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Effects of static stretching for 30 seconds and dynamic stretching on leg extension power.

The purposes of this study were to clarify the effects of static stretching for 30 seconds and dynamic stretching on leg extension power. Eleven healthy male students took part in this study. Each subject performed static stretching and dynamic stretching on the 5 muscle groups in the lower limbs and nonstretching on separate days. Leg extension power was measured before and after the static stretching, dynamic stretching, and nonstretching. No significant difference was found between leg extension power after static stretching (1788.5 +/- 85.7 W) and that after nonstretching (1784.8 +/- 108.4 W). On the other hand, leg extension power after dynamic stretching (2022.3 +/- 121.0 W) was significantly (p < 0.01) greater than that after nonstretching. These results suggest that static stretching for 30 seconds neither improves nor reduces muscular performance and that dynamic stretching enhances muscular performance.

Adult↗

Whole-body-vibration-induced increase in leg muscle activity during different squat exercises.

This study analyzed leg muscle activity during whole-body vibration (WBV) training. Subjects performed standard unloaded isometric exercises on a vibrating platform (Power Plate): high squat (HS), low squat (LS), and 1-legged squat (OL). Muscle activity of the rectus femoris, vastus lateralis, vastus medialis, and gastrocnemius was recorded in 15 men (age 21.2 +/- 0.8 years) through use of surface electromyography (EMG). The exercises were performed in 2 conditions: with WBV and without (control [CO]) a vibratory stimulus of 35 Hz. Muscle activation during WBV was compared with CO and with muscle activation during isolated maximal voluntary contractions (MVCs). Whole-body vibration resulted in a significantly higher (p < 0.05) EMG root-mean-square compared with CO in all muscle groups and all exercises (between +39.9 +/- 17.5% and +360.6 +/- 57.5%). The increase in muscle activity caused by WBV was significantly higher (p < 0.05) in OL compared with HS and LS. In conclusion, WBV resulted in an increased activation of the leg muscles. During WBV, leg muscle activity varied between 12.6 and 82.4% of MVC values.

Adult↗

Importance of total leg muscle mass for exercise intolerance in chronic heart failure.

Patients with chronic heart failure symptoms tend to avoid voluntary effort and are thus subject to physical deconditioning. The presence of symptoms in daily life is thought to predispose to physical deconditioning and subsequent skeletal muscle loss. This study was designed to describe the relation among daily physical activities, skeletal muscle loss and exercise capacity in patients with chronic heart failure. We studied 14 patients with severe cardiac dysfunction (left ventricular ejection fraction < 40%) and 7 age-matched normal subjects. We measured total leg muscle mass by dual energy X-ray absorptiometry. The patients were divided into 7 asymptomatic and 7 symptomatic individuals using questionnaires for specific physical activities. Peak oxygen uptake and anaerobic threshold were significantly reduced in cardiac patients as compared with normal subjects. The reduction in exercise capacity was greater in the symptomatic patients than in asymptomatic patients. Leg muscle mass was significantly reduced (-17%) in the symptomatic patients, while it remained normal in the asymptomatic patients. Oxygen uptake in unit muscle mass at the level of anaerobic threshold and at peak exercise was decreased in both the asymptomatic (-21% and -21%, respectively) and symptomatic patients (-27% and -30%, respectively) but the difference between these two groups was not significant. In the asymptomatic patients, the reduced exercise capacity was accounted for primarily by muscle mass-independent factors such as an impaired nutritive blood flow to exercising muscles or metabolic abnormalities within the muscle cell. In the symptomatic patients, the marked reduction in exercise tolerance was attributable to a decrease in leg muscle mass and to hemodynamic or metabolic abnormalities. We conclude that the loss of leg muscle mass plays an important role in exercise intolerance in patients who are prone to physical deconditioning as a result of symptomatic heart failure.

Absorptiometry, Photon↗

Ropinirole in the treatment of restless legs syndrome.

