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PubMedDate not supplied

Functional reach and single leg stance in patients with peripheral vestibular disorders.

The purpose of this study was to compare functional reach distance and right single leg stance time in patients who had peripheral vestibular disease. Twenty-eight patients (15 female, 13 male) between the ages of 35 and 84 were asked to perform 3 trials each of functional reach (FR) and right single leg stance (SLS). SLS times were measured by a Kistler static force platform on line with a Caspar personal computer. FR distance was measured by using a free-standing 147-cm rule. In addition, each subject filled out the Dizziness Handicap Inventory (DHI). Trials were randomized to prevent fatigue or practice effects. A Pearson product-moment correlation was performed between FR and SLS (r = 0.59, P = 0.001). Post hoc analyses of the first, the best, and the average scores highlighted the importance of using means for comparison in a population as variable as the vestibularly impaired. Post hoc analyses showed no correlation between the DHI score and either functional reach distance or single leg stance time. However, when the subjects were divided into groups based on DHI score (group 1 with DHI < or = 49/100, group 2 with DHI > or = 50/100) and a pooled two-sample t-test was performed, a significant difference (P = 0.05) was found in functional reach distance; the subjects who reported less perception of handicap reached farther than those who reported more perception of handicap. No difference was found between the two DHI groups in single leg stance time. Post hoc correlations of functional reach and single leg stance time. Post hoc correlations of functional reach and single leg stance within the two DHI groups showed a higher correlation in group 1 (DHI < or = 49/100), with r equals 0.65 (P < or = 0.01), than in group 2 (DHI > or = 50/100), with r equals 0.38 (P = 0.20). The study found a highly significant, moderate correlation between functional reach distance and single leg stance times in patients with peripheral vestibular disease. These results support the use of FR as an additional assessment tool with patients who have peripheral vestibular disease.

Adult↗
PubMed1997

Chronic exertional compartment syndrome in lower legs: localization and follow-up with thallium-201 SPECT imaging.

UNLABELLED: The purpose of this study was to ascertain whether 201Tl SPECT imaging of the leg is useful in precise localization of the ischemic compartment involved in chronic exertional compartment syndrome (CECS). METHODS: Imaging and quantitative analyses of postexercise 201Tl SPECT leg examinations were retrospectively performed in nine patients with clinically diagnosed CECS and eight control subjects. Imaging and quantitative criteria for the ischemic compartment were decreased 201Tl perfusion less than the lower limits of normal, which were defined as 2 s.d. below the mean percentage uptake of the control subjects. The SPECT imaging results were compared with those of quantitative analysis, postoperative SPECT images and clinical diagnoses. RESULTS: Postexercise normal legs had nonuniform 201Tl distribution in both legs and in the four compartments. Lower limits of normal mean percentage 201Tl uptake were about 60% for the anterior compartment and about 50% for the other three compartments. Redistribution was observed in 67% of normal compartments in the control subjects. The SPECT images demonstrated 16 ischemic compartments in eight of the nine patients. The SPECT results were consistent with those of quantitative analysis. There were discrepancies between the clinical and SPECT diagnoses in six legs (33% of the 18 legs) of five patients. Postoperative SPECT demonstrated 201Tl perfusion was improved in all involved compartments for that fasciotomy was performed. CONCLUSION: Thallium-201 SPECT imaging of the legs can easily provide precise localization of the ischemic compartment, which is demonstrated as decreased 201Tl distribution on the stress image. This technique is promising for the screening and follow-up of CECS.

Adult↗
PubMed1997

Fractures of experimentally traumatized embalmed versus unembalmed cadaver legs.

