Limb Mass Research Articles

Use of Dual-Energy X-Ray Absorptiometry to Assess Soft Tissue Composition in Breast Cancer Survivors With and Without Lymphedema.

Background: In patients with lymphedema (LE), in addition to hand dominance, between-group comparisons of interlimb soft tissue differences need to account for differences in whole-body adiposity, measured directly by dual energy X-ray absorptiometry (DXA) or indirectly by body mass index. No study has evaluated the effects of hand dominance and whole-body adiposity on limb composition in patients with LE. This study's purpose was to compare soft tissue composition of affected and unaffected limbs of women with breast cancer, who did and did not have LE, controlling for dominance and percent body fat. Methods and Results: Whole-body DXA scans were acquired and included measures of percent body fat, upper limb total mass, upper limb fat mass, and upper limb fat-free mass. Participants were classified into one of three groups: women without LE; women with only subjective LE; and women with objective signs of LE at the time of assessment. Differences among the LE groups were evaluated using analysis of variance (ANOVA) and Chi-square analyses. Analysis of covariance (ANCOVA) was used to control for percent body fat and for the affected limb dominance. Compared to women without LE, women with objective signs of LE have greater total limb mass, fat mass, and fat-free mass in their affected limbs, independent of affected side dominance and percent body fat. In addition, the interlimb differences in total mass, fat mass, and fat-free mass were greater for the women with objective signs of LE, compared to the other two groups. Conclusions: DXA is useful in identifying soft tissue changes in patients with LE. Given that limb circumferences measure only changes in limb volume and that bioimpedance provides estimates of extracellular fluid, DXA has the advantage of being able to estimate the volumes of specific tissues in the limb.

Accuracy and Diversity of Wearable Device-Based Gait Speed Measurement Among Older Men: Observational Study.

BackgroundGait speed measurements are widely used in clinical practice, as slow gait is a major predictor of frailty and a diagnostic criterion for sarcopenia. With the development of wearable devices, it is possible to estimate the gait speed in daily life by simply wearing the device.ObjectiveThis study aims to accurately determine the characteristics of daily life gait speed and analyze their association with sarcopenia.MethodsWe invited community-dwelling men aged >50 years who had visited the outpatient clinic at a tertiary university hospital to participate in the study. Daily life gait speed was assessed using a wearable smart belt (WELT) for a period of 4 weeks. Data from participants who wore the smart belt for at least 10 days during this period were included. After 4 weeks, data from a survey about medical and social history, usual gait speed measurements, handgrip strength measurements, and dual-energy x-ray absorptiometry were analyzed.ResultsA total of 217,578 daily life gait speed measurements from 106 participants (mean age 71.1, SD 7.6 years) were analyzed. The mean daily life gait speed was 1.23 (SD 0.26) m/s. The daily life gait speed of the participants varied according to the time of the day and day of the week. Daily life gait speed significantly slowed down with age (P<.001). Participants with sarcopenia had significantly lower mean daily life gait speed (mean 1.12, SD 0.11 m/s) than participants without sarcopenia (mean 1.23, SD 0.08 m/s; P<.001). Analysis of factors related to mean daily life gait speed showed that age and skeletal muscle mass of the lower limbs were significantly associated characteristics.ConclusionsMore diverse and accurate information about gait speed can be obtained by measuring daily life gait speed using a wearable device over an appropriate period, compared with one-time measurements performed in a laboratory setting. Importantly, in addition to age, daily life gait speed is significantly associated with skeletal muscle mass of the lower limbs.

Do Upper Limb Loss and Prosthesis Use Affect Lower Limb Gait Dynamics?

