Lower Extremity Research Articles

Unveiling the menstrual mind: Exploring proprioceptive proficiency, reaction responsiveness, and motor mastery in premenstrual syndrome versus Non-PMS cohorts: A two-arm parallel non-blinded cross-sectional study

IntroductionPremenstrual syndrome (PMS) is characterized by cyclical physical and mood disturbances during the luteal phase. Symptoms gradually intensify during this phase and typically subside a few days after menstruation begins. PMS encompasses neuromuscular and psychological symptoms that can significantly affect the quality of life of affected females. This study aims to compare proprioception, reaction time, and coordination between females with PMS and those with non-PMS. Material and methodsA cross-sectional study, conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, recruited 998 females with PMS and without PMS, aged 18–40 years based on premenstrual dysphoric disorder criteria. Participants underwent assessments of proprioception and reaction time using the Sensbalance Miniboard. Coordination was assessed using Lower Extremity Motor Coordination Test. Data analysis utilized the Kolmogorov-Smirnov test to determine the normality of the data while Mann Whitney-U test was used to compare the between group differences of the variables. ResultsSignificant differences were observed with p-value <0.05 for all the variables, proprioception (front, back, right and left), reaction time (front, back, right and left), coordination (right and left) between the PMS and non-PMS groups. ConclusionsFemales with PMS were associated with great variation in proprioception, reaction time and coordination when compared with females without PMS.

Benefits of Aerosolized, Point-of-care, Autologous Skin Cell Suspension (ASCS) for the Closure of Full-thickness Wounds From Thermal and Nonthermal Causes: Learning Curves From the First 50 Consecutive Cases at an Urban, Level 1 Trauma Center.

To determine the utility of Autologous Skin Cell Suspension (ASCS) in closing full-thickness (FT) defects from injury and infection. Although ASCS has documented success in closing partial-thickness burns, far less is known about the efficacy of ASCS in FT defects. Fifty consecutive patients with FT defects (burn 17, necrotizing infection 13, crush 7, degloving 5, and other 8) underwent closure with the bilayer technique of 3:1 widely meshed, thin, split-thickness skin graft and 80:1 expanded ASCS. End points were limb salvage rate, donor site reduction, operative and hospital throughput, incidence of complications, and re-epithelialization by 4, 8, and 12 weeks. Definitive wound closure was achieved in 76%, 94%, and 98% of patients, at 4, 8, and 12 weeks, respectively. Limb salvage occurred in 42/43 patients (10 upper and 33 lower extremities). The mean area grafted was 435cm 2 ; donor site size was 212cm 2 , representing a potential reduction of 50%. The mean surgical time was 71 minutes; the total operating room time was 124 minutes. The mean length of stay was 26.4 days; the time from grafting to discharge was 11.2 days. Four out of 50 patients (8%) required 6 reoperations for bleeding (1), breakdown (4), and amputation (1). Four out of 50 patients (8%) developed hypertrophic scarring, which responded to silicone sheeting (2) and laser resurfacing (2). The mean follow-up was 92.7 days. When used for the closure of FT wounds, point-of-care ASCS is effective and safe. Benefits include rapid re-epithelialization, high rate of limb salvage, reduction of donor site size and morbidity, and low incidence of hypertrophic scarring.

Anatomical variation types of the deep femoral vein and its tributaries

BackgroundThe deep femoral vein generally has individual differences in origin, course, tributary, caliber, and quantity. However, systematic research on deep femoral vein variations remains insufficient. Given this, this study used anatomical observation to reveal the types and ratios of variations in the deep femoral vein and its tributaries. MethodsThis study selected 63 gross specimens of intact lower extremities and dissected their 126 lower limbs layer by layer to explore variations in the deep femoral vein and its tributaries. ResultsA total of 15 lower limbs exhibit variations in the deep femoral vein and its tributaries, of which 93% were unilateral. No correlation was found between the mutations and gender. They can be generally classified into three types: variations in the small saphenous vein branch of the deep femoral vein (7.14%), variations in the popliteal vein branch of the deep femoral vein (3.96%), and multiple deep femoral vein variations (0.79%). ConclusionsVariations in the deep femoral vein and its tributaries are not rare and can achieve a variation rate of 11.9%. Moreover, 93% of the variations involve tributaries of the deep femoral vein, among which 60% occur in the small saphenous vein branch, and approximately 30% are related to the popliteal vein branch. The variation diversity can lay a theoretical foundation for clinical diagnosis and treatment.

