Normal Leg Research Articles

Ancient developmental genes underlie evolutionary novelties in walking fish

A critical question in biology is how new traits evolve, but studying this in wild animals remains challenging. Here, we probe the genetic basis of trait gain in sea robin fish, which have evolved specialized leg-like appendages for locomotion and digging along the ocean floor. We use genome sequencing, transcriptional profiling, and interspecific hybrid analysis to explore the molecular and developmental basis of leg formation. We identified the ancient, conserved transcription factor tbx3a as a major determinant of sensory leg development. Genome editing confirms that tbx3a is required for normal leg formation in sea robins, and for formation of enlarged central nervous system lobes, sensory papillae, and adult digging behavior. Our study establishes sea robins as a model organism for studying the evolution of major trait gain and illustrates how ancient developmental control genes can underlie novel organ formation.

Interactions between rearward-facing child restraint systems and the center console in frontal impact sled tests

Objective To quantify the head and chest injury metrics associated with a pediatric anthropomorphic test device (ATD) in rearward-facing infant child restraint system (CRS) models positioned directly behind a center console during frontal impact sled tests. Methods Sled tests using the Federal Motor Vehicle Safety Standard (FMVSS) 213 frontal crash pulse were performed. The test buck comprised a second row middle seat and center console from the same 2023 model mid-size SUV spaced as per the in-vehicle relative dimensions, a force plate covered with an automotive floor mat, a post-mounted shoulder belt simulating the in-vehicle roof-mounted seatbelt and an array of high-speed cameras. The 12-month-old Child Restraint/Air Bag Interaction (CRABI-12) ATD was seated in one of two rearward-facing infant CRS models (model A, rigid lower anchors; model B, flexible lower anchors), which was installed with either the base (support leg or no support leg; attached using lower anchors or the seatbelt) or without the base (attached using the European or US belt path). Conductive foil was attached to the rear surface of the center console and to the shell of the CRS and/or base to quantify contact. The vehicle seat was replaced every second test and the center console was replaced when damaged. Results For sled tests of the CRS models with a base attached using lower anchors, there was no contact of the CRS with the center console when the support leg was used, and all head and chest injury metrics were reduced compared to the tests of CRS with no support leg. However, there was contact between the CRS and the center console when the base of the CRS models was attached using the seatbelt, which typically increased head and chest injury metrics compared to the lower anchor attachment method. For CRS model B with the base attached using either the lower anchors or the seatbelt but no support leg, head acceleration 3 ms clip exceeded the injury assessment reference value (IARV) of 80 g. All tests resulted in HIC36 values below the IARV of 1000. The tests of the CRS models without a base using the European belt path did not result in contact and had the lowest head and chest injury metrics of all tests, which were all below IARVs. For the tests of the CRS models with the base attached using the seatbelt and tests using the US belt path, chest acceleration 3 ms clip values exceeded the IARV of 60 g. Peak normal support leg reaction forces in this study ranged from 3.6 to 4.3 kN. Conclusions The rearward-facing CRS models with a base and a support leg attached using lower anchors, or without a base using the European belt path, resulted in the lowest head and chest injury metrics due to not contacting the center console.

Bending induced polarization charges in non-polar porous polymer for stroke rehabilitation

Owing to the flexibility, lightweight, long-life and low cost, polymers are promising candidates to realize electromechanical conversion in wearable electronics. The flexoelectric effect enables non-piezoelectric materials to achieve electromechanical coupling, thereby broadening application ranges of nonpolar polymers. In this work, the porous samples of polydimethylsiloxane (PDMS) with various pore sizes and porosities are fabricated by the sacrificial salt template method and the chemical gas foaming method. The flexoelectric polarization response can be tuned directly by the structural characters of the porous PDMS. The transverse flexoelectric coefficient of porous PDMS can reach approximately 2.9 times the counterpart of the bulk one. The competitive mechanism between strain gradient and permittivity is proposed on flexoelectricity of random porous media by dielectric impedance spectrums and finite element analyses. The present regulation of flexoelectricity provides an alternative to electromechanical conversion. With the deep learning technique based on one-dimensional convolution neural networks, actions of both sick and normal legs of various stroke patients can be well recognized by the designed device of rehabilitation. The present rehabilitation monitoring system, which is an innovative application of the flexoelectricity in the porous polymers, offers a new approach to support physical therapy for post-stroke patients.

