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Lower-limb electromyographic responses across four recumbent cycling configurations in healthy young men.

Recumbent cycling provides an adjustable configuration in which backrest angle and crank-axis height can alter lower-limb loading. Backrest angle changes the orientation of the active musculature relative to gravity, whereas crank-axis height modifies the foot-pedal interface and the ankle lever arm. Whether such positioning is associated with differences in lower-limb electromyographic (EMG) activation across both factors together has not been examined. Using a randomized crossover design, fifty-nine healthy young men cycled at 100&#xa0;W and 50&#xa0;rpm under four conditions combining two backrest angles (30&#xb0;, 75&#xb0;) and two crank-axis heights (Rh, high, 77&#xa0;cm; Rl, low, 45&#xa0;cm). Surface EMG from the rectus femoris (RF), biceps femoris (BF), and gastrocnemius medialis (GAS) was analyzed for root mean square (RMS) amplitude, absolute onset sequence, and relative recruitment timing (%Sequence, derived using Telescan software and referenced to RF). RMS amplitude did not differ across conditions for any muscle (all p&#xa0;&#x2265;&#xa0;0.356), and absolute onset sequence showed no condition effect (all p&#xa0;&#x2265;&#xa0;0.197). For GAS %Sequence, the Greenhouse-Geisser-corrected omnibus test was significant (F(1.32, 76.56)&#xa0;=&#xa0;28.45, p&#xa0;<&#xa0;0.001), driven by a within-30&#xb0; contrast in which %Sequence was lower under Rl than Rh (paired t(58)&#xa0;=&#xa0;10.39, Holm-adjusted p&#xa0;<&#xa0;0.0001; mean difference 22.0 percentage points, 95&#xa0;% CI [17.8, 26.3]; dz&#xa0;=&#xa0;1.35). Because %Sequence is referenced to RF, this exploratory shift should be interpreted cautiously. Lower-limb activation may be constrained by the closed-chain nature of pedaling, whereas distal recruitment timing may be sensitive to crank-axis height and the foot-pedal interface.

Humans

Fabry's disease with familial lymphedema of the lower limbs. Case report and family study.

The case of a 49-year-old man with Fabry's disease (FD), confirmed by histopathological findings of kidney and skin biopsies and enzymatic studies, is reported. Clinical symptoms mainly consisted in severe neurological involvement, and in conspicuous lymphedema of the lower limbs. Two decreased brothers of the patient were also affected with symptons strongly suggesting FD, as well as the lymphedema of the lower limbs. On the basis of these data, the association of FD with familial lymphedema of the lower limbs is discussed: a lipid accumulation in the lymphatic as well as the blood vessel wall is proposed as a possible explanation; the hypothesis of an inborn error in the development of the lymphatic system, controlled by a gene closedly associated with the FD gene on the same chromosome can also be advanced.

Cerebroside-Sulfatase

[Dissecting aneurysm as a cause of acute non-traumatic ischemia of the lower limbs].

The results of the treatment the acute non-traumatic ischemia of the lower limbs caused by dissecting aneurysm are discussed. Out of 726 analysed patients 8 of them suffered from dissecting aneurysm, i.e. 1.1%. Dissecting aneurysm was more frequent in male patients. All patients with lower limbs ischemia caused by the dissecting aneurysm were operated. Vascular prosthesis was used in 6 cases, and restoration of arterial patency in 2 cases. Seven patients died during the early postoperative period and one was released home with proper blood flow.

Aged

Effects of blood flow restriction training combined with resistance training on lower-limb strength and sport-specific performance in athletes: a systematic review and meta-analysis.

