Double Foot Research Articles

TREINAMENTO DE FORÇA EM MEMBROS INFERIORES PARA JOGADORES DE BASQUETEBOL

ABSTRACT Introduction: Lower limb strength training can improve body balance and impact the professional level of athletes. According to recent research, the strength training design has been gaining emphasis in supplementing the training of Chinese basketball professionals, although it still lacks evidence about its real optimization effect. Objective: Study the lower limb explosive strength training method in basketball players by exploring its optimization effects. Methods: The randomized controlled experiment on 30 students randomly divided into control and experimental groups lasted 12 weeks, with three weekly training sessions, each lasting 80 minutes. The control group underwent the traditional mode of lower limb strength training. In contrast, the experimental group performed a functional training protocol consisting of the single-foot jump, spring exercise, push-pull exercise, and pedaling, among other movements, according to the students’ sports conditions and needs. Results: Statistically, the results of the functional evaluative tests showed an improvement of the test group's approach to single foot takeoff touch to (3.389 ± 0.042) m, the optimization rate was 2.5078%, the double foot takeoff touch height was improved to (3, 016 ± 0.299) m, the optimization rate was 0.7950%, the whole fast dribbling range was reduced to (20.176 ± 0.374) s, the optimization rate was 6.0401%, and benefit spectrum was significantly higher than that of the control group. Conclusion: Functional strength training can significantly increase the explosive power of the lower limbs of basketball athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Comparison of Physical Performance Profiles in Freestyle and Greco-Romen Wrestlers

Background and Study Aim. This study aimed to examine the differences between a range of performance parameters in -Greco-Roman and Freestyle wrestlers. The study group consisted of 60 young wrestlers, of which 30 were Greco-Roman, and 30 were freestyle.
 Material and Methods. The parameters analysed in the study included aerobic endurance, lower and upper extremity anaerobic power and capacity, postural sway, change of direction, sprint (5m-10m-20m-30m), and visual reaction. After calculating mean and standard deviation values with descriptive statistical methods, the conformity of all variables to normal distribution was checked with the Shapiro-Wilk Test. Differences between freestyle and Greco-Roman wrestlers were determined by t-test for independent samples. The statistical significance level was accepted as p<0.05.
 Results. Aerobic endurance, lower and upper extremity anaerobic power and capacity, postural sway (Right Foot Anterior-Posterior, Left Foot Total, Left Anterior-Posterior, Left Foot Medial-Lateral), change of direction, 5m and 10m sprint values, and visual reaction values of Greco-Roman and Freestyle wrestlers were found similar (p>0.05). In contrast, a significant difference (p<0.05) was seen in 20m and 30m sprints, double foot total, anterior-posterior, medial-lateral, right foot total, and right foot medial-lateral postural sway values
 Conclusions. Greco-Roman and freestyle wrestlers can be said to show similar performance values despite the different wrestling techniques and training methods they use.

Design and analysis of a novel 12-DOF self-balancing lower extremity exoskeleton for walking assistance

Lower extremity exoskeletons are often used as walking assistance rehabilitation robots for paralyzed patients. However, due to the requirement of crutches or other devices to maintain balance, the under-actuated exoskeleton has limited applicability. This paper aims to design a novel mechanism for the self-balancing lower extremity exoskeleton, which structurally consistent with the human anatomy and fully actuated with 12 DOFs. In this study, based on the human-centered design principles, a bio-inspired exoskeleton mechanism synthesis methodology is presented. The novel serial-parallel hybrid mechanism is designed based on a 3-DOF RCM hip mechanism, 1-DOF parallelogram-linkage knee mechanism, and 2-DOF decoupled parallel ankle mechanism. To describe the forward and inverse kinematics of the mechanism, the closed-form solutions by the D-H method and geometric method are obtained, respectively. In addition, to analyze the exoskeleton workspace, the reachable workspace equations in the double foot support and single foot support phases are established. The numerical simulation and experimental results show the kinematics model validity and self-balancing walking ability, which illustrate the feasibility of the proposed exoskeleton mechanism.

