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At least 199 records · Page 11Linked to original sources
PubMed2006

Relationship of chronic ankle instability to muscle activation patterns during the transition from double-leg to single-leg stance.

BACKGROUND: Impaired muscle activation may predispose subjects to develop chronic ankle instability. It has been suggested that impairments are found not only in structures around the injured ankle but also around the more proximal joint complexes. HYPOTHESIS: Subjects with chronic ankle instability were expected to show later onset times for lower limb and trunk muscle activation when compared with control subjects. They were expected to show less variability in muscle activation patterns compared with the control group. STUDY DESIGN: Controlled laboratory study. METHODS: Thirty control subjects and 10 subjects with chronic ankle instability participated in the study. The onset of muscle activity of 14 muscles of the lower limb and trunk was measured during the transition from a double-leg stance position to a single-leg stance position in eyes-open and eyes-closed test conditions. RESULTS: Subjects with chronic ankle instability showed significantly later onset times for the ankle, hip, and hamstring muscles compared with control subjects. They used a similar muscle activation pattern in both test conditions, whereas control subjects adjusted their activation pattern according to the condition. CONCLUSIONS: Differences in muscle activation patterns between subjects with chronic ankle instability and control subjects occur not only around the ankle but also around other joints. Subjects with chronic ankle instability show less variability in muscle activation patterns between test conditions. CLINICAL RELEVANCE: Knowledge of muscle activation patterns in the whole lower limb and trunk in noninjured subjects and the differences found in chronic ankle instability subjects broadens the physical therapy approach to the treatment of chronic ankle instability.

Adult↗
PubMed2001

Hemophilia A, von Willebrand disease, and atherosclerosis of abdominal aorta and leg arteries: factor VIII and von Willebrand factor defects appear to protect abdominal aorta and leg arteries from atherosclerosis.

We hypothesized that patients with hemophilia or von Willebrand disease might be protected from atherosclerosis because of their coagulation defect. We studied 40 subjects affected by these two coagulation diseases using echocolor Doppler of the abdominal aorta and leg arteries, and compared the results with those obtained in 40 control patients who were homogenous with study patients in terms of sex, age, and risk factors for atherosclerosis. The probands presented a lower number of plaques than the 40 control subjects in the aorta and in the leg arteries. The most serious hemophilic patients had fewer plaques than controls or than patients with mild hemophilia. Both hemophilia and von Willebrand disease seem to protect against atherosclerosis.

Aorta, Abdominal↗
PubMed2000

Restless legs syndrome: detection and management in primary care. National Heart, Lung, and Blood Institute Working Group on Restless Legs Syndrome.

Restless legs syndrome (RLS) is a neurologic movement disorder that is often associated with a sleep complaint. Patients with RLS have an irresistible urge to move their legs, which is usually due to disagreeable sensations that are worse during periods of inactivity and often interfere with sleep. It is estimated that between 2 and 15 percent of the population may experience symptoms of RLS. Primary RLS likely has a genetic origin. Secondary causes of RLS include iron deficiency, neurologic lesions, pregnancy and uremia. RLS also may occur secondarily to the use of certain medications. The diagnosis of RLS is based primarily on the patient's history. A list of questions that may be used as a basis to assess the likelihood of RLS is included in this article. Pharmacologic treatment of RLS includes dopaminergic agents, opioids, benzodiazepines and anticonvulsants. The primary care physician plays a central role in the diagnosis and management of RLS.

Anticonvulsants↗
PubMed1992

The treatment of the restless leg syndrome with or without periodic leg movements in sleep.

There are presently three main treatments for restless leg syndrome-periodic leg movements in sleep (RLS-PLMS). The benzodiazepines (especially clonazepam) are considered by most clinicians to be the treatment of choice in mild cases, especially in young subjects. In our experience, however, L-dopa and bromocriptine are more effective treatments, although no controlled studies have ever been conducted to compare their therapeutic benefits and the side effects of benzodiazepines and dopaminergic drugs. The use of opioids should be restricted to patients who have severe symptoms and who fail to respond to benzodiazepines or L-dopa. Propoxyphene was found less effective than L-dopa in decreasing PLMS, but some patients resistant to L-dopa may exhibit a masked therapeutic response to opioids. However, there is currently no method to predict the response to any treatment modality.

Anti-Anxiety Agents↗
PubMed2006

Effect of a maximal treadmill test on percent body fat using leg-to-leg bioelectrical impedance analysis in children.