Ropinirole is an original nonergoline dopamine agonist indicated for the treatment of Parkinson's disease. However, recent developments in the study of restless legs syndrome have demonstrated another role for this drug. The symptoms of restless legs syndrome are responsive to dopaminergic agents such as ropinirole. The dosage of ropinirole needed to treat the symptoms of restless legs syndrome appears to be much smaller than what is necessary for Parkinson's disease therapy. The liver is primarily responsible for the metabolism of ropinirole, which has an elimination half-life of approximately 6 h. Ropinirole is generally well tolerated, with no serious adverse effects. Clinical studies have indicated that ropinirole can effectively reduce the motor symptoms of restless legs syndrome and improve overall sleep quality.

Dopamine Agonists↗

Hematological change in venous blood of the lower leg during prolonged sitting in a low humidity and hypobaric environment.

The present study examined the effects of low humidity and hypobaric conditions on hematological change in venous blood of the lower leg during quiet prolonged sitting. Ten healthy male students participated as the subjects after singing a consent form to participate in this study. Their diet and water intake were controlled from 19:00 on the day before the experiments. The subjects sat for 130 min in a climatic chamber. Four experimental conditions in the chamber were designed from a combination of relative humidity (20% or 60%) and air pressure (sea level or equivalent to an altitude of 2,000 m). Ambient temperature was maintained at 24 degrees C in every condition. Venous blood was sampled from the lower leg before and after exposure to the experimental conditions, and was analyzed for blood viscosity and hematological indices. Also, body weight and leg circumference were measured as indices of total water loss and edema, respectively. Regarding the results of ANOVA, significant interactions between humidity and time were observed in blood viscosity, red blood cell count and hematocrit (each p<0.05). However, there were no significant differences in these indices among the conditions. Significant increases were observed in leg circumference (p<0.01), platelet count (p<0.05) and total protein (p<0.05) after the exposure compared with those before the exposure. There were no noticeable effects of hypobaric conditions in every measurement. In conclusion, prolonged sitting seems to be a more hazardous factor for thrombogenesis low humidity and hypobaric conditions during a long-distance flight.

Adult↗

Age-related influences of leg vein filling and emptying on blood volume redistribution and sympathetic reflex during lower body negative pressure in humans.

To test the hypothesis that leg vein filling and emptying functions could be impaired with advancing age, which would produce less blood volume redistribution toward the lower body and smaller sympathetic reflex response during mild gravitational stress, 9 young and 10 elderly healthy males were exposed to a lower body negative pressure (LBNP) of 15 mmHg. Venous occlusion plethysmography was used to determine the functions of the leg veins. We found that the baseline venous distensibility index (VDI) was lower (0.057 +/- 0.004 vs. 0.048 +/- 0.003 ml x 100 ml(-1) x mmHg(-1), young vs. elderly; p < 0.05), and half-emptying time (T(1/2)) was shorter (1.6 +/- 0.1 vs. 1.3 +/- 0.1 s, young vs. elderly; p < 0.05) in the elderly. At 15 mmHg-LBNP, VDI was decreased and T(1/2) was shortened significantly in the young group, but only slightly in the elderly group. Neither blood pressure nor heart rate changed significantly in either group. The reduction in peripheral venous pressure, which was recorded from the left antecubital vein at the cubital fossa, was less in the elderly, indicating a smaller decrease in central blood volume during LBNP; however, the enhancement of muscle sympathetic nerve activity was nearly the same as that in the young. We conclude that leg vein filling and emptying functions are impaired in elderly people, producing less blood pooling in the legs and smaller reduction in peripheral venous pressure during LBNP; the maintained sympathetic reflex response might be attributable to the well-preserved baroreflex function control of sympathetic outflow to the muscle in the elderly.

Adult↗

Type 2 diabetic individuals have impaired leg blood flow responses to exercise: role of endothelium-dependent vasodilation.

