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PubMed1989

[The effects of leg elevation to reduce leg edema resulting from prolonged standing].

In order to find the most comfortable and effective posture to reduce lower leg edema, 31 young women working in Chang Gung Memorial Hospital, ages ranging from 20 to 40, were studied by the volumetric displacement method with leg placed in a specially designed container. The effects of five different angles of leg elevation on reduction of leg edema were separately evaluated in 5 days. For each evaluation, two measurements of volumetric displacement of lower leg edema were performed after prolong sitting or standing of more than 4 hours, and at the end of 15 minutes of supine lying (angle of leg elevation = 0 degrees), or after the leg was elevated in an angle of 30 degrees, 45 degrees, 60 degrees, or 90 degrees respectively. A good correlation was found between the displaced volume and increasing angle of leg elevation (regression line Y = 99.109-0.016X, r = -0.96). There was a significant difference between leg elevation of 90 degrees and supine lying (t = 3.01, p less than 0.01). The degree of comfort in leg elevation was in the order of 30 degrees, 45 degrees, 60 degrees, 0 degrees, 90 degrees. Many subjects complained of numbness and throbbing pain over the lower legs or pain at the buttocks in the upright leg elevation to 90 degrees posture, but felt rather comfortable in the 30 degrees posture. Seventeen of these subjects were further studied for the degree of comfort in leg elevation at 30 degrees for 30 minutes as compared with those of 30 degrees, 15 minutes and 90 degrees, 15 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2006

Chronic venous leg ulcers benefit from surgery: long-term results from 173 legs.

OBJECTIVE: The purpose of this retrospective study was to present 7 years of data from operations of currently active, chronic venous leg ulcers (CEAP: C6), focusing on the short- and long-term effects of healing and recurrence and considering concomitant risk factors. METHODS: Between January 1997 and March 2004, 173 patients (239 legs) with a currently active, chronic venous leg ulcer were surgically treated. The surgical procedures included two main steps: (1) the surgical interruption of reflux in the superficial and perforating veins to reduce venous hypertension in the entire leg and/or the affected area and (2) the surgical procedure involving the ulcer. A total of 123 patients (173 legs) who came to the follow-up were examined. The follow-up period ranged from 3 months to 7 years. The data collection integrated a preoperative examination that included medical history and clinical diagnoses and incorporated measurements such as body mass index, ankle-brachial pressure index, and the neutral position method at the follow-up. The function of the veins was measured with duplex ultrasonography. Finally, the data were analyzed by using various statistical methods, including Kaplan-Meier analysis, Cox regression analysis, and paired t tests. RESULTS: Initially, ulcer healing occurred in 87% of the cases (151 legs). A total of 13% (22 legs) of the venous ulcers never healed, and recurrent venous ulcers occurred in 5% (9 legs). The Kaplan-Meier analyses of ulcer healing showed a healing rate of 85% in 6 months for all legs. The mean time of healing was 1.5 months. Furthermore, the Kaplan-Meier analyses of ulcer recurrence showed a 1.7% rate of recurrence in 6 months for all legs. The 5-year ulcer recurrence rate was 4.6%. The mean time of recurrence was 70.4 months. CONCLUSIONS: On the basis of the results from the 7 years of data from functional surgery of venous leg ulcers and as a result of the outcomes of our study, we recommend surgical treatment of venous leg ulcers at any stage. We therefore conclude that surgery is indicated before an ulcer is intractable to treatment. In general, our findings are based on the understanding and identification of the causes and symptoms of venous ulceration and illustrate that standard surgical methods can be applied for the therapy of venous leg ulcers at any stage.

Adult↗

PubMedDate not supplied

Dynamics of cutaneous laser Doppler flux with concentration of moving blood cells and blood cell velocity in legs with venous ulcers and in healthy legs.

Laser Doppler flux (LDF) is a product of the concentration of moving blood cells (CMBC) and the blood cell velocity (BCV). In an attempt to obtain more information about the cutaneous microcirculation in legs with venous ulcers and in healthy legs, the dynamics of the curves of the LDF, the CMBC, and the BCV were analyzed in 8 patients with venous leg ulcers and in 10 subjects with healthy legs. The curves of the CMBC and of the BCV were found to be in opposite phases both in the ulcerous legs and in the healthy legs. The maximal amplitude of the curves of the LDF and of the CMBC was greater in the legs with ulcers than in the healthy legs (p = 0.021 and p = 0.0085, respectively). The finding that the curves of the CMBC and the BCV were in opposite phase can be interpreted to reflect the capillary blood flow by fits and starts both in legs with venous ulcers and in healthy legs. The greater amplitude of the LDF and the CMBC in legs with venous ulcers reflects the blood flow in anatomically altered capillaries in those legs. It is useful to record the curves of the CMBC and the BCV together with the LDF because this gives additional information about the microcirculation of the skin.