BACKGROUND: In contemporary sports science, athletes and coaches continuously explore strategies to reduce training load and injury risk while increasing muscular strength and sport-specific performance. This meta-analysis evaluated the effects of blood flow restriction training (BFRT) combined with resistance training (RT) on lower-limb muscle strength and sport-specific performance in athletes. METHODS: Relevant randomized controlled trials (RCTs) were systematically searched across major databases (e.g. PubMed, Web of Science, Cochrane, CNKI, Wanfang Data, and Embase) from inception until November 2024. Two independent reviewers carefully assessed the studies. Data analysis was carried out using RevMan 5.4 software, which included heterogeneity testing, meta-analysis, subgroup analysis, and assessment of publication bias. RESULTS: Ten RCTs (181 athletes; 91 in the BFRT and RT group, 90 in the control group) were included. Outcomes determined BFRT combined with RT yielded notable enhancements in lower-limb muscle strength (SMD = 1.09, 95% CI [0.52, 1.66], p&#x2009;<&#x2009;0.05) and muscle hypertrophy (MD = 1.09, 95% CI [0.10, 2.09], p&#x2009;<&#x2009;0.05) compared to control training. However, no significant improvement in sport-specific performance was found (SMD = 0.11, 95% CI [-0.18, 0.40], p&#x2009;=&#x2009;0.46). Substantial heterogeneity was observed for strength outcomes (I2 = 75%), whereas low heterogeneity was observed for sport-specific performance and hypertrophy outcomes (I2 = 0%). No evidence of significant publication bias was detected. CONCLUSION: BFRT combined with RT appears to provide effective augmentation of lower-limb muscle strength and hypertrophy in athletes compared to RT or conventional training alone. It may be prudent to integrate this approach systematically into training cycles to optimize physiological muscle stimulation and training outcomes, despite not directly improving sport-specific performance.

Humans

Thermography in lower limb arterial disease.

Skin temperature distributions are described which correspond to different levels of arterial obstruction in the lower limbs. These temperature distributions are conveniently observed using thermography. Thermography may be used to measure the change in skin temperature when the limb performs work. These skin temperature changes have been correlated with the impairment of blood flow to the lower limb.

Adult

[Agenesis of the femoral vein in the framework of vascular dysplasias of the lower limbs. Clinical case].

Venous dilatations of the lower limbs, especially if associated with others abnormalities, may reflect pathogenetic mechanisms far more complex and diverse than plain insufficiency of the sephena, all the way to congenital vascular anomalies of all possible types and still dubious classification. In such conditions a prerequisite of prime importance is the complete exploration of the whole arterial and venous vasculature of the limb, first of all in order to avoid rash therapeutic decisions, and then to help clarify the diagnosis and select the most appropriate treatment from among the numerous technics available.

Angiography

[Surgical treatment of varicose veins of the lower limbs].

146 patients with varicosis of the lower limbs were operated upon in a method unified by the author. Consideration was given to the late results found in 132 patients followed up within the period from 1 to 9 years. 5 patients (3.8%) developed recurrence of the disease.

Fasciotomy

[Ankylosis in the lower limb in ankylosing spondylitis].

Synostosing ankylosis of lower limb joints was investigated radiologically and clinically in approximately 2000 patients with ankylosing spondylitis. Ankylosis was found in 8 hip joints and in 4 of the joints of the foot skeleton. Most commonly the initial picture of these diseases is that of an arthritis (sometimes specifically misinterpreted as such) years and decades before the manifestation of ankylosing spondylitis appears. The ossifying potential of the disease can apparently manifest itself early in limited areas. The radiological morphology with destruction and reconstruction is found mainly as the well known vertebral changes. Immobilization can at the most be regarded as a favourable factor in a predominantly immunological-inflammatory patho-mechanism. Additional local abnormalities of the vascular or enzymatic systems of the joints can be assumed.

Adolescent

Effects of blood flow restriction training combined with plyometric training on lower limb muscle strength and motor unit recruitment in basketball players: An experimental study.

OBJECTIVE: Previous studies have shown that plyometric training (PT) improves neuromuscular function and explosive power but not maximal strength. Blood flow restriction training (BFR) combined with low-intensity resistance training (RT) increases muscle mass and strength. This study investigated the effects of PT, and BFR combined with PT on lower-limb muscle function. METHODS: Twenty elite basketball players were randomly assigned to two groups: PT-alone group (PT, n&#x202f;=&#x202f;10) and BFR combine with PT group (PT-BFR, n&#x202f;=&#x202f;10). All participants underwent bodyweight-based plyometric training three times per week for eight weeks. Peak torque values for hip and knee flexion and extension, as well as root mean square (RMS) values derived from electromyography, were measured before and after the intervention. RESULTS: After the 8-week intervention, both groups showed significant improvements in knee flexion and extension peak torque at 180&#xb0;/s (all p&#x202f;<&#x202f;0.01). Between-group comparisons revealed greater gains in the PT-BFR group for hip extension and flexion at 60&#xb0;/s (p&#x202f;=&#x202f;0.036-0.002; &#x3b7;p2 = 0.225-0.233). RMS of the rectus femoris increased significantly more in the PT-BFR group than in the PT group (right: p&#x2009;=&#x2009;0.004, &#x3b7;p2 = 0.385; left: p&#x2009;=&#x2009;0.020, &#x3b7;p2 = 0.266), whereas no significant changes were observed in the gastrocnemius, tibialis anterior, or biceps femoris (all p&#x2009;>&#x2009;0.05). CMJ height also improved more in the PT-BFR group, with a significant group &#xd7;&#x2009;time interaction (p&#x2009;=&#x2009;0.042, &#x3b7;p2 = 0.210). CONCLUSION: Both training protocols enhanced bilateral lower-limb strength, with notable gains in the non-dominant leg; however, the magnitude did not differ substantially between groups. In contrast, compared with PT alone, BFR combined with PT produced superior enhancements in lower-limb muscle strength and neuromuscular recruitment. These findings suggest that when PT is employed to improve explosive power, it may be effectively combined with BFR to further augment muscular strength.

