Gait Symmetry Analysis in Patients after Treatment of Pilon Fractures by the Ilizarov Method

The aim of this study was to comprehensively assess the gait parameters in patients who had undergone treatment of pilon fractures by the Ilizarov method. We analyzed gait parameters in patients who had undergone treatment for pilon fractures by the Ilizarov method; 20 patients aged 47.0 years (25.2–78.6) were included in the study. The control group consisted of 32 healthy volunteers. Gait examination was performed using the pedobarographic platform. Statistically significant differences in the following gait parameters: maximum forefoot force (%), step length (cm), and step time (s) were found between the study group and the control group, between the nonoperated leg, and both the operated leg and the dominant limb. Statistically significant differences in the study group between the treated lower limb and the healthy lower limb were only observed in the case of the maximum forefoot force parameter (%). Healthy subjects from the control group obtained significantly higher values during locomotion for stride time, cadence step, and velocity than the patients, with stride time being statistically significantly shorter and the velocity and the cadence step higher. We observed symmetry in the gait parameters after treating pilon fractures by the Ilizarov method. This method of stabilization allows the restoration of gait parameters, with results similar to those obtained after the treatment of other motor organ pathologies described in the literature, although different from those observed in healthy subjects. In particular, the biomechanics of the lower limbs remain disturbed.

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A study of the efficacy of external fixation in healing large, deep and unstable diabetic foot wounds

International Surgery Journal ◽

10.18203/2349-2902.isj20190812 ◽

2019 ◽

Vol 6 (3) ◽

pp. 669

Author(s):

Byomokesh Patro ◽

Pankaj Surana ◽

Kailash Chandra Mahapatra

Keyword(s):

External Fixation ◽

External Fixator ◽

Lower Limb ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Working Environment ◽

Lower Limbs ◽

Control Group ◽

Study Group

Background: Infection of a diabetic foot wound heralds a poor outcome, early diagnosis and treatments are important. The aim of the study was to study the efficacy of external fixation in healing large, deep and unstable diabetic foot wounds.Methods: 50 patients with diabetic foot ulcer considered for the present study. Out of this 50 cases 25 are selected for external fixations (study group), after fulfilling the inclusion criteria and rest 25 cases are managed by posterior slab support. After reducing the infective load, the external fixator was applied as per application of external fixator procedure. The fixator is kept for 4 to 6 weeks. Daily dressings are done with advance dressing materials. Posterior slab group 25 patients are included having large, deep ulcers and unstable joints, to which posterior slabs were supported after proper and extensive debridement of wound under SA/LA.Results: DFU predominantly affects right lower limb than left lower limb. Both lower limbs affected in 4% cases. Because of different working environment males are more vulnerable to foot ulcerations. Out of 50 cases 48 (96%) of DFU are unilateral and 32 no of cases (64%) are predominantly occurs in right lower limb (Table 2). Out of 50 cases 38 no. of patient are males and 12 no. of patient are females. External fixator in exposed joint decreases the wounds in 52 days where as by posterior slab support 59 days. The mean surfaces are of the wound after therapy in study group is 75 cm2 and in control group it was 78 cm2.Conclusions: Large ulcers and exposed joints due to diabetic foot can be managed by external fixator for better prognosis than posterior slab method.

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Validation of the "Six Step Spot Test" for gait among patients with multiple sclerosis in Brazil

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2010000200009 ◽

2010 ◽

Vol 68 (2) ◽

pp. 198-204 ◽

Cited By ~ 9

Author(s):

Karina Pavan ◽

Charles Peter Tilbery ◽

Sergio Lianza ◽

Bruna Eriko Matsuda Marangoni

Keyword(s):