Intentional interruption of upper and lower limb coordination of able-bodied subjects alters their gait biomechanics. However, the effect of upper-limb loss (ULL) on lower-limb gait biomechanics is not fully understood. The aim of this secondary study was to perform a follow-up analysis of a previous dataset to characterize the spatiotemporal parameters and lower-limb kinematics and kinetics of gait for persons with ULL when wearing and not wearing an upper limb prosthesis (ULP). We were particularly interested in quantifying the effects of matching the mass and inertia of the prosthetic limb to the sound limb. Ten persons with unilateral ULL walked at a self-selected speed under three randomly presented conditions: 1) not wearing a prosthesis, 2) wearing their customary prosthesis, and 3) wearing a mock prosthesis that can be adjusted to match the length, mass, and inertial properties of each subject's sound limb. Walkway-embedded force plates and a 12-camera digital motion capture system recorded ground reaction forces (GRFs) and retroreflective marker position data, respectively. Average spatiotemporal (walking speed, cadence, stance time, swing time, step length, double support time), lower-limb kinematic (joint angles), and lower-limb kinetic (ground forces, joint moments and powers) data were processed and their statistical significance were analyzed. Walking speed for each condition was nearly equivalent (1.20±0.01 m/s) and differences between condition were non-significant (p=0.769). The interaction effect (side× prosthesis) was significant for peak hip extension (p=0.01) and second peak (propulsive) vertical GRF (p=0.028), but separate follow-up analyses of both main effects were not significant (p≥0.099). All other main effect comparisons were not significant (p≥0.102). Although the sample cohort was small and heterogeneous, the results of this study suggest that persons with unilateral ULL did not display significant limb side asymmetry in lower-limb gait spatiotemporal, kinetic, and kinematic parameters, regardless of ULP use.

Impact of square stepping exercises on mobility and balance in older adults - An experimental study

A fall is described as a life event in which an individual comes on the ground, floor which is mostly accidental in nature. During ageing, physiological changes set backs many changes such as mitochondrial dysfunction and dropped hormonal production. These physiological events results in gradual decreased bone density, decreased muscle mass and strength in lower limbs. Aims: The intent of this study is to explore the impact of Square Stepping Exercise (SSE) in older adults to enhance balance and mobility to reduce fall risk.

Increases in Integrin-ILK-RICTOR-Akt Proteins, Muscle Mass, and Strength after Eccentric Cycling Training.

Recently, it has been suggested that a cellular pathway composed of integrin, integrin-linked kinase (ILK), rapamycin-insensitive companion of mTOR (RICTOR), and Akt may facilitate long-term structural and functional adaptations associated with exercise, independent of the mTORC1 pathway. Therefore, we examined changes in integrin-ILK-RICTOR-Akt protein in vastus lateralis (VL) before and after 8 wk of eccentric cycling training (ECC), which was expected to increase muscle function and VL cross-sectional area (CSA). Eleven men (23 ± 4 yr) completed 24 sessions of ECC with progressive increases in intensity and duration, resulting in a twofold increase in work from the first three (75.4 ± 14.1 kJ) to the last three sessions (150.7 ± 28.4 kJ). Outcome measures included lower limb lean mass, VL CSA, static strength, and peak and average cycling power output. These measures and VL samples were taken before and 4-5 d after the last training session. Significant (P < 0.05) increases in integrin-β1 (1.64-fold) and RICTOR (2.99-fold) protein as well as the phosphorylated-to-total ILK ratio (1.70-fold) were found, but integrin-α7 and Akt did not change. Increases in lower limb, thigh, and trunk lean mass (2.8%-5.3%, P < 0.05) and CSA (13.3% ± 9.0%, P < 0.001) were observed. Static strength (18.1% ± 10.8%) and both peak (8.6% ± 10.5%) and average power output (7.4% ± 8.3%) also increased (P < 0.05). However, no significant correlations were found between the magnitude of increases in protein and the magnitude of increases in CSA, static strength, or power output. In addition to increased muscle mass, strength, and power, we demonstrate that ECC increases integrin-β1 and RICTOR total protein and p-ILK/t-ILK, which may play a role in protection against muscle damage as well as anabolic signaling to induce muscle adaptations.

