science.gov (United States)

    Battiston, Bruno; Tos, Pierluigi; Pontini, Italo; Ferrero, Sebastiano

    2002-01-01

    The need for reconstruction of lower limb amputations is increasing, due to high-energy trauma in road accidents and work-related injuries. The indication for lower limb replantation is still controversial. Compared with upper limb replantations, indications are more select due to the frequent complications in lower limb salvage procedures, such as severe general complications or local complications such as necrosis, infections, nonunions, the need for secondary lengthening, or other reconstructive procedures. The satisfactory results given by artificial prosthesis, such as quicker recovery time and fewer secondary procedures, also contribute to the higher degree of selection for lower limb replantation candidates. Since 1993, we have replanted 14 amputations of the lower limb in 12 patients, including 2 bilateral cases. Although survival of the replanted segment was obtained in all patients, 5 cases were subsequently amputated for severe secondary complications. Of the remaining 9 cases, evaluated by means of Chen criteria, 7 had good results (3 Chen I and 4 Chen II), 1 sufficient (Chen III), and 1 poor (Chen IV). The best results were obtained in young patients. Our experience led us to examine the necessity for careful, objective patient selection. We developed a score evaluation system by modifying the international classifying method for severe limb traumas (mangled extremity severity score, or MESS system). This relatively simple system, based on the retrospective study of our cases, considers several parameters (patient's age, general conditions, level and type of lesion, time of injury, and associated lesions), giving each one a score. The total score gives the indication for replantation, predicts the functional outcome, and facilitates decision-making.

  11. Development of subliminal persuasion system to improve the upper limb posture in laparoscopic training: a preliminary study.

    Science.gov (United States)

    Zhang, Di; Sessa, Salvatore; Kong, Weisheng; Cosentino, Sarah; Magistro, Daniele; Ishii, Hiroyuki; Zecca, Massimiliano; Takanishi, Atsuo

    2015-11-01

    Current training for laparoscopy focuses only on the enhancement of manual skill and does not give advice on improving trainees' posture. However, a poor posture can result in increased static muscle loading, faster fatigue, and impaired psychomotor task performance. In this paper, the authors propose a method, named subliminal persuasion, which gives the trainee real-time advice for correcting the upper limb posture during laparoscopic training like the expert but leads to a lower increment in the workload. A 9-axis inertial measurement unit was used to compute the upper limb posture, and a Detection Reaction Time device was developed and used to measure the workload. A monitor displayed not only images from laparoscope, but also a visual stimulus, a transparent red cross superimposed to the laparoscopic images, when the trainee had incorrect upper limb posture. One group was exposed, when their posture was not correct during training, to a short (about 33 ms) subliminal visual stimulus. The control group instead was exposed to longer (about 660 ms) supraliminal visual stimuli. We found that subliminal visual stimulation is a valid method to improve trainees' upper limb posture during laparoscopic training. Moreover, the additional workload required for subconscious processing of subliminal visual stimuli is less than the one required for supraliminal visual stimuli, which is processed instead at the conscious level. We propose subliminal persuasion as a method to give subconscious real-time stimuli to improve upper limb posture during laparoscopic training. Its effectiveness and efficiency were confirmed against supraliminal stimuli transmitted at the conscious level: Subliminal persuasion improved upper limb posture of trainees, with a smaller increase on the overall workload.

  12. Factors influencing goal attainment in patients with post-stroke upper limb spasticity following treatment with botulinum toxin A in real-life clinical practice: sub-analyses from the Upper Limb International Spasticity (ULIS)-II Study.

    Science.gov (United States)

    Fheodoroff, Klemens; Ashford, Stephen; Jacinto, Jorge; Maisonobe, Pascal; Balcaitiene, Jovita; Turner-Stokes, Lynne

    2015-04-08

    In this post-hoc analysis of the ULIS-II study, we investigated factors influencing person-centred goal setting and achievement following botulinum toxin-A (BoNT-A) treatment in 456 adults with post-stroke upper limb spasticity (ULS). Patients with primary goals categorised as passive function had greater motor impairment (p 1 year)) post-stroke (80.0% vs. 79.2%) or presence or absence of severe contractures (76.7% vs. 80.6%), although goal types differed. Earlier BoNT-A intervention was associated with greater achievement of active function goals. Severe contractures impacted negatively on goal achievement except in pain and passive function. Goal setting by patients with ULS is influenced by impairment severity, age and time since stroke. Our findings resonate with clinical experience and may assist patients and clinicians in selecting realistic, achievable goals for treatment.

  13. The phantom limb in dreams.

    Science.gov (United States)

    Brugger, Peter

    2008-12-01

    Mulder and colleagues [Mulder, T., Hochstenbach, J., Dijkstra, P. U., Geertzen, J. H. B. (2008). Born to adapt, but not in your dreams. Consciousness and Cognition, 17, 1266-1271.] report that a majority of amputees continue to experience a normally-limbed body during their night dreams. They interprete this observation as a failure of the body schema to adapt to the new body shape. The present note does not question this interpretation, but points to the already existing literature on the phenomenology of the phantom limb in dreams. A summary of published investigations is complemented by a note on phantom phenomena in the dreams of paraplegic patients and persons born without a limb. Integration of the available data allows the recommendation for prospective studies to consider dream content in more detail. For instance, "adaptation" to the loss of a limb can also manifest itself by seeing oneself surrounded by amputees. Such projective types of anosognosia ("transitivism") in nocturnal dreams should also be experimentally induced in normally-limbed individuals, and some relevant techniques are mentioned.

  14. Effect of various upper limb multibody models on soft tissue artefact correction: A case study.

    Science.gov (United States)

    Naaim, Alexandre; Moissenet, Florent; Duprey, Sonia; Begon, Mickaël; Chèze, Laurence

    2017-01-31

    Soft tissue artefacts (STA) introduce errors in joint kinematics when using cutaneous markers, especially on the scapula. Both segmental optimisation and multibody kinematics optimisation (MKO) algorithms have been developed to improve kinematics estimates. MKO based on a chain model with joint constraints avoids apparent joint dislocation but is sensitive to the biofidelity of chosen joint constraints. Since no recommendation exists for the scapula, our objective was to determine the best models to accurately estimate its kinematics. One participant was equipped with skin markers and with an intracortical pin screwed in the scapula. Segmental optimisation and MKO for 24-chain models (including four variations of the scapulothoracic joint) were compared against the pin-derived kinematics using root mean square error (RMSE) on Cardan angles. Segmental optimisation led to an accurate scapula kinematics (1.1°≤RMSE≤3.3°) even for high arm elevation angles. When MKO was applied, no clinically significant difference was found between the different scapulothoracic models (0.9°≤RMSE≤4.1°) except when a free scapulothoracic joint was modelled (1.9°≤RMSE≤9.6°). To conclude, using MKO as a STA correction method was not more accurate than segmental optimisation for estimating scapula kinematics.

  15. A Study of Surgical Management of Diabetic Limb Complications Among Rural Population

    OpenAIRE

    2012-01-01

    Surgical complication of diabetes mellitus has been a common clinical problem among the rural population because of illiteracy and poor health education. The present study was undertaken to evaluate patients with respect to age, sex, presentation and to do other specific investigations. The patients were treated by conservative or surgical methods, and the outcome was monitored.

  16. A pilot study to profile the lower limb musculoskeletal health in children with obesity.

    LENUS (Irish Health Repository)

    O'Malley, Grace

    2012-01-01

    : Evidence suggests a negative effect of obesity on musculoskeletal health in children. A pilot study was undertaken to investigate the presence of musculoskeletal impairments in children with obesity and to explore the relationships among body mass index, physical activity, and musculoskeletal measures.

  17. The Role of Sequential Pneumatic Compression in Limb Salvage in Non-reconstructable Critical Limb Ischemia.

    Science.gov (United States)

    Zaki, M; Elsherif, M; Tawfick, W; El Sharkawy, M; Hynes, N; Sultan, S

    2016-04-01

    Critical limb ischemia (CLI) is an increasingly alarming presentation of advanced generalized circulatory failure. Most patients presenting with CLI have profound cardiovascular comorbidities that hinder surgical intervention. Moreover, some patients present with non-reconstructable arterial anatomy. For this vulnerable cohort, primary amputation is often the only available option. This study aims at answering the question: Can sequential pneumatic compression (SPC) preclude amputation? A retrospective analysis of 187 patients (262 limbs) prescribed the Artassist SPC compared outcomes between the group of patients who acquired the device and those who did not. The primary end point was limb salvage; secondary end points were amputation-free survival and improvement in toe pressures. The mean age was 74.78 years, the median follow-up was 16 months, and the median duration of usage was 4 months. 81.72% of the patient acquired the device and 18.28% did not. The mean toe pressure was 61.4 mmHg pre-application, and 65 mmHg after application (p = .071). Amputation-free survival was 98% and 96% for those who acquired the device and 90% and 84% for those who did not at 6 and 12 months, respectively. There was a non-significant association between limb salvage and device acquisition (p = .714); however, there was a significant improvement in rest pain (p < .0001), reduction in minor amputation (p = .023), and amputation-free survival associated with using the device (p = .01). Although limb salvage is the paramount ambition for patients referred to vascular services, some patients with CLI are better served with primary amputation. Although the mechanism of SPC action is still ambiguous, there is strong evidence to support its role in preventing minor amputation, prolonging amputation-free survival, and improving rest pain in patients with non-reconstructable CLI; nevertheless, its role in prevention of major amputation lacks statistical significance. Copyright © 2015

  18. Studying Upper-Limb Amputee Prosthesis Use to Inform Device Design

    Science.gov (United States)

    2015-10-01

    processing pipelines that match standards in the field of biomechanics . This system and the associated pre and post processing techniques will provide much...These scripts have been written to match the guidelines of the international society of biomechanics (ISB) 8. Collection and setup of materials for the...adam.spiers@yale.edu Nearest person month worked: 12 Contribution to Project: Postdoc researcher responsible for running at-home and in-lab studies

  19. HIGH INTENSITY EXERCISE AND FLEXIBILITY OF THE LOWER LIMBS: DOSE-EFFECT STUDY

    Directory of Open Access Journals (Sweden)

    João Rafael Valentim-Silva

    Full Text Available ABSTRACT Introduction: Sports scientists have been studying the phenomenon involving different types of exercises and their influence on other activities. Stretching exercises have a negative influence on muscular strength and power output, as do high intensity or long duration cardiovascular training. Nevertheless, several studies have found the opposite to be true Nevertheless, few investigations have studied the opposite. Objective: To determine whether high intensity power exercise influences muscular flexibility in an acute manner. Methods: A sample of forty-three male and female young adults aged between 18 and 28 years, with a mean age of 22.88 + 3.04 years, who have practiced physical activity for at least six months. To determine flexibility, the sit-and-reach test was used. For the high intensity training, a 45º leg press was used. A 10-rep movement was performed at 85% of 1 RM, in both pre- and post-tests. Statistic analysis was conducted using the ANOVA and Scheffer's post-hoc tests, with a level of significance for differences of < 0.05. Results: Comparison of the pre- and post-tests proved to be statistically significant from the baseline from the fourth to the seventh repetitions. Conclusion: Strength exercises at 85% of 1RM seem to significantly increase range of motion in an acute manner, and the growth of this range of motion has a dose-effect response.

  20. Comparative study of INPIStron and spark gap

    Science.gov (United States)

    Han, Kwang S.; Lee, Ja H.

    1993-01-01

    An inverse pinch plasma switch, INPIStron, was studied in comparison to a conventional spark gap. The INPIStron is under development for high power switching applications. The INPIStron has an inverse pinch dynamics, opposed to Z-pinch dynamics in the spark gap. The electrical, plasma dynamics and radiative properties of the closing plasmas have been studied. Recently the high-voltage pulse transfer capabilities or both the INPIStron and the spark gap were also compared. The INPIStron with a low impedance Z = 9 ohms transfers 87 percent of an input pulse with a halfwidth of 2 mu s. For the same input pulse the spark gap of Z = 100 ohms transfers 68 percent. Fast framing and streak photography, taken with an TRW image converter camera, was used to observe the discharge uniformity and closing plasma speed in both switches. In order to assess the effects of closing plasmas on erosion of electrode material, emission spectra of two switches were studied with a spectrometer-optical multi channel analyzer (OMA) system. The typical emission spectra of the closing plasmas in the INPIStron and the spark gap showed that there were comparatively weak carbon line emission in 658.7 nm and copper (electrode material) line emissions in the INPIStron, indicating low erosion of materials in the INPIStron.

  1. Lower limb amputation rate in diabetic foot patients: a five year study

    Directory of Open Access Journals (Sweden)

    Mofid A

    2007-11-01

    Full Text Available Background: Diabetes mellitus is a common endocrine disorder with increasing prevalence. Diabetic foot is a costly and serious chronic complication of diabetes mellitus that if it does not controlled will cause severe morbidities in patients with diabetes mellitus. Based on the study of center of management and prevention of diseases about 230 milliard Rials were expended for direct costs of diabetes annually and instruction of patients about protection of foots in some countries, decrease rate of amputation between 44 to 85% and infact instruction of diabetic patients is the base of treatment and prevention of complications of diabetes mellitus."nMethods: In a cross sectional study with attention to one of important causes of refer of diabetic patients to hospitals diabetic ulcers of foots, we discuss about risk factors and ways of treatment and prevention of them. The study done on patients admitted in endocrinology unit of Imam Khomeini hospital. For analysis we used SPSS 11.5 program. Although the costs for patients are calculated."nResults: In this study from 245 patients that admitted because of diabetic foot (63.26% male and 36.73% female, 74 patients have done amputation. From these 74 patients (30.2%, 65.67% were male and 24.32% were female. Age average was 58.24+12.29 years And the mean duration of DM was 10.56+8.32 years and the past history of diabetic foot was present in 45.95% of them. Past history of smoking was present in 66.21% of patients."nConclusion: From 245 patients from 1996 to 2001 that admitted because of diabetic foot, 155 patients (63.26% were male and 90 patients (36.73% were female. From this numbers the most of them were in 60-70 years old and the least were 20-30 years old. Gender of most of them was male. For treatment of this complication a lot of costs were necessary and instruction of patients decrease this complications.

  2. Phantom limb syndrome: a review.

    Science.gov (United States)

    Chahine, Lama; Kanazi, Ghassan

    2007-06-01

    Phantom limb syndrome is a condition in which patients experience sensations, whether painful or otherwise, in a limb that does not exist. It has been reported to occur in 80-100% of amputees, and typically has a chronic course, often resistant to treatment. Risk factors include the presence of preoperative pain, traumatic amputation, and the type of anesthetic procedure used during amputation. Several pathophysiologic theories have been proposed, including spinal mechanisms, central sensitization, and somatosensory cortical rearrangements, and while recent studies have shed light on some interesting and significant data, a lot remains to be understood. Treatments include pharmacologic, mechanical, and behavioral modalities, but substantial efficacy in well-designed, randomized controlled trials has yet to be demonstrated. Phantom limb syndrome continues to be a difficult condition to both understand and treat.

  3. EFQPSK Versus CERN: A Comparative Study

    Science.gov (United States)

    Borah, Deva K.; Horan, Stephen

    2001-01-01

    This report presents a comparative study on Enhanced Feher's Quadrature Phase Shift Keying (EFQPSK) and Constrained Envelope Root Nyquist (CERN) techniques. These two techniques have been developed in recent times to provide high spectral and power efficiencies under nonlinear amplifier environment. The purpose of this study is to gain insights into these techniques and to help system planners and designers with an appropriate set of guidelines for using these techniques. The comparative study presented in this report relies on effective simulation models and procedures. Therefore, a significant part of this report is devoted to understanding the mathematical and simulation models of the techniques and their set-up procedures. In particular, mathematical models of EFQPSK and CERN, effects of the sampling rate in discrete time signal representation, and modeling of nonlinear amplifiers and predistorters have been considered in detail. The results of this study show that both EFQPSK and CERN signals provide spectrally efficient communications compared to filtered conventional linear modulation techniques when a nonlinear power amplifier is used. However, there are important differences. The spectral efficiency of CERN signals, with a small amount of input backoff, is significantly better than that of EFQPSK signals if the nonlinear amplifier is an ideal clipper. However, to achieve such spectral efficiencies with a practical nonlinear amplifier, CERN processing requires a predistorter which effectively translates the amplifier's characteristics close to those of an ideal clipper. Thus, the spectral performance of CERN signals strongly depends on the predistorter. EFQPSK signals, on the other hand, do not need such predistorters since their spectra are almost unaffected by the nonlinear amplifier, Ibis report discusses several receiver structures for EFQPSK signals. It is observed that optimal receiver structures can be realized for both coded and uncoded EFQPSK

  4. Comparative study of hydrogenated and lithiated superhalogens

    Science.gov (United States)

    Xu, Li-Na; Li, Ying; Liu, Jia-Yuan; Wu, Di; Sun, Yan-Bo; Li, Zhi-Ru

    2016-09-01

    The structural features, properties and stability of two kinds of representative superhalogen compounds, namely hydrogenated superhalogens and lithiated superhalogens, are theoretically studied in detail, providing further insight into the behavior of superhalogens. According to topological analysis of the electron localization function, most of superhalogen clusters as a whole combine with Li atom through ionic bond(s). In contrast, the H atom tends to bind with superhalogen by covalent bond although a portion of superhalogens are broken upon hydrogenation. In addition, the electric properties of these superhalogen compounds are also obtained and compared with those of traditional acid and salt molecules.

  5. On stellar limb darkening and exoplanetary transits

    CERN Document Server

    Howarth, Ian D

    2011-01-01

    This paper examines how to compare stellar limb-darkening coefficients evaluated from model atmospheres with those estimated from photometry. Limb-darkening coefficients derived from light-curve analyses using approximate limb-darkening `laws' are shown to be dependent on system geometry, while different characterizations of a given model atmosphere can give quite different numerical results. These issues are examined in the context of exoplanetary transits, which offer significant advantages over traditional binary-star eclipsing systems in the investigation of stellar limb darkening. `Like for like' comparisons between light-curve analyses and new model-atmosphere results, mediated by synthetic photometry, are conducted for a small sample of stars. Agreement between the resulting synthetic-photometry/atmosphere-model (SPAM) limb-darkening coefficients and empirical values ranges from very good to quite poor, even though there is only a small dispersion in fundamental stellar parameters.