Good physical function but reduced quality of life in children 3 years after ACL reconstruction.

To assess children's physical function and subjective knee status 1 and 3 years after anterior cruciate ligament (ACL) reconstruction. It was hypothesised that there was no difference between the operated and normal legs in relation to physical strength and function, that there was <-2 mm side-to-side difference in knee laxity, and that the subjective knee function was better 3 years after ACL reconstruction compared to 1 year after. Children (<16 years of age) who had an ACL reconstruction had follow-up with physical function tests (four hop tests and strength measurement in a power rig [PR]), anterior knee laxity (measured using a Rolimeter) and patient-reported outcome measures (Pedi-International Knee Documentation Committee [IKDC] and Knee injury and Osteoarthritis Outcome Score [KOOS]-Child) 1 and 3 years postoperatively. Changes from 1- to 3-year follow-up were evaluated with a paired t test. Out of 148 ACL reconstructed children, 60 had all measures. The four hop tests and the PR all yielded a Limb Symmetry Index >90% at both follow-ups. There was a significant improvement from 1- to 3-year follow-up in two-hop tests (6 m on time and crossover hop). Side-to-side knee laxity was >2 mm in four children at 1- and 3-year tests. Pedi-IKDC scores increased, and KOOS-Child improved significantly from 1 to 3 years in two of the five domains: 'Sport' and 'Quality of life', but scores were lower than in a cohort of normal children. The children had good objective physical function 1 and 3 years after ACL reconstruction. However, scores from the KOOS-Child sport-specific function and quality of life domains were lower than in normal children. Level II.

DESIGN AND DEVELOPMENT OF A DEVICE FOR REDUCTION OF DATA LOSS AND TIME TAKEN FOR TRANSFERRING THE DATA INTO AN ARTIFICIAL BIOCOMPOSITE SOCKET PROSTHESIS THROUGH ARDUINO

In recent years, technical innovations have made artificial limbs much more comfortable, but not patient satisfaction. In this work, an artificial bio-composite prosthesis is designed and developed. Further, the concept of cloning the movement action of the anatomical leg and feeding it to the prosthetic leg is achieved through an accelerometer sensor and microcontroller. Results demonstrate that the efficiency of the proposed device depends on the angle suspension, hinge lubrication and the prosthetic material, which should be sufficient to sustain the development and application of technological solutions. The proposed sensor-based technology plays an important role in rehabilitation field. It has been proven from this work that the data transfer from the normal leg to the prosthetic leg is quick and data loss is reduced. The design of the prototype could mimic various gestures and motions to make things feel much better for amputees. A prototype mimicking the functions of the human leg was successfully designed, bringing out various gestures and motions for the betterment of the amputees. This sensor-based technology gives a great solution for amputees to make life better like a normal person. As the sockets are made up of jute fiber reinforced epoxy biocomposite material, the skin irritation is reduced for the above-knee amputee patients. Through this proposed prosthetic leg, the patients can perform the normal actions of the leg as a healthy person. Also, the proposed mechanism is highly suitable for disabled patients for their better gait movement.

Walking leg regeneration in the sea spider Nymphon brevirostre Hodge, 1863 (Pycnogonida)