Aged↗

PubMed1993

Regional distribution of 201Tl during one-leg exercise: comparison with leg blood flow by plethysmography.

To validate the use of 201Tl distribution as an estimate of regional blood flow in the legs, 201Tl leg uptake was compared by whole body scintigraphy and simultaneously measured leg blood flow by plethysmography during one-leg exercise in 11 male subjects. 201Tl leg uptake ratio and leg blood flow ratio were also compared to exclude the effect of cardiac output variation in each subject. There was a good correlation between 201Tl leg uptake and leg blood flow (r = 0.85, P < 0.01, y = 0.28x + 1.00). Moreover, there was a highly linear correlation between these ratios (r = 0.98, P < 0.01, y = 0.75x + 0.13), although the 201Tl leg uptake ratio somewhat underestimated the leg blood flow ratio as exercise became strenuous. It is concluded that 201Tl leg uptake reflects regional blood flow in the legs during exercise.

Aged↗

PubMed1988

Neural control of leg movements in a metamorphic insect: sensory and motor elements of the larval thoracic legs in Manduca sexta.

During the metamorphosis of the hawkmoth Manduca sexta the larval thoracic legs degenerate to be replaced in the adult by legs of very different form and function. This change must be accompanied by a reorganization of the neural circuits controlling leg movements. As an initial step in the study of this reorganization we describe here the sensory and motor elements of this circuitry in the larval stage of life. Sensory neurons innervating mechanoreceptive hairs on the thoracic surface were stained individually with cobalt. Those innervating hairs on the general thoracic surface project topographically into two ventral regions of the segmental ganglia. Sensory neurons innervating leg sensilla also map topographically to the more ventral of these regions but in addition have arborizations in a midlateral region. The density of branching within this lateral "leg neuropil" is greatest for sensory neurons form sensilla on the more distal leg segments. Leg motor neurons were identified with intracellular recording and cobalt injection techniques. Those innervating muscles controlling distal leg segments have dense dendritic arbors in the lateral "leg neuropil," while motor neurons controlling more proximal segments and muscles of the ventral body wall have extensive arborizations in a dorsomedial region of the ganglion. In general, flexor motor neurons are excited by medial and inhibited by lateral leg sensilla, while the opposite is true of extensors. Distal segment motor neurons respond most strongly to sensory neurons from distal segments, thus suggesting some interaction within the lateral "leg neuropil." Thus, in the larval nervous system a highly ordered array of of sensory and motor elements underlies the specific behavioral responses of the legs to tactile stimulation.

Action Potentials↗

PubMed2004

Walking on a 'peg leg': extensor muscle activities and sensory feedback after distal leg denervation in cockroaches.

Previous studies in insects demonstrated that leg coordination changes following complete ablation of distal limb segments. However, normal coordination was restored when small 'peg leg' prostheses were attached to leg stumps to permit substrate contact. We have adapted this paradigm to preserve appropriate leg mass and inertia by severing all nerves and muscle tendons in the femur of the cockroach hind leg and converting the animal's own limb into a peg leg. Recordings of muscle activities and leg movements before and after denervation showed that: (1) the 'peg leg' is actively used in walking and regular bursts occur in motoneurons to leg extensor muscles; (2) driving of motoneuron activity is sufficient to produce 'fictive' bursting in a muscle whose tendon (apodeme) is cut in the ablation; and (3) similar motoneuron activities are found in walking on an oiled glass surface, when the effects of body weight and mechanical coupling are minimized. When distal segments were completely severed in these preparations, leg use and muscle bursting were disrupted but could be restored if the stumps were pressed against the substrate. These results support the hypothesis that feedback from receptors in proximal leg segments indicating forces allows for active leg use in walking.

Animals↗

PubMed2000

Correlation of diversity of leg morphology in Gryllus bimaculatus (cricket) with divergence in dpp expression pattern during leg development.

