Contralateral limb specificity for movement preparation in the parietal reach region

Background: Increased foot temperature among individuals with type 2 diabetes can be predictive of diabetic foot ulcer development. A combination of physiological and mechanical deficiencies may contribute to elevations in intact foot temperature during gait for individuals with type 2 diabetes and transtibial amputation. Objective: This study evaluated plantar foot temperature differences between individuals with type 2 diabetes with and without transtibial amputation. We hypothesized that individuals with transtibial amputation maintain increased foot temperature compared to those without amputation. Study Design: Cross-sectional, case control. Methods: A sample of 16 participants with type 2 diabetes and transtibial amputation, and 16 age- and sex-matched participants with type 2 diabetes without amputation were recruited. Foot temperatures were measured during resting, walking, and cooldown periods. Peak temperature, mean temperature, and rate of temperature change were analyzed for each period, and compared between cohorts. Results: Participants with amputation exhibited increased mean foot temperature while at rest and during walking. Participants without amputation exhibited increased rate of change of foot temperature during walking. No differences in peak temperature or rate of temperature change were observed during the baseline or cooldown periods. Conclusion: The current findings of altered foot temperature for individuals with transtibial amputation and type 2 diabetes suggest a possible reason for the high rates of contralateral limb ulceration and amputation among this population.

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Talar and Subtalar T1ρ Relaxation Times in Limbs with and without Chronic Ankle Instability

Cartilage ◽

10.1177/1947603521994626 ◽

2021 ◽

pp. 194760352199462

Author(s):

Kyeongtak Song ◽

Brian Pietrosimone ◽

Joshua N. Tennant ◽

Daniel B. Nissman ◽

Katherine M. Dederer ◽

...

Keyword(s):

Ankle Instability ◽

Relaxation Times ◽

Chronic Ankle Instability ◽

Talar Dome ◽

Contralateral Limb ◽

Secondary Purpose ◽

Healthy Control ◽

Control Limb ◽

Proteoglycan Content ◽

Magnetic Resonance Imaging Mri

Objective The primary aim was to determine differences in talocrural and subtalar joint (STJ) articular cartilage composition, using T1ρ magnetic resonance imaging (MRI) relaxation times, between limbs in individuals with unilateral chronic ankle instability (CAI) and compare with an uninjured control. Our secondary purpose was to determine the association between talocrural and STJ composition in limbs with and without CAI. Design T1ρ MRI relaxation times were collected on 15 CAI (11 females, 21.13 ± 1.81 years, body mass index [BMI] = 23.96 ± 2.74 kg/m2) and 15 uninjured control individuals (11 females, 21.07 ± 2.55 years, BMI = 24.59 ± 3.44 kg/m2). Talocrural cartilage was segmented manually to identify the overall talar dome. The SJT cartilage was segmented manually to identify the anterior, medial, and posterior regions of interest consistent with STJ anatomical articulations. For each segmented area, a T1ρ relaxation time mean and variability value was calculated. Greater T1ρ relaxation times were interpreted as decreased proteoglycan content. Results Individuals with CAI demonstrated a higher involved limb talocrural T1ρ mean and variability relative to their contralateral limb ( P < 0.05) and the healthy control limb ( P < 0.05). The CAI-involved limb also had a higher posterior STJ T1ρ mean relative to the healthy control limb ( P < 0.05). In healthy controls ( P < 0.05), but not the CAI-involved or contralateral limbs (p>0.05), talocrural and posterior STJ composition measures were positively associated. Conclusions Individuals with CAI have lower proteoglycan content in both the talocrural and posterior STJ in their involved limbs relative to the contralateral and a healthy control limb. Cartilage composition findings may be consistent with the early development of posttraumatic osteoarthritis.

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Lower extremity reamputation in people with diabetes: a systematic review and meta-analysis

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2021-002325 ◽

2021 ◽

Vol 9 (1) ◽

pp. e002325

Author(s):

Rongqi Liu ◽

Brian J Petersen ◽

Gary M Rothenberg ◽

David G Armstrong

Keyword(s):

Lower Extremity ◽

Temporal Trend ◽

Meta Analysis ◽

Kendall Test ◽

Incidence Rates ◽

Contralateral Limb ◽

Free Survival ◽

Patients With Diabetes ◽

Parametric Survival ◽

Qualitative Characteristics

In this study, we determined the reamputation-free survival to both limbs and to the contralateral limb only following an index amputation of any-level and assessed whether reamputation rates have changed over time. We completed a systematic search using PubMed and screened a total of 205 articles for data on reamputation rates. We reported qualitative characteristics of 56 studies that included data on reamputation rates and completed a meta-analysis on 22 of the studies which enrolled exclusively participants with diabetes. The random-effects meta-analysis fit a parametric survival distribution to the data for reamputations to both limbs and to the contralateral limb only. We assessed whether there was a temporal trend in the reamputation rate using the Mann-Kendall test. Incidence rates were high for reamputation to both limbs and to the contralateral limb only. At 1 year, the reamputation rate for all contralateral and ipsilateral reamputations was found to be 19% (IQR=5.1%–31.6%), and at 5 years, it was found to be 37.1% (IQR=27.0%–47.2%). The contralateral reamputation rate at 5 years was found to be 20.5% (IQR=13.3%–27.2%). We found no evidence of a trend in the reamputation rates over more than two decades of literature analyzed. The incidence of lower extremity reamputation is high among patients with diabetes who have undergone initial amputations secondary to diabetes, and rates of reamputation have not changed over at least two decades.

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Autologous Blood Injection and Wrist Immobilisation for Chronic Lateral Epicondylitis

Advances in Orthopedics ◽

10.1155/2012/387829 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Nicola Massy-Westropp ◽

Stuart Simmonds ◽

Suzanne Caragianis ◽

Andrew Potter

Keyword(s):

Tennis Elbow ◽

Autologous Blood ◽

Lateral Epicondylitis ◽

Contralateral Limb ◽

Cortisone Injection ◽

Autologous Blood Injection ◽

Blood Injection ◽

And Function ◽

Prospective Longitudinal ◽

Extensor Carpi Radialis

Purpose. This study explored the effect of autologous blood injection (with ultrasound guidance) to the elbows of patients who had radiologically assessed degeneration of the origin of extensor carpi radialis brevis and failed cortisone injection/s to the lateral epicondylitis.Methods. This prospective longitudinal series involved preinjection assessment of pain, grip strength, and function, using the patient-rated tennis elbow evaluation. Patients were injected with blood from the contralateral limb and then wore a customised wrist support for five days, after which they commenced a stretching, strengthening, and massage programme with an occupational therapist. These patients were assessed after six months and then finally between 18 months and five years after injection, using the patient-rated tennis elbow evaluation.Results. Thirty-eight of 40 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not.Conclusions. Autologous blood injection improved pain and function in a worker’s compensation cohort of patients with chronic lateral epicondylitis, who had not had relief with cortisone injection.

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