A Symmetry Evaluation Model for Lower Limb Segments during Upper Limb Loading

2022 ◽  
pp. 1-1
Author(s):  
Chenhui Dong ◽  
Ying Chen ◽  
Zhixin Li ◽  
Shiyun Lv ◽  
Zhan Huan ◽  
...  
Author(s):  
Makamas Kumprou ◽  
Pipatana Amatachaya ◽  
Thanat Sooknuan ◽  
Preeda Arayawichanon ◽  
Thiwabhorn Thaweewannakij ◽  
...  

Background: Walking devices are frequently prescribed for many individuals, including those with spinal cord injury (SCI), to promote their independence. However, without proper screening and follow-up care, the individuals may continue using the same device when their conditions have progressed, that may possibly worsen their walking ability. Objective: This study developed an upper limb loading device (ULLD), and assessed the possibility of using the tool to determine the optimal walking ability of ambulatory participants with SCI who used a walking device daily ([Formula: see text]). Methods: All participants were assessed for their optimal walking ability, i.e., the ability of walking with the least support device or no device as they could do safely and confidently. The participants were also assessed for their amount of weight-bearing on the upper limbs or upper limb loading while walking, amount of weight-bearing on the lower limbs or lower limb loading while stepping of the other leg, and walking performance. Results: The findings indicated that approximately one third of the participants (31%) could progress their walking ability from their current ability, whereby four participants could even walk without a walking device. The amount of upper limb loading while walking, lower limb loading ability, and walking performance were significantly different among the groups of optimal walking ability ([Formula: see text]). Furthermore, the amount of upper limb loading showed negative correlation to the amount of lower limb loading and walking performance ([Formula: see text] to [Formula: see text]0.493, [Formula: see text]). Conclusion: The findings suggest the potential benefit of using the upper limb loading device and the amount of upper limb loading for walking device prescription, and monitoring the change of walking ability among ambulatory individuals with SCI.


2020 ◽  
pp. 1-1
Author(s):  
Zhan Huan ◽  
Shiyun Lv ◽  
Zhenjie Hou ◽  
Jiuzhen Liang ◽  
Hongyang Geng

VASA ◽  
2008 ◽  
Vol 37 (4) ◽  
pp. 327-332 ◽  
Author(s):  
Koutouzis ◽  
Sfyroeras ◽  
Moulakakis ◽  
Kontaras ◽  
Nikolaou ◽  
...  

Background: The aim of this study was to investigate the presence, etiology and clinical significance of elevated troponin I in patients with acute upper or lower limb ischemia. The high sensitivity and specificity of cardiac troponin for the diagnosis of myocardial cell damage suggested a significant role for troponin in the patients investigated for this condition. The initial enthusiasm for the diagnostic potential of troponin was limited by the discovery that elevated cardiac troponin levels are also observed in conditions other than acute myocardial infarction, even conditions without obvious cardiac involvement. Patients and Methods: 71 consecutive patients participated in this study. 31 (44%) of them were men and mean age was 75.4 ± 10.3 years (range 44–92 years). 60 (85%) patients had acute lower limb ischemia and the remaining (11; 15%) had acute upper limb ischemia. Serial creatine kinase (CK), isoenzyme MB (CK-MB) and troponin I measurements were performed in all patients. Results: 33 (46%) patients had elevated peak troponin I (> 0.2 ng/ml) levels, all from the lower limb ischemia group (33/60 vs. 0/11 from the acute upper limb ischemia group; p = 0.04). Patients with lower limb ischemia had higher peak troponin I values than patients with upper limb ischemia (0.97 ± 2.3 [range 0.01–12.1] ng/ml vs. 0.04 ± 0.04 [0.01–0.14] ng/ml respectively; p = 0.003), higher peak CK values (2504 ± 7409 [range 42–45 940] U/ml vs. 340 ± 775 [range 34–2403] U/ml, p = 0.002, respectively, in the two groups) and peak CK-MB values (59.4 ± 84.5 [range 12–480] U/ml vs. 21.2 ± 9.1 [range 12–39] U/ml, respectively, in the two groups; p = 0.04). Peak cardiac troponin I levels were correlated with peak CK and CK-MB values. Conclusions: Patients with lower limb ischemia often have elevated troponin I without a primary cardiac source; this was not observed in patients presenting with acute upper limb ischemia. It is very important for these critically ill patients to focus on the main problem of acute limb ischemia and to attempt to treat the patient rather than the troponin elevation per se. Cardiac troponin elevation should not prevent physicians from providing immediate treatment for limb ischaemia to these patients, espescially when signs, symptoms and electrocardiographic findings preclude acute cardiac involvement.


Author(s):  
Rajendra Pai N. ◽  
U. Govindaraju

Ayurveda in its principle has given importance to individualistic approach rather than generalize. Application of this examination can be clearly seem like even though two patients suffering from same disease, the treatment modality may change depending upon the results of Dashvidha Pariksha. Prakruti and Pramana both used in Dashvidha Pariksha. Both determine the health of the individual and Bala (strength) of Rogi (Patient). Ayurveda followed Swa-angula Pramana as the unit of measurement for measuring the different parts of the body which is prime step assessing patient before treatment. Sushruta and Charaka had stated different Angula Pramana of each Pratyanga (body parts). Specificity is the characteristic property of Swa-angula Pramana. This can be applicable in present era for example artificial limbs. A scientific research includes collection, compilation, analysis and lastly scrutiny of entire findings to arrive at a conclusion. Study of Pramana and its relation with Prakruti was conducted in 1000 volunteers using Prakruti Parkishan proforma with an objective of evaluation of Anguli Pramana in various Prakriti. It was observed co-relating Pramana in each Prakruti and Granthokta Pramana that there is no vast difference in measurement of head, upper limb and lower limb. The observational study shows closer relation of features with classical texts.