Regeneration is widespread across all animal taxa, but patterns of its distribution and key factors determining regeneration capabilities stay enigmatic. A comparative approach could shed light on the problem, but its efficacy is limited by the fact that data is only available on a few species from derived taxa. Pycnogonida are nested basally within the Chelicerata. They can shed and replace their walking legs and have a high regeneration capacity. In this work, we carried careful observation on leg appendotomy and regeneration processes in a sea spider under laboratory settings. The limb structure and in vivo observation reveal autotomy as the most likely appendotomy mechanism. High regeneration capabilities were ascertained: an anatomically normal but small leg appeared in a single molting cycle and the full functionality regained in 2–3 cycles. Wound closure after appendotomy in N. brevirostre primarily relies on hemolymph coagulation, which apparently differs from both xiphosurans and crustaceans. Regeneration is provided by proliferation in the leg cutpiece. Regenerative morphogenesis resembles the normal ontogenetic morphogenesis of a walking leg, but accelerated. Unlike in most arthropods, in N. brevirostre, regeneration does not necessarily correspond to the molting cycle, inferring a plesiomorphic state.

Biomechanical Analysis about Syndesmotic Stability for AITFL Augmentation with Fibular Plate

Category: Trauma; Sports Introduction/Purpose: Surgical technique to treatment syndesmosis injury is controversial. Additional suture-tape (ST) augmentation of anterior inferior tibiofibular ligament (AITFL) has been reported to improve syndesmotic stability compared with only suture-button (SB) fixation. ST fixation on the fibula is mainly performed with suture anchors, but suture holes with fibular plates can also be used. However, there is no biomechanical study about syndesmotic injury treated with ST augmentation using fibular plate. The aim of this study is to evaluate the stability of the syndesmosis injury model treated with ST augmentation using fibular plate. Our hypothesis is that ST augmentation using fibular plate can provide equivalent syndesmotic stability compared with ST augmentation using suture anchor. Methods: 8 normal fresh-frozen cadaver legs (4 males and 4 females) were used. The mean age at the time of death was 84.3 (70- 101). The specimens were tested while applied traction and rotational forces to represent dorsiflexion and external rotation of ankle joint. The fibular rotational angle related to the tibia (FRA) and anterior tibiofibular diastasis(aTFD) were measured using the magnetic tracking system while each load was applied. Intact, injured, SB + ST augmentation using suture anchor (anchor model), SB + ST augmentation fixation using fibular plate (plate model) models made, and loaded forces and measured FRA and aTFD with each model. One-way ANOVA was used to evaluate the relationship of the angles or the diastasis among each model. Post-hoc analysis for differences among the models were checked using Dunnett’s test. P value of 0.05 was chosen as the level of significance. Results: With dorsiflexion forces, in the injured model, both FRA and aTFD were significantly increased compared with intact model. In the anchor and plate model, both FRA and aTFD were not significantly different compared with intact model. With external rotation forces, in the injured model, both FRA and aTFD were significantly increased compared with intact model. In the anchor and plate model, both FRA and aTFD were not significantly different compared with intact model. Conclusion: The result of this study presented that ST augmentation using fibular plate provide syndesmotic stability similarly with ST augmentation using suture anchor. This technique was considered to be useful in cases of syndesmosis injury with lateral malleolar fracture. Particularly, it is difficult to use suture anchor for ST fixation to the fibula when there is a comminuted fracture near the AITFL attachment of the fibula. Using plate allows for stable ST fixation to the fibula without worrying about it.

Functional leg performance 2 years after ACL surgery: a comparison between InternalBrace™-augmented repair versus reconstruction versus healthy controls