Multiple Sclerosis ◽

Healthy Subjects ◽

Clinical Manifestations ◽

Spot Test ◽

Lower Limbs ◽

Control Group ◽

Study Group ◽

Course Of Disease ◽

Time Performance ◽

Gradual Accumulation

The clinical manifestations of multiple sclerosis (MS) are variable among patients, and the course of disease is not linear. Different symptoms are presented, with gradual accumulation of disability. These variations are difficult to quantify in clinical practice, and several studies have attempted to create instruments capable of measuring these disabilities. The Six Step Spot Test (SSST) was developed for quantitative evaluation of the lower limbs (LL) over time. Performance in this test reflects the complexity of sensory-motor function, including LL strength, spasticity, coordination and balance, going beyond vision and cognition. The aim of the present study was to validate the SSST in a population of MS patients in Brazil. This prospective study included 75 patients with MS, with EDSS 0 to 6.5 in the study group. Ninety-one healthy subjects were randomly selected for the control group. The results showed that the groups were similar, and that the SSST is a reliable and reproducible test. According to the statistical analysis on the data in this study, the SSST is a valid, reliable and reproducible tool for use in the Brazilian MS patient population.

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Motor disability in patients with multiple sclerosis: transcranial magnetic stimulation study

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-020-00255-3 ◽

2020 ◽

Vol 56 (1) ◽

Author(s):

Anssam Bassem Mohy ◽

Aqeel Kareem Hatem ◽

Hussein Ghani Kadoori ◽

Farqad Bader Hamdan

Keyword(s):

Transcranial Magnetic Stimulation ◽

Lower Limb ◽

Magnetic Stimulation ◽

Motor Evoked Potential ◽

Invasive Procedure ◽

Single Pulse ◽

Lower Limbs ◽

Control Group ◽

Conduction Time ◽

Motor Disability

Abstract Background Transcranial magnetic stimulation (TMS) is a non-invasive procedure used in a small targeted region of the brain via electromagnetic induction and used diagnostically to measure the connection between the central nervous system (CNS) and skeletal muscle to evaluate the damage that occurs in MS. Objectives The study aims to investigate whether single-pulse TMS measures differ between patients with MS and healthy controls and to consider if these measures are associated with clinical disability. Patients and methods Single-pulse TMS was performed in 26 patients with MS who hand an Expanded Disability Status Scale (EDSS) score between 0 and 9.5 and in 26 normal subjects. Different TMS parameters from upper and lower limbs were investigated. Results TMS disclosed no difference in all MEP parameters between the right and left side of the upper and lower limbs in patients with MS and controls. In all patients, TMS parameters were different from the control group. Upper limb central motor conduction time (CMCT) was prolonged in MS patients with pyramidal signs. Upper and lower limb CMCT and CMCT-f wave (CMCT-f) were prolonged in patients with ataxia. Moreover, CMCT and CMCT-f were prolonged in MS patients with EDSS of 5–9.5 as compared to those with a score of 0–4.5. EDSS correlated with upper and lower limb cortical latency (CL), CMCT, and CMCT-f whereas motor evoked potential (MEP) amplitude not. Conclusion TMS yields objective data to evaluate clinical disability and its parameters correlated well with EDSS.

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Feasibility and Preliminary Efficacy of Gait Training Assisted by Multichannel Functional Electrical Stimulation in Early Stroke Rehabilitation: A Pilot Randomized Controlled Trial

Neurorehabilitation and Neural Repair ◽

10.1177/1545968320981942 ◽

2021 ◽

Vol 35 (2) ◽

pp. 131-144

Author(s):

Maijke van Bloemendaal ◽

Sicco A. Bus ◽

Frans Nollet ◽

Alexander C. H. Geurts ◽

Anita Beelen

Keyword(s):