Intact legs from six geriatric cadavers were fractured in a self-controlled study aimed at documenting the effects of embalming on both the soft and hard tissues of cadaver specimens subjected to biomechanical impact research. Upon bequeathal, one leg was removed and frozen while the other remained with the cadaver for embalming. The embalmed legs were amputated later and pre-test radiographs were made. For testing, a rod was inserted in the upright leg such that simulated upper body mass could be applied. A 50 kg cart propelled by a pneumatic accelerator to 7.5 m/s struck the anterior leg midway between the knee and ankle. The cart was headed by an instrumented steel pipe (4.75 cm dia.) coupled to a transducer which relayed impact force data to a Hewlett Packard 3562 A signal analyzer. Testing was captured on standard VHS video (30 frames/s) and 16 mm Color High Speed Film (1,000 frames/s). Post-test analyses included radiographs and thorough dissection. Peak forces were comparable for matched pairs. The unembalmed legs showed greater soft tissue damage (muscle and skin) but generally less bone fragmentation than their embalmed counterparts. Neurovascular components were virtually unharmed in most legs.

Aged↗
PubMed1999

[Clinical applications of the anterolateral skin flap and the fascial flap in the lower leg].

OBJECTIVE: To introduce the applied anatomy, operative method and clinical application of the anterolateral skin flap and fascial flap of the lower leg. METHODS: Anatomic dissection was performed on 14 adult cadavers' legs and one amputated lower limb. The origin, course and distribution of cutaneous branches of the superficial peroneal vessels were traced. Four types of anterolateral flaps were designed in the lower leg including the island skin flap, the island fascial flap, the rectangular flap, and the cross-leg flap. Since 1988, twenty-six cases of leg defects(21 patients), chronic osteomyelitis of the tibia(3 cases) and defects on the back of the opposite heel and ankle(2 cases) were treated with the operative methods. RESULTS: All the flaps survived. Primary healing occurred in 23 and secondary in 3 cases. Twenty cases were followed-up for 4 months to 5 years. The flaps were growing well, the tibia fracture healed 3 months after the treatment and the chronic osteomyelitis of tibia had no recurrence. CONCLUSION: This flap is a useful method for repairing various defects in the leg and adjacent regions. It is simple, safe and reliable in manipulation and has minimal influence to the donor site.

Adolescent↗
PubMed1991

Morphology and somatotopic organisation of the central projections of afferents from tactile hairs on the hind leg of the locust.

The morphology and organisation of the central projections of tactile hair afferents from the hind leg of the locust, Schistocerca gregaria, were examined by staining individual hair afferents. Each tactile hair on the femur, tibia, and tarsus is innervated by a single sensory afferent, which projects to the ipsilateral half of the metathoracic ganglion. Afferents arborize in the ventralmost and lateral ventral association centres (vVAC and lVAC). The projections are organised somatotopically in a map with three axes, according to the position of the hair on the leg. First, proximo-distal: afferents from hairs on the proximal leg segments project more anteriorly than do those from hairs on distal leg segments. Moreover, on any given segment the afferents from the more proximal hairs project more anteriorly than do the afferents from the distal hairs. Second, antero-posterior: afferents from hairs on the posterior surface of the leg project more medially than do afferents from anterior hairs. Third, dorso-ventral: afferents from hairs on ventral parts of the leg project more ventrally than do afferents from the dorsal hairs. The afferents from posterior and anterior hairs project to an area between the central projections from dorsal hairs and ventral hairs. The position of a projection within the map is dependent upon the location of the hair on the leg and not the peripheral routes taken by the axon of its afferent to reach the ganglion.

Animals↗
PubMed2005

Dynamic EGFR-Ras signalling in Drosophila leg development.

In Drosophila, as in many other animals, EGFR-Ras signalling has multiple developmental roles from oogenesis to differentiation. In leg development, in particular, it has been described to be responsible for the establishment of distal leg fates in a graded manner. Here, we investigate the patterns of expression of activators of EGFR-Ras signalling, as well as some of the effectors, in order to better understand the patterning of the distal leg, and to investigate further roles of this signalling pathway. These patterns, together with genetic data obtained by different mutant conditions for EGFR-Ras members and transgene expression, suggest two rounds of signalling in leg development. Early, the EGFR ligand Vein is the main player in distal leg patterning, possibly supported later by another ligand activated by Rhomboid. Later, in a second wave of signalling when all the proximal-distal leg fates have been specified, domains of EGFR/Ras activation appear inside each leg segment to regulate Notch-mediated joint development, and also some organs such as tendons and sensory organs. This second wave relies on a ligand activated by Rhomboid.