  6. A computational clonal analysis of the developing mouse limb bud.

    Directory of Open Access Journals (Sweden)

    Luciano Marcon

    Full Text Available A comprehensive spatio-temporal description of the tissue movements underlying organogenesis would be an extremely useful resource to developmental biology. Clonal analysis and fate mappings are popular experiments to study tissue movement during morphogenesis. Such experiments allow cell populations to be labeled at an early stage of development and to follow their spatial evolution over time. However, disentangling the cumulative effects of the multiple events responsible for the expansion of the labeled cell population is not always straightforward. To overcome this problem, we develop a novel computational method that combines accurate quantification of 2D limb bud morphologies and growth modeling to analyze mouse clonal data of early limb development. Firstly, we explore various tissue movements that match experimental limb bud shape changes. Secondly, by comparing computational clones with newly generated mouse clonal data we are able to choose and characterize the tissue movement map that better matches experimental data. Our computational analysis produces for the first time a two dimensional model of limb growth based on experimental data that can be used to better characterize limb tissue movement in space and time. The model shows that the distribution and shapes of clones can be described as a combination of anisotropic growth with isotropic cell mixing, without the need for lineage compartmentalization along the AP and PD axis. Lastly, we show that this comprehensive description can be used to reassess spatio-temporal gene regulations taking tissue movement into account and to investigate PD patterning hypothesis.

  7. Progressive thinning of visual motion area in lower limb amputees

    Directory of Open Access Journals (Sweden)

    Guangyao eJiang

    2016-03-01

    Full Text Available Accumulating evidence has indicated that amputation or deafferentation of a limb induces functional or structural reorganization in the visual areas. However, the extent of the visual areas involved after lower limb amputation remains uncertain. In this investigation, we studied 48 adult patients with unilateral lower limb amputation and 48 matched healthy controls using T1-weighted magnetic resonance imaging. Template-based regions of interest analysis was implemented to detect the changes of cortical thickness in the specific visual areas. Compared with normal controls, amputees exhibited significantly lower thickness in the V5/middle temporal (V5/MT+ visual area, as well as a trend of cortical thinning in the V3d. There was no significant difference in the other visual areas between the two groups. In addition, no significant difference of cortical thickness was found between patients with amputation at different levels. Across all amputees, correlation analyses revealed that the cortical thickness of the V5/MT+ was negatively correlated to the time since amputation. In conclusion, our findings indicate that the amputation of unilateral lower limb could induce changes in the motor-related visual cortex, and provide an update on the plasticity of the human brain after limb injury.

  8. Hair patterns of the lower limb in Central Indian males.

    Science.gov (United States)

    Chaurasia, B D

    1977-08-01

    The distribution of hair of the right lower limb has been studied in a random sample of 220 healthy Central Indian males 17 to 45 years of age. The common hair patterns observed are the proximal phalangeal hair in all toes in 55.45%, the middle phalangeal hair in the third toe in 8.18%, the tibial on the dorsum of foot in 69.55%, and the pedo-cruro-femoral in the lower limb in 70.00% subjects. Comparison of these findings with those of the right upper limb shows that hairiness of the two limbs is correlated, that the dorsum of foot is less hairy than the dorsum of hand, and that the third and second toes are comparable with the fourth and third fingers, respectively, as regards their middle phalangeal hair. Comparison with the available literature shows that the Central Indian males resemble the Whites in having greater frequency of middle phalangeal hair than those of the Negroes, that the dorsum of feet of this population is less hairy than the White and more hairy than the Negroes, and that the general hairiness of the lower limb is more or less equal in the three groups of persons.

  9. CURRICULAR OFFER INFLUENCING STUDENTS’ SATISFACTION: COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Oana DUMITRASCU

    2014-11-01

    Full Text Available The main objective of the study is the determination of students’ satisfaction regarding curricular activities. The study has been accomplished using the qualitative and quantitative research, using the bibliographic study, various secondary sources and different primary sources. The study is developed with a marketing research and accomplished using the survey method. 699 students from four universities have been questioned. Due to a comparative study the University of Applied Sciences Worms, University of Applied Sciences Wiesbaden Rüsselsheim, University of Applied Sciences Frankfurt am Main and Nürtingen-Geislingen University have been analysed and their similarities and differences have been identified. The collected data, based on the established sample, is evaluated through univariate and bivariate analysis. In accordance with the evaluated sample, specific gaps from each region are identified regarding the curricular offer of the analysed universities. As a result to the conducted study, recommendations for the University of Applied Sciences Worms regarding the student’s satisfaction concerning the curricular offer are presented.

  10. CURRICULAR OFFER INFLUENCING STUDENTS’ SATISFACTION: COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Oana DUMITRASCU

    2014-11-01

    Full Text Available The main objective of the study is the determination of students’ satisfaction regarding curricular activities. The study has been accomplished using the qualitative and quantitative research, using the bibliographic study, various secondary sources and different primary sources. The study is developed with a marketing research and accomplished using the survey method. 699 students from four universities have been questioned. Due to a comparative study the University of Applied Sciences Worms, University of Applied Sciences Wiesbaden Rüsselsheim, University of Applied Sciences Frankfurt am Main and Nürtingen-Geislingen University have been analysed and their similarities and differences have been identified. The collected data, based on the established sample, is evaluated through univariate and bivariate analysis. In accordance with the evaluated sample, specific gaps from each region are identified regarding the curricular offer of the analysed universities. As a result to the conducted study, recommendations for the University of Applied Sciences Worms regarding the student’s satisfaction concerning the curricular offer are presented.

  11. Driving performance on the descending limb of blood alcohol concentration (BAC in undergraduate students: a pilot study.

    Directory of Open Access Journals (Sweden)

    Mathieu Tremblay

    Full Text Available Young drivers are overrepresented in collisions resulting in fatalities. It is not uncommon for young drivers to socially binge drink and decide to drive a vehicle a few hours after consumption. To better understand the risks that may be associated with this behaviour, the present study has examined the effects of a social drinking bout followed by a simulated drive in undergraduate students on the descending limb of their BAC (blood alcohol concentration curve. Two groups of eight undergraduate students (n = 16 took part in this study. Participants in the alcohol group were assessed before drinking, then at moderate and low BAC as well as 24 hours post-acute consumption. This group consumed an average of 5.3 ± 1.4 (mean ± SD drinks in an hour in a social context and were then submitted to a driving and a predicted crash risk assessment. The control group was assessed at the same time points without alcohol intake or social context.; at 8 a.m., noon, 3 p.m. and 8 a.m. the next morning. These multiple time points were used to measure any potential learning effects from the assessment tools (i.e. driving simulator and useful field of view test (UFOV. Diminished driving performance at moderate BAC was observed with no increases in predicted crash risk. Moderate correlations between driving variables were observed. No association exists between driving variables and UFOV variables. The control group improved measures of selective attention after the third assessment. No learning effect was observed from multiple sessions with the driving simulator. Our results show that a moderate BAC, although legal, increases the risky behaviour. Effects of alcohol expectancy could have been displayed by the experimental group. UFOV measures and predicted crash risk categories were not sensitive enough to predict crash risk for young drivers, even when intoxicated.

  12. Driving Performance on the Descending Limb of Blood Alcohol Concentration (BAC) in Undergraduate Students: A Pilot Study

    Science.gov (United States)

    Silvey, Dustin; Behm, David; Albert, Wayne J.

    2015-01-01

    Young drivers are overrepresented in collisions resulting in fatalities. It is not uncommon for young drivers to socially binge drink and decide to drive a vehicle a few hours after consumption. To better understand the risks that may be associated with this behaviour, the present study has examined the effects of a social drinking bout followed by a simulated drive in undergraduate students on the descending limb of their BAC (blood alcohol concentration) curve. Two groups of eight undergraduate students (n = 16) took part in this study. Participants in the alcohol group were assessed before drinking, then at moderate and low BAC as well as 24 hours post-acute consumption. This group consumed an average of 5.3 ± 1.4 (mean ± SD) drinks in an hour in a social context and were then submitted to a driving and a predicted crash risk assessment. The control group was assessed at the same time points without alcohol intake or social context.; at 8 a.m., noon, 3 p.m. and 8 a.m. the next morning. These multiple time points were used to measure any potential learning effects from the assessment tools (i.e. driving simulator and useful field of view test (UFOV)). Diminished driving performance at moderate BAC was observed with no increases in predicted crash risk. Moderate correlations between driving variables were observed. No association exists between driving variables and UFOV variables. The control group improved measures of selective attention after the third asessement. No learning effect was observed from multiple sessions with the driving simulator. Our results show that a moderate BAC, although legal, increases the risky behaviour. Effects of alcohol expectancy could have been displayed by the experimental group. UFOV measures and predicted crash risk categories were not sentitive enough to predict crash risk for young drivers, even when intoxicated. PMID:25723618

  13. REHABILITATION IN SKILLED NURSING CENTRES FOR ELDERLY PEOPLE WITH LOWER LIMB AMPUTATIONS : A MIXED-METHODS, DESCRIPTIVE STUDY

    NARCIS (Netherlands)

    Fortington, Lauren V.; Rommers, Gerardus M.; Wind-Kral, Anne; Dijkstra, Pieter U.; Geertzen, Jan H. B.

    2013-01-01

    Objectives: To describe the current set-up, barriers and potential for providing rehabilitation to people with lower limb amputation in skilled nursing centres. Design: Survey and interviews. Subjects/participants: Elderly care physicians, physiotherapists. Methods: In 2011, clinicians from 34 skill

  14. Sports participation of Dutch lower limb amputees

    NARCIS (Netherlands)

    Bragaru, Mihail; Meulenbelt, Hendrik; Dijkstra, Pieter U.; Geertzen, Jan H.B.; Dekker, Rienk

    2013-01-01

    Objective: To analyze sports participation of Dutch lower limb amputees and factors influencing sports participation. Study design: A cross-sectional survey was performed. Dutch lower limb amputees (N = 2039) were invited to participate in a postal survey addressing personal and amputation character

  15. Claimed walking distance of lower limb amputees

    NARCIS (Netherlands)

    Geertzen, JHB; Bosmans, JC; Van der Schans, CP; Dijkstra, PU

    2005-01-01

    Purpose: Walking ability in general and specifically for lower limb amputees is of major importance for social mobility and ADL independence. Walking determines prosthesis prescription. The aim of this study was to mathematically analyse factors influencing claimed walking distance of lower limb amp

  16. Comparative bioequivalence study of meloxicam drugs

    Directory of Open Access Journals (Sweden)

    Ekut Karieva

    2011-03-01

    Full Text Available The governments of many countries strongly support the production and clinical use of generic medicinal products which are “copies” of patented drugs and can be marked at lower cost. At present time bioequivalence testing is regarded as a useful methodology to perform comparisons among different products containing the same active ingredient. This report presents the results of comparative bioequivalence study of three meloxicam formulations: brand-drug “Melbek” with tablets and capsules of meloxicam developed at the Tashkent Pharmaceutical Institute. The results obtained confirm the bioequivalence of the studied drugs, which indicate about scientifically based approach to the selection of excipients and technological process in the development of the above generic drugs.

  17. Study of endovenous microwave treatment for lower limb varicose veins%微波腔内治疗下肢静脉曲张的研究

    Institute of Scientific and Technical Information of China (English)

    梁民; 蒙锦莹; 杨林; 张澜; 陈延会; 祁光裕

    2012-01-01

    Objective To study the clinical outcome of endovenous microwave treatment (EMT) for the lower limbs varicose veins. Methods Thirty-six patients with varicose veins were treated by EMT (the EMT group) in the Department of General Surgery, First Hospital of Xianyang, Shaanxi Province, and the clinical data of 50 patients treated by the varicose veins stripping (the control group) were retrospectively compared. Results The two therapeutic regimens reached similar clinical outcomes. The operative time was shorter in the EMT group with less operation bleeding and less incisions. The length of hospital stay and the incidence rate of haemostasis was lower in the EMT group than in the control group; the limb numbness did not differ between the two groups. Conclusions EMT is a newly, safe, minimally invasion and easily operated technique in the treatment of varicose veins.%目的:探讨微波腔内闭合大隐静脉治疗静脉曲张的临床疗效.方法:将陕西省咸阳市第一人民医院普外科收治的36例病人(40条肢体)行微波腔内闭合曲张静脉;50例(60条肢体)行传统剥脱术的病人为对照组.比较两组病人手术时间、术中出血量、住院时间及术后恢复情况.结果:两种治疗均可有效治疗下肢静脉曲张,但微波治疗组比对照组具有更短的手术时间、更少的术中出血量及更少的手术切口,且病人术后住院时间亦明显缩短,微波治疗具有更低的术后下肢瘀血发生率;且其下肢麻木发生率亦低于对照组组,但无统计学差异(P=0.13).结论:微波腔内闭合术治疗下肢静脉曲张具有安全、操作简捷、创伤小、恢复快等优点.

  18. Case studies of the impact of orbital sampling on stratospheric trend detection and derivation of tropical vertical velocities: solar occultation vs. limb emission sounding

    Science.gov (United States)

    Millán, Luis F.; Livesey, Nathaniel J.; Santee, Michelle L.; Neu, Jessica L.; Manney, Gloria L.; Fuller, Ryan A.

    2016-09-01

    This study investigates the representativeness of two types of orbital sampling applied to stratospheric temperature and trace gas fields. Model fields are sampled using real sampling patterns from the Aura Microwave Limb Sounder (MLS), the HALogen Occultation Experiment (HALOE) and the Atmospheric Chemistry Experiment Fourier Transform Spectrometer (ACE-FTS). The MLS sampling acts as a proxy for a dense uniform sampling pattern typical of limb emission sounders, while HALOE and ACE-FTS represent coarse nonuniform sampling patterns characteristic of solar occultation instruments. First, this study revisits the impact of sampling patterns in terms of the sampling bias, as previous studies have done. Then, it quantifies the impact of different sampling patterns on the estimation of trends and their associated detectability. In general, we find that coarse nonuniform sampling patterns may introduce non-negligible errors in the inferred magnitude of temperature and trace gas trends and necessitate considerably longer records for their definitive detection. Lastly, we explore the impact of these sampling patterns on tropical vertical velocities derived from stratospheric water vapor measurements. We find that coarse nonuniform sampling may lead to a biased depiction of the tropical vertical velocities and, hence, to a biased estimation of the impact of the mechanisms that modulate these velocities. These case studies suggest that dense uniform sampling such as that available from limb emission sounders provides much greater fidelity in detecting signals of stratospheric change (for example, fingerprints of greenhouse gas warming and stratospheric ozone recovery) than coarse nonuniform sampling such as that of solar occultation instruments.

  19. Psychophysical Evaluation of the Capability for Phantom Limb Movement in Forearm Amputees.

    Science.gov (United States)

    Kawashima, Noritaka; Mita, Tomoki

    2016-01-01

    A phantom limb is the sensation that an amputated limb is still attached to the body and is moving together with other body parts. Phantom limb phenomenon is often described on the basis of the patient's subjective sense, for example as represented using a visual analog scale (VAS). The aim of this study was to propose a novel quantification method for behavioral aspect of phantom limb by psychophysics. Twelve unilateral forearm amputees were asked to perform phantom wrist motion with various motion frequencies (60, 80, 100, 120, 140, 160, 180, 200, 220, 240% of preferred speed). The attainment of phantom limb motion in each session was rated by the VAS ranging from 0 (hard) to 10 (easy). The relationship between the VAS and motion frequency was mathematically fitted by quadric function, and the value of shift and the degree of steepness were obtained as evaluation variables for the phantom limb movement. In order to test whether the proposed method can reasonably quantify the characteristics of phantom limb motion, we compared the variables among three different phantom limb movement conditions: (1) unilateral (phantom only), (2) bimanual, and (3) bimanual wrist movement with mirror reflection-induced visual feedback (MVF). While VAS rating showed a larger extent of inter- and intra-subject variability, the relationship of the VAS in response to motion frequency could be fitted by quadric curve, and the obtained parameters based on quadric function well characterize task-dependent changes in phantom limb movement. The present results suggest the potential usefulness of psychophysical evaluation as a validate assessment tool of phantom limb condition.

  20. Psychophysical Evaluation of the Capability for Phantom Limb Movement in Forearm Amputees.

    Directory of Open Access Journals (Sweden)

    Noritaka Kawashima

    Full Text Available A phantom limb is the sensation that an amputated limb is still attached to the body and is moving together with other body parts. Phantom limb phenomenon is often described on the basis of the patient's subjective sense, for example as represented using a visual analog scale (VAS. The aim of this study was to propose a novel quantification method for behavioral aspect of phantom limb by psychophysics. Twelve unilateral forearm amputees were asked to perform phantom wrist motion with various motion frequencies (60, 80, 100, 120, 140, 160, 180, 200, 220, 240% of preferred speed. The attainment of phantom limb motion in each session was rated by the VAS ranging from 0 (hard to 10 (easy. The relationship between the VAS and motion frequency was mathematically fitted by quadric function, and the value of shift and the degree of steepness were obtained as evaluation variables for the phantom limb movement. In order to test whether the proposed method can reasonably quantify the characteristics of phantom limb motion, we compared the variables among three different phantom limb movement conditions: (1 unilateral (phantom only, (2 bimanual, and (3 bimanual wrist movement with mirror reflection-induced visual feedback (MVF. While VAS rating showed a larger extent of inter- and intra-subject variability, the relationship of the VAS in response to motion frequency could be fitted by quadric curve, and the obtained parameters based on quadric function well characterize task-dependent changes in phantom limb movement. The present results suggest the potential usefulness of psychophysical evaluation as a validate assessment tool of phantom limb condition.

