PubMed · 13786397
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I WOLIN. 1961-06-17. Ankle sprains.. https://pubmed.ncbi.nlm.nih.gov/13786397/
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Atherosclerosis, nearly universally present in major arteries of Western adults, is characterized in all affected arteries by cholesterol-laden plaques and consistently associated with blood cholesterol levels. Other risk factors are reported to have relatively stronger or weaker associations with different atherosclerotic manifestations, but such differences have never previously been quantified. Measuring them may offer fresh clues to atherogenic processes and their prevention. The Atherosclerosis Risk in Communities Study (ARIC) ascertained incident coronary heart disease (CHD) and measured subclinical atherosclerosis as carotid artery intimal medial thickness using ultrasound and as lower extremity arterial disease (LEAD) using ankle-brachial blood pressure index. Blood cholesterol was associated with all endpoints. When standardized against LDL cholesterol associations, diabetes and smoking showed substantially different strengths of associations with different endpoints. Relative to associations with LDL cholesterol: (1) smoking, but not diabetes, increased in its strength of association with the severity of the underlying arterial disease; (2) the diabetes and smoking associations with CHD were much stronger in women than men, a phenomenon which, the standardization pattern suggests, is due to a gender difference in CHD pathogenesis, possibly attributable to arteriolar differences.
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This study investigates the importance of ankle muscular force and foot shape on body equilibrium at the end of a first step by means of a comparison between healthy children and children with unilateral clubfoot who showed Triceps surae atrophy. Subjects were asked to initiate gait at different velocities and to perform a few forward-oriented steps. In healthy children, there was a significant increase in the number of positive values of the centre of gravity vertical acceleration at foot contact (Z"HC) as velocity increased without any difference between the preferred and non-preferred stepping foot. These results indicated that ankle muscular forces from the leg of support intervene in braking the downfall of the body, as velocity and step length increase, and that this function does not depend on the subject's lateralization. In comparison with healthy children, clubfoot subjects showed a greater occurrence of low or negative Z"HC values when gait was initiated at a velocity greater than 0.8 m/s. However, except for two of them, there was no difference in Z"HC control between the steps initiated with the sound leg and those initiated with the affected leg. These results indicate that in unilateral clubfoot children, residual musculoskeletal impairment of one leg induces a deficit in equilibrium control as soon as step length needs a significant braking of the body's vertical fall. It is also shown that equilibrium is not limited to the gait period where the affected leg is the body's supporting leg but also when it is the stepping one. This could reflect a global alteration of the body scheme preserving symmetry in the control of both legs.