BackgroundWhile clinical and patient-reported outcomes have been investigated in patients after InternalBrace™-augmented anterior cruciate ligament repair (ACL-IB), less is known regarding restoration of functional performance. We aimed to determine differences in functional performance within and between patients 2 years after ACL-IB, patients 2 years after ACL reconstruction (ACL-R), and healthy controls.Materials and MethodsA total of 29 ACL-IB, 27 ACL-R (hamstring autograft), and 29 controls performed single-leg hop (maximum forward distance hop, SLH; side hop > 40 cm in 30 s, SH), proprioception (knee joint position sense at 30° and 60° flexion), and dynamic postural balance (Y Balance) tests. Differences were calculated within groups (side-to-side difference) and between the involved leg of patients and the non-dominant leg of controls, and were evaluated to predefined statistical (P < 0.05), clinically relevant, and methodological (smallest detectable change) thresholds. The number of exceeded thresholds represented no (0), small (1), moderate (2), or strong (3) differences. In addition, the relative number of participants achieving leg symmetry (≥ 90%) and normal performance (≥ 90% of the average performance of the non-dominant leg of controls) were compared between groups (chi-squared tests, P < 0.05).ResultsWe observed no-to-moderate leg differences within ACL-IB (moderate difference in hops) and within ACL-R (moderate difference in knee proprioception), no leg differences between patient groups, no-to-small leg differences between ACL-IB and controls, and no leg differences between ACL-R and controls in functional performance. However, two patients in ACL-IB and ACL-R, respectively, passed the hop pretest only with their uninvolved leg, and fewer patients after ACL-IB and ACL-R than controls reached a leg symmetry and normal leg performance of controls in SLH (P < 0.001).ConclusionsFunctional performance seems to be comparable 2 years postoperatively between ACL-IB and ACL-R for a specific subgroup of patients (i.e., proximal ACL tears, moderate activity level). However, the presumed advantage of comparable functional outcome with preserved knee structures after augmented ACL repair compared with ACL-R, and the tendency of both patient groups toward leg asymmetry and compromised single-leg hop performance in the involved legs, warrants further investigation.Level of Evidence Level III, case-control study.Trial registration clinicaltrials.gov, NCT04429165 (12/09/2020). Prospectively registered, https://clinicaltrials.gov/ct2/show/NCT04429165.

Role of the Hox Genes, Sex combs reduced, Fushi tarazu and Antennapedia, in Leg Development of the Spider Mite Tetranychus urticae.

Mites, the second largest arthropod group, exhibit rich phenotypic diversity in the development of appendages (legs). For example, the fourth pair of legs (L4) does not form until the second postembryonic developmental stage, namely the protonymph stage. These leg developmental diversities drive body plan diversity in mites. However, little is known about the mechanisms of leg development in mites. Hox genes, homeotic genes, can regulate the development of appendages in arthropods. Three Hox genes, Sex combs reduced (Scr), Fushi tarazu (Ftz) and Antennapedia (Antp), have previously been shown to be expressed in the leg segments of mites. Here, the quantitative real-time reverse transcription PCR shows that three Hox genes are significantly increased in the first molt stage. RNA interference results in a set of abnormalities, including L3 curl and L4 loss. These results suggest that these Hox genes are required for normal leg development. Furthermore, the loss of single Hox genes results in downregulating the expression of the appendage marker Distal-less (Dll), suggesting that the three Hox genes can work together with Dll to maintain leg development in Tetranychus urticae. This study will be essential to understanding the diversity of leg development in mites and changes in Hox gene function.

Economic and thermal performance analysis of two-stage thin-film solar thermoelectric power generator

One of the performance enhancement strategies in thermoelectric technology is application of two-stage leg instead of normal single stage leg structure. However, for a thin-film solar thermoelectric generator applying this strategy requires many in-depth considerations including economic -cost and reliability aspects. In this research, attempts are made to identify the economic and performance characteristics of a two-stage thin-film solar thermoelectric generator under various geometrical conditions and then compare with normal single stage configuration. Generally, in addition to being cost-effective compared to the single-stage design, the double-stage design can produce more power if the appropriate material is selected. The results of numerical simulations show that the use of bismuth tellurides in single stage thermoelectric generator (SATEG) legs improves the performance of the system in terms of power generation. But the use of skutterudites in the lower layer and bismuth tellurides in the upper layer of the two-stage case, in addition to increasing the output power, significantly reduces the dollar/watt value. Furthermore, the highest output power and exergy efficiency are obtained in the lower layer angle ratio of 0.8–1 and in the upper layer angle ratio of 2. Among the geometrical parameters, the radius of heated area (Rh) has the greatest effect on the performance of double-stage solar annular thermoelectric generator (DSATEG). The highest power output is obtained at Rh = 1.5, which is equal to 1.323W.

