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At least 19 recordsLinked to original sources

Leg movements of stick insects walking with five legs on a treadwheel and with one leg on a motor-driven belt. II. Leg coordination when step-frequencies differ from leg to leg.

Stick insects walking with five legs on a self-propelled treadwheel and with the left hindleg (L3) on a motor-driven belt may move the "belt" leg L3 and the "wheel" legs with different frequencies. When L3 made less steps than L2, that step of L2, which was performed during the swing phase of L3, is prolonged. The time interval between the end of swing phase of L3 and the onset of the following swing phase of L2 was remarkably constant. When L3 made more steps than L2, that step of L3, which was performed during the swing phase of L2, is prolonged. Again, the time interval between the end of swing phase of L3 preceding a L2 swing phase and the onset of the L2 swing phase was relatively constant. For both kinds of walking situations phase response curves were drawn. They show that two types of coordinating channels exist: An anteriorly directed type is more dependent on absolute time than on phase. A posteriorly directed type is phase-dependent. Both inhibit the transition from stance to swing for some time. The results are compared with the existing coordination models.

Animals↗

Computer-assisted detection of nocturnal leg motor activity in patients with restless legs syndrome and periodic leg movements during sleep.

STUDY OBJECTIVES: To assess the performance of a new method for automatic detection of periodic leg movements during sleep. METHODS: Leg movements during sleep were visually detected in the tibialis anterior muscles recordings of 15 patients with restless legs syndrome and 15 normal controls. Leg movements were detected automatically by means of a new computer method with which electromyogram signals are first digitally band-pass filtered and then rectified; subsequently, the detection of leg movements is performed by using 2 thresholds: one for the starting point and another to detect the end point of each leg movement. Sensitivity and false-positive rate were obtained; the American Sleep Disorders Association parameters were also computed, and the results analyzed by means of the Kendall W coefficient, the linear correlation coefficient and the Bland-Altman plots. SETTING: N/A. PARTICIPANTS: Fifteen patients with restless legs syndrome and periodic leg movements and 15 controls. MEASUREMENTS AND RESULTS: High values of the Kendall W coefficient of concordance between automatic and visual analysis were found with values close to 1 and the linear correlation coefficient for leg movements index and total leg movements index was > 0.950 (p < .000001). The Bland-Altman plots provided the limits of agreement between visual and computer detection, which were -9.01 and +9.89 for the periodic leg movement index. None of the normal controls was found to have periodic leg movement indexes >5 after automatic analysis. CONCLUSIONS: Our method can be applied to the clinical evaluation of periodic leg movements during sleep, with some caution in patients with a low periodic leg movement indexes. Large-scale research application is possible and can be considered as reliable.

Adult↗

Neural control of leg movements in a metamorphic insect: persistence of larval leg motor neurons to innervate the adult legs of Manduca sexta.

During metamorphosis of the hawkmoth Manduca sexta, the larval thoracic legs along with their associated sensory organs and muscles degenerate and new adult legs develop. The larval legs are small and relatively simple structures capable of lateral extension and medial flexion allowing them to grasp the substrate as the caterpillar crawls along. By contrast, the adult legs are used for walking with an alternating gait. They are much larger than the larval legs and articulate such that they are capable of movement in several directions. This change in form and function is accompanied by a reorganization of the neural circuits controlling leg movements. In a previous report (Kent and Levine: J. Comp. Neurol. 271:559-576, '88) we described motor neurons innervating the larval prothoracic legs, and here we describe motor neurons innervating the prothoracic legs of the adult. Using a combination of cobalt staining methods and the persistent fluorescent dye Fluoro-Gold, we have found that some, if not all, larval leg motor neurons are retained and innervate the new adult leg muscles. Moreover, we have been able to discover the fate of individual larval leg motor neurons by marking a single larval neuron with Fluoro-Gold and using a second fluorescent dye to double label the same neuron in the adult. Our results suggest that specific larval leg motor neurons innervate corresponding muscles in the adult stage, although their apparent function is significantly different. In addition, the motor neurons undergo significant remodeling of their dendritic branching patterns during metamorphosis, alterations which doubtless contribute to their new roles in adult behavior.