Impact of Joint Hypermobility on Running: Frontal plane lower extremity biomechanics

Impact of Joint Hypermobility on Running: Frontal plane lower extremity biomechanics

The acute effects of insoles on jumping performance and lower extremity biomechanics in volleyball players with flexible pes planus

The acute effects of insoles on jumping performance and lower extremity biomechanics in volleyball players with flexible pes planus

Lower extremity pain and/or numbness after laparoscopic surgery and robot-assisted surgery in the lithotomy position combined with the Trendelenburg position.

The purpose of this study was to investigate the incidence and risk factors of lower extremity pain and/or numbness after laparoscopic colorectal surgery and robot-assisted laparoscopic radical prostatectomy in the lithotomy position combined with the Trendelenburg position. The relationship between creatine kinase (CK) levels and lower extremity pain and/or numbness was also investigated. We retrospectively reviewed adult patients who underwent laparoscopic colorectal surgery and robot-assisted laparoscopic radical prostatectomy in the lithotomy position combined with the Trendelenburg position between May 2015 and April 2020. Logistic regression analysis was used to identify risk factors of lower extremity pain and/or numbness. Preoperative and postoperative CK levels were compared in patients with and those without lower extremity pain and/or numbness. Among 940 patients, 1.9% experienced lower extremity pain and/or numbness postoperatively. The incidences of lower extremity pain and/or numbness after laparoscopic colorectal surgery and after robot-assisted laparoscopic radical prostatectomy were 1.7% and 2.1%, respectively. Multivariate logistic regression analysis revealed that only duration of surgery > 4h (odds ratio = 3.144, 95% CI: 1.102-8.969, p = 0.032) was a significant predictor of lower extremity pain and/or numbness. Postoperative median CK level in patients with lower extremity pain and/or numbness was significantly higher than that in patients without lower extremity pain and/or numbness. The incidence of lower extremity pain and/or numbness after laparoscopic colorectal surgery was comparable to that after robot-assisted laparoscopic radical prostatectomy. Prolonged duration of surgery contributed to lower extremity pain and/or numbness. Significantly elevated CK levels in patients with lower extremity pain and/or numbness suggest the involvement of muscle injury in these symptoms.

Hip Strength, Change of Direction, and Falls in Recreational Pickleball Players.

While a high incidence of pickleball-related falls is reported, little is known regarding factors differentiating persons with and without a fall history during play. This study aimed to determine differences between recreational pickleball players who fell while playing and those who did not. Additional aims were to determine reasons for falling and to investigate associations among assessed factors. Cross-sectional study. Participants completed a survey reporting age, fall history, and reasons for falling during play. Hip abduction strength, single leg squat form, ankle dorsiflexion, and change of direction time using a modified T-test on a pickleball court (i.e.pickleball T-test) were assessed. Among the 92 individuals participating in the study, 42% reported a fall while playing and 30% reported falling more than once. Leading reasons for reported falls were lunging and moving backward. Participants who reported falling were significantly older (z = -2.60, p = 0.009) and slower on the pickleball T-test (z = -2.10, p = 0.036) than those who did not report falling. Hip abduction strength was not associated with fall history but was associated with faster time on the pickleball T-test (left rs = -.41, p < 0.001, right rs = -.48, p < 0.001). Single leg squat form and dorsiflexion were not related to fall history. Falls are common among recreational pickleball players, particularly older players. Fall prevention programs for pickleball players should be considered including multi-directional lunging, lower extremity strength and power development, and change of direction training that includes moving backward. 2.