Insects can be grouped into mainly two categories, holometabolous and hemimetabolous, according to the extent of their morphological change during metamorphosis. The three thoracic legs, for example, are known to develop through two overtly different pathways: holometabolous insects make legs through their imaginal discs, while hemimetabolous legs develop from their leg buds. Thus, how the molecular mechanisms of leg development differ from each other is an intriguing question. In the holometabolous long-germ insect, these mechanisms have been extensively studied using Drosophila melanogaster. However, little is known about the mechanism in the hemimetabolous insect. Thus, we studied leg development of the hemimetabolous short-germ insect, Gryllus bimaculatus (cricket), focusing on expression patterns of the three key signaling molecules, hedgehog (hh), wingless (wg) and decapentaplegic (dpp), which are essential during leg development in Drosophila. In Gryllus embryos, expression of hh is restricted in the posterior half of each leg bud, while dpp and wg are expressed in the dorsal and ventral sides of its anteroposterior (A/P) boundary, respectively. Their expression patterns are essentially comparable with those of the three genes in Drosophila leg imaginal discs, suggesting the existence of the common mechanism for leg pattern formation. However, we found that expression pattern of dpp was significantly divergent among Gryllus, Schistocerca (grasshopper) and Drosophila embryos, while expression patterns of hh and wg are conserved. Furthermore, the divergence was found between the pro/mesothoracic and metathoracic Gryllus leg buds. These observations imply that the divergence in the dpp expression pattern may correlate with diversity of leg morphology.

Animals↗

PubMed1993

Effect of one- and two-leg training on arm and two-leg maximum aerobic power.

The purpose of this study was to examine the effect of one- and two-leg training on arm and two-leg maximum aerobic power. Seven subjects cycle-trained both legs simultaneously for 30 min.day-1, 4 days.week-1 for 4 weeks. Nine subjects cycle-trained each leg 15 min.day-1, 4 days.week-1 for 4 weeks. Both groups trained at a heart rate equal to that measured at 75% of their two-leg maximum aerobic power. Thus, during each training session the groups performed 30 min of work at the same heart rate intensity. Five subjects served as a non-training control group. Arm and leg maximum oxygen uptake tests were conducted before and after training. Only two-leg training induced significant gains in arm aerobic power (P < 0.0003), whereas both modes of training resulted in significant increases in two-leg aerobic power (P < 0.0008). The data demonstrate that improvements in arm aerobic power were dependent on the quantity of leg muscle mass involved in the training, whereas gains in two-leg aerobic power occurred regardless of whether the legs were trained separately or simultaneously.

Adult↗

PubMed1975

Substrate utilization by the inactive leg during one-leg or arm exercise.

Substrate utilization by the nonexercising leg was studied in healthy subjects during one-leg exercise at an average work load of 105 W for 40 min (n equals 8) or during arm exercise at 65 W for 20 min (n equals 5). During one-leg exercise both the blood flow and the A-FV difference of oxygen for the non exercising leg rose, resulting in an approximately five fold increment in oxygen uptake. EMG activity of the leg was increased above basal. Despite unchanged or falling arterial levels of insulin, the A-FV difference for glucose across the nonexercising leg rose during exercise and the estimated glucose uptake increased approximately fourfold. Release of lactate in the basal state reverted to a significant net uptake of lactate by the nonexercising leg. During arm exercise there was a 20-70% rise in leg blood flow and the leg oxygen uptake rose 25-45% in spite of minimal EMG activity from the thigh muscles. There was a large uptake of lactate by the legs during arm exercise. We conclude that several important metabolic alterations take place in the nonexercising leg tissues during physical exertion: 1) blood flow and oxygen uptake rise, partly as a consequence of motor activation; 2) substrate utilization shifts from a predominant FFA uptake in the basal state to a greater utilization of carbohydrate; 3) nonexercising muscle, and possibly adipose tissue, play an important role in the removal of lactate during exercise.

Adult↗

PubMed2005

The profile of leg symptoms, clinical disability and reflux in legs with previously operated varicose disease.

