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At least 127 records · Page 7Linked to original sources
PubMed2006

An anatomic study of the intermuscular septum of the lower leg; branches from the posterior tibial artery and potential for reconstruction of the lower leg and the heel.

The anatomy of the intermuscular septum (IMS) of the lower leg has been studied in 10 legs of 10 cadavers. The IMS was well developed in the distal half of the lower leg and its vascular supply from the posterior tibial artery was frequently seen at 60mm proximal from the tip of the medial malleolus. We advocate that these anatomical features contribute to clinical applications of the IMS flap. It may be useful for reconstruction of the lower leg and heel as safer options with less morbidity.

Cadaver↗
PubMed2005

A collisional model of the energetic cost of support work qualitatively explains leg sequencing in walking and galloping, pseudo-elastic leg behavior in running and the walk-to-run transition.

Terrestrial legged locomotion requires repeated support forces to redirect the body's vertical velocity component from down to up. We assume that the redirection is accomplished by impulsive leg forces that cause small-angle glancing collisions of a point-mass model of the animal. We estimate the energetic costs of these collisions by assuming a metabolic cost proportional to positive muscle work involved in generating the impulses. The cost of bipedal running estimated from this collisional model becomes less than that of walking at a Froude number (v2/gl) of about 0.7. Two strategies to reduce locomotion costs associated with the motion redirection are: (1) having legs simulate purely elastic springs, as is observed in human running; and (2) sequencing the leg forces during the redirection phase; examples of this sequencing are the ba-da-dump pattern of a horse gallop and having push-off followed by heel-strike in human walking.

Animals↗
PubMed2005

Duration and amplitude decay of acute arterial leg inflow enhancement with intermittent pneumatic leg compression: an insight into the implicated physiologic mechanisms.

PURPOSE: By acutely enhancing the arterial leg inflow, intermittent pneumatic leg compression (IPC) improves the walking ability, arterial hemodynamics, and quality of life of claudicants. We quantified the duration of acute leg inflow enhancement with IPC of the foot (IPC(foot)), calf (IPC(calf)), or both (IPC(foot+calf)) and its amplitude decay in claudicants and controls in relation to the pulsatility index, an estimate of peripheral resistance. These findings are cross-correlated with the features of the three implicated physiologic mechanisms: (1) an increase in the arteriovenous pressure gradient, (2) suspension of peripheral sympathetic autoregulation, and (3) enhanced release of nitric oxide with flow and shear-stress increase. METHODS: Twenty-six limbs of 24 claudicants with superficial femoral artery occlusion or stenoses (>75%) and 24 limbs of 20 healthy controls matched for age and sex, meeting stringent selection criteria, had their popliteal volume flow and pulsating index (peak-to-peak velocity/mean velocity) measured with duplex scanning at rest and upon delivery of IPC. Spectral waveforms were analyzed for 50 seconds after IPC delivery per 5-second segments. The three IPC modes were applied in a true crossover design. Data analysis was performed with the Page, Friedman, Wilcoxon, Mann-Whitney and chi2 tests. RESULTS: The median duration of flow enhancement in claudicants exceeded 50 seconds with IPC(foot), IPC(calf), and IPC(foot+calf) but was shorter (P < .001) in the controls (32.5 to 40 seconds). Among the three IPC modes, the duration of flow enhancement differed (P < .05) only between IPC(foot) and IPC(foot+calf). After reaching its peak within 5 seconds of IPC, flow enhancement decayed at rates decreasing over time (trend, P < .05, Page test), which in both groups were highest at 5 to 20 seconds, moderate at 20 to 35 seconds, and lowest at 35 to 50 seconds (P < .05, Friedman test). Baseline and peak flow with all IPC modes was similar between the two groups. Pulsatility index attenuation in claudicating limbs lasted a median 32.5 seconds with IPC(foot), 37.5 seconds with IPC(calf), and 40 seconds with IPC(foot+calf); duration of pulsatility index attenuation was shorter in the control limbs with IPC(foot) (30 seconds), IPC(calf) (32.5 seconds), or IPC(foot+calf) (35 seconds), yet differences, as well as those among the 3 IPC modes, were not significant. CONCLUSION: Leg inflow enhancement with IPC exceeds 50 seconds in claudicants and lasts 32.5 to 40 seconds in the controls. Peak flow occurs concurrently with maximal pulsatility index attenuation, within 5 seconds of IPC. Irrespective of group or IPC mode, the decay rate (%) of flow enhancement is highest within 5 to 20 seconds of IPC, moderate at 20 to 35 seconds, and lowest at 35 to 50 seconds. Since attenuation in peripheral resistance terminates with the mid time period (20 to 35 seconds) of flow decay, and nitric oxide has a half-life of <7 to 10 seconds, the study's data indicate that all implicated physiologic mechanisms (1, 2, and 3) are likely active immediately after IPC delivery (0 to 20 sec) and all but nitric oxide are effective in the mid time period (20 to 35 seconds). As the pulsatility index has returned to baseline, the late phase of flow enhancement (35 to 50 seconds) could be attributable to the declining arteriovenous pressure gradient alone.