  1. Acute limb heating improves macro- and microvascular dilator function in the leg of aged humans.

    Science.gov (United States)

    Romero, Steven A; Gagnon, Daniel; Adams, Amy N; Cramer, Matthew N; Kouda, Ken; Crandall, Craig G

    2017-01-01

    Local heating of an extremity increases blood flow and vascular shear stress throughout the arterial tree. Local heating acutely improves macrovascular dilator function in the upper limbs of young healthy adults through a shear stress-dependent mechanism but has no such effect in the lower limbs of this age group. The effect of acute limb heating on dilator function within the atherosclerotic prone vasculature of the lower limbs of aged adults is unknown. Therefore, the purpose of this study was to test the hypothesis that acute lower limb heating improves macro- and microvascular dilator function within the leg vasculature of aged adults. Nine young and nine aged adults immersed their lower limbs at a depth of ~33 cm into a heated (~42°C) circulated water bath for 45 min. Before and 30 min after heating, macro (flow-mediated dilation)- and microvascular (reactive hyperemia) dilator functions were assessed in the lower limb, following 5 min of arterial occlusion, via Doppler ultrasound. Compared with preheat, macrovascular dilator function was unchanged following heating in young adults (P = 0.6) but was improved in aged adults (P = 0.04). Similarly, microvascular dilator function, as assessed by peak reactive hyperemia, was unchanged following heating in young adults (P = 0.1) but was improved in aged adults (P < 0.01). Taken together, these data suggest that acute lower limb heating improves both macro- and microvascular dilator function in an age dependent manner. We demonstrate that lower limb heating acutely improves macro- and microvascular dilator function within the atherosclerotic prone vasculature of the leg in aged adults. These findings provide evidence for a potential therapeutic use of chronic lower limb heating to improve vascular health in primary aging and various disease conditions. Copyright © 2017 the American Physiological Society.

  2. A comparative study of teenage pregnancy.

    Science.gov (United States)

    Mahavarkar, S H; Madhu, C K; Mule, V D

    2008-08-01

    Teenage pregnancy is a global problem and is considered a high-risk group, in spite of conflicting evidence. Our objective was to compare obstetric outcomes of pregnancy in teenagers and older women. This was a retrospective study of case records of pregnancies from August 2000 to July 2001. Girls aged pregnancy outcomes in older women (19-35 years) in the same hospital. The study took place in the Government General Hospital, Sangli, India, a teaching hospital in rural India, with an annual delivery rate of over 3,500. A total of 386 teenage pregnancies were compared with pregnancies in 3,326 older women. Socioeconomic data, age, number of pregnancies, antenatal care and complications, mode of delivery, and neonatal outcomes were considered. The incidence of teenage pregnancy in the study was 10%. A significant proportion of teenage pregnant mothers were in their first pregnancies. The teenage mothers were nearly three times more at risk of developing anaemia (OR = 2.83, 95% CI = 2.2-3.7, p Teenage mothers were twice as likely to develop hypertensive problems in pregnancy (OR = 2.2, 95% CI = 1.5-3.2, p teenage pregnancies are still a common occurrence in rural India in spite of various legislations and government programmes and teenage pregnancy is a risk factor for poor obstetric outcome in rural India. Cultural practices, poor socioeconomic conditions, low literacy rate and lack of awareness of the risks are some of the main contributory factors. Early booking, good care during pregnancy and delivery and proper utilisation of contraceptive services can prevent the incidence and complications in this high-risk group.

  3. Postnatal growth allometry of the extremities in Cebus albifrons and Cebus apella: a longitudinal and comparative study.

    Science.gov (United States)

    Jungers, W L; Fleagle, J G

    1980-11-01

    Cebus albifrons and Cebus apella, partially sympatric capuchin monkeys from South America, are known to differ substantially in adult body mass and bodily proportions. C. apella possesses a robust, stocky build in contrast to the more gracile, relatively longer limbed body design of C. alblfrons. Average birth weights and adult body lengths of these two congeners, however, are remarkably similar and do not serve to distinguish them. This study examines longitudinal growth rates and patterns of ontogenetic scaling in the extremities (humerus, radius, hand, femur, tibia, foot) in order to document the nature and magnitude of skeletal changes associated with increasing age and body mass. Our data indicate that the growth rates of the six skeletal components of the limbs differ only slightly and somewhat inconsistently between the two species. Body mass, however, increases at a consistently faster rate in C. apella. Relative to body mass, therefore, the extremities of C. albifrons scale much faster than those of C. apella. This implies that at any given postnatal body mass, C. alblfrons is longer limbed that C. apella. Conversely, C. apella is heavier than C. albifrons at any given limb length or age. We suggest that such differences in body mass distribution are causally related to differences in locomotor behavior and foraging strategies. Specifically, the relatively long-limbed C. albifrons is probably more cursorial and tends to travel longer distances each day than C. apella. C. apella is a much more deliberate quadruped and is also characterized by especially vigorous and powerful foraging and feeding behaviors. We also compare our results to other (mostly cross-sectional) studies of skeletal growth allometry in nonhuman primates.

  4. Comparative microscopy study of Vibrio cholerae flagella

    Science.gov (United States)

    Konnov, Nikolai P.; Baiburin, Vil B.; Zadnova, Svetlana P.; Volkov, Uryi P.

    1999-06-01

    A fine structure of bacteria flagella is an important problem of molecular cell biology. Bacteria flagella are the self-assembled structures that allow to use the flagellum protein in a number of biotechnological applications. However, at present, there is a little information about high resolution scanning probe microscopy study of flagellum structure, in particular, about investigation of Vibrio cholerae flagella. In our lab have been carried out the high resolution comparative investigation of V. cholerae flagella by means of various microscopes: tunneling (STM), scanning force (SFM) and electron transmission. As a scanning probe microscope is used designed in our lab versatile SPM with replaceable measuring heads. Bacteria were grown, fixed and treated according to the conventional techniques. For STM investigations samples were covered with Pt/Ir thin films by rotated vacuum evaporation, in SFM investigations were used uncovered samples. Electron microscopy of the negatively stained bacteria was used as a test procedure.

  5. Comparative studies on ecotoxicology of synthetic detergents.

    Science.gov (United States)

    Lal, H; Misra, V; Viswanathan, P N; Krishna Murti, C R

    1983-12-01

    To predict the comparative toxicological response of synthetic detergents on aquatic ecosystems, the effects of various concentrations of neutralized alkyl benzene sulfonate were studied. The median tolerance limit at 48 hr, 95% confidence limit, slope function, presumable harmless concentration, and rate of survival of different species of aquatic fauna such as water fleas (Daphnia magna), mosquito larvae (Culex pipiens), slug worms (Tubifex rivulorum), snails (Lymnaea vulgaris), tadpoles (Rana cyanophlyctis), and fish fingerlings (Cirrhina mrigala) were followed at 0, 24, 48, 72, and 96 hr. Any effect on quality of the water was also tested after the addition of various concentrations of detergents. The results showed that water fleas are more susceptible to detergent toxicity than fish fingerlings, tadpoles, slug worms, snails, and mosquito larvae. Behavioral changes were also observed as an index for detergent toxicity. The relative toxicity of the detergents to various species is discussed in relation to selective ecotoxicological response.

  6. A COMPARATIVE STUDY IN WIRELESS SENSOR NETWORKS

    Directory of Open Access Journals (Sweden)

    Hasan Al-Refai

    2014-02-01

    Full Text Available Sensor networks consist of a large number of small, low-powered wireless nodes with limited computation, communication, and sensing abilities, in a battery-powered sensor network, energy and communication bandwidth are a precious resources. Thus, there is a need to adapt the networking process to match the application in order to minimize the resources consumed and extend the life of the network. In this paper, we introduce a comparative study in different routing algorithms that propose vital solutions to the most important issues that should be taken into account when designing wireless network which are reliability, lifetime, communication bandwidth, transmission rand, and finally the limited energy issue, so we will introduce their algorithms and discuss how did they propose to solve such of these challenges and finally we will do some evaluation to each approach.

  7. COSMOS - a study comparing peripheral intravenous systems.

    Science.gov (United States)

    López, Juan Luis González; Del Palacio, Encarnación Ferenández; Marti, Carmen Benedicto; Corral, Javier Olivares; Portal, Pilar Herrera; Vilela, Ana Arribi

    In many areas of the world, safety peripheral intravenous systems have come into widespread use. The Madrid region was the first in Spain to adopt such an approach. These systems, though initially introduced to protect users from sharps injuries, have now evolved to include patient protection features as well. Patient protection, simply stated, means closing the system to pathogen entry. The authors' purpose was to investigate, in a prospective and randomized study, the clinical performance of a closed safe intravenous system versus an open system (COSMOS - Compact Closed System versus Mounted Open System). COSMOS is designed to provide definitive answers, from a nursing perspective, to many topics related to peripheral venous catheterization, which have important implications in intravenous therapy and which have not been validated scientifically. Furthermore, it forms pioneering research in that it is the first clinical trial on medical devices in a legislated environment carried out entirely by nurses and whose promoter and principal investigator is a nurse. The objectives of COSMOS are to compare the effectiveness (as defined by time of survival without complications) and rates of catheter-related complications, such as phlebitis, pain, extravasation, blockage and catheter-related infections. It also looks at rates of catheter colonization, the ease of handling of both systems and overall costs. This article outlines the authors' approach, both in preparing hospital units for such an evaluation as well as in the choice of parameters and their method of study. Further articles will detail the results and findings of the study.

  8. Therapeutic administration of atomoxetine combined with rTMS and occupational therapy for upper limb hemiparesis after stroke: a case series study of three patients.

    Science.gov (United States)

    Kinoshita, Shoji; Kakuda, Wataru; Yamada, Naoki; Momosaki, Ryo; Okuma, Ryo; Watanabe, Shu; Abo, Masahiro

    2016-03-01

    Atomoxetine, a selective noradrenaline reuptake inhibitor, has been reported to enhance brain plasticity, but has not yet been used in stroke patients. We reported the feasibility and clinical benefits on motor functional recovery of the combination of repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) in stroke patients. This pilot study was designed to evaluate the additive effects of oral atomoxetine to rTMS/OT in post-stroke hemiparetic patients. The study included three post-stroke patients with upper limb hemiparesis. Treatment with 40 mg/day atomoxetine commenced 2 weeks before admission. After confirming tolerance, the dose was increased to 120 mg/day. Low-frequency rTMS/OT was provided daily for 15 days during continued atomoxetine therapy. Motor function of the affected upper limb was evaluated with the Fugl-Meyer Assessment and Wolf Motor Function test. All patients completed the protocol and showed motor improvement up to 4 weeks after the treatment. No atomoxetine-related side effects were noted. Our protocol of triple therapy of atomoxetine, low-frequency rTMS, and OT is safe and feasible intervention for upper limb hemiparesis after stroke.

  9. Reasoning about “Capability”: Wild Robins Respond to Limb Visibility in Humans

    Directory of Open Access Journals (Sweden)

    Alexis Garland

    2016-07-01

    Full Text Available Little comparative work has focused on what nonhumans understand about what physical acts others are capable of performing, and none has yet done so in the wild, or within a competitive framework. This study shows that North Island robins visually attend to human limbs in the context of determining who to steal food from. We presented 24 wild North Island Robins (Petroica longipes with two experimenters. Robins could choose to steal a mealworm from one of two experimenters: one whose limbs were exposed and one who underwent a range of visual obstructions in two experiments. In most conditions, robins preferred to steal food located near the experimenter whose limbs were obscured by a cloth or board rather than food located near the experimenter whose limbs were not obscured. The robins’ responses indicate that human limb visibility is associated with reduced access to food. Current findings lay the groundwork for a closer look at the potential general use of causal reasoning in an inter-specific context of using limbs to perform physical acts, specifically within the context of pilfering. This study presents one of the first tests of the role of visual attendance of potential limb availability in a competitive context, and could provide an alternative hypothesis for how other species have passed tests designed to examine what individuals understand about the physical acts others are capable of performing.

  10. Reasoning about “Capability”: Wild Robins Respond to Limb Visibility in Humans

    Science.gov (United States)

    Garland, Alexis; Low, Jason

    2016-01-01

    Little comparative work has focused on what nonhumans understand about what physical acts others are capable of performing, and none has yet done so in the wild, or within a competitive framework. This study shows that North Island robins visually attend to human limbs in the context of determining who to steal food from. We presented 24 wild North Island Robins (Petroica longipes) with two experimenters. Robins could choose to steal a mealworm from one of two experimenters: one whose limbs were exposed and one who underwent a range of visual obstructions in two experiments. In most conditions, robins preferred to steal food located near the experimenter whose limbs were obscured by a cloth or board rather than food located near the experimenter whose limbs were not obscured. The robins’ responses indicate that human limb visibility is associated with reduced access to food. Current findings lay the groundwork for a closer look at the potential general use of causal reasoning in an inter-specific context of using limbs to perform physical acts, specifically within the context of pilfering. This study presents one of the first tests of the role of visual attendance of potential limb availability in a competitive context, and could provide an alternative hypothesis for how other species have passed tests designed to examine what individuals understand about the physical acts others are capable of performing. PMID:27455334

  11. Upper Limb Exoskeleton

    NARCIS (Netherlands)

    Rusak, Z.; Luijten, J.; Kooijman, A.

    2015-01-01

    The present invention relates a wearable exoskeleton for a user having a torso with an upper limb to support motion of the said upper limb. The wearable exoskeleton comprises a first fixed frame mountable to the torso, an upper arm brace and a first group of actuators for moving the upper arm brace

  12. Upper Limb Exoskeleton

    NARCIS (Netherlands)

    Rusak, Z.; Luijten, J.; Kooijman, A.

    2015-01-01

    The present invention relates a wearable exoskeleton for a user having a torso with an upper limb to support motion of the said upper limb. The wearable exoskeleton comprises a first fixed frame mountable to the torso, an upper arm brace and a first group of actuators for moving the upper arm brace

  13. Intentional burns in Nepal: a comparative study.

    Science.gov (United States)

    Lama, Bir Bahadur; Duke, Janine M; Sharma, Narayan Prasad; Thapa, Buland; Dahal, Peeyush; Bariya, Nara Devi; Marston, Wendy; Wallace, Hilary J

    2015-09-01

    Intentional burns injuries are associated with high mortality rates, and for survivors, high levels of physical and psychological morbidity. This study provides a comprehensive assessment of intentional burn admissions to the adult Burns Unit at Bir Hospital, Kathmandu, Nepal, during the period 2002-2013. A secondary data analysis of de-identified data of patients hospitalized at Bir Hospital, Kathmandu, with a burn during the period of 1 January 2002 to 31 August 2013. Socio-demographic, injury and psychosocial factors of patients with intentional and unintentional burns are described and compared. Chi-square tests, Fisher's exact test and Wilcoxon rank sum tests were used to determine statistical significance. There were a total of 1148 burn admissions of which 329 (29%) were for intentional burn, 293 (26%) were self-inflicted and 36 (3%) were due to assault. Mortality rates for intentional burns were approximately three times those for unintentional burns (60 vs. 22%). When compared to unintentional burns, patients with intentional burns were more likely to be female (79 vs. 48%), married (84 vs. 67%), younger (25 vs. 30 years), have more extensive burns (total body surface area, %: 55 vs. 25) and higher mortality (60 vs. 22%). Intentional burns were more likely to occur at home (95 vs. 67%), be caused by fire (96 vs. 77%), and kerosene was the most common accelerant (91 vs. 31%). A primary psychosocial risk factor was identified in the majority of intentional burn cases, with 60% experiencing adjustment problems/interpersonal conflict and 32% with evidence of a pre-existing psychological condition. A record of alcohol/substance abuse related to the patient or other was associated with a greater proportion of intentional burns when compared with unintentional burns (17 vs. 4%). The majority of intentional burn patients were female. Almost all intentional burns occurred in the home and were caused by fire, with kerosene the most common accelerant used. Underlying

  14. Field study for disposal of solid wastes from Advanced Coal Processes: Ohio LIMB Site Assessment. Final report, April 1986--November 1994

    Energy Technology Data Exchange (ETDEWEB)

    Weinberg, A.; Coel, B.J.; Butler, R.D.

    1994-10-01

    New air pollution regulations will require cleaner, more efficient processes for converting coal to electricity, producing solid byproducts or wastes that differ from conventional pulverized-coal combustion ash. Large scale landfill test cells containing byproducts were built at 3 sites and are to be monitored over at least 3 years. This report presents results of a 3-y field test at an ash disposal site in northern Ohio; the field test used ash from a combined lime injection-multistage burner (LIMB) retrofit at the Ohio Edison Edgewater plant. The landfill test cells used LIMB ash wetted only to control dusting in one cell, and LIMB ash wetted to optimize compaction density in the other cell. Both test cells had adequate load-bearing strength for landfill stability but had continuing dimensional instability. Heaving and expansion did not affect the landfill stability but probably contributed to greater permeability to infiltrating water. Leachate migration occurred from the base, but effects on downgradient groundwater were limited to increased chloride concentration in one well. Compressive strength of landfilled ash was adequate to support equipment, although permeability was higher and strength was lower than anticipated. Average moisture content has increased to about 90% (dry weight basis). Significant water infiltration has occurred; the model suggests that as much as 20% of the incident rainfall will pass through and exit as leachate. However, impacts on shallow ground water is minimal. Results of this field study suggest that LIMB ash from combustion of moderate to high sulfur coals will perform acceptably if engineering controls are used to condition and compact the materials, reduce water influx to the landfill, and minimize leachate production. Handling of the ash did not pose serious problems during cell construction; steaming and heat buildup were moderate.

  15. Measurement Issues in Anthropometric Measures of Limb Volume Change in Persons at Risk for and Living with Lymphedema: A Reliability Study

    Directory of Open Access Journals (Sweden)

    Dorit Tidhar

    2015-09-01

    Full Text Available Understanding whether a true change has occurred during the process of care is of utmost importance in lymphedema management secondary to cancer treatments. Decisions about when to order a garment, start an exercise program, and begin or end therapy are based primarily on measurements of limb volume, based on circumferences taken by physiotherapists using a flexible tape. This study aimed to assess intra-rater and inter-rater reliability of measurements taken by physiotherapists of legs and arms with and without lymphedema and to evaluate whether there is a difference in reliability when measuring a healthy versus a lymphedematous limb. The intra-rater reliability of arm and leg measurements by trained physiotherapist is very high (scaled standard error of measurements (SEMs for an arm and a leg volume were 0.82% and 0.64%, respectively and a cut-point of 1% scaled SEM may be recommended as a threshold for acceptable reliability. Physiotherapists can rely on the same error when assessing lymphedematous or healthy limbs. For those who work in teams and share patients, practice is needed in synchronizing the measurements and regularly monitoring their inter-rater reliability.