A cross-sectional study of foot-ground clearance in healthy community dwelling Japanese cohorts aged 50, 60 and 70 years

BackgroundFalls-related injuries are particularly serious for older people, causing pain, reduced community engagement and associated medical costs. Tripping is the leading cause of falls and the current study examined whether minimum ground clearance (MFC) of the swing foot, indicating high tripping risk, would be differentiated across cohorts of healthy 50-, 60- and 70-years old community residents in Japan.MethodsA cross-sectional population comprising the three groups (50s, 60s and 70s) of 123 Konosu City residents consented to be recorded when walking on an unobstructed surface at preferred speed. Gait biomechanics was measured using high speed (100 Hz) motion capture (OptiTrack – Natural Point Inc.), including step length and width, double support, foot contact angle and MFC (swing toe height above the ground). Multivariate Analysis of Variance (MANOVA) was used to confirm ageing effects on MFC and fundamental gait parameters. Pearson’s correlations were performed to identify the relationships between mean MFC and other MFC characteristics (SD and SI), step length, step width, double support time and foot contact angle.ResultsCompared to 50s, lower step length was seen (2.69 cm and 6.15 cm) for 60s and 70s, respectively. No other statistical effects were identified for spatio-temporal parameters between the three groups. The 50s cohort MFC was also significantly higher than 60s and 70s, while step-to-step MFC variability was greater in the 70s than 50s and 60s. Pearson’s correlations demonstrated that more symmetrical gait patterns were associated with greater MFC height, as reflected in greater symmetry in step width (50s), MFC (60s) and foot contact angle (70s). In the 70s increased MFC height correlated with higher MFC variability and reduced foot contact angle.ConclusionsMFC height reduces from 60 years but more variable MFC appears later, from 70 years. While symmetrical gait was accompanied by increased MFC height, in the 70s group attempts to increase MFC height may have caused more MFC variability and lower foot contact angles, compromising foot-ground clearance. Assessments of swing foot mechanics may be a useful component of community falls prevention.

Design of automatic side stand and spring compression control system using arduino programming

Motorcycles are undoubtedly heavy, which commonly poses a problem when erecting the bike onto conventional double foot kick stands as well as it seems difficult to lift the bikes. So, using side stands is better to handle while parking bike, but it makes severe injury if the stand is not released. Most of the street side accidents occur due to lagging in releasing the side stand. This work mainly aims in designing an intelligent mechanism that automatically lifts the side stand when the driver sits in the seat. By using this control system whose setup has the ignition switch, pressure sensor,relay switch, motor drive, dc motor all controlled by the Arduino uno board through the programming interface, when the ignition switch is turned on and when the person sits on the seat integrated with spring, the spring compresses and the signals the motor to turn on and hence the stand slides up. When the ignition switch is turned off and low pressure sensed the side stand automatically pulls out to withstand the two-wheeler.

Effects of Single-Foot Centered and Double-Foot Centered X-ray Projection on Hallux Valgus Measurement.

ObjectiveTo investigate whether use of single‐foot centered and double‐foot centered weight‐bearing X‐rays has an impact on the relevant indicators of hallux valgus.MethodsA total of 55 female patients from the Department of Ankle Surgery of Beijing Tongren Hospital with hallux valgus (110 feet) were collected from September to December 2015. The age of these patients ranged from 18 to 43 years, with an average age of 47.9 ± 8.5 years. All selected patients fit the diagnostic criteria of hallux valgus and had weight‐bearing single foot centered and double foot centered radiographs taken. During the projection, all patients were instructed to stand on the X‐ray box, with the knee joint straightened and legs perpendicular to the floor. The projection center of the single foot was directed at the lateral part of the scaphoid bone of the foot, while the projection center was directed at the position between the scaphoid bones of both feet for the double‐foot shooting. The hallux valgus angle (HAV), the intermetatarsal angle between the first and second metatarsals (IMA), the intermetatarsal angle between the first and fifth metatarsals (IM1‐5), and the metatarsal adduction angle (MAA) were measured and examined. The difference between these two shooting conditions was compared and analyzed.ResultsThe differences in X‐ray measurement results (IMA, HAV, IM1‐5, and MMA) between different measures for the same patient were not statistically significant. The values of HAV, IMA, IM1‐5, and MAA are common indexes for evaluating hallux valgus. The average IMA was 15.9° for single‐foot centered and 14.1° for double‐foot centered X‐rays. The average HAV was 30.2° for single‐foot centered and 29.7° for double‐foot centered X‐rays. The average IM1‐5 was 31.1° for single‐foot centered and 29.7° for double‐foot centered X‐rays. The average of metatarsal adduction angle was 13.8° for single‐foot centered and 14.1° for double‐foot centered X‐rays. The differences between single‐foot centered and double‐foot centered X‐rays were statistically significant in terms of the measurement index (P < 0.05). In addition, compared with double‐foot centered weight‐bearing X‐rays, the focus of single‐foot centered X‐rays was located on the lateral part of the scaphoid bone of the foot, and the ray was closer to the vertical foot in the single‐foot centered weight‐bearing X‐ray.ConclusionWhen the weight‐bearing position and projection distance are the same, the single‐foot centered weight‐bearing X‐ray is more effective in evaluating the severity of hallux valgus compared with the double‐foot centered weight‐bearing X‐ray.