Patients With Non-Obstructive Coronary Artery Disease and Polyvascular Disease. Sub-Analysis of the Real-World Registry KAMMA (Clinical Registry on Patient Population With Polyvascular Disease in the Russian Federation and Eurasian Countries).

To study the clinical status and data of laboratory and instrumental examination of patients with non-obstructive ischemic heart disease (IHD) and multifocal atherosclerosis (MFA) included in the KAMMA registry. The subanalysis included 1,893 IHD patients who underwent coronary angiography (CAG) and ultrasonic examination of peripheral arteries. Based on the CAG data, patients were divided into two groups: group 1, patients with obstructive coronary atherosclerosis (CA) (maximum stenosis ≥50% and/or history of percutaneous coronary intervention/coronary artery bypass grafting, n=1728; 91.3%) and group 2, patients with non-obstructive CA (maximum stenosis &lt;50%, n = 165; 8.7%). A comparative analysis based on the degree of coronary obstruction in patients with verified IHD who were included in the KAMMA registry showed that 8.7% of them had coronary artery stenosis of less than 50%. The overwhelming majority of patients with non-obstructive CA had MFA affecting the brachiocephalic arteries in 94.3% and the lower extremity arteries in 40.2%. Among patients with non-obstructive IHD, women predominated; risk factors such as smoking and type 2 diabetes mellitus were less frequent in this group than in the obstructive IHD group. Patients with non-obstructive CA more frequently had a history of dyslipidemia; they had higher total cholesterol and non-high-density lipoprotein cholesterol; and they more frequently received moderate-intensity statin therapy than patients with obstructive CA (55.8% vs. 34.5%). Characteristic features of patients with non-obstructive CA were less severe IHD and less frequent history of acute coronary syndrome. However, the incidence of stroke, peripheral arterial thrombosis, and chronic arterial insufficiency of the lower extremities did not differ in groups 1 and 2, whereas the incidence of paroxysmal atrial fibrillation was higher in the non-obstructive IHD group. IHD patients without coronary obstruction also require assessment of the peripheral arterial status, as they may have advanced MFA, which should be taken into account when choosing the "aggressiveness" of therapy.

Chronic Venous Insufficiency Evaluation and Medical Management.

This review will focus on comprehensive evaluation of chronic venous insufficiency (CVI), nuances in diagnostic testing and advances in medical therapies to provide improvement in patient specific outcomes. Chronic venous insufficiency of the lower extremities represents an often underrecognized source of morbidity. Comprehensive evaluation focuses on personal and family history of deep vein thrombosis and varicose veins. Diagnostic testing is initially with a thorough duplex ultrasound, but advanced imaging with CT scan and MRV may be indicated in selected patients who might benefit from more invasive intervention. Compression therapy, wraps and garments, remains the mainstay of conservative therapy for patients with CVI. In addition, there is renewed interest in lifestyle and nutritional supplements, most commonly micronized purified flavanoid fraction (MPFF), in relieving symptoms and preventing morbidity. A holistic approach to patients with CVI provides the best opportunity for enduring improvement in quality of life.

The Effect of Stretching on Lumbar Muscle Flexibility, Isokinetic Parameters and Lower Extremity Function

The Effect of Stretching on Lumbar Muscle Flexibility, Isokinetic Parameters and Lower Extremity Function

Comparison of Core Endurance, Strength, Power, Balance and Flexibility in Young Elite Sailors