Animals↗

Leg movements of stick insects walking with five legs on a treadwheel and with one leg on a motor-driven belt. I. General results and 1:1-coordination.

Five legs of a fixed stick insect walked on a double treadwheel. The left hindleg (L3) walked on a motor-driven belt. When the belt was slower than the wheels L3 made less steps than the other legs and when the belt was faster than the wheels it made more steps than the other legs. In the case of slowlier stepping of the "belt-leg", the motor neurons of the retractor coxae muscle of this leg showed a high activity when the leg was pulled backwards by the belt. This activity was modulated in the step rhythm of the "wheel-legs". When all legs showed the same stepping frequency (1:1-coordination) the protraction duration of L3 was almost independent of step-period, as well as the lag between onset of protraction of L3 and that of L2. In some cases only L3 could be made to step on the belt even when all other legs did not walk.

Animals↗

Compression bandages and stockings for venous leg ulcers.

OBJECTIVES: To assess the effectiveness and cost-effectiveness of compression bandaging and stockings in the treatment of venous leg ulcers. SEARCH STRATEGY: Searches of 19 databases, hand searching of journals, conference proceedings and bibliographies. Manufacturers of compression bandages and stockings and an Advisory Panel were contacted for unpublished studies. SELECTION CRITERIA: Trials that evaluated compression bandaging or stockings, as a treatment for venous leg ulcers. There was no restriction on date or language. Ulcer healing was the primary endpoint. DATA COLLECTION AND ANALYSIS: Details of eligible studies were extracted and summarised using a data extraction sheet. Data extraction was verified by two reviewers independently. MAIN RESULTS: Twenty two trials reporting 24 comparisons were identified. Compression was more effective than no compression (4/6 trials). When multi-layered systems were compared, elastic compression was more effective than non-elastic compression (5 trials). There was no difference in healing rates between 4-layer bandaging and other high compression multi-layered systems (3 trials). There was no difference in healing rates between elastomeric multi-layered systems (4 trials). Multi-layered high compression was more effective than single layer compression (4 trials). Compression stockings were evaluated in two trials. One found a high compression stocking plus a thrombo stocking to be more effective than a short stretch bandage. The second small trial reported no difference between the compression stockings and Unna's boot. There was insufficient data to draw conclusion about the relative cost-effectiveness of different regimens. REVIEWER'S CONCLUSIONS: Compression increases ulcer healing rates compared with no compression. Multi-layered systems are more effective than single-layered systems. High compression is more effective than low compression but there are no clear differences in the effectiveness of different types of high compression.

Bandages↗

Comparison of hand-to-leg and leg-to-leg bioelectric impedance devices in the assessment of body adiposity in prepubertal children. the STRIP study. Special Turku coronary Risk factor Intervention Project.

UNLABELLED: The body composition of 40 seven-year-old children and of 50 of their parents was measured using two bioelectric impedance devices, the Model 101, RJL Systems, USA (conventional hand-to-leg device) and TANITA body fat analyser, TBF 105, Tanita Co, Tokio, Japan (newer leg-to-leg device). There were strong correlations between impedances obtained by these two devices [r= 0.95, r = 0.93, r= 0.82, r = 0.81 for girls (n = 22), boys (n = 18), mothers (n = 27) and fathers (n = 23), respectively (p < 0.0001 for all)]. However, there was a clear difference in the absolute impedance values due to the fact that the devices measure different segments of the body. Fat percentages based on built-in equations of the two devices correlated in girls, mothers and fathers (r = 0.71, r = 0.94, r = 0.80, respectively; p < 0.001) but not in boys (r = 0.21, p = 0.41). Using the Bland-Altman comparison method, a large intraindividual difference was observed in the fat percentages by the two devices, independent of adiposity level. Both devices detected significant gender differences in fat percentages in 7-y-old girls and boys with similar BMIs. CONCLUSION: When using the Tanita 105 leg-to-leg bioelectric impedance device to assess adiposity in children there is an obvious need for revised equations. For this, comparative studies using more validated methods, i.e. densitometry or DEXA, as part of a multi-compartment model are needed.

