A Narrative Review on the Tests Used in Biomechanical Functional Assessment of the Foot and Leg: Diagnostic Tests of Deformities and Compensations

2020 ◽  
Vol 110 (6) ◽  
Author(s):  
Gaetano Di Stasio ◽  
Mia Montanelli
Keyword(s):  
Functional Assessment ◽  
Lower Limb ◽  
Diagnostic Tests ◽  
Evaluation Model ◽  
Scientific Evidence ◽  
Numerical Data ◽  
Functional Evaluation ◽  
Diagnostic Reliability ◽  
Clinical Diagnostic ◽  
Depth Analysis

Background To date, scientific literature has not as yet come up with any review showing the diagnostic tests used for functional assessment of the foot and leg. Methods A literature review was conducted of electronic databases (MEDLINE, PEDro, DOAJ, BioMed Central, PLOS, and Centre for Reviews and Dissemination at the University of York) up to December 8, 2018. The biomechanical tests, which have adequate supportive literature, were divided into qualitative tests that provide a dichotomy/trichotomy-type answer to clinical diagnostic questions; semiquantitative tests that provide numerical data to clinical diagnostic questions; and quantitative tests that record continuous numerical data (in analogue or digital form). Results These tests produce a useful functional evaluation model of the foot and leg for different purposes: evaluation of lower limb deficits or abnormalities in healthy patients and in athletes (in sports or other physical activities); assessment of tissue stress syndromes caused by pathomechanics; evaluation of lower limb deficits or abnormalities in rheumatic disease and diabetic foot patients; and to determine the appropriate functional or semifunctional foot orthotic therapy and therapeutic path used in gait rehabilitation. Conclusions Many of these tests have adequate diagnostic reliability and reproducibility and therefore can be considered diagnostic. Few of these are validated, and some have initiated the validation process by determining their sensitivity and specificity. The widespread use of these tools in clinical practice (diagnosis of function) lacks scientific evidence and in-depth analysis of their limitations.

scholarly journals Evaluating the Use of a Negative D-Dimer and Modified Low Wells Score in Excluding above Knee Deep Venous Thrombosis in an Outpatient Population, Assessing Need for Diagnostic Ultrasound

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Maryam Rahiminejad ◽  
Anshul Rastogi ◽  
Shirish Prabhudesai ◽  
David Mcclinton ◽  
Peter MacCallum ◽  
...  
Keyword(s):  
Risk Factor ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Lower Limb ◽  
Clinical Risk Factor ◽  
Diagnostic Pathway ◽  
Clinical Diagnostic ◽  
Retrospective Audit ◽  
Wells Score ◽  
D Dimer

Aims. Colour doppler ultrasonography (CDUS) is widely used in the diagnosis of deep venous thrombosis (DVT); however, the number of scans positive for above knee DVT is low. The present study evaluates the reliability of the D-dimer test combined with a clinical probability score (Wells score) in ruling out an above knee DVT and identifying patients who do not need a CDUS. Materials and Method. This study is a retrospective audit and reaudit of a total of 816 outpatients presenting with suspected lower limb DVT from March 2009 to March 2010 and from September 2011 to February 2012. Following the initial audit, a revised clinical diagnostic pathway was implemented. Results. In our initial audit, seven patients (4.9%) with a negative D-dimer and a low Wells score had a DVT. On review, all seven had a risk factor identified that was not included in the Wells score. No patient with negative D-dimer and low Wells score with no extra clinical risk factor had a DVT on CDUS (negative predictive value 100%). A reaudit confirmed adherence to our revised clinical diagnostic pathway. Conclusions. A negative D-dimer together with a low Wells score and no risk factors effectively excludes a lower limb DVT and an ultrasound is unnecessary in these patients.