Design and Research on a Biped Clamp and Pull Piezoelectric Linear Motor Based on Inchworm Principle

The piezoelectric linear motor based on piezoelectric ceramic stack has a potential in high-tech field’s application such as optical waveguide packaging. Mechanical properties of piezoelectric linear motors in the existing researches still need to be improved. So have designed double foot clamping type piezoelectric linear motor based on the principle of inchworm, and analyzed the working principle. The performance analysis of the driving mechanism shows that the relationship between the amplitude of driving mechanism and voltage values is positively proportional, and the influence of frequency on its amplitude is not big. The performance of the clamping mechanism was studied through experiments. First, verified the feasibility of the principle, tested the amplitude and found that the amplitude increases with the increase of the voltage, but due to the influence of clamping mechanism modal, amplitude tends to be zero as frequency increase to a certain extent. Second, amplitudes of the driving foot in two clamping mechanism were compared to ensure the consistency of amplitude of each driving foot, and the magnification of driving mechanism displacement was obtained by clamping mechanism in the practical work. Analyzed the rail vibration caused by driving foot and the prototype speed characteristics and load characteristic, and obtained speed characteristic curve are, in which, the speed of the motor increases with increasing voltage, but will not be able to continue to increase when the voltage reached to 60V, and the related curve between frequency and speed is similar to the frequency characteristic curve of the clamping mechanism, which is mainly due to the impact from the clamping mechanism modal. Obtained the maximum output of the motor power is 1.8 N through the load characteristic experiment.

Effect of CD40 small interfering RNA on the expressions of peripheral blood interleukin-21 and interleukin-35 in rats with autoimmune myocarditis

Objective To explore the effect of CD40 small interfering RNA(siRNA) on the expressions of peripheral blood interleukin(IL)-21 and IL-35 in rats with experimental autoimmune myocarditis (EAM) and its significance. Methods Twenty 6-8 week male Lewis rats were divided into normal group, EAM group, CD40siRNA group and siRNA group by using random number table, with 5 rats in each group.The normal rats were induced with phosphate buffer saline in double foot pads on day 0 and day 7, while the rest 3 groups were induced with cardiac myosin protein to establish EAM models.The rats in CD40siRNA group and siRNA group were respectively injected with CD40siRNA and siRNA slow virus expression vector through the tail vein of rats on day 7.The rats were executed on 21 day after echocardiogram examination was made.The histopathologic changes were observed by using light microscope and the myocardial histopathology scores were calculated.Enzyme- linked immunosorbent assay was used to determine the levels of IL-21 and IL-35 in peripheral blood. Results (1)Except the normal group, the total incidence rate of rats of each group was 100%, and there was no rat death.(2)Compared with EAM group, the heart mass/body ratio and myocardial histopathology scores were lower in CD40siRNA group, and the differences were significant (3.13±0.21 vs 3.80±0.29, 2.22±0.43 vs 3.32±0.51, F=0.332, 0.456, all P< 0.05). (3)The echocardiogram showed that there was only 1 rat in EAM group with massive pericardial effusion, and there was no pericardial effusion in CD40siRNA group.EAM group, CD40siRNA group and siRNA group displayed hypertrophy of the ventricular septum and left ventricular wall, narrow heart cavity and weakening of ventricular wall motion.The left ventricular shortening rate in CD40siRNA group was significantly higher than that in the EAM group[(63.34±11.06)% vs (38.56±6.98)%, F=16.080, P<0.05]. (4)The peripheral blood level of IL-21 in CD40siRNA group was lower than that in EAM group [(141.19±17.46) ng/L vs (157.81±17.58) ng/L, F=57.008, P<0.05], while its level of IL-35 was significantly higher than that in the EAM group [(195.96±18.26) ng/L vs (174.78±13.91) ng/L, F=31.727, P<0.05]. (5)The level of IL-21 in peripheral blood was positively correlated with myocardial histopathology scores in EAM group (r= 0.69, P< 0.05), but IL-35 was negatively correlated with myocardial histopathology scores (r=-0.64, P<0.05). Conclusions CD40siRNA might relieve the myocardial inflammation and reduce the myocardial injury of EAM rats.The levels of IL-21 and IL-35 can partly reflect the degree of myocardial injury.The mechanism may be related to down-regulating the expression IL-21 and up-regulating the expression of IL-35. Key words: CD40 small interfering RNA; Autoimmune myocarditis; Rat; Interleukin-21; Interleukin-35