PURPOSE: It is difficult to assess the severity and location of venous insufficiency in legs with recurrent varicose disease. This present purpose was to evaluate the distribution of reflux and the diagnostic role of current classifications in a consecutive series of legs with previously operated varicose disease. METHODS: A total of 90 legs in a cohort of 66 patients were included. The examination comprised CEAP clinical class, clinical disability score (CDS) and leg symptoms. Colour-flow duplex imaging (CFDI) was used to observe reflux in deep and superficial veins. Details of prior surgery were assessed. RESULTS: The site of superficial reflux was at the groin in 58% (recurrent or residive vein trunk or unoperated great saphenous vein), and the rate in the popliteal fossa was 11% (unoperated short saphenous vein). In 58% of the legs presenting superficial reflux at groin level, previous surgery at the saphenofemoral junction was noted. A sensation of pain was observed in 74% of the legs, sensation of oedema in 64%, itching in 26 %, and night cramps in 8%, respectively. Only itching was significantly infrequent in uncomplicated (CEAP C 2-3) legs, and in legs with local reflux was restricted to vein tributaries. Higher CDS (classes 2-3) were significantly more frequent among complicated legs (CEAP clinical class C2-3: 22% versus CEAP clinical class C4-6: 77%; p < 0.005). A similar situation was noted when legs with only local reflux were compared to those with more severe reflux (local reflux: 7% versus severe reflux: 48%; p < 0.005). CONCLUSIONS: Superficial reflux is frequently detected at groin level despite prior surgery. Unstructured evaluation of leg symptoms is not beneficial. Clinical disability scores associate well with the severity of the venous disease.

Adult↗

PubMed1989

The effect of leg position on knemometric measurements of lower leg length.

Using the Valk knemometer, lower leg length (LLL) was assessed relative to changes in the positioning of the upper leg. Lowering the chair height of the knemometer resulted in a more acute angle between the upper and lower leg and a decrease in LLL. This decrease in measurement was attributed to changes in the anatomical surface of the knee underlying the measuring platform as a result of increasing the acuity of the leg angle. Based on four different leg positions, the average change in LLL per centimeter change in chair height was 0.607 mm in a child sample of 50, and 0.655 mm in an adult sample of 20. The difference in chair height with the leg angle at 90 degrees and the lowest chair height possible, ranged from 12.3 to 30.3 mm, relative to lower leg length. This meant the longest leg in the study had a LLL measurement differing by 19.8 mm between these two positions. Due to the effect of leg position, we advised the use of a standard method of measuring LLL with respect to leg angle. Given the difficulties in accurately measuring leg angle with current available tools, we advise the most acute angle.

Adolescent↗

PubMed2005

Anatomic and functional leg-length inequality: a review and recommendation for clinical decision-making. Part II. The functional or unloaded leg-length asymmetry.

BACKGROUND: Part II of this review examines the functional "short leg" or unloaded leg length alignment asymmetry, including the relationship between an anatomic and functional leg-length inequality. Based on the reviewed evidence, an outline for clinical decision making regarding functional and anatomic leg-length inequality will be provided. METHODS: Online databases: Medline, CINAHL and Mantis. Plus library searches for the time frame of 1970-2005 were done using the term "leg-length inequality". RESULTS AND DISCUSSION: The evidence suggests that an unloaded leg-length asymmetry is a different phenomenon than an anatomic leg-length inequality, and may be due to suprapelvic muscle hypertonicity. Anatomic leg-length inequality and unloaded functional or leg-length alignment asymmetry may interact in a loaded (standing) posture, but not in an unloaded (prone/supine) posture. CONCLUSION: The unloaded, functional leg-length alignment asymmetry is a likely phenomenon, although more research regarding reliability of the measurement procedure and validity relative to spinal dysfunction is needed. Functional leg-length alignment asymmetry should be eliminated before any necessary treatment of anatomic LLI.

Journal Article↗

PubMed2006

Skin behavior during leg lengthening in patients with achondroplasia and hypochondroplasia: a short-term observation during leg lengthening.

