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1

Extracorporeal shock wave treatment for chronic plantar fasciitis (heel pain).  

PubMed

(1) Electrohydraulic, electromagnetic, or piezoelectric devices are used to translate energy into acoustic waves during extracorporeal shock wave treatment (ESWT) for chronic plantar fasciitis (or heel pain). These waves may help to accelerate the healing process via an unknown mechanism. (2) ESWT, which is performed as an outpatient procedure, is intended to alleviate the pain due to chronic plantar fasciitis. (3) Results from randomized controlled trials have been conflicting. Six trials reported data that favour ESWT over placebo or conservative treatment for efficacy outcomes, while three trials showed no significant difference between the ESWT group and the placebo group. (4) The lack of convergent findings from randomized trials of ESWT for chronic plantar fasciitis suggests uncertainty about its effectiveness. The evidence reviewed in this bulletin does not support the use of this technology for this condition. PMID:17302019

Ho, C

2007-01-01

2

Plantar heel pain.  

PubMed

Plantar heel pain is a common complaint encountered by orthopedic surgeons, internists, and family practitioners. Although it is most often caused by plantar fasciitis, this is a diagnosis of exclusion. Other mechanical, rheumatologic, and neurologic causes must be considered first. The history and physical examination are typically all that is needed to make the proper diagnosis, but diagnostic adjuncts are available to assist the clinician. When plantar fasciitis is diagnosed, conservative modalities must be tried first. Corticosteroid injections and extracorporeal shock-wave therapy may also be used. After 6 months of failed conservative treatments, surgical intervention should be considered. PMID:24559879

Rosenbaum, Andrew J; DiPreta, John A; Misener, David

2014-03-01

3

Proximal Plantar Fibroma as an Etiology of Recalcitrant Plantar Heel Pain  

Microsoft Academic Search

Prompted by repeated pathology reports of fibromas at the origin of the plantar fascia after fasciectomy for chronic plantar heel pain, this study examined the incidence of proximal plantar fibroma. A retrospective study of 100 pathology specimens from 97 patients with the preoperative diagnosis of recalcitrant plantar fasciitis was performed. Patients ranged in age from 36 to 82, and included

Shaun Hafner; Nancy Han; Martin M. Pressman; Christopher Wallace

2011-01-01

4

Interventions for treating plantar heel pain  

Microsoft Academic Search

Background: Ten percent of people may experience pain under the heel (plantar heel pain) at some time. Injections, insoles, heel pads, strapping and surgery have been common forms of treatment offered. The absolute and relative effectiveness of these interventions are poorly understood.Objectives: The objective of this review was to identify and evaluate the evidence for effectiveness of treatment in treating

F. Crawford; D. Atkins; J. Edwards

2001-01-01

5

Consensus for dry needling for plantar heel pain (plantar fasciitis): a modified Delphi study  

Microsoft Academic Search

HypothesisPlantar heel pain (plantar fasciitis) is a common and disabling condition. A variety of treatment options are available to patients with plantar heel, however the evidence for these treatments is generally weak and the best way to manage plantar heel pain remains unclear. Trigger point dry needling is increasingly used as an adjunct therapy for musculoskeletal pain. In patients with

Matthew P Cotchett; Karl B Landorf; Shannon E Munteanu; Anita M Raspovic

2011-01-01

6

Comparison between extracorporeal shockwave therapy, placebo ESWT and endoscopic plantar fasciotomy for the treatment of chronic plantar heel pain in the athlete  

PubMed Central

Summary Plantar fasciitis can be a chronic and debilitating condition affecting athletes of all levels. The aim of this study is to compare treatment outcomes for the treatment of chronic plantar fasciitis in athletes, comparing focused extra corporeal sound wave therapy (ESWT) and the surgical endoscopic plantar fasciotomy (EPF). A total of 37 eligible patients were enrolled in the study between May 2006 and December 2008 at a single institution. Patients were either enrolled in the surgical group, or to the ESWT group which included a placebo controlled, randomized group (P-ESWT). Pre and post Visual Analog Scores (VAS) and Roles and Maudlsey (RM) scores were recorded and compared between the three groups. The patient’s return to activity (RTA) was also documented. The results showed statistical improvement within the EPF and ESWT groups with both VAS & RM scores, with EPF being significantly better than both ESWT and P-ESWT in terms of treatment outcomes. Patients enrolled in the ESWT were able though to continue with their exercise regimen, while the EPF group was able to return to their athletic activity in an average of 2.8 months. In conclusion, EPF and ESWT are both effective forms of treatment for chronic plantar fasciitis; EPF being superior in outcomes yet ESWT treatment could be preferable since the athlete can remain active during treatment. Level of Evidence: II PMID:23738317

Saxena, Amol; Fournier, Magali; Gerdesmeyer, Ludger; Gollwitzer, Hans

2012-01-01

7

Neurosensory testing of the medial calcaneal and medial plantar nerves in patients with plantar heel pain  

Microsoft Academic Search

Eighty-two patients with a chief complaint of plantar heel pain were evaluated for sensory abnormalities within the cutaneous distribution of both the medial calcaneal nerve and the medial plantar nerve, using quantitative neurosensory testing with a pressure-specified sensory device. The results showed that 22.68% of the patients displayed isolated abnormal sensory function within the distribution of the medial calcaneal nerve,

Jonathan D. Rose; D. Scot Malay; Dean L. Sorrento

2003-01-01

8

Heel pain-plantar fasciitis: revision 2014.  

PubMed

The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to nonarthritic heel pain. J Orthop Sports Phys Ther 2014;44(11):A1-A23. doi:10.2519/jospt.2014.0303. PMID:25361863

Martin, Robroy L; Davenport, Todd E; Reischl, Stephen F; McPoil, Thomas G; Matheson, James W; Wukich, Dane K; McDonough, Christine M; Altman, Roy D; Beattie, Paul; Cornwall, Mark; Davis, Irene; DeWitt, John; Elliott, James; Irrgang, James J; Kaplan, Sandra; Paulseth, Stephen; Torburn, Leslie; Zachazewski, James; Godges, Joseph J

2014-11-01

9

Effectiveness of trigger point dry needling for plantar heel pain: study protocol for a randomised controlled trial  

Microsoft Academic Search

BACKGROUND: Plantar heel pain (plantar fasciitis) is a common and disabling condition, which has a detrimental impact on health-related quality of life. Despite the high prevalence of plantar heel pain, the optimal treatment for this disorder remains unclear. Consequently, an alternative therapy such as dry needling is increasingly being used as an adjunctive treatment by health practitioners. Only two trials

Matthew P Cotchett; Karl B Landorf; Shannon E Munteanu; Anita Raspovic

2011-01-01

10

Measurement of in-shoe plantar triaxial stresses in high-heeled shoes  

Microsoft Academic Search

Foot problems such as pain and calluses are common for high-heeled shoe wearers. These problems may be related to the excessive local plantar loading, including pressure and shear stress. The shear stress is important on such a declined support surface of high-heeled shoe. The purpose of this study was to investigate the distribution of contact pressures and shear stresses simultaneously

Yan Cong; Ming Zhang

2010-01-01

11

Regional plantar foot pressure distributions on high-heeled shoes-shank curve effects  

NASA Astrophysics Data System (ADS)

Forefoot pain is common in high-heeled shoe wearers due to the high pressure caused by the center of body mass moving forward and the increased arch height with heel elevation. Sufficient arch support could reduce the high pressure over forefoot. However, too much arch support could lead to abnormal foot alignment and pain over midfoot. Little information is reported on the relationship among plantar arch height, shank curve design and plantar pressure. This study aimed at quantifying the plantar arch height changes at different heel heights and investigating the effect of shank curve on plantar pressure distribution. The plantar arch height increased to (7.6±1.3)mm at heel height of 75 mm. The Chinese standard suggests the depth of last should be 8.5mm for heel height of 75 mm. When a shank curve with higher depth of last (11 mm) was used, the peak pressure over forefoot further decreased in midstance phase, which might ease the forefoot problems, while the peak pressure over midfoot increased but not exceeded the discomfort pressure thresholds. To achieve a more ideal pressure distribution in high-heeled shoes, a higher than expected depth of last would be suggested that would not cause discomfort over midfoot.

Cong, Yan; Lee, Winson; Zhang, Ming

2011-12-01

12

Effectiveness of dry needling and injections of myofascial trigger points associated with plantar heel pain: a systematic review  

Microsoft Academic Search

BACKGROUND: Plantar heel pain (plantar fasciitis) is one of the most common musculoskeletal pathologies of the foot. Plantar heel pain can be managed with dry needling and\\/or injection of myofascial trigger points (MTrPs) however the evidence for its effectiveness is uncertain. Therefore, we aimed to systematically review the current evidence for the effectiveness of dry needling and\\/or injections of MTrPs

Matthew P Cotchett; Karl B Landorf; Shannon E Munteanu

2010-01-01

13

Percutaneous drilling for chronic heel pain  

Microsoft Academic Search

The authors report a retrospective study involving 25 feet in 21 patients who underwent percutaneous drilling for chronic heel pain. Patients with increased activity of the heel were considered for surgical treatment if there was increased uptake on the delayed bone scans. The average follow-up was 21 months (range, 6 to 30 months). All patients were treated in day surgery

Stefano Santini; Arturo Rebeccato; Roberto Schiavon; Livio Nogarin

2003-01-01

14

The nonlinear finite element analysis and plantar pressure measurement for various shoe soles in heel region.  

PubMed

The most influential factor contributing to foot and shoe comfort is underfoot cushioning. The shock absorbing ability of footwear in the heel area is of particular importance in reducing the impact load during athletic activities and in therapeutic footwear prescribed for heel pain. Furthermore, foot care for foot problem patients is an important part of treatment and educational programs. Therefore, a well-designed sport shoe which can provide comfort and protection is essential. In order to design a functional shoe, biomechanics and other new technologies should be considered, and the design process should be examined in the biomechanics laboratory over and over. The design process requires too much time and effort since the entire experimental and test work can only be done after the prototype is manufactured. Therefore, this study tried to introduce the Finite Element Method (FEM) into the shoe design process by building a three-dimensional FE model with various shoe soles and loading conditions. The material properties of shoe materials were tested using an Instron Testing Machine. An in-shoe pressure insole was used to measure the plantar pressure in different ambulation conditions with various shoe constructions. The subject for this study was a healthy young male without any foot problem. The average plantar pressures obtained from approximately 50 steps in the heel region for each of the various conditions were collected. The results showed that the mean peak plantar pressure of the running situation was significantly higher than that of the walking situation as predicted, and that the insole could provide better cushioning compared to the other shoe constructions. The stress strain relationship for shoe materials was approximated better by a second-order nonlinear curve according to the Instron test. The results of the finite element method suggested that only the second-order nonlinear stress strain curve could correctly describe the shoe material, which also confirmed a potential valuable role for FEM in designing functional shoes. PMID:9369026

Shiang, T Y

1997-10-01

15

Influence of in-shoe heel lifts on plantar pressure and center of pressure in the medial-lateral direction during walking.  

PubMed

The aim of this study was to investigate how the height and material of in-shoe heel lifts affect plantar pressure and center of pressure (COP) trajectory in the medial-lateral direction during walking. Seventeen healthy young male adults were asked to walk along an 8m walkway while wearing a high-cut flat shoe and 5 different heel lifts. Peak pressure (PP), pressure-time integral (PTI) and contact area (CA) were measured by Pedar insole system for three foot regions: forefoot, midfoot and heel. Range and velocity of medial-lateral (ML) COP during forefoot contact phase (FFCP) and foot flat phase (FFP) were collected using Footscan pressure plate. Forefoot pressure and ML-COP parameters increased as the heel was elevated. Statistically significant attenuation of heel peak plantar pressure was provided by all heel lifts except for the hard lift. Post hoc tests suggest that material had a greater influence on the range and velocity of ML-COP during FFCP than heel height, while during FFP, heel height seemed to affect these parameters more. The findings from this study suggest that thick heel lifts should be used with caution, and that a heel lift made of materials with good support and elastic properties might be more appropriate to improve footwear comfort and medial-lateral motion control. PMID:24440428

Zhang, Xianyi; Li, Bo

2014-04-01

16

The effectiveness of extra corporeal shock wave therapy for plantar heel pain: a systematic review and meta-analysis  

PubMed Central

Background There is considerable controversy regarding the effectiveness of extracorporeal shock wave therapy in the management of plantar heel pain. Our aim was to conduct a systematic review of randomised controlled trials to investigate the effectiveness of extracorporeal shock wave therapy and to produce a precise estimate of the likely benefits of this therapy. Methods We conducted a systematic review of all randomised controlled trials (RCTs) identified from the Cochrane Controlled trials register, MEDLINE, EMBASE and CINAHL from 1966 until September 2004. We included randomised trials which evaluated extracorporeal shock wave therapy used to treat plantar heel pain. Trials comparing extra corporeal shock wave therapy with placebo or different doses of extra corporeal shock wave therapy were considered for inclusion in the review. We independently applied the inclusion and exclusion criteria to each identified randomised controlled trial, extracted data and assessed the methodological quality of each trial. Results Six RCTs (n = 897) permitted a pooled estimate of effectiveness based on pain scores collected using 10 cm visual analogue scales for morning pain. The estimated weighted mean difference was 0.42 (95% confidence interval 0.02 to 0.83) representing less than 0.5 cm on a visual analogue scale. There was no evidence of heterogeneity and a fixed effects model was used. Conclusion A meta-analysis of data from six randomised-controlled trials that included a total of 897 patients was statistically significant in favour of extracorporeal shock wave therapy for the treatment of plantar heel pain but the effect size was very small. A sensitivity analysis including only high quality trials did not detect a statistically significant effect. PMID:15847689

Thomson, Colin E; Crawford, Fay; Murray, Gordon D

2005-01-01

17

Randomized multicenter trial on the effect of radiotherapy for plantar Fasciitis (painful heel spur) using very low doses – a study protocol  

Microsoft Academic Search

BACKGROUND: A lot of retrospective data concerning the effect of radiotherapy on the painful heel spur (plantar fasciitis) is available in the literature. Nevertheless, a randomized proof of this effect is still missing. Thus, the GCGBD (German cooperative group on radiotherapy for benign diseases) of the DEGRO (German Society for Radiation Oncology) decided to start a randomized multicenter trial in

Marcus Niewald; M. Heinrich Seegenschmiedt; Oliver Micke; Stefan Graeber

2008-01-01

18

Stress analysis of the standing foot following surgical plantar fascia release  

Microsoft Academic Search

Plantar fascia release is a surgical alternative for patients who suffer chronic heel pain due to plantar fasciitis and are unaffected by conservative treatment. A computational (finite element) model for analysis of the structural behavior of the human foot during standing was utilized to investigate the biomechanical effects of releasing the plantar fascia. The model integrates a system of five

Amit Gefen

2002-01-01

19

Are Repeated Single-Limb Heel Raises and Manual Muscle Testing Associated With Peak Plantar-Flexor Force in People With Inclusion Body Myositis?  

PubMed Central

Background Repeated heel raises have been proposed as a method of ankle plantar-flexor strength testing that circumvents the limitations of manual muscle testing (MMT). Objective The study objective was to examine the relationships among ankle plantar-flexion isometric maximum voluntary contraction (MVC), repeated single-limb heel raises (SLHRs), and MMT in people with myositis. Design This was a cross-sectional study with a between-group design. The ability to complete 1 SLHR determined group assignment (SLHR group, n=24; no-SLHR group, n=19). Methods Forty-three participants with myositis (13 women; median age=64.9 years) participated. Outcome measures included MVC, predicted MVC, Kendall MMT, and Daniels-Worthingham MMT. Results The Kendall MMT was unable to detect significant ankle plantar-flexor weakness established by quantitative methods and was unable to discriminate between participants who could and those who could not perform the SLHR task. Ankle plantar-flexion MVC was not associated with the number of heel-raise repetitions in the SLHR group (pseudo R2=.13). No significant relationship was observed between MVC values and MMT grades in the SLHR and no-SLHR groups. However, a moderate relationship between MVC values and MMT grades was evident in a combined-group analysis (?=.50–.67). Limitations The lower half of both MMT grading scales was not represented in the study despite the profound weakness of the participants. Conclusions Both Kendall MMT and Daniels-Worthingham MMT had limited utility in the assessment of ankle plantar-flexor strength. Repeated SLHRs should not be used as a proxy measure of ankle plantar-flexion MVC in people with myositis. PMID:24309617

Shrader, Joseph A.; Davenport, Todd E.; Joe, Galen; Rakocevic, Goran; McElroy, Beverly; Dalakas, Marinos

2014-01-01

20

An innovative design for reconstruction of plantar heel by split partially overlapping anterolateral thigh flap  

Microsoft Academic Search

Introduction  Reconstruction of the weight bearing, thick and durable heel, in soft tissue injuries of the foot remains a difficult and\\u000a challenging problem. The thick glabrous epidermis and dermis, and the fibrous septae of the subcutaneous layer provide unique\\u000a properties for withstanding pressure and shock associated with gait.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and Methods  Here, the authors put forward an innovative method for a one-stage

Vigneswaran N; H. W. Ng; Y. M. Samuel Ho; S. Y. Michelle Ho; T. C. Marcus Wong; Guan-Ming Feng; Sheng-Fa Yao; Hsing-Kuang Lai; Patel Hasu; Jagdeep Chana; Chandra Bose; Hung-Chi Chen

21

Platelet-rich plasma for the treatment of chronic plantar fasciopathy in adults: a case series.  

PubMed

Plantar fasciopathy (PF) is a common source of pain and disability that is often refractory to conservative management. There are no uniformly effective standard-of-care treatments for chronic recalcitrant PF. Corticosteroid injection is considered a viable treatment option when traditional therapies fail, but is limited by suboptimal long-term efficacy and potential adverse effects. Platelet-rich plasma (PRP) is an emerging injection-based treatment for various chronic degenerative soft-tissue diseases. It is postulated to promote native tissue regeneration; however, consistent scientific evidence remains lacking. A prospective case series, including 24 consecutive PF cases, was conducted to report patient-rated pain and disability following PRP injection. Foot and Ankle Ability Measure (FAAM) scores were the primary clinical outcome measure. Foot-Single Assessment Numeric Evaluation (Foot-SANE) scores, Short Form-12 Health Survey version 2 (SF-12v2) questionnaires, and PRP treatment satisfaction surveys were secondary outcome measures. Statistical analysis compared baseline and 32 weeks post-injection time points. Patients receiving PRP injection reported clinically and statistically significant improvement in all outcome measures during this interval. There were no serious adverse events associated with treatment. PRP is considered a safe therapeutic option with the ability to decrease heel pain in patients with chronic PF refractory to appropriate conservative management. PMID:24287209

Wilson, John J; Lee, Kenneth S; Miller, Andrew T; Wang, Sijian

2014-02-01

22

Graston Instrument Soft Tissue Mobilization and Home Stretching for the Management of Plantar Heel Pain: A Case Series  

Microsoft Academic Search

ObjectiveThe purpose of this prospective case series was to describe the outcome of a set of patients with plantar fasciitis treated with Graston Instrument Soft Tissue Mobilization techniques (GT) and a home stretching program.

Brian Looney; Terry Srokose; César Fernández-de-las-Peñas; Joshua A. Cleland

2011-01-01

23

[Characterization of chronic plantar ulcers in former leprosy patients].  

PubMed

Between 1988 and 1992, 21 biopsies for pathological examination were taken from 20 Senegalese leprosy patients suffering from chronic plantar ulcers (CPU) suspected of malignant transformation. The diagnosis of squamous cell carcinoma was effectively made in 13 cases and that of pseudoepitheliomatous hyperplasia in the remaining 8 cases. The mean period of time between the onset of CPU and that of malignant transformation was 10 years (range: 1 to 15 years); the mean annual frequency of the malignant transformation was 2 per 1,000 CPU. In countries where pathological examination is not available, below knee amputation could be considered whenever main clinical signs of malignant transformation are present. In countries where pathological examination is available, the therapeutic decision may differ according to the diagnosis: below knee amputation supplemented with block dissection of inguinal lymph nodes whenever possible in cases of carcinoma; below knee amputation depending on the function status of the foot and on the volume of tumor in case of pseudo-epitheliomatous hyperplasia. PMID:8209625

Grauwin, M Y; Gentile, B; Chevallard, A; Cartel, J L

1994-01-01

24

[Tumoral proliferations in chronic plantar ulcers: how to treat?].  

PubMed

Between 1983 and 1994, 66 Senegalese leprosy patients were seen for cauliflower growths developed in chronic plantar ulcer (CPU), (2 patients had each 2 tumors). 68 biopsies for pathological examination were taken: the diagnosis of squamous cell carcinoma was effectively made in 39 cases (38 patients) and that of pseudo-epitheliomatous hyperplasia in the remaining 29 cases (28 patients). The mean annual frequency of cauliflower growths was 0.45 per 100 CPU. Among these tumors, the percentage of carcinoma was 57%. Of the 38 patients with a carcinoma, 5 refused amputation and all of them died. The 33 others were amputated and of these 8 died as a direct result of their carcinoma (24%). In the case of the 28 patients with hyperplasia, amputation was carried out on 18 patients and local excision on 10. In the months following the operation 8 recurrences were observed in 10 of the patients on whom excision had been carried out. These recurrences were treated by amputation. This gives a total of 93% of amputations in the cases of hyperplasia. These facts lead as to conclude that at least in countries where pathological examination is not available below knee amputation is the most reasonable action to take in the proliferative tumors developed on a CPU. PMID:9054196

Grauwin, M Y; Mane, I; Cartel, J L

1996-01-01

25

Options for diabetic patients with chronic heel ulcers  

Microsoft Academic Search

The presence of a heel ulcer in the diabetic patient is usually due to neuropathy, vasculopathy, or both. Diagnostic testing including noninvasive assessment by nerve conduction velocity and Doppler pressure measurements can provide the basis for subsequent treatment. The diagnosis of osteomyelitis is assisted by plain radiographs, isotope definition, and\\/or magnetic resonance imaging (MRI). The loss of the calcaneus may

John J Cevera; Laura L Bolton; Morris D Kerstein

1997-01-01

26

Surgical treatment for plantar fasciitis  

Microsoft Academic Search

The results of surgical treatment of 16 patients with plantar fasciitis were reviewed. The indication for surgery was intolerable heel pain despite previous conservative measures. Patients requiring surgical treatment constituted only 7% of overall patients treated for plantar fasciitis. The surgical procedure involved an open medial partial plantar fascia release from the calcaneus and excision of calcaneal spur.A questionnaire about

A. A. Faraj; M. Z. Querishe

2002-01-01

27

How I Manage Heel Spur Syndrome.  

ERIC Educational Resources Information Center

This article discusses plantar fascitis and heel spurs, the two contributing causes of heel spur syndrome. Treatment methods, which include rest, anti-inflammatory medication, shoe padding, and, as a last resort, surgery are described. (Author/MT)

Seder, Joseph I.

1987-01-01

28

Plantar Fibroma and Plantar Fibromatosis  

MedlinePLUS

... healed but painful wound, the return of a mass, and chronic neuritic pain, especially for an invasive lesion or in revision surgery. Frequently Asked Questions ?How did I get a plantar fibroma? You ...

29

Heel pain  

MedlinePLUS

Pain - heel ... Heel pain is most often the result of overuse. Rarely, it may be caused by an injury. Your heel ... on the heel Conditions that may cause heel pain include: When the tendon that connects the back ...

30

Ultrasound guided injection of dexamethasone versus placebo for treatment of plantar fasciitis: protocol for a randomised controlled trial  

Microsoft Academic Search

BACKGROUND: Plantar fasciitis is the most commonly reported cause of chronic pain beneath the heel. Management of this condition commonly involves the use of corticosteroid injection in cases where less invasive treatments have failed. However, despite widespread use, only two randomised trials have tested the effect of this treatment in comparison to placebo. These trials currently offer the best available

Andrew M McMillan; Karl B Landorf; Mark F Gilheany; Adam R Bird; Adam D Morrow; Hylton B Menz

2010-01-01

31

Efficacy of electro-acupuncture in chronic plantar fasciitis: a randomized controlled trial.  

PubMed

The aim of the study was to investigate the efficacy of electro-acupuncture coupled with conventional treatments and compare it with the efficacy of conventional treatments alone in patients with chronic plantar fasciitis. Thirty patients with chronic refractory plantar fasciitis were randomly assigned to two groups. Subjects in the control group received five weeks of conventional treatments, including stretching exercise, shoe modification and rescue analgesics. Subjects in the acupuncture group received the same treatments plus ten sessions of electro-acupuncture twice weekly. Endpoints included a success rate determined by a minimum of a 50% decrease in Visual Analog Scale (VAS) and Foot Function Index (FFI). At the end of treatment, VAS decreased significantly from 6.00 ± 1.69 to 1.89 ± 1.59 and from 6.27 ± 2.34 to 5.40 ± 2.26 in the acupuncture and control groups, respectively. FFI decreased significantly only in the acupuncture group (p < 0.05). Subjects in the acupuncture group obtained higher success rates than those in control group (80% and 13.3%, respectively). FFI in the acupuncture group was better than those in the control group (p < 0.001). At the sixth week follow-up, subjects in the acupuncture group showed a better FFI and success rate for pain during the day than those in the control group (p < 0.05). Electro-acupuncture coupled with conventional treatments provided a success rate of 80% in chronic planar fasciitis which was more effective than conventional treatments alone. The effects lasted for at least six weeks. PMID:23227789

Kumnerddee, Wipoo; Pattapong, Nitsara

2012-01-01

32

Heel Pain in Recreational Runners.  

ERIC Educational Resources Information Center

Provides physicians with the signs, symptoms, and management of heel/sole pain in recreational runners (usually due to plantar fasciitis, Achilles tendinitis, and calcaneal stress fractures). Remedies involve palliative treatment of symptoms, correction of underlying biomechanical problems, and flexibility exercises. (SM)

Bazzoli, Allan S.; Pollina, Frank S.