Animals↗
PubMed1995

A modular artificial neural net for controlling a six-legged walking system.

A system that controls the leg movement of an animal or a robot walking over irregular ground has to ensure stable support for the body and at the same time propel it forward. To do so, it has to react adaptively to unpredictable features of the environment. As part of our study of the underlying mechanisms, we present here a model for the control of the leg movement of a 6-legged walking system. The model is based on biological data obtained from the stick insect. It represents a combined treatment of realistic kinematics and biologically motivated, adaptive gait generation. The model extends a previous algorithmic model by substituting simple networks of artificial neurons for the algorithms previously used to control leg state and interleg coordination. Each system controlling an individual leg consists of three subnets. A hierarchically superior net contains two sensory and two 'premotor' units; it rhythmically suppresses the output of one or the other of the two subordinate nets. These are continuously active. They might be called the 'swing module' and the 'stance module' because they are responsible for controlling the swing (return stroke) and the stance (power stroke) movements, respectively. The swing module consists of three motor units and seven sensory units. It can produce appropriate return stroke movements for a broad range of initial and final positions, can cope with mechanical disturbances of the leg movement, and is able to react to an obstacle which hinders the normal performance of the swing movement. The complete model is able to walk at different speeds over irregular surfaces. The control system rapidly reestablishes a stable gait when the movement of the legs is disturbed.

Gait↗
PubMed1990

Sensory organs of the thoracic legs of the moth Manduca sexta.

The thoracic legs of the moth Manduca sexta acquire a new form and develop a new complement of sensory organs and muscles during metamorphosis from larva to adult. Because of our interest in the reorganization of neural circuitry and the acquisition of new behaviors during metamorphosis, we are characterizing sensory elements of larval and adult legs so that we may determine the contribution of new sensory inputs to the changes in behaviors. Here we describe the sensory structures of adult legs using scanning electron microscopy to view the external sensilla and cobalt staining to examine innervation by underlying sensory neurons. We find that, in contrast to larval legs, the adult legs are covered with a diverse array of sensilla. All three pairs of thoracic legs contain scattered, singly innervated scalelike sensilla. Campaniform sensilla occur singly or in clusters near joints. Hair plates, consisting of numerous singly innervated hairs, are also present near joints. Other more specialized sensilla occur on distal leg segments. These include singly innervated spines, two additional classes of singly innervated hairs, and three classes of multiply innervated sensilla. Internal sensory organs include chordotonal organs, subgenual organs, and multipolar joint receptors.

Animals↗
PubMed2006

Minimally invasive total hip replacement with the patient in the supine position and the contralateral leg elevated.

OBJECTIVE: Supine positioning of the patient taking into account - the demands of anesthesia in an emergency requiring intubation, - minimal time for sterile draping, - patient position can be adjusted by the assistants, - easier implant positioning due to the supine position. Reduction of operative trauma with earlier mobilization and shorter rehabilitation time compared with conventional technique. Application of standard instruments and implants. INDICATIONS: Coxarthroses, necroses of the femoral head. CONTRAINDICATIONS: For the "gynecologic position": - hip joint arthrodesis of the contralateral side. - flexion of the contralateral side < 20 degrees . For minimally invasive total hip replacement: - severe anatomic deformities. - revision operations. POSITIONING AND SURGICAL TECHNIQUE: Supine position of the patient with the contralateral leg held at approximately 30 degrees flexion in a gynecologic footrest attached to the operating table. Leg support that can be lowered for the leg being operated on. Minimally invasive anterolateral approach without dissection of muscles or tendons. Resection of the femoral neck and removal of the femoral head. Preparation of the acetabulum and implantation of the cup. Hyperextension of the leg by lowering the leg support with subsequent adduction and external rotation beneath the elevated contralateral leg. Preparation of the femur and implantation of the stem with subsequent repositioning and wound closure. RESULTS: 185 total hip replacements were performed with this positioning and surgical technique from September 2004 to June 2005. The first 108 minimally invasive procedures were compared with 117 conventional procedures. The patients operated in minimally invasive technique generally did better in terms of operating time, blood loss, use of analgesics, rehabilitation time, and functional outcomes. In seven patients, shaft fissures occurred within the first 3 months due to too abrupt intraoperative dislocation of the leg (learning curve!), but were all treated by application of cerclage and healed uneventfully.