Differential Diagnoses of Pediatric Upper Limb Masses

Upper limb masses are one of the most common presentations in the outpatient setting. However, there is a paucity of information in the literature regarding the epidemiology of upper-extremity masses in the pediatric population. The aim of this study was to determine the differential diagnoses and clinical characteristics in children aged ≤18 years presenting with upper limb masses. A retrospective review of patients aged ≤18 years managed at our institution over a 5-year period was performed. We obtained information on patient demographics, clinical features, radiological investigations, intraoperative features, and histology. We also evaluated the correlation between the clinical and histopathological diagnoses in patients who underwent surgery. There were 141 upper limb masses in our series. The mean age at presentation was 12 years (SD, 5 years). The most common presenting complaints were asymptomatic swelling, pain, and paresthesia. The majority (128; 91%) of tumors were benign; there were 5 locally aggressive tumors and 6 malignant tumors. The dominant hand was involved in 60 patients. Of 140 patients, 43 (31%) patients had surgery. The procedures included incisional biopsy, excisional biopsy, wide resection, and reconstruction. One patient required a below elbow amputation for an osteosarcoma. Ten percent of cases represented malignant or locally aggressive disease. We have used our observations to develop a clinical algorithm that can assist clinicians in evaluating and managing children and adolescents presenting with upper-extremity masses. Prognostic IV.

Penicilliosis marneffei in HIV negative children: three case reports

This study aimed to report the clinical characteristics of penicilliosis marneffei (PSM) in three children negative to HIV. Three children were diagnosed with PSM in the Department of Emergency Medicine, Hunan Children's Hospital between February 2016 to July 2020. The clinical characteristics, laboratory findings, and concomitant diseases were recorded, and the related literatures were reviewed. The clinical characteristics and treatment of PSM were reported according to our experience and literature review. The initial symptom was right lower limb mass in 1 child (first) who developed fever and cough about 1 month later and then was misdiagnosed with tuberculosis. The other child (second) had a fever, reductions in red blood cells, white blood cells and platelets, hepatosplenomegaly and lymphadenectasis. The third child had fever, jaundice, multiple organ dysfunction syndrome (MODS), hepatosplenomegaly and lymphadenectasis. The first child (Case 1) had STAT1 gene mutation on genetic examination, and the second child (Case 2) had history of onychomycosis and oral ulcer, the third child (Case 3) had STAT3 gene mutation on genetic examination, diagnosed with Hyperimmunoglobulin E syndromes (HIES). PSM was confirmed in all cases by the culture bone marrow. All three cases were diagnosed through medulloculture. Case 1 and Case 2 also had lymph node biopsy. Case 3 had sputum culture and bronchoalveolar lavage fluid (BALF). The first child was intravenously administered with voriconazole and amphotericin B liposomes, and orally administered with itraconazole for maintenance therapy, which was discontinued 1 year later. The second child was administered with voriconazole intravenously and thereafter orally for a total of 7 months. Recurrence was not observed. The third child was given amphotericin B for 2 days (discontinued due to liver dysfunction), and intravenous voriconazole for 4 days. The patient gave up therapy finally. In conclusion, HIV negative children can also develop PSM, and may be related to the STAT1/STAT3 gene mutation. For children having no response to antibiotic or antiviral therapy, bacterial/fungal culture or biopsy should be performed as soon as possible to confirm the diagnosis, and physicians should actively identify the underlying diseases of PSM patients, which is beneficial for the early diagnosis, early treatment and improvement of prognosis.

Move it or lose it: limb immobilisation results in impaired postprandial skeletal muscle glucose uptake.

Move it or lose it: limb immobilisation results in impaired postprandial skeletal muscle glucose uptake.

Effects of Cross-Education After 6 Weeks of Eccentric Single-Leg Decline Squats Performed With Different Execution Times: A Randomized Controlled Trial.