Carcass composition, meat quality, leg muscle status, and its mRNA expression profile in broilers affected by valgus-varus deformity

Valgus-varus deformity (VVD) is a common leg disease in commercial broilers, which seriously affects animal welfare and causes economic losses. Up to now, most of the studies on VVD have been on skeleton, whereas there are fewer studies on VVD muscle. In this study, carcass composition and meat quality of 35-day-old normal and VVD Cobb broilers assess the effect of VVD on broiler growth. Molecular biology, morphology, and RNA sequencing (RNA-seq) were used to study the difference between normal and VVD gastrocnemius muscle. In comparison with the normal broilers, the breast muscle and leg muscle of the VVD broilers had lower shear force, notably lower crude protein, lower water content, cooking loss, and deeper meat color (P < 0.05). The morphological results showed that the weight of skeletal muscle was significantly higher in the normal broilers than that in the VVD broilers (P < 0.01), the diameter and area of myofibrils in the affected VVD were smaller than in the normal broilers (P < 0.01). Quantitative real-time PCR (qPCR) of gastrocnemius muscle revealed that the expression of myasthenic marker genes, fast myofiber marker genes, and apoptosis-related factors were significantly higher in the VVD broilers than in the normal broilers (P < 0.01). In total, 736 differentially expressed genes (DEGs) were identified firstly in the normal and VVD leg muscle by RNA-seq. Gene ontology (GO) enrichment indicated that these DEGs were mainly involved in the multicellular organismal process and anatomical structure development. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that DEGs are significantly enriched in proteasome. Protein interaction analysis obtained that DEGs with high interaction were proteasome-related coding genes and ubiquitin-related genes, these DEGs were closely associated with muscle atrophy. These show that VVD has an adverse effect on growth characteristics, slaughter characteristics, and meat quality in broilers, which may cause leg muscle atrophy. This study provides some reference values and basis for studying the pathogenesis of VVD in broilers.

Scales Feature Foot Scanners as Parameters of Flat Feet in Children

The primary function of the legs is to provide the necessary support and encouragement for human bipedal movements. Flat feet or also known as pes planus, is a problem that is often encountered in daily pediatric practice for most children. This study aims to classify the shape of the soles of the feet in children aged 6-9 years to be divided into three parts, namely high arch, normal arch and flat arch. Clarke's angel is defined as the angle obtained by a tangent that joins the medial edge of the first metatarsal head and the heel, on the second line connects the metatarsal caput one with the centre of the longitudinal arch of the medial side. Of the 30 children, 66.67% (20 students) had a flatfoot foot shape and 33.33% (10 students) had a normal foot sole shape and none of the students had a cavus arch foot sole shape. The mode in children with normal legs is Enough with a percentage of 60% and in children with flatfoot is bad with a percentage of 75%. This proves the relationship between flatfoot and static balance in children. From the research we conducted, it can be concluded that the featured scales we made can capture the image of a child's feet to identify flat feet and the relationship between flat feet and the static balance of a child. From the research that has been carried out, we compare existing data using three methods. The primary method we use is Matlab software with comparison data using wet footprints and stork stand tests, which shows excellent accuracy and can be a reference for measuring the soles of the feet in the future.

