scholarly journals Intramuscular Properties of Resting Lumbar Muscles in Patients with Unilateral Lower Limb Amputation

2021 ◽  
Vol 11 (19) ◽  
pp. 9122
Author(s):  
Yunhee Chang ◽  
Jungsun Kang ◽  
Gyoosuk Kim ◽  
Hyunjun Shin ◽  
Sehoon Park
Keyword(s):  
Lower Limb ◽  
Dynamic Stiffness ◽  
Erector Spinae ◽  
Limb Amputation ◽  
Lumbar Region ◽  
Significant Difference ◽  
High Incidence ◽  
Lumbar Muscle ◽  
Potential Risk Factors ◽  
Lower Lumbar

Lower limb amputees (LLAs) have a high incidence of low back pain (LBP), and identifying the potential risk factors in this group is key for LBP prevention. This study analyzed the intramuscular properties of the resting lumbar muscle in thirteen unilateral LLAs and age-matched controls to predict the onset of LBP. To measure the lumbar intramuscular properties, resting erector spinae muscles located in the upper and lower lumbar regions were examined using a handheld myotonometer. The dynamic stiffness, oscillation frequency, and logarithmic decrement were measured. In our results, the stiffness and frequency of the upper lumbar region were greater in the amputee group than in the control, whereas the decrement did not differ between the two groups. Additionally, the measured values in the lower lumbar region showed no significant difference. Within each group, all three factors increased at the upper lumbar region. In the LLAs, the frequency and stiffness values of the upper lumbar on the non-amputated side were significantly higher than those on the amputated side. These results indicate that the upper lumbar muscles of the amputees were less flexible than that of the control. This study can help in providing therapeutic strategies treating LBP in amputees.

Clinical Features and Outcomes Following Bilateral Lower Limb Amputation in Korea

2006 ◽  
Vol 30 (2) ◽  
pp. 155-164 ◽  
Author(s):  
Ji Cheol Shin ◽  
Eun Joo Kim ◽  
Chang Il Park ◽  
Eun Sook Park ◽  
Kyoo-Ho Shin
Keyword(s):  
Clinical Features ◽  
Lower Limb ◽  
Daily Living ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Medical Problems ◽  
Amputation Level ◽  
Significant Difference ◽  
Bilateral Lower Limb ◽  
Lower Limb Amputees

The objectives of this study were to evaluate the clinical features and outcomes of 43 bilateral lower limb amputees. The clinical features obtained included the causes of amputation, level of amputation, concurrent medical problems, and stump condition. Outcome measures were obtained using the activities of daily living (ADL) index, the Frenchay Activities Index (FAI), and mobility grading with prostheses or wheelchair. Of 33 amputees who were prosthetic ambulators, 22 (67%), mainly bilateral trans-tibial (TT) amputees, were community ambulators, and participated in activities which included stair-walking, and six of 11 household ambulators were combination trans-femoral (TF) and TT amputees. Of 10 amputees who were wheelchair ambulators, only one was able to perform wheelchair transfers independently and five were independent wheelchair ambulators. Using the ADL index and FAI, there was no significant difference in scores according to the level of amputation ( p > 0.05), but the scores of community prosthetic ambulators were significantly higher than those of wheelchair ambulators ( p < 0.05). Age was found to be negatively correlated with ADL index and FAI scores ( r = −0.518 vs. r = −0.550) ( p < 0.01). This study concludes that overall independence in ADL after bilateral lower limb amputation improved with young age and prosthetic mobility.

scholarly journals Avaliação postural de sujeitos com amputação de membro inferior

2019 ◽  
Vol 29 (1) ◽  
pp. 33103
Author(s):  
Viviane Leite ◽  
Lisiane Piazza Luza ◽  
Sara Maria Soffiatti Dias ◽  
Thamara Caviquioni ◽  
Ediane Roberge Fernandes Zampirolo ◽  
...  
Keyword(s):  
Lower Limb ◽  
T Test ◽  
Limb Amputation ◽  
Postural Asymmetry ◽  
Significance Level ◽  
Below The Knee ◽  
Significant Difference ◽  
Ankle Angle ◽  
The Right ◽  
Left Scapula