AIM: The purpose of this investigation was to determine the effect of a maximal treadmill exercise test on percent body fat (%BF) in children using leg-to-leg bioelectrical impedance analysis (LBIA) (Tanita Model #TBF-300A). METHODS: Fifty-four children (24 females; 30 males) between 7-10 years of age participated in this study. LBIA measures of %BF were obtained immediately before and within 5 min after completing a maximal oxygen consumption test on a motorized treadmill. RESULTS: No pre- to post-test differences in %BF were observed in either group (mean difference: females 1.6%, males 1.5%). Impedance values significantly decreased postexercise (P < 0.05) in the female subjects. No significant differences were observed for fat mass, fat free mass, total body water or body weight postexercise when compared to pre-exercise values in either group. Correlations (P = 0.0001) of 0.997 were observed between pre- and postexercise measures of %BF. CONCLUSIONS: A maximal treadmill exercise test conducted prior to LBIA has no impact on %BF in children. Therefore, normal daily activities performed prior to LBIA assessment may have a limited impact on LBIA body composition measurement in children. As such, compliance with stringent pretesting exercise guidelines may not be essential when using LBIA to assess %BF in children.

Activities of Daily Living↗
PubMed1976

Repair of skin and soft tissue loss of the lower leg with cross-leg flaps.

Forty patients with severe leg injuries associated with skin or soft tissue loss were treated. Cross-leg flaps were used. The flaps healed well. Special attention was paid to the pre- and postoperative periods of disability of the patients. The former were very long (37.7 months) compared to the latter (10.5 months) which ceased when the patient became fit for work.

Child↗
PubMed1993

Full-thickness leg ulcers: patient demographics and predictors of healing. Multi-Center Leg Ulcer Study Group.

BACKGROUND: Despite increased knowledge about the immediate and underlying causes of chronic leg ulcers, their management remains a challenge. Some ulcers rapidly respond to treatment whereas others do not, and the decision to reassess the patient and treatment modality is usually based on the clinician's own experience. METHODS: Following diagnosis of the underlying cause of leg ulcers, 181 patients were screened. The use of a hydrocolloid dressing (DuoDERM) was evaluated in the treatment of 61 patients with 72 full-thickness ulcers. Patient characteristics associated with deep wounds as well as patient and wound characteristics predictive of the extent of healing and time required for healing were identified. RESULTS: Patients with full-thickness ulcers were more likely to be overweight (P < .001) and not fully mobile (P = .016). During a mean treatment time of 56 days, 54% of the full-thickness ulcers healed. Ulcers were less likely to heal if the patients were men (P = .02) or had diabetes mellitus (P < .003). A > 30% reduction in ulcer area after 2 weeks of treatment was a predictor of both treatment outcome (P = .016) and time required for healing (P = .004). Odor at baseline and advanced age also were associated with increased time required for healing (P = .005 and .017, respectively). CONCLUSIONS: Noninvasive clinical assessments can aid the clinician in predicting treatment outcome and may facilitate the decision to change therapy and evaluate treatment compliance.

Age Factors↗
PubMed1998

Influence of a specialised leg ulcer service and venous surgery on the outcome of venous leg ulcers.

OBJECTIVES: To assess the influence of a vascular-led community service on the outcome of chronic leg ulcers. DESIGN: Before and after study. METHOD: Healing and recurrence were compared between ulcerated limbs (n = 149) from a random sample of 200 patients treated in the community and consecutive limbs (n = 200) from 180 patients treated in specialised clinics. In these clinics, vascular disease was routinely identified with venous duplex and ankle-brachial pressure index. Surgery was offered if superficial vein reflux alone was detected. Compression bandaging was applied to limbs with ABPI > 0.85. Healed limbs were treated with compression hosiery. RESULTS: After the clinics were introduced, the 12 and 24-week healing rates increased from 12 and 29 per cent to 53 and 68 per cent respectively (p < 0.01), and the 6 and 12 month recurrence rates decreased from 43 and 54 per cent to 21 and 23 per cent respectively (p < 0.01). Superficial venous surgery reduced recurrence at 1 year to 9 per cent. CONCLUSION: Outcome of leg ulcers is improved in a vascular-led community service. Routine surgical correction, in cases of reflux limited to the superficial system, may further reduce the chance of recurrence.

Aged↗
PubMed2006

The effect of acute fluid consumption on measures of impedance and percent body fat using leg-to-leg bioelectrical impedance analysis.

