Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “LEGS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 541 records · Page 30Linked to original sources
PubMedDate not supplied

Abnormalities in the uninvolved lower limb in children with spastic hemiplegia: the effect of actual and functional leg-length discrepancy.

We assessed the pattern of gait in children with spastic hemiplegia and a leg-length discrepancy, particularly in relation to the uninvolved limb. The kinematics of the uninvolved limbs were compared with the pattern in normal children. The uninvolved limbs in children with hemiplegia and a significant leg-length discrepancy were compared with the uninvolved limb in those children who did not have a leg-length discrepancy. We found that the involved and uninvolved legs in patients with hemiplegia had characteristic patterns that were significantly different from normal. The kinematics of the involved leg were not affected by the presence of a leg-length discrepancy. The abnormal pattern in the uninvolved limb was more exaggerated in children with a leg-length discrepancy. The abnormal sagittal plane kinematics in the uninvolved lower limb in hemiplegic children appears to be related to the presence of an actual or functional leg-length discrepancy and have not previously been described. Our findings suggest that attention be paid to the functional and actual leg-length discrepancy that exists in these children, and early consideration be given to epiphysiodesis of the uninvolved limb.

Adolescent↗
PubMed1999

[External valvuloplasty for deep venous valve insufficiency of legs].

OBJECTIVE: To study and evaluate the therapeutic effects of external valvuloplasty for deep venous valve insufficiency of the legs. METHODS: External valvuloplasty of the femoral vein valve was performed in 26 patients (37 legs) with deep venous valve insufficiency of the legs. Among them, 12 were male and 14 were female. These patients ranged in age from 16 to 69 years (x +/- s, 50.8 +/- 10.0). External valvuloplasty of the first pair of the superficial femoral vein valve was carried out in all the legs. External valvuloplasty of the second pair of the superficial femoral vein valve was added in 7 legs and valvuloplasty of the common femoral vein valve in 6 legs. RESULTS: Venous claudication, swelling, aching disappeared in 81.1% patients (30/37), obviously improved in 18.9% (7/37) and varicose veins disappeared in all legs. Ulcer healing was seen in 7/9 patients. Deep venous valve sufficiency was demonstrated in 89.2% patients (33/37), and reflux I degrees - II degrees in 4 legs by color Doppler. CONCLUSIONS: External valvuloplasty is effective in treating deep venous valve insufficiency of the legs.

Adolescent↗
PubMed2003

Malignant melanoma and (18)F-FDG-PET: Should the whole body scan include the legs?

AIM: (18)F-FDG-PET (FDG-PET) is established in staging and follow-up of malignant melanoma. The legs are affected in 10-40% at time of diagnosis even if the primary is at the arms and torso. Imaging including the legs may detect distant manifestations but increases duration of the scan by approximately 30 min. We intended to disclose the diagnostic benefit of scanning the legs and to evaluate the therapeutic benefit resulting. PATIENTS, METHODS: In this retrospective analyse 213 consecutive PET studies of 153 patients with suspected or recent malignant melanoma were re-evaluated for metastatic spread by a blinded investigator. Histopathological follow-up was assessed for confirmation. RESULTS: Suspicious findings at the legs were depicted in 53 patients on 76 occasions. 38/53 showed pathologic uptake in the torso as well. In 15/53 patients it was restricted to the legs. One of them had a hitherto unknown, clinically relevant finding that was not apparent in palpation and inspection. In 6 other patients with primary location at the legs a validation of the positive PET findings was not possible up to now. CONCLUSION: Metastases and local recurrence of malignant melanoma at the legs were found in 41% of women and 27% of men. However, a long scan does not yield relevant additional data. We found isolated new manifestations at the legs in only 1/153 patients. We recommend performing a long scan only in patients with previous melanoma manifestations restricted to the legs. In all other cases a short scan of the torso and proximal thighs is sufficient. This allows a higher number of PET-scans without loss of diagnostic power and a shorter examination time.

Fluorodeoxyglucose F18↗
PubMed2004

Continuity through best practice: design and implementation of a nurse-led community leg-ulcer service.