Adipose Tissue↗

Methodology for determining the sensitivity of swing leg toe clearance and leg length to swing leg joint angles during gait.

During the swing phase of gait, the effective length of the leg-distance from the hip joint center to the toe-must be made shorter than the distance from the hip to the floor to avoid toe-stubbing or tripping while walking. Critical toe clearance occurs approximately halfway through swing phase when the distance between the toe and the floor reaches a local minimum. Analytical techniques derived in this study were used to evaluate: (1) the sensitivity of toe clearance to the swing leg hip, knee, and ankle joint angles; and (2) the sensitivity of the hip-toe distance to the swing leg knee and ankle joint angles. The toe clearance, hip-toe distance, toe clearance sensitivity (TCS), and hip-toe distance sensitivity (HTDS) were calculated for each frame of data during the swing phase of 10 able-bodied subjects. A minimum toe clearance of 1.9+/-0.5cm occurred at about 51% of the swing phase during able-bodied gait. At that particular time, the toe clearance was found to be most sensitive to the angle of the ankle (17.1cm/rad), then the hip (9.5cm/rad), and lastly the knee (2.5cm/rad). The hip-toe distance was found to be about twice as sensitive to the angle of the ankle (-15.3cm/rad) than to that of the knee (-7.6cm/rad) at the time of critical toe clearance. The methodology developed here and the baseline information calculated for able-bodied subjects could be used to evaluate the effects that different gait pathologies have on swing-phase toe clearance and hip-toe distance.

Adult↗

Time course of arousal response during periodic leg movements in patients with periodic leg movements and restless legs syndrome.

OBJECTIVE: The temporal evolution of periodic leg movements (PLM) and the relationship of their arousing effect on sleep episode has not been extensively investigated. We studied the nocturnal evolution of PLM associated or not with microarousal (MA) and associated with slow wave activity (PLM with slow wave activity) in 23 patients with PLM and/or restless legs syndrome (RLS). METHODS: All subjects had PLM associated with MA or with slow wave activity as well as without MA and all slept for 4 sleep cycles. Spectral electroencephalogrpahic (EEG) analysis was done for the 4 sleep cycles to assess the nocturnal variation in slow wave activity (SWA). RESULTS: Sixty percent of PLM were associated with MA, 4% were associated with slow wave activity whereas 36% showed no EEG changes. There was a clear prevalence of PLM with MA in stages 1 and 2 while PLM without MA were prevalent in slow wave sleep. The night-time PLM index progressively declined from the first to the last sleep cycle (P<0.005), without differences between PLM types, or between PLM and RLS patients. The decline of PLM duplicated the temporal trend in SWA over consecutive sleep cycles. CONCLUSIONS: PLM showed a typical pattern of progressive decline throughout the night following the exponential decline in SWA. These over-time variations occurred independently of changes in the rate of PLM associated or not with MA or associated with slow wave activity, suggesting that variations in arousal threshold and sleep propensity did not affect the PLM arousing effect. The PLM-related arousal response might be affected by interaction of circadian and sleep stage influences with the addition of sleep oscillatory processes.

Adult↗

Validity of the Leg-O-Meter, an instrument to measure leg circumference.