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Step Length ◽

Gait Training ◽

Control Group ◽

Significant Group ◽

Gait Symmetry ◽

Gait Parameters ◽

Walking Capacity ◽

Experimental Group

Background. Many stroke survivors suffer from leg muscle paresis, resulting in asymmetrical gait patterns, negatively affecting balance control and energy cost. Interventions targeting asymmetry early after stroke may enhance recovery of walking. Objective. To determine the feasibility and preliminary efficacy of up to 10 weeks of gait training assisted by multichannel functional electrical stimulation (MFES gait training) applied to the peroneal nerve and knee flexor or extensor muscle on the recovery of gait symmetry and walking capacity in patients starting in the subacute phase after stroke. Methods. Forty inpatient participants (≤31 days after stroke) were randomized to MFES gait training (experimental group) or conventional gait training (control group). Gait training was delivered in 30-minute sessions each workday. Feasibility was determined by adherence (≥75% sessions) and satisfaction with gait training (score ≥7 out of 10). Primary outcome for efficacy was step length symmetry. Secondary outcomes included other spatiotemporal gait parameters and walking capacity (Functional Gait Assessment and 10-Meter Walk Test). Linear mixed models estimated treatment effect postintervention and at 3-month follow-up. Results. Thirty-seven participants completed the study protocol (19 experimental group participants). Feasibility was confirmed by good adherence (90% of the participants) and participant satisfaction (median score 8). Both groups improved on all outcomes over time. No significant group differences in recovery were found for any outcome. Conclusions. MFES gait training is feasible early after stroke, but MFES efficacy for improving step length symmetry, other spatiotemporal gait parameters, or walking capacity could not be demonstrated. Trial Registration. Netherlands Trial Register (NTR4762).

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Deficits in anticipatory inhibition of postural muscle activity associated with load release while standing in individuals with spastic diplegic cerebral palsy

Journal of Neurophysiology ◽

10.1152/jn.00253.2012 ◽

2013 ◽

Vol 109 (8) ◽

pp. 1996-2006 ◽

Cited By ~ 5

Author(s):

Hidehito Tomita ◽

Yoshiki Fukaya ◽

Kenji Totsuka ◽

Yuri Tsukahara

Keyword(s):

Cerebral Palsy ◽

Lower Limb ◽

Muscle Activity ◽

Erector Spinae ◽

Lower Limbs ◽

Control Group ◽

Lower Limb Muscles ◽

Limb Muscles ◽

Postural Muscle ◽

Load Release

This study aimed to determine whether individuals with spastic diplegic cerebral palsy (SDCP) have deficits in anticipatory inhibition of postural muscle activity. Nine individuals with SDCP (SDCP group, 3 female and 6 male, 13–24 yr of age) and nine age- and sex-matched individuals without disability (control group) participated in this study. Participants stood on a force platform, which was used to measure the position of the center of pressure (CoP), while holding a light or heavy load in front of their bodies. They then released the load by abducting both shoulders. Surface electromyograms were recorded from the rectus abdominis, erector spinae (ES), rectus femoris (RF), medial hamstring (MH), tibialis anterior (TA), and gastrocnemius (GcM) muscles. In the control group, anticipatory inhibition before load release and load-related modulation of the inhibition were observed in all the dorsal muscles recorded (ES, MH, and GcM). In the SDCP group, similar results were obtained in the trunk muscle (ES) but not in the lower limb muscles (MH and GcM), although individual differences were seen, especially in MH. Anticipatory activation of the ventral lower limb muscles (RF and TA) and load-related modulation of the activation were observed in both participant groups. CoP path length during load release was longer in the SDCP group than in the control group. The present findings suggest that individuals with SDCP exhibit deficits in anticipatory inhibition of postural muscles at the dorsal part of the lower limbs, which is likely to result in a larger disturbance of postural equilibrium.