Biomechanical Study of Syndesmotic Stability in AITFL and PITFL Injury Models

Category: Basic Sciences/Biologics; Trauma Introduction/Purpose: Severe ankle syndesmotic injuries can cause not only anterior inferior tibiofibular ligament (AITFL) injury but also posterior inferior tibiofibular ligament (PITFL) injury. However, the biomechanical stability and the best surgical treatment method for PITFL injuries are unknown. This study aimed to evaluate the stability of AITFL and PITFL injury models and the treatment models with suture-button (SB) fixation, AITFL augmentation with suture-tape (aST), and PITFL augmentation with suture-tape (pST). We hypothesized that PITFL injury causes posterior instability of syndesmosis and that this can be stabilized with pST fixation Methods: This study was approved by our institution's ethics review board. Ten normal fresh-frozen cadaver legs (4 males and 6 females) that were donated to our university's department of anatomy were used. The specimens were tested with the application of traction and rotational forces for dorsiflexion and external and internal rotation of the ankle joint. The fibular rotational angle related to the tibia (FRA), anterior tibiofibular diastasis (aTFD), and posterior tibiofibular diastasis (pTFD) were measured using the magnetic tracking system. Intact, injured (AITFL, PITFL and IOM resection), SB fixation, SB + aST fixation, and SB + aST + pST fixation models were made and loaded with forces. One-way ANOVA was used to evaluate the relationship between the models. Post-hoc analysis of the differences between the models was performed using Dunnett's test. A p value of 0.05 was chosen as the level of significance. Results: In the injured model, both FRA and TFD were significantly increased compared with those of the intact model in all directions. In the SB fixation model, only FRA with an external rotation force was significantly increased compared with that of the intact model. In the SB+aST model, both FRA and aTFD were not significantly different from those in the intact model. Conclusion: The results of this study showed that there was external and internal rotational instability in the AITFL and PITFL injury models, while there was stability in the SB + aST model. SB fixation alone did not reduce FRA with an external rotation force and there was no significantly different FRA with an internal rotation force. With SB fixation alone, anterior instability was found to be greater than posterior stability, while aST fixation was associated with anterior stability. In this study, the change in syndesmosis stability after pST fixation was found to be restrictive.

Human Lower Extremity Motion Analysis introducing Kinovea

Human Motion is the most effective and fundamental functionality utilizing the lower extremities or legs. The replication of human movement is possible in the humanoid robots with simulation related prerequisites. The forward and backward motion simulation of the normal left and right leg is the primary requirement which has been demonstrated in this research paper. The balancing of body is feasible with the leg motion simulation in different conditions such as vertical acceleration and horizontal velocity. The leg motion video of 8secs with forward and backward movement has been taken into consideration for the simulation purpose to check the activity level of the legs. The similar movements can be mimicked in the autonomous bio-robotic systems. Keywords: Leg movement, Robotics, Kinovea, Motion simulation.

Tissue Dielectric Constant of the Lower Leg as an Index of Skin Water: Temporal Variations.

Tissue dielectric constant (TDC) measurements are a convenient, reliable, and accurate way to noninvasively access local tissue water content and its change with time or treatment. The method has been widely used for upper extremity lymphedema assessments but less so for lower extremities. For lower extremity assessments, it would be useful to have an estimate of the expected inter-leg TDC differentials of normal non-affected legs to help interpret measured inter-leg differentials when such measurements are done in patients with lower extremity edema or lymphedema. The goals of this study were to determine normal inter-leg TDC differences, quantify TDC temporal changes during 60 minutes of supine lying in a group of 10 middle-aged women (42-57 years), and evaluate the change in TDC values as measured throughout the day from 0800 to 2000 hours in a group of 10 younger women (23-28 years). The overall findings indicate that TDC measurements, as an assessment parameter of lower extremity localized skin-to-fat tissue water, are only minimally dependent on potential confounding factors such as 60-minute supine lying or the time of day at which the measurements are made. If the small sample size of the present study is reflective of the larger population, an inter-leg TDC ratio exceeding a value of 1.2 is suggested as a threshold for judging unilateral lower extremity edema or lymphedema. This possibility needs assessment in women with these conditions.

Motor signature of autism spectrum disorder in adults without intellectual impairment