  16. Two-dimensional finite difference model to study temperature distribution in SST regions of human limbs immediately after physical exercise in cold climate

    Science.gov (United States)

    Kumari, Babita; Adlakha, Neeru

    2015-02-01

    Thermoregulation is a complex mechanism regulating heat production within the body (chemical thermoregulation) and heat exchange between the body and the environment (physical thermoregulation) in such a way that the heat exchange is balanced and deep body temperatures are relatively stable. The external heat transfer mechanisms are radiation, conduction, convection and evaporation. The physical activity causes thermal stress and poses challenges for this thermoregulation. In this paper, a model has been developed to study temperature distribution in SST regions of human limbs immediately after physical exercise under cold climate. It is assumed that the subject is doing exercise initially and comes to rest at time t = 0. The human limb is assumed to be of cylindrical shape. The peripheral region of limb is divided into three natural components namely epidermis, dermis and subdermal tissues (SST). Appropriate boundary conditions have been framed based on the physical conditions of the problem. Finite difference has been employed for time, radial and angular variables. The numerical results have been used to obtain temperature profiles in the SST region immediately after continuous exercise for a two-dimensional unsteady state case. The results have been used to analyze the thermal stress in relation to light, moderate and vigorous intensity exercise.

  17. Canoe game-based virtual reality training to improve trunk postural stability, balance, and upper limb motor function in subacute stroke patients: a randomized controlled pilot study.

    Science.gov (United States)

    Lee, Myung-Mo; Shin, Doo-Chul; Song, Chang-Ho

    2016-07-01

    [Purpose] This study was aimed at investigating the preliminary therapeutic efficacy and usefulness of canoe game-based virtual reality training for stroke patients. [Subjects and Methods] Ten stroke patients were randomly assigned to an experimental group (EG; n=5) or a control group (CG; n=5). Patients in both groups participated in a conventional rehabilitation program, but those in the EG additionally participated in a 30-min canoe game-based virtual reality training program 3 days a week for 4 weeks. Therapeutic efficacy was assessed based on trunk postural stability, balance, and upper limb motor function. In addition, the usefulness of canoe game-based virtual reality training was assessed in the EG and therapist group (TG; n=20), which consisted of physical and occupational therapists, by using the System Usability Scale (SUS). [Results] Improvements in trunk postural stability, balance, and upper limb motor function were observed in the EG and CG, but were greater in the EG. The mean SUS scores in the EG and TG were 71 ± 5.2 and 74.2 ± 4.8, respectively. [Conclusion] Canoe game-based virtual reality training is an acceptable and effective intervention for improving trunk postural stability, balance, and upper limb motor function in stroke patients.

  18. The BEST study - a prospective study to compare business class ...

    African Journals Online (AJOL)

    ... a prospective study to compare business class versus economy class air travel as a cause of thrombosis. ... Patients/methods. ... Logistical regression analysis was used to determine the risk factors related to abnormally high D-dimer levels.

  19. A STUDY ON PERI - OPERATIVE MAGNESIUM SULPHATE ON POST - OPERATIVE PAIN MANAGEMENT IN PATIENTS UNDERGOING PELVIC AND LOWER LIMB SURGERIES

    Directory of Open Access Journals (Sweden)

    Sajan K.

    2015-01-01

    Full Text Available CONTEXT: Post - operative pain is the major morbidity of most of the surgeries. This study aims to find out the analgesic property of MAGNESIUM SULPHATE as it blocks N - Methyl D - Aspartate receptor. AIMS: To study the effect of Peri - operative IV Magnesium sulphate on Post - operative pain management and to determine the adverse reactions , if any. SETTINGS AND DESIGN: This prospective study is double - blind , randomised , placebo controlled clinical trial among the patients undergoing elective lower limb and pelvic surgery under spinal anaesthesia. METHODS AND MATERIAL: 60 ASA 1 & 2 patients aged between 18 and 50 years wa s selected and assigned to two groups ‘M’ group for magnesium and ‘S’ group for placebo. ‘M’ group was infused with 500ml normal saline containing Inj. Magnesium sulphate at a dose of 8mg/kg body weight/hour till the end of the surgery. The placebo group ‘ S’ also received same amount of normal saline till the end. Post - operative pain analysis was done with VAS scoring system at 3 , 6 , 12 & 24 hours. STATISTICAL ANALYSIS USED: Data analysis was done with SPSS software. To present the results , mean+SD was used and a ‘P’ value of < 0.05 was considered statistically significant. RESULTS: There existed a statistically significant difference in mean VAS within the groups during the observation period (p - value <0.000. The highest mean VAS in M groups was recorded a t 12 hours and in S group at 6 hours. Only 22 patient required morphine for pain relief in M group while all patients in group S required morphine. The total dose of morphine used was higher in the placebo group. But this mean difference was not statistica lly significant (p - value = 0.43. T he total dose of magnesium used and the post - operative morphine requirement showed a strong inverse relation with a p - value of < 0.0001. The rescue analgesic requirement was delayed in M group (p - value of 0.01 CONCLUSION S: We hypothesis that peri

  20. The effect of goals and vision on movements: a case study of optic ataxia and limb apraxia.

    Science.gov (United States)

    Ambron, Elisabetta; Lingnau, Angelika; Lunardelli, Alberta; Pesavento, Valentina; Rumiati, Raffaella I

    2015-04-01

    Normally we can perform a variety of goal-directed movements effortlessly. However, damage to the parietal cortex may dramatically reduce this ability, giving rise to optic ataxia and limb apraxia. Patients with optic ataxia show clear misreaches towards targets when presented in the peripheral visual field, whereas limb apraxia refers to the inability to use common tools or to imitate simple gestures. In the present paper we describe the case of a left-brain damaged patient, who presented both symptoms. We systematically investigated both spatial and temporal parameters of his movements, when asked to reach and grasp common objects to move (Experiment 1) or to use them (Experiment 2), presented either in the central or peripheral visual field. Different movement parameters changed in relation to the goal of the task (grasp to move vs. grasp to use), reflecting a normal modulation of the movement to accomplish tasks with different goals. On the other hand, grip aperture appeared to be more affected from both task goal and viewing condition, with a specific decrement observed when CF was asked to use objects presented peripherally. On the contrary, a neat effect of the viewing condition was observed in the spatial distribution of the end-points of the movements, and of the horizontal end point in particular, which were shifted towards the fixation point when reaching towards peripheral targets. We hypothesized that optic ataxia and limb apraxia have a differential effect on the patient's performance. The specific presence of optic ataxia would have an effect on the movement trajectory, but both symptoms might interact and influence the grasping component of the movement. As a 'cognitive side of motor control impairment', the presence of limb apraxia may have increased the task demands in grasping to use the objects thus exacerbating optic ataxia. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Effects of jump and balance training on knee kinematics and electromyography of female basketball athletes during a single limb drop landing: pre-post intervention study

    Directory of Open Access Journals (Sweden)

    Nagano Yasuharu

    2011-07-01

    Full Text Available Abstract Background Some research studies have investigated the effects of anterior cruciate ligament (ACL injury prevention programs on knee kinematics during landing tasks; however the results were different among the studies. Even though tibial rotation is usually observed at the time of ACL injury, the effects of training programs for knee kinematics in the horizontal plane have not yet been analyzed. The purpose of this study was to determine the effects of a jump and balance training program on knee kinematics including tibial rotation as well as on electromyography of the quadriceps and hamstrings in female athletes. Methods Eight female basketball athletes participated in the experiment. All subjects performed a single limb landing at three different times: the initial test, five weeks later, and one week after completing training. The jump and balance training program lasted for five weeks. Knee kinematics and simultaneous electromyography of the rectus femoris and Hamstrings before training were compared with those measured after completing the training program. Results After training, regarding the position of the knee at foot contact, the knee flexion angle for the Post-training trial (mean (SE: 24.4 (2.1 deg was significantly larger than that for the Pre-training trial (19.3 (2.5 deg (p Conclusions The jump and balance training program successfully increased knee flexion and hamstring activity of female athletes during landing, and has the possibility of producing partial effects to avoid the characteristic knee position observed in ACL injury, thereby preventing injury. However, the expected changes in frontal and transverse kinematics of the knee were not observed.

  2. COMPARATIVE STUDY ON ACCOUNTING AND FISCAL AMORTIZATION

    Directory of Open Access Journals (Sweden)

    MARIANA GURAU

    2012-05-01

    Full Text Available Placed in the international trend, Romanian accounting had experienced various changes, especially as regards of progress on disconnection between accounting and fiscality. In the present, fiscal rules should not have any role in accounting decisions, because accounting rules are applied to produce accounting information that is useful in making decisions and to provide a "true and fair view" upon financial reality of the entity. However, the barrier in the habit of accounting to thinking for fiscal point of view all economic transactions remains insurmountable, yet. Starting from this perspective on disconnection between accounting and fiscality would mean that amortization recorded in the accounting, as a result of management policy, to be different from fiscality amortization, to calculate income tax. Although formally accepted, disconnect between accounting and fiscality continues to meet many difficulties. In this sense, it is usual in practice to use the same method of amortization for accounting purposes and for fiscal purposes to prevent complications of double track amortization and prevent wandering in the rules in this field. Accounting rule is deliberately eluded in favor of the fiscal rules. This is the reason we proposed to make in this paper a comparative study between norms and rules on accounting and fiscal amortization, paper in which we intend to show the benefits of applying accounting and fiscal rules separately.

  3. Comparative study of selected parallel tempering methods

    Science.gov (United States)

    Malakis, A.; Papakonstantinou, T.

    2013-07-01

    We review several parallel tempering schemes and examine their main ingredients for accuracy and efficiency. The present study covers two selection methods of temperatures and several choices for the exchange of replicas, including a recent novel all-pair exchange method. We compare the resulting schemes and measure specific heat errors and efficiency using the two-dimensional (2D) Ising model. Our tests suggest that an earlier proposal for using numbers of local moves related to the canonical correlation times is one of the key ingredients for increasing efficiency, and protocols using cluster algorithms are found to be very effective. Some of the protocols are also tested for efficiency and ground state production in 3D spin-glass models where we find that a simple nearest-neighbor approach using a local n-fold-way algorithm is the most effective. Finally, we present evidence that the asymptotic limits of the ground state energy for the isotropic case and for an anisotropic case of the 3D spin-glass model are very close and may even coincide.

  4. Neurotrophic regulation of epidermal dedifferentiation during wound healing and limb regeneration in the axolotl (Ambystoma mexicanum).

    Science.gov (United States)

    Satoh, A; Graham, G M C; Bryant, S V; Gardiner, D M

    2008-07-15

    Adult urodeles (salamanders) are unique in their ability to regenerate complex organs perfectly. The recently developed Accessory Limb Model (ALM) in the axolotl provides an opportunity to identify and characterize the essential signaling events that control the early steps in limb regeneration. The ALM demonstrates that limb regeneration progresses in a stepwise fashion that is dependent on signals from the wound epidermis, nerves and dermal fibroblasts from opposite sides of the limb. When all the signals are present, a limb is formed de novo. The ALM thus provides an opportunity to identify and characterize the signaling pathways that control blastema morphogenesis and limb regeneration. In the present study, we have utilized the ALM to identity the buttonhead-like zinc-finger transcription factor, Sp9, as being involved in the formation of the regeneration epithelium. Sp9 expression is induced in basal keratinocytes of the apical blastema epithelium in a pattern that is comparable to its expression in developing limb buds, and it thus is an important marker for dedifferentiation of the epidermis. Induction of Sp9 expression is nerve-dependent, and we have identified KGF as an endogenous nerve factor that induces expression of Sp9 in the regeneration epithelium.

  5. Limb development in the gekkonid lizard Gonatodes albogularis: A reconsideration of homology in the lizard carpus and tarsus.

    Science.gov (United States)

    Leal, Francisca; Tarazona, Oscar A; Ramírez-Pinilla, Martha Patricia

    2010-11-01

    Despite the attention squamate lizards have received in the study of digit and limb loss, little is known about limb morphogenesis in pentadactyl lizards. Recent developmental studies have provided a basis for understanding lizard autopodial element homology based on developmental and comparative anatomy. In addition, the composition and identity of some carpal and tarsal elements of lizard limbs, and reptiles in general, have been the theme of discussions about their homology compared to non-squamate Lepidosauromorpha and basal Amniota. The study of additional embryonic material from different lizard families may improve our understanding of squamate limb evolution. Here, we analyze limb morphogenesis in the gekkonid lizard Gonatodes albogularis describing patterns of chondrogenesis and ossification from early stages of embryonic development to hatchlings. Our results are in general agreement with previous developmental studies, but we also show that limb development in squamates probably involves more chondrogenic elements for carpal and tarsal morphogenesis, as previously recognized on the grounds of comparative anatomy. We provide evidence for the transitory presence of distal carpale 1 and intermedium in the carpus and tibiale, intermedium, distal centralia, and distal tarsale 2 in the tarsus. Hence, we demonstrate that some elements that were believed to be lost in squamate evolution are conserved as transitory elements during limb development. However, these elements do not represent just phylogenetic burden but may be important for the morphogenesis of the lizard autopodium.

  6. Tolerance of Iloprost and results of treatment of chronic severe lower limb ischaemia in diabetic patients. A retrospective study of 64 consecutive cases.

    Science.gov (United States)

    Duthois, S; Cailleux, N; Benosman, B; Lévesque, H

    2003-02-01

    The aim of this study was to assess the tolerance and report obtained results with a stable prostacyclin analogue (iloprost) in diabetic patients with severe forms of permanent lower limb ischaemia. Sixty-four consecutive unselected patients, in stage III and IV of Leriche and Fontaine, turned down for vascular surgery after angiography and treated with iloprost during 28 days, were enrolled in this study. Patients were followed-up clinically (ischemic pain, trophic change, walking distance) and with transcutaneous oxymetry (D28). Long-term assessment (6 and 12 months) was expressed as rate of death, major amputation and of live patients with viable limbs and walking. There was no manifestation of intolerance to iloprost. Were considered as responders patients offering a lack or significant decrease in pain, a reduction of trophic lesions and improvement or recovery of walking. Response at two months is lasting: 29 responders (45.3%) and 35 non-responders (54.7%). At 6 months and one year, we observed that 8 (12.5%) and 15 (24.1%) patients respectively had died; 19 (29.6%) and 22 (34.3%) patients underwent major amputation, but 41 (64%) and 34 (53.1%) patients were still alive with their limb and conservative walking. In responder group, at 6 months, 28 (96.5%) patients were alive without amputation for only 13 (37.1%) among non-responders. At one year, 79.3% of the responders and 31.4% of the non-responders were alive without amputation. A total loss of walking, a segmental amputation and a previous amputation of opposite limb were more often noted in no responder group. But no predictive factor was referred to TcPO(2) in particular. Results ware similar in the group of 136 non diabetic patients treated during the same period (67.9% alive with limb at 6 months). This retrospective study, despite its limitations, underlines the clinical particularities of critical ischaemia in diabetics and the good tolerance to iloprost. This point allowed patients, in non

  7. Core muscle activation during dynamic upper limb exercises in women.

    Science.gov (United States)

    Tarnanen, Sami P; Siekkinen, Kirsti M; Häkkinen, Arja H; Mälkiä, Esko A; Kautiainen, Hannu J; Ylinen, Jari J

    2012-12-01

    Although several everyday functions and sporting activities demand controlled use of the abdominal and back muscles while working with the upper limbs, the activity of core muscles during dynamic upper limb exercises in the standing position has not been studied extensively. The purpose of this cross-sectional study was to examine abdominal and back muscle activity during dynamic upper limb exercises while standing and to evaluate whether dynamic exercises are appropriate for strengthening muscles. The activation of the rectus abdominis, obliquus externus abdominis, longissimus, and multifidus muscles during dynamic bilateral or unilateral shoulder exercises with or without fixation of the pelvis was measured in 20 healthy women using surface electromyography. Trunk muscle activation during isometric maximum contraction was used as a comparative reference. With bilateral shoulder extension and unilateral shoulder horizontal adduction, abdominal muscle activity was >60% of activity during reference exercises. With unilateral shoulder horizontal abduction and shoulder extension exercises, back muscle activity was >60% of the activity level reference exercise. Muscle activation levels were 35-64% lower during shoulder horizontal adduction and abduction without fixation compared with exercises with fixation. The results indicate that upper limb exercises performed in the standing position are effective for activating core muscles. Bilateral and unilateral shoulder extension and unilateral shoulder horizontal abduction and adduction with the pelvis fixed elicited the greatest activity of the core muscles.

  8. Regarding the quantification of peripheral microcirculation--Comparing responses evoked in the in vivo human lower limb by postural changes, suprasystolic occlusion and oxygen breathing.

    Science.gov (United States)

    Silva, Henrique; Ferreira, Hugo; Bujan, Ma Julia; Rodrigues, Luis Monteiro

    2015-05-01

    The human skin is an interesting model to explore microcirculation, particularly if using noninvasive technologies such as LDF (Laser Doppler Flowmetry) and tc (transcutaneous) gasimetry and methods as near as possible from the normal physiological state. In this study, we combined those technologies with three classical approaches--leg raising from supine, suprasystolic occlusion (in the ankle), and normobaric oxygen breathing to explore distal peripheral circulation in the foot. These methods are often cited, but a comparative assessment has not been done. The goal of this study was to identify relevant flow related descriptors, method-related advantages and pitfalls, and eventually, to find the best experimental approach. Volunteers (both genders, 22.1 ± 3.7 years old) were subjected to these methods and variables registered during basal, challenge and stabilization phases. Descriptive and comparative statistics were obtained, adopting a 95% confidence level. All flow-related quantitative descriptors potentially useful for the analysis were identified and compared. As expected, male patients consistently showed higher LDF levels and transepidermal water loss (TEWL) and lower tcpO2 values. However, lower results were recorded in the supine position, suggesting a postural dependence. Both leg raising and suprasystolic occlusion produced a hyperemic response after provocation, although different in magnitude, significantly reducing LDF and tcpO2 during provocation. The oxygen breathing method provided the most patient-friendly protocol, consistently reducing LDF (potentially by the inhibition of production of local vasodilators). TEWL increased during the provocation phase in all protocols, although not significantly. Baseline tcpO2 was found to correlate positively with the peak tcpO2 during oxygen breathing and basal LDF with peak flow during leg raising and suprasystolic occlusion. No statistical correlation between TEWL and LDF could be demonstrated under the

  9. Effects of repetitive peripheral magnetic stimulation on upper-limb spasticity and impairment in patients with spastic hemiparesis: a randomized, double-blind, sham-controlled study.