Preprocedural β-Blockers in the Functional Assessment of Intermediate Coronary Lesions by Instantaneous Wave-Free Ratio

Angiology ◽  
2021 ◽  
pp. 000331972199617
Author(s):  
Monica Verdoia ◽  
Rocco Gioscia ◽  
Matteo Nardin ◽  
Orazio Viola ◽  
Marta Francesca Brancati ◽  
...  
Keyword(s):  
Functional Assessment ◽  
Lesion Length ◽  
Functional Evaluation ◽  
Luminal Diameter ◽  
Coronary Syndrome ◽  
Coronary Stenoses ◽  
Minimal Luminal Diameter ◽  
Coronary Lesions ◽  
Β Blockers ◽  
The Impact

Aim: Instantaneous wave-free ratio (iFR) has emerged as the strategy of choice for the assessment of intermediate coronary lesions. The impact of preprocedural β-blockers therapy on the iFR was the aim of this study. Methods: We included patients undergoing functional assessment of intermediate (40%-70%) coronary lesions in 2 centers. The iFR measurement was performed by pressure-recording guidewire and calculated at the core laboratory using the manufacturers’ dedicated software. Minimal luminal diameter, reference diameter, percent diameter stenosis, and length of the lesion were measured. Positive iFR was considered for values <0.90. Results: We included 197 patients undergoing functional evaluation of 223 coronary lesions. Patients on β-blockers (69%) had more frequently hypertension ( P = .05); previous myocardial infarction ( P = .01); therapy with clopidogrel ( P = .02), statins, and aspirin; and acute coronary syndrome at presentation ( P < .001, respectively). Mean iFR values were slightly higher in patients on β-blockers (0.94 ± 0.06 vs 0.92 ± 0.06, P = .11). The rate of positive iFR was significantly lower with β-blockers (14.9% vs 27.5%, P = .04). On multivariate analysis, β-blockers use was a predictor of the significance of coronary stenoses (odds ratio [OR] = 0.48; 95% CI = 0.23-0.98; P = .05) together with lesion length (OR = 1.04; 95% CI = 1.01-1.07; P = .007). Conclusion: Among patients undergoing iFR, preprocedural β-blockers are associated with higher absolute values and a lower rate of positive iFR.

scholarly journals The short musculoskeletal functional assessment (SMFA) score amongst surgical patients with reconstructive lower limb injuries in war wounded civilians

Injury ◽  
2014 ◽  
Vol 45 (12) ◽  
pp. 1996-2001 ◽  
Author(s):  
Carrie Teicher ◽  
Nancy L. Foote ◽  
Ali M.K. Al Ani ◽  
Majd S. Alras ◽  
Sufyan I. Alqassab ◽  
...  
Keyword(s):  
Functional Assessment ◽  
Lower Limb ◽  
Surgical Patients ◽  
Lower Limb Injuries ◽  
Limb Injuries

scholarly journals User Experience Evaluation of Cross-Channel Consumption: Based on Grounded Theory and Neural Network

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Hua Yang ◽  
Huiying Wei ◽  
Xiang He ◽  
Yue Yan ◽  
Xiaoju Liu
Keyword(s):  
Neural Network ◽  
Grounded Theory ◽  
User Experience ◽  
Index System ◽  
Evaluation Model ◽  
Evaluation Index System ◽  
Theoretical Research ◽  
Evaluation Index ◽  
Channel Switching ◽  
Depth Analysis

With the rapid development of e-commerce technology, cross-channel consumption has become the mainstream mode of contemporary consumers. However, there are several problems of cross-channel consumption such as inconsistency of online and offline channel information and service, disfluency of channel switching which have brought adverse effects on user experience. The question arises here as to what factors influence user experience and how to build a scientific and effective evaluation index system. Different from previous studies based on sellers, this paper used grounded theory to analyze and summarize the evaluation index system of user experience under cross-channel consumption from the perspective of consumers. We summarized and refined four first level indexes which are “online platform attribute, offline entity attribute, channel switching attribute, and individual demand” and 13 second level indexes which are “platform operation, platform information, platform service, platform promotion, product quality, service quality, environment quality, channel consistency, channel switching cost, channel switching fluency, psychological expectation, personal interests and individual needs.” Then, we used BP neural network to build the evaluation model and trained and simulated the performance of the sample. The results show that the evaluation model has a good generalization ability and can effectively evaluate user experience under cross-channel consumption. Finally, implications and limitations are also discussed. This study helps to enrich the theoretical research on user experience and consumer behavior. It also provides targeted basis for in-depth analysis of cross-channel consumption behavior, establishment of user experience evaluation index system, and improving user experience and multichannel management of physical stores.