Aim: This study examines and compares the core endurance levels, balance performance, muscle strength, and flexibility among young elite saiflors in different sailing classes. Method: Athletes were randomly selected from the Galatasaray Sailing Club and divided into three groups: windsurfing (n=14), optimist (n=13), and laser class (n=13). Demographic features, body mass index, and dominant side of the body were recorded. Upper extremity strength was assessed using a hand dynamometer, while lower extremity power was evaluated through vertical jump, standing long jump, and single-leg jump tests. Core endurance was evaluated with sit-up, plank, and rotary stability tests. Balance and flexibility were assessed using Y balance, straight leg raise, shoulder flexibility, sit and reach, shoulder elevation, and total body rotation tests. The data from the three groups were analyzed using the Kruskal-Wallis H test, and inter-group comparisons were performed with the Mann-Whitney U test. Results: Significant differences were observed among the groups in the hand grip test for both right and left hands (p&amp;lt;0.001). The laser group displayed the highest mean value. The standing long jump test also showed a significant difference between the groups (p&amp;lt;0.05), with the laser group exhibiting the highest mean value. The single-leg jump test revealed a significant difference among the groups (p&amp;lt;0.05), with the windsurfing group having the highest average. The Y balance test indicated a significant difference among the groups (p&amp;lt;0.05), with the optimist group displaying the highest average values. Conclusion: These findings demonstrate that each sailing class necessitates distinct physical attributes and specific performance parameters, particularly in terms of strength and balance.

Survey of Common Injury among West Zone inter University Mens Handball Players

Handball is a vigorous and very injury prone sport involving the great physical demands Thusthe player who played handball were were know about the consequences all that and there overallpreventions. So this survey provides the actual relevance of injuries in handball which is played outdoor inin Indian conditions the source of the data is gathered by the researcher through questionnairemethod.the data of 100 number of players were found to be suitable to evaluate most frequent injuries inhandball are located in lower extremities spacially in ankle joint25 followed by knee joint 25 and inupper extremities there were wrist 18and shoulder15 was commonplace to occur injuries 100players who played handball were found to have injuries in their overall career.

Patellofemoral Pain: Correlations Between Hip Strength, Pain Severity, and Function

Introduction: Patellofemoral pain is a common condition that results in anterior knee pain and frequently affects a wide range of the population, from adolescents to older adults. The etiology of patellofemoral pain is multifactorial and usually results in peripatellar or retropatellar pain. The purpose of this study is to determine whether a correlation exists between the strength of the posterolateral hip musculature and the severity of pain or level of function experienced by individuals with patellofemoral pain. Methods: The participants rated pain and functional levels with the Numeric Pain Rating Scale and the Lower Extremity Functional Scale, respectively. The strength of the participants’ posterolateral hip musculature was assessed with a handheld dynamometer. This study used a quantitative, cross-sectional, correlational design to determine the nature of the correlations between these variables. Results: A total of 30 participants met the inclusion criteria and participated in the study. Posterolateral hip strength and pain severity ratings were found to be significantly negatively correlated at the .05 level, r (28) = -.375, p=.041. Posterolateral hip strength and the participants' level of function were significantly positively correlated at the .01 level, r (28) = .541, p = .002. Pain severity ratings and the participants' level of function were also significantly negatively correlated at the .001 level, r (28) = - .526, p = .003. Discussion: Due to the multifactorial nature of PFP, the most evidence-based treatment approach is a thorough assessment followed by the development and implementation of an individualized, comprehensive treatment plan. Based on the findings of the study, however, weakness of the posterolateral hip musculature may indeed be present in a significant percentage of individuals with PFP. The authors declare no competing interests.