AIMS: To evaluate the posture of subjects with lower limb amputee.METHODS: Ten subjects participated in the study, males, with 38,2 ± 8,2 years, with unilateral lower limb amputation and prosthesis users. For the postural evaluation, the Postural Evaluation Software (SAPO) was used, and the images were evaluated according to the software protocol. Data were analyzed through descriptive and inferential statistics (independent t test), with a significance level of p ≤ 0,05.RESULTS: The main alterations observed were: rearfoot valgus enlargement, flexed ankle, head tilted to the right and trunk in flexion. When compared the posture according to time of amputation, was observed a statistically significant difference in the horizontal asymmetry of scapula in relation to T3 (p = 0,004), being that subjects with amputation time of up to six years presented the left scapula higher than the right one (-5,28 ± 8,16°) and those with more than six years of amputation had the right upper right scapula (19,42 ± 11°). In the comparison between amputation levels, there was a statistically significant difference in the ankle angle (p = 0,008), with subjects with amputation below the knee presenting greater ankle flexion (81,97 ± 1,72°) than those with amputation at the level of the knee and above this (87,30 ± 2,65°).CONCLUSIONS: The findings of the present study demonstrate that all the evaluated subjects presented some postural alteration, however, it cannot be affirmed that the postural asymmetry of these is due to the amputation.

scholarly journals Differences in characteristics between people with lower limb amputations who died before 12 weeks and those who survived: Short Report

2011 ◽  
Vol 67 (1) ◽  
Author(s):  
L. Godlwana ◽  
A. Stewart ◽  
E. Musenge
Keyword(s):  
Lower Limb ◽  
Limb Amputation ◽  
Short Report ◽  
Test Study ◽  
Demographic Questionnaire ◽  
Significant Difference ◽  
Post Test ◽  
Status Index ◽  
Ethical Clearance

The baseline determinants of survival following a non-traumatic lower limb amputation (LLA) in participants in the Johannesburg metropolitan area are unknown.The aim of the study was to establish the characteristics of participants who had died by three months after LLAA longitudinal pre- test- post test study utilized participant interviews (n=73).  Consecutive  sampling  was  used  to  select  participants  who  met  the  inclusion criteria. Ethical clearance was obtained. Permission was obtained from the hospitals. Participants gave consent before taking part in the study. A demographic questionnaire, the EQ-5D, the Modified Household Economic and Social Status Index (HESSI) and the Barthel Index (BI) were used, to collect data. Participants  were  interviewed  preoperatively  and  then  followed  up  three  months  post-operatively  to  establish survival/ existence. Twenty-four  participants  (33%)  had  died.  The  preoperative  median  Visual  Analogue  Scale  (VAS)  of  the  EQ-5D was 60 and 70 showing no significant difference in quality of life (QOL) between those who survived and those who  died  respectively.  The  preoperative  median  total  BI  score  was  20  and  19  showing  significantly  inferior  function for the deceased (p=0.01). The deceased were significantly older (p=0.009) used alcohol (p=0.02) and smoked tobacco (p=0.03).Being older, having poorer function, being a smoker and drinking alcohol preoperatively seem to decrease the chance of survival following LLA in Johannesburg.

Preoperative characteristics and functional outcomes of lower limb amputees treated at Southern Älvsborg Hospital, Sweden

2013 ◽  
Vol 37 (4) ◽  
pp. 298-304 ◽  
Author(s):  
Maria Glemne ◽  
Nerrolyn Ramstrand ◽  
Jessica Crafoord ◽  
Linus Nygren
Keyword(s):  
Lower Limb ◽  
Functional Outcomes ◽  
Daily Practice ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Clinical Practices ◽  
Timed Up And Go ◽  
Significant Difference ◽  
Research Findings ◽  
Lower Limb Amputees

Background:Within the prosthetics profession, there is a lack of evidence to support many clinical practices. It is therefore important that clinicians systematically document and evaluate their daily practices.Objectives:To record preoperative characteristics and functional outcomes for patients with a lower limb amputation and to investigate variations between prosthetic users and non-prosthetic users.Study Design:Prospective cohort study.Methods:A total of 23 patients (mean age = 80 years, standard deviation = 7.3) who underwent a major lower limb amputation were assessed within 2 weeks of admission and 6 months post-operatively. Locomotor Capabilities Index-5, the Timed-Up-and-Go Test and prosthetic use were used to evaluate functional outcomes.Results:A total of 13 participants (57%) received a prosthesis within 6 months of amputation. Mean time to prosthetic fitting was 48 days (range = 28–97). No statistically significant difference was found between prosthetic users and non-prosthetic users regarding age, time to rehabilitation and Locomotor Capabilities Index-5 (p > 0.05). Locomotor Capabilities Index-5 basic was significantly lower at 6 months than prior to amputation (p = 0.039).Conclusion:The functional outcome at 6 months indicates a sizable restriction in mobility among lower limb amputees. No variation in preoperative characteristics between prosthetic users and non-prosthetic users could be confirmed in this study.Clinical relevanceThis study highlights the need for prosthetists to better incorporate research findings into their daily practice and presents an example of how to implement a procedure for assessment and documentation of patients’ functional outcomes in a clinical setting. Results confirm difficulties in identifying amputees who will become prosthetic users based on preoperative characteristics.

scholarly journals Satisfação e ajuste à prótese de indivíduos com amputação de membro inferior