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Efficacy of Ashwagandha (withania somnifera [l.] Dunal) in improving cardiorespiratory endurance (VO2 max test) in healthy subjects

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v12i1.4376 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Bargale Sushant Sukumar ◽

Tripathy T B ◽

Shashirekha H K ◽

Suhas Kumar Shetty

Keyword(s):

Healthy Subjects ◽

Withania Somnifera ◽

Nutritional Supplement ◽

Free Radical Scavenger ◽

Control Group ◽

Radical Scavenger ◽

Study Group ◽

Oxygen Intake ◽

Vo2 Max ◽

Cardiorespiratory Endurance

In Ayurveda, certain herbal formulas are considered to be Rasayana and they are typically taken over periods of time to regenerate both brain and body tissue. Ashwagandha (Withania Somnifera) is used as an adaptogen, antioxidant, immune modulator, free radical scavenger, anti stress, anti arthritic, antispasmodic, anti inflammatory, nervous tonic, nerve soothing and anticancer agent. Ashwagandha (WS) as a nutritional supplement is yet too established. Maximum oxygen uptake (VO2 max) is a gold standard of cardiopulmonary and muscle cell fitness is considered. The study evaluated the efficacy of Ashwagandha to improve cardiorespiratory endurance (VO2 max) in healthy subjects. They randomized single blind controlled comparative clinical study. 54 health volunteers in each group, study group received Ashwagandha Choorna 12gm with milk (200ml) empty stomach in the morning and the control group only milk (200ml). Maximal capacity of oxygen intake in ml/kg/min (VO2 max) with Rockport fitness walking test of both study and control group were measured before intervention (0th day), after the intervention (60th day) and follow up (90th day). A significant improvement in the VO2 max (F=20.675, P <0.0001) and Hemoglobin (X2=74.150 P <0.0001) in the study group was found. Supplementation of Ashwagandha (Withania Somnifera) with milk improve hemoglobin and VO2 max (maximum aerobic capacity).

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Dynamic Gait Parameters in Patients with Nonunion of the Tibia Following Treatment with the Ilizarov Method

Journal of Biomechanical Engineering ◽

10.1115/1.4051432 ◽

2021 ◽

Author(s):

Andzelika Pajchert Kozlowska ◽

Lukasz Pawik ◽

Lukasz Szelerski ◽

Slawomir Zarek ◽

Radoslaw Górski ◽

...

Keyword(s):

Maximum Force ◽

Control Group ◽

Ilizarov Method ◽

Dynamic Parameters ◽

Symmetrical Distribution ◽

Gait Parameters ◽

Tibial Nonunion ◽

Parameter Values ◽

Dynamic Gait ◽

Experimental Group

Abstract INTRODUCTION: The purpose of this study was a comprehensive assessment of the dynamic parameters of gait in patients who underwent Ilizarov treatment for nonunion of the tibia. MATERIALS AND METHODS: The experimental group consisted of24 individuals treated with the Ilizarov method for nonunion of the tibia.The control group comprised31healthy individuals,matched for BMI,sex,and age.The dynamic gait parameters in patients and in the control group were measured with a Zebris pedobarographic platform. RESULTS: The treatment group and the control group showed statistically significant differences in terms of the following gait parameters:Maximum force 1NOL(non-operated-limb),Time maximum force1OL(operated-limb),Time maximum force 1 NOL,Maximum force 2NOL,Time maximum force 2OL,and Maximum force forefoot OL.Most of the evaluated gait parameters were bilaterally similar in patients group.The only significant differences between the operated and non-operated limb were seen in terms of Time maximum force 2and Maximum force forefoot. CONCLUSIONS: The most pronounced abnormalities in dynamic gait parameters were observed in the forefoot.The patients treated with the Ilizarov method did not achieve a complete normalization of dynamic gait parameters,as their gait parameters did not equal those measured in the control group.The Ilizarov method for the treatment of tibial nonunion helps restore a symmetrical distribution of gait parameter values between the affected limb and the healthy limb.Patients with tibial nonunion treated with the Ilizarov method continue to show some abnormalities in their dynamic gait parameters after treatment.