Motor signs such as dyspraxia and abnormal gait are characteristic features of autism spectrum disorder (ASD). However, motor behavior in adults with ASD has scarcely been quantitatively characterized. In this pilot study, we aim to quantitatively examine motor signature of adults with ASD without intellectual impairment using marker-less visual-perceptive motion capture. 82 individuals (37 ASD and 45 healthy controls, HC) with an IQ > 85 and aged 18 to 65 years performed nine movement tasks and were filmed by a 3D-infrared camera. Anatomical models were quantified via custom-made software and resulting kinematic parameters were compared between individuals with ASD and HCs. Furthermore, the association between specific motor behaviour and severity of autistic symptoms (Autism Diagnostic Observation Schedule 2, Autism Spectrum Quotient) was explored. Adults with ASD showed a greater mediolateral deviation while walking, greater sway during normal, tandem and single leg stance, a reduced walking speed and cadence, a greater arrhythmicity during jumping jack tasks and an impaired manual dexterity during finger tapping tasks (p < 0.05 and |D|> 0.48) compared to HC. Furthermore, in the ASD group, some of these parameters correlated moderately to severity of ASD symptoms. Adults with ASD seem to display a specific motor signature in this disorder affecting movement timing and aspects of balance. The data appear to reinforce knowledge about motor signs reported in children and adolescents with ASD. Also, quantitative motor assessment via visual-perceptive computing may be a feasible instrument to detect subtle motor signs in ASD and perhaps suitable in the diagnosis of ASD in the future.

Peripheral Arterial Disease Prevalence in a Population-Based Sample of People with Diabetes on the Caribbean Island of Barbados.

BackgroundPeripheral arterial disease (PAD) is a risk factor for amputation and systemic atherosclerotic disease. Barbados has a high diabetes prevalence, and 89% of diabetes-related hospital admissions are for foot problems. Foot examination is infrequent in Barbados primary care. The prevalence and potential risk factors for PAD in people with diabetes in Barbados were studied.MethodsMultistage probability sampling was used to select a representative population sample of people ≥25 years of age with known diabetes or fasting blood glucose ≥7 mmol/L or HbA1c ≥6.5%. We administered the Edinburgh claudication questionnaire and assessed the ankle brachial pressure index (ABI) and Doppler waveform in both dorsalis pedis and posterior tibial arteries. Participants were classified into categories based on ABI as follows: PAD ≤0.90 in any leg; borderline 0.91 to 0.99 in one leg and the other not ≤0.90 or >0.4; normal 1.00 to 1.40 in both legs; and non-compressible >1.40 in one leg and the other not ≤0.9. Waveforms crossing the zero-flow baseline were categorised as normal. Multivariable logistic regression assessed the associations of potential risk factors with PAD.ResultsOf 236 participants (74% response rate, 33% male, median age 58.6 years), 51% had previously diagnosed diabetes. Of nine people with symptoms of definite or atypical claudication, four had PAD and one had non-compressible arteries. ABI prevalence (95% CI) was PAD 18.6% (13.8, 24.6), borderline 21.9% (16.6, 28.4), normal 55.5% (49.4, 61.5) and non-compressible 3.9% (1.6, 9.3). Increasing age and female gender were independently associated with PAD. Over 80% of normal legs (ABI 1.00 to 1.40) had normal posterior tibial and dorsalis pedis waveforms, while only 23% legs with PAD (ABI ≤0.90) had normal waveforms in both arteries (Kappa = 0.43).ConclusionAsymptomatic PAD is common in people with diabetes and requires ABI screening to detect it. Female gender is associated with PAD.

The effectiveness of rehabilitation intervention on knee recovery among patients with limited mobility after lower extremity injuries at Nam Dinh general Hospital in 2021

Objectives: To evaluate the effectiveness of rehabilitation intervention on knee recovery among patients with limited mobility after lower extremity injuries. The results from this study contributed to improving the understanding of the rehabilitation process on patients with limited knee mobility after surgery. Method: a quasi-experimental design study was conducted to compare the differences between before and after rehabilitation intervention from January 2021 to September 2021. 23 patients were treated at the Rehabilitation Department in Nam Dinh General Hospital were selected to participate in the study. Results: 65,2% of injuries were caused by traffc accidents, 8,7% were due to work accidents and 8.7% were due to daily-life accidents. The time from surgery to rehabilitation was: 43,5% below 1 month, 4,3% over 6 months. There was a signifcant change in the limb size difference between the operated leg and the normal leg. After applying rehabilitation intervention, all patients had an improvement in joint range ofmotion, muscle grade, muscle function according to Lysholm scale, pain level according to VAS scale before and after treatment, especially in cases of functional recovery less than 1 month after surgery. Conclusions: The rehabilitation effectiveness was good after patients were applied rehabilitation methods such as Paraffn, Electropulse, and Motiontherapy due to the improvement in range of motion (ROM), muscle level, muscle functionaccording to Lysholm scale, pain level according to VAS scale early after surgery.