The design of the new service was intended to facilitate continuity. The results after the first year of the new service revealed that care was both more effective and more efficient for all types of leg ulcers (Harrison, Graham, Friedberg, & Lorimer, 2003). Healing rates had dramatically improved, the frequency of nursing visits decreased, and supply costs declined. With the new service, comprehensive standardized assessments are made at baseline on all new admissions for home leg-ulcer care, and reassessments are regularly scheduled if the condition does not improve. With the evidence-based protocol, all providers and sectors of care are "working from the same script." Specific information is obtained on the client's health history, leg-ulcer history, preferences, and social context. Continuity is further facilitated through implementation of the primary nurse model, whereby one provider is responsible for developing the care plan and for subsequent evaluation and revision. Management continuity is advanced through health-care reorganization, with the development of an expert, dedicated nursing team, a consistent approach to training and skill development, improved coordination, an interdisciplinary approach for referral and consultation, and continuous quality improvement measures for education and practice audit. A number of strategies tailored to the new service have been highly effective. Strategic alliances among the researchers, home-care authority, nursing agency, nurses, and physicians are essential to the success of both design and implementation. Ongoing interdisciplinary and intersectoral communication expedites the referral process and helps to resolve issues as they develop. The majority of physicians have been very supportive of the use of the protocol and the evidence-based service. Surveys of care recipients have been mostly positive. Nurses who have been surveyed concerning the supports to implementation of the evidence-based service have indicated the following supports: ongoing education, nursing knowledge, a supportive clinical leader, support from two specialist physicians (a dermatologist and a vascular surgeon), a dedicated nursing team, positive outcomes (improved healing rates), and regional home care and agency support. The greatest challenge has been establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively to the leg-ulcer team, where they can continue to build expertise and skills. The nursing agency was initially reluctant to embrace the concept of a dedicated team, as it viewed wound care as a general function of all nurses. Many of the nurses trained in leg-ulcer care fulfilled a number of other specialized nursing functions. This had resource implications for the nursing agency, as other nurses needed training in various other specialized skills. There should be a balance between the size of the population being served and the size of the team, in order to maintain efficiency and sufficient exposure to skilful assessment and management of leg-ulcer care. During the first year of the leg-ulcer service a number of nurses were lost from the team for various reasons, including: outside opportunities for career advancement, the physical demands of this type of care, retirement, moving from the area, and lack of job security. In addition, the volume of nursing visits was decreased because of Ontario government cutbacks in the area of home-care services. New staff members on the team were laid off in the context of a unionized environment. The lack of long-term security and the reality of lower wages in the community sector have played havoc with recruitment and retention. A recently formed committee at the nursing agency on continuity of care, with representation from nursing, management, and administration, has identified a number of further barriers to continuity. These include fluctuating caseloads, difficulty attracting nurses to the community sector, and a unionized environment in which senior nurses displace junior nurses on low-caseload days. Strategies aimed at overcoming the barriers to continuity have been identified and are being implemented. Our experience confirms the need for evidence-based planning in order to understand the needs of the population with leg ulcers, current practices, and the organization of care prior to the restructuring of service delivery. The extensive needs assessment indicated the need for broad system changes in addition to adjustments in clinical care in order to meet best-practice guidelines. Despite ongoing barriers, the service model has improved continuity and dramatically increased the effectiveness and efficiency of leg-ulcer care in one community.

Benchmarking↗
PubMed1978

[Influence of dihydroergotamine and leg compression on the blood volume in different regions of the body (author's transl)].