Author(s):  
Lucas Sousa Macedo ◽  
Renato Polese Rusig ◽  
Gustavo Bersani Silva ◽  
Alvaro Baik Cho ◽  
Teng Hsiang Wei ◽  
...  

BACKGROUND: Microsurgical flaps are widely used to treat complex traumatic wounds of upper and lower limbs. Few studies have evaluated whether the vascular changes in preoperative computed tomography angiography (CTA) influence the selection of recipient vessel and type of anastomosis and the microsurgical flaps outcomes including complications. OBJECTIVE: The aim of this study was to evaluate if preoperative CTA reduces the occurrence of major complications (revision of the anastomosis, partial or total flap failure, and amputation) of the flaps in upper and lower limb trauma, and to describe and analyze the vascular lesions of the group with CTA and its relationship with complications. METHODS: A retrospective cohort study was undertaken with all 121 consecutive patients submitted to microsurgical flaps for traumatic lower and upper limb, from 2014 to 2020. Patients were divided into two groups: patients with preoperative CTA (CTA+) and patients not submitted to CTA (CTA–). The presence of postoperative complications was assessed and, within CTA+, we also analyzed the number of patent arteries on CTA and described the arterial lesions. RESULTS: Of the 121 flaps evaluated (84 in the lower limb and 37 in the upper limb), 64 patients underwent preoperative CTA. In the CTA+ group, 56% of patients with free flaps for lower limb had complete occlusion of one artery. CTA+ patients had a higher rate of complications (p = 0.031), which may represent a selection bias as the most complex limb injuries and may have CTA indicated more frequently. The highest rate of complications was observed in chronic cases (p = 0.034). There was no statistically significant difference in complications in patients with preoperative vascular injury or the number of patent arteries. CONCLUSIONS: CTA should not be performed routinely, however, CTA may help in surgical planning, especially in complex cases of high-energy and chronic cases, since it provides information on the best recipient artery and the adequate level to perform the microanastomosis, outside the lesion area.


2016 ◽  
Vol 26 (2) ◽  
Author(s):  
Deepesh Kumar ◽  
Sunny Verma ◽  
Sutapa Bhattacharya ◽  
Uttama Lahiri

Neurological disorders often manifest themselves in the form of movement deficit on the part of the patient. Conventional rehabilitation often used to address these deficits, though powerful are often monotonous in nature. Adequate audio-visual stimulation can prove to be motivational. In the research presented here we indicate the applicability of audio-visual stimulation to rehabilitation exercises to address at least some of the movement deficits for upper and lower limbs. Added to the audio-visual stimulation, we also use Functional Electrical Stimulation (FES). In our presented research we also show the applicability of FES in conjunction with audio-visual stimulation delivered through VR-based platform for grasping skills of patients with movement disorder.


Development ◽  
1956 ◽  
Vol 4 (3) ◽  
pp. 254-264
Author(s):  
Ronan O'Rahilly ◽  
Ernest Gardner ◽  
D. J. Gray

The limbs of amniote embryos are characterized by a thickening of the epiblast at their tips (Balfour, 1885). Kölliker (1879) illustrated such a thickening in a section of a chick embryo and, according to Braus (1906), was responsible for the term ‘ectodermal cap’ (Ektodermkappe). Saunders (1948) showed in the chick by experimental means that ‘the thickened ectoderm at the apex of the bud’ is ‘essential to the formation of the limb’. A similar thickening has frequently been noted at the apex of developing mammalian limbs. It can be seen in figures 3, 4, and 5 of Lewis's (1902) paper onthe development of the upper limb in man. Bardeen & Lewis (1901, fig. 19) called attention to the thickened epithelium at the free edge of the human lower limb bud. Steiner (1929, fig. 5), in a study of the development of human skin, illustrated the ‘ectodermal cap’ in the upper limb of a 9-mm. human embryo.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rasha M Ibrahim ◽  
Haitham M Hamdy ◽  
Amr A Mohammed ◽  
Ahmed M Elsadek ◽  
Ahmed M Bassiouny ◽  
...  

Abstract Background Limb-girdle muscular dystrophies (LGMDs) are a clinically and genetically heterogeneous group of disorders characterized by progressive muscle weakness and degenerative muscle changes. Studies have shown that ultrasound can be useful both for diagnosis and follow-up of LGMDs patients. Objectives This study aims to measure the sensitivity and the specificity of muscle ultrasound in assessment of suspected limb girdle muscular dystrophy patients. Subjects and Methods This cross-sectional descriptive study was conducted on Fifty-five patients with suspected LGMD from neuromuscular unit, myology clinic, Ain Shams University hospitals and eight healthy subjects. Age was above 2 years. Both sexes were included in the study. They underwent real-time B-mode ultrasonography performed with using Logiq p9 General Electric ultrasound machine and General Electric 7-11.5 MHZ linear array ultrasound probe. All ultrasound images have been obtained and scored by a single examiner and muscle echo intensity was visually graded semiquantitative according to Heckmatt's scale. The examiner was blinded to the muscle biopsy results and clinical evaluations. Results Statistical analysis revealed that the diagnostic performance of muscle US (Heckmatt’s score) in LGMD is most sensitive when calculated in all examined upper limb and lower limb muscles, followed by lower limb muscles alone. US of upper limb was found to be the least sensitive. Conclusions Muscle ultrasound is a practical and reproducible and valid tool that can be used in assessment of suspected LGMD patients.


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