scholarly journals A Novel Tool for Quantitative Assessment of Lower Limb Proprioception: Demonstration with Young Adults, Elderly and Stroke Survivors

2021 ◽  
Author(s):  
Asya Mikhaylov ◽  
Yogev Koren ◽  
Simona Bar-Haim ◽  
Ilana Nisky
Keyword(s):  
Young Adults ◽  
Lower Limb ◽  
Quantitative Assessment ◽  
Spatial Information ◽  
Tracking System ◽  
Task Type ◽  
Lower Limbs ◽  
Stroke Survivors ◽  
Assessment Protocol ◽  
The Mean

Abstract BackgroundStroke and ageing are common causes for proprioceptive impairments. Such impairments may contribute to disabilities in daily living activities, such as walking. Yet, current rehabilitation methods mainly focus on motor disabilities, and often neglect somatosensory impairments. Moreover, clinical methods for proprioception assessment of both the upper and lower limb are subjective and suffer from inconsistency between evaluators, and the majority of the research in quantitative assessment of proprioception focuses on the upper limb. To address these gaps, we present a novel tool for quantitative assessment of proprioception of the lower limb.MethodsWe developed a tool that consists of a magnetic tracking system with magnetic sensors placed on the participants’ toes while the participants were laying on their side. We designed an assessment protocol that includes contralateral position matching tests and ipsilateral position matching tests, and applied them to both lower limbs (N: non-dominant and D: dominant). We validated the tool on three groups of participants: young adults (n=18), elderly (n=8), and stroke survivors (n=5) by comparing the results of the mean absolute error (MAE), bias and the mean variable error (MVE).ResultsWe evaluated the effect of group type, proprioceptive input, task type and their interactions. We compared between young adults and elderly with statistical analysis, and demonstrated the results of the stroke survivors. We found significant differences in MAE and bias between the elderly and young adults in the contralateral tasks, particularly once spatial information is transmitted from the N limb to the D limb, indicating that the ability to transit spatial information contralaterally becomes more challenging with age. The bias also indicated that the contralateral task is more challenging with the groups, independently. ConclusionsUsing contralateral position matching may be an effective way to identify potential somatosensory impairments. In order to avoid a long and unnecessary assessment, we suggested using contralateral position matching as a screening phase in identifying lower limb proprioceptive impairments, followed by ipsilateral position matching only for individuals with impaired results for identifying possible confounds from motor and cognitive impairments.

The Effects of Uni- and Bilateral Fatigue on Postural and Power Tasks

2013 ◽  
Vol 29 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Paulo H. Marchetti ◽  
Maria I.V. Orselli ◽  
Marcos Duarte
Keyword(s):  
Lower Limb ◽  
Healthy Subjects ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Lower Limbs ◽  
Quiet Standing ◽  
Ground Reaction Forces ◽  
Before And After ◽  
Reaction Forces ◽  
The Mean

The aim of this study was to investigate the effects of unilateral and bilateral fatigue on both postural and power bipedal tasks. Ten healthy subjects performed two tasks: bipedal quiet standing and a maximal bipedal counter-movement jumping before and after unilateral (with either the dominant or nondominant lower limb) and bilateral (with both lower limbs) fatigue. We employed two force plates (one under each lower limb) to measure the ground reaction forces and center of pressure produced by subjects during the tasks. To quantify the postural sway during quiet standing, we calculated the resultant center of pressure (COP) speed and COP area of sway, as well as the mean weight distribution between lower limbs. To quantify the performance during the countermovement jumping, we calculated the jump height and the peak force of each lower limb. We observed that both unilateral and bilateral fatigue affected the performance of maximal voluntary jumping and standing tasks and that the effects of unilateral and bilateral fatigue were stronger in the dominant limb than in the nondominant limb during bipedal tasks. We conclude that unilateral neuromuscular fatigue affects both postural and power tasks negatively.

scholarly journals Pre- and Postoperative Evaluation by Photoplethysmography in Patients Receiving Surgery for Lower-Limb Varicose Veins