OBJECTIVE: To examine the effect of acute fluid consumption on measures of impedance and percent body fat (%BF) using a common leg-to-leg bioelectrical impedance analyzer system. DESIGN: Cross-sectional design with treatment order determined using a counterbalanced assignment. SETTING: University laboratory. SUBJECTS: In total, 21 recreationally active men (mean age 19.7 +/- 1.0 years; body mass index 24.2 +/- 2.3 kg/m2) volunteered to participate in this study. INTERVENTION: Subjects had their body composition assessed on three separate occasions. After an initial baseline body composition measurement, subjects consumed 591 ml of water (H2O), a carbohydrate/electrolyte drink (CHOE), or received nothing, used as the control (CON). Subjects were reassessed 20, 40, and 60 min after baseline (POST). Urine specific gravity (USG) was recorded at baseline and 60 min POST to assess hydration state. RESULTS: There were no significant changes in impedance or total body water (TBW) for any of the measurement time periods after drinking H2O or a CHOE beverage. Body weight (BW) (P < 0.0001) and %BF (P < 0.02) increased significantly 20 min POST and remained elevated at the 40 and 60 min POST time periods. After drinking, USG significantly decreased (P<0.0001) 60 min POST from baseline. For the CON trial, there were no significant changes in BW, %BF, TBW, or USG over time. CONCLUSIONS: Fluid consumption had no effect on lower-body impedance despite causing significant changes in hydration state. A slight overestimation in %BF (approximately 0.5%) was observed due to increased BW in the H20 and CHOE trials. This finding may have little practical significance when assessing body composition by LBIA.

Adipose Tissue↗
PubMed2006

Validity of the leg-to-leg bioimpedance to estimate changes in body fat during weight loss and regain in overweight women: a comparison with multi-compartment models.

OBJECTIVES: To investigate changes in body composition and the validity of the leg-to-leg bioimpedance (LTL) method to measure body fat during active weight loss (WL) and weight regain (WR). DESIGN: Longitudinal, 12-week weight loss intervention (3.3-3.8 MJ/day) and subsequent follow-up at 1 year. SUBJECTS: Fifty-eight adult women aged between 24 and 65 years (mean age: 46.8+/-8.9 years) and with a body mass index (BMI) > or =25 kg/m(2) (mean BMI: 31.6+/-2.5 kg/m(2), range=26.0-48.2 kg/m(2)) participated in the study. MEASUREMENTS: Fat mass (FM) was measured at baseline, 12 weeks, 24 weeks and 52 weeks using three- and four-compartment (4-C) models, air displacement plethysmography (ADP), deuterium dilution - total body water (TBW), dual-energy X-ray absorptiometry (DXA), skinfold thickness (SFT), tetrapolar bioelectrical impedance analysis (T-BIA) and LTL. RESULTS: At the end of the weight loss programme, subjects lost 9.9+/-3.5 kg weight (P<0.001) and 7.6+/-0.5 kg fat (P<0.001) but after 1 year they had regained 4.9+/-3.7 kg of weight and 3.7+/-2.9 kg of fat. The 4-C model showed that FM and TBW accounted for 76.2 and 23.6% of the loss in body mass and 81.8 and 17.7% of the tissue accrued during weight regain, respectively. The estimate of body fat change by LTL relative to multi-compartment models (WL(bias+/-2s.d.)=0.51+/-3.26 kg; WR(bias+/-2s.d.)=-0.25+/-2.30 kg) was similar to ADP, DXA and TBW in both phases but it was better than T-BIA (WL(bias+/-2s.d.)=0.17+/-7.90 kg; WR(bias+/-2s.d.)=-0.29+/-7.59 kg) and skinfold thickness (WL(bias+/-2s.d.)=2.68+/-6.68 kg; WR(bias+/-2s.d.)=-0.84+/-3.80 kg). CONCLUSIONS: Weight loss and regain were associated with minimal changes in lean tissue as measured using multi-compartment models. The LTL system is a useful method to measure body composition changes during clinical weight management programmes.

Adipose Tissue↗
PubMedDate not supplied

Evaluation of leg-to-leg BIA in assessing body composition in high-school-aged males and females.

The current investigation was conducted to evaluate the accuracy of the Tanita 300WA leg-to-leg (LL) bioelectrical impedance analyzer (BIA) for measuring body composition in an American high-school-aged population. Body composition was determined in 77 students, comparing BIA measurements with the criterion, hydrostatic weighing (HW). Among the males, there were no significant differences found in percent body fat (%BF) between BIA (14.1 +/- 7.8%) and HW (14.9 +/- 9.1%); however, skinfolds (SK; 11.8 +/- 7.2%) were significantly different from HW. A significant correlation in fat-free mass (FFM) was found between BIA and HW (r = 0.96, p < 0.001), and the standard error of estimate (SEE) for FFM was 3.28 kg for males. In females, a significant difference (p < 0.001) in %BF was found for both BIA (26.4 +/- 5.7%) and SK (27.9 +/- 5.1%) when compared with HW (23.6 +/- 5.9%). The correlation in FFM between BIA and HW was lower (r = 0.78, p < 0.001) and the SEE for FFM was 2.93 kg for females. The Tanita 300WA LL-BIA system is appropriate for assessing body composition in male adolescents, but it warrants future research in female adolescents.