Humans

[X-ray computed tomographic scans of lower limb and trunk muscles in facioscapulohumeral muscular dystrophy].

X-rays computed tomographic (CT) scans of muscles of the lower limbs and the trunk in 14 patients with facioscapulohumeral muscular dystrophy (FSH) were studied. The CT scans showed that the affected muscles were decreased in density and size. The laterality of muscular involvement was sometimes observed. The muscular lesions in the lower limbs showed proximal distribution. In the thigh, the hamstrings were affected first, the adductor muscles second, and then the muscular involvement progressed to the quadriceps femoris muscle. In the lower leg, the gastrocnemius and soleus muscles were relatively spared as compared with the tibialis anterior muscle. In the lumbar girdle, the abdominal muscles were involved first, the gluteal muscles second, the back muscles third, and the psoas major muscle were relatively spared. The muscular weakness of this distribution exacerbated lumbar lordosis. The neck muscles were less affected than those of the lumbar girdle. The CT scans in FSH demonstrated the characteristic pattern of muscular involvement, which differed from the inherited muscular diseases such as Duchenne muscular dystrophy, myotonic dystrophy, and others.

Adolescent

[Effect of electroacupuncture combined with suspension exercise therapy on lower limb motor function in elderly patients with post-stroke spastic hemiplegia].

