scholarly journals Kinematic Analysis of Lower Limb Joint Asymmetry during Gait in People with Multiple Sclerosis

Symmetry ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 598
Author(s):  
Massimiliano Pau ◽  
Bruno Leban ◽  
Michela Deidda ◽  
Federica Putzolu ◽  
Micaela Porta ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Lower Limb ◽  
Sagittal Plane ◽  
Cross Sectional Study ◽  
Camera Motion ◽  
Cross Sectional ◽  
Temporal Parameters ◽  
Wide Range ◽  
Edss Score ◽  
Spatio Temporal

The majority of people with Multiple Sclerosis (pwMS), report lower limb motor dysfunctions, which may relevantly affect postural control, gait and a wide range of activities of daily living. While it is quite common to observe a different impact of the disease on the two limbs (i.e., one of them is more affected), less clear are the effects of such asymmetry on gait performance. The present retrospective cross-sectional study aimed to characterize the magnitude of interlimb asymmetry in pwMS, particularly as regards the joint kinematics, using parameters derived from angle-angle diagrams. To this end, we analyzed gait patterns of 101 pwMS (55 women, 46 men, mean age 46.3, average Expanded Disability Status Scale (EDSS) score 3.5, range 1–6.5) and 81 unaffected individuals age- and sex-matched who underwent 3D computerized gait analysis carried out using an eight-camera motion capture system. Spatio-temporal parameters and kinematics in the sagittal plane at hip, knee and ankle joints were considered for the analysis. The angular trends of left and right sides were processed to build synchronized angle–angle diagrams (cyclograms) for each joint, and symmetry was assessed by computing several geometrical features such as area, orientation and Trend Symmetry. Based on cyclogram orientation and Trend Symmetry, the results show that pwMS exhibit significantly greater asymmetry in all three joints with respect to unaffected individuals. In particular, orientation values were as follows: 5.1 of pwMS vs. 1.6 of unaffected individuals at hip joint, 7.0 vs. 1.5 at knee and 6.4 vs. 3.0 at ankle (p < 0.001 in all cases), while for Trend Symmetry we obtained at hip 1.7 of pwMS vs. 0.3 of unaffected individuals, 4.2 vs. 0.5 at knee and 8.5 vs. 1.5 at ankle (p < 0.001 in all cases). Moreover, the same parameters were sensitive enough to discriminate individuals of different disability levels. With few exceptions, all the calculated symmetry parameters were found significantly correlated with the main spatio-temporal parameters of gait and the EDSS score. In particular, large correlations were detected between Trend Symmetry and gait speed (with rho values in the range of –0.58 to –0.63 depending on the considered joint, p < 0.001) and between Trend Symmetry and EDSS score (rho = 0.62 to 0.69, p < 0.001). Such results suggest not only that MS is associated with significantly marked interlimb asymmetry during gait but also that such asymmetry worsens as the disease progresses and that it has a relevant impact on gait performances.

Association of vitamin D metabolite levels with relapse rate and disability in multiple sclerosis

2008 ◽  
Vol 14 (9) ◽  
pp. 1220-1224 ◽  
Author(s):  
J Smolders ◽  
P Menheere ◽  
A Kessels ◽  
J Damoiseaux ◽  
R Hupperts
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Relapse Rate ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Vitamin D Supplementation ◽  
Biologically Active ◽  
Serum Samples ◽  
Cross Sectional ◽  
Edss Score

Background Multiple Sclerosis is associated with low serum levels of 25-hydroxyvitamin D (25(OH)D). We investigated the association between serum levels of 25(OH)D and 1,25-dihydroxyvitamin D (1,25(OH)2D), the biologically active metabolite, and clinical MS severity as expressed by EDSS-score and relapse rate. Study-design Cross-sectional study. Patients and Methods Serum samples from 267 MS patients were collected for 25(OH)D and 1,25(OH)2D measurement. Clinical MS parameters at the date of serum sampling were determined. Results: Both metabolite levels were significantly lower in the progressive forms compared to the relapsing remitting (RR)MS phenotype. In RRMS patients (disease course ≤ 5 years), high 25(OH)D levels were associated with a high chance of remaining relapse-free. Low 25(OH)D levels were associated with high EDSS-scores. 1,25(OH)2D was not directly associated with relapse rate or EDSS-score, and was dependent of age and 25(OH)D level. Conclusion Serum levels of 25(OH)D were associated with both relapse rate and disability in MS patients. These results are suggestive for a disease modulating effect of the serum concentrations of 25(OH)D on MS. The low circulating 1,25(OH)2D levels in progressive MS are due to older age and lower 25(OH)D levels. The potential consequences for vitamin D supplementation in MS will be discussed.