The objective of this study was to validate the Leg-O-Meter measure against the clinical assessment of edema made by physicians using data from a 1-year follow-up study of unselected patients with chronic venous disease of the leg (CVDL). The Leg-O-Meter consists of a tape measure fixed to a stand attached to a small board on which the patient is in standing position. Its reliability has been shown to be above 97%. Data from the Venous Insufficiency Epidemiologic and Economic Study (VEINES) were used: 1,521 patients from France, Belgium, Italy, and Quebec (Canada) who spontaneously consulted a physician between 1994 and 1995 with a complaint resulting from venous problems of the legs were included. Baseline variables included leg circumference measurements using the Leg-O-Meter; physicians were also asked to diagnose edema and report it as present or absent on each leg. Clinical edema and leg circumferences were assessed again 3 to 6 months after the baseline visit and 12 months after baseline. The tape measure of the Leg-O-Meter was fixed at 13 cm from the floor. The first and last assessments were used to evaluate the variation in edema during the follow-up period. Clinical variation in edema status was assessed as follows: improved, if edema was diagnosed at baseline but not at the final visit; unchanged, if edema was diagnosed at both visits; and worsened, if there was no diagnosis of edema at baseline but a diagnosis of edema was made at the final visit. Variation in measured edema was classified as improved if there was a decrease in leg circumference of more than 1 cm between baseline and final evaluation; unchanged, if the difference in leg circumference was between plus or minus 1 cm between the 2 assessments; and worsened, if there was an increase in leg circumference greater than 1 cm between the 2 assessments. Data-driven cut-off points were also used: 1.3 cm and 1.5 cm. Sensitivity and specificity of the Leg-O-Meter using physician diagnosis as "gold standard" were calculated. In addition, receiver operating characteristics (ROC) curves were calculated by using the 3 different leg circumference cut-off points in order to determine the accuracy of the Leg-O-Meter to detect changes in edema. The overall accuracy of the Leg-O-Meter was 0.84 (standard error (se) = 0.06). Accuracy was greater when 1.5 cm was used as a cut-point. The Leg-O-Meter is an objective, reliable, and standardized instrument to assess patients over time. A change of 1.5 cm between 2 measurements gives a valid estimate of improvement or worsening of edema, when compared to physicians' diagnosis. The Leg-O-Meter is also sensitive to any changes in leg circumferences, which is an advantage over the clinical evaluation of edema.

Anthropometry↗

Perturbation of the motor system in freely walking cockroaches. I. Rear leg amputation and the timing of motor activity in leg muscles.

1. The effects of amputation of a rear leg on the pattern of motor activity in the legs of freely walking cockroaches (Periplaneta americana L.) were studied. 2. Amputation affected both the frequency and the timing (phase) of motor bursts during a stepping cycle. Bursts in the stump of an amputated rear leg and in the contralateral (intact) rear leg often occurred at two or three times the frequency of bursts in the other legs. The remaining legs also showed multiple bursting during some steps. 3. Amputation affected the phase of motor bursts in two different ways. First, for every leg pair, phase was more variable after amputation, whether or not the mean phase was affected. Second, for some leg pairs, the mean phase itself was altered. During most steps, the timing of motor bursts in the stump of the amputated leg was walking-speed-dependent relative to bursts in the anterior legs. In contrast, the timing of bursts in the stump relative to bursts in the legs across the body from it showed no such speed-dependent timing. Timing between bursts in pairs of intact legs also showed either speed-dependent or speed-independent effects, depending on the pair under consideration. 4. The effects of amputation were not consistent. After loss of a leg, bursts in some leg pairs occurred synchronously in some insects and alternately in others. Even in single insects there were cases in which the timing between bursts in two legs switched from one value to another during walking. 5. These effects of amputation were manifest during slow walking only. At higher speeds, the timing of motor bursts in different pairs of legs was consistently closer to that seen during walking in intact insects. 6. Three conclusions are drawn from these results. (i) During slow walking, sensory feedback from the legs helps maintain the timing of adjacent ipsilateral leg pairs, but has little influence on contralateral pairs. (ii) During slow walking, either sensory input is quite variable, or it has variable effects on the motor pattern. (iii) During fast walking, sensory input from the legs seems to play a minimal role, if any, in the timing of the motor pattern of walking.

Amputation, Surgical↗

[Clinical studies on maintenance of cross-leg position through internal fixation with Kirschner wire after cross-leg flap procedure].