Adult↗
PubMed2004

Adaptive control for insect leg position: controller properties depend on substrate compliance.

This paper concentrates on the system that controls the femur-tibia joint in the legs of the stick insect, Carausius morosus. Earlier investigations have shown that this joint is subject to a mixture of proportional and differential control whereby the differential part plays a prominent role. Experiments presented here suggest another interpretation: single legs of a stick insect were systematically perturbed using devices of different compliance and compensatory forces and movements monitored. When the compliance is high (soft spring), forces are generated that return the leg close to its original position. When the compliance is low (stiff spring), larger forces are generated but sustained changes in position occur that are proportional to the force that is applied. Selective ablation of leg sense organs showed that the leg did not maintain its position after elimination of afferents of the femoral chordotonal organ. Ablation of leg campaniform sensilla had no effect. These data support the idea that different control strategies are used, depending upon substrate compliance. In particular, what we and other authors have called a differential controller, is now considered as an integral controller that "intelligently gives up" when the correlation between motor output and movement of the leg is low.

Animals↗
PubMed2005

Common motor mechanisms support body load in serially homologous legs of cockroaches in posture and walking.

We studied the mechanisms underlying support of body load in posture and walking in serially homologous legs of cockroaches. Activities of the trochanteral extensor muscle in the front or middle legs were recorded neurographically while animals were videotaped. Body load was increased via magnets attached to the thorax and varied through a coil below the substrate. In posture, tonic firing of the slow trochanteral extensor motoneuron (Ds) in each leg was strongly modulated by changing body load. Rapid load increases produced decreases in body height and sharp increments in extensor firing. The peak of extensor activity more closely approximated the maximum velocity of body displacement than the body position. In walking, extensor bursts in front and middle legs were initiated during swing and continued into the stance phase. Moderate tonic increases in body load elicited similar, specific, phase dependent changes in both legs: extensor firing was not altered in swing but was higher after foot placement in stance. These motor adjustments to load are not anticipatory but apparently depend upon sensory feedback. These data are consistent with previous findings in the hind legs and support the idea that body load is countered by common motor mechanisms in serially homologous legs.

Animals↗
PubMed2004

Expression patterns of leg genes in the mouthparts of the spider Cupiennius salei (Chelicerata: Arachnida).

The leg genes extradenticle, homothorax, dachshund, and Distal-less define three antagonistic developmental domains in the legs, but not in the antenna, of Drosophila. Here we report the expression patterns of these leg genes in the prosomal appendages of the spider Cupiennius salei. The prosoma of the spider bears six pairs of appendages: a pair of cheliceres, a pair of pedipalps, and four pairs of walking legs. Three types of appendages thus can be distinguished in the spider. We show here that in the pedipalp, the leg-like second prosomal appendage, the patterns are very similar to those in the legs themselves, indicating the presence of three antagonistic developmental domains in both appendage types. In contrast, in the chelicera, the fang-like first prosomal appendage, the patterns are different and there is no evidence for antagonistic domains. Together with data from Drosophila this suggests that leg-shaped morphology of arthropod appendages requires an underlying set of antagonistic developmental domains, whereas other morphologies (e.g. antenna, chelicera) may result from the loss of such antagonistic domains.