Double Column Foot Osteotomy to Correct Flexible Valgus Foot Deformity in Children with Spastic Cerebral Palsy

Backgound: Mobile (flexible or correctable) hindfoot valgus deformity is common in children with spastic cerebral palsy (CP). It is accompanied by short lateral and long medial foot column. Patients and Methods: Eleven ambulatory children (20 feet) suffering spastic cerebral palsy (CP), two hemiplegic and nine diplegic, presenting with mobile (flexible) hindfoot valgus deformity, were evaluated neurologically, orthopaedically, and radiographically, and operated upon in the National Institute of Neuromotor System between September 2012 and September 2013. Double column foot osteotomy with medial cuneiform closing-wedge and cuboid opening-wedge without attacking the calcaneus was performed in all of them. Results: The results were followed-up clinically and radiographically over a period ranging from a year and half (18 months) to two years (24 months) with an average of a year and 9 months (21 months), and were graded into four categories as excellent, good, fair, and poor according to the total calculated score. According to the suggested grading system, there were 8 excellent results, 8 good results, 4 fair results, and no poor results. Conclusion: Double column foot osteotomy shortening the medial foot column and lengthening the lateral foot column to correct moderate to severe hindfoot valgus in ambulatory children with spastic cerebral palsy (CP), compared favourably with similar series, and offered option for achieving foot alignment, improving pain and skin problems and avoiding the problems associated with arthrodesis. Level of Evidence: The study is type IV therapeutic level of evidence.

Correlation among proprioception, muscle strength, and balance.

[Purpose] To study the correlation among proprioception, muscle strength, and balance. [Subjects and Methods] A balance testing system (Biodex Balance System, BBS) and an isokinetic testing system (Biodex System 4, BS4) were used to test related indexes in 24 healthy young females. [Results] With the knee joint at 15 degree flexion, proprioception was significantly correlated with Limits of Stability-Time values, and was highly significantly correlated with Limits of Stability-Overall and Athlete Single Leg Medial/Lateral values. The sense of force was significantly correlated with Limits of Stability-Overall and Athlete Single Leg-Overall values. Quadriceps strength was significantly associated with Limits of Stability-Overall, Athlete Single Leg Medial/Lateral, and Athlete Double Leg-Overall values. The ratio of Quadriceps to Hamstring strength was significantly correlated with Athlete Single Leg Medial/Lateral, and Athlete Single Leg-Overall values. With the knee joint at 45°, proprioception was highly significantly correlated with dynamic balance, and was significantly correlated with double foot support under static balance; force sense had a high correlation with Limits of Stability-Overall, but no correlation with other indexes. Quadriceps strength had a significant correlation with dynamic and static balance; the ratio of Quadriceps/Hamstring had a highly significant correlation with Limits of Stability-Overall, Athlete Single Leg-Anterior/Posterior and Athlete Single Leg-Overall. [Conclusion] At different knee angles, the correlation differs among proprioception, force sense, quadriceps strength, the Quadriceps/Hamstring ratio, and balance.

Heel Ulcer and Blood Flow

A young female diabetic patient is reported, who presented with a double foot lesion. She presented with a first metatarsal head exposure concomitant with a heel wet gangrene. Magnetic resonance demonstrated osteomyelitis of the rear portion of the calcaneus. Transmetatarsal amputation was performed and a wide debridement was required to remove all gangrenous tissue from the heel wound. The pedal artery was palpable; the posterior tibial pulse was present, but weak.Transcutaneous oximetry (TcPO2) at the dorsum of the foot was TcPO2 = 56 mmHg despite significant oedema. Nevertheless, TcPO2 on the perilesional area of the heel ulcer (TcPO2 = 24mmHg) was suggestive for critical chronic ischemia. At angiographic examination, anterior tibial and peroneal arteries were patent, but the posterior tibial artery that showed severe stenosis then percutaneous angioplasty (PTA) was performed. Just the day after PTA, values of TcPO2 at the perilesional area of the heel ulcer increased to 41 mmHg. Heel osteomyelitis was subsequently treated by partial calcanectomy. The patient was discharged after a 21-day hospital stay. In the treatment of heel ulcers, it is clinically useful to use the angiosomic concept. The majority of the blood supply to the heel is provided by the posterior tibial artery, and only to a small extent by the posterior branch of peroneal artery. If the decrease in blood flow to this region is not detected, and direct flow based on the angiosome concept is not obtained, the healing of a heel ulcer may be delayed or impaired.