Effects of Weight-Bearing Posture During Heel Raise on Lower Extremity Muscle Activation in Adults with Chronic Ankle Instability

Effects of Weight-Bearing Posture During Heel Raise on Lower Extremity Muscle Activation in Adults with Chronic Ankle Instability

Effects of motor imagery-based brain-computer interface-controlled electrical stimulation on lower limb function in hemiplegic patients in the acute phase of stroke: a randomized controlled study

BackgroundLower limb motor dysfunction is one of the most serious consequences of stroke; however, there is insufficient evidence for optimal rehabilitation strategies. Improving lower limb motor function through effective rehabilitation strategies is a top priority for stroke patients. Neuroplasticity is a key factor in the recovery of motor function. The extent to which neuroplasticity-based rehabilitation therapy using brain-computer interface (BCI) is effective in treating lower limb motor dysfunction in acute ischemic stroke patients has not been extensively investigated.ObjectiveThis study aimed to assess the impact of BCI rehabilitation on lower limb motor dysfunction in individuals with acute ischemic stroke by evaluating motor function, walking ability, and daily living activities.MethodsThis study was conducted in a randomized controlled trial, involving 64 patients with acute ischemic stroke who experienced lower limb motor dysfunction. All patients were divided into two groups, with 32 patients assigned to the control group was given conventional rehabilitation once a day for 70 min, 5 times a week for 2 weeks, and the experimental group (n = 32) was given BCI rehabilitation on top of the conventional rehabilitation for 1 h a day, 30 min of therapy in the morning and an additional 30 min in the afternoon, for a total of 20 sessions over a two-week period. The primary outcome was lower extremity motor function, which was assessed using the lower extremity portion of the Fugl-Meyer Rating Scale (FMA-LE), and the secondary endpoints were the Functional Ambulation Scale (FAC), and the Modified Barthel index (MBI).ResultsAfter 20 sessions of treatment, both groups improved in motor function, walking function, and activities of daily living, and the improvements in FMA-LE scores (p &amp;lt; 0.001), FAC (p = 0.031), and MBI (p &amp;lt; 0.001) were more pronounced in the experimental group compared with the control group.ConclusionConventional rehabilitation therapy combined with BCI rehabilitation therapy can improve the lower limb motor function of hemiplegic patients with stroke, enhance the patient’s ability to perform activities of daily living, and promote the improvement of walking function, this is an effective rehabilitation policy to promote recovery from lower extremity motor function disorders.

A cross-sectional epidemiological study of animal bite victims in district hospital Alwar, Rajasthan, India

Background: Rabies, an invariably fatal viral disease, transmitted to humans through animal bites, mostly dogs. According to WHO, each year, 23000-25000 people die in the SEA region due to rabies. These accounts for approximately 45% human deaths due to rabies worldwide. Objective was to study epidemiological trend of animal bite in Alwar district hospital. Methods: A retrospective, record-based study was conducted in 200 animal bite victims presenting to district hospital Alwar, Rajasthan wherein information on monthly number of animal bite cases was collected from records section of the hospital. Information on annual number of animal bite cases was available from the annual report of the hospital from 2018 onwards, this data was used for studying the monthly variation in animal bite cases. Data were compiled and analyzed using Microsoft Excel. Results: Among 200 victims 76.3% were males, 56.7% belongs to 15-45 years, 61.6% were living in urban area, 31.3% and 21.7% of the victims were agriculture worker and laborers respectively. Among 95.8% victims bitten by dog, 89% of them were stray. 89.4% had category III bite, lower extremity affected in 60.8%, fate of animal was unknown in 78.6% and 46% of the victims were bitten during evening hours. Conclusions: Majority of bites were by stray dogs, unprovoked and category III bites. This indicates the need of large amount of anti-rabies serum or HRIG thereby increasing the cost of management of animal bite cases. There is a need to control stray dog population and immunize pet dogs.

Effect of lower extremity joint distraction exercises during warm-up on range of motion, flexibility, and jump performance in female volleyball players

Effect of lower extremity joint distraction exercises during warm-up on range of motion, flexibility, and jump performance in female volleyball players

Rare entrapment neuropathies of the lower extremity: A narrative review.

