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Biomedical subjects

A Jenkinson

Publications and source records attributed to A Jenkinson.

9 recordsLinked to original sources
PubMed2000

Leg length discrepancy--an experimental study of compensatory changes in three dimensions using gait analysis.

Patients with leg length discrepancy (LLD) develop compensatory mechanisms, which result in kinematic alterations in the lower limbs and pelvis. We investigated these compensatory mechanisms. Seven normal subjects underwent three-dimensional (3-D) gait analysis using a CODA MPX 30(R) analyser. The subjects were fitted with raises of varying heights to one lower limb and then analysed in static and dynamic modes. Pelvic obliquity was the most common mechanism used to compensate for small degrees of leg length discrepancy up to 2.2 cm, particularly in static standing. With larger degrees of discrepancy, the subjects developed flexion of the knee of the longer leg. Compensatory mechanisms during walking were more complex and included a combination of kinematic changes at the pelvis, knee and ankle. We developed mathematical models for the compensatory mechanisms at all the three levels. We conclude that 3-D gait analysis is a useful tool in the assessment of patients with functional and structural leg length discrepancies.

Adaptation, Physiological↗
PubMed1999

Dietary intakes of polyunsaturated fatty acids and indices of oxidative stress in human volunteers.

OBJECTIVE: To assess whether nutritionally-relevant changes in polyunsaturated fatty acid (PUFA) intake alter indices of oxidative stress in human volunteers DESIGN: A split plot/change over dietary study where half the volunteers consumed a diet containing 5% PUFA (low PUFA) as food energy for 4 weeks and after a 6 week washout period consumed a 15% PUFA (high PUFA) diet for another 4 weeks. The second group of volunteers completed this protocol in reverse. Total fat, carbohydrate, protein and vitamin E contents of the diets were constant. SUBJECTS: 10 healthy, non-smoking, male volunteers aged 32.6 +/- 1.7 y RESULTS: There was a significant increase in whole blood oxidised glutathione (P < 0.05), an index of oxidative stress, after consumption of the high PUFA diet. Moreover, urinary thiobarbituric acid reactive substances (TBARS), an index of lipid peroxidation, significantly increased (P = 0.038) following consumption of the high PUFA diet and decreased (P = 0.031) after consuming the low PUFA diet. However, there was no change in non specific plasma indices of lipid peroxidation, conjugated dienes and TBARS, nor in red cell antioxidant enzymes glutathione peroxidase, glutathione reductase, and catalase. However, superoxide dismutase significantly decreased (13%, P=0.018) after consumption of the low PUFA diet. Total cholesterol increased by 13% (P=0.014) after consumption of the low PUFA diet. CONCLUSIONS: This study indicates that although increasing dietary levels of PUFA may favourably alter cholesterol profiles, the same dietary changes may adversely affect some indices of lipid peroxidation. Care should be taken when providing dietary advice on PUFA intake and an adequate intake of antioxidants to match any increased PUFA may be important for preventing oxidative stress.

Adult↗
PubMed1998

Quantitative analysis and classification of gait patterns in cerebral palsy using a three-dimensional motion analyzer.

Gait disorders in cerebral palsy can be accurately analyzed using the CODA-3 system presenting quantitative data representing movement of the hip, knee, and ankle in the sagittal plane. We describe a technique that classifies abnormal gait automatically on the basis of sagittal kinematic data. Fifty-five hemiplegic and 91 diplegic patients were analyzed using an opto-electronic scanner (CODA-3). The sagittal kinematics of the affected limb in hemiplegics correlated with those of both affected limbs in diplegics. We introduce the concept of the "plegic limb." Sagittal kinematics of 237 affected limbs were studied using cluster statistical analysis. Eight clear groups emerged. The predominant clinical features, typical of each group, were identified and described (eg, stiff leg gait, genu recurvatum, or crouch gait). We propose this classification system as a new technique to use gait analysis data to automatically classify abnormal movements of the lower limb in cerebral palsy.

Adolescent↗
PubMedDate not supplied

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

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

Adolescent↗
PubMedDate not supplied

The kinematic patterns of toe-walkers.

Children who toe-walk can pose a diagnostic problem. The differential diagnosis includes mild spastic diplegia and idiopathic toe-walking. Clinical differentiation between these two patient groups can be particularly difficult, and there are no objective diagnostic tests to assist the clinician. We assessed 50 children who toe-walk to define the kinematic patterns of lower-limb joint motion in the sagittal plane. There were 23 children with mild spastic diplegia. 22 idiopathic toe-walkers, and five normal children who were asked to toe-walk. We found characteristic patterns of knee and ankle motion that differentiated spastic diplegia from idiopathic toe-walking. Normal children asked to toe-walk had the same pattern as the idiopathic group. Gait analysis is a diagnostic tool that enables the clinician objectively to differentiate mild spastic diplegia from idiopathic toe-walking.

Adolescent↗
PubMedDate not supplied

Split tibialis posterior tendon transfer in the treatment of spastic equinovarus foot.

Sixteen patients with cerebral palsy causing equinovarus deformity were treated surgically. All of these patients underwent preoperative gait analysis by using a CODA-3 motion analyzer. The equinus deformity was assessed by using sagittal kinematics, and in particular, the range of movement of the ankle during stance phase and the maximal dorsiflexion during swing. The varus deformity was assessed by the degree of varus of the foot at prepositioning. The degree of varus was obtained by measuring the angle generated between the plane of progression and a line joining a marker on the heel to a marker on the fifth metatarsal in the transverse plane. All patients underwent split tibialis posterior tendon transfer and, in 13, this was combined with tendo calcaneus lengthening. Clinical assessment and gait analysis repeated 1 year postoperatively confirmed good outcome after split tibialis posterior tendon transfer in combination with gastrocnemius lengthening. This was confirmed by using sagittal kinematic analysis and quantitative assessment of the degree of varus of the foot at the time of prepositioning.

Ankle Joint↗