Acute Disease↗
PubMed2003

Factor analysis of the International Restless Legs Syndrome Study Group's scale for restless legs severity.

OBJECTIVE: The International Restless Legs Syndrome Study Group has developed and validated a ten-item scale for assessing the severity of the restless legs syndrome. This International Restless Legs Severity Scale (IRLS) is reported to have a high degree of internal consistency and it has generally been used as a single scale. This study uses a factor analytic approach to evaluate the IRLS for possibly useful subscales. METHODS: A large convenience sample (n=516) of self-identified restless leg syndrome patients completed the IRLS over the Internet. Data were analyzed using principal component analyses. RESULTS: Two primary factors were identified, one with six items related to symptom severity and a second with three items related to impact of the symptoms on life. These accounted for 41.8 and 22.5% of the variance, respectively. CONCLUSIONS: The IRLS can be evaluated using separate subscale scores: one for symptoms and the other symptom impact. The relative merits of these subscale scores versus the score for the entire test need to be evaluated in different situations in further studies, in especially the ones involving assessing responsiveness to treatment effects.

Factor Analysis, Statistical↗
PubMed1981

[Longitudinal data of physical growth of healthy children. Lengths of trunk, hand, forearm, upper arm, whole arm, lower leg, thigh and whole leg of children aged 2,5 to 15 years. (author's transl)].

From 1968-78 a longitudinal study was performed concerning development of lengths of trunk, hand, forearm, upper arm, whole arm, lower leg, thigh and whole leg in 709 healthy boys and 711 girls aged 2,5 to 15 years. In boys the mean increase in lengths of trunk amounted to 17.7 cm, of hand to 8.1 cm, of forearm to 12.2 cm, of upper arm to 16.1 cm, of whole arm to 36.8 cm of lower leg to 21.5 cm, of thigh to 27.3 cm, and of whole leg to 54.0 cm. The corresponding lengths in girls amounted in 16.9 cm, 7.2 cm, 11.0 cm, 14.0 cm, 32.6 cm, 18.7 cm, 24.5 cm, and 46.4 cm. Lengths investigated increase almost linearly between 3 and 11 years of age both in boys and girls. Beginning with 12 years boys have an increased development of all lengths when compared with girls.

Adolescent↗
PubMed2000

Wound management for 287 patients with chronic leg ulcers demands 12 full-time nurses. Leg ulcer epidemiology and care in a well-defined population in southern Sweden.

OBJECTIVE: To study the prevalence, aetiology and treatment of chronic leg and foot ulcers, and to estimate the nurse's time in wound management. DESIGN: A structured questionnaire with 19 questions about chronic ulcers and wound management was sent to all district and community nurses in the county during 1 week in March 1998. A similar questionnaire has been administered regularly since 1986. SETTING: Primary and community care in the county of Blekinge, Sweden, with a population of 1,51,610. PATIENTS: 287 patients with chronic leg and foot ulcers were identified during the week studied. MAIN OUTCOME MEASURES: Prevalence of leg and foot ulcers, ulcer aetiology, treatment of ulcers and wound management time. RESULTS: The estimated prevalence of chronic leg and foot ulcers was 0.19%. Venous ulcers were the most common (38%), of which 87% were treated with some form of compression therapy. Seven percent of the nurse's workload was devoted to ulcer care. During the period 1986 to 1998, ulcers with missing or unknown aetiology decreased from 31% to 6% and ulcers with a duration of more than 2 years from 44% to 27%, while treatment time per ulcer decreased from 2.1 to 1.7 hours/week. CONCLUSION: Monitoring standards for ulcer aetiology through repeated questionnaires seems to ensure more accurate diagnoses. Thorough and detailed information about treatment time documents the workload for wound management.