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Orlando Adas Saliba Júnior ◽  
Mariangela Giannini ◽  
Ana Paula Mórbio ◽  
Orlando Saliba ◽  
Hamilton Almeida Rollo
Keyword(s):  
Lower Limb ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Varicose Vein Surgery ◽  
Postoperative Evaluation ◽  
Perforating Veins ◽  
Primary Varicose Veins ◽  
Ceap Classification ◽  
The Mean ◽  
Deep Vein

Objective. To evaluate the effectiveness of surgery in treating primary varicose veins in the lower limbs by photoplethysmography (PPG) and duplex mapping (DM).Method. Forty-eight lower limbs were clinically evaluated according to the CEAP classification system and subjected to PPG and DM exams. Each limb had a venous refill time (VRT) of <20 seconds and a normal deep vein system (DVS) by DM.Results. The mean pre- and postoperative VRTs were 13.79 and 26.43 seconds, respectively (P<0.0001). After surgery, 42 limbs (87.50%) had normal results by PPG (VRT > 20 seconds). Four limbs (8.33%) showed improved VRTs, but the VRTs did not reach 20 seconds. In the 2 limbs (4.17%) that maintained their original VRTs, the DM exams showed the presence of insufficient perforating veins.Conclusion. In most cases, PPG allows for a satisfactory evaluation of the outcome of varicose vein surgery.

scholarly journals TL 18165 - Relationship between lower limb dysmetria and plantar fasciitis

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 96S
Author(s):  
Henrique Mansur ◽  
Guilherme Gonçalves Feijó Carvalho ◽  
Isnar Moreira de Castro Júnior
Keyword(s):  
Lower Limb ◽  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Cross Sectional Study ◽  
Lower Limbs ◽  
Sectional Study ◽  
Cross Sectional ◽  
Calcaneal Spur ◽  
The Mean ◽  
The Relationship

Introduction: Plantar fasciitis is an inflammatory process of multifactorial etiology that affects the origin of the plantar fascia and surrounding structures. A difference in length between lower limbs is relatively common within the population and can sometimes cause changes in biomechanics and symptoms. The objective of this study is to evaluate the relationship between lower limb dysmetria and plantar fasciitis. Methods: A cross-sectional study was performed to measure the length of the lower limbs by scanometry in patients diagnosed with plantar fasciitis. Other risk factors, such as body mass index, foot shape and the presence of plantar calcaneal spur, were also assessed in foot radiographs. Results: Of the 54 patients included in the study, 44.4% were men, and the mean age was 50.38 (23-73 years); 81.5% had pain in one foot, and 53.7% had feet that were considered plantigrade. We observed dysmetria in 88.9% of the sample, with a mean of 0.749 cm (SD ±0.63). In addition, 46.3% feet with pain showed calcaneal spurs on the radiographs. Conclusion: Approximately 90% of patients showed lower-limb dysmetria and, in most cases, the side with the shorter limb was affected by plantar fasciitis

scholarly journals Effects of an Eight-Week Stepladder Exercise Protocol on Lower Limb Muscular Strength of Apparently Healthy Young Adults

2017 ◽  
Vol 18 (3) ◽  
Author(s):  
Oladapo Michael Olagbegi ◽  
Babatunde Olusola Adegoke ◽  
Candice Jo-Anne Christie ◽  
Olufemi Samuel Bolarinde ◽  
Joseph Adeiza Jegede
Keyword(s):  
Young Adults ◽  
Muscle Strength ◽  
Lower Limb ◽  
Muscular Strength ◽  
Lower Limbs ◽  
Stair Climbing ◽  
Lower Limb Muscle ◽  
Limb Muscle ◽  
Joint Stress ◽  
Apparently Healthy

AbstractPurpose. Backward descent of stairs is associated with improved muscle strength and reduced joint stress, but the effect of backward ascent of stairs on lower limb muscle strength has not been reported. This study compared the effects of forward and backward stair climbing on lower limb muscle strength in apparently healthy young adults. Methods. The total of 31 young volunteers were allocated to either forward or backward stair climbing group (n = 16 and 15, respectively). Dynamic quadriceps and hamstring muscle strength was assessed in addition to thigh girth at baseline and at weeks 4 and 8 with the use of the repetitive maximum method and tape measure, respectively. Results. Between baseline and week 8, muscular strength in both groups (quadriceps: 14.4 ± 3.6 to 16.4 ± 3.4 kg; 14.0 ± 2.9 to 15.3 ± 2.7 kg; hamstring: 12.2 ± 3.2 to 13.4 ± 3.2; 11.7 ± 2.5 to 12.9 ± 2.7 kg) increased significantly (p < 0.05) while the increase in thigh girth was not significant (p > 0.05). The groups were comparable in all three measures post intervention. Conclusions. Forward and backward stair climbing protocols are effective for improving the dynamic strength of the hamstring and quadriceps muscles of apparently healthy young adults. Thus, either protocol could be used for the improvement of lower limbs dynamic muscle strength.