After intravenous injection of 99mTc labelled autologous erythrocytes the radioactivity of a definite body-region is proportional to the local blood volume. By whole body scintigraphy it is possible to assess simultaneous changes of blood volume in different interesting regions. By this method the influence of 1 mg dihydroergotamine i.v. was investigated in 10 patients and of compression of both legs by inflatable leg cuffs (Jobst) with pressures of 25 and 40 mmHg (3,3 and 5,3 kPa) in 7 patients. After dihydroergotamine statistically significant decreases of blood volume were found in the legs and arms and increases in the thorax and liver. Over the abdominal region there was a statistically not significant decrease of blood volume. After leg compression a statistically significant decrease of blood volume in the legs and an increase in thorax, liver and abdomen were found. The arms showed a statistically not significant blood volume increase. The blood volume diminishing effect of dihydroergotamine in the legs was 20,4% in average, of a leg compression (25 mmHg=3,3 kPa) 33,4%. Contrary to the general opinion a reduction of blood volume was also found in legs with severe varicosis. The diminution of blood volume is even more intense in such cases than in normal legs. The results after dihydroergotamine are explained by its well known constrictor effect on the capacitance vessels in the extremities.

Abdomen↗
PubMed1984

Lateralization of weight in the presence of structural short leg: a preliminary report.

Previous research has reported upon the use of a radiographic method to determine the presence of structural short leg using full spine radiography. In the current study, ninety-two (92) freshman students at the National College of Chiropractic in Lombard, Illinois were first measured for the presence of structural short leg and then placed on a modified Janse-Illi four quadrant weight scale. Measurements of weight were taken at fifteen, thirty, forty-five and sixty seconds. Precise placement of the feet were used. The data collected in kilograms of weight was then converted to total force in Newtons, and the data was normalized as percentage of total body weight. This was then compared to the side of structural short leg. Certain trends have tended to appear. Those subjects with small leg length differential had a greater tendency to bear weight upon the homolateral side of short leg, while those with greater degree of short leg (six millimeters or more) tended to bear weight upon the contralateral leg. It is felt that this is so due to a compensatory mechanism involving the gluteus medius muscle in its use as a "tie-rod" for pelvic function. The greater the degree of short leg, the more the gluteus medius is needed to level the pelvis, and thus the greater shift of body weight to the contralateral side. With a small leg length differential the compensatory mechanism is believed not to be activated, and thus weight bearing will occur on the homolateral side.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Weight↗
PubMed1994

Exercise and training during graded leg ischaemia in healthy man with special reference to effects on skeletal muscle.

The influence of graded leg muscle ischaemia on the adaptation to training and on the acute response to exercise was studied in healthy subjects. Graded ischaemia during supine exercise was induced by application of 50 mmHg external pressure on the legs. This procedure reduced leg blood flow by 16%, venous oxygen saturation by 12 percentage units, and markedly increased lactate release (p < 0.05 for all). One-legged training was performed during four weeks, 4 sessions per week. Each session started with one leg training for 45 min with reduced blood flow (ischaemic training). The contralateral leg, serving as a control, was then trained with an identical power-output profile for 45 min but without flow restriction (non-ischaemic training). Ischaemic training enhanced the adaptation to training. Peak oxygen uptake and time to fatigue increased more (p < 0.05) with ischaemic than with non-ischaemic training. Citrate synthase activity, capillaries per fibre, and glycogen content were greater (p < 0.05) in the trained than in the detrained state. In the ischaemically trained leg, the type IIb fibre proportion was lower (p < 0.05) and the I fibre proportion tended to be higher (p = 0.06) in the trained than in the detrained state. Maximum voluntary dynamic strength was decreased by 8% (p < 0.01) in the ischaemically trained leg, but was unaffected in the non-ischaemically trained leg. During acute ischaemic exercise, as compared to non-ischaemic exercise, there was a higher degree of glycogen depletion, a greater depletion of type II, but not of type I fibres, a greater electromyographic activity, higher catecholamine concentrations, lower intramuscular ATP and creatine phosphate content, and an increased nitric oxide formation as estimated by increased plasma nitrate content. In conclusion, the mechanisms underlying the potentiation of the adaptation to training by ischaemia are assumed to depend on the operation of stimuli which were amplified during acute ischaemic exercise.

Acute Disease↗
PubMed1985

Axonal projections from transplanted ectopic legs in an insect.