OBJECTIVE: Diabetic individuals have impaired endothelium-dependent forearm vasodilatory responses to ischemia, acetylcholine, and other endothelium-dependent agonists. The functional significance of impaired endothelium-dependent dilation in diabetic individuals is uncertain but is most likely to be manifest during leg muscle exercise and may have relevance to peripheral vascular disease and leg ischemia, which is prevalent in diabetic individuals. The current study aimed to determine the relationship between leg blood flow (LBF) responses to endothelium-dependent vasodilation and dynamic large muscle exercise. RESEARCH DESIGN AND METHODS: LBF responses (thermodilution) to intrafemoral arterial infusions of an endothelium-dependent (acetylcholine) and endothelium-independent (sodium nitroprusside) vasodilator and a standardized 25-min cycling bout at 60% VO(2peak) were compared in nine male type 2 diabetic subjects and nine age-, sex-, VO(2peak)-, and weight-matched control subjects. RESULTS: LBF responses to acetylcholine and exercise but not sodium nitroprusside were significantly (P < 0.05) attenuated in patients with diabetes compared with healthy control subjects. The percentage increase in LBF in response to exercise and acetylcholine were significantly correlated (r = 0.54, P = 0.02). Furthermore, resting plasma glucose was significantly related to the LBF response to exercise (r = -0.66, P = 0.003) independently of insulin, HbA(1c), lipids, BMI, and blood pressure. CONCLUSIONS: The increase in LBF during exercise is substantially attenuated in type 2 diabetic compared with matched control subjects. Impaired endothelium-dependent vasodilation secondary to elevated plasma glucose may underlie this observation. This mechanism may be of importance in determining the leg ischemic threshold in diabetic individuals with peripheral vascular disease.

Acetylcholine↗

Subjective and myographic responses in arm and leg cycle exercising.

A study was performed to explore possible psychological benefits of additional arm work during cycle exercising. For this, the subjective and physiological responses of 12 healthy young males were studied during arm and leg exercise on a cycle ergometer with movable arm levers (at 2 distances of the handgrips from the body) and during leg exercise with the grips fixed. After warming up, the subjects kept for 20 min. a constant work load leading to heart rates of about 150 to 160 beats.min.-1. Neither the EMG data nor the ratings of discomfort showed a substantial relief by arm work, but the subjects had different preferences for arm and leg exercise and just leg work, accompanied by differences in discomfort and physiological responses.

Adult↗

Effects of a standing aid on loads on low back and legs during dishwashing.

In order to prevent low back pain during dishwashing, we developed a standing aid for supporting the forward bending posture, and then evaluated the effects of the standing aid on decreasing load on the low back and legs. Eight female volunteers were asked to wash plates for 60 minutes in each of three working postures: (a) without the standing aid, (b) with the standing aid under the thighs, and (c) with the standing aid under the shins. The following were measured: electromyogram (EMG), electrocardiogram (ECG), the force applied to the standing aid, the ground reaction force, the bending angle of the trunk, the bending angle of the knee, and local discomfort in body regions. While using the standing aid under the shins, the muscle load decreased in the low back and legs. While using the standing aid under the thighs, the muscle loads decreased in the low back but increased in the legs. It was suggested that the standing aid under the shins was more effective in decreasing the load on the low back and legs than the standing aid under the thighs.

Adolescent↗

Arterial collateral vessels in legs with obliterative arteriosclerosis.

A method for assessment of arterial collateral vessels and corresponding stenoses on arteriograms of arteriosclerotic legs is presented. The method is based on the concept that compensatory collateral vessels, by-passing stenoses of the conductive arterial segments, have to cross a plane traversing the distal part of each segment (common iliac artery, external iliac/common femoral artery and superficial femoral artery). The number of collateral vessels was counted and the minimum diameter within the corresponding conductive arterial segment was measured (three locations in each leg). There was a close correlation between the sum of remaining lumen diameters and the sum of corresponding collaterals in thirty-four legs (r = -0.77, P less than 0.001). Maximum lower leg blood flow during exercise (thermodilution) was better correlated to arteriosclerotic changes in the pelvic arterial tree than to changes in the femoral arteries, and the must abundant collateral vessels were found in individuals having central stenoses or occlusions.

Adult↗

Lower leg blood flow in intermittent claudication.

