scholarly journals Monoclonal Gammopathy Presenting as Peripheral Neuropathy

2021 ◽  
Author(s):  
Vishaka Agarwal ◽  
Koukutla Soundarya Rajeshwari ◽  
KT Jayakumar ◽  
. Satish ◽  
Chetan Somu
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Position Sense ◽  
Joint Position Sense ◽  
Lower Limbs ◽  
Foot Drop ◽  
Thigh Muscle ◽  
Upper Limbs ◽  
Long Duration

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a disorder of peripheral nervous system, which presents with a long duration (eight weeks) of sensory and/or motor, symmetric/asymmetric symptoms. Aetiology ranges from infections, inflammations, autoimmune disorders, to vasculitis and malignancies. Hereby, authors report a case of a male patient who presented with complains of bilateral lower limb numbness and weakness, and bilateral upper limb numbness, since two months, which was gradually progressive. On examination, he was found to have muscle wasting in his bilateral upper limb web spaces, left anterior thigh muscle, decreased tone in bilateral upper limbs and lower limbs, decreased power in both his upper limbs distally and decreased power in both his lower limbs (distal>>proximal) was seen. Superficial reflexes were normal with bilateral plantar being equivocal. Deep tendon reflexes were absent in bilateral upper and lower limbs. Tremors of bilateral upper limbs on extension were present. Loss of vibration sense throughout, loss of joint position sense at bilateral big toe and ankle joint and foot drop of his left lower limb were noticed. A diagnosis of CIDP with underlying plasma cell disorder was made after serum electrophoresis, immune-fixation and electrodiagnostic studies. The patient was started on prednisone 60 mg once daily, discharged and advised for monthly follow-up. Diagnosis of CIDP and the underlying cause is multifactorial, which can be misdiagnosed, presenting as a challenge. Hence, a detailed clinical examination, appropriate investigations are very crucial in diagnosing and treating a case of CIDP and its underlying cause. Treatment includes glucocorticoids like prednisone, IV Ig (Intravenous Immunoglobulin), plasma exchange, treating the underlying cause.

scholarly journals Cross-Sectional Survey of Musculoskeletal Disorders in Workers Practicing Traditional Methods of Underground Coal Mining

2020 ◽  
Vol 17 (7) ◽  
pp. 2566
Author(s):  
Madiha Ijaz ◽  
Sajid Rashid Ahmad ◽  
Muhammad M. Akram ◽  
Steven M. Thygerson ◽  
Falaq Ali Nadeem ◽  
...  
Keyword(s):  
Coal Mining ◽  
Upper Limb ◽  
Lower Limb ◽  
Lower Limbs ◽  
Underground Mines ◽  
Upper Limbs ◽  
Underground Coal Mining ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
R Programming

Background: In subcontinental underground mines, coal mining is carried out manually and requires many laborers to practice traditional means of coal excavation. Each task of this occupation disturbs workers’ musculoskeletal order. In order to propose and practice possible ergonomic interventions, it is necessary to know what tasks (drilling and blasting, coal cutting, dumping, transporting, timbering and supporting, loading and unloading) cause disorder in either upper limbs, lower limbs, or both. Methods: To this end, R-programming, version R 3.1.2 and SPSS, software 20, were used to calculate data obtained by studying 260 workers (working at different tasks of coal mining) from 20 mines of four districts of Punjab, Pakistan. In addition, a Standard Nordic Musculoskeletal Questionnaire (SNMQ) and Rapid Upper Limb Assessment (RULA) sheet were used to collect data and to analyze postures respectively. Results: In multi regression models, significance of the five tasks for upper and lower limb disorder is 0.00, which means that task based prevalence of upper and lower limb disorders are common in underground coal mines. The results of the multiple bar chart showed that 96 coal cutters got upper limb disorders and 82 got lower limb disorders. The task of timbering and supporting was shown to be dangerous for the lower limbs and relatively less dangerous for the upper limbs, with 25 workers reporting pain in their lower limbs, and 19 workers reporting pain in their upper limbs. Documented on the RULA sheet, all tasks got the maximum possible score (7), meaning that each of these tasks pose a threat to the posture of 100% of workers. The majority of participants (182) fell in the age group of 26 to 35 years. Of those workers, 131 reported pain in the lower limbs and slight discomfort (128) in the upper limbs. The significance value of age was 0.00 for upper limb disorder and was 0.012 for lower limb disorder. Frequency graphs show age in direct proportion to severity of pain while in inverse proportion with number of repetitions performed per min. Conclusions: All findings infer that each task of underground coal mining inflicts different levels of disorder in a workers’ musculoskeletal structure of the upper and lower limbs. It highlighted the need for urgent intervention in postural aspects of each task.