Ectopic legs were produced in the fleshfly Sarcophaga bullata by transplantation of leg imaginal discs. Cobalt or horseradish peroxidase (HRP) fills from these supernumerary legs showed that their sensory axons invariably innervate the metathoracic leg neuropil via an abdominal nerve. This was so irrespective of whether they differentiated from pro-, meso-, or metathoracic leg disc. Implantation of left leg discs on the right side and vice versa revealed that the site of implantation determined which side (left or right) of the ganglion was innervated. In general, the same results were obtained when the implantation was made after removal of a leg disc from the host, except in a few instances in which the implanted leg directly innervated the deafferented leg neuropil. The results indicate that axonal pathfinding from the imaginal discs in this insect is via contact guidance along preexisting nerves or imaginal disc stalks.

Animals↗
PubMed1986

The effects of one- and two-legged exercise on the lactate and ventilatory threshold.

The purpose of this investigation was to compare differences between one- and two-legged exercise on the lactate (LT) and ventilation (VT) threshold. On four separate occasions, eight male volunteer subjects (1-leg VO2max = 3.36 l X min-1; 2-leg VO2max = 4.27 l X min-1) performed 1- and 2-legged submaximal and maximal exercise. Submaximal threshold tests for 1- and 2-legs, began with a warm-up at 50 W and then increased every 3 minutes by 16 W and 50 W, respectively. Similar increments occurred every minute for the maximal tests. Venous blood samples were collected during the last 30 s of each work load, whereas noninvasive gas measures were calculated every 30 s. No differences in VO2 (l X min-1) were found between 1- and 2-legs at LT or VT, but significant differences (p less than 0.05) were recorded at a given power output. Lactate concentration ([LA]) was different (p less than 0.05) between 1- and 2-legs (2.52 vs. 1.97 mmol X l-1) at LT. This suggests it is VO2 rather than muscle mass which affects LT and VT. VO2max for 1-leg exercise was 79% of the 2-leg value. This implies the central circulation rather than the peripheral muscle is limiting to VO2max.

Adolescent↗
PubMed2006

Coordination of fore and hind leg stepping in cats on a transversely-split treadmill.

To gain insight into the mechanism of coordination of stepping in the fore and hind legs of quadrupeds, we examined the kinematics of leg movements and the motor patterns in fore and hind leg flexor muscles in decerebrate walking cats when the two pairs of legs stepped on separate treadmills running at different speeds. When the front treadmill was slowed progressively from 0.6 to 0.3 m/s with the rear treadmill running at 0.6 m/s, the rate of stepping in both the fore and hind legs decreased and a 1:1 stepping ratio was maintained. The decrease in the rate of stepping in the hind legs was due primarily to an increase in the duration of the swing phase. Slowing the speed of the rear treadmill while keeping the front treadmill speed at 0.6 m/s decreased the rate of stepping of the hind legs, but had relatively little influence on the average rate of stepping in the forelegs. In this situation stepping in the fore and hind legs was uncoupled and the time of stepping in one hind leg relative to the ipsilateral foreleg progressively shifted during a walking sequence. Analysis of the timing of electromyographic (EMG) recordings from flexor muscles of the hip and elbow joints yielded insight into the neuronal mechanisms underlying the asymmetry in slowing either the front or rear treadmill. We propose that ipsilateral pattern generating networks are asymmetrically coupled via descending inhibitory pathways and an ascending excitatory pathway. We discuss how the characteristics of these linkages are functionally appropriate for establishing the normal timing of stepping in the hind and forelegs during slow walking.

Animals↗
PubMed1994

Radioprotection by WR-151327 against the late normal tissue damage in mouse hind legs from gamma ray radiation.