1989-01-01

33

Chronic bilateral heel pain in a child with Sever disease: case report and review of literature  

PubMed Central

We are presenting a case report of a 10-year-old male with a 1 year history of bilateral heel pain. Sever disease is self limiting condition of calcaneal apophysis. It is the most common cause of heel pain in the growing child. There is no documented case of this condition in this region. This case highlights the clinical features of this self limiting disorder as seen in this patient and reviews the current literature. PMID:20069067

2009-01-01

34

Plantar fasciitis and the calcaneal spur: Fact or fiction?  

Microsoft Academic Search

BackgroundPlantar fasciitis is a common diagnosis in patients presenting with heel pain. The presence of co-existing calcaneal spurs has often been reported but confusion exists as to whether it is a casual or significant association.

K. S. Johal; S. A. Milner

35

Intraosseous lipoma of the calcaneus mimicking plantar fascitis  

Microsoft Academic Search

Benign lytic lesions of the calcaneus are rare and are usually asymptomatic. We report this case of a 55-year-old man with bilateral non-traumatic plantar heel pain, which was treated conservatively as plantar fasciitis. At three months follow-up, the patient had complete relief of symptoms in the left heel with partial relief of symptoms on the right side. However under the

K. Karthik; S. Aarthi

2011-01-01

36

Heel Pain  

MedlinePLUS

... or other soft-tissue growth. Prevention A variety of steps can be taken to avoid heel pain and accompanying afflictions: Wear shoes that fit well—front, back, and sides—and have shock-absorbent soles, rigid shanks, and supportive heel counters Wear the proper shoes for each activity Do not wear ...

37

Reliability and Validity of the Standing Heel-Rise Test  

ERIC Educational Resources Information Center

A standardized protocol for a pediatric heel-rise test was developed and reliability and validity are reported. Fifty-seven children developing typically (CDT) and 34 children with plantar flexion weakness performed three tests: unilateral heel rise, vertical jump, and force measurement using handheld dynamometry. Intraclass correlation…

Yocum, Allison; McCoy, Sarah Westcott; Bjornson, Kristie F.; Mullens, Pamela; Burton, Gay Naganuma

2010-01-01

38

Mechanical Information of Plantar Fascia during Normal Gait  

NASA Astrophysics Data System (ADS)

The plantar fascia is an important foot tissue in stabilizing the longitudinal arch of human foot. Direct measurement to monitor the mechanical situation of plantar fascia at human locomotion is difficult. The purpose of this study was to construct a three-dimensional finite element model of the foot to calculate the internal stress/strain value of plantar fascia during different stage of gait. The simulated stress distribution of plantar fascia was the lowest at heel-strike, which concentrated on the medial side of calcaneal tubercle. The peak stress of plantar fascia was appeared at push-off, and the value is more than 5 times of the heel-strike position. Current FE model was able to explore the plantar fascia tension trend at the main sub-phases of foot. More detailed fascia model and intrinsic muscle forces could be developed in the further study.

Gu, Yaodong; Li, Zhiyong

39

Classification of Parkinson gait and normal gait using Spatial-Temporal Image of Plantar pressure  

Microsoft Academic Search

The purpose of this paper is the classification of Spatial-Temporal Image of Plantar pressure (STIP) among normal step and the patients step of Parkinson disease. For this, we created a new image data, STIP, that have information of the change of plantar pressure during heel to toe motion (i.e., contain spatial and temporal information for plantar pressure). To get STIP,

Hyo-Seon Jeon; Jonghee Han; Won-Jin Yi; BeomSeok Jeon; Kwang Suk Park

2008-01-01

40

Treatment of recalcitrant plantar fasciitis by sonographically-guided needle fasciotomy  

Microsoft Academic Search

Plantar fasciotomy was carried out in 32 patients who had typical heel pain that had persisted for three months or longer. Following induction of local anesthesia, an 18-gauge needle was guided toward and into the plantar fascia by real-time sonography. The criterion for operative success was the appearance of an acoustic window within the plantar fascia. Pain intensity was graded

Y. Folman; G. Bartal; A. Breitgand; S. Shabat; N. Ron

2005-01-01

41

Subcalcaneal Bursitis With Plantar Fasciitis Treated by Arthroscopy  

PubMed Central

We report the successful arthroscopic treatment of a case of subcalcaneal bursitis with plantar fasciitis. To our knowledge, this is the first report on arthroscopic excision of a subcalcaneal bursa. Right heel pain developed in a 50-year-old woman, without any obvious cause. She reported that the heel pain occurred immediately after waking and that the heel ached when she walked. Magnetic resonance imaging showed an extra-articular, homogeneous, high-intensity lesion in the fat pad adjacent to the calcaneal tubercle on T2-weighted sagittal and coronal images and thickening of the plantar fascia on T2-weighted sagittal images. A diagnosis of a recalcitrant subcalcaneal bursitis with plantar fasciitis was made, and surgery was performed. The arthroscope was placed between the calcaneus and the plantar fascia. With the surgeon viewing from the lateral portal and working from the medial portal, the dorsal surface of the degenerative plantar fascia was debrided and the medial half of the plantar fascia was released, followed by debridement of the subcalcaneal bursal cavity through the incised plantar fascia. Full weight bearing and gait were allowed immediately after the operation. At the latest follow-up, the patient had achieved complete resolution of heel pain without a recurrence of the mass, confirmed by magnetic resonance imaging. PMID:23875139

Yamakado, Kotaro

2013-01-01

42

Plantar fasciitis  

MedlinePLUS

... 70. It is one of the most common orthopedic foot complaints. Plantar fasciitis was commonly thought to ... JA, Moeller JL, Hutchinson MR.Common issues in orthopedics. In: Rakel RE, ed. Textbook of Family Medicine . ...

43

Extracorporeal shock wave therapy for the treatment of chronic plantar fasciitis: Indications, protocol, intermediate results, and a comparison of results to fasciotomy  

Microsoft Academic Search

A review of the history, mechanism of action, and application of extracorporeal shock wave therapy for chronic plantar fasciitis is presented. The results of 40 feet treated with this modality are reviewed after a mean follow-up time of 8.4 months. All procedures were performed under intravenous sedation and local infiltrative anesthesia. An electrohydraulic shock wave with a mean of 20.6

Lowell Scott Weil Jr.; Thomas S. Roukis; Lowell Scott Weil Sr.; Anthony H. Borrelli

2002-01-01

44

Association of Achilles tendinopathy and plantar spurs.  

PubMed

Plantar spurs and Achilles tendinopathy are common causes of heel pain. In the authors' practice, it was anecdotally noted that patients with Achilles tendinopathy often presented with plantar spurs. Nonetheless, there is a shortage of studies investigating whether Achilles tendinopathy and plantar spurs exist concomitantly. A better understanding of the association between the 2 pathologies might help physicians recognize and treat both conditions, educate patients about Achilles tendinopathy and plantar spurs, and ultimately investigate possible underlying causes of both pathologies that could be addressed together. The authors examined the prevalence of plantar spurs in patients diagnosed with Achilles tendinopathy as well as demographic differences within the unilateral and bilateral Achilles tendinopathy populations. A total of 785 patient records were retrospectively reviewed. Mean patient age was 56.2±15.5 years (46.9% men and 53.1% women). Seventy-two (9.2%) patients were affected bilaterally by Achilles tendinopathy. Lateral radiographs were reviewed by an orthopedic surgeon to identify the presence of plantar spurs. A total of 329 (41.9%) patients with Achilles tendinopathy were found to have a concomitant plantar spur. Patients with unilateral Achilles tendinopathy and a plantar spur were more likely to be women (58.7% vs 49.8%, P=.020) and older (62.7 vs 51.7 years, P<.001). In the bilateral Achilles tendinopathy group, there were 46 (63.9%) patients with at least one foot presenting with a plantar spur. The study's findings suggest a significant association between Achilles tendinopathy and plantar spurs. Older women with Achilles tendinopathy are at greater risk of being affected by plantar spurs. PMID:25275977

Vulcano, Ettore; Mani, Sriniwasan; Do, Huong; Bohne, Walter H; Ellis, Scott J

2014-10-01

45

The Diagnosis and Treatment of Heel Pain: A Clinical Practice Guideline–Revision 2010  

Microsoft Academic Search

Heel pain, whether plantar or posterior, is predominantly a mechanical pathology although an array of diverse pathologies including neurologic, arthritic, traumatic, neoplastic, infectious, or vascular etiologies must be considered. This clinical practice guideline (CPG) is a revision of the original 2001 document developed by the American College of Foot and Ankle Surgeons (ACFAS) heel pain committee.

James L. Thomas; Jeffrey C. Christensen; Steven R. Kravitz; Robert W. Mendicino; John M. Schuberth; John V. Vanore; Lowell Scott Weil Sr.; Howard J. Zlotoff; Richard Bouché; Jeffrey Baker

2010-01-01

46

Ultrasound study of heel to calcaneum depth in neonates  

PubMed Central

AIM—To investigate whether it would be safe to extend the currently recommended area of sampling to the whole heel in neonates.?METHODS—Eighty newborn infants were studied, weight range 0.56 to 4.34 kg, gestation 24 to 42 weeks. Ultrasound scanning was used to measure the shortest distance between the skin and the perichondrium of the calcaneum.?RESULTS—The shortest depth of perichondrium was in the centre of the heel and ranged from 3 to 8 mm. In 78 of the 80 infants the distance was 4 mm or more. There was a small but significant positive correlation with weight.?CONCLUSIONS—Standard automated lancets for preterm use that puncture to a depth of 2.4 mm may be safely used anywhere over the plantar surface of the heel. The posterior aspect of the heel should be avoided. Reducing the density of heel pricks should reduce the associated pain.?? PMID:10212093

Jain, A.; Rutter, N.

1999-01-01

47

Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months' Follow-Up  

SciTech Connect

Purpose: To conduct a randomized trial of radiation therapy for painful heel spur, comparing a standard dose with a very low dose. Methods and Materials: Sixty-six patients were randomized to receive radiation therapy either with a total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy twice weekly (standard dose) or with a total dose of 0.6 Gy applied in 6 fractions of 0.1 Gy twice weekly (low dose). In all patients lateral opposing 4- to 6-MV photon beams were used. The results were measured using a visual analogue scale, the Calcaneodynia score, and the SF12 health survey. The fundamental phase of the study ended after 3 months, and the follow-up was continued up to 1 year. Patients with insufficient pain relief after 3 months were offered reirradiation with the standard dosage at any time afterward. Results: Of 66 patients, 4 were excluded because of withdrawal of consent or screening failures. After 3 months the results in the standard arm were highly significantly superior compared with those in the low-dose arm (visual analogue scale, P=.001; Calcaneodynia score, P=.027; SF12, P=.045). The accrual of patients was stopped at this point. Further evaluation after 12 months' follow-up showed the following results: (1) highly significant fewer patients were reirradiated in the standard arm compared with the low-dose arm (P<.001); (2) the results of patients in the low-dose arm who were reirradiated were identical to those in the standard arm not reirradiated (reirradiation as a salvage therapy if the lower dose was ineffective); (3) patients experiencing a favorable result after 3 months showed this even after 12 months, and some results even improved further between 3 and 12 months. Conclusions: This study confirms the superior analgesic effect of radiation therapy with 6-Gy doses on painful heel spur even for a longer time period of at least 1 year.

Niewald, Marcus, E-mail: marcus.niewald@uks.eu [Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar (Germany)] [Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar (Germany); Seegenschmiedt, M. Heinrich [Radiotherapy Center, Hamburg (Germany)] [Radiotherapy Center, Hamburg (Germany); Micke, Oliver [Franziskus Hospital, Bielefeld (Germany)] [Franziskus Hospital, Bielefeld (Germany); Graeber, Stefan [Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, Homburg/Saar (Germany)] [Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, Homburg/Saar (Germany); Muecke, Ralf [Lippe Hospital, Lemgo (Germany)] [Lippe Hospital, Lemgo (Germany); Schaefer, Vera; Scheid, Christine; Fleckenstein, Jochen; Licht, Norbert; Ruebe, Christian [Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar (Germany)] [Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar (Germany)

2012-11-15

48

Heel reconstruction with free instep flap: a case report  

PubMed Central

Introduction Reconstruction of weight-bearing heel defects remains a challenge because of the unique characteristics of the plantar skin. Though numerous surgical reconstructive options have been reported, the instep flap represents an ideal option and seems to be more acceptable to patients than others. However, when the heel defect expands to the instep area, the ipsilateral instep is not available for flap elevation. A free instep flap harvested from the contralateral foot can be a good solution, but this method has been scarcely reported. Case presentation A 41-year-old Asian man presented to our institution with a soft-tissue lesion in the weight-bearing heel and instep area. His heel was reconstructed with a free instep flap from the other foot, end-to-side anastomosis of its medial plantar artery to the recipient posterior tibial artery and end-to-side coaptation of the cutaneous sensory fascicles of the flap to the medial plantar nerve. Conclusion The flap survived successfully, and no ulceration occurred in the flap. At the last follow-up appointment at 30 months post-surgery, a very good functional and aesthetic outcome was verified, indicating that the suggested approach may prove to be the treatment of choice in selected cases of weight-bearing heel reconstruction. PMID:25260532

2014-01-01

49

How We Manage Plantar Fasciitis (With Memory Jogger).  

ERIC Educational Resources Information Center

Common among runners and athletes who participate in jumping sports, plantar fasciitis is an overuse injury that is potentially incapacitating, causes heel and arch pain, and usually occurs after sudden increases in running mileage, frequency, or speed. Therapy is described. (Author/CB)

Tanner, Suzanne M.; Harvey, Jack S.

1988-01-01

50

Children with ADHD Show No Deficits in Plantar Foot Sensitivity and Static Balance Compared to Healthy Controls  

ERIC Educational Resources Information Center

The goal of this study was to investigate plantar foot sensitivity and balance control of ADHD (n = 21) impaired children compared to age-matched healthy controls (n = 25). Thresholds were measured at 200 Hz at three anatomical locations of the plantar foot area of both feet (hallux, first metatarsal head (METI) and heel). Body balance was…

Schlee, Gunther; Neubert, Tom; Worenz, Andreas; Milani, Thomas L.

2012-01-01

51

Biomechanical evaluation of heel elevation on load transfer — experimental measurement and finite element analysis  

NASA Astrophysics Data System (ADS)

In spite of ill-effects of high heel shoes, they are widely used for women. Hence, it is essential to understand the load transfer biomechanics in order to design better fit and comfortable shoes. In this study, both experimental measurement and finite element analysis were used to evaluate the biomechanical effects of heel height on foot load transfer. A controlled experiment was conducted using custom-designed platforms. Under different weight-bearing conditions, peak plantar pressure, contact area and center of pressure were analyzed. A three-dimensional finite element foot model was used to simulate the high-heel support and to predict the internal stress distributions and deformations for different heel heights. Results from both experiment and model indicated that heel elevations had significant effects on all variables. When heel elevation increased, the center of pressure shifted from the midfoot region to the forefoot region, the contact area was reduced by 26% from 0 to 10.2 cm heel and the internal stress of foot bones increased. Prediction results also showed that the strain and total tension force of plantar fascia was minimum at 5.1 cm heel condition. This study helps to better understand the biomechanical behavior of foot, and to provide better suggestions for design parameters of high heeled shoes.

Luximon, Yan; Luximon, Ameersing; Yu, Jia; Zhang, Ming

2012-02-01

52

Effect of heel construction on muscular control potential of the ankle joint in running.  

PubMed

The purpose of this study was to investigate the effect of heel construction on ankle joint mechanics during the early stance phase of running. Kinematic and kinetic parameters (ankle joint angles, angular velocities and joint moments, lever arms of ground reaction force, triceps surae muscle tendon unit lengths, and rates of muscle tendon unit length change) were calculated from 19 male subjects running at 3.3 m/s in shoes with different heel constructions. Increasing heel height and posterior wedging amplified initial plantar flexion velocity and range. The potential for a muscle to control the movement of a joint depends upon its ability to produce joint moments. Runners in this study showed decreased external eversion moments and an increase in eversion range. Maximum eversion angles were not significantly affected by shoe conditions. Without considerable tendon prestretch, joint moment generation potentials of triceps surae and deep plantar flexors might be inhibited due to rapid plantar flexion based on the force-velocity relationship. It could be speculated that increasing ankle inversion at heel strike could be a strategy to keep maximum eversion angles inside an adequate range, if joint moment generation potentials of deep plantar flexors are inhibited due to rapid plantar flexion. PMID:23434878

Willwacher, Steffen; Potthast, Wolfgang; Konrad, Markus; Brüggemann, Gert-Peter

2013-12-01

53

Development of a finite element model of female foot for high-heeled shoe design  

Microsoft Academic Search

BackgroundWearing high-heeled shoes may produce deleterious effects on the musculoskeletal system while elevation of the shoe heel with arch insole insert is used as a treatment strategy for plantar fasciitis. Due to limitations of the experimental approaches, direct measurements of internal stress\\/strain of the foot are impossible or invasive. This study aims at developing a finite element model for evaluating

Jia Yu; Jason Tak-Man Cheung; Yubo Fan; Yan Zhang; Aaron Kam-Lun Leung; Ming Zhang

2008-01-01

54

Analysis of muscular fatigue and foot stability during high-heeled gait  

Microsoft Academic Search

Plantar pressure measurements and surface electromyography (EMG) were used to determine the effects of muscular fatigue induced by high-heeled gait. The medio-lateral (M\\/L) stability of the foot was characterized by measuring the M\\/L deviations of the center of pressure (COP) and correlating these data with fatigue of lower-limb muscles seen on EMG. EMG measurements from habitual high-heeled shoe wearers demonstrated

Amit Gefen; M. Megido-Ravid; Y. Itzchak; M. Arcan

2002-01-01

55

Detachable high heel shoe construction  

E-print Network

The goal on this investigation was to develop a detachable high heel shoe construction that could enter the current high heel market. The impact of high heel shoes on women's fashion is enormous but there are associated ...

Morales, Alfredo Louis

2007-01-01

56

Pediatric heel pain.  

PubMed

Heel pain is a common complaint among young children and adolescents. It has many causes, including trauma, overuse injuries, and tumors, and therefore a thorough clinical examination is warranted. This article outlines some common causes of pediatric heel pain. PMID:24075133

Joseph, Alison M; Labib, Irene K

2013-10-01

57

Percutaneous Bipolar Radiofrequency Microdebridement for Recalcitrant Proximal Plantar Fasciosis  

Microsoft Academic Search

Success rates for traditional methods of surgical intervention for chronic plantar fasciosis are low, and associated with high rates of complications and long recovery times. The purpose of this prospective case series was to assess the effectiveness of percutaneous bipolar radiofrequency microfasciotomy for the treatment of recalcitrant proximal plantar fasciosis in 21 patients. The mean preoperative American Orthopaedic Foot &

Matthew D. Sorensen; Christopher F. Hyer; Terrence M. Philbin

2011-01-01

58

Diabetic foot ulcer incidence in relation to plantar pressure magnitude and measurement location?,??,?  

PubMed Central

Aims We prospectively examined the relationship between site-specific peak plantar pressure (PPP) and ulcer risk. Researchers have previously reported associations between diabetic foot ulcer and elevated plantar foot pressure, but the effect of location-specific pressures has not been studied. Methods Diabetic subjects (n = 591) were enrolled from a single VA hospital. Five measurements of in-shoe plantar pressure were collected using F-Scan. Pressures were measured at 8 areas: heel, lateral midfoot, medial midfoot, first metatarsal, second through fourth metatarsal, fifth metatarsal, hallux, and other toes. The relationship between incident plantar foot ulcer and PPP or pressure–time integral (PTI) was assessed using Cox regression. Results During follow-up (2.4 years), 47 subjects developed plantar ulcers (10 heel, 12 metatarsal, 19 hallux, 6 other). Overall mean PPP was higher for ulcer subjects (219 vs. 194 kPa), but the relationship differed by site (the metatarsals with ulcers had higher pressure, while the opposite was true for the hallux and heel). A statistical analysis was not performed on the means, but hazard ratios from a Cox survival analysis were nonsignificant for PPP across all sites and when adjusted for location. However, when the metatarsals were considered separately, higher baseline PPP was significantly associated with greater ulcer risk; at other sites, this relationship was nonsignificant. Hazard ratios for all PTI data were nonsignificant. Conclusions Location must be considered when assessing the relationship between PPP and plantar ulceration. PMID:24012295

Ledoux, William R.; Shofer, Jane B.; Cowley, Matthew S.; Ahroni, Jessie H.; Cohen, Victoria; Boyko, Edward J.

2014-01-01

59

Plantar Wart (Verruca Plantaris)  

MedlinePLUS

... Wart (Verruca Plantaris) Text Size Print Bookmark Plantar Wart (Verruca Plantaris) What is a Plantar Wart? A wart is a small growth on the skin that ... when the skin is infected by a virus. Warts can develop anywhere on the foot, but typically ...

60

Effect of Field Size and Length of Plantar Spur on Treatment Outcome in Radiation Therapy of Plantar Fasciitis: The Bigger the Better?  

SciTech Connect

Purpose: Radiation therapy is well established in the treatment of painful plantar fasciitis or heel spur. A retrospective analysis was conducted to investigate the effect of field definition on treatment outcome and to determine the impact of factors potentially involved. Methods and Materials: A review of treatment data of 250 patients (285 heels) with a mean follow-up time of 11 months showed that complete symptom remission occurred in 38%, partial remission in 32%, and no change in 19% (11% were lost to follow-up). Variables such as radiologic evidence of plantar spurs, their length, radiation dose, field size, age, sex, and onset of pain before administration of radiation therapy were investigated in univariate and multivariate regression analyses. Results: Treatment response depended upon age >53 years, length of heel spur ?6.5 mm (or no radiologic evidence of a heel spur), and onset of pain <12 months before radiation therapy. Patients with these clinical prerequisites stood a 93% chance of clinical response. Without these prerequisites, only 49% showed any impact. No influence of field size on treatment outcome became evident. Conclusion: Patients with short plantar heel spurs benefit from radiation therapy equally well as patients without any radiologic evidence. Moreover, smaller field sizes have the same positive effect as commonly used large field definitions covering the entire calcaneal bone. This leads to a recommendation of a considerable reduction of field size in future clinical practice.

Hermann, Robert Michael, E-mail: hermann@strahlentherapie-westerstede.com [Zentrum für Strahlentherapie und Radioonkologie, Bremen/Westerstede (Germany); Abteilung Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover (Germany); Meyer, Andreas [Abteilung Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover (Germany); Gemeinschaftspraxis für Strahlentherapie Hildesheim/Goslar (Germany); Becker, Alexandra [Zentrum für Strahlentherapie und Radioonkologie, Bremen/Westerstede (Germany); Schneider, Michael [Orthopaedic Centre for Musculoskeletal Research, University of Würzburg (Germany); Reible, Michael; Carl, Ulrich Martin [Zentrum für Strahlentherapie und Radioonkologie, Bremen/Westerstede (Germany); Christiansen, Hans [Abteilung Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover (Germany); Nitsche, Mirko [Zentrum für Strahlentherapie und Radioonkologie, Bremen/Westerstede (Germany); Klinik für Strahlentherapie, Karl-Lennert-Krebscentrum, Universität Kiel (Germany)

2013-12-01

61

Soft-tissue osteochondroma of the heel pad: A case report and review of literature  

Microsoft Academic Search

Extraskeletal osteochondroma of the foot are rare benign cartilaginous tumours. We present a case of soft-tissue osteochondroma in the heel pad superficial to the postero-inferior aspect of the calcaneus. We propose the pathogenesis of this lesion might be related to metaplasia in the plantar aponeurosis as described in literature, or it may be a fracture of the calcaneal osteochondroma, growing

Roop Singh; Mantu Jain; Ramchander Siwach; Rajeev Sen; Rajesh Kumar Rohilla; Kiranpreet Kaur

2010-01-01

62

Reconstruction of lateral forefoot using reversed medial plantar flap with free anterolateral thigh flap.  

PubMed

Skin defects of the heel have frequently been reconstructed using the medial plantar flap; however, forefoot coverage has remained a challenge, because the alternatives for flap coverage have been very limited. We describe a case of malignant melanoma on the lateral forefoot that was radically removed and reconstructed successfully with a distally based medial plantar flap, together with a free anterolateral thigh flap. The advantages of this flap include that it does not reduce the vascular supply to the foot owing to reconstruction of the medial plantar vascular systems, reduces the risk of flap congestion, minimizes donor site morbidity, and enables the transport of structurally similar tissues to the plantar forefoot. We believe this technique is a reasonable reconstructive option for large lateral plantar forefoot defects. PMID:24534560

Fujioka, Masaki; Hayashida, Kenji; Senju, Chikako

2014-01-01

63

Synovial Sarcoma Involving the Calcaneus and Plantar Compartment of the Foot: A Case Report  

Microsoft Academic Search

Synovial sarcoma arising in the foot is a rare finding. We report a 64-year-old female with synovial sarcoma involving the calcaneus and central plantar compartment. The patient presented with a 2-year history of painful heel with soft tissue mass presentation 21 months after initial pain. We performed an incisional biopsy with frozen section; histopathology was consistent with synovial sarcoma.

John Haight; Russell Caprioli; Michael Esposito; Antonio Macias; Maria Lucchese; Elijah Davis

2010-01-01

64

Plantar fascia (image)  

MedlinePLUS

The plantar fascia is a very thick band of tissue that covers the bones on the bottom of the foot. It ... band of tissue causes a high arch. This fascia can become inflamed and painful in some people, ...

65

Chiropractic management of pediatric plantar fasciitis: a case report  

PubMed Central

Objective The purpose of this report is to present the case of a 10-year-old football player with bilateral plantar fasciitis who improved with a multimodal conservative approach using chiropractic treatment. Clinical Features The patient presented with bilateral plantar heel pain at the origin of the plantar fascia with a duration of 3 weeks. Intervention and Outcome Treatment was provided for 6 visits over a 6-week period. Chiropractic care consisted of manipulative therapy, soft tissue therapy, and home rehabilitation exercises. The soft tissue technique (Graston Technique) was performed to the origin of the plantar fascia and the triceps surae bilaterally. High-velocity, low-amplitude manipulation was applied to the restricted ankle mortise joint. After 6 treatments, the patient reported resolution of foot pain bilaterally and improvements in activities of daily livings. Three months later, the patient reported no further complications and the absence of pain. Conclusion This patient with bilateral plantar fasciitis improved after a course of a multimodal treatment approach using chiropractic manipulation and soft tissue therapy in addition to exercise and stretching therapies. PMID:22942843

Daniels, Clinton J.; Morrell, Adam P.