Age Distribution↗
PubMed1990

A new method for repairing skin defects of the lower leg under unsatisfactory conditions: utilization of peroneal island flap from the opposite sound leg.

As a new procedure for the repair of tissue defects in the lower leg under unsatisfactory conditions, we have devised a surgical procedure for peroneal island flap transfer from the opposite sound leg. This report presents three patients treated by cross-leg island flaps with reversed blood flow. This procedure can be applied for reconstruction of the leg with severe circulatory disturbance caused by arterial damage due to trauma and arterial disease such as Buerger's disease. Furthermore, joint exercise is possible because the pedicle is long and no rigid immobilization is required.

Humans↗
PubMed1992

Periodic leg movements in sleep with restless legs syndrome: effect of clonazepam treatment.

Fifteen patients with restless legs syndrome underwent whole-night polysomnographic recordings before and during clonazepam treatment. The treatment with 0.5 to 1.5 mg clonazepam improved subjective complaints of all the 15 patients. All the patients presented periodic leg movements on the polysomnograms before the treatment. The clonazepam treatment significantly decreased the total numbers of leg movements and the numbers of leg movements per hour without affecting the mean intermovement interval.

Aged↗
PubMed2001

Measurement of body fat using leg to leg bioimpedance.

AIMS: (1) To validate a leg to leg bioimpedance analysis (BIA) device in the measurement of body composition in children by assessment of its agreement with dual energy x ray absorptiometry (DXA) and its repeatability. (2) To establish a reference range of percentage body fat in Hong Kong Chinese children. METHODS: Sequential BIA and DXA methods were used to determine body composition in 49 children aged 7-18 years; agreement between the two methods was calculated. Repeatability for the BIA method was established from duplicate measurements. Body composition was then determined by BIA in 1139 girls and 1243 boys aged 7-16 years, who were randomly sampled in eight local primary and secondary schools to establish reference ranges. RESULTS: The 95% limits of agreement between BIA and DXA methods were considered acceptable (-3.3 kg to -0.5 kg fat mass and -3.9 to 0.6% body fat). The percentage body fat increased with increasing age. Compared to the 1993 Hong Kong growth survey, these children had higher body mass index. Mean (SD) percentage body fat at 7 years of age was 17.2% (4.4%) and 14.0% (3.4%) respectively for boys and girls, which increased to 19.3% (4.8%) and 27.8% (6.3%) at age 16. CONCLUSION: Leg to leg BIA is a valid alternative method to DXA for the measurement of body fat. Provisional reference ranges for percentage body fat for Hong Kong Chinese children aged 7-16 years are provided.

Absorptiometry, Photon↗
PubMed1987

Arterial disease in chronic leg ulceration: an underestimated hazard? Lothian and Forth Valley leg ulcer study.

Six hundred patients with chronic leg ulcers were interviewed and examined for evidence of arterial impairment. There were 827 ulcerated legs. Pedal pulses could not be felt in 94 (11%). A Doppler resting pressure index of 0.9 or less was found in 176 legs (21%). Risk factors for arterial impairment included age, ulceration affecting the foot, and a history of claudication, ischaemic heart disease, or cerebrovascular disease. Roughly half the patients with arterial impairment also showed the clinical features of chronic venous insufficiency. Careful assessment for arterial disease is mandatory before patients with chronic leg ulcers are treated with elastic compression.

Age Factors↗
PubMed1997

Changes in leg vein filling and emptying characteristics and leg volumes during long-term head-down bed rest.

Leg venous hemodynamics [venous distensibility index (VDI), arterial flow index (AFI), half-emptying time (T1/2)], and leg volumes (LV) were assessed by mercury strain-gauge plethysmography with venous occlusion and volometry, respectively, in seven men before, during, and after 42 days of 6 degrees head-down bed rest. Results showed a high increase in VDI up to day 26 of bed rest (+50% vs. control at day 26, P < 0.05), which tended to subside thereafter (+20% increase vs. control value at day 41, P < 0.05). VDI changes were associated with parallel changes in T1/2 (+54% vs. control at day 26 of bed rest, P < 0.05, and +25% vs. control at day 41, P < 0.05) and with a decrease in AFI (-49% at day 41 vs. P < 0.05). LV continuously decreased throughout bed rest (-13% vs. control at day 41, P < 0.05) but was correlated with VDI only during the first month of bed rest. These results show that during long-term 6 degrees head-down bed rest alterations of leg venous compliance are associated with impairment of venous emptying capacities and arterial flow. Changes in skeletal muscle mass and fluid shifts may account for venous changes during the first month of bed rest but, subsequently, other physiological factors, to be determined, may also be involved in leg venous hemodynamic alterations.