Cross-education of strength refers to the strength gain that is transferred to the contralateral limb after a unilateral training program. Unilateral eccentric training using different muscle contraction times would improve the structural and functional properties of the untrained contralateral limb. Randomized controlled trial. Level 2. Thirty-six participants were randomized into a control group, experimental group 1 (EG6s; eccentric contraction runtime = 6 seconds) and experimental group 2 (EG3s; eccentric contraction runtime = 3 seconds). The thickness and elastographic index of the patellar tendon (PT), lean mass and fat percentage of the thigh, contractile properties of the vastus lateralis (VL), as well as isometric, concentric, and eccentric knee extensor peak torques, and eccentric single-leg decline squat (SLDSe) 1 repetition maximum (1-RM) were measured after 6 weeks of SLDSe training (3 times per week, 80% of 1-RM) and after 6 weeks of detraining in the untrained contralateral limb. After training, there was an increase in lean thigh mass of the untrained limb in both groups: EG6s (0.17 ± 0.29 kg;P = 0.03; effect size [ES] = 0.15) and EG3s (0.15 ± 0.23 kg; P = 0.04; ES = 0.19). Likewise, both EG6s (62.30 ± 19.09 kg; P < 0.001; ES = 4.23) and EG3s (68.09 ± 27.49 kg; P < 0.001; ES = 3.40) increased their 1-RM, isometric (EG6s: 48.64 ± 44.82 N·m, P < 0.001, ES = 0.63; EG3s: 34.81 ± 47.30 N·m, P = 0.004, ES = 0.38), concentric at 60 deg/s and 180 deg/s and eccentric at 60 deg/s and 180 deg/s knee extensor peak torques (P < 0.05) in the untrained limb. However, no differences were found in the contractile properties of the VL or in the thickness of the PT after eccentric training in either of the 2 experimental groups. Regardless of the runtime of the contraction, 6 weeks of SLSDe was effective for inducing structural and strength adaptations in the contralateral untrained limb. However, most of these adaptations were lost after 6 weeks of detraining. Our study suggests that cross-education training can be of great importance for clinical application and musculoskeletal and neuromuscular rehabilitative processes after unilateral injury.

Morphometric Study and Clinical Significance of Muscle/Tendon Ratio of Palmaris Longus

Hypothesis- Is there a functional relevance of relative length of muscle to tendon ratio in Palmaris longus muscle? Material and Methods Material for the present study consisted of 36 detached upper limbs of different age groups. The limbs used were those available in the Anatomy department at AIIMS, New delhi. The length and width of the PL-Muscle Belly (PL-MB) and PL-Tendon (PL-T) were measured with the help of centimeter scale and a thread. The unpaired t test was used to study the significance of the differences in right and left Palmaris longus muscle (PL). Muscle belly length (MBL): It is the dimension taken in Proximal-Distal plane from the medial epicondyle of the humerus to the musculotendinous junction. Tendon Length (TL): The point of measurement taken for the tendon is in Proximal-Distal plane from the musculotendinous junction to its distal attachment. Muscle belly width (MBW): It is the dimension taken in Medio-lateral plane at the maximum width of the muscle belly. Summary of Results Various parameters that includesmean of length of total muscle, muscle belly, tendon and relative ratio of belly length with respect to tendon length were calculated and tabulated. These data were compared with previous literatures. Among 36 specimens, we found absence of PL in 6 specimens. This is more common on left side as per previous literature. In the present study, this preference was not seen. It was found that relative ratio of M/T was lesser on left side (0.66) than right side (0.92) indicating towards lesser muscle mass in left upper limbs. This increased tendon length indicates differential evolution of PL in both limbs. Conclusion- Currently, PL has clinical significance in surgery as it has tendon transfer applicability. Further evaluation of M/T ratio of this muscle in large sample size and also in living subjects may give new clues in understanding the evolution pattern of PL and its relevance to dexterity. It may also be useful to correlate the same with the occupation of the individuals.

Waveform analysis of shank loaded wearable resistance during sprint running acceleration

ABSTRACT Lower-limb wearable resistance (WR) provides a specific and targeted overload to the musculature involved in sprint running, however, it is unknown if greater impact forces occur with the additional limb mass. This study compared the contact times and ground reaction force waveforms between sprint running with no load and 2% body mass (BM) shank-positioned WR over 30 m. Fifteen male university-level sprint specialists completed two maximum effort sprints with each condition in a randomized order. Sprint running with shank WR resulted in trivial changes to contact times at 5 m, 10 m, and 20 m (effect size [ES] = <0.20, p > 0.05) and a small, significant increase to contact time at 30 m by 1.94% (ES = 0.25, p = 0.03). Significant differences in ground reaction force between unloaded and shank loaded sprint running were limited to the anterior-posterior direction and occurred between 20% and 30% of ground contact at 10 m, 20 m, and 30 m. Shank WR did not result in greater magnitudes of horizontal or vertical forces during the initial impact portion of ground contact. Practitioners can prescribe shank WR training with loads ≤2% BM without concern for increased risk of injurious impact forces.