    Science.gov (United States)

    Krewer, Carmen; Hartl, Sandra; Müller, Friedemann; Koenig, Eberhard

    2014-06-01

    To investigate short-term and long-term effects of repetitive peripheral magnetic stimulation (rpMS) on spasticity and motor function. Monocentric, randomized, double-blind, sham-controlled trial. Neurologic rehabilitation hospital. Patients (N=66) with severe hemiparesis and mild to moderate spasticity resulting from a stroke or a traumatic brain injury. The average time ± SD since injury for the intervention groups was 26 ± 71 weeks or 37 ± 82 weeks. rpMS for 20 minutes or sham stimulation with subsequent occupational therapy for 20 minutes, 2 times a day, over a 2-week period. Modified Tardieu Scale and Fugl-Meyer Assessment (arm score), assessed before therapy, at the end of the 2-week treatment period, and 2 weeks after study treatment. Additionally, the Tardieu Scale was assessed after the first and before the third therapy session to determine any short-term effects. Spasticity (Tardieu >0) was present in 83% of wrist flexors, 62% of elbow flexors, 44% of elbow extensors, and 10% of wrist extensors. Compared with the sham stimulation group, the rpMS group showed short-term effects on spasticity for wrist flexors (P=.048), and long-term effects for elbow extensors (P<.045). Arm motor function (rpMS group: median 5 [4-27]; sham group: median 4 [4-9]) did not significantly change over the study period in either group, whereas rpMS had a positive effect on sensory function. Therapy with rpMS increases sensory function in patients with severe limb paresis. The magnetic stimulation, however, has limited effect on spasticity and no effect on motor function. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  10. Effect of Upper Limb Deformities on Gross Motor and Upper Limb Functions in Children with Spastic Cerebral Palsy

    Science.gov (United States)

    Park, Eun Sook; Sim, Eun Geol; Rha, Dong-wook

    2011-01-01

    The aims of this study were to investigate the nature and extent of upper limb deformities via the use of various classifications, and to analyze the relationship between upper limb deformities and gross motor or upper limb functionality levels. Upper extremity data were collected from 234 children with spastic cerebral palsy (CP) who were…

  11. Gait termination in lower limb amputees

    NARCIS (Netherlands)

    Vrieling, A. H.; van Keeken, H. G.; Schoppen, T.; Otten, E.; Halbertsma, J. P. K.; Hof, A. L.; Postema, K.

    Objective: To study the limitations in function and adjustment strategies of lower limb amputees in gait termination. Design: Observational cohort study. Setting: University Medical Centre. Participants: Unilateral transfemoral and transtibial amputees, and able-bodied control subjects. Main outcome

  12. Gait initiation in lower limb amputees

    NARCIS (Netherlands)

    Vrieling, A.H.; van Keeken, H.G.; Schoppen, T.; Otten, E.; Halbertsma, J.P.; Hof, A.L.; Postema, K.

    2008-01-01

    Objective: To study limitations in function and adjustment strategies in lower limb amputees during gait initiation. Design: Observational cohort study. Setting: University Medical Center. Participants: Amputees with a unilateral transfemoral or transtibial amputation, and able-bodied subjects. Main

  13. Obstacle crossing in lower limb amputees

    NARCIS (Netherlands)

    Vrieling, A.H.; van Keeken, H.G.; Schoppen, Tanneke; Otten, Egbert; Halbertsma, J.P.; Hof, A.L.; Postema, K.

    2007-01-01

    Objective: To study limitations in function and adjustment strategies in lower limb amputees during obstacle crossing. Design: Observational cohort study. Subjects: Transfemoral and transtibial amputees and able-bodied control subjects. Methods: In a motion analysis laboratory unimpeded and obstacle

  14. Gait termination in lower limb amputees

    NARCIS (Netherlands)

    Vrieling, A. H.; van Keeken, H. G.; Schoppen, T.; Otten, E.; Halbertsma, J. P. K.; Hof, A. L.; Postema, K.

    2008-01-01

    Objective: To study the limitations in function and adjustment strategies of lower limb amputees in gait termination. Design: Observational cohort study. Setting: University Medical Centre. Participants: Unilateral transfemoral and transtibial amputees, and able-bodied control subjects. Main outcome

  15. The Effect of Charcot Neuroarthropathy on Limb Preservation in Diabetic Patients with Foot Wound and Critical Limb Ischemia after Balloon Angioplasty

    Directory of Open Access Journals (Sweden)

    Mehmet Burak Çildağ

    2017-01-01

    Full Text Available Objective. The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI and those who have Charchot neuroarthropathy (CN accompanied by CLI. Methods. This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK vessel. Only those patients with postprocedural technical success of 100% were selected from the database. All patients were classified into two groups as patients with CLI and CN and patients with CLI only without CN. The Kaplan-Meier method was used to compare the limb preservation rates for the two groups. Results. There was no statistically significant difference between patient age, gender, diabetic disease duration, and comorbid disease such as chronic renal insufficiency, hypertension, and coronary artery disease of the two groups (p>0.05. Limb preservation in the 12 months was 59.1% in the CN group and 92.7% in the group without CN. Also, limb preservation rates between the two groups displayed statistically significant differences (p<0.005. Conclusion. This study showed that CLI can accompany CN in patients with diabetes. Limb preservation rates with endovascular treatment in diabetic patients with CLI only are better than in diabetic patients with CLI and CN.

  16. Psychosocial and Functional Outcomes in Long-Term Survivors of Osteosarcoma: A Comparison of Limb-Salvage Surgery and Amputation

    Science.gov (United States)

    Robert, Rhonda S.; Ottaviani, Giulia; Huh, Winston W.; Palla, Shana; Jaffe, Norman

    2009-01-01

    Background Traditionally, physicians have believed that limb-salvage surgery has functional and cosmetic advantages over amputation, yet the literature is equivocal. Therefore, we sought to compare the psychosocial and functional outcomes in osteosarcoma survivors after limb-salvage surgery and amputation. We hypothesized there to be neither psychosocial nor functional outcome differences between groups. Procedure Participants received treatment of extremity osteosarcoma, had received their cancer diagnosis at least 2 years prior, and were at least 16 years old. A comprehensive set of validated psychosocial and functional measures was used to assess outcome. Results Fifty-seven patients participated in this study (33 who underwent limb-salvage surgery and 24 who underwent amputation). Participants had gone 12–24 years since diagnosis and were 16–52 years old at study participation. We used multiple linear regression models to examine differences in quality of life, body image, self-esteem, and social support between the two groups and found no differences. Lower limb function was a significant predictor of quality of life (p amputation, amputation after failed limb salvage, than by those who did not. Conclusions Participants with more functional lower limbs had better quality of life than did those with less functional lower limbs regardless of whether they underwent amputation or limb-salvage surgery. PMID:20135700

  17. Reorganization of gait after limb-saving surgery of the lower limb

    NARCIS (Netherlands)

    de Visser, E; Veth, RPH; Schreuder, HWB; Duysens, J; Mulder, T

    2003-01-01

    Objective: In this study, the concept of a cognitive dual-task performance and visual restriction during walking has been used to study the recovery of gait after limb-saving surgery in ten patients. Design: All patients were recovering from some form of treatment to tumors of the lower limbs. Patie

  18. Upper limb international spasticity study: rationale and protocol for a large, international, multicentre prospective cohort study investigating management and goal attainment following treatment with botulinum toxin A in real-life clinical practice

    OpenAIRE

    Turner-Stokes, Lynne; Fheodoroff, Klemens; Jacinto, Jorge; Maisonobe, Pascal; Zakine, Benjamin

    2013-01-01

    Objectives This article provides an overview of the Upper Limb International Spasticity (ULIS) programme, which aims to develop a common core dataset for evaluation of real-life practice and outcomes in the treatment of upper-limb spasticity with botulinum toxin A (BoNT-A). Here we present the study protocol for ULIS-II, a large, international cohort study, to describe the rationale and steps to ensure the validity of goal attainment scaling (GAS) as the primary outcome measure. Methods and a...

  19. A Comparative Study of Principals' Administrative Behaviour.

    Science.gov (United States)

    Chung, Kyung Ae

    1989-01-01

    Compared are the managerial behaviors and beliefs of Korean and American secondary school principals. Generalizations are proposed in the areas of work hours, work pace, communication skills, organizational style, instructional leadership, and other managerial behaviors. (16 references) (SI)

  20. Comparative study of environmental impact assessment methods ...

    African Journals Online (AJOL)

    STORAGESEVER

    2009-07-20

    Jul 20, 2009 ... Then both approaches required be comparing and contrasting. Among these methods .... should include political powers (factors related to the poli- cy test) and .... mental system and predict the component behavior. Using the ...

  1. THE INFLUENCE OF LOWER LIMB MOVEMENT ON UPPER LIMB MOVEMENT SYMMETRY WHILE SWIMMING THE BREASTSTROKE

    Directory of Open Access Journals (Sweden)

    M. Jaszczak

    2011-09-01

    Full Text Available This study 1 examined the influence of lower limb movement on upper limb movement symmetry, 2 determined the part of the propulsion phase displaying the greatest hand movement asymmetry, 3 diagnosed the range of upper limb propulsion phase which is the most prone to the influence of the lower limbs while swimming the breaststroke. Twenty-four participants took part in two tests. Half of them performed an asymmetrical leg movement. The propulsion in the first test was generated by four limbs while in the second one only by the upper limbs. The pressure differentials exerted by the water on the back and on the palm of the right and left hand were measured. Then, the asymmetry coefficient of the hand movement was determined. No changes in the level of the asymmetry index in participants performing correct (symmetrical lower limb movement were observed. Incorrect (asymmetrical leg motion resulted in an increase of hand asymmetry. It could be concluded that lower limb faults neutralize upper limb performance when swimming on a rectilinear path. However, most asymmetrical arm performance should be identified with the conversion of propulsion into recovery. Nevertheless, its proneness to influence improper leg performance might be expected at the beginning of arm propulsion.

  2. SKIN STAPLED OR SUTURED: A COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Veerendra Kumar

    2015-01-01

    Full Text Available BACKGROUND: The choice of wound closure after a surgical procedure has been a surgeon’s dilemma . The concerns have been as to how fast , uneventful , less painful , with minimal complications and comfortable will the patient’s recovery be. A well - known technology is surgical staples which are easier to use , less time consuming and a needle free method o f wound closure. OBJECTIVE: To compare skin staples with non - absorbable skin suture for skin closure in surgical laparotomy procedures for the following character : wound infection , dehiscence , cosmesis and postoperative pain . METHODS: This is a comparative study conducted on 100 patients divided in two groups randomly at Bapuji Hospital for cases undergoing surgical laparotomy procedures. Skin closure was done with 2 - 0 polyamide skin sutures in one group and skin closure was achieved with skin staples in th e other group. The outcome of wound was assessed on 3rd , 5th and 7th postoperative days using ASEPSIS score. Wound cosmesis was assessed on the 7th postoperative day and followed up at 1st month and 3rd month , using modified Hollander cosmesis scale. Postoperative pain was assessed using the visual analogue scale on the 1st , 3rd and 7th postoperative days. RESULTS : The mean wound ASPESIS scores on day 3 for skin staples and sutured group was 0.28 and 0.36 (p=0.7 respectively. The score on day 5 for staples and sutured group was 0.12 and 0.28 (p=0.4 respectively. The results in both the groups were the same , 0.08 on day 7(p=0. Wound cosmesis mean score assessment on day 7 for skin staples suturing group was 5.84 and 5.68 respectively (p=0.3. The mean score for cosmesis assessment at 1 month , and 3 rd month for skin staples and suturing group was 5.92 and 5.68 (p=0.1 and was 6.00 and 5.92 (p=0.36 respectively which was not satistically significant . The visual analogue scale score for postopera tive pain on 1st day , 3 rd and 7 th day for skin staples and suturing group 54

  3. The mangled limb: salvage versus amputation.

    Science.gov (United States)

    Wolinsky, Philip R; Webb, Lawrence X; Harvey, Edward J; Tejwani, Nirmal C

    2011-01-01

    A mangled extremity is defined as a limb with injury to three of four systems in the extremity. The decision to salvage or amputate the injured limb has generated much controversy in the literature, with studies to support advantages of each approach. Various scoring systems have proved unreliable in predicting the need for amputation or salvage; however, a recurring theme in the literature is that the key to limb viability seems to be the severity of the soft-tissue injury. Factors such as associated injuries, patient age, and comorbidities (such as diabetes) also should be considered. Attempted limb salvage should be considered only if a patient is hemodynamically stable enough to tolerate the necessary surgical procedures and blood loss associated with limb salvage. For persistently hemodynamically unstable patients and those in extremis, life comes before limb. Recently, the Lower Extremity Assessment Project study attempted to answer the question of whether amputation or limb salvage achieves a better outcome. The study also evaluated other factors, including return-to-work status, impact of the level of and bilaterality of the amputation, and economic cost. There appears to be no significant difference in return to work, functional outcomes, or the cost of treatment (including the prosthesis) between the two groups. A team approach with different specialties, including orthopaedics, plastic surgery, vascular surgery and trauma general surgery, is recommended for treating patients with a mangled extremity.

  4. The functional anatomy of suggested limb paralysis.

    Science.gov (United States)

    Deeley, Quinton; Oakley, David A; Toone, Brian; Bell, Vaughan; Walsh, Eamonn; Marquand, Andre F; Giampietro, Vincent; Brammer, Michael J; Williams, Steven C R; Mehta, Mitul A; Halligan, Peter W

    2013-02-01

    Suggestions of limb paralysis in highly hypnotically suggestible subjects have been employed to successfully model conversion disorders, revealing similar patterns of brain activation associated with attempted movement of the affected limb. However, previous studies differ with regard to the executive regions involved during involuntary inhibition of the affected limb. This difference may have arisen as previous studies did not control for differences in hypnosis depth between conditions and/or include subjective measures to explore the experience of suggested paralysis. In the current study we employed functional magnetic resonance imaging (fMRI) to examine the functional anatomy of left and right upper limb movements in eight healthy subjects selected for high hypnotic suggestibility during (i) hypnosis (NORMAL) and (ii) attempted movement following additional left upper limb paralysis suggestions (PARALYSIS). Contrast of left upper limb motor function during NORMAL relative to PARALYSIS conditions revealed greater activation of contralateral M1/S1 and ipsilateral cerebellum, consistent with the engagement of these regions in the completion of movements. By contrast, two significant observations were noted in PARALYSIS relative to NORMAL conditions. In conjunction with reports of attempts to move the paralysed limb, greater supplementary motor area (SMA) activation was observed, a finding consistent with the role of SMA in motor intention and planning. The anterior cingulate cortex (ACC, BA 24) was also significantly more active in PARALYSIS relative to NORMAL conditions - suggesting that ACC (BA 24) may be implicated in involuntary, as well as voluntary inhibition of prepotent motor responses.

  5. Out on a Limb: Investigating the Anatomy of Tree Limbs

    Science.gov (United States)

    Shaw, Edward L.

    2008-01-01

    The author presents several upper elementary science activities involving tree limbs that were collected after severe weather conditions. The activities involved 3rd-grade students arranging tree limb pieces in the correct order from the trunk to the tip of the limb, measuring the pieces, determining the age of a tree limb by its rings,…

  6. Out on a Limb: Investigating the Anatomy of Tree Limbs

    Science.gov (United States)

    Shaw, Edward L.

    2008-01-01

    The author presents several upper elementary science activities involving tree limbs that were collected after severe weather conditions. The activities involved 3rd-grade students arranging tree limb pieces in the correct order from the trunk to the tip of the limb, measuring the pieces, determining the age of a tree limb by its rings,…

  7. Endovascular therapy as the primary approach for limb salvage in patients with critical limb ischemia: experience with 443 infrapopliteal procedures.

    Science.gov (United States)

    Bosiers, Marc; Hart, Joseph P; Deloose, Koen; Verbist, Jurgen; Peeters, Patrick

    2006-01-01

    Endovascular strategies for the treatment of critical infrageniculate peripheral arterial occlusive disease exist and are becoming the primary methodology for such lesions at many centers. Although technically feasible for experienced operators, the evidence to support this strategy for below the knee (BTK) interventions is still evolving. We studied the 6-month and 1-year outcomes of percutaneous transluminal angioplasty (PTA) alone, PTA with stenting, and excimer laser recanalization for BTK lesions in patients with critical limb ischemia. Between September 2002 and June 2005, 443 patients (355 Rutherford category 4, 82 category 5, 6 category 6) underwent intervention for 681 BTK lesions. Follow-up was performed at 6-month intervals after index intervention: limb salvage data were recorded and duplex ultrasonography was performed to measure the patency of treated areas. The primary patency and limb salvage rates of the entire population were 85.2% and 97.0% and 74.2% and 96.6% at 6 months and 1 year, respectively. Stratified for the treatment strategy (PTA alone in 79, PTA with stenting in 300 patients, and excimer laser in 64), 1-year primary patency rates were 68.6%, 75.5%, and 75.4%, whereas the limb salvage rates were 96.7%, 98.6%, and 87.9% for each modality, respectively. Endovascular intervention will become the primary treatment for BTK lesions in patients with critical limb ischemia, with 1-year primary patency and limb salvage rates that compare favorably with published surgical data. Prospective, randomized, multicenter trials will be needed to further establish the role of endovascular intervention in this challenging patient group.

