Lower Limbs Of Healthy Subjects Research Articles

Does the osteopathic pedal pump reduce lower limb volume in healthy subjects?

Lymphatic treatments are gentle and passive techniques believed to enhance movement of lymph back into the central circulatory system. Animal studies provide supportive evidence, yet there are few studies in humans. The aim of this study is to investigate whether the osteopathic pedal pump protocol reduces volume in the lower limbs of healthy subjects. A total of 30 first- and second-year medical students were recruited. Subjects were excluded from participating if they had acute asthma, chronic obstructive pulmonary disease (COPD), congestive heart failure, active infections, fractures of the lower extremities, or metastatic cancer. A within-subjects study design with pre- and posttreatment measurement of lower limb volume was utilized. Pretreatment lower limb volume measurements were obtained utilizing a volumetric water gauge prior tomyofascial thoracic inlet release anda 5min pedal lymphatic pump protocol treatment. Posttreatment lower limb measurements were taken immediately following the protocol treatment. A telephone interview was conducted 2-3days after the treatment to assess the participants' experience of the treatment and whether the treatment elicited a subjective change from baseline. A paired t test was utilized to determine the statistical significance of volume displacement posttreatment. The mean change of pretreatment to posttreatment lower limb volume was-45.63mL with a standard deviation of 37.65mL. The change between the pretreatment and posttreatment volume measurements was statistically significant (p<0.001). The minimum displacement was+19mL, and the maximum displacement was-167mL. The majority of participants perceived the treatment as effective and enjoyable, were likely to recommend it to others, and were willing to have it performed on them at routine office visits if there was a need. The osteopathic pedal pump technique, when utilized on those without leg lymphedema, reduces lower limb volume as measured by the volumetric water gauge. Further studies are warranted, especially in persons with excess lower-extremity edema, lymphedema or venous stasis.

Strategies for maintaining dynamic balance in persons with neurological disorders during overground walking.

Maintaining a stable gait requires a dynamic balance control, that can be altered in persons with Multiple Sclerosis (MS), Stroke (ST), and Parkinson's disease (PD). The understanding of the strategy for Center of Mass (CoM) positioning adopted by patients during walking is important to be able to program treatments aimed at improving gait control and preventing falls. Forty-four persons with a mild-to-moderate neurological disorder (20 with MS, 14 with ST, 10 with PD) underwent clinical examination and gait analysis. Ten Healthy Subjects (HS) walking at matched speed provided the normative data. Dynamic balance was assessed using the margin of stability (MoS). It was calculated as the distance between the extrapolated Center of Pressure and the extrapolated CoM at mid-stance. The MoS values for lower limbs were calculated in patients and compared with speed-matched values of HS. Persons with neurological disorder showed increased MoS in the medio-lateral direction with respect to HS. Within-group comparison analysis showed a symmetry between lower limbs in HS (Mean (95%CI) [mm], dominant vs non-dominant limb, 43.3 (31.9-54.6) vs 42.9 (28.8-56.9)) and PD (less affected vs more affected limb, 71.1 (59.8-82.5) vs 72.5 (58.5-86.6)), while a significant asymmetry was found in MS (54.4 (46.4-62.4) vs 81.1 (71.2-91.1)) and ST (52.1 (42.6-61.7) vs 74.7 (62.8-86.6)) participants. The history of falls was comparable among PD, MS, and ST groups, and the MoS in the frontal plane showed a strong correlation with these records. Objective assessment of MoS revealed pathology-specific strategies showing different impacts in MS, ST, and PD on the ability to control CoM information to manage the balance between limbs during gait. MoS evaluation will provide useful information to address a tailored rehabilitation program and to monitor disease progression.

Electrodiagnostic reference data for motor nerve conduction studies in Saudi Arabia.