2019 ◽  
Vol 29 (1) ◽  
pp. 33075
Author(s):  
Aline Beatriz Córdova De Souza ◽  
Lisiane Piazza Luza ◽  
Greicy Kelly Wosniak Pires ◽  
Elizandra Gonçalves Ferreira ◽  
Sara Maria Soffiatti Dias ◽  
...  
Keyword(s):  
Lower Limb ◽  
Rio Grande ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Residual Limb ◽  
Rio Grande Do Sul ◽  
Traumatic Amputation ◽  
Inferential Statistics ◽  
Evaluation Questionnaire ◽  
Significant Difference

AIMS: Evaluate satisfaction and adjustment to the prosthesis of individuals with lower limb amputation.METHODS: Participants were 24 patients with lower limb amputation with 46,1±17,5 years and using the prosthesis for 10,8±8,7 years. A card was used to characterize the individuals and the Prosthesis Evaluation Questionnaire (PEQ) to evaluate satisfaction and adjustment to the prosthesis. Data were collected from institutions that serving amputees in the states of Rio Grande do Sul and Santa Catarina and analyzed by descriptive and inferential statistics at a 5% significance level.RESULTS: There was no significant difference in the results of the PEQ between individuals when compared to the level of amputation and time using the prosthesis. Regarding the scores between groups with vascular and traumatic amputation, was a significant difference in residual limb health subscale, with higher scores and consequently better health of the residual limb in amputees with vascular causes, besides better higher scores on the scale of satisfaction in these individuals.CONCLUSIONS: It was concluded that patients with a vascular cause of amputation are more satisfied with their prosthesis, with the way they walk and how things are from amputation and also have better health of the residual limb in relation to individuals with traumatic amputation. However, the level and time of amputation do not seem to influence the satisfaction and adjustment of the prosthesis.

scholarly journals A Prospective Randomised Trial Comparing Spinal Anaesthesia using Hyperbaric Cinchocaine with General Anaesthesia for Lower Limb Vascular Surgery

1986 ◽  
Vol 14 (4) ◽  
pp. 373-380 ◽  
Author(s):  
P. T. Cook ◽  
M. J. davies ◽  
K. D. Cronin ◽  
P. Moran
Keyword(s):  
Vascular Surgery ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Myocardial Infarct ◽  
Randomised Trial ◽  
Limb Amputation ◽  
Significant Difference ◽  
Spinal Group ◽  
General Anaesthesia Group

One hundred and one patients were randomly allocated to have their peripheral vascular surgery performed under general anaesthesia (51 patients) or spinal anaesthesia (50 patients). Intraoperative haemodynamic changes were markedly different between the two groups with a higher incidence of hypotension in the spinal group (72% vs 31%) and a higher incidence of hypertension in the general anaesthesia group (22% vs 0%). Blood loss was significantly less in the spinal group (560, SD 340, ml vs 792, SD 440, ml). Postoperatively three patients from the general anaesthesia group died from causes unrelated to the anaesthesia, and one had a myocardial infarct. Two patients in the spinal group had myocardial infarcts, both had been treated for bradycardia and hypotension intraoperatively, and one died. There was a significantly higher incidence of postoperative chest infection in the general anaesthesia group (33% vs 16%). There was no significant difference between the groups in the incidence of postoperative confusion, or lower limb amputation rate or need for further surgery prior to hospital discharge.

scholarly journals The influence of smoking on the level of lower limb amputation

1987 ◽  
Vol 11 (3) ◽  
pp. 113-116 ◽  
Author(s):  
C. P. U. Stewart
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
General Population ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Lower Limb ◽  
Limb Amputation ◽  
Peripheral Vascular ◽  
Knee Amputation ◽  
High Incidence

A review of smoking habits of 77 vascular related amputees demonstrated a high incidence of smoking significantly greater for men than in the general population. Male smoking amputees with atherosclerosis related peripheral vascular disease were found to have a high risk of having an above-knee amputation. Those with diabetes mellitus whether male or female, smokers or not, had a significantly greater chance of having a below-knee amputation. Overall, non-smokers were found more likely to have a below-knee amputation than an above-knee (p<0.05).

scholarly journals Effects of Different Sling Settings on Electromyographic Activities of Selected Trunk Muscles: A Preliminary Research

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Xin Li ◽  
Howe Liu ◽  
Ke-yu Lin ◽  
Ping Miao ◽  
Bao-feng Zhang ◽  
...  
Keyword(s):  
Erector Spinae ◽  
Transversus Abdominis ◽  
Trunk Muscles ◽  
Emg Activity ◽  
Lumbar Region ◽  
Mean Power ◽  
Mean Power Frequency ◽  
Effective Measure ◽  
Significant Difference ◽  
Dominant Side