OBJECTIVE: To observe the efficacy of electroacupuncture (EA) combined with suspension exercise therapy in elderly patients with post-stroke spastic hemiplegia and its effect on lower limb motor function. METHODS: A total of 120 elderly patients with post-stroke spastic hemiplegia were enrolled. Using a 2&#xd7;2 factorial design, all the patients were assigned to a group A (conventional treatment), a group B (conventional treatment combined with suspension exercise therapy), a group C (conventional treatment combined with EA at Jiaji [EX-B2] and limb acupoints), and a group D(conventional treatment combined with suspension exercise therapy and EA at Jiaji [EX-B2] and limb acupoints), with 30 patients in each group. The main acupoints were bilateral Jiaji (EX-B2) points at the C2-C7, T2-T12, L1-L5, and S1 segments. The adjunct acupoints included Jianyu (LI15), Binao (LI14), Huantiao (GB30), Chengfu (BL36), etc. on the affected side.Continuous wave was applied at a frequency of 100 Hz with a current intensity of 1.5-3.0 mA, and needles were retained for 30 min, once daily for 4 weeks. Before treatment and after 2 and 4 weeks of treatment, the modified Ashworth scale (MAS),Fugl-Meyer assessment (FMA), Berg balance scale (BBS), and Barthel index scores were evaluated in the four groups. Root mean square (RMS) values of surface electromyography (sEMG) of the erector spinae and rectus abdominis muscles on the affected side, as well as balance function indexes, including the mean pressure symmetry index (SI), contact area SI, ellipse area, and displacement distances of the center of pressure in the anteroposterior (AP) and mediolateral (ML) directions, were measured. Clinical efficacy was also compared among the four groups. RESULTS: After 2 and 4 weeks of treatment, MAS scores in all groups were lower than those before treatment (P<0.05), whereas FMA, BBS, and Barthel index scores were higher than those before treatment (P<0.05). After 4 weeks of treatment, MAS scores were lower than those after 2 weeks of treatment (P<0.05), whereas FMA, BBS, and Barthel index scores were higher than those after 2 weeks of treatment (P<0.05) in the four groups. At both 2 and 4 weeks after treatment, group D had lower MAS scores (P<0.05) and higher FMA,BBS, and Barthel index scores (P<0.05) than the other three groups. After 2 and 4 weeks of treatment, RMS values of sEMG of the erector spinae and rectus abdominis muscles on the affected side at all tested angles were higher than those before treatment in all groups (P<0.05), and the values after 4 weeks of treatment were higher than those after 2 weeks of treatment(P<0.05). At both 2 and 4 weeks after treatment, all these indexes in the group D were higher than those in the other three groups (P<0.05). After 2 and 4 weeks of treatment, the mean pressure SI, contact area SI and ellipse area of each group were lower than those before treatment (P<0.05). After 4 weeks of treatment, the mean pressure SI, contact area SI and ellipse area of each group were lower than those after 2 weeks of treatment (P<0.05). After 2 and 4 weeks of treatment, the AP displacement distances of groups A, C and D were lower than those before treatment (P<0.05), and after 4 weeks of treatment, the AP displacement distances of groups A, C and D were lower than those after 2 weeks of treatment (P<0.05);after 2 weeks of treatment, there was no statistically significant difference in AP displacement distance in the group B compared with before treatment (P>0.05), and after 4 weeks of treatment, the AP displacement distance of group B was lower than that before treatment (P<0.05). After 2 weeks of treatment, there was no statistically significant difference in ML displacement distance in group A compared with before treatment (P>0.05); after 4 weeks of treatment, the ML displacement distance of group A was lower than that before treatment (P<0.05). After 2 and 4 weeks of treatment, there was no statistically significant difference in ML displacement distance in the group B compared with that before treatment (P>0.05).After 2 and 4 weeks of treatment, the ML displacement distances of groups C and D were lower than those before treatment(P<0.05), and after 4 weeks of treatment, the ML displacement distances of groups C and D were lower than those after 2 weeks of treatment (P<0.05). At both 2 and 4 weeks after treatment, mean pressure SI, contact area SI, ellipse area, and AP and ML displacement distances in the group D were lower than those in the other three groups (P<0.05). Factorial analysis of variance showed that EA had the strongest main effect on FMA score (F=6.243, P<0.05), suspension exercise therapy had the strongest main effect on BBS score (F=6.292, P<0.05), and the interaction effect was most significant for MAS score (F=5.941, P<0.05), indicating that the combined therapy produced a greater synergistic effect on reducing muscle tone than on the other outcome measures. The total effective rate in the group D was 93.3% (28/30), which was higher than those in the group A (53.3% [16/30]), group B (56.7% [17/30]), and group C (66.7% [20/30], P<0.05). CONCLUSION: EA combined with suspension exercise therapy could effectively promote the recovery of lower limb function in elderly patients with post-stroke spastic hemiplegia, improve motor and balance functions, and enhance activities of daily living.

Humans

Dynamic lymphadenoscintigraphy of the lower limbs (notes on technique and normal findings).

The use of dynamic lymphadenoscintigraphy is proposed for the study of the lymphatic flow in the lower limbs. The method is based on the determination of the flow curves of radiocolloid (antimony-sulphide labelled with 99mTc) in the lower limbs, on the time of its appearance in the inguinal lymphatic vessels and in the liver, and also on the recording by periodically repeated photoscans of the progress of the radiocolloid in the pre-lymph node ducts. Thus, the method is suggested for use in the observation of flow variations as an expression of metastatic or systemic lymph node diseases and in the differential diagnosis of lymphatic and venous oedema.

Humans

Arterial embolectomy in the lower limbs.

A series of arterial embolectomies of the lower limb is reviewed, and the results are compared with those in a previous series reported from this hospital. There were 40 emboli in the 36 patients, with an operative mortality of 16% and a limb salvage rate of 85%. This represents a considerable improvement on the results reported from the first series and is attributed to the greater experience of surgeons with the Fogarty embolectomy catheter. However, there has been no decrease in the delay between the onset of symptoms and the embolectomy. If this aspect of management could be improved, then even better results should be obtained.

Aged

Ischemic contracture in the lower limb.