Effect of CD40 siRNA on Th17 cells and IL-17 and IL-23 in rats with experimental autoimmune myocarditis

Objective: To investigate the effect of CD40 siRNA on the myocardial pathologic changes, expression of Th17 cells specific transfer factor gene RORC mRNA of myocardium and concentration of Th17 cells related cytokines interleukin -17 (IL-17) and interleukin -23 (IL-23) in peripheral blood of rats with EAM. Methods: Forty 6-8 week old healthy male Lewis rats with body weight ranging from 185 to 210 gram were divided into EAM group (n=10), CD40 siRNA group (n=10), siRNA group (n=10), and control group (n=10) randomly. The rats in EAM group, CD40 siRNA group, and siRNA group were immunized with cardiac C protein and completed Freund adjuvant in double foot pads. The rats in control group were injected with PBS buffer in double foot pads. On the eighth day after immunization, rats in CD40 siRNA group and siRNA group were injected with CD40 siRNA expression vector and siRNA expression vector three times a week. These rats were sacrificed on day 21 after inoculation. The myocardial histopathologic changes were observed by light microscope and the myocardial histopathology scores were also calculated. The expression of RORC mRNA of myocardium was detected by real-time quantitative polymerase chain reaction (RQ-PCR). Enzyme linked immunoabsorption assay (ELISA) was used to determine the serum level of IL-17 and IL-23. Results: 1. Compared to EAM group, the myocardial histopathology scores in CD40 siRNA group significantly lower (13.33±5.56 vs. 17.00±2.16, P<0.05. 2. The expression of RORC mRNA in CD40 siRNA group decreased significantly compared to the EAM group (2.13±0.28 vs. 2.93±0.36,P<0.05). 3. The serum level of both IL-17 and IL-23 in CD40 siRNA group also decreased significantly compared to EAM group (both P<0.05). Conclusions: The results indicated that CD40 siRNA expression vector might reduce myocardial injury by inhibiting T helper lymphocyte IL-17 activation and down-regulating the expression of IL-17 and IL-23.

The Technology of Merging Single Force Plate Gait Trails to Simulate Full Gait Cycle in Environmental Health Research

The article studies the way of combining double foot data into one gait cycle from data collected from only one force plate, and the reliability with comparing the Root Mean Square Error (RMSE) between combined and original trails is validated. The joint moment values, knee muscles value were also computed by OpenSim based on the dynamic model. Correlation coefficients and normalized RMSE were used as the compared factors between two trails. Correlation coefficients are all above 0.9 for joint moments, and all above 0.95 for knee muscles except for biceps femoris - long head. The technology would get higher reliability and improving the accuracy of simulation result by increasing the numbers of collection trails and selecting pairs trails which got higher correlation coefficients.

Effects of Anti-Fatigue Flooring on Gait Parameters

Falls among industrial workers are the leading cause of work related injuries. Nowadays, many industries are opting for anti-fatigue cushioned flooring to reduce fall-related socio-economic cost. The goal of this study is to test SATECH's anti-fatigue flooring for stable gait. A pilot test with five healthy subjects (25–35 years old) has been conducted with six motion capture cameras and two force platforms embedded in a walkway to obtain kinematics and kinetics of whole body gait on two different floors. In conditions where the same floor material was used on the whole walkway, the anti-fatigue floor had smaller values of step length (p&lt;0.01) associated with walking and lower values of required coefficient of friction (RCOF) (p&lt;0.05). Toe clearance, heel contact velocity, whole body center of mass (COM) velocity, single foot stance, and double foot stance did not show significant differences between conditions. The results of this study suggest that subjects were to follow a more stable gait on the SATECH anti-fatigue flooring.