Aerobic capacity and skeletal muscle characteristics in glycogen storage disease IIIa: an observational study

BackgroundIndividuals with glycogen storage disease IIIa (GSD IIIa) (OMIM #232400) experience muscle weakness and exercise limitation that worsen through adulthood. However, normative data for markers of physical capacity, such as strength and cardiovascular fitness, are limited. Furthermore, the impact of the disease on muscle size and quality is unstudied in weight bearing skeletal muscle, a key predictor of physical function. We aim to produce normative reference values of aerobic capacity and strength in individuals with GSD IIIa, and to investigate the role of muscle size and quality on exercise impairment.ResultsPeak oxygen uptake (V̇O2peak) was lower in the individuals with GSD IIIa than predicted based on demographic data (17.0 (9.0) ml/kg/min, 53 (24)% of predicted, p = 0.001). Knee extension maximum voluntary contraction (MVC) was also substantially lower than age matched predicted values (MVC: 146 (116) Nm, 57% predicted, p = 0.045), though no difference was found in MVC relative to body mass (1.88 (2.74) Nm/kg, 61% of predicted, p = 0.263). There was a strong association between aerobic capacity and maximal leg strength (r = 0.920; p = 0.003). Substantial inter-individual variation was present, with a high physical capacity group that had normal leg strength (MVC), and relatively high V̇O2peak, and a low physical capacity that display impaired strength and substantially lower V̇O2peak. The higher physical capacity sub-group were younger, had larger Vastus Lateralis (VL) muscles, greater muscle quality, undertook more physical activity (PA), and reported higher health-related quality of life.ConclusionsV̇O2peak and knee extension strength are lower in individuals with GSD IIIa than predicted based on their demographic data. Patients with higher physical capacity have superior muscle size and structure characteristics and higher health-related quality of life, than those with lower physical capacity. This study provides normative values of these important markers of physical capacity.

Evaluation of Hip Frontal Plane Flexibility and Strength in Male Sprinter Runners With Unilateral Patellofemoral Arthropathy: A Case-Control Study

Background and Objectives: Patellofemoral Arthropathy (PFA) is the most common knee disorder in runners and various factors can lead to the development of its symptoms. It has been proposed that frontal plane motions of the hip and knee can raise the dynamic quadriceps angle during functional tasks. The aim of this study was to evaluate frontal plane acting hip muscle flexibility and strength differences in male sprinter runners with unilateral PFA. Methods: A total of 38 male runners complaining of peripatellar pain or showing positive unilateral patellar grind test, assigned to the normal and sound legs, and 20 matched control groups were compared in this case-control study. Participants’ hip abductor and adductor muscles strength and their flexibility were evaluated through a hand-held dynamometer and 2D motion analysis tracker software. To measure the strength, participants were positioned side-lying position, performing abduction and adduction, while a dynamometer was placed on the lateral and medial femoral epicondyle. Active and passive abduction and adduction range of motion were recorded via a camera in the supine position and the film was analyzed by the software. Results: Abductor muscle strength and abduction-to-adduction ratio on the involved side were significantly lower than the uninvolved side (P=0.029, P=0.008, d=-0.388, d=-0.459), while greater adduction and lower abduction to adduction ratio were found in the control group (P&lt;0.001, F=3.599). Also, lesser passive abduction and active adduction range of motion were found in the control group on both sides (P&lt;0.001, F=2.792, F=8.979). Conclusion: Strength changes of the involved side compared with uninvolved side and less flexible side, but more probably inhibited and stronger adductors in the control group may suggest impaired muscular interaction based on frontal plane muscles torque/length curve function in unilateral PFA. Changes in the strength of the involved side compared to the healthy side and the adductor muscles with more flexibility and strength but more inhibited by the abductor’s muscles in the control group could indicate.