Twenty cases of ischemic contracture in the lower limb demonstrate that the age distribution may be higher than that of patients with similar lesions in the upper limbs. Non-traumatic and traumatic causes are encountered equally frequently. Pain is one of the most important symptoms associated with long standing lesions. The ischemic lesion develops most frequently and severely in the anterior compartment of the leg. The functional prognosis is poor when both nerves are affected and when the deformity is severe.

Adolescent

Arterial and venous blood viscosity in ischemic lower limbs in patients affected by peripheral obliterative arterial disease.

Blood, plasma and serum viscosity, packed red cell volume, and plasma fibrinogen concentration was measured in a group of 13 subjects, suffering from peripheral obliterative arterial disease of the lower limbs (stage III or IV), awaiting surgery, and in 9 control subjects, none of whom showed signs of circulatory disease of the lower limbs either by clinical examination or by instrumental measurements. The blood samples were taken from the: (a) antecubital vein; (b) femoral vein; (c) femoral artery. In the patients venous blood viscosity was significantly higher than arterial blood viscosity. No significant differences have been found between the femoral and the antecubital vein, but in the femoral vein blood viscosity was slightly higher. Packed red cell volume and plasma viscosity were slightly but significantly higher in venous blood, while no difference was seen in serum viscosity and in plasma fibrinogen concentration. In the control subjects blood viscosity values were decidedly lower than in patients and no statistically significant differences were to be found between artery and vein, even if viscosity values were lower in artery. These results support the hypothesis that an interrelation exists between hyperivscosity syndrome and vascular ischaemia-inducing diseases.

Adult

Rehabilitation after arterial reconstruction of the lower limbs. A four to six years follow-up study.

The social fate of 105 patients was followed 4 to 6 years after arterial reconstruction of the arteries of the lower limbs. At the time of operation half of the patients had ischemic symptoms at rest. None died, and none were amputated as a result of the arterial reconstruction. In 84 per cent the operation aimed at restoring the working-capacity including the ability to do housework. In 11 per cent the aim was preservation of personal independence. Five per cent had non-disabling claudication. In 60 per cent the working-capacity was restored, and only 5 per cent were confined to nursing care. At the end of the follow-up period 74 per cent of the patients were alive, and of these 50 per cent had retained their working-capacity. Forty-five per cent were personal independent pensioners and 5 per cent were confined to nursing care. The majority of senescent patients, threatened by amputation of the lower limbs, will retain their personal independence after arterial reconstruction. The socioeconomic importance of this fact is stressed.

Adult

Review of 1,375 cases of vascular reconstruction for ischemic disorder of the lower limbs Statistical analysis of late postoperative thromboses with evaluation of the effect of an anti-platelet agent[tauthor's transl)].

The authors are presenting 1.375 cases of arterial reconstruciton of the lower limbs, those patients having undergone 1.562 operatons between 1963 and 1974. Although mention is made of long-term postoperative morbidity (false femoral aneurysm, infection, amputation), the study is mainly centered on the problem of late thromboses, calculated in percentages per year and classified according to the time lapse since the initail operation. Comparison is made between the percentages before and after 1972. Since 1972, Dipyridamol, an anti-platelet agent, has been administered systematically to all vascular reconstructions of the lower limbs. The action of this type of drug on the platelet adhesivenss is briefly treated. In this respect the numbers calculated suggests a decrease of about 25 % in the numbers of late thrombosis, all other treatment remaining unchanged for the past 11 years. In conclusion, operative indication and surgical skill remain primordial in this type of surgery. However, the anti-platelet treatment, associated with fat-free diet, no tobacco, vasodilators or anticoagulants, seems to bring a further guarantee to permeability of arterial reconstructions.

Arteriosclerosis Obliterans

[Arteritis of the lower limbs in diabetics].

37 cases of diabetic arteritis of lower limbs in diabetic patients were retrospectively studied, from 1988 to 1991. Mean age was 66 years. Masculine predominance was evident with a sex ratio of 1/10. The majority of our patients have consulted at a late stage with trophic disturbance of inferior limbs, indeed 18 patients were seen at the 4th stage. Mortification was observed in 55% cases. Arteriography has allowed to show an elective localization of lesions at the femoralis arteria, profunda femoralis arteria and distal axes. Operative indication was made in 22 patients. Conservative surgery was performed for 50% of the operated patients. Conservative surgery results had been relatively less satisfactory than for others arteritis, particular because of late consultation and the condition of diabetic patients.

Aged