scholarly journals What People with Newly Diagnosed MS (and their Families and Friends) Need to Know

2000 ◽  
Vol 2 (3) ◽  
pp. 29-39 ◽  
Author(s):  
Judy Wollin ◽  
Helen Dale ◽  
Nancy Spenser ◽  
Anne Walsh
Keyword(s):  
Multiple Sclerosis ◽  
Small Sample Size ◽  
Cross Sectional Study ◽  
Small Sample ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Wide Range ◽  
Study Participants ◽  
To Receive ◽  
Depth Interviews

Abstract The aim of this retrospective study was to determine from people with multiple sclerosis (MS) and their families what information would assist a person with newly diagnosed MS — in which format, when, and from whom it should be delivered. Thirty-four Queensland, Australia, residents with MS and 18 family members and friends participated in the main study. Participants were self-selected for this purposive, statewide, cross-sectional study. Nine of the respondents answered open-ended questions in addition to the standard questionnaires, and seven respondents gave in-depth interviews. The respondents recommended that people with a recent MS diagnosis and their families be given a wide range of information reflective of their personal needs. The information should be provided in person (in both group and individual sessions). They preferred to receive the information from their physicians and the staff of the Multiple Sclerosis Society. Research aimed at cures and therapies, as well as counseling and support services, should be discussed early in the course of the disease. Because of the small sample size and retrospective design, additional studies with larger populations are suggested to confirm these results and their cross-cultural applicability.

scholarly journals A comprehensive study of clinical features and management of ulcers of the lower limb

2019 ◽  
Vol 6 (11) ◽  
pp. 4024
Author(s):  
Pradip Kumar Mohanta ◽  
Chinmoy Mallik ◽  
Suman Kumar Chatterjee
Keyword(s):  
Lower Limb ◽  
Cross Sectional Study ◽  
Venous Hypertension ◽  
Leg Ulcers ◽  
Cross Sectional ◽  
Chewing Tobacco ◽  
Wide Range ◽  
Chronic Leg Ulcers ◽  
Disease Free

Background: Leg ulcers are debilitating and painful, greatly reducing patient’s quality of life. These ulcers are often difficult to treat and the successful treatment of leg ulcers depends upon the accurate diagnosis and treatment of the underlying cause.Methods: This prospective cross sectional study was conducted by Department of General Surgery at College of Medicine and JNM Hospital, Nadia. The study was conducted during the period from September 2017 to August 2019 which included 193 patients presenting with ulcers of the lower limb and admitted in surgical wards of our hospital.Results: Most of the patients were engaged in agriculture (23.8%) followed by business (22.8%) and service (14.5%). 52.03% of the patients had habit of smoking, chewing tobacco and drinking of alcohol. Most of the ulcers were diabetic (36.3%) followed by venous (22.3%) (Z=2.17; p=0). Only 4.7% and 3.1% were malignant and trophic ulcers. Peripheral neuropathy (23.3%) was the most common type of ulcer followed by venous hypertension (22.3%). At the end of study period, 180 ulcers were healed, 3 had recurrence, 5 were disease free and 5 patients died.Conclusions: Thus, the study of various cases of leg ulcers arouses lot of interest and is mind boggling as far as the treatment of these cases are concerned. With the availability of arsenal of investigation wide range of antibiotics and with ever improving dressing material, there is certainly a great improvement in treatment of chronic leg ulcers.

scholarly journals Assessment of cerebral hemodynamics in multiple sclerosis patients

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Nouran M. Salah ◽  
Ahmed M. Elsadek ◽  
Lobna M. ELnabil ◽  
Ayman M. Nassef ◽  
Azza A. Abdelaziz ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Autonomic Dysfunction ◽  
Demyelinating Disease ◽  
Disease Status ◽  
Cross Sectional Study ◽  
Cerebral Hemodynamics ◽  
Breath Holding ◽  
Cross Sectional ◽  
Wide Range ◽  
Multiple Sclerosis Patients