Adiposity↗
PubMed1998

crooked legs encodes a family of zinc finger proteins required for leg morphogenesis and ecdysone-regulated gene expression during Drosophila metamorphosis.

Drosophila imaginal discs undergo extensive pattern formation during larval development, resulting in each cell acquiring a specific adult fate. The final manifestation of this pattern into adult structures is dependent on pulses of the steroid hormone ecdysone during metamorphosis, which trigger disc eversion, elongation and differentiation. We have defined genetic criteria that allow us to screen for ecdysone-inducible regulatory genes that are required for this transformation from patterned disc to adult structure. We describe here the first genetic locus isolated using these criteria: crooked legs (crol). crol mutants die during pupal development with defects in adult head eversion and leg morphogenesis. The crol gene is induced by ecdysone during the onset of metamorphosis and encodes at least three protein isoforms that contain 12-18 C2H2 zinc fingers. Consistent with this sequence motif, crol mutations have stage-specific effects on ecdysone-regulated gene expression. The EcR ecdysone receptor, and the BR-C, E74 and E75 early regulatory genes, are submaximally induced in crol mutants in response to the prepupal ecdysone pulse. These changes in gene activity are consistent with the crol lethal phenotypes and provide a basis for understanding the molecular mechanisms of crol action. The genetic criteria described here provide a new direction for identifying regulators of adult tissue development during insect metamorphosis.

Amino Acid Sequence↗
PubMedDate not supplied

The wearing of compression hosiery for leg problems other than leg ulcers.

Many people have leg problems other than ulceration. Practitioners from one primary care trust in Suffolk considered nursing assessment of these patients and the fitting of prescribed compression hosiery where appropriate as a health promotion initiative. However, ongoing assessment adds to heavy clinical demands on community practitioners. Engaging with people to take greater responsibility for their health, and recognition that practice should be underpinned by credible evidence, provided the backdrop to a two-staged retrospective audit. Results are based on the nursing records of 101 patients wearing prescribed compression hosiery other than for previous venous ulceration. It was concluded that following an initial detailed holistic assessment, including ankle brachial pressure index, those patients who meet identified characteristics can be empowered to return for reassessment only if there is a change in their health status, or skin changes to their legs. An information leaflet is considered critical to this strategy.

Adult↗
PubMed2005

Evaluation of the BOD POD and leg-to-leg bioelectrical impedance analysis for estimating percent body fat in National Collegiate Athletic Association Division III collegiate wrestlers.

The purpose of this study was to compare percent body fat (%BF) estimated by air displacement plethysmography (ADP) and leg-to-leg bioelectrical impedance analysis (LBIA) with hydrostatic weighing (HW) in a group (n = 25) of NCAA Division III collegiate wrestlers. Body composition was assessed during the preseason wrestling weight certification program (WCP) using the NCAA approved methods (HW, 3-site skinfold [SF], and ADP) and LBIA, which is currently an unaccepted method of assessment. A urine specific gravity less than 1.020, measured by refractometry, was required before all testing. Each subject had all of the assessments performed on the same day. LBIA measurements (Athletic mode) were determined using a Tanita body fat analyzer (model TBF-300A). Hydrostatic weighing, corrected for residual lung volume, was used as the criterion measurement. The %BF data (mean +/- SD) were LBIA (12.3 +/- 4.6), ADP (13.8 +/- 6.3), SF (14.2 +/- 5.3), and HW (14.5 +/- 6.0). %BF estimated by LBIA was significantly (p < 0.01) smaller than HW and SF. There were no significant differences in body density or %BF estimated by ADP, SF, and HW. All methods showed significant correlations (r = 0.80-0.96; p < 0.01) with HW. The standard errors of estimate (SEE) for %BF were 1.68, 1.87, and 3.60%; pure errors (PE) were 1.88, 1.94, and 4.16% (ADP, SF, and LBIA, respectively). Bland-Atman plots for %BF demonstrated no systematic bias for ADP, SF, and LBIA when compared with HW. These preliminary findings support the use of ADP and SF for estimating %BF during the NCAA WCP in Division III wrestlers. LBIA, which consistently underestimated %BF, is not supported by these data as a valid assessment method for this athletic group.