Numerical Study of Aerodynamic Losses of Effusion Cooling Holes in Aero-Engine Combustor Liners

2010 ◽  
Vol 133 (2) ◽  
Author(s):  
A. Andreini ◽  
A. Bonini ◽  
G. Caciolli ◽  
B. Facchini ◽  
S. Taddei
Keyword(s):  
Mass Flow ◽  
Cooling System ◽  
Numerical Study ◽  
Numerical Data ◽  
Good Reliability ◽  
Data Set ◽  
Discharge Coefficients ◽  
Wide Range ◽  
Depth Analysis ◽  
Aero Engine

Due to the stringent cooling requirements of novel aero-engines combustor liners, a comprehensive understanding of the phenomena concerning the interaction of hot gases with typical coolant jets plays a major role in the design of efficient cooling systems. In this work, an aerodynamic analysis of the effusion cooling system of an aero-engine combustor liner was performed; the aim was the definition of a correlation for the discharge coefficient (CD) of the single effusion hole. The data were taken from a set of CFD RANS (Reynolds-averaged Navier-Stokes) simulations, in which the behavior of the effusion cooling system was investigated over a wide range of thermo/fluid-dynamics conditions. In some of these tests, the influence on the effusion flow of an additional air bleeding port was taken into account, making it possible to analyze its effects on effusion holes CD. An in depth analysis of the numerical data set has pointed out the opportunity of an efficient reduction through the ratio of the annulus and the hole Reynolds numbers: The dependence of the discharge coefficients from this parameter is roughly linear. The correlation was included in an in-house one-dimensional thermo/fluid network solver, and its results were compared with CFD data. An overall good agreement of pressure and mass flow rate distributions was observed. The main source of inaccuracy was observed in the case of relevant air bleed mass flow rates due to the inherent three-dimensional behavior of the flow close to bleed opening. An additional comparison with experimental data was performed in order to improve the confidence in the accuracy of the correlation: Within the validity range of pressure ratios in which the correlation is defined (>1.02), this comparison pointed out a good reliability in the prediction of discharge coefficients. An approach to model air bleeding was then proposed, with the assessment of its impact on liner wall temperature prediction.

A Study on an Evaluation Method of a Rehabilitation Robot Based on Fuzzy Comprehensive Evaluation

2014 ◽  
Vol 926-930 ◽  
pp. 1144-1147
Author(s):  
Lei Chen ◽  
Chang Niu Yang ◽  
Wen Quan Huang ◽  
Ze Gang Sun ◽  
Yu Cong Liu
Keyword(s):  
Lower Limb ◽  
Evaluation Method ◽  
Comprehensive Evaluation ◽  
Evaluation Model ◽  
Fuzzy Comprehensive Evaluation ◽  
Actual State ◽  
Rehabilitation Robot ◽  
Rehabilitation Training ◽  
Limb Rehabilitation ◽  
Lower Limb Rehabilitation

To solve the rehabilitation evaluation problem of rehabilitation training, a rehabilitation evaluation method based on fuzzy comprehensive evaluation was presented for 6-DOF wearable lower limb rehabilitation robot. Relative degradation degree was introduced to represent the transformation of the actual state of rehabilitation training and the very poor rehabilitation. On the basis, Rehabilitation evaluation model was built based on fuzzy comprehensive evaluation, each layer of which was evaluated respectively, and suggests rehabilitation evaluation results of a lower limb rehabilitation robot. The instance analysis shows that the method is reasonable and effective.

scholarly journals La valutazione delle ulcere vascolari degli arti inferiori attraverso la Wound Trend Scale: l’esperienza dell’Azienda USL di Piacenza/Assessment of vascular ulcers of the lower limbs through the Wound Trend Scale: the experience of the LHA of Piacenza

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Fabio Mozzarelli ◽  
Sara Gaetti
Keyword(s):  
Vascular Surgery ◽  
Health Authority ◽  
Lower Limb ◽  
Predictive Ability ◽  
Lower Limbs ◽  
Convenience Sample ◽  
Venous Ulcers ◽  
Appropriate Care ◽  
Depth Analysis ◽  
Type Of Injury