BACKGROUND: Although distraction osteogenesis is a recently established method of limb lengthening, it is not well known how soft tissues behave during bone lengthening. Because skin is tissue that can be easily and directly observed, we analyzed skin extension during limb lengthening to study the condition of soft tissues. METHOD: We examined three achondroplastic and two hypochondroplastic patients who underwent bilateral tibial lengthening with unilateral bone lengtheners. To analyze skin extension during leg lengthening, the bilateral skin surface was marked in a latticework pattern, starting 10 cm proximal to the knee joint down to 10 cm distal to the ankle joint, with black ink. The longitudinal length and the area of lattices, and the circumferential length of legs were measured. RESULTS: We found that: (1) the longitudinal extension of the skin during leg lengthening occurs not only in the bone lengthening portion between fixator pins but also around the knee or ankle joints; (2) circumferential length of legs was decreased, and soft tissue volume also does not increase in proportion to the increase in leg length. Soft tissue volume started to increase in the central region of the legs after a 30% increase in leg length was obtained, resulting in the 10% increase in the volume at the end point. CONCLUSIONS: These data suggest that soft tissue extension precedes soft tissue neogenesis at least during the initial period of leg lengthening, possibly based on its viscoelastic properties. After a 30% increase in leg length is obtained, soft tissue neogenesis takes place in the central region of the leg.

Achondroplasia↗

PubMed1999

Validation of a leg-to-leg bioimpedance analysis system in assessing body composition in postmenopausal women.

OBJECTIVES: To evaluate the validity of a leg-to-leg bioimpedance analysis (BIA) system in predicting body composition as measured by dual-energy X-ray absorptiometry (DXA) in postmenopausal women. SUBJECTS AND METHODS: Body fat mass (FM), %Fat and fat free mass (FFM) were measured in 124 postmenopausal women (age: 51-63 y, body mass index (BMI): 17-38 kg/m2) first by the leg-to-leg BIA system, and then by DXA as reference method. Bland-Altman analysis was used to determine the bias and 95% limits of agreement between the two methods for the assessment of the individual. Precision error (CV%) of the BIA system was obtained by repeated measurements with intermediate repositioning. RESULTS: The leg-to-leg BIA system had a high reproducibility with within-day CVs being 0.6% for FFM and 1.1% for FM, and between-day CVs about twice that. The impedance index (Ht2/Z) obtained by the leg-to-leg BIA was moderately correlated to FFM measured by DXA (r=0.66). A significant, systematic bias was observed between the two methods. The BIA system overestimated FM by a mean of 3.1 kg, and underestimated FFM by 2.7 kg. The analysis of 95% limits of agreement showed that for most individuals, %Fat estimated by the BIA might differ from that measured by DXA by 12% below to 45% above, indicating the lack of agreement between the two methods for the assessment of the individual. CONCLUSIONS: The leg-to-leg BIA system can provide simple, rapid and highly reproducible measurements of body composition for groups, but it has limited accuracy for the assessment of the individual. Population-specific equations will be needed to improve its accuracy in estimating body composition in postmenopausal women.

Absorptiometry, Photon↗

PubMed2007

Leg crossing with muscle tensing, a physical counter-manoeuvre to prevent syncope, enhances leg blood flow.

In patients with orthostatic intolerance, the mechanisms to maintain BP (blood pressure) fail. A physical counter-manoeuvre to postpone or even prevent orthostatic intolerance in these patients is leg crossing combined with muscle tensing. Although the central haemodynamic effects of physical counter-manoeuvres are well documented, not much is known about the peripheral haemodynamic events. Therefore the purpose of the present study was to examine the peripheral haemodynamic effects of leg crossing combined with muscle tensing during 70 degrees head-up tilt. Healthy subjects (n=13) were monitored for 10 min in the supine position followed by 10 min in 70 degrees head-up tilt and, finally, for 2 min of leg crossing with muscle tensing in 70 degrees head-up tilt. MAP (mean arterial BP), heart rate, stroke volume, cardiac output and total peripheral resistance were measured continuously by Portapres. Leg blood flow was measured using Doppler ultrasound. Leg vascular conductance was calculated as leg blood flow/MAP. A significant increase in MAP (13 mmHg), stroke volume (27%) and cardiac output (18%), a significant decrease in heart rate (-5 beats/min) and no change in total peripheral resistance during the physical counter-manoeuvre were observed when compared with baseline 70 degrees head-up tilt. A significant increase in leg blood flow (325 ml/min) and leg vascular conductance (2.9 arbitrary units) were seen during the physical counter-manoeuvre when compared with baseline 70 degrees head-up tilt. In conclusion, the present study indicates that the physical counter-manoeuvre of leg crossing combined with muscle tensing clearly enhances leg blood flow and, at the same time, elevates MAP.

Adult↗

PubMed1986

Failure to augment maximal limb blood flow in response to one-leg versus two-leg exercise in patients with severe heart failure.