Lower limb entrapment neuropathies comprise a wide range of disorders, including less common conditions like tarsal tunnel syndrome, Morton neuroma, obturator nerve entrapment syndrome, superior gluteal nerve entrapment, and cluneal nerve entrapment syndrome. Despite being less prevalent, these syndromes are equally significant, presenting with symptoms such as pain, dysesthesia, muscular weakness, and distinct physical signs. Accurate diagnosis of these less common disorders is crucial for successful therapy and patient recovery, as they can sometimes be mistaken for lumbar plexopathies, radiculopathies, or musculotendinous diseases. This narrative review highlights the significance of identifying and diagnosing these particular neuropathies through a comprehensive assessment of the patient's medical history, detailed physical examination, and the use of electrodiagnostic and/or ultrasound investigations. When the diagnosis is uncertain, advanced imaging techniques like magnetic resonance neurography or magnetic resonance imaging are necessary to confirm the diagnosis. A positive diagnosis ensures prompt and targeted treatments, preventing further nerve impairments and muscle wasting. This article explores the epidemiology, anatomy, pathophysiology, etiology, clinical presentation, and electrodiagnostic interpretation of lower limb entrapment neuropathies, highlighting the importance of precise diagnosis in achieving favorable patient outcomes.

Assessing Functional Ankle Instability in Sport: A Critical Review and Bibliometric Analysis.

Functional Ankle Instability (FAI) is the subject of extensive research in sports and other environments. Given the importance of accurately measuring this latent construct, it is imperative to carry out a careful assessment of the available tools. In this context, the aim of this review was to take an in-depth look at the six most cited measurement tools to assess FAI, with a specific focus on patient-reported outcome measures related to ankle and foot. Four electronic databases (Web of Science, Scopus, Pubmed, and SportDiscus) were searched (up to November 2022) to identify the six most cited questionnaires for assessing FAI. Our analysis showed that the most cited questionnaires are the following: the Lower Extremity Functional Scale (LEFS), the Foot Function Index (FFI), the Foot and Ankle Ability Measure (FAAM), the Foot and Ankle Outcome Score (FAOS), the Olerud and Molander Ankle Score (OMAS), and the Cumberland Ankle Instability Tool (CAIT). Each questionnaire was thoroughly assessed and discussed in three sections: Development, Reliability, and Summaries. In addition, bibliometric data were calculated to analyze the relevance of each questionnaire. Despite variations in terms of validity and reliability, conceptualization, structure, and usefulness, the six questionnaires proved to be robust from a psychometric point of view, being widely supported in the literature. The bibliometric analyses suggested that the FAOS ranks first and the FFI ranks sixth in the weighted average of the impact factors of their original publications.

Primary LYmphedema Multidisciplinary Approach in Patients Affected by Primary Lower Extremity Lymphedema.

Background: Primary lymphedema is a chronic condition caused by a developmental abnormality of the lymphatic system, leading to its malfunction. Various surgical options, including physiologic and excisional procedures, have been proposed. The aim of this study was to present a comprehensive algorithm for the treatment of primary lower extremity lymphedema: the Primary LYmphedema Multidisciplinary Approach (P-LYMA). Methods: Nineteen patients were treated following the P-LYMA protocol. Patients underwent pre- and postoperative complex decongestive therapy (CDT). A variety of physiologic and excisional procedures were performed, either independently or in combination. The primary outcome was to assess the circumferential reduction rate (CRR). The Lymphedema Quality of Life Score (LeQOLiS), reduction in the number of cellulitis episodes, and complications were recorded. Results: The mean CRR was 73 ± 20% at twelve months postoperatively. The frequency of cellulitis episodes per year decreased from a mean of 1.9 ± 0.8 preoperatively to 0.4 ± 0.6 during follow-up. Two patients experienced minor complications. The mean hospitalization time was 5 days. Patients' quality of life, as measured by the LeQOLiS, significantly improved from 70.4 ± 12 preoperatively to 24 ± 14 at twelve months postoperatively. Conclusions: The P-LYMA algorithm maximizes surgical outcomes and improves the quality of life in patients with primary lymphedema. CDT is essential for optimizing results.