Adolescent↗
PubMed2005

Gender differences in leg stiffness and stiffness recruitment strategy during two-legged hopping.

The authors compared leg stiffness (K(VERT)), muscle activation, and joint movement patterns between 11 men and 10 women during hopping. Physically active and healthy men and women performed continuous 2-legged hopping at their preferred rate and at 3.0 Hz. Compared with men, women demonstrated decreased K(VERT); however, after the authors normalized for body mass, gender differences in K(VERT) were eliminated. In comparison with men, women also demonstrated increased quadriceps and soleus activity, as well as greater quadriceps-to-hamstrings coactivation ratios. There were no significant gender differences for joint movement patterns (p>.05). The relationship between the observed gender differences in muscle recruitment and the increased risk of anterior cruciate ligament injury in women requires further study.

Adult↗
PubMed2000

[Heavy legs, venous insufficiency of the legs and hormone substitution therapy].

The effects of estrogens and gestagens on veins and circulation have been studied since prescription of these hormones as oral contraception and description of related thromboembolic events. The identification of different receptors and the description of these receptors in venous walls have helped to understand some hormonal effects. However, the actual knowledge remains insufficient to explain the complexity of the actions of hormones on venous function. The distribution, the density and the receptor types vary with age, gender, hormonal status and vascular bed. Gestagens mainly reduce the tone of venous walls, whereas estrogens have various effects. Between 25% and 50% of European adults and even 80% or more in some risk groups complain about heavy legs, with or without chronic venous insufficiency. The number of women to whom hormonal substitution is or could be prescribed increases along with aging of populations and the better understanding of potential benefits. The need for a better understanding of vascular effects of sexual hormones is growing, since the incidence of chronic venous insufficiency of the legs increases with age. The life prognosis will not be affected by a deterioration of a chronic venous insufficiency. In contrast, the quality of life, morbidity and the cost of treatment will be expected to change. In addition, thromboembolic events have to be considered, as has been shown in recent studies. These findings outline the need for further studies on the relation between hormones and venous function and for some caution when prescribing hormonal substitution.

Adult↗
PubMed1975

Effects of prefrontal lesions on left leg-right leg differentiation to nondirectional acoustic cues in dogs.

Twenty five dogs were trained preoperatively in left leg- right leg differentiation to nondirectional acoustic cues. Removal of the medial precruciate cortex as well as the proreal or orbital cortex together with underlying fibers did not affect performance of the task, whereas lesions which involved the fibers underlying the medial precruciate cortex produced more or less pronounced, yet moderate impairment. Comparison between impairment described in this paper and that obtained following similar lesions in earlier experiment with directional cues indicates that fibers underlying the medial precruciate cortex are of greater importance when directional cues are involved in task.

Acoustic Stimulation↗
PubMed2006

Effect of mode selection when using leg-to-leg BIA to estimate body fat in collegiate wrestlers.

AIM: When using leg-to-leg bioelectrical impedance analysis (LBIA) to examine body composition, a computer-programmed mode (i.e., standard STD or athletic ATH) must be selected prior to assessment. This study examined the effect of LBIA mode selection on the estimated %BF of collegiate wrestlers. METHODS: Forty hydrated (Usg <1.02) wrestlers had %BF estimated using the ATH mode, which was then compared to the STD mode and hydrostatic weighing (HW), used as the reference method. Mean difference from HW (MD), standard error of estimate (SEE), and pure error (PE) values were calculated for the entire sample and three data subsets according to body mass index (BMI, kg/m(2)): <25 (n=16), 25-29.9 (n=18), and >30 (n=6). RESULTS: The %BF (mean+/-SD) was underestimated by the ATH (12.1+/-4.7) and overestimated by the STD (17.1+/-5.2) mode when compared to HW (14.1+/-6.3) for the entire sample (P<0.05). When examined relative to BMI, the ATH mode accurately estimated %BF in the BMI <25 group (MD=-1.2%, SEE=2.7%, PE=2.8%) and the STD mode accurately estimated %BF in the BMI >30 group (MD=1.5%, SEE=2.4%, PE=2.8%). Both modes inaccurately assessed %BF in the BMI 25-29.9 group with predictive errors >3.5%BF. CONCLUSIONS: The ATH mode is not appropriate for all individuals meeting the definition of athletic. However, the predictive accuracy of LBIA may be improved by selecting the ATH mode when BMI <25 and the STD mode when BMI >30, even when testing athletes.

Adipose Tissue↗