OBJECTIVE: To study the feasibility of a new method for the cross-leg position maintained by the Kirschner wire internal fixation after the cross-leg flap procedure. METHODS: From December 2004 to October 2005, 5 patients (4 males, 1 female; aged 14-52 years) were admitted to our department, who suffered from the tibia exposure or the internal fixation plate exposure after operation because of the tibia fracture by trauma for 1-8 weeks. The soft tissue defects ranged in area from 2.4 cm x 2.0 cm to 4. 2 cm x 3.0 cm. The soft tissue around the wound in the leg was too poor in condition to perform an operation of the local flap transplantation, but the wound and the tibia had no obvious infection, so an operation of the cross-leg flap transplantation was performed to cover the wounds. The operation was performed with the routine cross-leg flap method introduced in the medical literature. After operation the cross-leg position was maintained through a simple internal fixation with two Kirschner wire, which were inserted through the tibia of the cross region of both the legs, and layers of dressings were placed as a cushion between the crossed legs in case of the crushing skin ulcer formation. The effect of fixation, blood circulation in the cutaneous flap, and the stress of the pedicle were observed postoperatively. After 3-4 weeks the pedicle of the cross-leg flap was cut off; the crossed legs were detached and the Kirschner wire were pulled out. RESULTS: All the flaps survived with a good blood circulation and a low pedicle stress. The patients had a relatively comfortable position because all the areas of the legs could be allowed to make some motions except the cross-area of the legs. Another advantage of this fixation method was its convenience for observing the blood circulation of the cutaneous flap and for changing the dressings. Neither infection in the holes of the Kirschner wire nor crushing skin ulcer formation in the area of the cross-leg could be observed. The follow-up for 3-18 months revealed that all the flaps were in good condition with no edema, contracture or skin pigmentation. CONCLUSION: The method of using the Kirschner wire to maintain the cross-leg position after the cross-leg flap procedure has more advantages than the plaster fixation. This improved method is simpler, and can achieve a tighter fixation in the cross-leg area to maintain the cross-leg position, allowing a micro-motion in other parts of the legs. The patients can have a relatively comfortable posture, and have a more convenient dressing changes and observation on the blood circulation in the flaps.

Adolescent↗

Perturbation of leg protraction causes context-dependent modulation of inter-leg coordination, but not of avoidance reflexes.

All animals capable of legged locomotion execute fast, adaptive compensatory movements in response to perturbation of a step cycle. In terms of motor control, such adaptive behaviour typically involves changes in the kinematics of the perturbed limb as well as changes in coordination between legs. Moreover, the unpredictable variety of real life situations implies that compensatory responses should be sensitive to the behavioural context of the animal. We have investigated the extent to which the compensatory response of a walking stick insect (Carausius morosus) adapts in parallel to strong context-dependent adaptation of step kinematics and inter-leg coordination. The behavioural contexts we chose were straight walking and visually induced curve walking, for both of which the steady state limb kinematics and inter-leg coupling strengths were known. In case of curve walking, we further distinguished contexts according to whether the inner or the outer leg was perturbed. The three contexts differed strongly with respect to the set of joint actions before perturbation. Upon mechanical perturbation of front leg protraction, we studied context-dependent differences in a local avoidance reflex of the perturbed leg, as well as in coordination mechanisms that couple the step cycles of the perturbed leg to its unperturbed neighbours. In all three walking contexts, obstacle contact caused an avoidance movement of the front leg that deviated from the unperturbed swing trajectory. Swing duration was increased while step distance was decreased; however, both effects vanished in the subsequent unperturbed step. The prevailing immediate reaction of the three leg joints were retraction of the coxa (>76%), levation of the femur (>80%), and flexion of the tibia (>80%), regardless of the behavioural context and, therefore, joint action prior to perturbation. Moreover, activation of each one of these joint actions was shown to be independent of the other two. Thus, local avoidance reflexes are not modulated by the descending visual information that causes transition from straight to curve walking, but are composed of context-independent joint actions. Perturbation of the front leg also caused significant shifts of the touch-down position of the perturbed leg and of its unperturbed neighbours. If the inner front leg was perturbed, this shift could persist until the subsequent step. Perturbation affected both the spatial location and the timing of touch-down and lift-off transitions in unperturbed neighbouring legs. These effects on inter-leg coordination were context-dependent. For example, time delay to lift-off of the contralateral neighbour was shortened in inner and straight walking legs, but not in outer legs. Finally, a targeting mechanism that determines foot placement in stick insects was shown to be affected by perturbation in a context-dependent manner. We conclude that the immediate compensatory response of the perturbed leg is not adapted to the behavioural context in spite of strongly differing step kinematics, whereas the compensatory effect on inter-limb coupling is context-dependent.