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Assessment of an Assistive Control Approach Applied in an Active Knee Orthosis Plus Walker for Post-Stroke Gait Rehabilitation

Sensors ◽

10.3390/s20092452 ◽

2020 ◽

Vol 20 (9) ◽

pp. 2452

Author(s):

Ana Cecilia Villa-Parra ◽

Jessica Lima ◽

Denis Delisle-Rodriguez ◽

Laura Vargas-Valencia ◽

Anselmo Frizera-Neto ◽

...

Keyword(s):

Healthy Subjects ◽

Muscle Activation ◽

Inertial Sensors ◽

Lower Limbs ◽

Trunk Muscles ◽

Control Group ◽

Gait Rehabilitation ◽

Control Approach ◽

Post Stroke ◽

Knee Orthosis

The goal of this study is the assessment of an assistive control approach applied to an active knee orthosis plus a walker for gait rehabilitation. The study evaluates post-stroke patients and healthy subjects (control group) in terms of kinematics, kinetics, and muscle activity. Muscle and gait information of interest were acquired from their lower limbs and trunk, and a comparison was conducted between patients and control group. Signals from plantar pressure, gait phase, and knee angle and torque were acquired during gait, which allowed us to verify that the stance control strategy proposed here was efficient at improving the patients’ gaits (comparing their results to the control group), without the necessity of imposing a fixed knee trajectory. An innovative evaluation of trunk muscles related to the maintenance of dynamic postural equilibrium during gait assisted by our active knee orthosis plus walker was also conducted through inertial sensors. An increase in gait cycle (stance phase) was also observed when comparing the results of this study to our previous work. Regarding the kinematics, the maximum knee torque was lower for patients when compared to the control group, which implies that our orthosis did not demand from the patients a knee torque greater than that for healthy subjects. Through surface electromyography (sEMG) analysis, a significant reduction in trunk muscle activation and fatigability, before and during the use of our orthosis by patients, was also observed. This suggest that our orthosis, together with the assistive control approach proposed here, is promising and could be considered to complement post-stroke patient gait rehabilitation.

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Dysfunctional muscle activities and co-contraction in the lower-limb of lumbar disc herniation patients during walking

Scientific Reports ◽

10.1038/s41598-020-77150-7 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Wei Wang ◽

Hui Wei ◽

Runxiu Shi ◽

Leitong Lin ◽

Lechi Zhang ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lower Limb ◽

Gait Cycle ◽

Lumbar Disc ◽

Lower Limbs ◽

Heel Strike ◽

Control Group ◽

Double Support ◽

Support Phase

AbstractThis study aimed to investigate lower-limb muscle activities in gait phases and co-contraction of one gait cycle in patients with lumbar disc herniation (LDH). This study enrolled 17 LDH patients and 17 sex- and age-matched healthy individuals. Bilateral muscle activities of the rectus femoris (RF), biceps femoris long head (BL), tibialis anterior (TA), and lateral gastrocnemius (LG) during walking were recorded. The gait cycle was divided into four phases by the heel strike and top off according to the kinematics tracks. Root mean square (RMS), mean frequency (MF), and co-contraction of surface electromyography signals were calculated. The LDH patients showed enhanced BL RMS during the single support phase (SS), second double support phase, and swing phase (SW) as well as decreased MF of RF during SS and of TA and LG during SW (p < 0.05). The co-contraction of the TA-LG was increased in LDH patients than in the control group (p < 0.05). Positive correlations were observed between TA-LG co-contraction (affected side, r = 0.557, p = 0.020; contralateral side, r = 0.627, p = 0.007) and the Oswestry disability index scores in LDH patients. LDH patients have increased BL firing rate and insufficient motor unit recruitment in specific phases in the lower limbs during walking. Dysfunction in LDH patients was associated with immoderate intermuscular co-contraction of the TA-LG during walking.

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

Journal of Applied Biomechanics ◽

10.1123/jab.29.1.44 ◽

2013 ◽

Vol 29 (1) ◽

pp. 44-48 ◽

Cited By ~ 7

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.

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