Lower leg blood flow was measured at rest and both during and after graduated bicycle exercise in five healthy men and in seventeen patients suffering from various degrees of obliterating arteriosclerosis of the lower limbs. A thermodilution technique was used for flow determinations. The subject exercised in the sitting position and the work load was increased stepwise from a starting load of 100 kpm/min (100 kpm/min load increment every second minute until exhaustion). Three flow phases were depicted during and after the exercise: the aerobic phase, the phase of relative ischaemia and a postexercise phase. During exercise, lower leg blood flow increased approximately twenty times in healthy subjects, while in the arteriosclerotic subjects there was a two-fold to ten-fold increase in flow. In patients with serious distal and proximal stenoses a proximal steal phenomenon was demonstrated during submaximal and maximal exercise. A close correlation was found between maximum individual work load capacity and maximum lower leg blood flow (r = 0.71, P less than 0.001). In the patient group lower leg blood flow at a certain work load was 45% (P less than 0.001) higher in the sitting than in the supine position.

Adult↗

Biomechanical study on axillary crutches during single-leg swing-through gait.

This paper describes a kinetic and kinematic study on axillary crutches during one-leg swing-through gait. The primary objective is to evaluate the interplay of forces at the crutch and body interfaces and to relate them in the understanding of problems associated with the use of axillary crutches. Ten normal adult male subjects with simulated left leg impairment participated in the study. For data acquisition, the VICON kinematic system, a Kistler force plate and an instrumented crutch (with force transducers at the two upper struts close to the axillary bar and one near the crutch tip) were used. Results showed that the peak ground reaction force on the weight-bearing leg during lower limb stance increased by 21.6 percent bodyweight. The peak reaction force transmitted to the arm during crutch stance was 44.4 percent bodyweight. These increased loadings could be detrimental to patients with unsound weight-bearing leg and upper extremities respectively. When the crutches were used incorrectly, 34 percent bodyweight was carried by the underarm. This could cause undue pressure over the neurovascular structures at the axillary region.

Adult↗

One leg swing through gait using two crutches. An analysis of the ground reaction forces and gait phases.

Using a Force Plate the gait cycle for one leg swing-through gait of ten normal subjects on Canadian crutches was monitored, and a composite diagram of forces on the lower limb and both crutches was produced. In addition the relationship of the stance and swing phase for both the lower limb and crutches was studied and the percentage of these phases and their overlap included on the composite diagram. The average maximum vertical ground reaction to the leg was 1.32 body weight, 16 per cent higher than that reported for normal walking. The horizontal force on the lower limb in the direction of walking was 0.35 body weight, compared to 0.15 for normal walking. Vertical ground reaction to crutches was on average 0.54 body weight on the side of the landing leg and 0.51 on the contralateral side. Horizontal ground reaction on the crutches at right angles to the direction of ambulation was 0.09 body weight on the right and 0.08 on the left. The results were considered to indicate caution in the prescription of one leg swing-through gait in subjects with diseased bone and joints in the lower limb.

Adult↗

Duration of leg pain as a predictor of outcome after surgery for lumbar disc herniation: a prospective cohort study with 1-year follow up.

OBJECT: The aim of this study was to investigate different variables in the duration of symptoms that can be used to predict outcome after lumbar microdiscectomy. METHODS: In a prospective study of 132 consecutive patients who underwent surgery for lumbar disc herniation, the authors evaluated the prognostic value of different variables in the duration of symptoms for the 1-year period after surgery. The 1-year follow-up investigation was conducted by an independent observer. Assessment of outcome was performed using a clinical overall score (COS), which was recently assessed for its reliability and validity. As for factors predictive of outcome, only duration of leg pain and sick leave reached statistical significance in the multivariate analysis. Results of the univariate analysis demonstrated that in patients experiencing preoperative leg pain fewer than 4 months and between 4 and 8 months, a significantly lower COS at the 1-year follow up was demonstrated compared with those in whom the duration of leg pain was longer (> 8 months). One hundred eight patients returned to work within the 1st year after surgery. Patients who took a sick leave of more than 28 weeks before the operation were at higher risk of not returning to work. CONCLUSIONS: Analysis of these results indicates that leg pain lasting more than 8 months correlates with an unfavorable postoperative outcome in patients with lumbar disc herniation, as well as a high risk of not returning to work.

Adult↗

Effect of calcium and phosphorus on the incidence of leg abnormalities in growing broilers.