2012-01-01

66

A new method to normalize plantar pressure measurements for foot size and foot progression angle.  

PubMed

Plantar pressure measurement provides important information about the structure and function of the foot and is a helpful tool to evaluate patients with foot complaints. In general, average and maximum plantar pressure of 6-11 areas under the foot are used to compare groups of subjects. However, masking the foot means a loss of important information about the plantar pressure distribution pattern. Therefore, the purpose of this study was to develop and test a simple method that normalizes the plantar pressure pattern for foot size, foot progression angle, and total plantar pressure. Moreover, scaling the plantar pressure to a standard foot opens the door for more sophisticated analysis techniques such as pattern recognition and machine learning. Twelve subjects walked at preferred and half of the preferred walking speed over a pressure plate. To test the method, subjects walked in a straight line and in an approaching angle of approximately 40 degrees . To calculate the normalized foot, the plantar pressure pattern was rotated over the foot progression angle and normalized for foot size. After normalization, the mean shortest distance between the contour lines of straight walking and walking at an angle had a mean of 0.22 cm (SD: 0.06 cm) for the forefoot and 0.14 cm (SD: 0.06 cm) for the heel. In addition, the contour lines of normalized feet for the various subjects were almost identical. The proposed method appeared to be successful in aligning plantar pressure of various feet without losing information. PMID:19056086

Keijsers, N L W; Stolwijk, N M; Nienhuis, B; Duysens, J

2009-01-01

67

High Heels in 2010?  

Microsoft Academic Search

The author discusses modern dress codes that require female employees to wear skirts and high heels, and which the Equal Employment Opportunity Commission has generally held, and courts have ratified, that employers may establish varying dress codes for men and women without violating discrimination laws.

Shailee Diwanji

2010-01-01

68

Heel pain and HIV-associated lipodystrophy: a report of two cases  

PubMed Central

Plantar fasciitis is diagnosed based on a pathognomonic clinical presentation and physical examination including plantar heel pain with the initial few steps after a period of inactivity. People living with HIV/AIDS, who are taking anti-retroviral medications, often have an associated redistribution of body fat (lipodystrophy). Lipoatrophy of the extremities may involve the heel fat-pad in this population and result in the signs and symptoms of plantar fasciitis. Two cases of plantar heel pain in HIV-associated lipodystrophy are presented to discuss the possible clinical association between the two conditions. Although conservative therapies have limited evidence, they are commonly used and have been seen, clinically, to result in a resolution of symptoms. In the presented cases, the individuals benefited from soft tissue therapy, modalities, activity modification and education on proper footwear. Clinicians should be aware that the association between these two conditions may be a significant cause of morbidity in a population of patients with HIV. PMID:18516231

Stupar, Maja; Tibbles, Anthony

2008-01-01

69

Heel to toe motion characteristics in Parkinson patients during free walking  

Microsoft Academic Search

Objective. Plantar pressures of Parkinson patients in a mild or moderate stage of the disease were analyzed in order to determine characteristics of the heel to toe motion of the foot in Parkinson patients during free walking.Design. Pressure sensitive insoles were used to quantify the in-shoe pressure distribution for 24 patients with Parkinson's disease and for 24 age-matched healthy adults.

Stefan Kimmeskamp; Ewald M. Hennig

2001-01-01

70

Imaging of plantar fascia and Achilles injuries undertaken at the London 2012 Olympics.  

PubMed

Plantar fascia and distal Achilles injuries are common in elite athletes. Acute athletic injuries of the plantar fascia include acute plantar fasciopathy and partial or complete tears. Underlying most acute injuries is a background of underlying chronic plantar fasciopathy. Injuries may affect the central or less commonly lateral portions of the fascia and acute tears are generally proximal. Athletic Achilles injuries may occur at the mid tendon or the distal insertion, and there may be an underlying chronic tendinopathy. Acute or chronic paratendinopathy may occur as a separate entity or combined with Achilles injury. In this article, the spectrum of athletic injuries of the plantar fascia and Achilles is described, illustrated by imaging findings from the London 2012 Olympic games. PMID:23903598

Elias, David A; Carne, Andrew; Bethapudi, Sarath; Engebretsen, Lars; Budgett, Richard; O'Connor, Philip

2013-12-01

71

Spatial relationships between shearing stresses and pressure on the plantar skin surface during gait.  

PubMed

Based on the hypothesis that diabetic foot lesions have a mechanical etiology, extensive efforts have sought to establish a relationship between ulcer occurrence and plantar pressure distribution. However, these factors are still not fully understood. The purpose of this study was to simultaneously record shear and pressure distributions in the heel and forefoot and to answer whether: (i) peak pressure and peak shear for anterior-posterior (AP) and medio-lateral (ML) occur at different locations, and if (ii) peak pressure is always centrally located between sites of maximum AP and ML shear stresses. A custom built system was used to collect shear and pressure data simultaneously on 11 subjects using the 2-step method. The peak pressure was found to be 362 kPa ± 106 in the heel and 527 kPa ± 123 in the forefoot. In addition, the average peak shear values were higher in the forefoot than in the heel. The greatest shear on the plantar surface of the forefoot occurred in the anterior direction (mean and std. dev.: 37.7 ± 7.6 kPa), whereas for the heel, peak shear the foot was in the posterior direction (21.2 ± 5 kPa). The results of this study suggest that the interactions of the shear forces caused greater "spreading" in the forefoot and greater tissue "dragging" in the heel. The results also showed that peak shear stresses do not occur at the same site or time as peak pressure. This may be an important factor in locating where skin breakdown occurs in patients at high-risk for ulceration. PMID:22169152

Stucke, Samantha; McFarland, Daniel; Goss, Larry; Fonov, Sergey; McMillan, Grant R; Tucker, Amy; Berme, Necip; Cenk Guler, Hasan; Bigelow, Chris; Davis, Brian L

2012-02-01

72

On muscle, tendon and high heels.  

PubMed

Wearing high heels (HH) places the calf muscle-tendon unit (MTU) in a shortened position. As muscles and tendons are highly malleable tissues, chronic use of HH might induce structural and functional changes in the calf MTU. To test this hypothesis, 11 women regularly wearing HH and a control group of 9 women were recruited. Gastrocnemius medialis (GM) fascicle length, pennation angle and physiological cross-sectional area (PCSA), the Achilles' tendon (AT) length, cross-sectional area (CSA) and mechanical properties, and the plantarflexion torque-angle and torque-velocity relationships were assessed in both groups. Shorter GM fascicle lengths were observed in the HH group (49.6+/-5.7 mm vs 56.0+/-7.7 mm), resulting in greater tendon-to-fascicle length ratios. Also, because of greater AT CSA, AT stiffness was higher in the HH group (136.2+/-26.5 N mm(-1) vs 111.3+/-20.2 N mm(-1)). However, no differences in the GM PCSA to AT CSA ratio, torque-angle and torque-velocity relationships were found. We conclude that long-term use of high-heeled shoes induces shortening of the GM muscle fascicles and increases AT stiffness, reducing the ankle's active range of motion. Functionally, these two phenomena seem to counteract each other since no significant differences in static or dynamic torques were observed. PMID:20639419

Csapo, R; Maganaris, C N; Seynnes, O R; Narici, M V

2010-08-01

73

Forging............ Crowding.................... Lagging............ Heeling wide...............  

E-print Network

your dog, Leave your dog, Down, Sit, Call Dog Finish Exercise finished Forging............... Crowding Stand and Exam Glove # ______ Send your dog Take it Finish Exercise finished Forward Stand your dog (full exam) Call your dog to heel Exercise finished Displays fear or resentment

New Hampshire, University of

74

A comparative study of efficacy of oral nonsteroidal antiinflammatory agents and locally injectable steroid for the treatment of plantar fasciitis  

PubMed Central

Objectives: To compare the effectiveness of oral nonsteroidal antiinflammatory drugs (NSAIDs) and locally injectable steroid (methylprednisolone) in the treatment of plantar fasciitis. Materials and Methods: One hundred and twenty subjects with unilateral plantar fasciitis were recruited and randomly allocated to two study groups. Group I (NSAIDs group) (n=60) received oral tablet diclofenac (50 mg) and paracetamol (500 mg) twice a day (BD) along with tab. ranitidine 150 mg BD. Group II (injectable steroid group) (n=60) received injection of 1 ml of methylprednisolone (Depomedrol) (40 mg) and 2 ml of 0.5% bupivacaine into the inflammed plantar fascia. Pain intensity was measured using 10 cm visual analog scale (VAS). Subjects were evaluated clinically before, and 1 week, 2 weeks, 4 weeks, and 8 weeks (2 months) after the initiation of treatment in both the groups. The outcome was assessed in terms of VAS score and recurrence of the heel pain. Statistical Analysis Used: “Z” test and Chi-square test were used wherever applicable. Results: Pain relief was significant after steroid injection (P<0.001) and the improvement was sustained. The recurrence of heel pain was significantly higher in the oral NSAIDS group (P<0.001). Conclusion: Local injection of steroid is more effective in the treatment of plantar fasciitis than oral NSAIDs.

Biswas, Chaitali; Pal, Anirban; Acharya, Amita

2011-01-01

75

Effect of variable body mass on plantar foot pressure and off-loading device efficacy.  

PubMed

An increasing body of evidence has implicated obesity as having a negative effect on the development, treatment, and outcome of lower extremity pathologic entities, including diabetic foot disease. The objective of the present study was to increase the body of knowledge with respect to the effects of obesity on foot function. Specifically, we attempted to (1) describe the relationship between an increasing body mass index (BMI) on plantar foot pressures during gait, and (2) evaluate the efficacy of commonly prescribed off-loading devices with an increasing BMI. A repeated measures design was used to compare the peak plantar foot pressures under multiple test conditions, with the volunteers acting as their own controls. The primary outcome measure was the mean peak plantar pressure in the heel, midfoot, forefoot, and first metatarsal, and the 2 variables were modification of patient weight (from "normal" BMI to "overweight," "obese," and "morbidly obese") and footwear (from an athletic sneaker to a surgical shoe, controlled ankle motion walker, and total contact cast). Statistically significant increases in the peak plantar pressures were observed with increasing volunteer BMI weight class, regardless of the off-loading device used. The present investigation has provided unique and specific data with respect to the changes that occur in the peak plantar pressures with variable BMIs across different anatomic levels and with commonly used off-loading devices. From our results, we have concluded that although the plantar pressures increase with increasing weight, it appears that at least some reduction in pressure can be achieved with an off-loading device, most effectively with the total contact cast, regardless of the patient's BMI. PMID:24735742

Pirozzi, Kelly; McGuire, James; Meyr, Andrew J

2014-01-01

76

Plantar Fasciitis: Prescribing Effective Treatments.  

ERIC Educational Resources Information Center

Plantar fasciitis is an extremely common, painful injury seen among people in running and jumping sports. While prognosis for recovery with conservative care is excellent, prolonged duration of symptoms affects sports participation. Studies on treatment options show mixed results, so finding effective treatments can be challenging. A logical…

Shea, Michael; Fields, Karl B.

2002-01-01

77

Finite element modelling of plantar pressure beneath the second ray with flexor muscle loading.  

PubMed

INTRODUCTION:: Little is understood about the effects of flexor loading on plantar pressure distribution. The goal of the current work is to model flexor muscle loading applied to the distal phalanges in order to study the effect of these loads on plantar normal stress (pressure) beneath the metatarsal head. METHODS:: The finite element model is a two-dimensional, plane strain sagittal section incorporating the second metatarsal, proximal phalanx, and plantar and dorsal soft tissue (Figure 1). The metatarsophalangeal joint is simulated by a nodal hinge that transfers loads and produces reasonable kinematic motion between the articular surfaces of the proximal[Figure: see text] phalanx and metatarsal head. Soft tissues are simulated by a uniform continuum. A single flexor tendon passes over the condyle of the metatarsal heads with sliding contact against intervening soft tissue, and is attached to the distal end of the proximal phalanx. A rigid element at the proximal end is fixed by boundary conditions to simulate reactions at the distal cuneiform joint. Material properties of bone are from published values, one tenth the stiffness of bone is used for the flexor tendon, and the soft tissue continuum is hyperelastic using coefficients obtained from compression of the heel plantar fat pad. A 188 N vertical ground reaction force and a flexor tendon load at a 10 degree angle from the X (horizontal) axis are applied to the model. RESULTS:: Figure 2 shows Y direction normal stress distribution along the plantar surface for two load cases: no load and a 250 N load to the flexor tendon. DISCUSSION:: Bending moments at the proximal metatarsal correspond to values obtained by Sharkey et al. Tension in the flexor tendon served to counter the moment in the metatarsal created by the vertical load, and at the same time, to apply an additional axial load. Under flexor loading, focal plantar pressure shifts toward the proximal phalanx and yields a 60% reduction in peak pressure, indicative of the load sharing between the sub-metatarsal head and subphalangeal regions. [Figure: see text] CONCLUSIONS:: The model yields verifiable and reasonable reactions and a significant relationship between flexor muscle loading and peak plantar pressure. Refinement of the model, such as adding the middle and distal phalanges, should reveal further insight into the mechanics of plantar loading. PMID:11415715

Lemmon, DR; Cavanagh, PR

1997-04-01

78

Description of plantar pressure distribution in athletes  

Microsoft Academic Search

BackgroundLower extremities injuries caused by non-body contact are highly prevalent in sports. Repetitive high loads on the foot could cause these injuries. Plantar pressure refers to the pressure measured on the plantar surface of the foot.ObjectiveTo measure the plantar pressure in soccer and basketball players.DesignDescriptive study.SettingSoccer and basketball players enrolled in elite division leagues.ParticipantsPlayers were selected from the teams of

F Esparza; J Abellàn; P Ibañez; J M Sànchez Ayuso

2011-01-01

79

Higher plantar pressure on the medial side in four soccer-related movements  

PubMed Central

Objective To measure the plantar pressure in four soccer?related movements in 15 male soccer players (mean (SD) age 20.9 (1.3)?years, height 173 (4)?cm, weight 61.7 (3.6)?kg). Design To record plantar pressure distribution, the players wore soccer boots with 12 circular studs and with an insole pressure recorder device equipped with 99 sensors. Plantar pressure was recorded in five successful trials in each of the four soccer?related movements: running, sideward cutting, 45° cutting and landing from a vertical jump. Each footprint was divided into 10 recorded areas for analysis. Results Compared with running at 3.3?m/s, maximal speed sideward cutting and 45° cutting induced higher peak pressure (p<0.05) under the second toe, medial forefoot, medial arch and medial heel. The peak pressure of the maximal jump landing was lower under the medial forefoot and lateral forefoot as compared with running (p<0.05). The pressure–time integral showed that sideward cutting and 45° cutting induced higher pressures (p<0.05) than running for all recorded areas, except for the lateral forefoot and the lateral arch. In all the four soccer?related movements, a higher pressure was found on the medial side of the plantar surface as compared with the lateral side. Conclusions These data suggest that the medial side of the plantar surface may be more prone to injuries, and that foot orthosis adoption, improved soccer boot design and specific muscle training could be considered to reduce pressure and the subsequent risk of injury. PMID:17178776

Wong, Pui-lam; Chamari, Karim; De Wei Mao; Wisl?ff, Ulrik; Hong, Youlian

2007-01-01

80

The compressive mechanical properties of diabetic and non-diabetic plantar soft tissue  

PubMed Central

Diabetic subjects are at an increased risk of developing plantar ulcers. Knowledge of the physiologic compressive properties of the plantar soft tissue is critical to understanding possible mechanisms of ulcer formation and improving treatment options. The purpose of this study was to determine the compressive mechanical properties of the plantar soft tissue in both diabetic and non-diabetic specimens from six relevant locations beneath the foot, namely the hallux (big toe), first, third, and fifth metatarsal heads, lateral midfoot, and calcaneus (heel). Cylindrical specimens (1.905cm diameter) from these locations were excised and separated from the skin and bone from 4 diabetic and 4 non-diabetic age-matched, elderly, fresh-frozen cadaveric feet. Specimens were then subjected to biomechanically realistic strains of ?50% in compression using triangle wave tests conducted at five frequencies ranging from 1 to 10 Hz to determine tissue modulus, energy loss, and strain rate dependence. Diabetic vs. non-diabetic results across all specimens, locations, and testing frequencies demonstrated altered mechanical properties with significantly increased modulus (1146.7 vs. 593.0kPa) but no change in energy loss (68.5 vs. 67.9%). All tissue demonstrated strain rate dependence and tissue beneath the calcaneus was found to have decreased modulus and energy loss compared to other areas. The results of this study could be used to generate material properties for all areas of the plantar soft tissue in diabetic or non-diabetic feet, with implications for foot computational modeling efforts and potentially for pressure alleviating footwear that could reduce plantar ulcer incidence. PMID:20207359

Pai, Shruti; Ledoux, William R.

2010-01-01

81

Practice Recommendations for Preventing Heel Pressure Ulcers  

Microsoft Academic Search

Heels are the second most common anatomical location for pressure ulcers. A combination of risk factors, including pressure, may cause ulceration. Heel pressure ulcers are a particular concern for surgical patients. A review of the literature, including poster presentations, shows that controlled clinical studies to assess the effectiveness and cost-effectiveness of available interventions are not available. Case series (with or

Evonne Fowler; Suzy Scott-Williams; James B. McGuire

82

An Unusual Cause of Intractable Heel Pain  

Microsoft Academic Search

We report a case of severe heel pain that did not respond to noninvasive measures. Magnetic resonance imaging scans revealed a soft tissue mass that after complete surgical excision was found to be an epidermal cyst. The patient experienced full resolution of the symptoms after excision of the epidermal cyst. To our knowledge, intractable heel pain due to an epidermal

Samuel Ghani; Muhammad Ali Fazal

2011-01-01

83

A 4-week instructed minimalist running transition and gait-retraining changes plantar pressure and force.  

PubMed

The purpose of this study is to compare changes in plantar pressure and force using conventional running shoes (CRS) and minimalist footwear (MFW) pre and post a 4-week MFW familiarization period. Ten female runners (age: 21?±?2 years; stature: 165.8?±?4.5?cm; mass: 55.9?±?3.2?kg) completed two 11?km/h treadmill runs, 24 hours apart, in both CRS and MFW (pretest). Plantar data were measured using sensory insoles for foot strike patterns, stride frequency, mean maximum force ( M ? F ¯ ), mean maximum pressure ( M ? P ¯ ) and eight mean maximum regional pressures. Subjects then completed a 4-week familiarization period consisting of running in MFW and simple gait-retraining, before repeating the tests (posttest). During the pretests, 30% of subjects adopted a forefoot strike in MFW, following familiarization this increased to 80%; no change occurred in CRS. A significant decrease in M ? F ¯ in both MFW and CRS (P?=?0.024) was observed from pre-post, and a significant decrease in heel pressures in MFW. M ? P ¯ was higher in MFW throughout testing (P?heel pressures. Higher M ? P ¯ was observed throughout testing in the MFW condition. PMID:24004458

Warne, J P; Kilduff, S M; Gregan, B C; Nevill, A M; Moran, K A; Warrington, G D

2014-12-01

84

Neurotized distally based sural flap for heel reconstruction.  

PubMed

The use of local flaps for the reconstruction of leg has lost their popularity with the more often performed flaps on the basis of perforators and microsurgical technique. Like the head and neck reconstruction, in the lower extremity there are limited units of tissue to base the flaps because of the lack of vascularity and arc of mobilization. The distally based sural flap represents an ideal flap for the reconstruction of heel, and with the inclusion of the sural nerve, we can neurotize the flap to give the stability of a weight-bearing area and provide the necessary sensibility to avoid ulcerations of the reconstructed heel. We present a case of a 32-year-old woman with a traumatic loss of the tissue covering the heel, with a diagnosis of a pseudoepithelial hyperplasia treated in previous occasions with skin grafts that led to chronic ulcerations. A distally based sural flap was planned for a definitive coverage, planning a perineural neurorrhaphy, to the intermediate dorsal cutaneous branch of the superficial peroneal nerve to give sensibility to the flap. PMID:23757153

Mendieta, Mauricio J; Roblero, Carlos; Vega, Juan C

2013-10-01

85

Heel ulcer and blood flow: the importance of the angiosome concept.  

PubMed

A young female diabetic patient is reported, who presented with a double foot lesion. She presented with a first metatarsal head exposure concomitant with a heel wet gangrene. Magnetic resonance demonstrated osteomyelitis of the rear portion of the calcaneus. Transmetatarsal amputation was performed and a wide debridement was required to remove all gangrenous tissue from the heel wound. The pedal artery was palpable; the posterior tibial pulse was present, but weak.Transcutaneous oximetry (TcPO2) at the dorsum of the foot was TcPO2 = 56 mmHg despite significant oedema. Nevertheless, TcPO2 on the perilesional area of the heel ulcer (TcPO2 = 24mmHg) was suggestive for critical chronic ischemia. At angiographic examination, anterior tibial and peroneal arteries were patent, but the posterior tibial artery that showed severe stenosis then percutaneous angioplasty (PTA) was performed. Just the day after PTA, values of TcPO2 at the perilesional area of the heel ulcer increased to 41 mmHg. Heel osteomyelitis was subsequently treated by partial calcanectomy. The patient was discharged after a 21-day hospital stay. In the treatment of heel ulcers, it is clinically useful to use the angiosomic concept. The majority of the blood supply to the heel is provided by the posterior tibial artery, and only to a small extent by the posterior branch of peroneal artery. If the decrease in blood flow to this region is not detected, and direct flow based on the angiosome concept is not obtained, the healing of a heel ulcer may be delayed or impaired. PMID:24043681

Faglia, Ezio; Clerici, Giacomo; Caminiti, Maurizio; Vincenzo, Curci; Cetta, Francesco

2013-09-01

86

Complex heel reconstruction with a sural fasciomyocutaneous perforator flap.  

PubMed

Reconstruction of weight-bearing surfaces at the foot and ankle is controversial. Free tissue transfer and local fasciocutaneous perforator flaps are preferred for plantar reconstruction, but high rates of flap breakdown and ulceration have caused unsatisfactory functional outcomes. We present a modified "sural fasciomyocutaneous perforator flap" and its functional outcome. Between January 2007 and September 2010, 19 patients were treated for soft-tissue defects in the weight-bearing area with sural fasciomyocutaneous perforator flaps. The gastrocnemius, preserved in the base of the flap, was applied as padding under the calcaneus. In follow-up from 9 to 25 months (mean 13.8 months), each patient's pain score, defect size, ulcer formation, protective sensation recovery, and normal footwear were analyzed. The majority of the flaps survived with satisfactory aesthetic and functional results. One case of partial flap loss and one case of delayed ulceration were noted. With partial weight bearing at 4 weeks, satisfactory gait recovery was obtained at 5 to 8 months (in conjunction with protective sensation recovery). Sural fasciomyocutaneous perforator flap is a reliable modality in heel construction, showing advantages of low ulceration rate, durability, and good protective sensation recovery compared with conventional free tissue transfer and local fasciocutaneous perforator flap. PMID:24163225

Lu, Shengdi; Chai, Yimin; Wang, Chunyang; Wen, Gen

2014-02-01

87

Abnormalities of plantar pressure distribution in early, intermediate, and late stages of diabetic neuropathy.  

PubMed

Inconsistent findings with regard to plantar pressure while walking in the diabetic population may be due to the heterogeneity of the studied groups resulting from the classification/grouping criteria adopted. The clinical diagnosis and classification of diabetes have inherent uncertainties that compromise the definition of its onset and the differentiation of its severity stages. A fuzzy system could improve the precision of the diagnosis and classification of diabetic neuropathy because it takes those uncertainties into account and combines different assessment methods. Here, we investigated how plantar pressure abnormalities evolve throughout different severity stages of diabetic polyneuropathy (absent, n=38; mild, n=20; moderate, n=47; severe, n=24). Pressure distribution was analysed over five areas while patients walked barefoot. Patients with mild neuropathy displayed an increase in pressure-time integral at the forefoot and a lower peak pressure at the heel. The peak and pressure-time integral under the forefoot and heel were aggravated in later stages of the disease (moderate and severe) compared with early stages of the disease (absent and mild). In the severe group, lower pressures at the lateral forefoot and hallux were observed, which could be related to symptoms that develop with the aggravation of neuropathy: atrophy of the intrinsic foot muscles, reduction of distal muscle activity, and joint stiffness. Although there were clear alterations over the forefoot and in a number of plantar areas with higher pressures within each severity stage, they did not follow the aggravation evolution of neuropathy classified by the fuzzy model. Based on these results, therapeutic interventions should begin in the early stages of this disease to prevent further consequences of the disease. PMID:25086801

Sacco, Isabel C N; Hamamoto, Adriana N; Tonicelli, Lucas M G; Watari, Ricky; Ortega, Neli R S; Sartor, Cristina D

2014-09-01

88

Practice recommendations for preventing heel pressure ulcers.  