PURPOSE: To evaluate the protective effect of WR-151327 on late radiation-induced damage to normal tissues in mice. METHODS AND MATERIALS: The right hind legs of mice with or without WR-151327 administration (400 mg/kg) were irradiated with 137Cs gamma rays. Leg contracture and skin shrinkage assays were performed at 380 days after irradiation. The mice were killed on day 400 postirradiation and histological sections of the legs were made. The thickness of the dermis, epidermis, and skin (dermis plus epidermis) was measured. The muscular area of the legs and the posterior knee angle between the femur and tibia were also measured. The left hind legs were similarly assessed as nonirradiated controls. Group means and standard deviations were calculated and dose-response curves were drawn for every endpoint. Then, the dose modifying factor (DMF) for each endpoint and the correlations among endpoints were determined. RESULTS: Late damage assayed by leg contracture and skin shrinkage progressed with increasing radiation dose. However, it was reduced by drug treatment. The significant effect was indicated for skin shrinkage by a DMF of 1.8 at 35%. The DMF for leg contracture was 1.3 at 6 mm. In the irradiated legs, epidermal hyperplasia and dermal fibrosis in the skin, muscular atrophy, and extension disturbance of the knee joint were observed. These changes progressed with increasing radiation dose. Skin damage assayed by the present endpoints was also reduced by drug treatment by DMFs of 1.4 to 1.7. However, DMFs for damage to the muscle and knee were not determined because no isoeffect was observed. There were good correlations between leg contracture or skin shrinkage and the other endpoints in both untreated and drug-treated mice. CONCLUSIONS: WR-151327 has the potential to protect against radiation-induced late normal tissue damage.

Animals↗
PubMed2004

Determinants of severity for superficial cellutitis (erysipelas) of the leg: a retrospective study.

BACKGROUND: Superficial cellulitis (erysipelas) of the leg is a frequent infectious disease with a favorable outcome, whereas some patients present a serious disease. The determinants of severity for superficial cellulitis (erysipelas) of the leg have not yet been clearly established. In order to determine the characteristics of patients presenting with severe superficial cellulitis of the leg, we analyzed patients with favorable and unfavorable outcome. METHODS: The records of 167 patients referred to Rouen University Hospital for non-superficial cellulitis of the leg were analyzed. Two severity groups of patients were retrospectively defined. Patients in the severe group either died secondary to infection during hospital stay or were hospitalized for a duration at least equal to the 90th percentile (i.e., >21 days of hospitalization). The remaining patients were considered as presenting with non-severe cellulitis. Potential determinants of severity were analyzed by univariate and multivariate analysis based on logistic regression. RESULTS: From univariate analysis, the following general factors were positively associated with severity: advanced age, arterial hypertension, diabetes mellitus, elevated leukocytosis, and elevated neutrophilia. The local factors associated with severity were ulcer of the leg and arteriosclerosis obliterans of the leg. From multivariate analysis, only age (P=0.004), diabetes mellitus (P=0.01), and leukocytosis (P=0.04) appeared to be independently associated with severity. A close to significant association was also found with arteriosclerosis obliterans of the leg (P=0.07). Whereas general complications occurred more frequently in the severe group, no such difference was observed for local complications. CONCLUSIONS: Determinants of severity for superficial cellulitis of the leg include high age and associated medical conditions. Aged patients and patients with diabetes mellitus, elevated leukocytosis, or possibly arteriosclerosis obliterans of the leg should preferably be hospitalized for specific care of associated conditions to avoid the occurrence of general complications.

Journal Article↗
PubMed2005

An analytical estimation of the energy cost for legged locomotion.

Legged locomotion requires the determination of a number of parameters such as stride period, stride length, order of leg movements, leg trajectory, etc. How are these parameters determined? It has been reported that the locomotor patterns of many legged animals exhibit common characteristics, which suggests that there exists a basic strategy for legged locomotion. In this study we derive an equation to estimate the cost of transport for legged locomotion and examine a criterion of the minimization of the transport cost as a candidate of the strategy. The obtained optimal locomotor pattern that minimizes the cost suitably represents many characteristics of the pattern observed in legged animals. This suggests that the locomotor pattern of legged animals is well optimized with regard to the energetic cost. The result also suggests that the existence of specific gait patterns and the phase transition between them could be the result due to optimization; they are induced by the change in the distribution of ground reaction forces for each leg during locomotion.

Animals↗
PubMed2002

Lupus anticoagulant and venous leg ulceration.