Abstract Background Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system. Autonomic dysfunction is present in a wide range of patients (15–80%) that might present with abnormalities in the regulation of the cardiovascular system, sleep disturbance, urinary symptoms, sexual problems, and temperature regulation problem. Although the predominant view is that of an autoimmune inflammatory condition, changes in brain vasculature can occur and contribute to pathophysiology. Objectives The aim of this study was to evaluate cerebral hemodynamics and assess autonomic dysfunction in patients with MS and explore its relationship with disease status. Methods Eighty patients diagnosed with MS according to McDonald criteria 2017 were recruited to this comparative cross-sectional study. All participants underwent assessment of cerebral hemodynamics through transcranial Doppler ultrasonography. Cerebral vasomotor reactivity (CVR) to hypercapnia was measured by the breath-holding index (BHI). They were also assessed for autonomic dysfunction by autonomic questionnaire and blood pressure measurements in both erect and supine positions. Results BHI values showed decreased CVR and were significantly lower in SPMS than in RRMS patients. Autonomic functions were more affected in SPMS than RRMS with total score 2.58 ± 1.13 for the RRMS group and 4.05 ± 1.04 for the SPMS group. Conclusions Cerebrovascular hemodynamic insufficiency in MS may be secondary to the downstream effects of neuro-inflammatory cascades.

scholarly journals Which of the five classical ballet positions is the most demanding for the dancer’s body? An electromyography-based study to determine muscular activity

2020 ◽  
Vol 22 (4) ◽  
Author(s):  
Joanna Gorwa ◽  
Jarosław Kabaciński ◽  
Michał Murawa ◽  
Anna Fryzowicz
Keyword(s):  
Lower Limb ◽  
Sagittal Plane ◽  
External Rotation ◽  
Muscular Activity ◽  
Cross Sectional Study ◽  
Electromyographic Activity ◽  
Cross Sectional ◽  
Figure Skaters ◽  
Foot Progression Angle ◽  
Classical Ballet

Purpose: The study aimed to determine which of the five classical ballet positions is the most demanding regarding muscular activity, values of external rotation in the hip joints, angular values of foot progression as well as the inclination (tilt) of the pelvis in the sagittal plane. Methods: In this cross-sectional study, 14 female pre-professional ballet dancers (aged 11–16) participated. Participants were tasked with the sequential adoption of five classical ballet positions (CP1–CP5). The electromyographic activity of the muscles of the trunk and the lower limb was recorded with surface electrodes. Kinematic data including hip and knee external rotation, foot progression angle and pelvic tilt were collected using a motion capture system. Results: Symmetric positions CP1 and CP2 were not as demanding as asymmetric CP3–CP5. Higher values of hip and foot external rotation without greater muscular effort in CP2 than CP1 was noticed. Considering asymmetric positions, CP3 did not trigger a greater activity of hip or foot muscular groups than CP4 and CP5. CP4 was characterised by the greatest pelvic anterior tilt and the lowest activity of GM in the forward lower limb. In CP5, forward lower limb entailed a higher activity of muscles supporting the foot than in the remaining positions. Conclusion: In terms of biomechanics, the most demanding classical ballet position in pre-professional dancers is CP4, followed by CP5, CP3, CP1 and CP2. This finding can be applied in educational methodology of dancers, figure skaters, synchronized swimmers, acrobatic gymnasts, rhythmic gymnasts or cheerleaders.

Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
Mohammad Enayet Hussain ◽  
Bithi Debnath ◽  
AFM Al Masum Khan ◽  
Md Ferdous Mian ◽  
Md Nahidul Islam ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Clinical Diagnosis ◽  
Optic Neuropathy ◽  
Cross Sectional Study ◽  
P Value ◽  
Pattern Reversal ◽  
Cross Sectional ◽  
The Mean ◽  
Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

Multiple Sclerosis: Treadmill Versus Cycle Ergometry Maximal Exercise Test Responses

2020 ◽  
Vol 9 (3) ◽  
pp. 113-117
Author(s):  
Garett Griffith ◽  
Badeia Saed ◽  
Tracy Baynard
Keyword(s):  
Multiple Sclerosis ◽  
Aerobic Capacity ◽  
Work Capacity ◽  
Cross Sectional Study ◽  
Cycle Ergometer ◽  
Cycle Ergometry ◽  
Cross Sectional ◽  
Complete Test ◽  
Peak Aerobic Capacity ◽  
Predicted Values