PubMed

Heels are the second most common anatomical location for pressure ulcers. A combination of risk factors, including pressure, may cause ulceration. Heel pressure ulcers are a particular concern for surgical patients. A review of the literature, including poster presentations, shows that controlled clinical studies to assess the effectiveness and cost-effectiveness of available interventions are not available. Case series (with or without historical controls) as well as pressure ulcer guideline recommendations suggest the most important aspect of heel ulcer prevention is pressure relief (offloading). It also has been documented that the incidence of heel ulcers can be reduced using a total-patient care approach and heel offloading devices. Guidelines, observational studies, and expert opinion intimate that reducing heel ulceration rates can be expected to improve patient outcomes, decrease costs associated with their care, and avoid costs related to hospital-acquired pressure ulcers. The heel pressure ulcer prevention strategies reviewed should be implemented until the results of prospective, randomized controlled studies to compare the effectiveness and cost-effectiveness of these strategies are available. PMID:18927483

Fowler, Evonne; Scott-Williams, Suzy; McGuire, James B

2008-10-01

89

Histomorphological Evaluation of Diabetic and Non-Diabetic Plantar Soft Tissue  

PubMed Central

Background Diabetic foot ulceration has a complex and multi-factorial etiology and can involve changes in the pathophysiology of the plantar soft tissue. In the current study, histomorphological analyses of diabetic and non-diabetic plantar tissue were performed. It was hypothesized that the diabetic tissue would have thicker skin (epidermis and dermis), less interdigitation between the dermis and epidermis, thicker elastic septa and decreased adipose cell size. Materials and Methods Two locations of the foot (the heel and the first metatarsal) were examined, both of which have been reported to be locations with a high incidence of ulceration. Stereological methods and quantitative morphological techniques were used to evaluate the skin thickness, interdigitation index, elastic septae thickness and adipocyte cell size. Results The diabetic donors had a greater body mass index (BMI) than the non-diabetic donors. The diabetic tissue had significantly thicker elastic septae and dermis. However, no significant difference was observed in the interdigitation index or adipocyte size. Conclusion These findings demonstrate that morphological changes can be evaluated histologically to give a better understanding of the pathological changes in the plantar soft tissue with diabetes. These evaluations can then be associated with biomechanical changes that occur in diabetes to provide new insight into how microstructural changes can alter macroscopic properties. Clinical Relevance An understanding of the histomorphological changes in the soft tissue in relationship to the location on the foot could help to explain the biomechanical changes that occur in diabetes and the subsequent increase in susceptibility to breakdown. PMID:22049867

Wang, Yak-Nam; Lee, Kara; Ledoux, William R.

2014-01-01

90

Effect of arch type and Body Mass Index on plantar pressure distribution during stance phase of gait.  

PubMed

Several factors have been associated with the presence of abnormally high plantar foot pressure including: (i) increased body weight, (ii) foot structure and (iii) walking strategy. It is predicted that the biomechanics of the foot is influenced by the structure of the foot, primarily the Medial Longitudinal Arch. The objective of this study was to examine if Body Mass Index and the foot arch have a direct effect on dynamic peak plantar pressure for healthy subjects. Following a clinical lower limb examination, the Tekscan HR mat was utilised for this study, plantar pressure was profiled at specific events during stance phase of gait including heel strike, midstance and toe off. Results indicated to the preferable normal arch as this produced a low plantar pressure distribution in all cases. The 2nd and 3rd metatarsal head region recorded the highest pressure for all arch types during dynamic analysis. The lowest pressure for the normal and overweight BMI was at toe-off. While the obese BMI group showed highest pressure during toe-off. The obese BMI flat arch subcategory indicated to functional ambulation differences. Future work involves comparing this healthy database to a demographically matched diabetic group. PMID:25088082

O'Brien, Davida Louise; Tyndyk, Magdalena

2014-01-01

91

Plantar angiomyxolipoma in a child  

PubMed Central

Angiomyxolipoma, a lipoma variant with myxoid areas and vascular proliferation was originally described in 1996 and till date has only 12 cases in published literature. Only two cases have been reported in children involving buccal mucosa and knee, respectively. The authors report a case of angiomyxolipoma, on the plantar surface of the left foot, in a 4-year-old male child who presented to our institution in Abha city (Kingdom of Saudi Arabia). The significant differential diagnosis of this neoplasm from other similar lipomatous tumours occurring in adult and paediatric population is discussed. The importance of recognising these tumours lies in their recognition as separate entity and the present case may add to the knowledge, clinical behaviour and prognosis of these less reported lipomatous neoplasms. PMID:22674110

Shraim, Mubarak Al; Hasan, Mahboob; Hawan, Ali; Radad, Khaled; Eid, Refaat

2011-01-01

92

Foot plantar pressure measurement system: a review.  

PubMed

Foot plantar pressure is the pressure field that acts between the foot and the support surface during everyday locomotor activities. Information derived from such pressure measures is important in gait and posture research for diagnosing lower limb problems, footwear design, sport biomechanics, injury prevention and other applications. This paper reviews foot plantar sensors characteristics as reported in the literature in addition to foot plantar pressure measurement systems applied to a variety of research problems. Strengths and limitations of current systems are discussed and a wireless foot plantar pressure system is proposed suitable for measuring high pressure distributions under the foot with high accuracy and reliability. The novel system is based on highly linear pressure sensors with no hysteresis. PMID:23012576

Razak, Abdul Hadi Abdul; Zayegh, Aladin; Begg, Rezaul K; Wahab, Yufridin

2012-01-01

93

Preventing pressure ulcers on the heel: a Canadian cost study.  

PubMed

An adaptation of a clinical study of 130 patients at risk of developing a pressure ulcer on the heels was performed using Canadian costs. The aim of the study was to compare the cost effectiveness of a specially shaped hydrocellular dressing (Allevyn Heel) versus that of a protective heel bandage (Soffban and gauze) in pressure ulcer prevention over an 8-week period. PMID:19873692

Torra I Bou, Joan-Enric; Rueda López, Justo; Camañes, Gemma; Herrero Narváez, Elias; Blanco Blanco, Joan; Ballesté Torralba, Jordi; Martinez-Esparza, Elvira Hernández; García, Lorena San Miguel; Soriano, José Verdú

2009-01-01

94

Diabetic Heel Ulcer in the Sudan: Determinants of Outcome  

Microsoft Academic Search

Heel ulceration, on average, costs 1.5 times more than metatarsal ulceration. The aim of this study was to analyze the determinant factors of healing in diabetic patients with heel ulcers and the late outcomes at Jabir Abu Eliz Diabetic Centre Khartoum, Khartoum, Sudan. Data were collected prospectively for 96 of 100 diabetic patients presenting with heel ulcers at the Jabir Abu

Haseeb E. Bakheit; Mohamed F. Mohamed; Seif ElDin I. Mahadi; Abu Bakr H. Widatalla; Mohamed A. Shawer; Amar H. Khamis; Mohamed E. Ahmed

95

Plantar vibration improves leg fluid flow in perimenopausal women  

Microsoft Academic Search

Abstract Recent studies have indicated that plantar based vibration may be an effective approach for the prevention and treatment of osteoporosis. We addressed the hypothesis of whether the plantar vibration operated by way of the skeletal muscle pump, resulting in enhanced blood and fluid flow to the lower body. We combined,plantar stimulation with upright tilt table testing in 18 women

Julian M. Stewart; Carol Karman; Leslie D. Montgomery

2004-01-01

96

The effect of backpack load on muscle activities of the trunk and lower extremities and plantar foot pressure in flatfoot.  

PubMed

[Purpose] The purpose of this study was to investigate the changes in muscle activation of the trunk and lower extremities and plantar foot pressure due to backpack loads of 0, 10, 15, and 20% of body weight during level walking in individuals with flatfoot. [Methods] Fourteen young flatfoot subjects and 12 normal foot subjects participated in this study. In each session, the subjects were assigned to carry a backpack load, and there were four level walking modes: (1) unloaded walking (0%), (2) 10% body weight (BW) load, (3) 15% BW load, and (4) 20% BW load. Trunk and lower extremity muscle activities were recorded by surface EMG, and contact area and plantar foot pressure were determined using a RS scan system. [Results] The erector spinae, vastus medialis, tibialis anterior and gastrocnemius muscle activities, but not the rectus femoris and rectus abdominis muscle activities of flatfoot subjects significantly and progressively increased as load increased in flatfoot subjects. Contact area and pressure of the lateral and medial heel zones were significantly increased too. [Conclusion] Based on this data, the weight of a backpack could influence muscle activation and plantar foot pressure in flatfoot. PMID:24396193

Son, Hohee

2013-11-01

97

Neuromuscular performance of paretic versus non-paretic plantar flexors after stroke  

Microsoft Academic Search

The objective of this study was to compare the neuromuscular function of the paretic and non-paretic plantar flexors (i.e.\\u000a soleus, gastrocnemius medialis, lateralis) in chronic stroke patients. It was hypothesized that the contractile rate of force\\u000a development (RFD) and neural activation, assessed by electromyogram (EMG) and V-waves normalized to the M-wave, and voluntary\\u000a activation (twitch interpolation) would be reduced during

Marius Steiro Fimland; Per Marius R. Moen; Tessa Hill; Tor Ivar Gjellesvik; Tom Tørhaug; Jan Helgerud; Jan Hoff

98

Effects of Combined Foot/Ankle Electromyostimulation and Resistance Training on the In-Shoe Plantar Pressure Patterns during Sprint in Young Athletes.  

PubMed

Several studies have already reported that specific foot/ankle muscle reinforcement strategies induced strength and joint position sense performance enhancement. Nevertheless the effects of such protocols on sprint performance and plantar loading distribution have not been addressed yet. The objective of the study is to investigate the influence of a 5-wk foot/ankle strength training program on plantar loading characteristics during sprinting in adolescent males. Sixteen adolescent male athletes of a national training academy were randomly assigned to either a combined foot/ankle electromyostimulation and resistance training (FAST) or a control (C) group. FAST consisted of foot medial arch and extrinsic ankle muscles reinforcement exercises, whereas C maintained their usual training routine. Before and after training, in-shoe loading patterns were measured during 30-m running sprints using pressure sensitive insoles (right foot) and divided into nine regions for analysis. Although sprint times remained unchanged in both groups from pre- to post- training (3.90 ± 0.32 vs. 3.98 ± 0.46 s in FAST and 3.83 ± 0.42 vs. 3.81 ± 0.44 s in C), changes in force and pressure appeared from heel to forefoot between FAST and C. In FAST, mean pressure and force increased in the lateral heel area from pre- to post- training (67.1 ± 44.1 vs. 82.9 ± 28.6 kPa [p = 0.06]; 25.5 ± 17.8 vs. 34.1 ± 14.3 N [p = 0.05]) and did not change in the medial forefoot (151.0 ± 23.2 vs. 146.1 ± 30.0 kPa; 142.1 ± 29.4 vs. 136.0 ± 33.8; NS). Mean area increased in FAST under the lateral heel from pre- to post- (4.5 ± 1.3 vs. 5.7 ± 1.6 cm(2) [p < 0.05]) and remained unchanged in C (5.5 ± 2.8 vs. 5.0 ± 3.0 cm(2)). FAST program induced significant promising lateral and unwanted posterior transfer of the plantar loads without affecting significantly sprinting performance. Key pointsWe have evaluated the effects of a foot/ankle strength training program on sprint performance and on related plantar loading characteristics in teenage athletes, and this have not been examined previously.Our results showed no significant pre- to post- changes in sprint performance.This study revealed initially a lateral transfer and secondly a posterior transfer of the plantar loads after the foot/ankle strength training program. PMID:24149874

Fourchet, François; Kuitunen, Sami; Girard, Olivier; Beard, Adam J; Millet, Grégoire P

2011-01-01

99

The influence of heel height on utilized coefficient of friction during walking  

Microsoft Academic Search

Wearing high heel shoes has been associated with an increased potential for slips and falls. The association between wearing high heels and the increased potential for slipping suggests that the friction demand while wearing high heels may be greater when compared to wearing low heel shoes. The purpose of this study was to determine if heel height affects utilized friction

Mark G. Blanchette; John R. Brault; Christopher M. Powers

2011-01-01

100

Influence of Inflammatory Polyarthritis on Quantitative Heel Ultrasound Measurements  

PubMed Central

Background There are few data concerning the impact of inflammatory polyarthritis (IP) on quantitative heel ultrasound (QUS) measurements. The aims of this analysis were i) to determine the influence of IP on QUS measurements at the heel and, ii) among those with IP to determine the influence of disease related factors on these measurements. Methods Men and women aged 16?years and over with recent onset IP were recruited to the Norfolk Arthritis Register (NOAR). Individuals with an onset of joint symptoms between 1989 and 1999 were included in this analysis. At the baseline visit subjects underwent a standardised interview and clinical examination with blood taken for rheumatoid factor. A population-based prospective study of chronic disease (EPIC-Norfolk) independently recruited men and women aged 40 to 79?years from the same geographic area between 1993 and 1997. At a follow up assessment between 1998 and 2000 subjects in EPIC-Norfolk were invited to have quantitative ultrasound measurements of the heel (CUBA-Clinical) performed. We compared speed of sound (SOS) and broadband ultrasound attenuation (BUA), in those subjects recruited to NOAR who had ultrasound measurements performed (as part of EPIC-Norfolk) subsequent to the onset of joint symptoms with a group of age and sex matched non-IP controls who had participated in EPIC-Norfolk. Fixed effect linear regression was used to explore the influence of IP on the heel ultrasound parameters (SOS and BUA) so the association could be quantified as the mean difference in BUA and SOS between cases and controls. In those with IP, linear regression was used to examine the association between these parameters and disease related factors. Results 139 men and women with IP and 278 controls (mean age 63.2?years) were studied. Among those with IP, mean BUA was 76.3?dB/MHz and SOS 1621.8?m/s. SOS was lower among those with IP than the controls (difference?=??10.0; 95% confidence interval (CI) –17.4, -2.6) though BUA was similar (difference?=??1.2; 95% CI ?4.5, +2.1). The difference in SOS persisted after adjusting for body mass index and steroid use. Among those with IP, disease activity as determined by the number of swollen joints at baseline, was associated with a lower SOS. In addition SOS was lower in the subgroup that satisfied the 1987 ACR criteria. By contrast, disease duration, steroid use and HAQ score were not associated with either BUA or SOS. Conclusions In this general population derived cohort of individuals with inflammatory polyarthritis there is evidence from ultrasound of a potentially adverse effect on the skeleton. The effect appears more marked in those with active disease. PMID:22834652

2012-01-01

101

Dielectric Elastomer Generators for Foot Plantar Pressure Based Energy Scavenging  

E-print Network

Dielectric Elastomer Generators for Foot Plantar Pressure Based Energy Scavenging Vishwa Goudar. Dielectric Elastomers (DEs) are now gaining notice as low-cost electrostatic transducers with high energy

Potkonjak, Miodrag

102

Time to onset of pain: effects of magnitude and location for static pressures applied to the plantar foot.  

PubMed

Mechanisms that cause foot discomfort during prolonged standing are poorly understood. There is currently no method for evaluating discomfort associated with low levels of static pressure that are typical during standing. Pain thresholds were measured for 20 healthy participants by applying five levels of static pressure at different plantar foot locations. A survival analysis was performed to determine the effects of pressure magnitude and foot location on the time until pain onset. Time to pain onset was significantly affected by pressure magnitude (P < 0.001); time decreased as pressure increased. Foot location was also significant (P < 0.001); greatest times to pain onset (least sensitive) were observed under the heel and fifth metatarsal head, shortest times (most sensitive) were found under the midfoot. This research presents a novel methodology for evaluating static pressure that may be applicable to product design. PMID:25118168

Wiggermann, Neal; Keyserling, W Monroe

2015-01-01

103

A Biomechanical Evaluation of Standing in High Heeled Shoes  

Microsoft Academic Search

The purpose of this study was to determine the action of the ground reaction force upon the heels of women standing in high-heeled shoes. The study involved a non-invasive determination of the location of the subtalar joint axis, the joint about which the foot bends in and out. It was determined where the ground reaction force acts relative to the

Paula D. Henderson; Penn State; Stephen J. Piazza

104

Heel-region properties of prosthetic feet and shoes  

Microsoft Academic Search

The properties of the prosthetic components pre- scribed to amputees have the potential to ameliorate or exacer- bate their comfort, mobility, and health. To measure the difference in heel-region structural properties of currently available prosthetic feet and shoes, we simulated the period of initial heel-ground contact with a pendulum apparatus. The energy dissipation capacity of the various prosthetic feet ranged

Glenn K. Klute; Jocelyn S. Berge; Ava D. Segal

2004-01-01

105

Recovery of plutonium from electrorefining anode heels at Savannah River  

SciTech Connect

In a joint effort, the Savannah River Laboratory (SRL), Savannah River Plant (SRP), and the Rocky Flats Plant (RFP) have developed two processes to recover plutonium from electrorefining anode heel residues. Aqueous dissolution of anode heel metal was demonstrated at SRL on a laboratory scale and on a larger pilot scale using either sulfamic acid or nitric acid-hydrazine-fluoride solutions. This direct anode heel metal dissolution requires the use of a geometrically favorable dissolver. The second process developed involves first diluting the plutonium in the anode heel residues by alloying with aluminum. The alloyed anode heel plutonium can then be dissolved using a nitric acid-fluoride-mercury(II) solution in large non-geometrically favorable equipment where nuclear safety is ensured by concentration control.

Gray, J H; Gray, L W; Karraker, D G

1987-03-01

106

Plantar fascia calcification a sequelae of corticosteroid injection in the treatment of recalcitrant plantar fasciitis.  

PubMed

We report the case of a 72-year-old woman suffering with severe plantar fasciitis who received a therapeutic corticosteroid injection. Two-and-a-half years after the injection she developed a small calcified lump under the skin which subsequently caused ulceration and infection. She went on to develop a diabetic foot infection requiring an extended course of intravenous antibiotics. PMID:23955985

Fox, Thomas Peter; Oliver, Govind; Wek, Caesar; Hester, Thomas

2013-01-01

107

Plantar pressure characteristics in hallux valgus feet.  

PubMed

Due to the pathoanatomical changes in hallux valgus feet, the plantar flexion moment of the first metatarsophalangeal joint is reduced. Therefore, load bearing of the hallux is decreased during push-off. We assessed loading parameters in hallux valgus feet. Based on dorsal-plantar weight bearing radiographs of 61 feet, the intermetatarsal-, hallux valgus-, distal metatarsal articulation-angle, and sesamoid position were evaluated. Plantar pressure assessment was performed with the emed® system during level walking. We found negative correlations between hallux valgus angle and peak pressure in the great toe (r?=?-0.301, p?

Koller, Ulrich; Willegger, Madeleine; Windhager, Reinhard; Wanivenhaus, Axel; Trnka, Hans-Joerg; Schuh, Reinhard

2014-12-01

108

The role of hamstring tightness in plantar fasciitis.  

PubMed

The purpose of this prospective cohort study was to determine if hamstring tightness was an increased risk in plantar fasciitis. It was thought that there is an increased risk of plantar fasciitis when hamstring tightness is present. A total of 105 patients (68 women, 37 men) were included in the study, 79 of whom were diagnosed with plantar fasciitis. Body mass index (BMI) was calculated and the presence of plantar fasciitis, equinus, and calcaneal spurs were assessed. The popliteal angle was measured using standard diagnostic techniques. Without controlling for covariates, BMI, the presence of a calcaneal spur, tightness in the gastrocnemius, gastrocnemius-soleus, and hamstring all had statistically significant association with plantar fasciitis. After controlling for covariates, patients with hamstring tightness were about 8.7 times as likely to experience plantar fasciitis (P < .0001). Patients with BMI >35 were approximately 2.4 times as likely to experience plantar fasciitis compared with those with BMI <35 (P = .04). This study demonstrates that hamstring tightness plays a significant role in the presence of plantar fasciitis and should be addressed along with equinus and obesity when providing treatment to patients with this diagnosis. PMID:21368068

Labovitz, Jonathan M; Yu, Jenny; Kim, Chul

2011-06-01

109

Influence of sensory input on plantar pressure distribution  

Microsoft Academic Search

The sensory feedback control system plays a central role in human locomotion. However, few studies have been published discussing the influence of sensory input at the plantar surface of the foot on the kinematics and kinetics of locomotion. The purpose of this study was to examine the effect of changes in sensory input at the plantar surface of the foot

H Chen; BM Nigg; M Hulliger; J de Koning

1995-01-01

110

Impact of Diabetes and Peripheral Arterial Occlusive Disease on the Functional Microcirculation at the Plantar Foot  

PubMed Central

Background: Plastic and reconstructive surgeons are commonly faced with chronic ulcerations and consecutive wound infections of the feet as complications in patients with diabetes and/or peripheral arterial occlusive disease (PAOD). Microcirculatory changes seem to play an important role. However, the evaluation of functional changes in the soft tissue microcirculation at the plantar foot using combined Laser-Doppler and Photospectrometry System has not yet been performed in patients with DM or PAOD. Methods: A prospective, controlled cohort study was designed consisting of a total of 107 subjects allocated to 1 of 3 groups—group A: healthy subjects (57% males, 63.3 y); group B: patients with diabetes mellitus (DM) (53% males, 59.4 y); and group C: patients with PAOD (81% males, 66.1 y). Microcirculatory data were assessed using a combined Laser-Doppler and Photospectrometry System. Results: Global cutaneous oxygen saturation microcirculation at the plantar foot of healthy individuals was 8.4% higher than in patients with DM and 8.1% higher than in patients with PAOD (both P = 0.033). Patients with diabetes did not show significant differences in global cutaneous blood flow when compared with either healthy subjects or patients suffering from PAOD. Conclusions: Functional microcirculation at the plantar foot differs between healthy subjects and patients suffering from diabetes or PAOD of the same age. Patients with either diabetes or PAOD demonstrate deteriorated cutaneous oxygen saturation with equivalent blood perfusion at the plantar foot. More clinical studies have to be conducted to evaluate therapeutical methods that might ameliorate cutaneous oxygen saturation within diabetic foot disease and PAOD. PMID:25289243

Kabbani, Mohammad; Rotter, Robert; Busche, Marc; Wuerfel, Waldemar; Jokuszies, Andreas; Knobloch, Karsten; Vogt, Peter M.

2013-01-01

111

Outpatient percutaneous heel cord lengthening in children.  

PubMed

Outpatient percutaneous tendo Achillis lengthening is a quick, complication-free, inexpensive approach to a common pediatric orthopedic problem. The procedure is a known alternative to conventional open procedures, but it is not widely used. This study outlines the advantage of the percutaneous procedure performed in outpatient surgery with the patient under a general anesthetic. Fifty-five patients were operated on between December 1980 and March 1984. Overall results were excellent, with 97% improvement in gait. There were no infections. Percutaneous heel cord lengthening in children is a safe and simple operation, yielding results equal to those of open procedures. The advantage of outpatient surgery adds a further positive dimension to this procedure. PMID:3584437

Moreau, M J; Lake, D M

1987-01-01

112

MR elastographic methods for the evaluation of plantar fat pads: preliminary comparison of the shear modulus for shearing deformation and compressive deformation in normal subjects  

NASA Astrophysics Data System (ADS)

MR elastography (MRE) images the intrinsic mechanical properties of soft tissues; e.g., the shear modulus, ?. The ? of the plantar soft tissues is important in understanding the mechanisms whereby the forces induced during normal motion produce ulcers that lead to amputation in diabetic feet. We compared the compliance of the heel fat pad to compressive forces and to shearing forces. The design of prosthetics to protect the foot depends on the proper understanding of the mechanisms inducing damage. In the heel fat pads of six normal subjects, between 25 and 65 years of age, the ? for deformation perpendicular to the direction of weight bearing is similar but not identical to that determined for deformation along the weight bearing axis. The average difference between ? along the weight bearing axis and ? perpendicular to the weight bearing axis, is well correlated with age (Correlation Coefficient = 0.789). The p-value for the data being random was 0.0347 indicating that the observed difference is not likely to be random. The p-value for control points is 0.8989, indicating a random process. The results are suggestive that the high compressive forces imposed during walking damage the heel fat pads over time resulting in softening to compression preferentially over shearing. It is important to validate the observed effect with larger numbers of subjects, and better controls including measures of activity, and to understand if diseases like diabetes increase the observed damage.

Weaver, John B.; Miller, Timothy B.; Perrinez, Philip R.; Doyley, Marvin M.; Wang, Huifang; Cheung, Yvonne Y.; Wrobel, James S.; Comi, Richard J.; Kennedy, Francis E.; Paulsen, Keith D.

2006-03-01

113

Gait pattern generation with knee stretch motion for biped robot using toe and heel joints  

Microsoft Academic Search

This paper presents a new alternative methodology to generate gait pattern with a knee stretched motion for biped robot utilizing toe and heel joints. During walking sequence, human heels act as passive joints that create some support area which enhances the stability of human walking. This research tries to replace human-heel like mechanism with a heel joint in the biped

Nandha Handharu; Jungwon Yoon; Gabsoon Kim

2008-01-01

114

Plantar fascia anatomy and its relationship with Achilles tendon and paratenon.  