  8. Network based transcription factor analysis of regenerating axolotl limbs

    Directory of Open Access Journals (Sweden)

    Cameron Jo Ann

    2011-03-01

    Full Text Available Abstract Background Studies on amphibian limb regeneration began in the early 1700's but we still do not completely understand the cellular and molecular events of this unique process. Understanding a complex biological process such as limb regeneration is more complicated than the knowledge of the individual genes or proteins involved. Here we followed a systems biology approach in an effort to construct the networks and pathways of protein interactions involved in formation of the accumulation blastema in regenerating axolotl limbs. Results We used the human orthologs of proteins previously identified by our research team as bait to identify the transcription factor (TF pathways and networks that regulate blastema formation in amputated axolotl limbs. The five most connected factors, c-Myc, SP1, HNF4A, ESR1 and p53 regulate ~50% of the proteins in our data. Among these, c-Myc and SP1 regulate 36.2% of the proteins. c-Myc was the most highly connected TF (71 targets. Network analysis showed that TGF-β1 and fibronectin (FN lead to the activation of these TFs. We found that other TFs known to be involved in epigenetic reprogramming, such as Klf4, Oct4, and Lin28 are also connected to c-Myc and SP1. Conclusions Our study provides a systems biology approach to how different molecular entities inter-connect with each other during the formation of an accumulation blastema in regenerating axolotl limbs. This approach provides an in silico methodology to identify proteins that are not detected by experimental methods such as proteomics but are potentially important to blastema formation. We found that the TFs, c-Myc and SP1 and their target genes could potentially play a central role in limb regeneration. Systems biology has the potential to map out numerous other pathways that are crucial to blastema formation in regeneration-competent limbs, to compare these to the pathways that characterize regeneration-deficient limbs and finally, to identify stem

  9. The VA-Cyberware lower limb prosthetics-orthotics optical laser digitizer.

    Science.gov (United States)

    Houston, V L; Mason, C P; Beattie, A C; LaBlanc, K P; Garbarini, M; Lorenze, E J; Thongpop, C M

    1995-02-01

    Characterization of the residual limbs and limb segments of patients for prosthesis and orthosis design has principally been a subjective process, highly dependent upon the skill, level of training, and experience of the prosthetist/orthotist involved. Even with the application of computer-aided design (CAD) and computer-aided manufacturing (CAM) technologies in prosthetics and orthotics, residual limb/limb segment characterization has remained substantially subjective and dependent upon prosthetist/orthotist skill, training, and experience. To eliminate the variations and errors that frequently occur because of this dependence, and to further quantify the patient measurement process, rehabilitation engineering researchers at the New York Department of Veterans Affairs Medical Center developed an optical laser digitizer for quantitative characterization of patients' residual limbs'/limb segments' spatial geometry and surface topography. The optical digitizer developed is described, and results of laboratory and clinical tests with the digitizer are presented. Examples showing the capability of the digitizer to accurately, rapidly, repeatably, and consistently capture the contours over the entire surfaces of the residual limbs of patients with below-knee (BK) and above-knee (AK) amputation, the lower limbs of orthotics patients, and the feet and ankles of pedorthics patients, are given. In addition, results of a comparative clinical study of optical digitization and standard prosthetics CAD plaster wrap cast electromechanical digitization of the residual limbs of subjects with BK and AK amputation are presented. The enhanced accuracy, repeatability, and consistency afforded by optical digitization are shown. Finally, areas for refinement of the optical digitizer's design, identified in the project's laboratory and clinical tests, are discussed.

  10. A multi-center study on low-frequency rTMS combined with intensive occupational therapy for upper limb hemiparesis in post-stroke patients.

    Science.gov (United States)

    Kakuda, Wataru; Abo, Masahiro; Shimizu, Masato; Sasanuma, Jinichi; Okamoto, Takatsugu; Yokoi, Aki; Taguchi, Kensuke; Mitani, Sugao; Harashima, Hiroaki; Urushidani, Naoki; Urashima, Mitsuyoshi

    2012-01-20

    Both low-frequency repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) have been recently reported to be clinically beneficial for post-stroke patients with upper limb hemiparesis. Based on these reports, we developed an inpatient combination protocol of these two modalities for the treatment of such patients. The aims of this pilot study were to confirm the safety and feasibility of the protocol in a large number of patients from different institutions, and identify predictors of the clinical response to the treatment. The study subjects were 204 post-stroke patients with upper limb hemiparesis (mean age at admission 58.5 ± 13.4 years, mean time after stroke 5.0 ± 4.5 years, ± SD) from five institutions in Japan. During 15-day hospitalization, each patient received 22 treatment sessions of 20-min low-frequency rTMS and 120-min intensive OT daily. Low-frequency rTMS of 1 Hz was applied to the contralesional hemisphere over the primary motor area. The intensive OT, consisting of 60-min one-to-one training and 60-min self-exercise, was provided after the application of low-frequency rTMS. Fugl-Meyer Assessment (FMA) and Wolf Motor Function Test (WMFT) were performed serially. The physiatrists and occupational therapists involved in this study received training prior to the study to standardize the therapeutic protocol. All patients completed the protocol without any adverse effects. The FMA score increased and WMFT log performance time decreased significantly at discharge, relative to the respective values at admission (change in FMA score: median at admission, 47 points; median at discharge, 51 points; p stroke patients with upper limb hemiparesis. The response to the treatment was not influenced by age or time after stroke onset. The efficacy of the intervention should be confirmed in a randomized controlled study including a control group.

  11. Upper limb joint muscle/tendon injury and anthropometric adaptations in French competitive tennis players.

    Science.gov (United States)

    Rogowski, Isabelle; Creveaux, Thomas; Genevois, Cyril; Klouche, Shahnaz; Rahme, Michel; Hardy, Philippe

    2016-01-01

    The purpose of this study was to examine the relationship between the upper limb anthropometric dimensions and a history of dominant upper limb injury in tennis players. Dominant and non-dominant wrist, forearm, elbow and arm circumferences, along with a history of dominant upper limb injuries, were assessed in 147 male and female players, assigned to four groups based on location of injury: wrist (n = 9), elbow (n = 25), shoulder (n = 14) and healthy players (n = 99). From anthropometric dimensions, bilateral differences in circumferences and in proportions were calculated. The wrist group presented a significant bilateral difference in arm circumference, and asymmetrical bilateral proportions between wrist and forearm, as well as between elbow and arm, compared to the healthy group (6.6 ± 3.1% vs. 4.9 ± 4.0%, P tennis injury and asymmetry in upper limb proportions using high-tech measurements in symptomatic tennis players.

  12. The Teaching of Anthropology: A Comparative Study.

    Science.gov (United States)

    Lombard, Jacques

    1984-01-01

    College-level anthropology teaching in various countries, including Belgium, France, Germany, the Netherlands, Portugal, South Africa, the United Kingdom, and Yugoslavia, is compared. Terminology is examined and historical background is provided. Also discussed are educational crises, the organization of teaching, and teaching methods. (RM)

  13. Lymphoscintigraphy of the lower limbs: a retrospective study of 154 cases from March 2009 to June 2010

    Energy Technology Data Exchange (ETDEWEB)

    Barral, Carlyle Marques; Carvalho, Luciana Araujo; Stehling, Alexandre Pace; Silva, Antonio Carlos Moura da; Castro, Atena Cipriano; Ivo, Claudio Santana; Korman, Daniel Einstoss; Couto, Eneida de Melo; Magalhaes, Leonardo Neuenschwander; Felix, Marco Tulio Marques; Machado, Fernando Santana [ECOAR Medicina Diagnostica, Belo Horizonte, MG (Brazil)

    2013-07-01

    Introduction: Lymphoscintigraphy of the lower limbs (LLL) is an effective method to assess lymphatic function. Objective: to present the case of 154 patients undergoing LLL between March 2009 and June 2010. Methods: Images of the pelvis and lower limbs were acquired after simultaneous intradermal administration of 1.0 mCi of 99mTc-Dextran 500 in 0.1mL in the interdigital space of the first and second toes, bilaterally. Results: 129 (83.77%) patients were female, mean age was 51.48 years, with 32 patients (20.78%) aged between 40 and 49 years. 58 patients (37.66%) had body mass index between 25 and 30 kg/m², 92 patients (59.74%) reported edema, lymphedema or swelling as the reason for examination. 93 patients (60.39%) without previous vascular surgery or procedure, 108 patients (70.13%) without previous inflammation, erysipelas or trauma. 103 patients (66.88%) presented with bilateral swelling upon examination, with 48 patients (31.17%) reporting edema that worsened in the evening. 77 patients (50%) with symptoms for over a year. 31 patients (20.13%) were hypertensive. Scintigraphic findings: 149 patients (96.75%) with some abnormality caracteupon examination, 38 with severe bilateral delay in lymphatic transit time, 85 (55.19%) with normo functioning lymph nodes, 62 patients with bilateral radiotracer drainage via small saphenous veins, 84 patients (54.55%) without collateral vessels, 92 (59.74%) without lymphatic retention, 85 patients (55.19%) without dermal backflow. 15 patients (9.74%) showed lymph nodes in the popliteal region. Conclusions: lower limb lymphoscintigraphy is available as a method to detect lymphedema and changes in lymphatic drainage, and is important for initial investigative screenings, early stage assessments of edema, and for monitoring therapeutic, clinical or surgical interventions. (author)

  14. Major ozonated autohemotherapy promotes the recovery of upper limb motor function in patients with acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Xiaona Wu; Zhensheng Li; Xiaoyan Liu; Haiyan Peng; Yongjun Huang; Gaoquan Luo; Kairun Peng

    2013-01-01

    Major ozonated autohemotherapy is classically used in treating ischemic disorder of the lower limbs. In the present study, we performed major ozonated autohemotherapy treatment in patients with acute cerebral infarction, and assessed outcomes according to the U.S. National Institutes of Health Stroke Score, Modified Rankin Scale, and transcranial magnetic stimulation motor-evoked potential. Compared with the control group, the clinical total effective rate and the cortical potential rise rate of the upper limbs were significantly higher, the central motor conduction time of upper limb was significantly shorter, and the upper limb motor-evoked potential amplitude was significantly increased, in the ozone group. In the ozone group, the National Institutes of Health Stroke Score was positively correlated with the central motor conduction time and the motor-evoked potential amplitude of the upper limb. Central motor conduction time and motor-evoked potential amplitude of the upper limb may be effective indicators of motor-evoked potentials to assess upper limb motor function in cerebral infarct patients. Furthermore, major ozonated autohemotherapy may promote motor function recovery of the upper limb in patients with acute cerebral infarction.

  15. Sit-to-Stand in People with Stroke: Effect of Lower Limb Constraint-Induced Movement Strategies

    Directory of Open Access Journals (Sweden)

    Charla Krystine Gray

    2014-01-01

    Full Text Available Background. Weight-bearing asymmetry and impaired balance may contribute to the increased fall risk in people with stroke when rising to stand from sitting. Objective. This study investigated the effect of constraint-induced movement (CIM strategies on weight-bearing symmetry and balance during sit-to-stand in people with stroke. Methods. A nonrandom convenience sample of fifteen people with stroke performed the sit-to-stand task using three CIM strategies including a solid or compliant (foam block strategy, with the unaffected limb placed on the block, and an asymmetrical foot position strategy, with the unaffected limb placed ahead of the affected limb. Duration of the task, affected limb weight-bearing, and centre of pressure and centre of mass displacement were measured in the frontal and sagittal plane. Results. Affected limb weight-bearing was increased and frontal plane centre of pressure and centre of mass moved toward the affected limb compared to baseline with all CIM strategies. Centre of mass displacement in the sagittal plane was greater with the compliant block and asymmetrical foot strategies. Conclusions. The CIM strategies demonstrated greater loading of the affected limb and movement of the centre of pressure and centre of mass toward the affected limb. The compliant block and asymmetrical foot conditions may challenge sagittal plane balance during sit-to-stand in people with stroke.

  16. Results from the Upper Limb International Spasticity Study-II (ULIS-II):a large, international, prospective cohort study investigating practice and goal attainment following treatment with botulinum toxin A in real-life clinical management

    OpenAIRE

    Turner-Stokes, Lynne; Fheodoroff, Klemens; Jacinto, Jorge; Maisonobe, Pascal

    2013-01-01

    Objective: To describe real-life practice and person-centred outcomes in the treatment of poststroke upper limb spasticity with botulinum toxin A (BoNT-A).Design: Observational, prospective study.Setting: 84 secondary care centres in 22 countries.Participants: 456 adults (≥18 years) with poststroke upper limb spasticity treated with one cycle of BoNT-A.Methods/outcomes: Muscle selection, BoNT-A preparation, injection technique and timing of follow-up were conducted according to routine practi...

  17. Critical Limb Ischemia (CLI)

    Science.gov (United States)

    ... Buerger’s Disease Carotid Artery Disease Chronic Venous Insufficiency Congenital Vascular Malformation Critical Limb Ischemia (CLI) Deep Vein Thrombosis (DVT) Diabetes and Vascular Disease Fibromuscular Dysplasia High Blood Pressure and Vascular Disease Kidney Failure ...

  18. A comparison of intrathecal dexmedetomidine, clonidine, and fentanyl as adjuvants to hyperbaric bupivacaine for lower limb surgery: A double blind controlled study

    Directory of Open Access Journals (Sweden)

    Vidhi Mahendru

    2013-01-01

    Aim: The purpose of this study was to compare the onset, duration of sensory and motor block, hemodynamic effects, postoperative analgesia, and adverse effects of dexmedetomidine, clonidine, and fentanyl used intrathecally with hyperbaric 0.5% bupivacaine for spinal anesthesia. Settings and Design: The study was conducted in prospective, double blind manner. It included 120 American Society of Anesthesiology (ASA class I and II patients undergoing lower limb surgery under spinal anesthesia after approval from hospital ethics committee with written and informed consent of patients. Materials and Methods: The patients were randomly allocated into four groups (30 patients each. Group BS received 12.5 mg hyperbaric bupivacaine with normal saline, group BF received 12.5 mg bupivacaine with 25 g fentanyl, group BC received 12.5 mg of bupivacaine supplemented 30 g clonidine, and group BD received 12.5 mg bupivacaine plus 5 g dexmedetomidine. The onset time to reach peak sensory and motor level, the regression time of sensory and motor block, hemodynamic changes, and side effects were recorded. Results: Patients in Group BD had significantly longer sensory and motor block times than patients in Groups BC, BF, and BS with Groups BC and BF having comparable duration of sensory and motor block. The mean time of two segment sensory block regression was 147 ± 21 min in Group BD, 117 ± 22 in Group BC, 119 ± 23 in Group BF, and 102 ± 17 in Group BS (P < 0.0001. The regression time of motor block to reach modified Bromage zero (0 was 275 ± 25, 199 ± 26, 196 ± 27, 161 ± 20 in Group BD, BC, BF, and BS, respectively (P < 0.0001. The onset times to reach T8 dermatome and modified Bromage 3 motor block were not significantly different between the groups. Dexmedetomidine group showed significantly less and delayed requirement of rescue analgesic. Conclusions: Intrathecal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability, and reduced

  19. Catatonic schizophrenia: an international comparative study.

    Science.gov (United States)

    Chandrasena, R

    1986-04-01

    Thirty-five hospitalized catatonic schizophrenic patients from Sri Lanka were compared with 22 patients in the U.K. and 13 in Canada. The phenomenology was established using the Present State Examination. Results suggest that ethnicity, chronicity of illness and reception of neuroleptic treatment may influence the lower prevalence of catatonic symptoms among the U.K. and Canadian schizophrenics. Onset of illness appears to be among young adults and mutism, stupor, mannerisms, stereotypes and negativism were the common catatonic symptoms observed.

  20. Lower limb pain in sympathetic-sensory coupling

    Institute of Scientific and Technical Information of China (English)

    Hongjun Yang; Kairun Peng; Sanjue Hu; Li Xuan

    2011-01-01

    Previous studies have shown that sympathetic nerves are related to certain types of pain, and this phenomenon is referred to as sympathetic-sensory coupling. Chronic pain resulting from nerve injury can be exacerbated by sympathetic stimulation or relieved by sympathetic inhibition. In the present study, the correlation between pain and sympathetic nerves was analyzed in patients with severe pain in lower limbs, as well as in a chronically compressed dorsal root ganglion (CCD) rat model (model of low back pain and sciatica). Patients with severe pain in the lower limbs underwent chemical lumbar sympathectomy (CLS), and the analgesic effects of CLS were compared with painkillers. Results demonstrated significantly relieved lower limb pain following CLS, and the analgesic effects of CLS were superior to those seen with painkillers. In the CCD rat model, dorsal root ganglion neuronal activity significantly increased as a result of electrical stimulation to the sympathetic nerves. These results suggest that sympathetic nerves are closely associated with pain and sympathetic-sensory coupling is likely in lower limb pain in both patients and rat models of CCD.

  1. A Clinical Evaluation of Postamputation Phenomena Including Phantom Limb Pain after Lower Limb Amputation in Dysvascular Patients.

    Science.gov (United States)

    Richardson, Cliff; Crawford, Kath; Milnes, Karen; Bouch, Elizabeth; Kulkarni, Jai

    2015-08-01

    To explore the effects of phantom phenomena on a group of dysvascular lower limb amputees. This was a cross-sectional study of dysvascular lower limb amputees. A modified version of the phantom phenomena questionnaire was used to measure the prevalence of phantom phenomena and the effects of those phenomena on daily life. Eighty-nine amputees were recruited. The majority were inpatients (72%) and male (72%). Most had pain before amputation (83%). Sixty-three percent had phantom limb pain. No associations were found between phantom limb pain and preamputation pain (p = .397). Phantom limb pain was present immediately on waking from amputation in 23%. Phantom limb pain is highly fluctuant. It is more likely that phantom limb pain was present with more time passed since amputation (p = .002). Outpatients with unhealed wounds were less likely to have phantom limb pain (p = .007). The effects of postamputation phenomena include sleep loss and social restrictions. These results challenge the belief that phantom limb pain reduces over time as more outpatients reported phantom limb pain than inpatients. Preamputation pain is not linked to the presence of phantom limb pain. The fluctuant nature of phantom limb pain makes its treatment complex. Some may wish intensity to reduce, whereas others may prefer to reduce the number of episodes or duration of each episode instead. More research is needed to clarify the needs of amputees in relation to the postamputation phenomena.

  2. Effect of lower limb rehabilitation robot on lower limb motor function of hemiplegic patients after stroke

    Directory of Open Access Journals (Sweden)

    Jian-liang LU

    2017-07-01

    Full Text Available Objective To observe the rehabilitation effect of lower limb rehabilitation robot training on the lower limb motor function of hemiplegic patients after stroke. Methods A total of 60 stroke patients (duration < 6 months accepted conventional rehabilitation training combined with body weight support treadmill training (BWSTT group, N = 30 or conventional rehabilitation training combined with lower limb rehabilitation robot training (Robot group, N = 30. Fugl - Meyer Assessment Scale for Lower Extremity (FMA-LE was used to evaluate lower limb motor function. Berg Balance Scale (BBS was used to evaluate balance function. Lower limb rehabilitation robot torque feedback system was used to evaluate lower limb muscle strength. All evaluations were performed before and after 8-week training.   Results Compared with before training, the FMA-LE score (P = 0.000, BBS score (P = 0.000, hemiplegic side of hip joint feedback torque value (HJTV, P = 0.000 and knee joint feedback torque value (KJTV, P = 0.000 were increased in both groups after 8-week training. Compared with BWSTT group, the hemiplegic side of HJTV (P = 0.000 and KJTV (P = 0.000 were increased in Robot group after 8-week training, while the FMA-LE score (P = 0.118 and BBS score (P = 0.159 had no statistically significant difference between 2 groups.  Conclusions The lower limb rehabilitation robot or body weight support treadmill training combined with conventional rehabilitation training could improve the lower limb motor function of hemiplegic patients after stroke. The lower limb rehabilitation robot training was better than body weight support treadmill training on the recovery of lower limb muscle strength. DOI: 10.3969/j.issn.1672-6731.2017.05.004  

  3. Longitudinal study of the effect of rubber slat mats on locomotory ability, body, limb and claw lesions, and dirtiness of group housed sows.