Changes in Muscle Mass after Botulinum Toxin Injection in Children with Spastic Hemiplegic Cerebral Palsy.

We aimed to evaluate muscle mass changes after injection of botulinum toxin (BoNT) in children with spastic hemiplegic cerebral palsy (CP). Children aged between 2 and 12 years who were diagnosed with hemiplegic CP with spastic equinus foot were prospectively recruited and administered BoNT in the affected leg. Lean body mass (LBM) of both legs and total limbs was measured by dual-energy X-ray absorptiometry (DXA) preinjection and 4 and 12 weeks after injection. A total of 15 children were enrolled into the study. LBM of both legs and total limbs increased significantly over 12 weeks of growth. The ratio of LBM of the affected leg to total limbs and to the unaffected leg significantly reduced at 4 weeks after injection compared with preinjection but significantly increased at 12 weeks after injection compared with 4 weeks after injection. In conclusion, the muscle mass of the affected leg after BoNT injection in children with hemiplegic spastic CP decreased at 4 weeks after BoNT injection but significantly recovered after 12 weeks after injection.

Physical activity of women over 60 - methodology of activity measurement.

Physical activity has a positive effect on health. The level of physical activity changes with age. Elderly people often reduce their physical activity, among other things, due to deteriorating health or the belief that it is inappropriate to indulge in sports or be physically active at old agge. On the other hand, the lack of systematic physical activity in the elderly can lead to a reduction in the body's efficiency in many health aspects. Although there are many methods of measuring human physical activity, there is no ideal tool for measuring that activity. The main aim of the study was to assess the effectiveness of the use of selected methods of measuring physical activity in the elderly, as well as to evaluate the influence of the measured activity on the nutritional status of women over 60 years of age. The study was carried out in the area of western Poland in a group of 110 generally healthy women above the age of 60, who were divided into 3 groups of intensity of undertaken physical activity (low active 30.00%, moderately active 41.82% and active 28.18%). A pedometer and a physical activity diary were used to measure physical activity. Body composition was assessed by the bioelectrical impedance method which uses a body composition analyzer. Body height and weight, lean mass of limbs and body, adipose tissue content, total water content, waist circumference to hip circumference (WHR), and BMI (Body Mass Index) were assessed. The correlation coefficient between the methods of assessing physical activity, i.e. the number of minutes/day and the number of steps/day, was 0.92 and was statistically significant at the level of p<0.001. This was assumed to be a strict correlation. Based on the physical activity diary, it was estimated that women spent an average of 92.85 minutes a day on physical activity, while the data obtained from the pedometer showed that they performed an average of 4,462 steps a day. The average age of the respondents was 67.25 years, and average BMI - 28.07 kg/m2. A close correlation was demonstrated between the applied methods for assessing physical activity shows about the appropriate selection of methods, as well as, due to their ease of use, their use to assess physical activity in the elderly.

On the Origin of Hard X-Ray Emissions from the Behind-the-limb Flare on 2014 September 1

Abstract The origin of hard X-rays and γ-rays emitted from the solar atmosphere during occulted solar flares is still debated. The hard X-ray emissions could come from flaring loop tops rising above the limb or coronal mass ejection shock waves, two by-products of energetic solar storms. For the shock scenario to work, accelerated particles must be released on magnetic field lines rooted on the visible disk and precipitate. We present a new Monte Carlo code that computes particle acceleration at shocks propagating along large coronal magnetic loops. A first implementation of the model is carried out for the 2014 September 1 event, and the modeled electron spectra are compared with those inferred from Fermi Gamma-ray Burst Monitor (GBM) measurements. When particle diffusion processes are invoked, our model can reproduce the hard electron spectra measured by GBM nearly 10 minutes after the estimated on-disk hard X-rays appear to have ceased from the flare site.