BACKGROUND: Most leg ulcers occur in patients with venous insufficiency. However, not all patients with venous insufficiency develop leg ulcers. Recent studies have found that factors causing clotting abnormalities, e.g. anticardiolipin antibody (ACA), are associated with leg ulcers. Although lupus anticoagulant, like ACA, belongs to the group of antiphospholipid antibodies, its presence in patients with venous leg ulceration has not been previously reported. OBJECTIVES: To determine the presence of lupus anticoagulant in patients with venous leg ulceration. METHODS: We investigated the presence of lupus anticoagulant in 27 patients with venous leg ulcers and compared these data with controls. Lupus anticoagulant was evaluated in all subjects by the Russell's viper venom test. RESULTS: Of 27 patients with venous leg ulceration, 16 (59%) were shown to have lupus anticoagulant, while only one of 32 controls (3%) was found to have lupus anticoagulant. Thus, lupus anticoagulant was significantly more frequent in patients with venous leg ulcers than in controls (P < 0.001). CONCLUSIONS: We suggest that lupus anticoagulant could be a hitherto unknown factor contributing to the development of venous leg ulcers.

Aged↗
PubMed2006

Comparison of different microprocessor controlled knee joints on the energy consumption during walking in trans-femoral amputees: intelligent knee prosthesis (IP) versus C-leg.

The purpose of this study was to investigate the characteristic differences between the IP and C-Leg by making a comparative study of energy consumption and walking speeds in trans-femoral amputees. The subjects consisted of four persons with traumatic trans-femoral amputations aged 17 - 33 years who had been using the IP and were active in society. Fourteen able-bodied persons served as controls. First the energy consumption at walking speeds of 30, 50, 70, and 90 m/min was measured when using the IP. Then the knee joint was switched to the C-Leg. The same energy consumption measurement was taken once the subjects were accustomed to using the C-Leg. The most metabolically efficient walking speed was also determined. At a walking speed of 30 m/min using the IP and C-Leg, the oxygen rate (ml/kg/ min) was, on average, 42.5% and 33.3% higher (P< 0.05) than for the able-bodied group. At 50 m/min, the equivalent figures were 56.6% and 49.5% (P< 0.05), while at 70 m/min the figures were 57.8% and 51.2% (P<0.05), and at 90m/min the figures were 61.9% and 55.2% (P<0.05%). Comparing the oxygen rates for the subjects using the IP and C-Leg at walking speeds of 30 m/min and 90 m/min it was found that subjects who used C-Leg walked somewhat more efficiently than those who used IP. However, there was no significant difference between the two types at each walking speed. It was also determined that the most energy-efficient walking speed for subjects using the IP and C-Leg was the same as for the controls. Although the subjects in this study walked with comparable speed and efficiency whether they used the IP or C-Leg, the subjects' energy consumption while walking with the IP and C-Leg at normal speeds were much lower than previously reported. This study suggested that the microprocessor controlled knee joints appeared to be valid alternative for improving walking performance of trans-femoral amputees.

Adolescent↗
PubMed2001

Leg power and hopping stiffness: relationship with sprint running performance.

PURPOSE: Although sprint performance undoubtedly involves muscle power, the stiffness of the leg also determines sprint performance while running at maximal velocity. Results that include both of these characteristics have not been directly obtained in previous studies on human runners. We have therefore studied the link between leg power, leg stiffness, and sprint performance. METHODS: The acceleration and maximal running velocity developed by 11 subjects (age 16 +/- 1) during a 40-m sprint were measured by radar. Their leg muscle volumes were estimated anthropometrically. Leg power was measured by an ergometric treadmill test and by a hopping test. Each subject executed a maximal sprint acceleration on the treadmill equipped with force and speed transducers, from which forward power was calculated. A hopping jump test was executed at 2 Hz on a force platform. Leg stiffness was calculated using the flight and contact times of the hopping test. RESULTS: The treadmill forward leg power was correlated with both the initial acceleration (r = 0.80, P < 0.01) and the maximal running velocity (r = 0.73, P < 0.05) during track sprinting. The leg stiffness calculated from hopping was significantly correlated with the maximal velocity but not with acceleration. CONCLUSION: Although muscle power is needed for acceleration and maintaining a maximal velocity in sprint performance, high leg stiffness may be needed for high running speed. The ability to produce a stiff rebound during the maximal running velocity could be explored by measuring the stiffness of a rebound during a vertical jump.