Adult↗
PubMed2005

Evaluation of leg-to-leg BIA in assessing body composition of high-school wrestlers.

PURPOSE: To evaluate the accuracy of leg-to-leg bioelectrical impedance analysis (BIA) in assessing fat-free mass (FFM) using the TBF-300WA in comparison with hydrostatic weighing (HW) and skinfolds (SK) in high-school (HS) wrestlers in a hydrated state. METHODS: Body composition was determined by BIA, HW, and three-site SK in 129 HS wrestlers (mean +/- SD, age: 15.5 +/- 1.3, height 1.70 +/- 0.08 m, body mass 65.6 +/- 13.1 kg). For all methods, body density (Db) was converted to percent body fat (%BF) using the Brozek equation. Hydration state was quantified by evaluating urine specific gravity. RESULTS: There were no significant differences for estimated FFM between BIA (56.9 +/- 8.4 kg) and HW (56.2 +/- 9.9 kg) or between SK (56.1 +/- 8.9 kg) and HW. The standard errors of estimate for FFM with HW as the reference method were 3.64 kg for BIA and 1.97 kg for SK. Significant correlations were found for FFM between HW and BIA (r = 0.93, P < 0.001), and between HW and SK (r = 0.98, P < 0.001). The FFM difference between BIA and HW was significantly correlated with the FFM average of the two methods (r = -0.39, P < 0.001). The FFM difference between SK and HW was also significantly correlated with the FFM average (r = -0.44, P < 0.001). CONCLUSIONS: This study demonstrates that SK should be considered as the preferred field method of estimating the FFM of HS wrestlers because of its greater individual precision than the leg-to-leg BIA method. Although the BIA is an attractive assessment tool and easy to use, it should be recommended as an alternative to the SK method only when trained skinfold technicians are not available.

Adolescent↗
PubMed2004

The Lindsay Leg Club Model: a model for evidence-based leg ulcer management.

Leg Club is a unique model of community-based leg ulcer care. By providing nursing care in a non-medical, social environment, the model has several benefits: it removes the stigma associated with leg ulcers and helps isolated older people reintegrate into their communities, which in turn improves concordance and has a positive impact on healing and recurrence rates. In an atmosphere of de-stigmatisation, empathy and peer support, positive health beliefs are promoted and patients take ownership of their treatment. The Leg Club model creates a framework in which nurses, patients and local community can collaborate as partners in the provision of holistic care. The model also provides an environment for appropriate supportive education, advice and information.

Community Health Centers↗
PubMed1999

Lower leg pain. Diagnosis and treatment of compartment syndromes and other pain syndromes of the leg.

Leg pain in athletes has many aetiologies. The clinician must strive to specifically define the clinical problem in order to administer the appropriate treatment for the athlete's condition. Clinical conditions in the leg causing symptoms in athletes include chronic exertional compartment syndrome (CECC), tendinitis, medial tibial stress syndrome, stress fractures, fascial defects, musculotendinous junction disruptions (tennis leg), popliteal artery entrapment syndrome, effort-induced venous thrombosis and nerve entrapment. Appropriate diagnostic studies are needed to allow accurate diagnosis. A work-up might include radiographs, bone scans and compartment pressure measurement. Many of these conditions relate to overuse and training errors. Conservative measures including rest, activity modification and rehabilitation will permit a gradual return to participation in sports. Some problems such as CECC, popliteal artery entrapment syndrome and nerve entrapment may require surgical intervention to allow the resolution of symptoms. Clinicians should be familiar with the range of problems causing leg pain in order to prescribe specific treatment for each athlete.

Athletic Injuries↗
PubMed2001

Validity of leg-to-leg bioelectrical impedance measurement in males.