Evolutionary history or function? Which preponderates in the expression of the muscle mass of the thoracic limb in wild carnivorans?

Thoracic limbs are extremely versatile and exhibit informative characteristics about habits of the Carnivora order in the wild. Despite this relevance, comparative studies with quantitative variables on thoracic limb muscles are still scarce in carnivorans. The aims of this study were to measure the mass of the intrinsic muscles of the thoracic limb of neotropical species of the Carnivora order and to establish comparative conjectures. For this purpose, 39 thoracic limbs of 10 neotropical carnivorans species were dissected. The mass of each muscle was measured on a digital scale, muscles were grouped by function, and the mass average percentage that each functional group of muscles occupied in the thoracic limb was calculated. The data of the present study was added to that available in the literature for 22 other carnivoran species. Three groups of species were considered: Canidae, Musteloidea, and Feliformia. Comparatively, the eight canid species included in this analyses concentrate muscle mass proximally in the thoracic limb to prioritize essential cursoriality. The nine musteloids had more muscle mass in the distal muscles due to the demand for versatility and manual strength, and the 14 Feliformia species exhibited an intermediate trend. The analysis of clusters revealed a great overlap of the percentage distribution of muscle mass with the phylogeny previously established for carnivorans. It could be verified that the distribution of muscle masses meets the demand of the locomotor habits of the species up to a certain level, from which phylogeny begins to limit morphological adaptations.

The Influence of Body Fat Distribution on Postural Balance and Muscle Quality in Women Aged 60 Years and Over.

The aim of this study was to investigate the influence of body fat distribution on postural balance and lower-limb muscle quality in women aged 60 years and over. Two hundred and twenty-two volunteers took part in this cross-sectional analysis. Participants underwent body fat distribution assessment using dual-energy x-ray absorptiometry and were classified as nonobese, gynoid obese, or android obese. Postural balance was assessed during quiet standing, with and without vision restriction, using a force platform. Specific torque was defined as the ratio of knee extensors peak torque (evaluated by an isokinetic dynamometer) to the lean mass of the same limb (evaluated by dual-energy x-ray absorptiometry). Compared with nonobese participants, both obese groups exhibited higher range of postural sway along the anteroposterior and mediolateral axes (P < .05). However, there were no differences between participants with gynoid and android obesity. The android obese group exhibited greater speed of postural sway in the condition without vision restriction than both nonobese (P = .040) and gynoid obese (P = .004) groups. Regarding muscle quality, only participants with gynoid obesity (P = .004) presented lower specific torque than their nonobese peers. These results may be clinically useful when designing falls prevention exercises targeting the obese population.

Mechanical Assessment of Tissue Properties During Tourniquet Application.

Successful tourniquet application increases survival rate of exsanguinating extremity hemorrhage victims. Tactile feedback during tourniquet application training should reflect human tissue properties in order to increase success in the field. This study aims to understand the mechanical properties of a human limb during tourniquet application. Six cadaveric extremities-three uppers and three lowers-were tested from three body mass index groups: low (<19) healthy (19-24), and overweight (>24). Each specimen donned with a tourniquet and mounted to a servo-hydraulic testing machine, which enabled controlled tightening of the tourniquet while recording the tourniquet tension force and strap displacement. A thin-film pressure sensor placed between the specimen and the tourniquet recorded contact pressure. Each limb was tested with the tourniquet applied at two different sites resulting in testing at the upper arm, forearm, thigh, and shank. The load displacement curves during radial compression were found to be nonlinear overall, with identifiable linear regions. Average contact pressure under the tourniquet strap at 200N and 300N of tension force was 126.3 (σ = 41.2) mm Hg and 205.3 (σ = 75.3) mm Hg, respectively. There were no significant differences in tissue stiffness or contact pressure at 300N of tension force between limb (upper vs. lower) or body mass index. At 200N of tension, the upper limb had significantly higher contact pressure than the lower limb (P = 0.040). Relative radial compression was significantly different between upper (16.74, σ = 4.16%) and lower (10.15, σ = 2.25%) extremities at 200N tension (P = 0.005). Simulation of tissue compression during tourniquet application may be achieved with a material exhibiting elastic properties to mimic the force-displacement behavior seen in cadaveric tissue or with different layers of material. Different trainers for underweight, healthy, and overweight limbs may not be needed. Separate tourniquet training fixtures should be created for the upper and lower extremities.