Objectives:To determine nerve conduction studies (NCS) reference data for motor nerves and F-waves in the upper and lower limbs of healthy subjects in Saudi Arabia.Methods:This is a cross-sectional study conducted between May 2015 and June 2019. Healthy subjects without neurological or systemic diseases were recruited. Motor NCS were performed following a standard protocol. Pearson correlations were employed between NCS parameters and age, gender, height, weight, and body mass index. Reference data were generated using the percentile method.Results:A total of 127 subjects were recruited for the upper limb studies and 137 for the lower limb studies. Quantile regression models were generated to estimate compound muscle action potential amplitude (adjusted for age), as well as F-wave minimal latency (adjusted for height). The estimated reference limits of distal motor latency (ms) and conduction velocity (m/s) for the different nerves were, respectively, 3.7 and 50 for the median nerve, 3.3 and 50 for the ulnar nerve, 5.8 and 40 for the tibial nerve, and 5.0 and 40 for the fibular nerve.Conclusion:The reference data for motor NCS parameters and F-wave minimal latency are generally comparable with those of Western countries. However, minimal differences were observed. The underrepresentation of the older age group warrants future studies.

Comparative Analysis of Lower Limb Alignments in Healthy Subjects and Subjects with Back Pain

The objective of the present study was to comparatively analyze the clinical status of the lower limbs in healthy subjects and subjects with back pain. Forty three (43) male and female subjects with average age of 36.91± 3.97 were selected as the statistical sample of the study. This population was recognized intelligently by utilizing the Nordic Musculoskeletal Questionnaire (NMQ). Furthermore, the NMQ was used to designate 43 male and female subjects with average age of 37.88 ± 4.12 and similar anthropometric characteristics with the statistical population as the research control sample. In the next phase, tibial torsion and femoral torsion angles were measured using a goniometer. Foot typicality was designated using a foot arch index while intercondylar and intermalleolar distances were measured using a clinical caliper. The results depict that the size of the foot arch is steeper in people with back pains compared to those with flat foot arch (p<0.05). It also indicates that there is no significant correlation between the tibia, femur torsion, knee condition of the healthy subjects and subjects with back pain. Therefore, it is deduced that steep foot arch can be a key component in the generation of back pains.

Intersession reliability of thoracolumbar multisegmental motor responses

Study designExperimental design.ObjectiveTo determine test-retest reliability across sessions of the thoracolumbar multisegmental motor responses (MMR) in the upper and lower limbs of healthy subjects. Test-retest reliability of MMR has not been established or examined in previous studies.SettingsNeuro Laboratory of the Texas Woman's University (School of Physical Therapy, Houston, TX, USA).MethodsThe MMR of 15 healthy subjects were tested over two sessions. T11–12 vertebral segments were electrically stimulated using surface electrodes. MMR signals of the upper and lower limbs were recorded, using surface electrodes, from the upper extremity muscles (abductor pollicis brevis, flexor carpi radialis, biceps brachii, triceps brachii), and from the lower extremity muscles (vastus medialis obliqus, medial hamstring, soleus, tibialis anterior). The peak-to-peak maximum amplitude and deflection latency were the dependent parameters. Data from the first session was compared with a second session (on a different day), using interclass correlation coefficient (ICC), to evaluate the reliability across sessions. In addition, data from the right limbs were compared with the left limbs.ResultsMMR of the right and left, upper and lower extremities were comparable between limbs in all subjects. Further, signals were highly correlated between days of testing (ICC = 0.58–0.99) and was not statistically different between the two sessions in the same subject.ConclusionThese results indicate that MMR studies could be useful for serial testing of patients with neurological disorders, such as spinal cord injuries and diseases.

Impedance plethysmography as a tool for assessing exertion-related blood flow changes in the lower limbs in healthy subjects

Impedance plethysmography, also known as the impedance test, the blood flow test, or impedance phlebography, is a non-invasive test that measures blood flow in the vessels of the peripheral vascular system by monitoring changes in electrical resistance (impedance) to detect deep thrombosis (blood clots or thrombophlebitis).The aim of our study was to use this technique for assessing changes in blood flow in the lower limbs in healthy subjects wearing protective footwear while walking.The test was performed on a group of 30 professional firefighters (age 30.7±4.5, BMI 25.1±3). Blood flow was monitored in the peripheral vascular system of the lower limbs during walking on a treadmill. The testing protocol consisted of the following three phases: warm-up, exercise, and rest.In order to identify differences between the three phases of the study, analysis of variance (ANOVA) with repeated measures was conducted. The statistically significant parameters of blood flow in the lower limbs were the impedance ratio (IR) (p<0.001), slope ratio (SR) (p<0.001), crest width (CW) (p<0.001), and alternative blood flow (ABF) (p<0.001). All of them showed an upward trend.The study confirmed the validity of impedance plethysmography as a non-invasive technique for measuring blood flow changes in the lower limbs in healthy subjects, especially under non-steady-state conditions, such as walking. This technique provides valuable quantitative data.Therefore, impedance plethysmography may be considered a reliable research method enabling evaluation of local blood flow in healthy subjects under different conditions.