Animals↗

Effect of arm-cranking on leg blood flow and noradrenaline spillover during leg exercise in man.

Controversy exists whether recruitment of a large muscle mass in dynamic exercise may outstrip the pumping capacity of the heart and require neurogenic vasoconstriction in exercising muscle to prevent a fall in arterial blood pressure. To elucidate this question, seven healthy young men cycled for 70 minutes at a work load of 55-60% VO2max. At 30 to 50 minutes, arm cranking was added and total work load increased to (mean +/- SE) 82 +/- 4% of VO2max. During leg exercise, leg blood flow average 6.15 +/- .511 minutes-1, mean arterial blood pressure 137 +/- 4 mmHg and leg conductance 42.3 +/- 2.2 ml minutes-1 mmHg-1. When arm cranking was added to leg cycling, leg blood flow did not change significantly, mean arterial blood pressure increased transiently to 147 +/- 5 mmHg and leg vascular conductance decreased transiently to 33.5 +/- 3.1 ml minutes-1 mmHg-1. Furthermore, arm cranking doubled leg noradrenaline spillover. When arm cranking was discontinued and leg cycling continued, leg blood flow was unchanged but mean arterial blood pressure decreased to values significantly below those measured in the first leg exercise period. Furthermore, leg vascular conductance increased transiently, and noradrenaline spillover decreased towards values measured during the first leg exercise period. It is concluded that addition of arm cranking to leg cycling increases leg noradrenaline spillover and decreases leg vascular conductance but leg blood flow remains unchanged because of a simultaneous increase in mean arterial blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Aerobic capacity with two leg work versus one leg plus both arms work in men with peripheral vascular disease.

The purpose of this pilot study was to examine the correlation between ergometry in men with peripheral vascular disease exercising with both legs and with one leg and both arms. Fifteen men with peripheral vascular disease performed three symptom-limited exercise tests on an ergometer that could be operated from a wheelchair with both legs or with one leg and both arms. The three exercise conditions were both legs (arms stabilized), left leg plus both arms, and right leg plus both arms. The exercise parameters compared were maximum oxygen consumption, maximum heart rate, and duration of exercise. Blood pressure was monitored at two-minute intervals and oxygen saturation and electrocardiogram were monitored continuously. The mean VO2 max +/- standard deviation for both legs, right leg plus both arms, and left leg plus both arms were 14.36 +/- 6.15, 14.86 +/- 4.09, 14.01 +/- 4.14 ml O2/kg-min, respectively. The mean duration of exercise +/- standard deviation were 12.01 +/- 5.74, 10.94 +/- 4.68, and 9.81 +/- 4.70 minutes respectively. The mean maximum heart rate +/- standard deviation were 126 +/- 24, 137 +/- 23, 136 +/- 23, respectively for the same exercise conditions. The Pearson Correlation Coefficients for VO2 for both legs versus right leg plus both arms and left leg plus both arms were .639 and .873, respectively. The Pearson Correlation Coefficients for duration of exercise for both legs versus right leg plus both arms and left leg plus both arms were .837 and .877, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Oxygen uptake in one-legged and two-legged exercise.