Anthropometric Profiles in Table Tennis Players: Analysis of Sex, Age, and Ranking

Table tennis has recently evolved towards a more spectacular sport increasing match-play demands and the intensity and speed of actions by regulations and equipment modification. Since these changes can alter the body composition and performance, this study aimed to analyze the differences in anthropometric attributes of 495 table tennis players (288 men, 207 women) according to sex, age, and ranking. Players were classified according to sex, age categories (Senior, Under-18, Under-15, Under 13, and Under 11), and ranking position. Anthropometry measurements included eight skinfolds’ thicknesses (biceps brachii, triceps, subscapular, iliac crest, supraspinal, abdominal, thigh, and medial calf), four girths (biceps brachii relaxed and contracted, thigh, and calf), and three breadths (biepicondylar femur, biepicondylar humerus, and bistiloyd wrist) to determine fat mass, lean mass, bone, cross sectional area (CSA) for arm, leg, and thigh, and somatotype. Results revealed that table tennis players presented differences in body mass composition, anthropometry, and somatotype according to sex and age category and ranking. It seems confirmed that regular table tennis practice during the childhood is associated with a healthy body composition status, that appears to be maintained across older ages if keeping the practice. Senior table tennis players showed a fat mass &lt;20% and lean mass ~45% in men and ~37% in women. A new contribution is that higher lean mass in the upper limbs was associated with higher ranking position (i.e., better performance), endomorphic somatotypes were negative related to performance, and ectomorphic profiles seems more effective, which suggest the potential influence of morphologic changes in table tennis competition performance.

An adaptive controller for human lower extremity exoskeleton robot

Exoskeleton robot-assisted physical therapy has recently been studied extensively due to its proven effectiveness in providing different forms of physical therapy at any stage of physical recovery. The efficacy of robot-assisted physical therapy depends on the maneuverability of the robot during the rehabilitation application. Robot dynamics is inherently nonlinear. Often, robot control algorithms are developed based on an approximate robot dynamic model which leads to system instability and tracking errors. Accurately determining a rehabilitation robot's payload (human limb masses and inertial properties) is frequently impractical. An adaptive control scheme can handle modeling errors very efficiently. In this paper, a 7 degrees of freedom (DOF) human lower extremity dynamic model was developed using the Newton Euler’s method. To simulate joint friction, a realistic friction model is included. A direct adaptive controller is designed so that the robot can follow the prescribed trajectory with high speed and accuracy. A total of 31 model parameters were considered for adaption. To ensure system stability, the controller's adaptive gains are determined based on the Lyapunov stability approach. Simulation results show excellent tracking performance of the developed controller in the presence of joint friction.

Limb Salvage Surgery in Fungating Giant Cell Tumors: A Report of Three Cases

Introduction:The WHO defines giant cell tumor as a benign locally aggressive neoplasm with metastasizing capacity and aggressive behavior. Very rarely, these tumors are seen fungating, mostly when neglected. But when they do, the treatment option commonly conferred is amputation of the limb which is disabling and traumatizing.Case Report:We report three cases of fungating limb masses (proximal tibia, distal fibula, and distal radius) diagnosed with giant cell tumor histologically, undergoing limb saving surgeries with various reconstruction techniques to endorse a good quality of life and functioning limb.Conclusion:Our study is one of the earliest to report medium-term follow-up after such limb salvage procedure. We recommend that salvage procedures should be considered in giant cell tumors even in the presence of fungation if there is no neurovascular encasement.