    Science.gov (United States)

    Calderón Díaz, J A; Fahey, A G; Kilbride, A L; Green, L E; Boyle, L A

    2013-08-01

    This study evaluated the influence of floor type on sow welfare with particular focus on lameness, claw lesions (CL), and injuries. The study used 164 gilts housed in groups of 8 from AI to 110 d of pregnancy in pens with concrete (n = 84) slatted floor left uncovered or covered by 10-mm rubber slat mats (n = 80) through 2 parities. Lameness (0 = normal to 5 = severe), limb (0 = normal to 6 = severe) and body (0 = normal to 5 = severe) lesions, and manure on the body (MOB; score 0 to 2) were recorded at AI, 24 to 72 h postmixing, between 50 and 70 d of pregnancy, and 2 wk before farrowing. Claw lesions (score 0 = normal to 3 = severe) were recorded at AI and between 50 and 70 d of pregnancy. The dirtiness and wetness of the floors was scored weekly (score 0 = clean to 4 = >75% of the pen soiled/wet). Data from the first and second parities were analyzed separately. Sows were categorized as nonlame (score ≤ 1) or lame (score ≥ 2). Median (M(e)) scores were calculated for CL and body and limb lesions and were classified as less than or equal to the median or greater than the median lesion scores. Sows on rubber slat mats had a reduced risk of lameness during both parities (P concrete. They also had an increased risk of scores greater than the median for toe overgrowth (M(e) = 2 and M(e) = 3 in the first and second parity, respectively) and heel sole crack (HSC; M(e) = 3) during both parities (P flooring type. There was also no association between body lesion score and flooring type. In this study, CL were not associated with an increased risk of lameness. Therefore, even though rubber slat mats were associated with an increased risk of CL, they improved the welfare of group housed sows by reducing the risk of lameness and limb lesions.

  4. Comparative Transport Studies of '1212' Superconductors

    Directory of Open Access Journals (Sweden)

    Albert Gapud

    1999-12-01

    Full Text Available HgBa2CaCu2O6+δ (Hg -1212 thin films were fabricated by exchanging the T1 cations in TlBa2CaCu2O7-δ (Tl-1212 thin films with Hg cations, causing a 30-K increase in Tc. To determine how this exchange effects such a Tc increase, the irreversibility lines, temperature dependence of critical current density, and temperature dependence of Hall angle ofHg-1212 and TI-1212 thin films were measured and then compared. The results strongly suggest that the Tc shift is caused by a doubling of charge carrier density.

  5. Metachronous multicentric giant-cell tumor of the bone in the lower limb. Case report and Ki-67 immunohistochemistry study.

    Science.gov (United States)

    Rousseau, Marc-Antoine; Handra-Luca, Adriana; Lazennec, Jean-Yves; Catonné, Yves; Saillant, Gérard

    2004-07-01

    Multicentric giant-cell tumors of the bone (GCTs) are rare. Little is known about the mechanisms by which these tumors spread and how 1% of GCT turn out to be multicentric. We report the case of a 19-year-old woman with metachronous multiple and recurrent GCTs that were unusual in their pattern of progression along the right lower limb over a 23-year period. Histology showed no evidence of malignant transformation. The treatment was repeated curettage and packing with cement. This did not permit a wide surgical margin, but avoided amputation and preserved full limb function. We tested the proliferation index marker Ki-67 in the tumor specimens. Ki-67 expression was limited to the mononuclear cell component of the tumors. The proliferation index was similar in each new tumor and higher in recurrences for each location. In this case, proliferation was initially low in the new tumor location, despite the time difference and independent from the initial clone evolution. Proliferation index increased in recurrent GCTs after marginal margin resection.

  6. Investigating pulmonary embolism in the emergency department with lower limb plethysmography: the Manchester Investigation of Pulmonary Embolism Diagnosis (MIOPED) study.

    Science.gov (United States)

    Hogg, K; Dawson, D; Mackway-Jones, K

    2006-02-01

    To measure the diagnostic accuracy of computerised strain gauge plethysmography in the diagnosis of pulmonary embolism (PE). Two researchers prospectively recruited 425 patients with pleuritic chest pain presenting to the emergency department (ED). Lower limb computerised strain gauge plethysmography was performed in the ED. All patients underwent an independent reference standard diagnostic algorithm to establish the presence or absence of PE. A low modified Wells' clinical probability combined with a normal D-dimer excluded PE. All others required diagnostic imaging with PIOPED interpreted ventilation perfusion scanning and/or computerised tomography (CT) pulmonary angiography. Patients with a nondiagnostic CT had digital subtraction pulmonary angiography. All patients were followed up clinically for 3 months. The sensitivity of computerised strain gauge plethysmography was 33.3% (95% confidence interval (CI) 16.3 to 56.2%) and specificity 64.1% (95% CI 59.0 to 68.8%). The negative likelihood ratio was 1.04 (95% CI 0.68 to 1.33) and positive likelihood ratio 0.93 (95% CI 0.45 to 1.60). Lower limb computerised strain gauge plethysmography does not aid in the diagnosis of PE.

  7. Home-based Computer Assisted Arm Rehabilitation (hCAAR) robotic device for upper limb exercise after stroke: results of a feasibility study in home setting.

    Science.gov (United States)

    Sivan, Manoj; Gallagher, Justin; Makower, Sophie; Keeling, David; Bhakta, Bipin; O'Connor, Rory J; Levesley, Martin

    2014-12-12

    Home-based robotic technologies may offer the possibility of self-directed upper limb exercise after stroke as a means of increasing the intensity of rehabilitation treatment. The current literature has a paucity of robotic devices that have been tested in a home environment. The aim of this research project was to evaluate a robotic device Home-based Computer Assisted Arm Rehabilitation (hCAAR) that can be used independently at home by stroke survivors with upper limb weakness. hCAAR device comprises of a joystick handle moved by the weak upper limb to perform tasks on the computer screen. The device provides assistance to the movements depending on users ability. Nineteen participants (stroke survivors with upper limb weakness) were recruited. Outcome measures performed at baseline (A0), at end of 8-weeks of hCAAR use (A1) and 1 month after end of hCAAR use (A2) were: Optotrak kinematic variables, Fugl Meyer Upper Extremity motor subscale (FM-UE), Action Research Arm Test (ARAT), Medical Research Council (MRC) and Modified Ashworth Scale (MAS), Chedoke Arm and Hand Activity Inventory (CAHAI) and ABILHAND. Two participants were unable to use hCAAR: one due to severe paresis and the other due to personal problems. The remaining 17 participants were able to use the device independently in their home setting. No serious adverse events were reported. The median usage time was 433 minutes (IQR 250 - 791 min). A statistically significant improvement was observed in the kinematic and clinical outcomes at A1. The median gain in the scores at A1 were by: movement time 19%, path length 15% and jerk 19%, FM-UE 1 point, total MAS 1.5 point, total MRC 2 points, ARAT 3 points, CAHAI 5.5 points and ABILHAND 3 points. Three participants showed clinically significant improvement in all the clinical outcomes. The hCAAR feasibility study is the first clinical study of its kind reported in the current literature; in this study, 17 participants used the robotic device independently

  8. Computational fluid dynamics evaluation of the cross-limb stent graft configuration for endovascular aneurysm repair.

    Science.gov (United States)

    Shek, Tina L T; Tse, Leonard W; Nabovati, Aydin; Amon, Cristina H

    2012-12-01

    The technique of crossing the limbs of bifurcated modular stent grafts for endovascular aneurysm repair (EVAR) is often employed in the face of splayed aortic bifurcations to facilitate cannulation and prevent device kinking. However, little has been reported about the implications of cross-limb EVAR, especially in comparison to conventional EVAR. Previous computational fluid dynamics studies of conventional EVAR grafts have mostly utilized simplified planar stent graft geometries. We herein examined the differences between conventional and cross-limb EVAR by comparing their hemodynamic flow fields (i.e., in the "direct" and "cross" configurations, respectively). We also added a "planar" configuration, which is commonly found in the literature, to identify how well this configuration compares to out-of-plane stent graft configurations from a hemodynamic perspective. A representative patient's cross-limb stent graft geometry was segmented using computed tomography imaging in Mimics software. The cross-limb graft geometry was used to build its direct and planar counterparts in SolidWorks. Physiologic velocity and mass flow boundary conditions and blood properties were implemented for steady-state and pulsatile transient simulations in ANSYS CFX. Displacement forces, wall shear stress (WSS), and oscillatory shear index (OSI) were all comparable between the direct and cross configurations, whereas the planar geometry yielded very different predictions of hemodynamics compared to the out-of-plane stent graft configurations, particularly for displacement forces. This single-patient study suggests that the short-term hemodynamics involved in crossing the limbs is as safe as conventional EVAR. Higher helicity and improved WSS distribution of the cross-limb configuration suggest improved flow-related thrombosis resistance in the short term. However, there may be long-term fatigue implications to stent graft use in the cross configuration when compared to the direct

  9. Genetic network models: a comparative study

    Science.gov (United States)

    van Someren, Eugene P.; Wessels, Lodewyk F. A.; Reinders, Marcel J. T.

    2001-06-01

    Currently, the need arises for tools capable of unraveling the functionality of genes based on the analysis of microarray measurements. Modeling genetic interactions by means of genetic network models provides a methodology to infer functional relationships between genes. Although a wide variety of different models have been introduced so far, it remains, in general, unclear what the strengths and weaknesses of each of these approaches are and where these models overlap and differ. This paper compares different genetic modeling approaches that attempt to extract the gene regulation matrix from expression data. A taxonomy of continuous genetic network models is proposed and the following important characteristics are suggested and employed to compare the models: inferential power; predictive power; robustness; consistency; stability and computational cost. Where possible, synthetic time series data are employed to investigate some of these properties. The comparison shows that although genetic network modeling might provide valuable information regarding genetic interactions, current models show disappointing results on simple artificial problems. For now, the simplest models are favored because they generalize better, but more complex models will probably prevail once their bias is more thoroughly understood and their variance is better controlled.

  10. Advertisement Analysis: A Comparative Critical Study

    Science.gov (United States)

    Abdelaal, Noureldin Mohamed; Sase, Amal Saleh

    2014-01-01

    This study aimed at analyzing two advertisements, and investigating how advertisers use discourse and semiotics to make people and customers buy into their ideas, beliefs, or simply their products. The two advertisements analyzed are beauty products which have been selected from internet magazines. The methodology adopted in this study is…

  11. [Hand-arm vibration syndrome and upper limbs diseases in the forest workers of Italia meridionale].

    Science.gov (United States)

    Fenga, C; Rapisarda, V; Valentino, M; Cacciola, A; Deboli, R; Calvo, A; Germanò, D

    2007-01-01

    Vibration exposure of the hand-arm system is associated with an increased risk of upper-limb vascular, neurological and musculoskeletal lesions, or hand-arm vibration syndrome (HAVS). The prevalence of occupational HAVS and upper-limb disorders was studied among 278 Forestry Service workers in Sicily and Calabria. Subjects who used chain-saws (18 weeks/year) had a greater prevalence of peripheral sensory-neural disturbances (28%), upper-limb musculoskeletal disorders (33%) and carpal tunnel syndrome (19%) compared with 260 manual workers from the same Corps not exposed to hand-transmitted vibration. Raynaud's phenomenon was comparable in exposed and control subjects (5.3% vs. 4.7%.) Upper-limb neuropathies were significantly associated with energy-equivalent frequency-weighted acceleration; exposure duration; and cumulative vibration dose (m2/s4h). The variable "years of work with vibrating tools" was strongly associated with peripheral neuropathies; carpal tunnel syndrome; and upper-limb musculotendinous syndromes. Data suggest that in Sicily and Calabria, where the climate is milder than in other areas of Italy, forestry work with hand-held vibrating tools does not entail a greater prevalence of peripheral vascular disorders (Raynaud's phenomenon), while the prevalence of occupational upper-limb neurological and musculoskeletal disorders, in which combined ergonomic and mechanical risk factors have a large pathogenic role, is significantly increased.

  12. Anestesia neuroaxial comparada à anestesia geral para revascularização dos membros inferiores em idosos: revisão sistemática com metanálise de ensaios clínicos aleatórios Anestesia neuroaxial comparada a la anestesia general para la revascularización de los miembros inferiores en ancianos: revisión sistemática con metanálisis de ensayos clínicos aleatorios Neuroaxis block compared to general anesthesia for revascularization of the lower limbs in the elderly: a systematic review with metanalysis of randomized clinical studies

    Directory of Open Access Journals (Sweden)

    Fabiano Timbó Barbosa

    2009-04-01

    . Two investigators undertook an independent analysis of the studies published to identify randomized clinical trials (RCTs comparing NB with GA for RLL. The full text of the RCTs that fulfill the inclusion criteria was analyzed. Disagreements were analyzed in consensus meetings. The software Review Manager was used for the Metanalysis by means of odds ratio with a confidence interval of 95%. RESULTS: Three studies involving 465 patients were selected. Metanalysis of the following parameters did not show statistically significant differences: mortality (OR: 0.90; CI 95%: 0.30-2.73; p = 0.85 for spinal anesthesia; OR: 1.30, CI 95%: 0.38-4.48, p = 0.68, for epidural block; myocardial infarction (OR: 1.38, CI 95%: 0.29-6.46, p = 0.68; and rate of lower limb amputation (OR: 0.81, CI 95%: 0.30-2.19, p = 0.68, for spinal block; OR: 0.70, CI 95%: 0.24-2.07, p = 0.52 for epidural block. A statistically significant difference was observed for pneumonia (OR: 0.37, CI 95%: 0.15-0.89, p = 0.03; however, clinical heterogeneity was present. CONCLUSIONS: This metanalysis did not generate enough evidence to demonstrate that NB is more efficient, equivalent, or less efficient than GA for RLL in the elderly.

  13. Comparative study of the sectional slice of the anterior commissure and the internal capsule with its MRI images

    Institute of Scientific and Technical Information of China (English)

    WANG Dandan; MA Wenyi; Zhang Xiaoyang; YUAN Lixiang; YUAN Wu; LI Yunsheng

    2015-01-01

    Objective:The brain of 100 normal persons were performed MRI scan and image analysis. 12 adult female brain specimens fixed by formalin, were made into the thickness of 0. 5mm by celloidin embedding technique. We analyzed the anatomical position of the relationship about the anterior limb of internal capsule and the anterior commissure in eollodion-embedded plans, and then compared with the brain MRI of normal people. We also further compared the statistical differences of the internal capsule’ s volume. This research aimed to pro-vide a reliable sectional anatomic basis for the study of the central nervous system and deep brain stimulation to treat the mental neurological diseases. Results:1. Continous observation of celloid in brain slices horizontal section:Approximately 130 slices of each specimen, from the parietal lobe,the internal capsule was the typical structure"><" on the level of about 35 mm . On the level of about 41mm, the anterior commissure was"arc" through the bot-tom head of the caudate nucleus connecting the bilateral anterior limb, which located between the caudate nucleus and the lentiform nucleus. The posterior limb of internal capsule situated between the dorsal thalamus and the lenti-form nucleus on the level of about 46 mm. Coronal section:about 150 slices of per specimen, from the former lat-eral ventricle horn back,on the level of about 16 mm the anterior commissure was "arch" connecting the anterior limb. About 28 mm dimension, the interior capsule fore limb located between the caudate nucleus and the puta-men, the posterior limb of internal capsule located between the globus pallidus and the dorsal thalamus, extending down to the cerebral peduncle. Sagittal section:about 180 slices of per specimen, from the outside to the inside at the beginning of the temporal lobe, the corona radia taextends between the putamen and dorsal thalamus, and then formsthe posterior limb of the internal capsule at the level of about 21 mm. About 25 mm level

  14. Use of an innovative model to evaluate mobility in seniors with lower-limb amputations of vascular origin: a pilot study

    Directory of Open Access Journals (Sweden)

    Corriveau Hélène

    2010-09-01

    Full Text Available Abstract Background The mobility of older individuals has often been only partially assessed, without considering all important aspects such as potential (available versus effective (used mobilities and the physical and psychosocial factors that modulate them. This study proposes a new model for evaluating mobility that considers all important aspects, applied here to lower-limb amputees with vascular origin. This model integrates the concepts of potential mobility (e.g. balance, speed of movement, effective mobility (e.g. life habits, movements in living areas and factors that modulate these two types of mobility (e.g. strength, sensitivity, social support, depression. The main objective was to characterize potential and effective mobility as well as mobility modulators in a small sample of people with lower-limb amputations of vascular origin with different characteristics. The second objective of this pilot study was to assess the feasibility of measuring all variables in the model in a residential context. Methods An observational and transversal design was used with a heterogeneous sample of 10 participants with a lower-limb amputation of vascular origin, aged 51 to 83, assessed between eight and 18 months after discharge from an acute care hospital. A questionnaire of participant characteristics and 16 reliable and valid measurements were used. Results The results show that the potential mobility indicators do not accurately predict effective mobility, i.e., participants who perform well on traditional measures done in the laboratory or clinic are not always those who perform well in the real world. The model generated 4 different profiles (categories of participants ranging from reduced to excellent potential mobility and low to excellent effective mobility, and characterized the modulating factors. The evaluations were acceptable in terms of the time taken (three hours and the overall measurements, with a few exceptions, which were

  15. COMPARATIVE STUDY OF LIGHT SOURCES FOR HOUSEHOLD

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    Andrzej PAWLAK

    2017-01-01

    Full Text Available The article describes test results that provided the ground to define and evaluate basic photometric, colorimetric and electric parameters of selected, widely available light sources, which are equivalent to a traditional incandescent 60-Watt light bulb. Overall, one halogen light bulb, three compact fluorescent lamps and eleven LED light sources were tested. In general, it was concluded that in most cases (branded products, in particular the measured and calculated parameters differ from the values declared by manufacturers only to a small degree. LED sources prove to be the most beneficial substitute for traditional light bulbs, considering both their operational parameters and their price, which is comparable with the price of compact fluorescent lamps or, in some instances, even lower.

