scholarly journals INTRAOPERATIONAL CORRECTION OF HAEMODYNAMIC DISTURBANCES IN PATIENTS UNDERGOING LAPAROSCOPIC SURGERY FOR HIATAL HERNIA

2017 ◽  
Vol 8 (1) ◽  
pp. 40-45
Author(s):  
M A Burikov ◽  
I I Katelnitsky ◽  
I V Skazkin ◽  
L L Timofeeva
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Technique ◽  
Hiatal Hernia ◽  
Lower Limb ◽  
Lower Limbs ◽  
Venous Diameter ◽  
The Impact

The aim of the article is to review the results of regional lower limb haemodynamics, haemostatic disturbances in patients undergoing laparoscopic surgery for hiatal hernia and intermittent pneumocompression in terms of embolism prevention. The impact of laparoscopic surgical technique on linear bloodflow velocity and venous diameter in lower limbs.

scholarly journals Effects of Whole-Body Vibration Training on Lower Limb Blood Flow in Children with Myelomeningocele—A Randomized Trial

2021 ◽  
Vol 10 (18) ◽  
pp. 4273
Author(s):  
Małgorzata Domagalska-Szopa ◽  
Andrzej Szopa ◽  
Andrzej Siwiec ◽  
Ilona Kwiecień-Czerwieniec ◽  
Lutz Schreiber ◽  
...  
Keyword(s):  
Blood Flow ◽  
Lower Limb ◽  
Whole Body Vibration ◽  
Lower Limbs ◽  
Whole Body ◽  
Control Group ◽  
Body Vibration ◽  
Conventional Physiotherapy ◽  
Whole Body Vibration Training ◽  
The Impact

The objective of the present study was to determine the effectiveness of a three-week Whole-Body Vibration (WBV) training on the vascular blood flow of the lower limbs in children with myelomeningocele. The secondary goal was to evaluate the effect of WBV on the ROM of lower limb joints in this population. A total of 30 children with MMC (7–16 years old) were enrolled in the study. Children were randomly allocated to two groups of equal numbers, using an envelope code. The experimental group underwent a 3-week WBV training, while the control group received a 3-week conventional physiotherapy (PT) program. The examination consisted of two parts: (1) Doppler USG examination of the lower limb vascular blood flow; (2) evaluation of ROM. The results obtained revealed three main findings. First, WBV training effectively improved blood flow by increasing flow velocities in all tested arteries, while the impact of the PT program was limited to a single parameter. Second, WBV training effectively improved vascular resistance in arteries of the lower legs, while the PT program did not achieve any significant differences. Third, both types of treatment intervention significantly improved ROM in all joints of the lower limbs in MMC participants.

scholarly journals Impact of Self-Selected Customized Orthotics on Lower Limbs Biomechanics

2021 ◽  
Author(s):  
Benjamin Dourthe ◽  
Judith Osterloh ◽  
Vinzenz Von Tscharner ◽  
Sandro Nigg ◽  
Benno M. Nigg
Keyword(s):  
Isometric Contraction ◽  
Lower Limb ◽  
Statistical Significance ◽  
Lower Limbs ◽  
Patient Specific ◽  
Emg Activity ◽  
Post Intervention ◽  
Walking Intervention ◽  
Foot Arch ◽  
The Impact

Customized insoles are commonly prescribed to prevent or treat a variety of foot pathologies and to reduce foot and lower limb fatigue. Due to the patient-specific design and production of such orthotics, the concept of self-selected customized orthotics (SSCO) has recently been developed. The goal of this study was to assess the impact of SSCO technology on several physiological and biomechanical variables during uphill power walking. Thirty male participants underwent an uphill power walking intervention at constant speed in two insoles conditions (control and SSCO). The electromyographic (EMG) activity of their right gastrocnemii and vastii muscles was measured. Perceived fatigue was assessed every 5 minutes and the intervention stopped when the targeted fatigue level was reached. Baseline and post-intervention assessments were also performed. Sixty-three percent of the participants experienced an improvement in foot fatigue while wearing the SSCO. The foot arch seemed to collapse less when participants wore the SSCO, but statistical significance was not reached. The changes in mean EMG activity was not consistent between the 50% isometric contraction and the walking trial. In conclusion, while some interesting trends were observed when wearing SSCO, further investigations should be performed to try and reach statistical significance.

scholarly journals The impact of exercise of lower limbs on dynamic balance and valgus of the knees among young footballers