PubMed

Although the plantar fascia (PF) has been studied quite well from a biomechanical viewpoint, its microscopic properties have been overlooked: nothing is known about its content of elastic fibers, the features of the extracellular matrix or the extent of innervation. From a functional and clinical standpoint, the PF is often correlated with the triceps surae muscle, but the anatomical grounds for this link are not clear. The aim of this work was to focus on the PF macroscopic and microscopic properties and study how Achilles tendon diseases might affect it. Twelve feet from unembalmed human cadavers were dissected to isolate the PF. Specimens from each PF were tested with various histological and immunohistochemical stains. In a second stage, 52 magnetic resonance images (MRI) obtained from patients complaining of aspecific ankle or foot pain were analyzed, dividing the cases into two groups based on the presence or absence of signs of degeneration and/or inflammation of the Achilles tendon. The thickness of PF and paratenon was assessed in the two groups and statistical analyses were conducted. The PF is a tissue firmly joined to plantar muscles and skin. Analyzing its possible connections to the sural structures showed that this fascia is more closely connected to the paratenon of Achilles tendon than to the Achilles tendon, through the periosteum of the heel. The PF extended medially and laterally, continuing into the deep fasciae enveloping the abductor hallucis and abductor digiti minimi muscles, respectively. The PF was rich in hyaluronan, probably produced by fibroblastic-like cells described as 'fasciacytes'. Nerve endings and Pacini and Ruffini corpuscles were present, particularly in the medial and lateral portions, and on the surface of the muscles, suggesting a role for the PF in the proprioception of foot. In the radiological study, 27 of the 52 MRI showed signs of Achilles tendon inflammation and/or degeneration, and the PF was 3.43 ± 0.48 mm thick (99%CI and SD = 0.95), as opposed to 2.09 ± 0.24 mm (99%CI, SD = 0.47) in the patients in which the MRI revealed no Achilles tendon diseases; this difference in thickness of 1.29 ± 0.57 mm (99%CI) was statistically significant (P < 0.001). In the group of 27/52 patients with tendinopathies, the PF was more than 4.5 mm thick in 5, i.e. they exceeded the threshold for a diagnosis of plantar fasciitis. None of the other 25/52 paitents had a PF more than 4 mm thick. There was a statistically significant correlation between the thicknesses of the PF and the paratenon. These findings suggest that the plantar fascia has a role not only in supporting the longitudinal arch of the foot, but also in its proprioception and peripheral motor coordination. Its relationship with the paratenon of the Achilles tendon is consistent with the idea of triceps surae structures being involved in the PF pathology, so their rehabilitation can be considered appropriate. Finally, the high concentration of hyaluronan in the PF points to the feasibility of using hyaluronan injections in the fascia to treat plantar fasciitis. PMID:24028383

Stecco, Carla; Corradin, Marco; Macchi, Veronica; Morra, Aldo; Porzionato, Andrea; Biz, Carlo; De Caro, Raffaele

2013-12-01

115

Validation of Plantar Pressure Measurements for a Novel In-Shoe Plantar Sensory Replacement Unit  

PubMed Central

An article by Ferber and coauthors in Journal of Diabetes Science and Technology reported on the ability of novel in-shoe plantar sensory replacement unit (PSRU) to provide alert-based feedback derived from analyzing plantar pressure (PP) threshold measurements in real time. The study aimed at comparing the PSRU device to a gold standard pressure-sensing device (GS-PSD) to determine the correlation between concurrent measure of PP during walking. Data were collected simultaneously from 10 participants who walked overground with both devices. The variable of interest was the number of recorded data points greater than 32 mm Hg for each of the PSRU sensors and corresponding average recordings from the GS-PSD. Authors concluded that the PSRU provides analogous data to the GS-PSD. However, several aspects of the study should be considered when interpreting their clinical relevance. PMID:24124943

Sawacha, Zimi

2013-01-01

116

Heel-line hyperpigmentation: a variant of sock-line hyperpigmentation after the use of heel-length socks.  

PubMed

Two infants developed hyperpigmented curvilinear patches on the posterior heel after wearing heel-length socks. Both of the patient's lesions improved after discontinuing the use of the heel-length socks. Hyperpigmented patches called sock-line or mitten-line hyperpigmentation have been reported at sites of tight elastic bands from socks or mittens in infants on the calves and wrists. Recognizing this clinical entity is important to differentiate it from other causes of linear lesions such as child abuse or amniotic band syndrome. PMID:23432211

Ciliberto, Heather; Berk, David; Salphale, Pankaj; Bayliss, Susan

2013-01-01

117

Convective burn from use of hairdryer for heel warming prior to the heel prick test - a case report  

PubMed Central

Background Blood sampling through heel lancing is the most common invasive painful procedure performed on newborn infants. Case Presentation We report the case of a five day old infant who sustained burns to the left foot and leg after the mother's hairdryer was used by the midwife to warm the baby's heel prior to capillary blood sampling (CBS) with an automated device. Conclusion Heel warming is not recommended for routine CBS although it is often practiced. If pre-warming is to be practiced, standardised devices should be used rather than improvised techniques. This will reduce the risk of injury to these infants. PMID:21569274

2011-01-01

118

Don't Ignore Your Kid's Heel Pain  

MedlinePLUS

... Videos & Podcasts » Articles » Text Size Print Bookmark Don’t Ignore Your Kid’s Heel Pain Address Pain Early, ... and imaging beyond basic x-rays, which don’t always reveal the cause of the pain. Preparation ...

119

Fiber optic plantar pressure/shear sensor  

NASA Astrophysics Data System (ADS)

A full-scale foot pressure/shear sensor that has been developed to help diagnose the cause of ulcer formation in diabetic patients is presented. The design involves a tactile sensor array using intersecting optical fibers embedded in soft elastomer. The basic configuration incorporates a mesh that is comprised of two sets of parallel optical fiber plane; the planes are configured so the parallel rows of fiber of the top and bottom planes are perpendicular to each other. Threedimensional information is determined by measuring the loss of light from each of the waveguide to map the overall pressure distribution and the shifting of the layers relative to each other. In this paper we will present the latest development on the fiber optic plantar pressure/shear sensor which can measure normal force up from 19.09 kPa to 1000 kPa.

Soetanto, William; Nguyen, Ngoc T.; Wang, Wei-Chih

2011-04-01

120

Foot Modeling and Smart Plantar Pressure Reconstruction from Three Sensors  

PubMed Central

In order to monitor pressure under feet, this study presents a biomechanical model of the human foot. The main elements of the foot that induce the plantar pressure distribution are described. Then the link between the forces applied at the ankle and the distribution of the plantar pressure is established. Assumptions are made by defining the concepts of a 3D internal foot shape, which can be extracted from the plantar pressure measurements, and a uniform elastic medium, which describes the soft tissues behaviour. In a second part, we show that just 3 discrete pressure sensors per foot are enough to generate real time plantar pressure cartographies in the standing position or during walking. Finally, the generated cartographies are compared with pressure cartographies issued from the F-SCAN system. The results show 0.01 daN (2% of full scale) average error, in the standing position. PMID:25400713

Ghaida, Hussein Abou; Mottet, Serge; Goujon, Jean-Marc

2014-01-01

121

Validation of Plantar Pressure Measurements for a Novel In-Shoe Plantar Sensory Replacement Unit  

PubMed Central

Background Research concerning prevention of diabetic foot complications is critical. A novel in-shoe plantar sensory replacement unit (PSRU) has been developed that provides alert-based feedback derived from analyzing plantar pressure threshold measurements in real time. The purpose of this study was to compare the PSRU device to a gold standard pressure-sensing device (GS-PSD) to determine the correlation between concurrent measures of plantar pressure during walking. Methods The PSRU had an array of eight sensors with a range of 10–75 mm Hg and collected data at 4 Hz, whereas the GS-PSD had 99 sensors with a range of 1–112 mm Hg and collected data at 100 Hz. Based on an a priori power analysis, data were collected from 10 participants (3 female, 7 male) while walking over ground in both devices. The primary variable of interest was the number of data points recorded that were greater than 32 mm Hg (capillary arterial pressure—the minimum pressure reported to cause pressure ulcers) for each of the eight PSRU sensors and corresponding average recordings from the GS-PSD sensor clusters. Intraclass correlation coefficient (2,1) was used to compare data between the two devices. Results Compared with the GS-PSD, we found good-to-very-good correlations (r-value range 0.67–0.86; p-value range 0.01–0.05) for six of the PSRU’s eight sensors and poor correlation for only two sensors (r = 0.41, p = .15; r = 0.38, p = .18) when measuring the number of data points recorded that were greater than 32 mm Hg. Conclusions Based on the results of the present study, we conclude the PSRU provides analogous data when compared with a GS-PSD. PMID:24124942

Ferber, Reed; Webber, Talia; Kin, B; Everett, Breanne; Groenland, Marcel

2013-01-01

122

Aspects of treatment for posterior heel pain in young athletes.  

PubMed

Posterior heel pain occurs in young athletes involved in running and jumping. Due to the pain, the child often limits his/her physical activity level, with a possible negative effect on health and well-being. Although numerous research studies have examined the cause and treatment of heel and Achilles tendon pain in adults, there are no randomized clinical trials on treatment in children and adolescents. Therefore, there is limited evidence for how to treat young athletes with this type of complaint. The purpose of this review was to analyze critically and summarize the literature in regards to the cause and treatment of posterior heel pain in young athletes. The various diagnoses and clinical presentations relating to posterior heel and Achilles tendon pain are discussed. The theory and mechanism behind various recommended treatment strategies are also reviewed in the context of use in the young athlete. In summary, it is important to perform a thorough evaluation of each young athlete with heel pain to determine the appropriate diagnosis and to treat the deficits found and allow for a gradual progression to training. However, the recommendations at this time are based on clinical experience and a few retrospective studies, so further well designed prospective studies with validated outcome measures are urgently needed for the young athlete. PMID:24198561

Elengard, Thomas; Karlsson, Jón; Silbernagel, Karin Grävare

2010-01-01

123

The upright posture improves plantar stepping and alters responses to serotonergic drugs in spinal rats  

PubMed Central

Recent studies on the restoration of locomotion after spinal cord injury have employed robotic means of positioning rats above a treadmill such that the animals are held in an upright posture and engage in bipedal locomotor activity. However, the impact of the upright posture alone, which alters hindlimb loading, an important variable in locomotor control, has not been examined. Here we compared the locomotor capabilities of chronic spinal rats when placed in the horizontal and upright postures. Hindlimb locomotor movements induced by exteroceptive stimulation (tail pinching) were monitored with video and EMG recordings. We found that the upright posture alone significantly improved plantar stepping. Locomotor trials using anaesthesia of the paws and air stepping demonstrated that the cutaneous receptors of the paws are responsible for the improved plantar stepping observed when the animals are placed in the upright posture. We also tested the effectiveness of serotonergic drugs that facilitate locomotor activity in spinal rats in both the horizontal and upright postures. Quipazine and (±)-8-hydroxy-2-(dipropylamino)tetralin hydrobromide (8-OH-DPAT) improved locomotion in the horizontal posture but in the upright posture either interfered with or had no effect on plantar walking. Combined treatment with quipazine and 8-OH-DPAT at lower doses dramatically improved locomotor activity in both postures and mitigated the need to activate the locomotor CPG with exteroceptive stimulation. Our results suggest that afferent input from the paw facilitates the spinal CPG for locomotion. These potent effects of afferent input from the paw should be taken into account when interpreting the results obtained with rats in an upright posture and when designing interventions for restoration of locomotion after spinal cord injury. PMID:22351637

Slawinska, Urszula; Majczynski, Henryk; Dai, Yue; Jordan, Larry M

2012-01-01

124

Does Plasmodium falciparum have an Achilles' heel?  

PubMed Central

Background Plasmodium falciparum is the parasite that causes the most severe form of malaria responsible for nearly a million deaths a year. Currently, science has been established about its cellular structures, its metabolic processes, and even the molecular structures of its intrinsic membrane proteins responsible for transporting water, nutrient, and waste molecules across the parasite plasma membrane (PPM). Presentation of the hypothesis I hypothesize that Plasmodium falciparum has an Achilles’ heel that can be attacked with erythritol, the well-known sweetener that is classified as generally safe. This hypothesis is based on the molecular structure of the parasite’s membrane and the quantitative mechanics of how erythritol interacts with the multi-functional channel protein expressed in the PPM. Most organisms have in their cell membrane two types of water-channel proteins: aquaporins to maintain hydro-homeostasis across the membrane and aquaglyceroporins to uptake glycerols etc. In contrast, P. falciparum has only one type of such proteins---the multi-functional aquaglyceroporin (PfAQP) expressed in the PPM---to do both jobs. Moreover, the parasite also uses PfAQP to excrete its metabolic wastes (ammonia included) produced at a very high rate in the blood stage. This extremely high efficiency of the bug using one protein for multiple essential tasks makes the parasite fatally vulnerable. Erythritol in the blood stream can kill the parasite by clogging up its PfAQP channel that needs to be open for maintaining hydro-homeostasis and for excreting toxic wastes across the bug’s PPM. Testing the hypothesis In vitro tests are to measure the growth/death rate of P. falciparum in blood with various erythritol concentrations. In vivo experiments are to administer groups of infected mice with various doses of erythritol and monitor the parasite growth levels from blood samples drawn from each group. Clinic trials can be performed to observe the added effects of administering to patients erythritol along with the known drugs because erythritol was classified as a safe food ingredient. Implications of the hypothesis If proven true, erythritol will cure the most severe form of malaria without significant side effects.

Chen, Liao Y.

2014-01-01

125

Farriery for the hoof with low or underrun heels.  

PubMed

Underrun heels are common and involve hoof capsule distortion in which the horn tubules of the heels undergo bending and lengthening, resulting in decreased strength and functionality. The syndrome varies in clinical presentation, depending on duration, severity of distortion, presence of secondary problems, and presence of lameness. Primary treatment goals are to maintain soundness and functional integrity of the foot and to establish a normal hoof capsule. Resolution of the problem is generally not achieved in horses in a heavy work schedule, and realistic goals in this situation are to maintain function, alleviate lameness, and arrest progression of the distortion. PMID:22981194

Hunt, Robert J

2012-08-01

126

Quantification of tritium ``heels`` and isotope exchange mechanisms in La-Ni-Al tritides  

Microsoft Academic Search

Formation of tritium heels in LANA (LaNi{sub 5-x}Alâ) 0.30 (x=0.30) and 0.75 tritides was quantified; size of the heel is dependent on storage and processing conditions. Absorption-desorption cycling of the tritide beds mitigates formation of the tritium heel and can reduce its size. The higher pressure material LANA 0.30 showed slower heel formation than LANA 0.75; this allows more tritium

Wermer

1992-01-01

127

Occurrence, Characterization and Synthesis of Hanford and SRS Tank Heel Materials  

Microsoft Academic Search

The long-range objective of this study was to develop chemically assisted technologies for removing heels from tanks. In FY 01, the first two steps toward this objective were taken: (1) catalogue the occurrence and nature of tank heels and assess which materials are available for study and (2) develop methods for synthesizing non-radioactive surrogate heel materials for use in testing

JAMES L

2002-01-01

128

46 CFR 174.055 - Calculation of wind heeling moment (Hm).  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Calculation of wind heeling moment (Hm). 174.055 Section...Drilling Units § 174.055 Calculation of wind heeling moment (Hm). (a) The wind heeling moment (Hm) of a unit in a given...

2013-10-01

129

46 CFR 174.055 - Calculation of wind heeling moment (Hm).  

Code of Federal Regulations, 2011 CFR

...2011-10-01 2011-10-01 false Calculation of wind heeling moment (Hm). 174.055 Section...Drilling Units § 174.055 Calculation of wind heeling moment (Hm). (a) The wind heeling moment (Hm) of a unit in a given...

2011-10-01

130

46 CFR 174.055 - Calculation of wind heeling moment (Hm).  

Code of Federal Regulations, 2012 CFR

...2012-10-01 2012-10-01 false Calculation of wind heeling moment (Hm). 174.055 Section...Drilling Units § 174.055 Calculation of wind heeling moment (Hm). (a) The wind heeling moment (Hm) of a unit in a given...

2012-10-01

131

In-shoe plantar pressure measurement and analysis system based on fabric pressure sensing array  

Microsoft Academic Search

Spatial and temporal plantar pressure distributions are important and useful measures in footwear evaluation, athletic training, clinical gait analysis, and pathology foot diagnosis. However, present plantar pressure measurement and analysis systems are more or less uncomfortable to wear and expensive. This paper presents an in-shoe plantar pressure measurement and analysis system based on a textile fabric sensor array, which is

Lin Shu; Tao Hua; Yangyong Wang; Qiao Li; David Dagan Feng; Xiaoming Tao

2010-01-01

132

Skin-to-skin contact (Kangaroo Care) analgesia for preterm infant heel stick.  

PubMed

The purpose of the study was to compare a heel stick conducted during Kangaroo Care (skin-to-skin contact) with the mother to a heel stick in a warmer in reducing premature infant physiologic and behavioral pain responses. Twenty-four premature infants in a university-based neonatal intensive care unit were recruited and randomized to 2 sequences: sequence A group received 3 hours of Kangaroo Care (with a heel stick in Kangaroo Care) followed by 3 hours in a warmer (with a heel stick in the warmer). Sequence B group had warmer care and a heel stick (in the warmer) before Kangaroo Care and a heel stick (in Kangaroo Care). Heart rate, respiratory rate, oxygen saturation, crying time, and behavioral state were measured before, during, and after heel stick. Repeated measures ANOVA and Mann Whitney U statistics were performed. Heart rate and length of crying in response to pain were significantly reduced during Kangaroo Care and the Kangaroo Care heel stick as compared to when infants were in the warmer and had a heel stick in the warmer. Three infants did not cry at all during the Kangaroo Care heel stick; infants slept more during Kangaroo Care than in the warmer. Kangaroo Care positioning before and during heel stick is a simple and inexpensive analgesic intervention to ameliorate pain in stable premature infants. PMID:16082239

Ludington-Hoe, Susan M; Hosseini, Robert; Torowicz, Deborah L

2005-01-01

133

Skin-to-Skin Contact Analgesia for Preterm Infant Heel Stick.  

PubMed Central

Objectives The purpose of the study was to compare a heel stick conducted during skin-to-skin contact with the mother to a heel stick in an incubator in reducing premature infant physiologic and behavioral pain responses. Study Design 24 premature infants in a University-based NICU were recruited and randomized to two sequences: Sequence A group received three hours of skin-to-skin contact with a heel stick in skin-to-skin followed by three hours in an incubator with a heel stick in the incubator. Sequence B group had incubator care and heel stick before skin contact care and heel stick. Heart rate, respiratory rate, oxygen saturation, crying time and behavioral state were measured before, during, and after heel stick. Repeated measures ANOVA and Mann Whitney U statistics were performed. Results Heart rate and crying responses to pain were significantly reduced during the skin-to-skin contact and skin contact heel stick as compared to incubator care and incubator heel stick. Three infants did not cry at all during the skin contact heel stick. Infants slept more during skin-to-skin contact than in the incubator. Conclusion Skin-to-skin positioning before and during a heel stick is a simple and inexpensive intervention to ameliorate pain in medically stable premature infants. PMID:16082239

Ludington-Hoe, Susan M.; Hosseini, Robert B.

2005-01-01

134

Effects of knee joint angle on the fascicle behavior of the gastrocnemius muscle during eccentric plantar flexions  

Microsoft Academic Search

The present study aimed to clarify the effects of knee joint angle on the behavior of the medial gastrocnemius muscle (MG) fascicles during eccentric plantar flexions. Eight male subjects performed maximal eccentric plantar flexions at two knee positions [fully extended (K0) and 90° flexed (K90)]. The eccentric actions were preceded by static plantar flexion at a 30° plantar flexed position

Taku Wakahara; Hiroaki Kanehisa; Yasuo Kawakami; Tetsuo Fukunaga

2009-01-01

135

Nordic Walking Practice Might Improve Plantar Pressure Distribution  

ERIC Educational Resources Information Center

Nordic walking (NW), characterized by the use of two walking poles, is becoming increasingly popular (Morgulec-Adamowicz, Marszalek, & Jagustyn, 2011). We studied walking pressure patterns of 20 experienced and 30 beginner Nordic walkers. Plantar pressures from nine foot zones were measured during trials performed at two walking speeds (preferred…

Perez-Soriano, Pedro; Llana-Belloch, Salvador; Martinez-Nova, Alfonso; Morey-Klapsing, G.; Encarnacion-Martinez, Alberto

2011-01-01

136

The relationship between plantar pressure and footprint shape.  

PubMed

Fossil footprints preserve the only direct evidence of the external foot morphologies and gaits of extinct hominin taxa. However, their interpretation requires an understanding of the complex interaction among foot anatomy, foot function, and soft sediment mechanics. We applied an experimental approach aimed at understanding how one measure of foot function, the distribution of plantar pressure, influences footprint topography. Thirty-eight habitually unshod and minimally shod Daasanach individuals (19 male, 19 female) walked across a pressure pad and produced footprints in sediment directly excavated from the geological layer that preserves 1.5 Ma fossil footprints at Ileret, Kenya. Calibrated pressure data were collected and three-dimensional models of all footprints were produced using photogrammetry. We found significant correlations (Spearman's rank, p < 0.0001) between measurements of plantar pressure distribution and relative footprint depths at ten anatomical regions across the foot. Furthermore, plantar pressure distributions followed a pattern similar to footprint topography, with areas of higher pressure tending to leave deeper impressions. This differs from the results of experimental studies performed in different types of sediment, supporting the hypothesis that sediment type influences the relationship between plantar pressure and footprint topography. Our results also lend support to previous interpretations that the shapes of the Ileret footprints preserve evidence of a medial transfer of plantar pressure during late stance phase, as seen in modern humans. However, the weakness of the correlations indicates that much of the variation in relative depths within footprints is not explained by pressure distributions under the foot when walking on firm ground, using the methods applied here. This warrants caution when interpreting the unique foot anatomies and foot functions of extinct hominins evidenced by their footprint structures. Further research is necessary to clarify how anatomical, functional, and sedimentary variables influence footprint formation and how each can be inferred from footprint morphology. PMID:23725794

Hatala, Kevin G; Dingwall, Heather L; Wunderlich, Roshna E; Richmond, Brian G

2013-07-01

137

Casting methods and plantar pressure: effects of custom-made foot orthoses on dynamic plantar pressure distribution.  

PubMed

Foot orthoses are widely used to treat various foot problems. A literature search revealed no publications on differences in plantar pressure distribution resulting from casting methods for foot orthoses. Four casting methods were used for construction of orthoses. Two foam box techniques were used: accommodative full weightbearing method (A) and functional semiweightbearing method (B). Also, two suspension plaster casting techniques were used: accommodative casting (C) and functional subtalar joint neutral position (Root) method (D). Their effects on contact area, plantar pressure, and walking convenience were evaluated. All orthoses increased the total contact area (mean, 17.4%) compared with shoes without orthoses. Differences in contact areas between orthoses for total plantar surface were statistically significant. Peak pressures for the total plantar surface were lower with orthoses than without orthoses (mean, 22.8%). Among orthoses, only the difference between orthoses A and B was statistically significant. Differences between orthoses for the forefoot were small and not statistically significant. The gait lines of the shoe without an insole and of the accommodative orthoses are more medially located than those of functional orthoses. Walking convenience in the shoe was better rated than that with orthoses. There were no differences in perception of walking convenience between orthoses A, B, and C. Orthosis D had the lowest convenience rating. The four casting methods resulted in differences between orthoses with respect to contact areas and walking convenience but only slight differences in peak pressures. PMID:16415278

Guldemond, Nick A; Leffers, Pieter; Sanders, Antal P; Emmen, Hans; Schaper, Nicolaas C; Walenkamp, Geert H I M

2006-01-01

138

Heel and toe driving on fuel cell vehicle  

DOEpatents

A system and method for providing nearly instantaneous power in a fuel cell vehicle. The method includes monitoring the brake pedal angle and the accelerator pedal angle of the vehicle, and if the vehicle driver is pressing both the brake pedal and the accelerator pedal at the same time and the vehicle is in a drive gear, activating a heel and toe mode. When the heel and toe mode is activated, the speed of a cathode compressor is increased to a predetermined speed set-point, which is higher than the normal compressor speed for the pedal position. Thus, when the vehicle brake is removed, the compressor speed is high enough to provide enough air to the cathode, so that the stack can generate nearly immediate power.

Choi, Tayoung; Chen, Dongmei

2012-12-11

139

Heel raises versus prefabricated orthoses in the treatment of posterior heel pain associated with calcaneal apophysitis (Sever's Disease): study protocol for a randomised controlled trial  

Microsoft Academic Search

BACKGROUND: Posterior Heel pain can present in children of 8 to 14 years, associated with or clinically diagnosed as Sever's disease, or calcaneal apophysitis. Presently, there are no comparative randomised studies evaluating treatment options for posterior heel pain in children with the clinical diagnosis of calcaneal apophysitis or Sever's disease. This study seeks to compare the clinical efficacy of some

Alicia M James; Cylie M Williams; Terry P Haines

2010-01-01

140

Plantar pressure parameters for dynamic gait stability analysis.  

PubMed

Dynamic stability measurement is necessary to evaluate human performance over a variety of locomotor environments. In this paper, the suitability of parameters extracted from plantar-pressure measurements as input into a dynamic stability model was investigated. FScan in-shoe pressure data were collected from 15 subjects as they completed four successively more unstable walking tasks. Six parameters met the criteria of being reliably calculated from plantar pressure data, increasing as the task became more unstable, and relating to past measures from the literature: anterior/posterior centre of force (CoF) position, medio-lateral CoF position, double support time, stance time, cell triggering frequency, and maximum lateral CoF position. These parameters could be combined to create an index of dynamic gait stability. PMID:17946632

Lemaire, Edward D; Biswas, Ajoy; Kofman, Jonathan

2006-01-01

141

The role of bone scintigraphy in determining the etiology of heel pain  

Microsoft Academic Search

In this study we aimed to determine the role of bone scintigraphy as an objective diagnostic method in patients with heel\\u000a pain.\\u000a \\u000a 67 heels of 50 of 182 patients with defined features who attended the orthopedics outpatient clinic with heel pain over a\\u000a 3-year period, were treated with combined methods such as nonsteroidal anti-inflammatory drugs (NSAID) and contrast baths,\\u000a stretching

Hakan Özdemir; Aysun Özdemir; Yetkin Söyüncü; Mustafa Ürgüden

2002-01-01

142

Heel blood sampling in European neonatal intensive care units: compliance with pain management guidelines  

Microsoft Academic Search

ObjectiveTo describe the use of heel blood sampling and non-pharmacological analgesia in a large representative sample of neonatal intensive care units (NICUs) in eight European countries, and compare their self-reported practices with evidence-based recommendations.MethodsInformation on use of heel blood sampling and associated procedures (oral sweet solutions, non-nutritive sucking, swaddling or positioning, topical anaesthetics and heel warming) were collected through a

Valentina Losacco; Marina Cuttini; Gorm Greisen; Dominique Haumont; Carmen R Pallás-Alonso; Veronique Pierrat; Inga Warren; Bert J Smit; Björn Westrup

2011-01-01

143

Hammertoe surgery: arthroplasty, arthrodesis or plantar plate repair?  

PubMed

In cases of painful complex hammertoe deformity, there is no single approach that can be used in all circumstances. If conservative care fails, surgical management may include interphalangeal joint arthroplasty, arthrodesis, and/or plantar plate repair. The best and most pragmatic surgical plan must be patient-centered, taking the age, activity level, expectations of the patient, and precise etiology of the hammertoe deformity into account. PMID:22727377

Kernbach, Klaus J

2012-07-01

144

Isolated plantar dislocation of the 1st metatarsophalangeal joint.  