PURPOSE: The purpose of this study was to determine the primary factors causing the differential oxygen uptake (VO2) response at submaximal intensities between one-legged and two-legged exercise, and whether peak oxygen uptake (VO2peak) increases in proportion to the increase in active muscle mass. METHODS: Two different types of exercise were used for this experiment, each requiring a different movement, a different method of stabilizing posture, and, finally, a different limiting VO2peak. In experiment 1, nine male subjects performed one-legged cycling (OLC) and two-legged cycling exercise (TLC) at a pedaling rate of 80 rpm. The exercise intensity was first set at 80 W and was increased by 40 W every 3 min until exhaustion. In experiment 2, six healthy male subjects performed one-legged knee-extension (OKE) and two-legged knee-extension (TKE) exercise at a rate of 50 contractions per minute. The knee-extension exercise was done at constant work rates for a 3-min session in OKE or a 4-min session in TKE. The exercise bouts were performed intermittently at four to seven different submaximal intensities and VO2 was determined at each intensity in all exercises. RESULTS: At submaximal intensities, VO2 in relation to work rate of one-legged exercise was more steep than those of two-legged exercise, and the mean values of VO2 were significantly higher in one-legged exercise than those in two-legged exercise in both knee extension and cycling exercise. Mean values of VO2peak for two-legged exercise were significantly higher than that for one-legged exercise (P < 0.01); however, it was much lower than two times of that for one-legged exercise even in knee extension exercise where the VO2peak would be limited peripherally. CONCLUSION: The findings of this study suggest that the differential VO2 response between one-legged and two-legged exercise would be attributed not only to the difference in force application throughout the exercise movement and to the effect of a postural component but also to the inhibited circulatory response caused by the multiple limb exercise. In addition, it was supposed that VO2peak does not increase in proportion to the exercising muscle mass even during smaller muscle activity where the cardiac pumping capacity has not reached its upper limit.

Adult↗

Lactate and glucose exchange across the forearm, legs, and splanchnic bed during and after prolonged leg exercise.

The net exchange of glucose and lactate across the leg and the splanchnic bed and the arterialdeep venous (A-DV) differences for these substrates in the forearm were determined in healthy subjects during 3-3.5 h of leg exercise (bicycle ergometer) at 58% maximum O(2) uptake and during a 40-min post-exercise recovery period. Leg glucose uptake rose 16-fold during exercise and throughout the exercise period exceeded splanchnic glucose output. The latter reached a peak increment (3.5 times basal) at 90 min and fell by 60% during the third hour. As a result, blood glucose declined 40%, reaching frank hypoglycemia (blood glucose, <45 mg/dl) in 50% of subjects at 3.5 h. Splanchnic lactate uptake rose progressively during exercise to values four times the basal rate at 3 h in association with a rise in arterial lactate to 1.5 mM. There was, however, no significant net output of lactate from the legs beyond 90 min of exercise. In contrast, the A-DV lactate difference in the forearm became progressively more negative throughout exercise, reaching values three times the basal level at 3.5 h. The rise in arterial lactate during exercise was proportional to the elevation in plasma epinephrine, which rose ninefold. During recovery, splanchnic lactate uptake rose further to values six times the basal rate, whereas lactate output by the legs was no greater than in the basal state. The A-DV lactate difference in the forearm became even more negative than during exercise, reaching values four times basal. During exercise as well as recovery, forearm uptake of blood glucose could account for no more than 25-67% of forearm lactate release. Leg glucose uptake during recovery was threefold to fivefold higher than in the basal state in the face of plasma insulin concentrations that were 60% below basal and in association with a respiratory exchange ratio of 0.7. We conclude that (a) during prolonged leg exercise at 58% maximum O(2) uptake an imbalance between splanchnic glucose production and leg glucose utilization results in a fall in blood glucose that may reach hypoglycemic levels in healthy subjects; (b) there is a marked increase in the uptake of lactate by the splanchnic bed that cannot be attributed to increased output of lactate from the exercising legs; (c) lactate is released by forearm muscle and, together with other relatively inactive muscle, may be an important source of the increased lactate turnover during and after prolonged leg exercise; (d) the increasingly negative A-DV lactate difference in the forearm cannot be accounted for by uptake of blood glucose, suggesting the breakdown of glycogen in forearm muscle during and after leg exercise; (e) increased glucose uptake by the legs in association with hypoinsulinemia during recovery suggests an increase in insulin sensitivity that permits glycogen repletion in previously exercising muscle in the absence of food ingestion; and (f) the evidence for increased lactate output in the forearm and augmented glucose uptake in the legs during recovery raises the possibility that after leg exercise glycogen stores are decreasing in muscle that was relatively inactive (e.g., that of the forearm) while increasing in the previously exercising leg muscles.