2019 ◽  
Author(s):  
Bartosz Wilczyński ◽  
Katarzyna Zorena ◽  
Piotr Wąż
Keyword(s):  
Lower Limb ◽  
Dynamic Balance ◽  
Intervention Group ◽  
Lower Limbs ◽  
Football Players ◽  
Valgus Knee ◽  
Balance Test ◽  
And Control ◽  
The Impact ◽  
Dynamic Valgus

Abstract Background Participation of children and youth in sporting activities, among others in training and football competitions, is an optimistic manifestation of activation in the current trend of computerization. Unfortunately, this is also often associated with musculoskeletal injuries. An example is the association of dynamic valgus and disturbed dynamic balance with lower limb injuries. The main purpose of the studies is to determine the impact of three strengthening exercises on the parameters of dynamic knee valgus and balance of lower limbs. The secondary objectives are to investigate the dominant influence and the length of lower limb on the valgus values and to determine risk of injury to young football players. Methods 134 young footballers training at the Arka Gdynia SI club were invited to first stage of the research in order to examine anthropometric features and kinematics of the lower limb. Single Leg Squat Test was used, which was recorded. The samples were analyzed video to determine exact knee angle of valgus. During the second stage, to which players with valgus knee were qualified (≥15˚), the Y-Balance Test was additionally used. Intervention group underwent an exercise program to strengthen gluteus medius, popliteal and tibialis posterior muscles for 6 weeks to repeat tests in the third stage. Results Statistical methods used at the assumed level of significance allow to conclude that there are no differences in results of dynamic valgus (≥15˚) and dynamic balance between the intervention group and control group during the 6 week period between stages. In addition, there were results confirming the lack of influence of length and dominant lower limb on valgus. Results of composite direction in the Y-Balance Test test determine the low risk of injury in both intervention and control groups. Conclusions Intervention did not affect the dynamic valgus and knee balance in young football players. Both the length and the dominant limb did not affect the results. The "low risk" occurrence of injuries among the examined participants with valgus knee due to the values of dynamic balance was determined.

scholarly journals Effects of active muscle forces on driver’s lower-limb injuries due to emergency brake in various frontal impacts

2019 ◽  
Vol 234 (7) ◽  
pp. 2014-2024
Author(s):  
Fan Li ◽  
Wei Huang ◽  
Xingsheng Wang ◽  
Xiaojiang Lv ◽  
Fuhao Mo
Keyword(s):  
Muscle Contraction ◽  
Lower Limb ◽  
Injury Risk ◽  
Muscle Activation ◽  
Bending Moment ◽  
Lower Limbs ◽  
Lower Limb Injuries ◽  
Lower Limb Injury ◽  
Limb Injuries ◽  
The Impact

Accident data shows that driver’s kinematics response in real accidents can be significantly different from that in dummy or cadaver tests because of driver’s muscle contraction. In this study, a finite element human-body model consisting of an upper body of a dummy model and a lower limb–pelvis biomechanical model with three-dimensional active muscles was developed to investigate in depth the lower-limb injuries. Driver’s emergency reaction during frontal impact was simulated by modelling muscle active contraction based on a series of volunteer experimental tests. Besides, a realistic impact environment with the response of the restraint system and the invasion of the driver’s compartment was established in this study. The results show that muscle contraction can cause extra loads on lower limbs during the impact, which can increase the injury risk of lower limbs. As for the femur injury, muscle contraction caused an additional 1 kN axial load on the femur, and the femur resultant bending moment of active models was also higher by about 10–40 N m. Besides, the tibial index of the model with muscle activation was about 0.1 higher. In addition, the results indicate that the femur injury is strongly related to the combined action of both axial force and bending moment. The variation of the injury tolerance along the tibia shaft should be considered when evaluating the tibia injury. Overall, the current lower-limb injury criteria can be still the lack of robustness.

scholarly journals Sports-related lower limb muscle injuries: pattern recognition approach and MRI review

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Jaime Isern-Kebschull ◽  
Sandra Mechó ◽  
Ricard Pruna ◽  
Ara Kassarjian ◽  
Xavier Valle ◽  
...  
Keyword(s):  
Lower Limb ◽  
Elite Athletes ◽  
Imaging Modality ◽  
Clinical Importance ◽  
Classification Systems ◽  
Lower Limbs ◽  
Muscle Injuries ◽  
Mri Findings ◽  
Duke Classification ◽  
The Impact