PubMed

Plantar dislocation of the 1st metatarsophalangeal joint is an extremely rare injury. To the best of our knowledge, there are no previous reports in the literature of an isolated dislocation of this type requiring open reduction and surgical repair. In this case report, we describe the clinical and operative findings and discuss in detail our surgical technique for the successful management of this unusual injury. PMID:24075504

Lomax, A; Miller, R J; Kumar, C S

2013-12-01

145

Plantar flexion: an effective training for peripheral arterial disease  

Microsoft Academic Search

This study examined whether a training intervention likely to elicit adaptations in the leg could result in reduced leg pain\\u000a and increased whole body physical capacity. Twenty-seven peripheral arterial disease (PAD) patients were randomized to either\\u000a an individual leg plantar flexion training group (TG) training 4 × 4 min intervals at 80% of maximal work rate three times\\u000a per week for 8 weeks

Eivind Wang; Jan Hoff; Henrik Loe; Nils Kaehler; Jan Helgerud

2008-01-01

146

Plantar and dorsal foot loading measurements in patients after rotationplasty  

Microsoft Academic Search

Objective. The present study investigated the plantar and dorsal foot loading patterns inside the prosthesis of patients after rotationplasty.Design. In vivo foot pressure distribution measurements during free walking in rotationplasty patients at an average follow-up of 10.4 years after surgery.Methods. Fourteen subjects participated in the study and were measured during free walking. Capacitive pressure sensitive insoles were worn inside the

Axel Hillmann; Dieter Rosenbaum; Winfried Winkelmann

2000-01-01

147

Plantar pitted keratolysis: a study from non-risk groups  

PubMed Central

Pitted keratolysis is an acquired, superficial bacterial infection of the skin which is characterized by typical malodor and pits in the hyperkeratotic areas of the soles. It is more common in barefooted people in tropical areas, or those who have to wear occlusive shoes, such as soldiers, sailors and athletes. In this study, we evaluated 41 patients who had been diagnosed with plantar pitted keratolysis. The patients were of high socioeconomic status, were office-workers, and most had a university degree. Malodor and plantar hyperhydrosis were the most frequently reported symptoms. The weight-bearing metatarsal parts of the feet were those most affected. Almost half the women in the study gave a history of regular pedicure and foot care in a spa salon. Mean treatment duration was 19 days. All patients were informed about the etiology of the disease, predisposing factors and preventive methods. Recurrences were observed in only 17% of patients during the one year follow-up period. This study emphasizes that even malodorous feet among non-risk city dwellers may be a sign of plantar pitted keratolysis. A study of the real incidence of the disease in a large population-based series is needed. PMID:25386314

Kaptanoglu, Asli Feride; Yuksel, Ozlem; Ozyurt, Selcuk

2012-01-01

148

A knowledge-based modeling for plantar pressure image reconstruction.  

PubMed

It is known that prolonged pressure on the plantar area is one of the main factors in developing foot ulcers. With current technology, electronic pressure monitoring systems can be placed as an insole into regular shoes to continuously monitor the plantar area and provide evidence on ulcer formation process as well as insight for proper orthotic footwear design. The reliability of these systems heavily depends on the spatial resolution of their sensor platforms. However, due to the cost and energy constraints, practical wireless in-shoe pressure monitoring systems have a limited number of sensors, i.e., typically . In this paper, we present a knowledge-based regression model (SCPM) to reconstruct a spatially continuous plantar pressure image from a small number of pressure sensors. This model makes use of high-resolution pressure data collected clinically to train a per-subject regression function. SCPM is shown to outperform all other tested interpolation methods for sensors, with less than one-third of the error for K=10 sensors. SCPM bridges the gap between the technological capability and medical need and can play an important role in the adoption of sensing insole for a wide range of medical applications. PMID:24833414

Ostadabbas, Sarah; Nourani, Mehrdad; Saeed, Adnan; Yousefi, Rasoul; Pompeo, Matthew

2014-10-01

149

Neonatal pain response to heel stick vs venepuncture for routine blood sampling.  

PubMed

Neonatal pain response and adverse effects and maternal anxiety were assessed in 27 infants who were randomly allocated to venepuncture or heel stick. Pain was assessed by nurses using the Neonatal Infant Pain Scale (NIPS) and a three point scale for the mothers. NIPS scores were higher in the heel stick group compared with the venepuncture group. Maternal anxiety was higher before the procedure while perception of an infant's pain was lower in the venepuncture group compared with the heel stick group. Venepuncture is less painful than heel stick in newborn infants undergoing routine blood sampling. PMID:9377140

Shah, V S; Taddio, A; Bennett, S; Speidel, B D

1997-09-01

150

Heel raises versus prefabricated orthoses in the treatment of posterior heel pain associated with calcaneal apophysitis (Sever's Disease): study protocol for a randomised controlled trial  

PubMed Central

Background Posterior Heel pain can present in children of 8 to 14 years, associated with or clinically diagnosed as Sever's disease, or calcaneal apophysitis. Presently, there are no comparative randomised studies evaluating treatment options for posterior heel pain in children with the clinical diagnosis of calcaneal apophysitis or Sever's disease. This study seeks to compare the clinical efficacy of some currently employed treatment options for the relief of disability and pain associated with posterior heel pain in children. Method Design: Factorial 2 × 2 randomised controlled trial with monthly follow-up for 3 months. Participants: Children with clinically diagnosed posterior heel pain possibly associated with calcaneal apophysitis/Sever's disease (n = 124). Interventions: Treatment factor 1 will be two types of shoe orthoses: a heel raise or prefabricated orthoses. Both of these interventions are widely available, mutually exclusive treatment approaches that are relatively low in cost. Treatment factor 2 will be a footwear prescription/replacement intervention involving a shoe with a firm heel counter, dual density EVA midsole and rear foot control. The alternate condition in this factor is no footwear prescription/replacement, with the participant wearing their current footwear. Outcomes: Oxford Foot and Ankle Questionnaire and the Faces pain scale. Discussion This will be a randomised trial to compare the efficacy of various treatment options for posterior heel pain in children that may be associated with calcaneal apophysitis also known as Sever's disease. Trial Registration Trial Number: ACTRN12609000696291 Ethics Approval Southern Health: HREC Ref: 09271B PMID:20196866

2010-01-01

151

Hybrid toe and heel joints for biped\\/humanoid robots for natural gait  

Microsoft Academic Search

A biped\\/humanoid robot with toe and heel joints is capable of more natural locomotion due to the additional degrees of freedom available. Though passive spring loaded joints can help to some extent, they introduce constraints between the joint torque and the joint angular displacement. In this paper, we propose to use hybrid active\\/passive toe and heel joints in order to

R Prasanth KumarI; Nandha Handharu; Jungwon Yoon; Gap-soon Kim

2007-01-01

152

Sensory and Biomechanical Characterization of Two Painful Syndromes in the Heel  

Microsoft Academic Search

This study evaluated sensory and biomechanical assets in 2 heel pain conditions with similar symptoms, entrapment syndrome of the nerve to abductor digiti quinti and myofascial syndrome of abductor hallucis. Thirty-three patients with unilateral heel pain and 20 asymptomatic subjects underwent pressure pain threshold measurement in the painful area in site A (medial process of calcaneal tuberosity, trigger point site

Raoul Saggini; Rosa Grazia Bellomo; Giannapia Affaitati; Domenico Lapenna; Maria Adele Giamberardino

2007-01-01

153

Efficient Dynamic Walking: Design Strategies to Reduce Energetic Losses of a Compass Walker at Heel Strike  

Microsoft Academic Search

Understanding the dynamics of bipedal locomotion is a key issue for the design of efficient walking systems. The mechanical analysis of the gait involves the study of the single support phase and the impulsive motion of heel strike. The aim of this work is to gain insight into the dynamics and energetics of heel-strike impacts. For this purpose, we use

József Kövecses

2009-01-01

154

A chymotrypsin-like proteinase that may be involved in desquamation in plantar stratum corneum  

Microsoft Academic Search

We have recently reported that unipolar cell shedding from plantar stratum corneum incubated in vitro, and the associated degradation of the desmosomal protein desmoglein I, are dependent on the activity of a proteinase that can be inhibited by aprotinin, chymostatin and zinc ion. The aim of this work was to find a proteinase in plantar stratum corneum that fulfils the

T. Egelrud; A. Lundström

1991-01-01

155

The Relationship of Plantar Flexor Strength to Functional Balance in Older Adults  

Microsoft Academic Search

The incidence of falls in older adults increases with a decline in lower extremity strength, functional balance, and multi-tasking while walking. This study examined the relationship between plantar flexor muscle strength and balance as it is used in everyday tasks. The participants were thirty-eight adults age 65 or older residing in an independent living community. Participants' plantar flexor strength was

Amber N. Droegemeier; Kirsten A. Ensz; Danielle M. Hildebrand; Kelly S. Moore

156

INFLUENCE OF SHOE MIDSOLE MATERIAL HARDNESS ON PERCEIVED COMFORT, REARFOOT MOTION, AND PLANTAR PRESSURE  

Microsoft Academic Search

The purpose of this study was to determine the influence of different midsole hardness on perceived comfort, rearfoot motion, and plantar pressure. Fifteen injury-free male amateur runners participated in this study. Rearfoot motion, plantar pressure, and perceived comfort were recorded while running. Smaller rearfoot maximal pronation, lower comfort scale, and greater maximum force and peak pressure of the lateral side

Youlian Hong; Lin Wang

157

Effects of low-dye taping on plantar pressure pre and post exercise: an exploratory study  

Microsoft Academic Search

BACKGROUND: Low-Dye taping is used for excessive pronation at the subtalar joint of the foot. Previous research has focused on the tape's immediate effect on plantar pressure. Its effectiveness following exercise has not been investigated. Peak plantar pressure distribution provides an indirect representation of subtalar joint kinematics. The objectives of the study were 1) To determine the effects of Low-Dye

Damien Nolan; Norelee Kennedy

2009-01-01

158

Botulinum neurotoxin treatment of palmar and plantar hyperhidrosis.  

PubMed

Palmar and plantar hyperhidrosis is relatively common and can have severe psychological and medical consequences for those afflicted. A multitude of treatments exist but are often inadequate especially for those with significant disease. In these cases botulinum neurotoxin provides a reliable method for reducing the symptoms and improving quality of life. Although actual administration is relatively straightforward, pain management is a crucial component that requires a mastery of several techniques. Patients have a high degree of satisfaction with botulinum neurotoxin treatment and are motivated to come back for repeat treatments, usually every 6 months. PMID:25152344

Weinberg, Tessa; Solish, Nowell; Murray, Christian

2014-10-01

159

Resistance exercise prevents plantar flexor deconditioning during bed rest  

NASA Technical Reports Server (NTRS)

Because resistance exercise (REX) and unloading induce opposing neuromuscular adaptations, we tested the efficacy of REX against the effects of 14 d of bed rest unloading (BRU) on the plantar flexor muscle group. Sixteen men were randomly assigned to no exercise (NOE, N = 8) or REX (N = 8). REX performed 5 sets x 6-10 repetitions to failure of constant resistance concentric/eccentric plantar flexion every other day during BRU. One-repetition maximum (1RM) strength was tested on the training device. The angle-specific torque-velocity relationship across 5 velocities (0, 0.52, 1.05, 1.75, and 2.97 rad.s-1) and the full range-of-motion power-velocity relationship were assessed on a dynamometer. Torque-position analyses identified strength changes at shortened, neutral, and stretched muscle lengths. Concentric and eccentric contractile work were measured across ten repetitions at 1.05 rad.s-1. Maximal neural activation was measured by surface electromyography (EMG). 1RM decreased 9% in NOE and improved 11% in REX (P < 0.05). Concentric (0.52 and 1.05 rad.s-1), eccentric (0.52 and 2.97 rad.s-1), and isometric angle-specific torques decreased (P < 0.05) in NOE, averaging 18%, 17%, and 13%, respectively. Power dropped (P < 0.05) in NOE at three eccentric (21%) and two concentric (14%) velocities. REX protected angle-specific torque and average power at all velocities. Concentric and eccentric strength decreased at stretched (16%) and neutral (17%) muscle lengths (P < 0.05) in NOE while REX maintained or improved strength at all joint positions. Concentric (15%) and eccentric (11%) contractile work fell in NOE (P < 0.05) but not in REX. Maximal plantar flexor EMG did not change in either group. In summary, constant resistance concentric/eccentric REX completely prevented plantar flexor performance deconditioning induced by BRU. The reported benefits of REX should prove useful in prescribing exercise for astronauts in microgravity and for patients susceptible to functional decline during bed- or chair-bound hospital stays.

Bamman, M. M.; Hunter, G. R.; Stevens, B. R.; Guilliams, M. E.; Greenisen, M. C.

1997-01-01

160

The influence of heel height on utilized coefficient of friction during walking.  

PubMed

Wearing high heel shoes has been associated with an increased potential for slips and falls. The association between wearing high heels and the increased potential for slipping suggests that the friction demand while wearing high heels may be greater when compared to wearing low heel shoes. The purpose of this study was to determine if heel height affects utilized friction (uCOF) during walking. A secondary purpose of this study was to compare kinematics at the ankle, knee, and hip that may explain uCOF differences among shoes with varied heel heights. Fifteen healthy women (mean age 24.5±2.5yrs) participated. Subjects walked at self-selected velocity under 3 different shoe conditions that varied in heel height (low: 1.27cm, medium: 6.35cm, and high: 9.53cm). Ground reaction forces (GRFs) were recorded using a force platform (1560Hz). Kinematic data were obtained using an 8 camera motion analysis system (120Hz). Utilized friction was calculated as the ratio of resultant shear force to vertical force. One-way repeated measures ANOVAs were performed to test for differences in peak uCOF, GRFs at peak uCOF and lower extremity joint angles at peak uCOF. On average, peak uCOF was found to increase with heel height. The increased uCOF observed in high heel shoes was related to an increase in the resultant shear force and decrease in the vertical force. Our results signify the need for proper public education and increased footwear industry awareness of how high heel shoes affect slip risk. PMID:21536444

Blanchette, Mark G; Brault, John R; Powers, Christopher M

2011-05-01

161

Influence of Different Designs of High-Heeled Shoes on Kinematics, Kinetics, and Muscle EMG of Female Gait  

Microsoft Academic Search

Many studies have investigated the differences in gait patterns with increasing heel height. The purpose of this investigation is to study the differences in gait patterns when wearing stiletto and wedge type high-heeled shoes with different heel designs versus barefoot walking. A Vicon 512 Motion Analysis system and four Kistler force plates were used to record changes in lower-extremity joint

Deger Ozkaramanli

2007-01-01

162

Effect of shoe heel height on vastus medialis and vastus lateralis electromyographic activity during sit to stand  

Microsoft Academic Search

BACKGROUND: It has been proposed that high-heeled shoes may contribute to the development and progression of knee pain. However, surprisingly little research has been carried out on how shoe heel height affects muscle activity around the knee joint. The purpose of this study was to investigate the effect of differing heel height on the electromyographic (EMG) activity in vastus medialis

Lindsay Edwards; John Dixon; Jillian R Kent; David Hodgson; Vicki J Whittaker

2008-01-01

163

Design and Test of a Soft Plantar Force Measurement System for Gait Detection  

PubMed Central

This work describes a plantar force measurement system. The MEMS pressure sensor, as the key sensing element, is designed, fabricated and embedded into a flexible silicon oil-filled bladder made of silicon rubber to constitute a single sensing unit. A conditioning circuit is designed for signal processing and data acquisition. The characteristics of the plantar force sensing unit are investigated by both static and dynamic tests. A comparison of characteristics between the proposed plantar force sensing unit and a commercial flexible force sensor is presented. A practical experiment of plantar force measurement has been carried out to validate the system. The results demonstrate that the proposed measurement system has a potential for success in the application of plantar force measurement during normal gait. PMID:23208558

Zhang, Xuefeng; Zhao, Yulong; Duan, Zhengyong; Liu, Yan

2012-01-01

164

Use of primary corticosteroid injection in the management of plantar fasciopathy: is it time to challenge existing practice?  

PubMed

Plantar fasciopathy (PF) is characterized by degeneration of the fascia at the calcaneal enthesis. It is a common cause of foot pain, accounting for 90% of clinical presentations of heel pathology. In 2009-2010, 9.3 million working days were lost in England due to musculoskeletal disorders, with 2.4 million of those attributable to lower-limb disorders, averaging 16.3 lost working days per case. Numerous studies have attempted to establish the short- and long-term clinical efficacy of corticosteroid injections in the management of PF. Earlier studies have not informed clinical practice. As the research base has developed, evidence has emerged supporting clinical efficacy. With diverse opinions surrounding the etiology and efficacy debate, there does not seem to be a consensus of opinion on a common treatment pathway. For example, in England, the National Institute for Clinical Health and Excellence does not publish strategic guidance for clinical practice. Herein, we review and evaluate core literature that examines the clinical efficacy of corticosteroid injection as a treatment for PF. Outcome measures were wide ranging but largely yielded results supportive of the short- and long-term benefits of this modality. The analysis also looked to establish, where possible, "proof of concept." This article provides evidence supporting the clinical efficacy of corticosteroid injections, in particular those guided by imaging technology. The evidence challenges existing orthodoxy, which marginalizes this treatment as a secondary option. This challenge is supported by recently revised guidelines published by the American College of Foot and Ankle Surgeons advocating corticosteroid injection as a primary treatment option. PMID:24072372

Kirkland, Paul; Beeson, Paul

2013-01-01

165

Backwards in High Heels: Getting Women Elected, 1842-1990  

NSDL National Science Digital Library

Incorporated as the capital of the Republic of Texas in 1839, Austin didnâÂÂt elect its first female council woman until the middle of the 20th century. The first female legislators didnâÂÂt find their way into office until the 1970s, and it wasnâÂÂt until 1990 that Texas elected a female governor. This exhibit by AustinâÂÂs Public Library tells the story of women in the cityâÂÂs politics through photographs, essays, and old newspaper clippings. Categories include WomenâÂÂs Work, Political Pioneers, and A Foot in the Door, among many others. Of particular interest, the biography of Ann Richards, the former governor of Texas, contextualizes her famous quote: âÂÂGinger Rogers did everything that Fred Astaire did. She just did it backwards and in high heels.âÂÂ

2014-02-25

166

Radiation levels on empty cylinders containing heel material  

SciTech Connect

Empty UF{sub 6} cylinders containing heel material were found to emit radiation levels in excess of 200 mr/hr, the maximum amount stated in ORO-651. The radiation levels were as high as 335 mr/hr for thick wall (48X and 48Y) cylinders and 1050 mr/hr for thin wall (48G and 48H) cylinders. The high readings were found only on the bottom of the cylinders. These radiation levels exceeded the maximum levels established in DOT 49 CFR, Part 173.441 for shipment of cylinders. Holding periods of four weeks for thick-wall cylinders and ten weeks for thin-wall cylinders were established to allow the radiation levels to decay prior to shipment.

Shockley, C.W. [Martin Marietta Energy Systems, Inc., Paducah, KY (United States)

1991-12-31

167

The Artificial Gravity Bed Rest Pilot Project: Effects on Knee Extensor and Plantar Flexor Muscle Groups  

NASA Technical Reports Server (NTRS)

The goal of this project was to examine the effects of artificial gravity (2.5 g) on skeletal muscle strength and key anabolic/catabolic markers known to regulate muscle mass. Two groups of subjects were selected for study: 1) a 21 day-bed rest (BR) control (C) group (N=7); and 2) an AG group (N=8), which was exposed to 21 days of bed-rest plus daily 1 hr exposures to AG (2.5 g). This particular experiment was part of an integrated AG Pilot Project sponsored by NASA/Johnson Space Center. The in vivo torque-velocity relationships of the knee extensors and plantar flexors of the ankle were determined pre and post treatment. Also, pre- and post treatment biopsy samples were obtained from both the vastus lateralis and soleus muscles and were used, in part, for a series of analyses on gene expression (mRNA abundance) of key factors implicated in the anabolic versus catabolic state of the muscle. Post/Pre toque-velocity determinations revealed greater decrements in knee extensor performance in the C versus AG group (P less than 0.04). The plantar flexor muscle group of the AG subjects actually demonstrated a net gain in torque-velocity relationship; whereas, in the C group the overall post/pre responses declined (AG vs C; P less than 0.001). Measurements of muscle fiber cross-sectional area (for both muscles) demonstrated a loss of approx. 20% in the C group while no losses were evident in the AG group. RT-PCR analyses of muscle biopsy specimens demonstrated that markers of growth and cytoskeletal integrity (IGF-1, IGF-1 BP4, mechano growth factor, total RNA, and pro-collagen 3a) were higher in the AG group, whereas catabolic markers (myostatin and atrogen) were elevated in the C group. Importantly, these patterns were seen in both muscles. Based on these observations we conclude that paradigms of AG have the potential to maintain the functional, biochemical, and structural homeostasis of skeletal muscle in the face of chronic unloading states. These findings also warrant further studies since it is likely that other robust paradigms of AG that employ various exercise strategies may be more effective in counteracting long duration unloading states as anticipated on the platforms of the Moon and Mars.

Caiozzo, V. J.; Haddad, F.; Lee, S.; Baker, M.; Baldwin, K. M.

2007-01-01

168

Free medial plantar artery flap for the reconstruction of great toe pulp.  

PubMed

The great toe is an important body structure both functionally and cosmetically. The defect over the great toe is very challenging to treat. Our patient was a 9-year-old boy, presenting with posttraumatic loss of partial right great toe pulp. The mode of injury was the toe getting caught in the cycle wheel and sustaining amputation of the plantar aspect of the great toe. The great toe with exposed bone was reconstructed with a free medial plantar artery flap, harvested from the same limb. To our best knowledge, this was the first reported case of free medial plantar artery flap used for the reconstruction of great toe defects. PMID:24472390

Jyoshid, R B; Vardhan, Harsha; Anto, Francis

2014-06-01

169

Benefits of conservative "wait and see" approach for recurrent plantar keloid.  

PubMed

Keloid formation of the plantar region is rare and a unique challenge to surgeons. We used a conservative "wait and see" approach for recurrent keloid in the plantar region in two patients and recommended that the patients used custom-made shoes. Both patients were pleased with the result. The keloids regressed and flattened. During our minimum of five years follow-up the patients had no pain, tenderness, paraesthesiae, or problems with walking. We found no complications. Keloids should not be treated aggressively, and in plantar keloids the conservative "wait and see" approach may provide successful results without any complication. PMID:23802183

Gideroglu, Kaan; Misirlioglu, Aykut; Toksoy, Serdar; Yildirim, Serkan; Akoz, Tayfun

2013-12-01

170

[Simplification and codification of treatment for leprous plantar ulcers].  

PubMed

Practically leprous plantar ulcers (PU) are difficult to treat and heal under field condition. Considering the important number of patients showing a PU, the directors of national leprosy control programmes are determined, within the programmes on prevention of disabilities (POD), to treat the PU in the field. Therefore it appears to be essential to codify and simplify their treatment thus enabling it to be effective. The healing of PU being the only criteria of effectiveness of the technique. Four clinical stages were defined, each corresponding to a precise way of treatment using only essential and basic products at low cost. During the trainings about the treatment techniques and attitudes much emphasize is given on the discharge of the PU, on the trimming of the wound and on the products to use according to PU's evolutionary stage. PMID:9281295

Grauwin, M Y; Hirzel, C; Mane, I; Cartel, J L; Lepers, J P

1997-01-01

171

Analysis of Factors Affecting Stress Solution at Concrete Gravity Dam Heel  

NASA Astrophysics Data System (ADS)

Along with Vietnam's development, various hydraulic constructions including concrete gravity dams have been being built. In some of these dams, the fractures occurred at the heel of the dams are even in small and media dams. There are various reasons cause the factures at dam heel but the main reason is the stress states at dam heel are not determined correctly while designing dam. In this paper, several factors affecting stress solution at concrete gravity dam heel such as element mesh size, crack joints of upstream foundation, execution process are investigated by using finite element model of Banve concrete gravity dam. This work is very significant when the more high concrete gravity dams will be constructed in Vietnam year after year.

Hung, Vu Hoang; Quoc Cong, Trinh; Tongchun, Li

2010-05-01

172

Effect of shoe type on plantar pressure: a gender comparison.  

PubMed

Despite the differences in materials, racing flats have begun to be used not only for racing, but also for daily training. As there are data suggesting a gender difference in overuse injuries in runners, shoe choice may affect loading patterns during running. The purpose was to determine differences in plantar pressure between genders when running in training shoes and racing flats. In-shoe plantar pressure data were collected from 34 subjects (17m, 17f) who ran over-ground in both a racing flat and training shoe. Contact area (CA), maximum force (MF), and contact time under the entire foot and beneath eight foot regions were collected. Each variable was analyzed using a shoe by gender repeated measures ANOVA (alpha=0.05). In men, MF was increased in the racing flats (p=0.016) beneath the medial midfoot (MMF), yet was increased beneath the medial forefoot (MFF) in the training shoe (p=0.018). Independent of gender, CA was decreased in the racing flats beneath the entire foot (p=0.029), the MMF (p=0.013), and the MFF (p=0.030), and increased beneath the lateral forefoot (LFF) (p=0.023). In the racing flats, MF was increased beneath the entire foot (p<0.001) and the LFF (p<0.001). Independent of the shoe, CA was decreased in men beneath the MFF (p=0.007) and middle forefoot (p<0.001), while MF was increased in the LFF (p=0.002). The LFF is an area of increased stress fracture risk in men. Based on the gender differences in loading, running shoe design should be gender specific in an attempt to prevent injuries. PMID:19765995

Queen, Robin M; Abbey, Alicia N; Wiegerinck, Johannes I; Yoder, Jordan C; Nunley, James A

2010-01-01

173

Knee Stretch Walking Method for Biped Robot: Using Toe and Heel Joints to Increase Walking Strides  

NASA Astrophysics Data System (ADS)

This paper proposes a knee stretch walking method for biped robots; the method involves the use of the toes and heel joints to increase walking strides. A knee can be stretched by switching control variables. By a knee stretch walking with heel contacts to the ground and toe takeoffs from the ground, biped robots can increase their walking stride and speed. The validity of the proposed method is confirmed by simulation and experimental results.