Thoracolumbar multisegmental motor responses in the upper and lower limbs in healthy subjects

Experimental design. This descriptive study presents muscular responses from both the upper and the lower extremities during T11-12 segmental stimulation. Neuro Lab of the Texas Woman's University (School of Physical Therapy, TX, USA). A total of 13 healthy subjects were electrically stimulated using surface electrodes. In trial 1, signals were recorded from the flexor hallucis brevis, soleus, vastus medialis and gluteus medius in the lower right extremity. In trial 2, responses were recorded from the abductor digiti minimi, abductor pollicis brevis (APB), flexor carpi radialis and biceps brachii in the right upper extremity. In trial 3, stimulation was carried out and signals were recorded for both the upper and the lower extremities simultaneously, using different muscle combinations. Five traces per muscle were averaged for each step of the testing. Amplitude and deflection latency were the measured parameters and were compared using descriptive statistics. Results showed signal amplitudes ranging from 85 to 821 μV in the upper extremity and from 582 to 3927 μV in the lower extremity, with the largest signal recorded in the soleus muscle and the APB. Response latency varies between 5.5 and 14 ms in the upper limbs and between 7.7 and 27 ms in the lower limbs and was comparable in bilateral recording. These muscular responses seem to be elicited from electrical stimulation of motor nuclei in lower limb muscles or from pathways to those nuclei in upper limb muscles, and could be useful in testing patients with spinal disorders.

Desempenho do membro não-acometido em pacientes com reconstrução do ligamento cruzado anterior

Défices sensoriais persistentes após a reconstrução do ligamento cruzado anterior (LCA) podem causar alterações como fraqueza muscular e comprometimento do equilíbrio e do desempenho funcional. Diversos estudos discutem se essas alterações também estão presentes no membro inferior não-acometido e se esse membro pode ser utilizado como referência nas avaliações desses pacientes. O objetivo do presente estudo foi comparar o torque extensor e flexor do joelho, o equilíbrio unipodal e o desempenho funcional sobre o membro não-acometido de pacientes submetidos à reconstrução do LCA, com membros inferiores de sujeitos saudáveis. Participaram do estudo 23 indivíduos submetidos à reconstrução do LCA e 22 sujeitos saudáveis, que foram avaliados quanto ao torque extensor e flexor do joelho durante contração isocinética concêntrica a 60 graus/s no dinamômetro isocinético, à velocidade média de oscilação do centro de pressão em apoio unipodal no baropodômetro, e submetidos a dois testes de salto para avaliar o desempenho funcional. Os resultados não revelaram diferenças entre o membro não-acometido e os membros inferiores do grupo controle em todas as variáveis estudadas (p&gt;0,05). Esses resultados sugerem que o membro não-acometido de pacientes submetidos à reconstrução do LCA pode ser utilizado como referência nos estudos de avaliação desses pacientes.

Differences Between Upper and Lower Limbs in Venous Endothelial Reactivity in Humans

Objective: To determine the variability of endothelial reactivity to venostasis in the upper and lower limbs of healthy subjects. Participants: Ten healthy volunteers were investigated twice, at an interval of 1-week. Main outcome measures: Plasma concentrations of substances released from endothelial cells were determined in each limb after 10 min of venostasis in a sequential manner. Tissue plasminogen activator (tPA), plasminogen activator inhibiting factor (PAI-1), thrombin–antithrombin complexes (TAT) and D-dimers (D-Di) were used as indicators of the thrombotic process and its reactions; angiotensin converting enzyme (ACE) and endothelin-1 (ET1) were related to endothelial cell activity involved in vascular tone regulation. Results: No difference was observed in endothelial cell recovery following venostasis after an interval of 1 week. A significant difference in endothelial cell release was found between the upper and lower limbs and between the right and left legs. Conclusions: Excellent reproducibility of measurements was observed. In keeping with the higher frequency of venous thrombosis in the lower limbs, the left leg seemed to be less reactive after venostasis, and the endothelium was more reactive in the upper than in the lower limbs.