Abstract Muscle injuries of the lower limbs are currently the most common sport-related injuries, the impact of which is particularly significant in elite athletes. MRI is the imaging modality of choice in assessing acute muscle injuries and radiologists play a key role in the current scenario of multidisciplinary health care teams involved in the care of elite athletes with muscle injuries. Despite the frequency and clinical relevance of muscle injuries, there is still a lack of uniformity in the description, diagnosis, and classification of lesions. The characteristics of the connective tissues (distribution and thickness) differ among muscles, being of high variability in the lower limb. This variability is of great clinical importance in determining the prognosis of muscle injuries. Recently, three classification systems, the Munich consensus statement, the British Athletics Muscle Injury classification, and the FC Barcelona-Aspetar-Duke classification, have been proposed to assess the severity of muscle injuries. A protocolized approach to the evaluation of MRI findings is essential to accurately assess the severity of acute lesions and to evaluate the progression of reparative changes. Certain MRI findings which are seen during recovery may suggest muscle overload or adaptative changes and appear to be clinically useful for sport physicians and physiotherapists.

scholarly journals Fatigue Induced by Repeated Changes of Direction in Élite Female Football (Soccer) Players: Impact on Lower Limb Biomechanics and Implications for ACL Injury Prevention

2021 ◽  
Vol 9 ◽  
Author(s):  
Matteo Zago ◽  
Sina David ◽  
Filippo Bertozzi ◽  
Claudia Brunetti ◽  
Alice Gatti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lower Limb ◽  
Lactate Concentration ◽  
Acl Injury ◽  
Injury Mechanism ◽  
Lower Limbs ◽  
Initial Contact ◽  
Test Duration ◽  
Limb Kinematics ◽  
The Impact

BackgroundThe etiology of Anterior Cruciate Ligament (ACL) injury in women football results from the interaction of several extrinsic and intrinsic risk factors. Extrinsic factors change dynamically, also due to fatigue. However, existing biomechanical findings concerning the impact of fatigue on the risk of ACL injuries remains inconsistent. We hypothesized that fatigue induced by acute workload in short and intense game periods, might in either of two ways: by pushing lower limbs mechanics toward a pattern close to injury mechanism, or alternatively by inducing opposed protective compensatory adjustments.AimIn this study, we aimed at assessing the extent to which fatigue impact on joints kinematics and kinetics while performing repeated changes of direction (CoDs) in the light of the ACL risk factors.MethodsThis was an observational, cross-sectional associative study. Twenty female players (age: 20–31 years, 1st–2nd Italian division) performed a continuous shuttle run test (5-m) involving repeated 180°-CoDs until exhaustion. During the whole test, 3D kinematics and ground reaction forces were used to compute lower limb joints angles and internal moments. Measures of exercise internal load were: peak post-exercise blood lactate concentration, heart rate (HR) and perceived exertion. Continuous linear correlations between kinematics/kinetics waveforms (during the ground contact phase of the pivoting limb) and the number of consecutive CoD were computed during the exercise using a Statistical Parametric Mapping (SPM) approach.ResultsThe test lasted 153 ± 72 s, with a rate of 14 ± 2 CoDs/min. Participants reached 95% of maximum HR and a peak lactate concentration of 11.2 ± 2.8 mmol/L. Exercise duration was inversely related to lactate concentration (r = −0.517, p < 0.01), while neither%HRmax nor [La–]b nor RPE were correlated with test duration before exhaustion (p > 0.05). Alterations in lower limb kinematics were found in 100%, and in lower limb kinetics in 85% of the players. The most common kinematic pattern was a concurrent progressive reduction in hip and knee flexion angle at initial contact (10 players); 5 of them also showed a significantly more adducted hip. Knee extension moment decreased in 8, knee valgus moment increased in 5 players. A subset of participants showed a drift of pivoting limb kinematics that matches the known ACL injury mechanism; other players displayed less definite or even opposed behaviors.DiscussionPlayers exhibited different strategies to cope with repeated CoDs, ranging from protective to potentially dangerous behaviors. While the latter was not a univocal effect, it reinforces the importance of individual biomechanical assessment when coping with fatigue.