Le ulcere cutanee vascolari degli arti inferiori, siano esse di origine venosa, arteriosa o mista, rappresentano una patologia diffusa che colpisce dallo 0,3 al 5% della popolazione, consumando fra l'1 ed il 3% del fondo sanitario Nazionale. La cura delle persone con questo tipo di lesioni deve avvalersi di strumenti idonei alla valutazione delle caratteristiche delle ulcere in modo che possa innescare il trattamento clinico/assistenziale più adeguato. Il presente studio intende verificare l'appropriatezza nella descrizione delle lesioni e la capacità predittiva sull’evoluzione delle stesse della Wound Trend Scale (WTS). La ricerca è stata condotta presso l’unità operativa di chirurgia vascolare e nell’ambulatorio di vulnologia dell’Azienda USL di Piacenza; ha coinvolto 11 pazienti con 12 lesioni vascolari degli arti inferiori. Il campione di convenienza utilizzato era composto per la maggior parte da pazienti di sesso femminile (73%) con un’età media di 79,2 anni (DS±0,7). È emersa una maggiore frequenza di ulcere venose (58%) prevalentemente localizzate in sede perimalleolare (50%). La WTS composta da 14 items, oltre ad informare rispetto alle caratteristiche delle lesioni, permette di indicare l’evoluzione delle stesse attraverso tre misurazioni seriate con intervalli stabiliti in base alla gravità della ferita. Dallo studio è emerso che l’83% delle ulcere ha mostrato un’evoluzione verso la guarigione, mentre il restante 17% è stato connotato da un peggioramento della lesione. La WTS si pone come un valido strumento per la descrizione delle ulcere con caratteristiche di predittività rispetto all’evoluzione delle stesse ma necessita di maggiori approfondimenti per testarne l’appropriatezza. Vascular ulcers of the lower limbs, be they venous, arterial or mixed, represent a widespread pathology affecting from 0,3 to 5% of the population, consuming between 1 and 3% of the National health fund. The care of people with this type of injury must use tools that are suitable for assessing the characteristics of ulcers so that it can trigger the most appropriate care treatment. The present study intends to verify the appropriateness in the description of the lesions and the predictive ability on the evolution of the same ones of the Wound Trend Scale (WTS). The research was conducted at the vascular surgery ward and in the volnology service of the Health Authority of Piacenza; involved 11 patients with 12 lower limb vascular ulcers. The convenience sample used was mostly composed of female patients (73%) with a mean age of 79,2 years (DS±0.7). A greater frequency of venous ulcers (58%) has emerged, mainly located in the perimalleolar site (50%). The WTS consists of 14 items, in addition to informing the characteristics of the lesions, premise to indicate the evolution of the same through three measurements with intervals established based on the severity of the wound. The study found that 83% of ulcers showed an evolution towards healing, while the remaining 17% was characterized by a worsening of the lesion. The WTS stands as a valid tool for the description of ulcers with predictive characteristics with respect to their evolution but needs more in-depth analysis to test their appropriateness.

scholarly journals Management of celiac disease: from evidence to clinical practice

2017 ◽  
Vol 11 (4) ◽  
pp. 345
Author(s):  
Tiziana M. Attardo ◽  
Elena Magnani ◽  
Carlotta Casati ◽  
Danilo Cavalieri ◽  
Pietro Crispino ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Diagnostic Tests ◽  
Genetic Factors ◽  
Clinical Presentation ◽  
Scientific Evidence ◽  
Methodological Approach ◽  
Human Leukocyte ◽  
Gluten Sensitivity ◽  
Adoptive Immunity

Celiac disease (CD) is a complex polygenic disorder, which involves genetic factors human leukocyte complex (HLA) and non-HLA genes, environmental factors, innate and adoptive immunity, and a robust chronic T-mediated autoimmune component. The main goal of the present monograph is to define a methodological approach for the disease, characterized by frequent late diagnosis, in order for the physician to become aware of the disease management, the diversity of the clinical presentation itself and in different patients. A unique attention is payed to the specific diagnostic tests to define a correct and accurate application of them, and in addition, to disease follow-up and possible complications. Moreover, a dedicated space is assigned to refractory CD, to potential CD and non-celiac gluten sensitivity. Legislative aspects of the celiac disease in Italy are addressed, too. The celiac disease guidelines and their evaluation by means of Appraisal of Guidelines, Research and Evaluation II instrument allow us to classify the different recommendations and to apply them according to the stakeholders’ involvement, pertinence, methodological accuracy, clarity and publishing independence. Finally, the most current scientific evidence is taken into account to create a complete updated monograph.

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