scholarly journals Neural coupling between upper and lower limbs during recumbent stepping

2004 ◽  
Vol 97 (4) ◽  
pp. 1299-1308 ◽  
Author(s):  
Helen J. Huang ◽  
Daniel P. Ferris
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Lower Limbs ◽  
Gait Rehabilitation ◽  
Upper Limbs ◽  
Neurologically Impaired ◽  
Resistance Level ◽  
Neuromuscular Activation ◽  
Lower Limb Muscles ◽  
Robotic Devices

During gait rehabilitation, therapists or robotic devices often supply physical assistance to a patient's lower limbs to aid stepping. The expensive equipment and intensive manual labor required for these therapies limit their availability to patients. One alternative solution is to design devices where patients could use their upper limbs to provide physical assistance to their lower limbs (i.e., self-assistance). To explore potential neural effects of coupling upper and lower limbs, we investigated neuromuscular recruitment during self-driven and externally driven lower limb motion. Healthy subjects exercised on a recumbent stepper using different combinations of upper and lower limb exertions. The recumbent stepper mechanically coupled the upper and lower limbs, allowing users to drive the stepping motion with upper and/or lower limbs. We instructed subjects to step with 1) active upper and lower limbs at an easy resistance level (active arms and legs); 2) active upper limbs and relaxed lower limbs at easy, medium, and hard resistance levels (self-driven); and 3) relaxed upper and lower limbs while another person drove the stepping motion (externally driven). We recorded surface electromyography (EMG) from six lower limb muscles. Self-driven EMG amplitudes were always higher than externally driven EMG amplitudes ( P < 0.05). As resistance and upper limb exertion increased, self-driven EMG amplitudes also increased. EMG bursts during self-driven and active arms and legs stepping occurred at similar times. These results indicate that active upper limb movement increases neuromuscular activation of the lower limbs during cyclic stepping motions. Neurologically impaired humans that actively engage their upper limbs during gait rehabilitation may increase neuromuscular activation and enhance activity-dependent plasticity.

scholarly journals Chronic inflammatory demyelinating polyneuropathy presenting with autonomic symptoms: a case report

2017 ◽  
Vol 4 (1) ◽  
pp. 282
Author(s):  
Alagoma M. Iyagba ◽  
Pedro C. Emem Chioma
Keyword(s):  
Nerve Conduction ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Conduction Block ◽  
Sensory Nerve ◽  
Weather Conditions ◽  
Position Sense ◽  
Joint Position Sense ◽  
Nerve Conduction Studies ◽  
Lower Limbs ◽  
Hands And Feet

A 31 year old female presented with a one-year history of burning sensations, numbness and tingling feelings in her hands and feet. There was also excessive sweatiness of her hands and feet while experiencing these symptoms. Her symptoms were worse at night and during hot weather conditions and aggravated by contact with light clothing. She could not tolerate her shoes. She also complained of weakness in her distal lower limbs. Examination revealed prominent wasting of the thenar and hypothenar eminences, marked bilateral weakness of hand grip, palmar, and dorsal interossei. There was also the significant weakness of the dorsiflexor of the feet with allodynia. Vibration and joint position sense were impaired in the distal lower limbs. Ankle reflexes were diminished. Nerve conduction studies showed nerve conduction block in three nerves. She also had abnormalities from motor and sensory nerve conduction studies involving multiple nerves. She showed remarkable improvements in her symptoms after a course of pulsed oral dexamethasone therapy.