Animals↗
PubMed2005

Development of the adult leg epidermis in Manduca sexta: contribution of different larval cell populations.

During metamorphosis of the tobacco hornworm Manduca sexta, the simple thoracic legs of the larva are remodeled into the more complex adult legs. Most of the adult leg epidermis derives from the adult primordia, small sets of epidermal cells located in specific regions of the larval leg, which proliferate rapidly in the final larval instar. In contrast, the contribution of the epidermal cells outside the primordia is unknown. In this study we have determined their contribution to the adult leg by labeling them with 5-bromodeoxyuridine (BUdR) and following their fate. Although the labeled cells diminished drastically in number, small groups of these cells persisted into the midpupal stage suggesting that they do contribute to the adult leg epidermis. We also found that during the wandering stage the adult primordia went through active proliferation and very little cell death, while the cells outside the primordia went through extensive cell death accounting for the decrease in their number. Our results indicate that two distinct cell populations exist outside the adult primordia. Most cells belong to the first population, which is larval-specific and disappears through apoptosis early in metamorphosis. The second population consists of polymorphic cells that contribute to the larval, pupal and adult leg epidermis.

Animals↗
PubMed1992

Steadiness in one-legged stance: development of a reliable force-platform testing procedure.

Postural steadiness in one-legged stance has potential for evaluation of unilateral injuries and disorders, but any test protocol must be demonstrated to be both feasible and reliable. A testing protocol for using a force platform to measure steadiness in one-legged stance with eyes opened and eyes closed was successfully developed, and its within-session retest reliability was investigated in a group of 24 young, healthy subjects. Strategies were used to minimize the loss of data for trials in which the subjects incurred significant loss of balance from the one-legged position. The performance scores examined were the standard deviation of the three orthogonal force components and the two horizontal center of pressure (CP) coordinates averaged over four consecutive five-second trials. The retest coefficients for all test conditions were substantially improved compared with testing protocols reported earlier. Retest reliability was higher for performance scores based on force measures than for performance scores based on CP measures. The difference was statistically significant in two of the stances, with a similar trend in the other two stances. Further, factor analysis showed that force measures were the best predictors of steadiness in one-legged stance. Analysis of variance failed to detect any systematic effect for leg preference or laterality on steadiness in one-legged stance with eyes opened or eyes closed in the healthy subjects with no history of injury (p greater than .05). The test protocol described enables the development of clinical or experimental trials with repeated-measures design using the subject's nonaffected leg as a control.

Adolescent↗
PubMed1991

Early development of leg and wing primordia in the Drosophila embryo.

The development of the leg and wing primordia in the Drosophila embryo has been traced using molecular markers. Distal-less and disconnected gene expression provide molecular labels for the leg primordia throughout embryonic development, disconnected expression in the developing leg primordia depends on Distal-less activity. The leg primordia arise as discrete clusters of cells that occupy well defined positions in the embryonic ectoderm. At later stages of embryogenesis the primordia become morphologically recognizable and are intimately associated with the development of the Keilin's organs. The presumptive leg disc and the Keilin's organ appear to derive from a common primordium. Similarly the Abnormal leg pattern gene provides a molecular label for the wing and haltere primordia. The dorsal thoracic primordia appear to be of independent origin from the legs.

Animals↗
PubMed2005

Functional aspects of cross-legged sitting with special attention to piriformis muscles and sacroiliac joints.