Adult↗

Bioimpedance analysis: evaluation of leg-to-leg system based on pressure contact footpad electrodes.

Conventional single frequency bioimpedance analysis (BIA) systems require technician placement of arm and leg gel electrodes, a suitable location for recumbent measurements, and a separate measurement of body weight. The aim of this study was to evaluate a new single frequency 50 KHz leg-to-leg bioimpedance analysis (BIA) system combined with a digital scale that employs stainless steel pressure-contact foot pad electrodes for standing impedance and body weight measurements. Healthy adults were evaluated for 1) electrode validity and 2) potential for body component estimation. Pressure-contact foot-pad electrode measured impedance was highly correlated with (N = 9, r = 0.99, P < 0.001) impedance measured using conventional gel electrodes applied to the plantar surface of both lower extremities; mean (+/-SD) impedance was systematically higher by about 15 ohms for pressure contact electrodes (526 +/- 56 ohms vs 511 +/- 59 ohms; P < 0.001). Second, the relationship between stature-adjusted leg-to-leg impedance (H2/Z) measured by the new system and two body composition components (total body water by 3H2O dilution (N = 144); and fat-free body mass, by underwater weighing and dual x-ray absorptiometry (N = 231)) was modeled using multiple regression analysis. Correlation coefficients for H2/Z alone versus body composition components were lower for leg-to-leg BIA than for arm-to-leg BIA; correlation coefficients and SEEs became similar for the leg-to-leg and arm-to-leg BIA systems with addition of three covariates (age, gender, and waist/hip circumference ratio) to regression models. The leg-to-leg pressure contact electrode BIA system has overall performance characteristics for impedance measurement and body composition analysis similar to conventional arm-to-leg gel electrode BIA and offers the advantage of increased speed and ease of measurement.

Absorptiometry, Photon↗

Effects of ATP-induced leg vasodilation on VO2 peak and leg O2 extraction during maximal exercise in humans.

During maximal whole body exercise VO2 peak is limited by O2 delivery. In turn, it is though that blood flow at near-maximal exercise must be restrained by the sympathetic nervous system to maintain mean arterial pressure. To determine whether enhancing vasodilation across the leg results in higher O2 delivery and leg VO2 during near-maximal and maximal exercise in humans, seven men performed two maximal incremental exercise tests on the cycle ergometer. In random order, one test was performed with and one without (control exercise) infusion of ATP (8 mg in 1 ml of isotonic saline solution) into the right femoral artery at a rate of 80 microg.kg body mass-1.min-1. During near-maximal exercise (92% of VO2 peak), the infusion of ATP increased leg vascular conductance (+43%, P<0.05), leg blood flow (+20%, 1.7 l/min, P<0.05), and leg O2 delivery (+20%, 0.3 l/min, P<0.05). No effects were observed on leg or systemic VO2. Leg O2 fractional extraction was decreased from 85+/-3 (control) to 78+/-4% (ATP) in the infused leg (P<0.05), while it remained unchanged in the left leg (84+/-2 and 83+/-2%; control and ATP; n=3). ATP infusion at maximal exercise increased leg vascular conductance by 17% (P<0.05), while leg blood flow tended to be elevated by 0.8 l/min (P=0.08). However, neither systemic nor leg peak VO2 values where enhanced due to a reduction of O2 extraction from 84+/-4 to 76+/-4%, in the control and ATP conditions, respectively (P<0.05). In summary, the VO2 of the skeletal muscles of the lower extremities is not enhanced by limb vasodilation at near-maximal or maximal exercise in humans. The fact that ATP infusion resulted in a reduction of O2 extraction across the exercising leg suggests a vasodilating effect of ATP on less-active muscle fibers and other noncontracting tissues and that under normal conditions these regions are under high vasoconstrictor influence to ensure the most efficient flow distribution of the available cardiac output to the most active muscle fibers of the exercising limb.

Adenosine Triphosphate↗