Recordings from Human Dorsal Column Nuclei Using Stimulation of the Lower Limb

Neurosurgery ◽  
1990 ◽  
Vol 26 (2) ◽  
pp. 291-299 ◽  
Author(s):  
Aage R. Møller ◽  
Peter J. Jannetta ◽  
Hae Dong Jho
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Peroneal Nerve ◽  
Dorsal Surface ◽  
Dorsal Column ◽  
Spasmodic Torticollis ◽  
Lower Limbs ◽  
Upper Limbs ◽  
Dorsal Column Nuclei ◽  
Stimulation Of

Abstract Responses from the surface of the dorsal column nuclei and the dorsal surface of the spinal cord were recorded using monopolar electrodes after stimulation of the lower limbs (common peroneal nerve at the knee and posterior tibial nerve at the ankle) in patients undergoing neurosurgical operations for spasmodic torticollis. Those responses were smaller in amplitude than responses to stimulation of the upper limbs (median nerve at the wrist), and the waveforms differed. The negative deflection that is prominent in the response to stimulation of the upper limbs is more variable, broader, and relatively smaller in amplitude than the response to upper limb stimulation. Another difference between responses to upper and lower limb stimulation was that multiple peaks were superimposed on the initial response to stimulation of the lower limbs, but were not as consistently seen in the responses to upper limb stimulation. The negative peak in the response from the dorsal column nuclei to lower limb stimulation was of about the same latency as the P27peak in the far-field response (somatosensory evoked potential) to stimulation of the peroneal nerve.

Use of upper-limb compression garments in the management of lipoedema

2021 ◽  
Vol 3 (Sup4) ◽  
pp. S2-S4
Author(s):  
Rebecca Elwell ◽  
Anna Rich
Keyword(s):  
Health Service ◽  
Upper Limb ◽  
Resource Use ◽  
Lower Limb ◽  
Lower Limbs ◽  
Upper Limbs ◽  
Compression Garments ◽  
Anti Inflammatory ◽  
Compression Treatment ◽  
Limb Compression

Compression hosiery is commonly used for the management of lymphoedema as well as lipoedema, but it is more commonly indicated for the lower limbs than for the upper limbs. The effects of compression hosiery on upper-limb lipoedema are poorly understood and researched. It is known that compression hosiery works in conjunction with activity or movement when standing or walking, which produces anti-inflammatory and oxygenating effects in the tissues. This effect is naturally difficult to realise in the upper limbs. Lymphoedema practitioners who treat those with lipoedema should bear in mind that compression treatment might not produce the same effects in upper-limb lipoedema as it does in lower-limb lipoedema. In these times of an overstretched health service, pragmatic resource use is essential.

Use of upper-limb compression garments in the management of lipoedema

2020 ◽  
Vol 25 (Sup10) ◽  
pp. S26-S27
Author(s):  
Rebecca Elwell ◽  
Anna Rich
Keyword(s):  
Health Service ◽  
Upper Limb ◽  
Resource Use ◽  
Lower Limb ◽  
Lower Limbs ◽  
Upper Limbs ◽  
Compression Garments ◽  
Anti Inflammatory ◽  
Compression Treatment ◽  
Limb Compression

Compression hosiery is commonly used for the management of lymphoedema as well as lipoedema, but it is more commonly indicated for the lower limbs than for the upper limbs. The effects of compression hosiery on upper-limb lipoedema are poorly understood and researched. It is known that compression hosiery works in conjunction with activity or movement when standing or walking, which produces anti-inflammatory and oxygenating effects in the tissues. This effect is naturally difficult to realise in the upper limbs. Lymphoedema practitioners who treat those with lipoedema should bear in mind that compression treatment might not produce the same effects in upper-limb lipoedema as it does in lower-limb lipoedema. In these times of an overstretched health service, pragmatic resource use is essential.