BACKGROUND: Transversely oriented pelvic muscles such as the internal abdominal oblique, transversus abdominis, piriformis and pelvic floor muscles may contribute to sacroiliac joint stability by pressing the sacrum between the hipbones. Surface electromyographic measurements showed that leg crossing lowers the activity of the internal oblique abdominal muscle significantly. This suggests that leg crossing is a substitute for abdominal muscle activity. No previous studies addressed piriformis muscle and related pelvic structures in cross-legged sitting. METHODS: Angles of pelvis and femur were measured in healthy subjects in standing, normal sitting and cross-legged sitting, and were used to simulate these postures on embalmed pelvises and measure piriformis muscle elongation. Deformations of pelvic ring and iliolumbar ligament caused by piriformis muscle force were measured on embalmed pelvises. FINDINGS: Cross-legged sitting resulted in a relative elongation of the piriformis muscle of 11.7% compared to normal sitting and even 21.4% compared to standing. Application of piriformis muscle force resulted in inward deformation of the pelvic ring and compression of the sacroiliac joints and the dorsal side of the pubic symphysis. INTERPRETATION: Cross-legged sitting is common. We believe that it contributes to sacroiliac joint stability. This study demonstrates the influence of the piriformis muscle on sacroiliac joint compression. The elongation of the piriformis muscle bilaterally by crossing the legs may be functional in the build-up of active or passive tension between sacrum and femur.

Abdominal Muscles↗
PubMed2006

Interventions for leg edema and varicosities in pregnancy. What evidence?

Leg oedema from venous insufficiency is not dangerous but it can cause women symptoms such as pain, feelings of heaviness, night cramps and paraesthesiae. Leg oedema can be a sign of pre-eclampsia when associated with raised blood pressure or proteinuria. The objective of this review was to assess the effects of treatment to relieve the symptoms associated with varicosity in pregnancy and to reduce leg oedema. We searched the Cochrane Pregnancy and Childbirth Group trials register in October 2004 for randomised trials of any form of treatment for varicosity and or leg oedema in pregnancy. Trial quality was assessed and data were extracted. Four trials of three different treatments were included. In one trial, women given rutoside capsules in the last 3 months of pregnancy noted an improvement in symptoms compared with placebo (relative risk 0.54 95% CI 0.32, 0.89). They had a decrease in ankle circumference at 36 weeks' gestation after 8 weeks of treatment, while women given placebo had a small increase. In one trial, women with ankle oedema had a small non-significant reduction in lower leg volume when treated with external pneumatic intermittent compression for 30 min. In another trial compression stockings prophylactically reduced the emergence of leg symptoms but not venous varicosities (relative risk 0.74 95% CI 0.59, 0.93). Lymphatic reflexology was studied in too few women to draw conclusions. In conclusions, rutosides appear to relieve symptoms of venous insufficiency in late pregnancy. However, it is not known if the drug is safe in pregnancy. External pneumatic compression appears to reduce ankle swelling and compression stockings reduce leg symptoms but not varicose veins.

Capillary Fragility↗
PubMed1992

The use of MRI in the investigation of leg oedema.

Magnetic resonance imaging (MRI) was used in the diagnosis of various conditions giving rise to leg oedema, with special attention to the oedema after femoro-distal vascular reconstruction for obliterative atherosclerosis (n = 14). Patients with deep venous thrombosis (n = 6), chronic lymphoedema (n = 6) and closed muscular compartment syndrome (n = 2) were also investigated. Leg volume increase was measured according to the formula of a truncated cone. Interstitial fluid hydrostatic pressure (Pif) was recorded with the wick-in-needle technique. Spin echo series with 10 mm transverse slices were obtained with MRI. Following vascular reconstructions, leg volume increased 26% on the operated side. In the operated leg, no gradient in Pif was found between the posterior muscular compartment and the subcutaneous tissue. However, there was a significantly higher Pif in the subcutaneous tissue compared to the anterior muscular compartment (p less than 0.05). In the operated group, MRI revealed oedema around the entire circumference of the leg, mainly restricted to the subcutaneous tissue. In contrast, oedema of the leg muscles, particularly in the posterior compartments, was typical for patients having deep venous thrombosis. The group with chronic lymphoedema showed circumferential subcutaneous oedema alone or in combination with a fibrotic honeycomb pattern. Oedema of the affected muscular compartment was easily observed in patients who had a closed compartment syndrome. In conclusion, the use of MRI is promising in the investigation of conditions giving rise to leg oedema. It is likely that the formation of post-reconstructive oedema is taking place in the subcutaneous tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