BACKGROUND: This study determined the validity of the leg-to-leg bioelectrical impedance analysis (BIA) system (Tanita Body Fat Analyzer, TBF 105, Tanita Corporation of America, Inc., Arlington Heights, IL) in estimating body composition in males. METHODS EXPERIMENTAL DESIGN: Fat-free mass (FFM) was estimated using BIA and underwater weighing, and compared. SETTING: Subjects were recruited from the community. PARTICIPANTS: Heterogeneous group of males (N=192) was recruited, with a mean+/-SD age of 39.0+/-16.8 yrs; body mass index, 26.0+/-4.0 kg/m2, percent body fat, 18.1+/-8.9 percent. MEASURES: Prior to BIA testing, subjects were required to adhere to standard BIA testing guidelines, and bioelectrical impedance was measured in subjects standing erect with bare feet on the analyzer's footpads, and wearing a swimsuit. Underwater weighing was conducted using standard procedures, with direct measurement of residual volume. RESULTS: A Bland-Altman plot of difference between FFM measured by underwater weighing and BIA versus average FFM by the two methods showed no systematic difference (mean difference, 0.07+/-3.5 kg). FFM was estimated at 66.3+/-8.6 kg with underwater weighing, and 66.2+/-7.7 kg with BIA (r=0.92, p<0.001; SEE 3.5 kg). CONCLUSIONS: These data indicate that the leg-to-leg bioelectrical impedance system accurately assesses FFM in a heterogenous group of males when compared to underwater weighing.

Adipose Tissue↗
PubMed2001

A comparison of leg-to-leg bioelectrical impedance and skinfolds in assessing body fat in collegiate wrestlers.

A comparison of the leg-to-leg bioelectrical impedance (BIA) system and skinfold analysis in estimating % body fat in a large number of National Collegiate Athletic Association (NCAA) collegiate wrestlers was conducted. A series of 5 cross-sectional assessments, including the NCAA Division I and III Championships, were completed throughout the 1998-1999 wrestling season with samples ranging from (N = 90-274). Body density was determined from the 3 skinfold measures using the Lohman prediction equation. BIA measurements were determined using the Tanita body fat analyzer, model 305. Significant correlations between methods ranging from (r = 0.67-0.83, p < 0.001) and low standard error of estimates (SEE) for % body fat ranging from 2.1-3.5% were found throughout the 5 assessment periods. This preliminary study demonstrated that the leg-to-leg bioelectrical impedance system accurately estimated % body fat when compared to skinfolds in a diverse collegiate wrestling population.

Adolescent↗
PubMed2001

[MR angiography of pelvic and leg arteries: initiation with time-resolved data acquisition of the lower legs].

58 patients suffering from peripheral arterial vascular disease were examined using contrast-enhanced MR angiography with the intention of optimizing the visualization of lower leg arteries. Different from the customary acquisition order, were first the arteries of the lower legs depicted with three time-resolved phases. Afterwards, the iliacal and femoral vessels were imaged by applying the floating-table technique in two steps. In all cases, the lower leg arteries were depicted without overlying veins. By injecting the contrast agent in two phases, imaging quality of the iliofemoral arteries was not significantly reduced.--In conclusion, we would recommend the hybrid technique of peripheral contrast-enhanced MRA with primarily starting the acquisition of the lower legs in cases of foot infections or ulcerations where the transit time is reduced bi- or unilaterally.

Adult↗
PubMed2005

[Pathophysiology of restless leg syndrome and periodic leg movement disorder in view of the latest research findings].

Both restless leg syndrome and periodic leg movement disorder have been classified as primary sleep disorders by the International Classification of Sleep Disorders. Considering the characteristic clinical symptoms, it is supposed that their pathomechanism involves the peripheral and central stimulus-processing mechanisms of the nervous system as well as several elements of the motor system. During the last couple of years many new elements of the pathomechanism have been discovered, in particular the dysfunction of the postsynaptic dopamine receptors related to the iron metabolism of the central nervous system, the role of opiate receptors, and the involvement of subclinical small fiber neuropathy. Many of these findings have been incorporated into the diagnostic and treatment protocols used in the management of patients with restless leg syndrome or periodic leg movement disorder. Considering the rapidly increasing number of publications on their pathomechanism and the various fields it involves, the authors found it necessary to evaluate these data and to interpret their relationships within the frame of sleep-wake regulation.

Central Nervous System↗