Computed tomography angiography and microsurgical flaps for traumatic wounds: What is the added value?

2021 ◽  
pp. 1-9
Author(s):  
Lucas Sousa Macedo ◽  
Renato Polese Rusig ◽  
Gustavo Bersani Silva ◽  
Alvaro Baik Cho ◽  
Teng Hsiang Wei ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Upper Limb ◽  
Computed Tomography Angiography ◽  
Lower Limb ◽  
High Energy ◽  
Lower Limbs ◽  
Added Value ◽  
Vascular Lesions ◽  
Limb Injuries ◽  
Significant Difference

BACKGROUND: Microsurgical flaps are widely used to treat complex traumatic wounds of upper and lower limbs. Few studies have evaluated whether the vascular changes in preoperative computed tomography angiography (CTA) influence the selection of recipient vessel and type of anastomosis and the microsurgical flaps outcomes including complications. OBJECTIVE: The aim of this study was to evaluate if preoperative CTA reduces the occurrence of major complications (revision of the anastomosis, partial or total flap failure, and amputation) of the flaps in upper and lower limb trauma, and to describe and analyze the vascular lesions of the group with CTA and its relationship with complications. METHODS: A retrospective cohort study was undertaken with all 121 consecutive patients submitted to microsurgical flaps for traumatic lower and upper limb, from 2014 to 2020. Patients were divided into two groups: patients with preoperative CTA (CTA+) and patients not submitted to CTA (CTA–). The presence of postoperative complications was assessed and, within CTA+, we also analyzed the number of patent arteries on CTA and described the arterial lesions. RESULTS: Of the 121 flaps evaluated (84 in the lower limb and 37 in the upper limb), 64 patients underwent preoperative CTA. In the CTA+ group, 56% of patients with free flaps for lower limb had complete occlusion of one artery. CTA+ patients had a higher rate of complications (p = 0.031), which may represent a selection bias as the most complex limb injuries and may have CTA indicated more frequently. The highest rate of complications was observed in chronic cases (p = 0.034). There was no statistically significant difference in complications in patients with preoperative vascular injury or the number of patent arteries. CONCLUSIONS: CTA should not be performed routinely, however, CTA may help in surgical planning, especially in complex cases of high-energy and chronic cases, since it provides information on the best recipient artery and the adequate level to perform the microanastomosis, outside the lesion area.

scholarly journals Audio-visual stimulation in conjunction with functional electrical stimulation to address upper limb and lower limb movement disorder

2016 ◽  
Vol 26 (2) ◽  
Author(s):  
Deepesh Kumar ◽  
Sunny Verma ◽  
Sutapa Bhattacharya ◽  
Uttama Lahiri
Keyword(s):  
Electrical Stimulation ◽  
Movement Disorder ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Lower Limb ◽  
Neurological Disorders ◽  
Visual Stimulation ◽  
Lower Limbs ◽  
Lower Limb Movement ◽  
Rehabilitation Exercises

Neurological disorders often manifest themselves in the form of movement deficit on the part of the patient. Conventional rehabilitation often used to address these deficits, though powerful are often monotonous in nature. Adequate audio-visual stimulation can prove to be motivational. In the research presented here we indicate the applicability of audio-visual stimulation to rehabilitation exercises to address at least some of the movement deficits for upper and lower limbs. Added to the audio-visual stimulation, we also use Functional Electrical Stimulation (FES). In our presented research we also show the applicability of FES in conjunction with audio-visual stimulation delivered through VR-based platform for grasping skills of patients with movement disorder.