ABSTRACT Background: Multiple sclerosis (MS) is an autoimmune disease that impacts the central nervous system. MS generally results in decreased mobility and work capacity. Our objective was to determine exercise testing responses on both a treadmill and cycle ergometer among individuals with MS who were able to ambulate freely. Methods: Twenty-six individuals with MS participated in a cross-sectional study (44 ± 11 years; body mass index 26.8 ± 6.2 kg·m−2; expanded disability scale score 3.1 ± 0.9), with 24 individuals with complete test data for both treadmill and cycle ergometry tests. Peak aerobic capacity (VO2peak) for both treadmill and cycle ergometry tests were measured with indirect calorimetry. Results: Participants safely completed both treadmill and cycle ergometry tests, and treadmill testing yielded higher values (26.7 ± 6.4 mL·kg−1·min−1) compared with cycle ergometry (23.7 ± 5.7 mL·kg−1·min−1), with values ~12% greater for treadmill. When comparing tests to their respected predicted values within modality, treadmill tests were 8% lower and cycle ergometry tests were 10% lower than predicted. Conclusions: While peak aerobic capacity was very low for this population, treadmill tests were still higher than cycle ergometry data, with this difference between modes being similar to that observed in healthy adult populations. Additional research is required to determine if these findings are impacted by participation in physical activity or regular exercise.

To Study the Clinical Profile and Management of Cellulitis of Lower Limb in Northern India

2021 ◽  
pp. 153473462098667
Author(s):  
Tripta S. Bhagat ◽  
Luv Kumar ◽  
Prakhar Garg ◽  
Apoorv Goel ◽  
Amit Aggarwal ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Lower Limb ◽  
Surgical Intervention ◽  
Significant Risk ◽  
Cross Sectional Study ◽  
Common Complication ◽  
Cross Sectional ◽  
Medical College ◽  
Northern India ◽  
Working Age

Cellulitis is a bacterial infection of the dermis and subcutaneous tissues occupying a large proportion of hospital beds. This study was conducted for analysis of patients with cellulitis according to their demographics and clinical presentation and to examine their comorbidities, complications, and its management. This observational cross-sectional study was conducted in the Department of Surgery at Santosh Medical College and Hospitals involving a total of 60 cases having cellulitis and other soft tissue infections of lower limb. Analysis of their demographic profile, management, and complications was done. Cellulitis is seen commonly in males, 46 (76.6%). The mean age of patients affected by cellulitis in the study was 36.4 ± 1.23 years. The most common site affected is leg involving more people in field jobs. The most common risk factor was trauma in 46.6%, and other factors were diabetes mellitus and smoking, while abscess formation was the most common complication observed in 36.6% of cases. A total of 56.6% cases were managed conservatively, while 43.3% cases required surgical intervention. Mean hospital stay in this study was 5.02 ± 0.23 days. It was concluded that cellulitis is subcutaneous, spreading bacterial infection is more common in males, and its incidence is highest in working age group population. Lower limb is commonly involved. Trauma, smoking, and diabetes are significant risk factors for development of cellulitis. Abscess is the most common complication. About 50% patients with cellulitis can be managed conservatively and the rest require surgical intervention.

scholarly journals Minimum acceptable diet among children aged 6–23 months in South Kivu, Democratic Republic of Congo: a community-based cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Richard Mbusa Kambale ◽  
Gaylord Amani Ngaboyeka ◽  
Joe Bwija Kasengi ◽  
Sarah Niyitegeka ◽  
Boss Rutakaza Cinkenye ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Feeding Practices ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Republic Of Congo ◽  
Wide Range ◽  
South Kivu

Abstract Background Suboptimal child nutrition remains the main factor underlying child undernutrition in Democratic Republic of Congo (DRC). This study aimed to assess the prevalence of minimum acceptable diet and associated factors among children aged 6–23 months old. Methods Community-based cross-sectional study including 742 mothers with children aged 6–23 months old was conducted in 2 Health Zones of South Kivu, Eastern DRC. WHO indicators of Infant and Young Child Feeding (IYCF) regarding complementary feeding practices were used. Logistic regression analysis was used to quantify the association between sociodemographic indicators and adequate minimum acceptable diet for both univariate and multivariate analysis. Results Overall, 33% of infants had minimum acceptable diet. After controlling for a wide range of covariates, residence urban area (AOR 2.39; 95% CI 1.43, 3.85), attendance postnatal care (AOR 1.68; 95% CI 1.12, 2.97), education status of mother (AOR 1.83; 95% CI 1.20, 2.77) and household socioeconomic status (AOR 1.72; 95% CI 1.14, 2.59) were factors positively associated with minimum acceptable diet. Conclusion Actions targeting these factors are expected to improve infant feeding practices in South Kivu.

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