Sato, Takahiko; Shimmyo, Shuhei; Nakazato, Miki; Mikami, Kei; Sato, Tomoya; Sakaino, Sho; Ohnishi, Kouhei

174

Management of ischemic heel ulceration and gangrene: An evaluation of factors associated with successful healing  

Microsoft Academic Search

Objective: The objective of this study was to determine the effectiveness of treatment of nonhealing heel ulcers and gangrene and to define those variables that are associated with success.Methods: A multi-institutional review was undertaken at four university or university-affiliated hospitals of all patients with wounds of the heel and arterial insufficiency, which was defined as absent pedal pulses and a

Gerald S Treiman; Gustavo S. C Oderich; Amir Ashrafi; Peter A Schneider

2000-01-01

175

Extracorporal shock wave therapy in patients with tennis elbow and painful heel  

Microsoft Academic Search

The aim of this study was to evaluate the effect of extracorporal shock wave therapy (ESWT) in tennis elbow and painful heel.\\u000a Nineteen patients with tennis elbow and 44 patients with painful heel in which conservative treatment had failed underwent\\u000a ESWT. Both groups received 3000 shock waves of 0.12 mJ\\/mm2 three times at weekly intervals. After a follow-up of 5

Dietrich S. Hammer; Stefan Rupp; Stefan Ensslin; Dieter Kohn; Romain Seil

2000-01-01

176

Ground reaction forces and plantar pressure distribution during occasional loaded gait.  

PubMed

This study compared the ground reaction forces (GRF) and plantar pressures between unloaded and occasional loaded gait. The GRF and plantar pressures of 60 participants were recorded during unloaded gait and occasional loaded gait (wearing a backpack that raised their body mass index to 30); this load criterion was adopted because is considered potentially harmful in permanent loaded gait (obese people). The results indicate an overall increase (absolute values) of GRF and plantar pressures during occasional loaded gait (p < 0.05); also, higher normalized (by total weight) values in the medial midfoot and toes, and lower values in the lateral rearfoot region were observed. During loaded gait the magnitude of the vertical GRF (impact and thrust maximum) decreased and the shear forces increased more than did the proportion of the load (normalized values). These data suggest a different pattern of GRF and plantar pressure distribution during occasional loaded compared to unloaded gait. PMID:23157973

Castro, Marcelo; Abreu, Sofia; Sousa, Helena; Machado, Leandro; Santos, Rubim; Vilas-Boas, João Paulo

2013-05-01

177

Cryotherapy versus salicylic acid for the treatment of plantar warts (verrucae): a randomised controlled trial  

Microsoft Academic Search

Objective To compare the clinical effectiveness of cryotherapy versus salicylic acid for the treatment of plantar warts.Design A multicentre, open, two arm randomised controlled trial.Setting University podiatry school clinics, NHS podiatry clinics, and primary care in England, Scotland, and Ireland.Participants 240 patients aged 12 years and over, with a plantar wart that in the opinion of the healthcare professional was

Sarah Cockayne; Catherine Hewitt; Kate Hicks; Shalmini Jayakody; Arthur Ricky Kang’ombe; Eugena Stamuli; Gwen Turner; Kim Thomas; Mike Curran; Gary Denby; Farina Hashmi; Caroline McIntosh; Nichola McLarnon; David Torgerson; Ian Watt

2011-01-01

178

What are the effects of obesity in children on plantar pressure distributions?  

Microsoft Academic Search

OBJECTIVE: This study examined the effects of obesity on static and dynamic plantar pressure distributions displayed by children.DESIGN: Field-based experimental data on body mass index (BMI) and plantar pressures were collected for 10 obese children and 10 nonobese controls.SUBJECTS: In all, 10 obese (age 8.8±2.0 y, BMI 25.8±3.8 kg m?2) children matched to 10 nonobese children (age 8.9±2.1 y, BMI

A M Dowling; J R Steele; L A Baur

2004-01-01

179

Determinants of premature infant pain responses to heel sticks.  

PubMed

The exposure of premature infants to stressors, such as pain intended to ensure their survival, may instead alter their brain development and contribute to several learning and behavioral difficulties observed in later childhood. The objective of this descriptive, cross-sectional study was to compare the pain responses of 72 preterm infants to a heel stick procedure taking into consideration a variety of factors, including the use of opioids and sedatives. The pain scores assessed on the Preterm Infant Pain Profile (PIPP) scale were highest for the lowest gestational age (GA) group. Multiple linear regression analysis with the four predictor variables noted to be correlated with the PIPP scores (GA, type of needle, severity of illness, and behavioral state) indicated a significant overall relationship (F [5/66] = 5.62, p < 0.01) and accounted for 44% of the variance. All but severity of illness did not add significantly to the variance. Gender, postnatal age, amount, opioids, and sedatives used were not correlated to the PIPP scores. It was concluded that sick premature infants and those who have been exposed to a variety of painful procedures may not manifest behavioral or physiological signs of pain, but may be the most to benefit from precise pain assessment and prudent management. PMID:20687304

Badr, Lina Kurdahi; Abdallah, Bahia; Hawari, Mirvat; Sidani, Saadieh; Kassar, May; Nakad, Pascale; Breidi, Julianna

2010-01-01

180

[The design of plantar pressure distribution monitoring system and preliminary clinical application].  

PubMed

Plantar pressure distribution can reflect the force of several key points on foot while standing and walking. A comprehensive understanding of the plantar pressure distribution makes great sense in the following aspects: the understanding of the normal foot biomechanics and function, clinical diagnosis, measurement of disease extent, postoperative efficacy evaluation, and rehabilitation research. A simple plantar pressure measurement device was designed in this study. This paper uses FlexiForce flexible sensor to pickup plantar pressure signal and USB A/D board to do data acquisition. The data are transferred into a laptop and processed by a VB-based software which can display, remember and replay the data. We chose patients with hallux valgus and normal people to measure the pressure distribution and make contrast analysis of plantar pressure with this device. It can be concluded that people with hallux valgus have higher pressure on the second metatarsophalangeal joint and the distribution move outward. The plantar pressure of patients postoperative could be greatly improved compared to the preoperative. The function of this device has been confirmed. PMID:25039156

Zhu, Xianfeng; Zhao, Zilei; Xu, Donghao; Xu, Dongming

2014-04-01

181

A constitutive model for the mechanical characterization of the plantar fascia.  

PubMed

A constitutive model is proposed to describe the mechanical behavior of the plantar fascia. The mechanical characterization of the plantar fascia regards the role in the foot biomechanics and it is involved in many alterations of its functional behavior, both of mechanical and nonmechanical origin. The structural conformation of the plantar fascia in its middle part is characterized by the presence of collagen fibers reinforcing the tissue along a preferential orientation, which is that supporting the major loading. According to this anatomical evidence, the tissue is described by developing an isotropic fiber-reinforced constitutive model and since the elastic response of the fascia is here considered, the constitutive model is based on the theory of hyperelasticity. The model is consistent with a kinematical description of large strains mechanical behavior, which is typical of soft tissues. A fitting procedure of the constitutive model is implemented making use of experimental curves taken from the literature and referring to specimens of human plantar fascia. A satisfactory fitting of the tensile behavior of the plantar fascia has been performed, showing that the model correctly interprets the mechanical behavior of the tissue in the light of comparison to experimental data at disposal. A critical analysis of the model with respect to the problem of the identification of the constitutive parameters is proposed as the basis for planning a future experimental investigation of mechanical behavior of the plantar fascia. PMID:20175692

Natali, Arturo N; Pavan, Piero G; Stecco, Carla

2010-10-01

182

Heel neuroma: the enigma of recalcitrant heel pain and an innovative approach highlighting sixty surgical cases and a review of two hundred and fifty-seven symptomatic but non-surgical cases  

Microsoft Academic Search

The authors report resolution of recalcitrant heel pain by describing new insights into innervation of the heel. They elucidate biomechanical mechanisms responsible for entrapment of this innervation and explain the diagnostic and therapeutic techniques necessary to manage this etiology, including an innovative therapeutic approach. A one-to-ten year follow-up of the course of 317 heel pain syndrome patients was conducted. The

Ira D. Shandles; James Pruchniewski; Katy L. Reynolds

2002-01-01

183

Heel effect adaptive flat field correction of digital x-ray detectors  

SciTech Connect

Purpose: Anode heel effect renders large-scale background nonuniformities in digital radiographs. Conventional offset/gain calibration is performed at mono source-to-image distance (SID), and disregards the SID-dependent characteristic of heel effect. It results in a residual nonuniform background in the corrected radiographs when the SID settings for calibration and correction differ. In this work, the authors develop a robust and efficient computational method for digital x-ray detector gain correction adapted to SID-variant heel effect, without resorting to physical filters, phantoms, complicated heel effect models, or multiple-SID calibration and interpolation.Methods: The authors present the Duo-SID projection correction method. In our approach, conventional offset/gain calibrations are performed only twice, at the minimum and maximum SIDs of the system in typical clinical use. A fast iterative separation algorithm is devised to extract the detector gain and basis heel patterns from the min/max SID calibrations. The resultant detector gain is independent of SID, while the basis heel patterns are parameterized by the min- and max-SID. The heel pattern at any SID is obtained from the min-SID basis heel pattern via projection imaging principles. The system gain desired at a specific acquisition SID is then constructed using the projected heel pattern and detector gain map.Results: The method was evaluated for flat field and anatomical phantom image corrections. It demonstrated promising improvements over interpolation and conventional gain calibration/correction methods, lowering their correction errors by approximately 70% and 80%, respectively. The separation algorithm was able to extract the detector gain and heel patterns with less than 2% error, and the Duo-SID corrected images showed perceptually appealing uniform background across the detector.Conclusions: The Duo-SID correction method has substantially improved on conventional offset/gain corrections for digital x-ray imaging in an SID-variant environment. The technique is relatively simple, and can be easily incorporated into multiple-point gain calibration/correction techniques. It offers a potentially valuable tool for preprocessing digital x-ray images to boost image quality of mammography, chest and cardiac radiography, as well as automated computer aided diagnostic radiology.

Yu, Yongjian [X-ray Products, Varian Medical Systems Inc., Liverpool, New York 13088 (United States)] [X-ray Products, Varian Medical Systems Inc., Liverpool, New York 13088 (United States); Wang, Jue [Department of Mathematics, Union College, Schenectady, New York 12308 (United States)] [Department of Mathematics, Union College, Schenectady, New York 12308 (United States)

2013-08-15

184

Kangaroo Care Modifies Preterm Infant Heart Rate Variability in Response to Heel Stick Pain: Pilot Study  

PubMed Central

Background Heel stick is the most common painful procedure for preterm infants in neonatal intensive care units. Resultant pain causes adverse physiological effects in major organ systems. Kangaroo Care (KC), involving mother-infant skin-to-skin contact is a promising analgesic for infant pain; however, the effect of KC on the autonomic nervous system's response to pain is unknown. Aim To determine if KC results in improved balance in autonomic responses to heel stick pain than the standard method where infants remain in an incubator care (IC) for the heel stick. Study Design A randomized cross-over trial. Subjects Fourteen preterm infants, 30-32 weeks gestational age and less than 9 days postnatal age. Outcome Measures Infant behavioral state, heart rate, heart rate variability (HRV) indices including low frequency (LF) and high frequency (HF) power, and the LF/HF ratio measured over Baseline, Heel Warming, Heel Stick, and Recovery periods in KC and IC conditions. Results HRV differences between KC and IC were that LF was higher in KC at Baseline (p<.01) and at Heel Stick (p< .001), and HF was higher in KC at Baseline than in the IC condition (p< .05). The LF/HF ratio had less fluctuation across the periods in KC than in IC condition and was significantly lower during Recovery in KC than in IC (p< .001). Conclusions Infants experienced better balance in response in KC than IC condition as shown by more autonomic stability during heel stick. KC may be helpful in mediating physiologic response to painful procedures in preterm infants. PMID:19505775

Cong, Xiaomei; Ludington-Hoe, Susan M.; McCain, Gail; Fu, Pingfu

2009-01-01

185

Strain and loading of the second metatarsal during heel-lift.  

PubMed

Metatarsal stress fractures occur in military recruits after long marches and in athletes after episodes of overtraining involving running or jumping. It has been demonstrated that contraction of the plantar flexors of the toes helps to counteract the moments placed on the metatarsals by body weight. It is possible that physiological fatigue due to strenuous or repetitive exercise reduces the rate and force of contraction of the plantar flexors, thereby increasing metatarsal strain per cycle, and that this mechanism is the primary cause of stress fractures of these bones. To test the hypothesis that fatigue of the plantar flexors causes increased metatarsal loading, thereby predisposing these bones to stress fracture, we measured metatarsal strains in nine fresh cadaveric feet with use of an apparatus that simulated physiological loading due to body weight as well as contraction of the plantar flexors. Each foot was loaded to 750 newtons of ground-reaction force by simulated contraction of the triceps surae, and strains were recorded in the mid-part of the shaft of the second metatarsal. Tests were repeated with use of simulated activity of different combinations of the flexor digitorum longus, flexor hallucis longus, peroneus brevis, peroneus longus, and tibialis posterior muscles. In situ bending moments and axial loads subsequently were derived for each configuration. Dorsal strain was significantly reduced by simulated contraction of the flexor hallucis longus. Plantar-dorsal bending was significantly reduced by simulated contraction of the flexor digitorum longus. PMID:7608227

Sharkey, N A; Ferris, L; Smith, T S; Matthews, D K

1995-07-01

186

An investigation into plantar pressure measurement protocols for footwear research.  

PubMed

Many researchers investigate how footwear design affects plantar pressure (PP) and ask participants to walk in unfamiliar footwear as part of their studies. However, there are no clear guidelines for the required period of time or number of steps a healthy participant requires to acclimatise to unfamiliar footwear. Nor are there clear guidelines for how many steps should be collected to produce data that is representative of gait in each particular shoe being tested. There were therefore two aims to this study: (1) to investigate the number of steps required to produce an average step that is representative of normal gait; (2) to investigate the number of steps required for a participant to acclimatise to a range of footwear types. PP data were collected in 20 healthy participants whilst they walked for 400m in a range of footwear. The results showed that the number of steps required for both acclimatisation and to ensure data quality are dependent on shoe type and the foot region being investigated. It is recommended that 30 steps from one foot are collected during data collection and an acclimatisation period of at least 166 steps is given for each shoe condition. The former recommendation is not met by most studies in the literature. PMID:25161007

Melvin, J M A; Preece, S; Nester, C J; Howard, D

2014-09-01

187

Lower leg muscle strengthening does not redistribute plantar load in diabetic polyneuropathy: a randomised controlled trial  

PubMed Central

Background Higher plantar pressures play an important role in the development of plantar foot ulceration in diabetic polyneuropathy and earlier studies suggest that higher pressures under the forefoot may be related to a decrease in lower leg muscle strength. Therefore, in this randomised controlled trial we evaluated whether lower-extremity strength training can reduce plantar pressures in diabetic polyneuropathy. Methods This study was embedded in an unblinded randomised controlled trial. Participants had diabetes and polyneuropathy and were randomly assigned to the intervention group (n?=?48) receiving strength training during 24 weeks, or the control group (n?=?46) receiving no intervention. Plantar pressures were measured in both groups at 0, 12, 24 and 52 weeks. A random intercept model was applied to evaluate the effects of the intervention on peak pressures and pressure–time-integrals, displacement of center-of-pressure and the forefoot to rearfoot pressure–time-integral-ratio. Results Plantar pressure patterns were not affected by the strength training. In both the intervention and control groups the peak pressure and the pressure–time-integral under the forefoot increased by 55.7 kPa (95% CI: 14.7, 96.8) and 2.0 kPa.s (95% CI: 0.9, 3.2) over 52 weeks, respectively. Both groups experienced a high number of drop-outs, mainly due to deterioration of health status and lower-extremity disabilities. Conclusions Plantar pressures under the forefoot increase progressively over time in people with diabetic polyneuropathy, but in this study were not affected by strength training. Future intervention studies should take this increase of plantar pressure into account and alternative interventions should be developed to reduce the progressive lower extremity problems in these patients. Trial registration This study was embedded in a clinical trial with trial number NCT00759265. PMID:24138784

2013-01-01

188

The influence of a yacht's heeling stability on optimum sail design  

NASA Astrophysics Data System (ADS)

This paper presents fundamental results concerning the optimum design of yacht sails and masts. The aerodynamics of a high aspect ratio sail in uniform flow is analysed using lifting line theory to maximise thrust for a given sail area. The novel feature of this work is that thrust is optimised subject to the constraint that the aerodynamic heeling moment generated by the sail is balanced by the righting moment due to hull buoyancy (and the weight of the keel). Initially, the heel angle is therefore unknown, and determined as part of the solution process. Under the assumption of small heel angle, the problem reduces to minimising a quadratic form in the Fourier coefficients for the circulation distribution along the mast, and a simple analytic solution can be derived. It is found that if the mast is too high, the upper section is unused, and as a consequence there is a theoretically ideal mast height for a yacht of given heeling stability. Under the constraints of given sail area and heeling equilibrium it is found that no advantage is to be gained by allowing reverse circulation near the top of the mast. Various implications for yacht performance are discussed.

Sneyd, A. D.; Sugimoto, T.

1997-01-01

189

Quantification of tritium ``heels`` and isotope exchange mechanisms in La-Ni-Al tritides  

SciTech Connect

Formation of tritium heels in LANA (LaNi{sub 5-x}Al{sub x}) 0.30 (x=0.30) and 0.75 tritides was quantified; size of the heel is dependent on storage and processing conditions. Absorption-desorption cycling of the tritide beds mitigates formation of the tritium heel and can reduce its size. The higher pressure material LANA 0.30 showed slower heel formation than LANA 0.75; this allows more tritium to be removed at the maximum processing temperature. In plant application, LANA 0.30 beds are used as compressors; except during compressor operation, their aging will be very slow. Tritium heel removal by D exchange was demonstrated. Absorption-desorption cycling during an exchange cycle does not improve the exchange efficiency. Residual tritium can be removed to very low levels. For a tritide bed scheduled for removal from the process, a final tritium level can be estimated based on the number of D exchange cycles. 13 refs, 8 figs, 6 tabs.

Wermer, J.R.

1992-07-27

190

Effect of Different Forefoot and Heel Support Surfaces on the Activities of the RF and HAM Muscles during the Sit-to-stand Task while Wearing High-heel Shoes  

PubMed Central

[Purpose] The purpose of this study was to show the effect of different forefoot and heel support surfaces on the activities of the rectus femoris and medial hamstring muscles during the sit-to-stand task while wearing high-heel shoes. [Subjects] Fifteen female subjects were recruited. [Methods] The muscle activities of the rectus femoris and hamstring muscles were recorded using an MP150 system during the sit-to-stand task while wearing various high-heeled shoes. [Results] The activities of the rectus femoris and medial hamstring muscles significantly decreased when subjects wore condition 1 shoes compared with when they wore condition 2, 3 or 4 high-heeled shoes. The activities of the rectus femoris and medial hamstring muscles significantly decreased when subjects wore condition 2 high-heeled shoes compared with condition 3 or 4 high-heeled shoes. [Conclusion] The results can be interpreted as indicating that the size of the forefoot supporting surface can influence the lower extremity muscles of women wearing high-heeled shoes more than the size of the heel supporting surface. PMID:25364105

Yoo, Won-gyu

2014-01-01

191

The Effects of Wearing High Heels while Pressing a Car Accelerator Pedal on Lower Extremity Muscle Activation  

PubMed Central

[Purpose] The purpose of this study was to determine the effects of wearing high heels while driving on lower extremity muscle activation. [Subjects] The subjects of this experimental study were 14 healthy women in their 20s who normally wear shoes with high heels. [Methods] The subjects were asked to place their shoes on an accelerator pedal with the heel touching the floor and then asked to press the pedal with as much pressure as possible for 3 seconds before removing their feet from the pedal. A total of 3 measurements were taken for each heel height (flat, 5?cm, 7?cm), and the heel height was randomly selected. [Results] The levels of muscle activity, indicated as the percentage of reference voluntary contraction, for gastrocnemius muscle in the flat, 5?cm, and 7?cm shoes were 180.8±61.8%, 285.4±122.3%, and 366.2±193.7%, respectively, and there were significant differences between groups. Those for the soleus muscle were 477.3±209.2%, 718.8±380.5%, and 882.4±509.9%, and there were significant differences between groups. [Conclusion] To summarize the results of this study, it was found that female drivers require greater lower extremity muscle activation when wearing high heels than when wearing low heels. Furthermore, instability and muscle fatigue of the ankle joint, which results from wearing high heels on a daily basis, could also occur while driving.

Jung, Jaemin; Lee, Sang-yeol

2014-01-01

192

Effects of shoe inserts and heel height on foot pressure, impact force, and perceived comfort during walking  

Microsoft Academic Search

Studying the impact of high-heeled shoes on kinetic changes and perceived discomfort provides a basis to advance the design and minimize the adverse effects on the human musculoskeletal system. Previous studies demonstrated the effects of inserts on kinetics and perceived comfort in flat or running shoes. No study attempted to investigate the effectiveness of inserts in high heel shoes. The

Lee Yung-Hui; Hong Wei-Hsien

2005-01-01

193

Effects of shoe inserts and heel height on foot pressure, impact force, and perceived comfort during walking  

Microsoft Academic Search

Studying the impact of high-heeled shoes on kinetic changes and perceived discomfort provides a basis to advance the design and minimize the adverse effects on the human musculoskeletal system. Previous studies demonstrated the effects of inserts on kinetics and perceived comfort in flat or running shoes. No study attempted to investigate the effectiveness of inserts in high heel shoes. The

Lee Yung-Hui; Hong Wei-Hsien

194

A Biomechanical Evaluation of Standing in High-Heeled Shoes Paula D. Henderson, McNair Scholar, Penn State  

E-print Network

-heels. Historically, the first form of high heels as we know started during the 14th century. Gentry and noble men, 1959). Whether it is to gain a height advantage, look professional, or stay with the trend of fashion), as it is known to the fashion-conscious world, more than half the members of the America Orthopedic Foot & Ankle

Omiecinski, Curtis

195

Modification of the Syme amputation to prevent postoperative heel pad migration.  

PubMed

The Syme amputation (ankle disarticulation level amputation) can be a valuable procedure for properly selected patients but might be underused owing to the problem of postoperative migration of the heel pad cushion. The present report presents a modification of the Syme amputation technique to prevent postoperative heel pad migration. The technique was performed in 12 patients, most of whom were male patients with diabetic foot infections. At an average follow-up of 7 years, the soft tissue cushion remained in a stable position, without ulceration. Also, patient satisfaction was high with the Syme level of amputation using the modified technique. PMID:24021266

Bibbo, Christopher

2013-01-01

196

The effect of heel height on gait and posture: a review of the literature.  

PubMed

This article explores relevant full-text literature to reveal the effects of heel height on gait and posture and the kinetics and kinematics of the foot, ankle, knee, hip, and spine. Furthermore, special attention will be given to the implications of increased heel height for clinicians treating locomotor disorders and provide information to aid clinical decision making. Full-text articles accessed from databases including AMED, ASSIA, Blackwell Synergy, BNI, Voyager, CINAHL, ScienceDirect, and Taylor Francis inform the review. PMID:19917737

Cowley, Emma E; Chevalier, Thierry L; Chockalingam, Nachiappan

2009-01-01

197

Plantar calcaneal enthesophytes: new observations regarding sites of origin based on radiographic, MR imaging, anatomic, and paleopathologic analysis  

Microsoft Academic Search

Objective. To determine the relationship between sites of calcaneal plantar enthesophytes and surrounding fascial and soft tissue structures using routine radiography, MR imaging, and data derived from cadaveric and paleopathologic specimens. Design and patients. Two observers analyzed the MR imaging studies of 40 ankles in 38 patients (35 males, 3 females; mean age 48.3 years) with plantar calcaneal enthesophytes that

M. Abreu; C. Chung; L. Mendes; A. Mohana-Borges; D. Trudell; D. Resnick

2003-01-01

198

Occurrence, Characterization and Synthesis of Hanford and SRS Tank Heel Materials  

SciTech Connect

The long-range objective of this study was to develop chemically assisted technologies for removing heels from tanks. In FY 01, the first two steps toward this objective were taken: (1) catalogue the occurrence and nature of tank heels and assess which materials are available for study and (2) develop methods for synthesizing non-radioactive surrogate heel materials for use in testing potential removal technologies. The chief finding of Task 1 was the existence of ''heels'', depending on the definition used. Hard materials that would be almost impossible to remove by sluicing are all but absent from the records of both Savannah River and Hanford. Historical usage suggests that the term ''heel'' may also apply to chunky, granular, or semi-solid pasty accumulations. These materials are documented and may also be difficult to remove by conventional sluicing technologies. Such heels may be comprised of normal sludge components, dominantly iron and aluminum hydroxides, or they may result from added materials which were not part of the normal fuel reprocessing operations: Portland cement, diatomaceous earth, sand and soil and spent zeolite ion exchange ''resins''. The occurrence and chemistry of the most notable ''heel'', that of the zeolite mass in Tank 19F at Savannah River, is reviewed in some detail. Secondly, no clear correlation was found between high tank temperatures and difficulties encountered in removing materials from a tank at a later date; nor did the sludges from these tanks give any indication of being particularly solid. Experimental studies to develop synthetic heel materials were caned out using a number of different approaches. For normal sludge materials settling, even when assisted by a centrifuge, it proved ineffective. The same result was obtained from drying sludge samples. Even exposing sludges to a molten salt melt at 233 C, only produced a fine powder, rather than a resilient ceramic which resisted disaggregation. A cohesive material, however, was produced by wicking the pore fluid out of a sludge gel (into packed diatomaceous earth), while simultaneously applying pressure to compact the sludge as it dehydrated. Osmotic gradients could provide the same function as the capillary forces provided by the diatomaceous earth sorbant placed in contact with the sludge. Tests on the anomalous materials added to the tanks all indicated potential problems. Hard granules, and maybe chunks, may be encountered where Portland cement was added to a tank. Sand, spent zeolite resin, and diatomaceous earth, will all react with the tank fluids to produce a sodalite/cancrinite material. The degree of reaction determines whether the grains become cemented together. SRS activities showed that heels formed when spent zeolites were added to tanks can be readily dislodged and it is expected that heels from sand would possess equal or less cohesion. Diatomaceous earth may form more resilient crusts or masses. To summarize, the existence of ''hard'' heels has yet to be documented. A broader definition suggests inclusion of poorly cohesive cancrinite-cemented masses and dense past-like accumulations of abnormally compacted ''normal'' sludges. Chemical treatments to remove these materials must focus on agents that are active against aluminosilicates and hydrous oxides of iron and aluminum. Exploiting the high pore-water content of these materials may provide a second avenue for dislodging such accumulations. Techniques were developed to produce synthetic sludges on which various removal technologies could be tried.