Introduction. The supine and prone sling exercise may facilitate activation of the local trunk muscles. Does the side-lying sling exercise activate trunk muscles more easily than the supine and prone training with sling settings? Clinical work has shown that the side-lying sling exercise could reduce pain in patients with unilateral low back pain (LBP), but the mechanism behind it is unclear. The fundamental purpose of this preliminary study was to examine the electromyography (EMG) characteristics of trunk muscles during different sling lumbar settings on sixteen healthy adults. Methods. Amplitude and mean power frequency (MPF) of EMG signals were recorded from the transversus abdominis (TA), rectus abdominis (RA), multifidus (MF), erector spinae (ES), gluteus maximus (Gmax), and gluteus medius (Gmed) muscles while the subjects performed the supine lumbar setting (SLS), prone lumbar setting (PLS), left side-lying lumbar setting (LSLS), and right side-lying lumbar setting (RSLS). Results. During SLS and PLS, TA and MF showed significantly higher activity than RA and ES on the same side, respectively. The EMG activities of ES, TA, MF, Gmax, and Gmed had significant differences between the different sides during LSLS and RSLS, and the dominant-side muscles showed higher activity than the other side. There was no significant difference in core trunk muscles between different sling lumbar settings—only that the SLS of the MF/ES ratio was significantly higher than LSLS and RSLS. Conclusions. Sling exercises can be an effective measure to enhance MF and TA EMG activity, and the side-lying position can increase dominant-side Gmax and Gmed activity. Side-lying sling training does not activate more core muscles than the supine and prone training. Supine and prone exercise should be preferred over SLT to stabilize the lumbar region because of its high local/global muscle ratio.

Lower Back EMG Activity during Exercise on a Vertical versus Partially Reclined Stair-Climbing Machine

1999 ◽  
Vol 8 (3) ◽  
pp. 219-229 ◽  
Author(s):  
Jeffrey A. Bauer ◽  
Thomas S. Thomas ◽  
Daniel P. Connaughton
Keyword(s):  
Erector Spinae ◽  
Stair Climbing ◽  
Additional Stress ◽  
Emg Activity ◽  
Electromyographic Activity ◽  
Heart Rates ◽  
Lower Back ◽  
Significant Difference ◽  
High Incidence ◽  
Familiarization Session

Lower back discomfort is common among users of standard vertical stair-climbing machines. A partially reclined stair-climbing machine (PRSC) has been designed to provide more comfort and protection to the lower back while providing the same exercise benefits. Ten individuals were recruited to exercise on both machines while their erector spinae electromyographic activity and heart rates were recorded. There was no significant difference (p < .05) in erector spinae muscle activity during exercise on either machine. Workout intensity levels necessary to achieve target heart rates were established during a familiarization session and tracked during exercise. The mean heart rates for both groups remained within the target zones throughout the exercise sessions, but a nonsignificant (p > .05) trend toward increased heart rate on both machines was observed in the women participants. Because of the high incidence of low back pain and injury, we need exercise modalities that provide both cardiovascular and muscular fitness development without placing additional stress on this region.

Pattern of upper limb amputation associated with lower limb amputation: the UK military experience from Iraq and Afghanistan

2021 ◽  
pp. bmjmilitary-2021-001783
Author(s):  
Louise McMenemy ◽  
V Mondini ◽  
D C Roberts ◽  
A Kedgley ◽  
J C Clasper ◽  
...  
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Limb Amputation ◽  
Life Outcomes ◽  
Manual Search ◽  
Large Numbers ◽  
Significant Difference ◽  
Extremity Injuries ◽  
The Uk ◽  
The Right

IntroductionThe conflicts in Iraq and Afghanistan resulted in large numbers of personnel sustaining extremity injuries. In the context of polytrauma, partial hand amputation is often unrecorded. The aim of this work was to quantify the burden of upper limb (UL) amputation at any level occurring concurrently with a major (ankle and proximal) lower limb (LL) amputation. Knowledge of this cohort could aid in prosthetic modification to further improve quality of life outcomes in a population with dexterity loss.MethodA trauma database search was undertaken for all UK military LL amputees from the conflicts in Iraq and Afghanistan. A manual search method was employed to identify from the major LL amputees those who had a concurrent UL amputation at any level (including isolated finger amputation). Demographics, level of amputation, and injury profile data were recorded.ResultsSixty-eight individuals were identified; the most prevalent population was bilateral LL with a unilateral UL amputation (60%). Most UL amputations were partial hand (75%). The was no statistically significant difference between left or right side (p=0.13). On the left side, correlation was found between amputation of the thumb and third digit (rho=0.34; p=0.005) not seen on the right.ConclusionWe have determined the rate of UL amputation at any level, in combination with LL amputation as a result of blast injury. Knowledge of these combinations enables further research to support anecdotal evidence that there is a need for tailored prosthetics in the context of potential dexterity loss making donning and doffing problematic.

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