  16. Earthquake Correlations and Networks- A Comparative Study

    CERN Document Server

    G., T R Krishna Mohan P

    2010-01-01

    We quantify the correlation between earthquakes and use the same to distinguish between relevant causally connected earthquakes. Our correlation metric is a variation on the one introduced by Baiesi and Paczuski (2004). A network of earthquakes is constructed, which is time ordered and with links between the more correlated ones. Recurrences to earthquakes are identified employing correlation thresholds to demarcate the most meaningful ones in each cluster. Data pertaining to three different seismic regions, viz. California, Japan and Himalayas, are comparatively analyzed using such a network model. The distribution of recurrence lengths and recurrence times are two of the key features analyzed to draw conclusions about the universal aspects of such a network model. We find that the unimodal feature of recurrence length distribution, which helps to associate typical rupture lengths with different magnitude earthquakes, is robust across the different seismic regions. The out-degree of the networks shows a hub ...

  17. Nonlinear analysis of RED - a comparative study

    Energy Technology Data Exchange (ETDEWEB)

    Jiang Kai; Wang Xiaofan E-mail: xfwang@sjtu.edu.cn; Xi Yugeng

    2004-09-01

    Random Early Detection (RED) is an active queue management (AQM) mechanism for routers on the Internet. In this paper, performance of RED and Adaptive RED are compared from the viewpoint of nonlinear dynamics. In particular, we reveal the relationship between the performance of the network and its nonlinear dynamical behavior. We measure the maximal Lyapunov exponent and Hurst parameter of the average queue length of RED and Adaptive RED, as well as the throughput and packet loss rate of the aggregate traffic on the bottleneck link. Our simulation scenarios include FTP flows and Web flows, one-way and two-way traffic. In most situations, Adaptive RED has smaller maximal Lyapunov exponents, lower Hurst parameters, higher throughput and lower packet loss rate than that of RED. This confirms that Adaptive RED has better performance than RED.

  18. A comparative study of microbiological and physicochemical ...

    African Journals Online (AJOL)

    Ethiopian Journal of Environmental Studies and Management ... Rwandan Water and Sanitation Corporation ltd (WASAC) water branches: Kimisagara WASAC water ... strategy for better water quality especially along the distribution network.

  19. MULLIGAN MOBILIZATION VERSUS STRETCHING ON THE MANAGEMENT OF PIRIFORMIS SYNDROME A COMPARATIVE STUDY

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    Samahir Abuaraki Elbkheet

    2016-04-01

    Full Text Available Background: Piriformis syndrome is a commonly overlooked specific cause of low back pain. Apart from mimicking the sciatica-like symptoms, unilateral piriformis tightness can cause rotational dysfunction and pain in the lumbar region. This could lead to low back pain which is a common musculo skeletal problem and a major reason for activity limitation. Stretching the piriformis tightened muscle is a preferred choice of treatment against surgical intervention to release the muscle. Mulligan’s mobilization is based on movement with mobilization which is proven to be effective in many musculo skeletal dysfunctions including the lumbar spine. The purpose of this study is to explore and compare the two treatment methods in relieving the low back pain in clinical conditions with piriformis syndrome. Methods: In this experimental study, 40 patients with piriformis syndrome were selected and divided into two groups. One group was given only piriformis stretching for the tightened muscle and the other group given Mulligan mobilization for lumbo sacral joints. VAS and lower limb functional index were taken to compare before and after the treatment regime of 4 weeks. Results: There was no significant difference between the two groups in both pain scale and lower limb mobility and function. But there was significant improvement in pain relief and LLFI after the treatment regime in both groups compared to the pre-treatment status. Conclusion: Even as the piriformis syndrome is caused by the tightness of the muscle, the consequence in the lower back and lumbar spine mobility can be improved by a Mulligan mobilization as a single mode of intervention.

  20. Transplantation of autologous bone marrow mononuclear cells for patients with lower limb ischemia

    Institute of Scientific and Technical Information of China (English)

    GU Yong-quan; LI Xue-feng; YU Heng-xi; CUI Shi-jun; WANG Zhong-gao; ZHANG Jian; GUO Lian-rui; QI Li-xing; ZHANG Shu-wen; XU Juan; LI Jian-xin; LUO Tao; JI Bing-xin

    2008-01-01

    Background Many treatment options for lower limb ischemia are difficult to apply for the patients with poor arterial outflow or with poor general conditions.The effect of medical treatment alone is far from ideal.especially in patients with diabetic foot.A high level amputation is inevitable in these patients.This study aimed to explore the effect of transplantation of autologous bone marrow mononuclear cells on the treatment of lower limb ischemia and to compare the effect of intra-artedal transplantation with that of intra-muscular transplantation.Methods In this clinical trial,32 patients with lower limb ischemia were divided into two groups.Group 1 (16 patients with 18 affected limbs) received transplantation of autologous bone marrow mononuclear cells by intra-muscular injection into the affected limbs;and group 2(16 patients with 17 affected limbs)received transplantation of autologous bone marrow mononucJear cells by intra-arterial injection into the affected limbs.Rest pain,coldness,ankle/brachial index (ABI),claudication,transcutaneous oxygen pressure(tcPO2)and angiography(15 limbs of 14 patients)were evaluated before and after the mononuclear cell transplantation to determine the effect of the treatment.Results Two patients died from heart failure.The improvement of rest pain was seen in 76.5%(13/17)of group 1 and 93.3%(14/15)of group 2.The improvement of coldness was 100%in both groups.The increase of ABI was 44.4%(8/18)in group 1 and 41.2%(7,17)in group 2.The value of tcPO2 increased to 20 mmHg or more in 20 limbs.Nine of 15 limbs which underwent angiography showed rich collaterals.Limb salvage rate was 83.3%(15,18)in group 1 and 94.1%(16/17)in group 2.There was no statistically significant difference in the effectiveness of the treatment between the two groups.Conclusions Transplantation of autologous bone marrow mononucJear cells is a simple,safe and effective method for the treatment of lower limb ischemia,and the two approaches for the implantation

  1. Time dependent profile retrieval of UV/vis absorbing radicals from balloon-borne limb measurements – a case study on NO2 and O3

    Directory of Open Access Journals (Sweden)

    R. Schofield

    2010-07-01

    Full Text Available A new "Bayesian" minimization algorithm for the retrieval of the diurnal variation of UV/vis absorbing radicals (O3, NO2, BrO, OClO and HONO from balloon-borne limb scattered skylight observations is discussed. The method evaluates spectroscopic measurements in combination with radiative transfer calculations to drive a mathematical inversion on a discrete time and height grid. Here, the proposed method is applied to data obtained during two deployments of the mini-DOAS instrument on different balloon payloads in northern Brazil in June 2005. The retrieval is tested by comparing the inferred profiles to in-situ ozone sounding data and to measurements of the ENVISAT/SCIAMACHY satellite instrument performed during a collocated overpass. The comparison demonstrates the strength and validity of our approach. In particular for time-varying radical concentrations, photochemical corrections due to temporal mismatch of the corresponding observations are rendered dispensable. Thus, limb scanning UV/vis spectrometry from balloon platforms offers a more direct and concise approach for satellite validation of radical measurements than solar occultation measurements. Furthermore, monitoring of the diurnal variation of stratospheric radicals allows us to constrain photochemical parameters which are critical for stratospheric ozone chemistry, such as the photolysis frequency of N2O5 by observations of the diurnal variation of NO2.

  2. Mid-thigh cortical bone structural parameters, muscle mass and strength, and association with lower limb fractures in older men and women (AGES-Reykjavik Study).

    Science.gov (United States)

    Johannesdottir, Fjola; Aspelund, Thor; Siggeirsdottir, Kristin; Jonsson, Brynjolfur Y; Mogensen, Brynjolfur; Sigurdsson, Sigurdur; Harris, Tamara B; Gudnason, Vilmundur G; Lang, Thomas F; Sigurdsson, Gunnar

    2012-05-01

    In a cross-sectional study we investigated the relationship between muscle and bone parameters in the mid-thigh in older people using data from a single axial computed tomographic section through the mid-thigh. Additionally, we studied the association of these variables with incident low-trauma lower limb fractures. A total of 3,762 older individuals (1,838 men and 1,924 women), aged 66-96 years, participants in the AGES-Reykjavik study, were studied. The total cross-sectional muscular area and knee extensor strength declined with age similarly in both sexes. Muscle parameters correlated most strongly with cortical area and total shaft area (adjusted for age, height, and weight) but explained lower limb fractures. Small muscular area, low knee extensor strength, large MA, low cortical thickness, and high BR were significantly associated with fractures in both sexes. Our results show that bone and muscle loss proceed at different rates and with different gender patterns.

  3. A STUDY ON CLINICAL ASSESSMENT OF VARICOSE VEINS BY CLINICAL SCORES AND VALIDATING THE OUTCOME OF TRENDELENBURG PROCEDURE IN VARICOSE VEINS OF LOWER LIMBS

    Directory of Open Access Journals (Sweden)

    Nilavi

    2016-06-01

    Full Text Available cose veins of Lower Limbs. This study was conducted in the Department of General Surgery, ESIC Hospital, over a period of 12 months. METHODS AND MATERIALS This analytical study group consisted of 92 patients between 20 to 80 yrs., inclusive of both males (n=78 and females (n=14. They were assessed for severity of varicose veins by documenting a detailed history, clinical examination findings, imaging studies on a pre-structured case sheet and the result of surgery. It was found that majority of the patients were ≤60 yrs. and the left lower limb was predominantly affected in both sexes. RESULTS Using the VCSS system, 19.57% (n=18 cases had mild disease, 67.39% (n=62 cases had moderate disease and 13.04% (n=12 had severe disease. In the present study as per the VDS system, majority of the patients (n=51 55.43% had grade III disability and 40.22% (n=37 of the patients had moderate grade of venous reflux, i.e. venous reflux duration <1 second. All 92 patients had surgery with majority had uneventful postoperative periods 58.17% (n=52, whereas a few had complications 44.44% (n=40. CONCLUSION A statistically significant result was found for the clinical assessment scores and also for the surgical outcome.

  4. Smartphone supported upper limb prosthesis

    Directory of Open Access Journals (Sweden)

    Hepp D.

    2015-09-01

    Full Text Available State of the art upper limb prostheses offer up to six active DoFs (degrees of freedom and are controlled using different grip patterns. This low number of DoFs combined with a machine-human-interface which does not provide control over all DoFs separately result in a lack of usability for the patient. The aim of this novel upper limb prosthesis is both offering simplified control possibilities for changing grip patterns depending on the patients’ priorities and the improvement of grasp capability. Design development followed the design process requirements given by the European Medical Device Directive 93/42 ECC and was structured into the topics mechanics, software and drive technology. First user needs were identified by literature research and by patient feedback. Consequently, concepts were evaluated against technical and usability requirements. A first evaluation prototype with one active DoF per finger was manufactured. In a second step a test setup with two active DoF per finger was designed. The prototype is connected to an Android based smartphone application. Two main grip patterns can be preselected in the software application and afterwards changed and used by the EMG signal. Three different control algorithms can be selected: “all-day”, “fine” and “tired muscle”. Further parameters can be adjusted to customize the prosthesis to the patients’ needs. First patient feedback certified the prosthesis an improved level of handling compared to the existing devices. Using the two DoF test setup, the possibilities of finger control with a neural network are evaluated at the moment. In a first user feedback test, the smartphone based software application increased the device usability, e.g. the change within preselected grip patterns and the “tired muscle” algorithm. Although the overall software application was positively rated, the handling of the prosthesis itself needs to be proven within a patient study to be

  5. The effect of different skin-ankle brace application pressures on quiet single-limb balance and electromyographic activation onset of lower limb muscles

    Directory of Open Access Journals (Sweden)

    Papadakis Stamatios A

    2007-09-01

    Full Text Available Abstract Background Several studies have been carried out in order to investigate the effect of ankle bracing on ankle joint function and performance. However, no study so far has examined the role of skin-brace interface pressure in neuromuscular control. The aim of this study was to investigate the effect of different skin-ankle brace interface pressures on quiet single limb balance and the electromyographic (EMG activation sequence of four lower limb muscles. Methods Thirty three male physical education students who volunteered to take part in the study were measured under three ankle brace conditions: i without brace, ii with brace and 30 kPa application pressure and iii with brace and 60 kPa application pressure. Single limb balance (anteroposterior and mediolateral parameter was assessed on the dominant lower limb, with open and closed eyes, on a force platform, simultaneously with the EMG recording of four lower lower limb muscles' (gastrocnemius, peroneus longus, rectus femoris and biceps femoris activation onset. Results The results showed that overall balance (total stability parameter was not significantly affected in any of the three ankle brace conditions. However, the anteroposterior centre of pressure excursion and centre of pressure excursion velocity were significantly increased with the application of ankle brace, both with 30 and 60 kPa application pressures. Furthermore, it was found that single limb balance was significantly worse with closed eyes compared to open eyes. EMG measurements showed that the sequence of lower limb activation onset was not affected in any of the three ankle brace application conditions. The results of this study showed that the application of an ankle brace with two different skin-brace interface pressures had no effect on overall single limb balance and the sequence of lower limb muscle activation. Conclusion These findings suggest that peripheral joint receptors are either not adequately

  6. Advertisement Analysis: A Comparative Critical Study

    Directory of Open Access Journals (Sweden)

    Noureldin Mohamed Abdelaal

    2014-12-01

    Full Text Available This study aimed at analyzing two advertisements, and investigating how advertisers use discourse and semiotics to make people and customers buy into their ideas, beliefs, or simply their products. The two advertisements analyzed are beauty products which have been selected from internet magazines. The methodology adopted in this study is qualitative method. The first advertisement is analyzed qualitatively in terms of content; there was no focus on a specific theoretical frame work, while the second advertisement analysis is based on Fairclough’s framework, the critical discourse analysis framework.

  7. Annual Journal citation indices: a comparative study

    CERN Document Server

    Khaleque, Abdul; Sen, Parongama

    2016-01-01

    We study the statistics of citations made to the indexed Science journals in the Journal Citation Reports during the period 2004-2013 using different measures. We consider different measures which quantify the impact of the journals. To our surprise, we find that the apparently uncorrelated measures, even when defined in an arbitrary manner, show strong correlations. This is checked over all the years considered. Impact factor being one of these measures, the present work raises the question whether it is actually a nearly perfect index as claimed often. In addition we study the distributions of the different indices which also behave similarly.

  8. Child Labor in Africa: A Comparative Study

    DEFF Research Database (Denmark)

    Canagarajah, Sudharshan; Nielsen, Helena Skyt

    2001-01-01

    This paper analyzes the determinants of child labor in Africa as inferred from recent empirical studies. The empirical analysis is based upon five country studies undertaken in three different African countries, namely Côte d'Ivoire, Ghana, and Zambia. Some support is found for the popular belief...... of poverty as a determinant of child labor, however other determinants are of similar importance. Among school costs, transportation costs have the greatest effect on child labor and school attendance, whereas the hypothesis of imperfect capital markets and that of household composition generally find some...

  9. Child Labor in Africa: A Comparative Study

    DEFF Research Database (Denmark)

    Nielsen, Helena Skyt; Canagarajah, Sudharshan

    1999-01-01

    This paper analyzes the determinants of child labor in Africa as inferred from recent empirical studies. The empirical analysis is based upon five country studies undertaken in three different African countries, namely Côte d'Ivoire, Ghana, and Zambia. Some support is found for the popular belief...... of poverty as a determinant of child labor, however other determinants are of similar importance. Among school costs, transportation costs have the greatest effect on child labor and school attendance, whereas the hypothesis of imperfect capital markets and that of household composition generally find some...

  10. Annual Journal Citation Indices: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Abdul Khaleque

    2016-06-01

    Full Text Available We study the statistics of citations made to the indexed Science journals in the Journal Citation Reports during the period 2004-2013 using different measures. We consider different measures which quantify the impact of the journals. To our surprise, we find that the apparently uncorrelated measures, even when defined in an arbitrary manner, show strong correlations. This is checked over all the years considered. Impact factor being one of these measures, the present work raises the question whether it is actually a nearly perfect index as claimed often. In addition, we study the distributions of the different indices which also behave similarly.

  11. A Comparative Comment on the Case Studies

    DEFF Research Database (Denmark)

    Kjeldsen, Christian Christrup; Ley, Thomas; Jensen, Niels Rosendal;

    2012-01-01

    Denne konklusion sammenfatter hovedtrækkene af de gennemførte case studies i WorkAble-projektet. Vigtige pointer er, at unge på tværs af de forskellige case studies har vanskeligt ved at blive hørt og taget alvorligt. I stedet spises de af med "realistisk vejledning" eller dårlige uddannelses- og...... arbejdstilbud. Konklusionen foreslår at give unge mere tid til at træffe de alvorlige valg vedr. deres fremtid ved at indføre et refugium, som i tankegang minder om Eriksons ungdomsmoratorium....

  12. The costs of managing lower limb-threatening ischaemia.

    Science.gov (United States)

    Singh, S; Evans, L; Datta, D; Gaines, P; Beard, J D

    1996-10-01

    One hundred and fifty consecutive patients presenting with limb-threatening ischaemia were studied prospectively to determine treatment and rehabilitation costs in the first year. Limb salvage was attempted in 104 (69%) patients but failed in 13%. Mortality at 1 year was 27%. The cost of treatment, inpatient stay, occupational therapy, physiotherapy, convalescence, disablement services, home adaptations, home care, district nursing, transportation and outpatient visits were determined for each patient. The patients were classified according to their presentation and initial treatment into five groups (number of patients) whose median management costs (interquartile range) for 12 months were: Gp 1 (23 - Revascularisation for acute ischaemia = 3970 pounds (2984-5511) Gp 2 (29) - Angioplasty for critical ischaemia = 6611 pounds (3630-10,200) Gp 3 (52) - Reconstruction for critical ischaemia = 6766 pounds (4337-9677) Gp 4 (34) - Primary amputation = 10,162 pounds (7894-13,026) Gp 5 (12) - Primary bilateral amputations = 13,848 pounds (11,440-18,056) At 1 year, there was no significant difference in the cost of managing a patient with a critically ischaemic limb by angioplasty or surgical reconstruction. The cost of revascularisation for acute ischaemia was comparatively low because these patients required minimal rehabilitation. The median cost of managing a patient following amputation was almost twice that of successful limb salvage justifying an aggressive revascularisation policy. However, justification of such a policy on economic grounds requires salvage failure episode to be minimised as they increase costs considerably.

  13. Comparative Anticonvulsant