Design of Passive Lower Limb Exoskeleton to Aid in Injury Mitigation and Muscular Efficiency

2020 ◽  
Author(s):  
Dylan Tracey ◽  
Hao Zhang
Keyword(s):  
Lower Limb ◽  
Stride Length ◽  
Human Locomotion ◽  
Running Economy ◽  
Lower Limbs ◽  
Stride Frequency ◽  
Load Variations ◽  
Lower Limb Exoskeleton ◽  
Viable Solution ◽  
The Impact

Abstract With the duties and responsibilities of the military, they are on the cutting edge of R&D and the latest and greatest technologies. One significant problem effecting thousands of soldiers are injuries to the lower limbs, specifically the knees, as a result of high impact to the joints and muscles. Through the research of biomechanics and ergonomics during human locomotion of running, cause and effects fatigue, muscular activation during running, gait cycle force analysis, and biomimicry of kangaroos, we were able to identify lower limb exoskeletons as a viable solution to the problem. The purpose of this research was to develop a relatively inexpensive prototype of a passive lower limb exoskeleton to aid in injury mitigation and muscular efficiency for soldiers. The hypothesis was that a lower limb exoskeleton would reduce/mitigate injuries by reducing stride length and increases stride frequency to lower impact on the knees while running. The prototype was tested by one participant on a 2-mile course with two load variations tested while running. The key results were seen from the spring systems potential to increase average stride cadence/frequency by 6–14% and reduce impact on joints and muscles by increasing the number of steps and reducing high center of gravity oscillation by 13–27%. Furthermore, this study provides evidence and research that proves that a passive lower limb exoskeleton design, which increases stride frequency and reduces stride length, can mitigate injuries to the lower limbs when running with weight by reducing the impact forces on the knees and improving running economy.

scholarly journals Inter-Limb Asymmetry in Force Accuracy and Steadiness Changes after a 12-Week Strength Training Program in Young Healthy Men

Symmetry ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2226
Author(s):  
Rafał Szafraniec ◽  
Tadeusz Stefaniak ◽  
Dariusz Harmaciński ◽  
Michał Kuczyński
Keyword(s):  
Strength Training ◽  
Training Program ◽  
Lower Limb ◽  
Lower Limbs ◽  
Matching Task ◽  
Healthy Men ◽  
Force Matching ◽  
Limb Asymmetry ◽  
The Impact ◽  
Force Accuracy

The study aimed to investigate the impact of a 12-week strength training program on force accuracy and steadiness changes in lower limbs in young healthy men. Twenty subjects with a dominant right lower limb were included. They performed a force matching task both pre and post strength training program. The ability to reproduce force was determined by calculating three errors: absolute error (AE), constant error (CE), and variable error (VE). After intervention AE and VE improved in both legs indicating higher improvement in the dominant leg (p = 0.032 for AE and p = 0.005 for VE). However, CE improved only in the dominant leg (p = 0.001). We conclude that strength training improved the accuracy and consistency of force in a force reproduction task. This improvement was more evident in the dominant lower limb. Most likely, the inter-limb asymmetry in changes of force application ability caused by strength training is due to the different mechanisms responsible for the control of voluntary movements in the dominant and non-dominant lower limb.

The Impact of COVID-19 Pandemic on Vascular Leg Ulcers

2021 ◽  
pp. 153473462110109
Author(s):  
Marianna Sallustro ◽  
Anna Florio
Keyword(s):  
Primary Care ◽  
Lower Limb ◽  
Deleterious Effect ◽  
Skin Lesions ◽  
Lower Limbs ◽  
Limb Amputation ◽  
Leg Ulcers ◽  
Skin Wounds ◽  
Primary Care Settings ◽  
The Impact

The aim of this study was to evaluate the impact of 2 lockdown periods during coronavirus disease 2019 (COVID-19) on the course and management of nonhealing vascular ulcers of lower limbs. A total of 41 patients were included in the study. Before the pandemic began they had been seen at our unit at weekly intervals. During lockdown from March 9, 2020, to May 18, 2020 subjects were not allowed to enter the hospital unless they needed urgency or emergency surgery, or oncological management. During the second lockdown, from October 19, 2020, to December 11, 2020 patients could be followed up at distance by direct outreach including telephoning contacts. Data obtained early after each lockdown were compared with those obtained prior to the pandemic. Data for the first lockdown show that pain intensified and there was an increase in the recurrence rate of wounds, of their severity, and of superimposed infections as compared with the prelockdown period. The risk of lower-limb amputation was also considerably greater. During the second and less restrictive lockdown, patients were followed up by telemedicine and data indicate that skin lesions had not worsened any further. The management of vascular wounds was impacted by the pandemic unfavorably with health care failures in the hospital as well as in the primary care settings. In conclusion, the treatment of vascular leg ulcers is challenged by the COVID-19 pandemic as this spreads worldwide. This seems to be in keeping with what happens for other diseases. The data we obtained indicate that the pandemic-related lockdown has a deleterious effect on vascular skin wounds, with an increase of severity and mortality risk. The impact appears to be proportional to the number and the degree of limitations imposed on people.

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