Adolescent↗
PubMed2005

The impact of dyspnoea and leg fatigue during exercise on health-related quality of life in patients with COPD.

OBJECTIVE: COPD patients frequently complain of symptoms such as dyspnoea and leg fatigue during exercise. However, the impact of these symptoms on the health-related quality of life (HRQoL) is not known. This study tested whether dyspnoea and leg fatigue during exercise affects the HRQoL of patients with COPD. METHODS: In a cross-sectional study, 90 patients with stable COPD (mean age, 76.0+/-0.7 years; FEV(1), 1.11+/-0.04 L) completed the St. George's Respiratory Questionnaire (SGRQ), pulmonary function testing, arterial blood gas analysis, and a 6-min walking distance test (6MWD). Dyspnoea and leg fatigue during exercise were quantitated into 12 grades using the Borg scale (0--10). Correlations between the SGRQ and various variables were determined. In a longitudinal study, 22 patients with COPD (mean age, 71.5+/-1.1 years; FEV(1), 1.31+/-0.08 L) completed a pulmonary rehabilitation program, for which correlations between changes in the SGRQ as well as changes in both dyspnoea and leg fatigue, during the 6MWD before and 3 months after pulmonary rehabilitation, were examined. RESULTS: For the cross-sectional study, the total SGRQ score correlated significantly with the walking distance, dyspnoea and leg fatigue during the 6MWD and FEV(1), respectively. Stepwise multiple regression analysis showed that dyspnoea and leg fatigue during the 6MWD were independent variables for HRQoL measured by the SGRQ. For the longitudinal study, changes in the SGRQ correlated significantly with changes in dyspnoea and leg fatigue, before and 3 months after, pulmonary rehabilitation. CONCLUSIONS: Symptoms, such as the degree of dyspnoea and leg fatigue during exercise, are significant variables which influence the HRQoL of patients with COPD. In addition, the improvement in HRQoL following pulmonary rehabilitation may be due to improvements in dyspnoea and leg fatigue in patients with COPD.

Aged↗
PubMed1990

Euglycemic hyperinsulinemia augments amino acid uptake by human leg tissues during hyperaminoacidemia.

The effect of insulin on leg and whole body protein turnover was determined by leg exchange and plasma kinetics of [15N]phenylalanine and [1-13C]leucine during amino acid (AA) sufficiency. Eight healthy subjects were studied during AA infusion alone and during infusion of glucose and insulin (0.29 nmol.m-2.min-1) with additional AA. Insulin strongly stimulated the positive leg AA balance seen with AA (AA alone, 2.6 +/- 6.1 vs. insulin + AA, 33.1 +/- 5.8 nmol phenylalanine . 100 g leg-1.min-1; P less than 0.001). Phenylalanine uptake by leg tissues rose during insulin plus AA (47.3 +/- 11.5 vs. 73.1 +/- 7.3 nmol. 100 g-1.min-1; P = 0.022) but with only a slight reduction in leg phenylalanine release (44.7 +/- 8.1 vs. 40.0 +/- 7.9 nmol.100 g-1.min-1). Leg nonoxidative leucine plus alpha-ketoisocaproate (KIC) uptake was increased slightly with insulin (129 +/- 26 vs. 146 +/- 21 nmol.100 g-1. min-1), but leg leucine oxidation increased fourfold (P = 0.012). Leg leucine plus KIC release was reduced by insulin (120 +/- 17 vs. 84 +/- 10 nmol.100 g-1.min-1; P = 0.005); endogenous leucine appearance of leucine and phenylalanine decreased with insulin (leucine, 1.97 +/- 0.08 vs. 1.65 +/- 0.10; phenylalanine, 0.76 +/- 0.03 vs. 0.54 +/- 0.08 mumols.kg-1.min-1; P less than 0.02). The results suggest that insulin, given with sufficient amino acids, may stimulate leg and whole body protein balance by mechanisms including stimulation of protein synthesis and inhibition of protein breakdown.

Adult↗