Sensitivity of the Toe Height to Multijoint Angular Changes in the Lower Limbs During Unobstructed and Obstructed Gait

2020 ◽  
pp. 1-9
Author(s):  
Chuyi Cui ◽  
Brittney Muir ◽  
Shirley Rietdyk ◽  
Jeffrey Haddad ◽  
Richard van Emmerik ◽  
...  
Keyword(s):  
Young Adults ◽  
Lower Limb ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Singular Value ◽  
Lower Limbs ◽  
Joint Angles ◽  
Adult Lifespan ◽  
Main Contributor ◽  
Bilateral Lower Limb

Tripping while walking is a main contributor to falls across the adult lifespan. Trip risk is proportional to variability in toe clearance. To determine the sources of this variability, the authors computed for 10 young adults the sensitivity of toe clearance to 10 bilateral lower limb joint angles during unobstructed and obstructed walking when the lead and the trail limb crossed the obstacle. The authors computed a novel measure—singular value of the appropriate Jacobian—as the combined toe clearance sensitivity to 4 groups of angles: all sagittal and all frontal plane angles and all swing and all stance limb angles. Toe clearance was most sensitive to the stance hip ab/adduction for unobstructed gait. For obstructed gait, sensitivity to other joints increased and matched the sensitivity to stance hip ab/adduction. Combined sensitivities revealed critical information that was not evident in the sensitivities to individual angles. The combined sensitivity to stance limb angles was 84% higher than swing limb angles. The combined sensitivity to the sagittal plane angles was lower than the sensitivity to the frontal plane angles during unobstructed gait, and this relation was reversed during obstacle crossing. The results highlight the importance of the stance limb joints and indicate that frontal plane angles should not be ignored.

scholarly journals Effect of lower limb dominance on walking adaptations in young adults when stepping into a hole

2020 ◽  
Vol 13 (5) ◽  
pp. 133-143
Author(s):  
Luciana Oliveira Dos Santos ◽  
Andréia Abud da Silva Costa ◽  
Renato Moraes
Keyword(s):  
Young Adults ◽  
Lower Limb ◽  
The Other ◽  
Lower Limbs ◽  
Normal Walking ◽  
Other Hand ◽  
The Individual ◽  
Limb Dominance

Background. Depending on the dimensions of a hole, the characteristics of the walking surface, and the position of the hole relative to normal walking, individuals may need to step into the hole with the dominant or non-dominant limb. Aim. We investigated the effect of the lower limb dominance in walking adaptations in the presence of a hole on the ground. Methods: Twenty young adults walked and stepped into a hole positioned in the middle of the pathway using the dominant and non-dominant lower limbs. Results. For the trailing limb, the impulses were not affected by the lower limb dominance, but for the leading limb, the non-dominant leg increased the braking and propulsive impulses compared to the dominant leg. On the other hand, toe-off velocity increased when the non-dominant leg was used as trailing and leading limbs. Stride speed increased when the non-dominant leg was the trailing limb. Interpretation. Our results were consistent with asymmetrical behavior between dominant and non-dominant legs. Although the differences between the dominant and non-dominant legs have not affected the success in the task, they can put the individual at higher risk of stumbling and consequently a fall when stepping with the non-dominant leg into the hole.

scholarly journals Acute limb heating improves macro- and microvascular dilator function in the leg of aged humans