Stepping responses made by elderly and young female adults to approach and accommodate known surface height changes

Falls on stairs, kerbs and footpaths are a major cause of morbidity in older female adults. This investigation examined the stepping responses made by 48 elderly (mean age 67 years, S.D. 5.4 years) and 48 young (mean age 20 years, S.D. 2.4 years) healthy, community-dwelling adult females to approach and accommodate known surface height changes. The surface was designed to simulate an object like a kerb or step in the walking path. For ascent, the surface was 9 m long (height, 15 cm) with a 13 m ground-level approach. For descent, it was 15 m long (height, 15 cm) with a 7 m ground-level departure. These tasks (particularly descent) perturbed the gait of the elderly more than the young. The elderly exerted more control or were more cautious. They made earlier and larger step adjustments ( p < .05), primarily employed a short step crossing strategy (elderly, 60%; young, 19%), exhibited less footfall variability ( p < .05), moved slower across the step ( p < .001) and spent more time in double foot support while crossing the step. In descent, the elderly preferred to land on the forefoot ( p < .001). In both conditions, the elderly placed the feet closer to the step and cleared it by a lesser margin. Step descent appears to be particularly hazardous for older females since foot clearances were small and foot placement was closer to the step.

Crew Performance in Spacelab

This paper discusses two studies utilizing videotaped footage of crew members working in the micro-g environments aboard two flights of Spacelab. Various aspects of crew restraint, stabilization, manipulation of controls, and moving about were observed, operationally defined, and quantified by observing videotaped scenes of spacelab crew members. In the first study four performance behaviors were quantified in order to provide estimates of their frequency of occurrence and variation over the course of each of the flights: (1) movement between work stations (translation), (2) holding on with one hand to stabilize while working (Hand Hold), (3) use of provided foot restraints while working (Foot Restraint), (4) out-of-control body movements (Struggle). Eighty one-minute segments were randomly chosen of which 59 met the restrictive definitions for coding. Four raters timed all behaviors using stopwatches. Inter-rater reliabilities (Chronbach's ALPHA) varied between .87 and .96 for the four behaviors. The averaged responses of the four raters showed the following mean proportions of time for each of the behaviors: Translating=9.4%, Hand Hold=32.2%, Foot Restraint=35.3%, and Struggle=3.7%. Because more than a third of a crew member's time was spent inefficiently holding on with one hand while trying to work with the other, a second study was conducted exploring the use of foot restraints and hand stabilization. In both flights hand stabilization occurred more often when using a single cloth foot loop than when using two, t(90)=2.37, p &lt; .01. Crew members increased their use of double foot restraints with experience.

Age and sexual behavior of Japanese macaques (Macaca Fuscata)

The sexual behavior of the Arashiyama West troop, a natural semi-free-ranging troop of Japanese macaques, was studied during the 1973-1974 and 1974-1975 breeding seasons. The troop was transported intact from Japan to its current location in South Texas. There they have been free to move about in a 42.2-hectare electric fence enclosure. This report describes the relationships among age, aging, and sexual behavior. Males beginning at the age of 2.5 years were observed to series-mount estrous females in the double foot clasp mount position. Mounting in series in the double foot position is the normal pattern for Japanese macaque males. The ejaculation of semen with concomitant body movements indicative of orgasm begins at age 4.5 years at the earliest and continues until death. Males 4.5 and 5.5 years of age, sexually mature in the physiological sense, were not consistently sexually mature in the behavioral sense. The oldest male displayed traits that appear analogous to traits observed in aging human males. Females begin to experience estrus at 3.5 years of age. However, like pubescent males, pubescent females display behavioral patterns of sexual immaturity. The oldest female of the troop has remained sexually active. The attainment of sexual maturity by adulthood can be viewed as a learned process leading to efficiency and prowess, followed in old age by sexual involution.

Pedal anomaly; report of a case.

Duplication of a lower extremity, and more especially of a foot, has been reported infrequently and at wide intervals in the medical literature. Smook 1 reported a case of hyperdactylia which, when examined more closely, was apparently an embryonic attempt at double foot formation. Gould and Pyle 2 cited the case of a female infant with a cloven or double foot, and Mayer and Sashin 3 reported a genuine double foot, the components of which were joined side-by-side and which was treated successfully by surgical operation. Another author 4 presented a series of several severely deformed fetuses having doubly formed extremities. We submit the following case report concerning a pedal anomaly the exact nature of which apparently is unique or has never been recorded in the medical literature. REPORT OF A CASE A man 53 years of age first registered at the clinic for diagnosis and treatment of episodes of