Effect of multidirectional and unidirectional wobble board lateral step-upexercise in pain, symptom and ADLamong unilateral medial compartmental osteoarthrosis of knee

Biomedicine ◽  
2021 ◽  
Vol 41 (3) ◽  
pp. 669-677
Author(s):  
K Kotteeswaran ◽  
Natarajan Shanmugasundaram ◽  
S. Shalini ◽  
M.V. Sowmya
Keyword(s):  
Daily Living ◽  
Muscle Power ◽  
Balance Control ◽  
Weight Bearing ◽  
Position Sense ◽  
Joint Position Sense ◽  
Exercise Group ◽  
Thigh Muscle ◽  
Control Group ◽  
Pain Symptom

Introduction and Aim:Osteoarthrosis is defined as degenerative condition of the synovial joints. Weak thigh muscle will cause impaired walking and balance and leads to risk of fall during activities of daily living. Use of MD and UD wobble board is hypothesized to improve balance and proprioception. So, pain, muscle power and proprioception are clinically important for balance control. Hence there is a need to study weight bearing exercise to hip abductor in various balance strategies to achieve muscle strength, joint position sense, balance, and activity of daily living.   Methodology: Knee osteoarthrosis subjects(n=219) were selected according to selection criteria andwere randomly allocated into 3 groups as multidirectional wobble board lateral step-up exercise group, unidirectional wobble board lateral step-up exercise group and control group. The pre-test KOOS pain, symptoms and ADL measurements were taken before the intervention and another measurement during the 2nd week of intervention and at the end of the intervention period during 4thweek post-test measurements were measured and statistically analysed.   Results:  At the end of 4th week control, UD and MD was found to be statistically significant with H=200.192 with p<0.001. KOOS symptoms between 3 groups was found to be statistically significant with H=200.288 and p <0.001. KOOS ADL values was found to be statistically significant between 3 groups with H=193.640 and p<0.001.   Conclusion: This study concludes that both unidirectional and multidirectional wobble board lateral step-up exercise showed improvement with KOOS pain, symptom and ADL scores compared to control group.

scholarly journals Maturational stages: comparison of growth and physical capacity indicators in adolescents

2018 ◽  
Vol 28 (1) ◽  
pp. 42 ◽  
Author(s):  
Vanessa Carla Monteiro Pinto ◽  
Petrus Gantois Massa Dias dos Santos ◽  
Rafaela Catherine Da Silva Cunha de Medeiros ◽  
Francisco Emílio Simplício Souza ◽  
Thaisys Blanc dos Santos Simões ◽  
...  
Keyword(s):  
Upper Limb ◽  
Motor Performance ◽  
Evaluation Method ◽  
Physical Capacity ◽  
Lower Limbs ◽  
Stage Iii ◽  
Childhood And Adolescence ◽  
Upper Limbs ◽  
Explosive Strength ◽  
Maturational Stage

Introduction: The identification of physical capacity is an important marker related to healthy behavior during childhood and adolescence, in which some factors appear to contribute to motor performance such as maturation and hormonal levels. Objective: To compare growth indicators, physical capacity and hormonal markers according to gender and maturational stage in adolescents. Methods: Eighty-nine adolescents of both genders aged 10-13 years participated in the study. Sexual maturation was evaluated using the Tanner’s self-evaluation method. Physical capacity (explosive strength of upper and lower limbs, upper limb velocity and agility) and hormonal markers (testosterone and estradiol) were evaluated through the chemiluminescence method. Results: In the comparison by gender, girls had higher weight (p = 0.023), height (p = 0.018) and fat percentage values (p = 0.001), while boys presented better motor performance for the explosive strength of upper limbs (p = 0.005) and lower limbs (p = 0.011), agility (0.018) and upper limb velocity (p = 0.014). Regarding maturational stage, boys did not present differences in any variable analyzed; (Stage V versus I), height (stage III, IV and V versus I) and upper limb explosive strength (stage III and IV versus I). Conclusion: Growth, weight and height, as well as explosive strength of upper limbs were higher in girls at more advanced maturational stages and appear to be gender dependent.

Sign in / Sign up

Export Citation Format

Share Document