Experiments were conducted to determine the effect of various dietary levels of Ca and P on growth and leg abnormalities in broiler cockerels fed corn and soybean meal diets varying in Ca and P content. Experiment 1 was a 2 x 4 factorial arrangement utilizing .77 and .97% Ca and .33, .38, .43, and .48% available (non-phytate) P (AP). The higher level of Ca reduced the growth rate of chicks fed low levels of AP. Neither Ca nor AP affected the incidence of crooked legs or dyschondroplasia. Increasing AP to .43% increased (P less than .05) the percentage of bone ash and bone weight. In Experiment 2, chicks were reared for 3 wk on diets containing either .40 or .50% AP. From 3 to 6 wk of age, the chicks were fed diets containing from .25 to .50% AP. The Ca:AP ratios were 2:1 in all diets. The level of AP in diets fed to 3 wk of age had no influence on chick growth, the incidence of crooked legs, or dyschondroplasia in either the starting or growing period. In Experiment 3, the chicks were reared in environmental chambers and from 3 to 6 wk of age and exposed to either constant temperature (27 C) and relative humidity (RH) (50%) or cyclic temperature (27 to 38 C) and RH (80 to 50%). The chicks were fed diets containing either .30% AP and .60% CA or .45% AP and .90% Ca from 3 to 6 wk of age. Cyclic temperature and higher RH depressed growth (P less than .05) but had no effect on the incidence of weak legs or dyschondroplasia.

Animals↗

Leg length discrepancy: how much is too much?

A survey of 74 skeletally mature patients with leg length discrepancies of 1.5 cm or more revealed that patients with less than a 2.0-cm discrepancy did not consider their short leg to be a problem in any way. As the amount of discrepancy increased, there were more problems, although there was no critical "cutoff" point. Some patients functioned well athletically with discrepancies of over 2.5 cm. A survey of pediatric orthopedists reflected the wide variety of opinion regarding indications for equalization of leg length discrepancy noted in the literature. It is concluded that there seems little indication for equalization of discrepancies less than 2 cm. For larger amounts of discrepancy, "clinical judgment" still must be weighed on an individual basis, as individual variation among patients with leg length discrepancy confounds any precise classification of functional disability.

Adolescent↗

Minimally invasive fasciotomy in chronic exertional compartment syndrome and fascial hernias of the anterior lower leg: short- and long-term results.

This study evaluated the efficacy of a minimally invasive percutaneous fasciotomy in chronic exertional compartment syndrome and fascial hernias of the anterior lower leg (N = 118). Approximately one-third of symptomatic legs (n = 41) demonstrated fascial herniation and underwent fasciotomy without compartment pressure measurements via a small percutaneous incision using a fasciotome. Symptomatic legs with an intact fascia (n = 77) received similar operative treatment based on pressure measurements. Relief of symptoms was obtained in all but two patients. Postoperative complications included hematoma (9%), superficial peroneal nerve injury (2%), anterior ankle pain (5%), and recurrence (2%). Most patients (96%) reported unlimited exercise after a mean follow-up of 62 months. However, mild symptoms associated with nerve injury as well as ankle pain persisted (4%). A minimally invasive fasciotomy of the anterior lower leg harboring fascial hernias or a chronic exertional compartment syndrome is effective. Complications such as nerve injury and anterior ankle pain may be related to a too distally performed fasciotomy.

Administration, Cutaneous↗

Hydroxyurea-induced leg ulceration in 14 patients.

BACKGROUND: Hydroxyurea is an antineoplastic agent commonly used to treat myeloproliferative disorders and other nonneoplastic conditions. OBJECTIVE: To further define the typical features of hydroxyurea-related cutaneous ulcers of the leg. DESIGN: Retrospective, descriptive study of the medical records of patients who developed leg ulcers while receiving hydroxyurea therapy. SETTING: A tertiary care medical center. PATIENTS: Patients with myeloproliferative disorders who were treated with hydroxyurea. RESULTS: 14 patients with extremely painful leg ulcers were identified. The most common ulcer site was the malleoli. Multiple ulcers were seen in 64% of patients. Patients had received hydroxyurea for an average of 6 years before ulcers developed. All ulcers healed after discontinuation of hydroxyurea treatment, and 2 patients developed ulcers after treatment was restarted. CONCLUSION: Hydroxyurea induces painful leg ulcers that are usually difficult to treat and require cessation of hydroxyurea therapy.

Adult↗