Lower limb blood flow, oxygen uptake, and femoral vein O2 content were measured at rest and during maximal bicycle exercise, performed with two legs and one leg, in four normal subjects and in five patients with severe congestive heart failure. While in normal subjects femoral vein blood flow and lower limb vascular conductance were significantly greater during one-leg exercise than during two-leg exercise (6084 +/- 745 vs 5370 +/- 803 ml/min, p less than .05, and 52.3 +/- 8.0 vs 45.1 +/- 8.2 U X 10(3), p less than .05, respectively), in patients with severe congestive heart failure these values were similar during the two forms of exercise (1082 +/- 459 vs 1053 +/- 479 ml/min and 9.6 +/- 3.7 vs 9.4 +/- 3.5 U X 10(3), respectively). In five additional patients, one-leg maximal bicycle exercise was performed before and after administration of phentolamine into the femoral artery of the active leg. Regional alpha-adrenergic blockade with phentolamine did not alter maximal oxygen uptake attained during one-leg bicycle exercise (9.8 +/- 1.5 vs 10.3 +/- 1.9 ml/kg). Lower limb blood flow and femoral vein O2 content attained during maximal one-leg exercise were also similar before and after phentolamine. Thus, in contrast with normal subjects, patients with severe congestive heart failure were unable to further increase limb blood flow during one-leg bicycle exercise. Moreover, local alpha-adrenergic blockade does not augment blood flow to the active limb during maximal one-leg bicycle exercise. This suggests that the ability of the muscular vasculature to vasodilate during exercise is impaired and may be a limiting factor to maximal exercise capacity in such patients.

Heart Failure↗

PubMed2000

Test-retest reliability study of a new improved Leg-O-meter, the Leg-O-meter II, in patients suffering from venous insufficiency of the lower limbs.

The objective of this study was to evaluate the interobserver and test-retest reliability of the new improved Leg-O-Meter, the Leg-O-Meter II, an instrument designed to measure leg circumference. The new 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. Only the left limb is measured. For this study the tape measure of the Leg-O-Meter was fixed at 13 cm from the board. Subjects were recruited from patients consulting the phlebology clinic of Hopital St-Michel, Paris, France. Thirty-nine patients were asked to participate in the test phase and a subsample of 20 patients were asked to participate in addition to a retest phase 10 minutes after their first measurement. Patients were asked to enter a closed room where four independent and blinded observers consecutively took measurements of their left calf with the Leg-O-Meter II. Twenty patients were also asked to come back 10 minutes later for a second round of measurements. While waiting, patients were seated. Variables collected included leg circumference, presence of edema, clinical presentation, and venous insufficiency treatment history. The order of the observers was randomized between patients. Under the assumption of a two-way random effects model, an intraclass correlation coefficient (ICC) was used to determine the reliability of a measure with the Leg-O-Meter II as well as the test-retest reliability. The interobserver and test-retest reliabilities of the Leg-O-Meter II were 98.28% [96.90%, 100.00%] CI95% and 95.90% [92.00%, 100.00%] CI95%, respectively. The Leg-O-Meter II has higher interobserver reliability and is easier to manipulate than the previous version. In addition, it has substantive test-retest reliability.

Anthropometry↗

PubMed2003

Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health.

BACKGROUND: Restless legs syndrome is a common yet frequently undiagnosed sensorimotor disorder. In 1995, the International Restless Legs Syndrome Study Group developed standardized criteria for the diagnosis of restless legs syndrome. Since that time, additional scientific scrutiny and clinical experience have led to a better understanding of the condition. Modification of the criteria is now necessary to better reflect that increased body of knowledge, as well as to clarify slight confusion with the wording of the original criteria. SETTING: The restless legs syndrome diagnostic criteria and epidemiology workshop at the National Institutes of Health. PARTICIPANTS: Members of the International Restless Legs Syndrome Study Group and authorities on epidemiology and the design of questionnaires and scales. OBJECTIVE: To modify the current criteria for the diagnosis of restless legs syndrome, to develop new criteria for the diagnosis of restless legs syndrome in the cognitively impaired elderly and in children, to create standardized criteria for the identification of augmentation, and to establish consistent questions for use in epidemiology studies. RESULTS: The essential diagnostic criteria for restless legs syndrome were developed and approved by workshop participants and the executive committee of the International Restless Legs Syndrome Study Group. Criteria were also developed and approved for the additional aforementioned groups.

Age Factors↗