2017 ◽  
Vol 312 (1) ◽  
pp. H89-H97 ◽  
Author(s):  
Steven A. Romero ◽  
Daniel Gagnon ◽  
Amy N. Adams ◽  
Matthew N. Cramer ◽  
Ken Kouda ◽  
...  
Keyword(s):  
Shear Stress ◽  
Young Adults ◽  
Lower Limb ◽  
Local Heating ◽  
Reactive Hyperemia ◽  
Arterial Occlusion ◽  
Lower Limbs ◽  
Dependent Manner ◽  
Arterial Tree ◽  
Stress Dependent

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. NEW & NOTEWORTHY 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.

scholarly journals Normative Values for Femoral Length, Tibial Length, and the Femorotibial Ratio in Adults Using Standing Full-Length Radiography

Osteology ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 86-91
Author(s):  
Stuart A Aitken
Keyword(s):  
Linear Relationship ◽  
Lower Limb ◽  
Measurement Method ◽  
Full Length ◽  
Lower Limbs ◽  
Limb Length ◽  
Normative Values ◽  
Femoral Length ◽  
Tibial Length ◽  
The Mean

Knowledge of the normal length and skeletal proportions of the lower limb is required as part of the evaluation of limb length discrepancy. When measuring limb length, modern standing full-length digital radiographs confer a level of clinical accuracy interchangeable with that of CT imaging. This study reports a set of normative values for lower limb length using the standing full-length radiographs of 753 patients (61% male). Lower limb length, femoral length, tibial length, and the femorotibial ratio were measured in 1077 limbs. The reliability of the measurement method was tested using the intra-class correlation (ICC) of agreement between three observers. The mean length of 1077 lower limbs was 89.0 cm (range 70.2 to 103.9 cm). Mean femoral length was 50.0 cm (39.3 to 58.4 cm) and tibial length was 39.0 cm (30.8 to 46.5 cm). The median side-to-side difference was 0.4 cm (0.2 to 0.7, max 1.8 cm) between 324 paired limbs. The mean ratio of femoral length to tibial length for the study population was 1.28:1 (range 1.16 to 1.39). A moderately strong inverse linear relationship (r = −0.35, p < 0.001, Pearson’s) was identified between tibial length and the corresponding femorotibial ratio. The PACS-based length measurement method used in this study displayed excellent inter-observer reliability (ICC of 0.99). This study presents a normal range of values for lower limb length in adults and is the first to identify a linear relationship between tibial length and the femorotibial ratio.

scholarly journals Siliconomas of the lower limb: Tumour-like excision and reconstruction

2016 ◽  
Vol 49 (03) ◽  
pp. 384-389
Author(s):  
Tommaso Agostini ◽  
Raffaella Perello
Keyword(s):  
Lower Limb ◽  
Silicone Oil ◽  
Multiorgan Failure ◽  
Fat Grafting ◽  
Lower Limbs ◽  
Immediate Reconstruction ◽  
Silicone Injection ◽  
Aesthetic Appearance ◽  
The Mean ◽  
Oil Injection

ABSTRACTBackground: Silicone oil injection can cause several complications including pain, cellulitis, abscesses, skin compromise, migration, embolism and multiorgan failure. Oil-infested tissue excision remains the solely treatment to prevent such complications. Objectives: The authors evaluate tumor-like excision of the oil-infested tissue as a treatment for patients experiencing silicone injections in the lower limbs, to both preserve aesthetic appearance and solve further risk of complication from silicone. Methods: Between January 2004 and January 2011 a total of 12 consecutive, nonrandomized female patients underwent surgical management of siliconoma of the lower limb. The mean age was 41-years, range from 22 to 61 years and all patients didn’t referred comorbidities. Eight siliconomas were located on the leg and 4 were on the thigh. The mean area of siliconoma was 35 cm2, range from 25 to 60 cm2. Each patient was evaluated by ultrasonography and EchocolorDoppler of the soft tissue and in order to achieve a “staging” of siliconoma. Results: Healing was uneventful in all cases. Three patients (25%) suffering hypertrophic scarring underwent further injection of corticosteroids to improve hypertrophic scars quality. Two patients (16.6%) required a further session of structural fat grafting to improve thigh’s profile. All patients were satisfied with the cosmetic results and indispositions requiring medical therapy disappeared. Conclusions: Tumor-like excision and immediate reconstruction appears to be a safe and consistent surgical option that preserves aesthetic appearance for patients victims of illegal oil silicone injection of the lower limbs.

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