KRUMHANSL, JAMES L.

2002-07-01

199

THE RELATIONSHIP BETWEEN ISOTONIC PLANTAR FLEXOR ENDURANCE, NAVICULAR DROP, AND EXERCISE-RELATED LEG PAIN IN A COHORT OF COLLEGIATE CROSS-COUNTRY RUNNERS  

PubMed Central

Purpose: The purpose of this study was to examine the relationships between isotonic ankle plantar flexor endurance (PFE), foot pronation as measured by navicular drop, and exercise-related leg pain (ERLP). Background: Exercise-related leg pain is a common occurrence in competitive and recreational runners. The identification of factors contributing to the development of ERLP may help guide methods for the prevention and management of overuse injuries. Methods: Seventy-seven (44 males, 33 females) competitive runners from five collegiate cross-country (XC) teams consented to participate in the study. Isotonic ankle PFE and foot pronation were measured using the standing heel-rise and navicular drop (ND) tests, respectively. Demographic information, anthropometric measurements, and ERLP history were also recorded. Subjects were then prospectively tracked for occurrence of ERLP during the 2009 intercollegiate cross-country season. Multivariate logistic regression analysis was used to examine the relationships between isotonic ankle joint PFE and ND and the occurrence of ERLP. Results: While no significant differences were identified for isotonic ankle PFE between groups of collegiate XC runners with and without ERLP, runners with a ND >10 mm were almost 7 times (OR=6.6, 95% CI=1.2–38.0) more likely to incur medial ERLP than runners with ND <10 mm. Runners with a history of ERLP in the month previous to the start of the XC season were 12 times (OR=12.3, 95% CI=3.1–48.9) more likely to develop an in-season occurrence of ERLP. Conclusion: While PFE did not appear to be a risk factor in the development of ERLP in this group of collegiate XC runners, those with a ND greater than 10 mm may be at greater odds of incurring medial ERLP. Level of Evidence: 2b. PMID:22666641

Reinking, Mark F.; Rauh, Mitchell J.

2012-01-01

200

Interpretation of plantar reflexes: biasing effect of other signs and symptoms.  

PubMed Central

Twenty neurologists were asked to judge a number of plantar responses on film. Each film was preceded by a slide with a fictitious abstract of history and examination (minus the plantar reflex). The main part of the presentation only served to disguise the fact that two films, both showing equivocal toe movements, were presented twice at the same sitting, but with opposing information as to the probability of a Babinski sign. Interpretation of these identical pictures differed significantly (P less than 0.01), conforming to the information given. Thirty other neurologists who rated the films without previous data showed no such change of opinion. PMID:303691

Van Gijn, J; Bonke, B

1977-01-01

201

Bronchiolitis obliterans syndrome: the Achilles' heel of lung transplantation.  

PubMed

Lung transplantation is a therapeutic option for patients with end-stage pulmonary disorders. Unfortunately, chronic lung allograft dysfunction (CLAD), most commonly manifest as bronchiolitis obliterans syndrome (BOS), continues to be highly prevalent and is the major limitation to long-term survival. The pathogenesis of BOS is complex and involves alloimmune and nonalloimmune pathways. Clinically, BOS manifests as airway obstruction and dyspnea that are classically progressive and ultimately fatal; however, the course is highly variable, and distinguishable phenotypes may exist. There are few controlled studies assessing treatment efficacy, but only a minority of patients respond to current treatment modalities. Ultimately, preventive strategies may prove more effective at prolonging survival after lung transplantation, but their remains considerable debate and little data regarding the best strategies to prevent BOS. A better understanding of the risk factors and their relationship to the pathological mechanisms of chronic lung allograft rejection should lead to better pharmacological targets to prevent or treat this syndrome. PMID:23821508

Weigt, S Samuel; DerHovanessian, Ariss; Wallace, W Dean; Lynch, Joseph P; Belperio, John A

2013-06-01

202

Failure Mechanism and Solution Study of IC Wire Bond Heel Crack on Leadframe  

Microsoft Academic Search

Many discussion and activity were focusing on the 1st bond (ball bond) on fine pitch for IC wire bonding in the past few years. However, the industry has been getting more and more challenges on the 2nd bond (stitch bond) to seek the robust interconnect solutions. The weak bond and heel crack are two major issues in terms of the

Meijiang Song; Jinzhong Yao; Yongsheng Lu

2008-01-01

203

Is there an association between the use of heeled footwear and schizophrenia?  

Microsoft Academic Search

Existing etiological and pathogenetical theories of schizophrenia have only been able to find support in some epidemiological, clinical, and pathophysiological facts. A selective literature review and synthesis is used to present a hypothesis that finds support in all facts and is contradicted by none.Heeled footwear began to be used more than a 1000 years ago, and led to the occurrence

Jarl Flensmark

2004-01-01

204

The pedestrian environment - the Achilies Heel of travel by low floor bus?  

Microsoft Academic Search

Achilles was one of the great heroes of Greek mythology, a person of outstanding martial powers who only had one weakness. Soon after Achilles' birth his mother Thetis, a sea nymph, dipped him into the River Styx to protect his body from harm. However, the water did not touch the heel by which Thetis held him, leaving him with one

I Lavery; S Davey

1996-01-01

205

Skin conductance and the stress response from heel stick in preterm infants  

PubMed Central

AIM—To evaluate whether spontaneous skin conductance activity is an objective method for measuring the stress response to painful stimuli in premature infants. The number and amplitude of the waves and the baseline increase with the activity of the sympathetic nervous system.?METHODS—In 20 preterm infants of gestational age ? 29 weeks, behavioural state and spontaneous skin conductance activity variables were measured for three minutes before, during, and for three minutes after heel stick.?RESULTS—The number of waves (p < 0.001), the amplitude of the waves (p = 0.001), and the level of the behavioural state (p < 0.001) increased during heel stick, and then decreased to levels found before the procedure. The baseline increased both during (p < 0.001) and after heel stick (p < 0.001), compared with levels before.?CONCLUSION—Spontaneous skin conductance activity reflects the stress response to heel stick in premature infants from at least 29 weeks of gestational age.? PMID:10952711

Storm, H

2000-01-01

206

Pain reduction of heel stick in neonates: Yakson compared to non-nutritive sucking.  

PubMed

The purpose of this study was to test the effect of Yakson (i.e. a traditional Korean touching method) and non-nutritive sucking (NNS) on reducing the pain that neonates experience when undergoing the heel stick procedure for blood testing. Ninety-nine healthy neonates were recruited and assigned into three groups: Yakson (n = 33), NNS (n = 33), and control group (n = 33). Each intervention was provided to the Yakson and NNS groups from 1 min before heel stick until the completion of the heel stick. For the Yakson group, a researcher caressed the belly of a neonate with one hand while supporting the back with the other hand. For the NNS group, a pacifier packed with sterile gauze was put in the neonate's mouth. The oxygen saturation levels in the Yakson and NNS group neonates were maintained significantly better than in the control group neonates. There was no significant difference between the groups with regard to heart rate and neonatal infant pain, measured using the Neonatal Infant Pain Scale. Findings indicate that Yakson can be used during heel stick to help neonates maintain their oxygen saturation level following the procedure. PMID:17962243

Im, Hyesang; Kim, Eunjung; Park, Eunsook; Sung, Kyungsuk; Oh, Wonoak

2008-02-01

207

Feasibility of Quantitative Ultrasound Measurement of the Heel Bone in People with Intellectual Disabilities  

ERIC Educational Resources Information Center

Low bone mineral density (BMD) and fractures are common in people with intellectual disabilities (ID). Reduced mobility in case of motor impairment and the use of anti-epileptic drugs contribute to the development of low BMD. Quantitative ultrasound (QUS) measurement of the heel bone is a non-invasive and radiation-free method for measuring bone…

Mergler, S.; Lobker, B.; Evenhuis, H. M.; Penning, C.

2010-01-01

208

Efficacy of dorsal pedal artery bypass in limb salvage for ischemic heel ulcers  

Microsoft Academic Search

Purpose: Although pedal artery bypass has been established as an effective and durable limb salvage procedure, the utility of these bypass grafts in limb salvage, specifically for the difficult problem of heel ulceration, remains undefined. Methods: We retrospectively reviewed 432 pedal bypass grafts placed for indications of ischemic gangrene or ulceration isolated to either the forefoot (n = 336) or

Scott A. Berceli; Allen K. Chan; Frank B. Pomposelli; Gary W. Gibbons; David R. Campbell; Cameron M. Akbari; David T. Brophy; Frank W. LoGerfo

1999-01-01

209

Acceleration of the calcaneus at heel strike in neutrally aligned and pes planus feet  

Microsoft Academic Search

Objective. The purpose of this research was twofold: (1) to study the impulsive acceleration of the calcaneus at heel strike in subjects with neutrally aligned (i.e., normal) feet and (2) to explore how the acceleration may differ in subjects with pes planus (i.e., flat) feet. The component of the acceleration vector aligned with the long axis of the tibia was

William R. Ledoux; Howard J. Hillstrom

2001-01-01

210

The medial plantar flap vascularized by the reverse flow lateral plantar artery: a novel variation through the case of aggressive digital papillary adenocarcinoma of the sole.  

PubMed

Aggressive digital papillary adenocarcinoma (ADPA) is a rare neoplasm of eccrine sweat gland origin that typically presents as a mass on the distal extremities. It is associated with high rates of local recurrence and distal metastasis. Presented here is the case of a 61-year-old male who developed ADPA on his distal sole just above the head of the first metatarsal bone. Wide excision of the tumor involving a 3-cm skin margin from previous surgical scar of biopsy was performed, and sentinel lymph node biopsies were taken from the popliteal fossa and inguinal regions. During this wide excision surgery, the pedicle for the reverse medial plantar flap had to be removed along with the tumor. Reconstructive surgery was performed with a medial plantar flap that was vascularized with a lateral plantar artery in a reverse fashion. This flap successfully covered the defect and the patient can walk without any problems. However, the pedicle crossed the donor site somewhat tightly and the flap became congested for a while. Therefore, it is important to ensure careful handling of the donor site when performing this procedure. PMID:22711199

Hayashi, Ayato; Matsumura, Takashi; Horiguchi, Masatoshi; Komuro, Yuzo; Itoh, Munenari; Idezuki, Takeo; Igarashi, Atsuyuki; Mizuno, Hiroshi

2012-07-01

211

Dissolution of Plutonium Scrub Alloy and Anode Heel Materials in H-Canyon  

SciTech Connect

H-Canyon has a ''gap'' in dissolver operations during the last three months of FY03. One group of material to be processed during the gap is pre-existing scrub alloy material. There are 14 cans of material containing approximately 3.8 kilograms of plutonium. Of the 14 cans, it was anticipated that four cans contain salts, two cans contain anode heel materials, and eight cans contain scrub alloy buttons. H-Canyon desires to process the materials using a flowsheet similar to the SS and C (sand, slag and crucible) dissolution flowsheet used in F-Canyon. The materials will be loaded into carbon steel cans and then placed into aluminum metal charging bundles. Samples were sent to Savannah River Technology Center (SRTC) for characterization and flowsheet testing -- four MSE salts, two anode heels, and seven scrub alloy buttons. SRTC dissolved and characterized each of the samples. Two of them, originally thought to be MSE salts, were found to be graphite mold materials and were unsuitable for processing in H-Canyon. Characterization studies confirmed that the identification of the remaining items as MSE salts, scrub alloy buttons, and anode heel materials was correct. The MSE salts and anode heels solids are comprised primarily of plutonium, potassium, sodium and chloride. Both the MSE salts and anode heels left behind small amounts of residual solids. The scrub alloy buttons are comprised primarily of plutonium and aluminum. The solids dissolve readily with light, effervescent gas generation at the material surface and only trace amounts of NOx generation. Of the seven button samples, four dissolved completely. Two button samples contained small amounts of tantalum that did not dissolve. The last of the seven scrub alloy samples left a trace amount of residual plutonium solids. It is anticipated that the presence of undissolved fissile material is a function of where the sample was located relative to the button surface.

PIERCE, RA

2004-04-12

212

The Relationship of Body Weight and Clinical Foot and Ankle Measurements to the Heel Forces of Forward and Backward Walking  

PubMed Central

Objective: To compare and contrast the relationships of selected static clinical measurements with the heel forces of forward and backward walking among healthy high school athletes. Design and Setting: Single-group, cross-order-controlled, repeated-measures design. All data were collected in a high school athletic training room. Subjects: Seventeen healthy high school student-athlete volunteers. Measurements: We performed static clinical measurements of the foot, ankle, and knee using handheld goniometers. We used a metric ruler to assess navicular drop and a beam balance platform scale to measure body weight. Mean peak heel forces were measured using F-scan insole force sensors. Data were sampled for 3 5-second trials (50-Hz sampling rate). Mean peak heel forces were determined from 3 to 5 consecutive right foot contacts during forward and backward walking at approximately 4.02 to 4.83 km/h (2.5 to 3.0 mph). Subjects wore their own athletic shoes and alternated their initial walking direction. Results: Forward stepwise multiple regression analyses revealed that body weight, navicular drop, and standing foot angle predicted mean peak heel forces during forward and backward walking. Conclusions: Heel forces during forward and backward walking increase as body weight and navicular drop magnitude increase, and they decrease as standing foot angle increases. Subtle differences in foot, ankle, and knee joint postures and kinematics can affect heel forces even among normal subjects. Injury and protective bracing or taping may further affect these heel forces. PMID:16558581

Albensi, Raymond J.; Nyland, John; Caborn, David N.M.

1999-01-01

213

Measuring system of a 3D force platform for plantar pressure distribution  

Microsoft Academic Search

Spatial plantar pressure measurement system were investigated to extract features of gait in clinical podiatry. In this paper, the design of a novel 3D platform system suitable for the measurement of human foot pressure distribution is proposed. This consists of a 3D force measuring platform equipped with sensor array, and user-friendly software to graph and analyze the data. Also, a

Huijing Wang; Sanfeng Chen; Junyao Liu

2009-01-01

214

Anatomía de la inervación del Hallux: nervio cutáneo dorsal interno y plantar interno  

Microsoft Academic Search

This is a detailed anatomical study of the inervation of hallux in its dorsal and medial aspect of plantar medial nerve and cutaneous dorsal medial nervel of hallux, in a series of cases, in fresh cadavers, in the period from February to April 2004. A total of 20 feet was analyzed. The crosses the extensor hallucis longus tendon towards medial

Kinsthmena Andrea; Ardila Buitrago; Enrique Manuel Vergara Amador; Residente de Ortopedia

2005-01-01

215

Ankle dorsi-and plantar-flexion torques measured by dynamometry in healthy subjects  

E-print Network

: The results documented normal strength values depending on gender and age on ankle dorsi- and plantar Ledoux, Valérie Doppler, Christine Payan and Jean-Yves Hogrel* Abstract Background: Ankle strength is often impaired in some of the most common neuromuscular disorders. Consequently, strength generated

216

Biomechanical consequences of lateral column lengthening of the calcaneus: part I. long plantar ligament strain  

Microsoft Academic Search

Lateral column lengthening of the calcaneus has been a powerful tool used to correct peritalar subluxation in symptomatic flat feet. The mechanical basis and limits for correction with this procedure are not well understood. A flatfoot model was created on 8 fresh-frozen cadaver feet by sectioning the deltoid ligament, talonavicular capsule, and spring ligament. Strain-gauge analysis of the long plantar

Kent R DiNucci; Jeffrey C Christensen; Kris A DiNucci

2004-01-01

217

In-Shoe Plantar Pressures and Ground Reaction Forces during Overweight Adults' Overground Walking  

ERIC Educational Resources Information Center

Purpose: Because walking is highly recommended for prevention and treatment of obesity and some of its biomechanical aspects are not clearly understood for overweight people, we compared the absolute and normalized ground reaction forces (GRF), plantar pressures, and temporal parameters of normal-weight and overweight participants during…

de Castro, Marcelo P.; Abreu, Sofia C.; Sousa, Helena; Machado, Leandro; Santos, Rubim; Vilas-Boas, João Paulo

2014-01-01

218

Design of Plantar Force Sensor for Ankle Rehabilitation Monitor  

Microsoft Academic Search

Ankle injuries are one of the most common types of athletic injuries and can have lasting adverse affects on daily life as well as athletic performance without proper rehabilitation and in severe cases can result in chronic ankle instability. Physiotherapy while effective, still employs many techniques that are largely qualitative for lack of an easily accessible system that can offer

Evan Downie

2010-01-01

219

Chronic spinal infusion of loperamide alleviates postsurgical pain in rats.  

PubMed

Plantar incision in rat generates spontaneous pain behaviour. The opioid drug, morphine used to treat postsurgical pain produces tolerance after long-term administration. Loperamide, a potent mu-opioid agonist, has documented analgesic action in various pain conditions. However, loperamide analgesia and associated tolerance following continuous spinal administration in postsurgical pain has not been reported. Chronic spinal infusion of drugs was achieved using intrathecal catheters connected to osmotic minipump. Coinciding with the onset of spinal infusion of loperamide or morphine, rats were subjected to plantar incision. Pain-related behaviour was assessed by Hargreaves apparatus (thermal hyperalgesia) and von Frey filaments (mechanical allodynia). Morphine and loperamide (0.5, 1 and 2 microL/h) induced analgesia was observed until 7th day post-plantar incision in Sprague-Dawley rats. Morphine and loperamide produced dose-dependent analgesia. Loperamide, in the highest dose, produced analgesia till 7th day. However, the highest dose of morphine produced inhibition of thermal hyperalgesia till 5th day and mechanical allodynia only till 3rd day post-plantar incision. Morphine and loperamide produced analgesia in postsurgical pain, which may be mediated through different mechanisms. Longer duration of analgesia with loperamide could probably be due sustained blockade of calcium channels. PMID:24772934

Kumar, Rakesh; Reeta, K H; Ray, Subrata Basu

2014-04-01

220

Frequency response characteristics of ankle plantar flexors in humans following spinal cord injury: relation to degree of spasticity.  

PubMed

Frequency response characteristics of the ankle plantar flexors were studied in adults both with and without spinal cord injury (SCI) to determine how the muscle contractile properties change after SCI. and to see if there is a relation between the severity of spasticity and how the properties change. Ten controls and ten complete, chronic spinal cord injured subjects were tested, where the tibial nerve was stimulated electrically in a stochastic manner with the ankle fixed isometrically at various joint angles. A nonparametric linear frequency response function was derived, from which a second-order transfer function was calculated. The contractile dynamics were then characterized by the three classic second-order parameters: gain, damping ratio, and natural frequency. We found that in subjects with low degrees of spasticity (as determined by clinical evaluation), the contractile dynamics presented the largest changes, in which the speed of contraction increased significantly while there were no statistical differences in the gains between the two groups. This similarity emerged even though there was noticeable atrophy in the SCI patient group. Differences between the controls and subjects with high levels of spasticity were markedly different, in that these SCI subjects had slower contractile speeds than the controls, but significantly lower gains. Moderately spastic subjects fell somewhere in between, where the speed of muscle contraction increased modestly yet the gain was significantly smaller than that of the control subjects. These findings indicate that in subjects with chronic spinal cord injury, the severity of spasticity can significantly influence the degree of change in muscle contractile properties. It appears that high degrees of spasticity tend to preserve contractile dynamics, while in less spastic subjects, muscle contractile properties may display faster response characteristics. PMID:12398427

Hidler, Joseph M; Harvey, Richard L; Rymer, W Zev

2002-01-01

221

Management of pain from heel stick in neonates: an analysis of research conducted in Thailand.  

PubMed

The heel stick procedure is the most common painful procedure performed in preterm and full-term neonates. Various nonpharmacologic interventions have been used for pain relief. However, the magnitude of the effect of different interventions has received little attention. In this study, 4 eligible studies conducted in Thailand, focusing on the effects of interventions on pain responses to heel stick procedure in neonates, were obtained for analysis. Swaddling in full-term newborns was found to have the largest mean effect size (dmn = 0.79). However, the moderate-to-large effect sizes (dmn = 0.5-0.75) of positioning in preterm newborns tended to exist throughout the poststick period while the effect sizes of other interventions decreased over time. The effect sizes of these interventions for physiological responses varied. PMID:14655790

Prasopkittikun, Tassanee; Tilokskulchai, Fongcum

2003-01-01

222

Lower Limb Muscles SEMG Activity during High-Heeled Latin Dancing  

Microsoft Academic Search

\\u000a aim of this study is to provide information about surface electromyography (SEMG) activity pattern in lower limb muscles during\\u000a Latin dancing with different heel height shoes. SEMG signals from tibialis anterior, medial and lateral sides of gastrocnemius,\\u000a soleus and biceps femoris of ten professional female dancers were recorded. All the muscles average EMG (aEMG) values except\\u000a biceps femoris were significantly

Y. D. Gu; J. S. Li; G. Q. Ruan; Y. C. Wang; M. J. Lake; X. J. Ren

223

Kangaroo mother care diminishes pain from heel lance in very preterm neonates: A crossover trial  

Microsoft Academic Search

BACKGROUND: Skin-to-skin contact, or kangaroo mother care (KMC) has been shown to be efficacious in diminishing pain response to heel lance in full term and moderately preterm neonates. The purpose of this study was to determine if KMC would also be efficacious in very preterm neonates. METHODS: Preterm neonates (n = 61) between 28 0\\/7 and 31 6\\/7 weeks gestational

C Celeste Johnston; Francoise Filion; Marsha Campbell-Yeo; Celine Goulet; Linda Bell; Kathryn McNaughton; Jasmine Byron; Marilyn Aita; G Allen Finley; Claire-Dominique Walker

2008-01-01

224

Ability to perform a single heel-rise is significantly related to patient-reported outcome after Achilles tendon rupture.  

PubMed

This study evaluated the short-term recovery of function after an acute Achilles tendon rupture, measured by a single-legged heel-rise test, with main emphasis on the relation to the patient-reported outcomes and fear of physical activity and movement (kinesiophobia). Eighty-one patients treated surgically or non-surgically with early active rehabilitation after Achilles tendon rupture were included in the study. Patient's ability to perform a single-legged heel-rise, physical activity level, patient-reported symptoms, general health, and kinesiophobia was evaluated 12 weeks after the injury. The heel-rise test showed that 40 out of 81 (49%) patients were unable to perform a single heel-rise 12 weeks after the injury. We found that patients who were able to perform a heel-rise were significantly younger, more often of male gender, reported a lesser degree of symptoms, and also had a higher degree of physical activity at 12 weeks. There was also a significant negative correlation between kinesiophobia and all the patient-reported outcomes and the physical activity level. The heel-rise ability appears to be an important early achievement and reflects the general level of healing, which influences patient-reported outcome and physical activity. Future treatment protocols focusing on regaining strength early after the injury therefore seem to be of great importance. Kinesiophobia needs to be addressed early during the rehabilitation process. PMID:22716232

Olsson, N; Karlsson, J; Eriksson, B I; Brorsson, A; Lundberg, M; Silbernagel, K G

2014-02-01

225

Heel lance in newborn during breastfeeding: an evaluation of analgesic effect of this procedure  

PubMed Central

Objectives The reduction of pain due to routine invasive procedures (capillary heel stick blood sampling for neonatal metabolic screening) in the newborn is an important objective for the so-called "Hospital with no pain". Practices such as skin to skin contact, or breastfeeding, in healthy newborn, may represent an alternative to the use of analgesic drugs. The aim of our work is to evaluate the analgesic effect of breastfeeding during heel puncture in full term healthy newborn. Methods We studied 200 healthy full term newborns (100 cases and 100 controls), proposing the puncture to mothers during breastfeeding, and explaining to them all the advantages of this practice. Pain assessment was evaluated by DAN scale (Douleur Aigue Nouveau ne scale). Results The difference in score of pain according to the DAN scale was significant in the two groups of patients (p = 0.000); the medium score was 5.15 for controls and 2.65 for cases (newborns sampled during breastfeeding). Conclusion Our results confirmed the evidence of analgesic effect of breastfeeding during heel puncture. This procedure could easily be adopted routinely in maternity wards. PMID:19490654

Uga, Elena; Candriella, Manuela; Perino, Antonella; Alloni, Viviana; Angilella, Giuseppina; Trada, Michela; Ziliotto, Anna Maria; Rossi, Maura Barbara; Tozzini, Danila; Tripaldi, Clelia; Vaglio, Michela; Grossi, Luigina; Allen, Michaela; Provera, Sandro

2008-01-01

226

Design and Reliability of a Novel Heel Rise Test Measuring Device for Plantarflexion Endurance  

PubMed Central

Background. Plantarflexion results from the combined action of the soleus and gastrocnemius muscles in the calf. The heel rise test is commonly used to test calf muscle endurance, function, and performance by a wide variety of professionals; however, no uniform description of the test is available. This paper aims to document the construction and reliability of a novel heel rise test device and measurement protocol that is suitable for the needs of most individuals. Methods. This device was constructed from compact and lightweight materials and is fully adjustable, enabling the testing of a wide variety of individuals. It is easy to assemble and disassemble, ensuring that it is portable for use in different settings. Findings. We tested reliability on 40 participants, finding excellent interrater reliability (ICC2,1 0.97, 95% CI: 0.94 to 0.98). Limits of agreement were less than two repetitions in 90% of cases and the Bland-Altman plot showed no bias. Interpretation. We have designed a novel, standardized, simple, and reliable device and measurement protocol for the heel rise test which can be used by researchers and clinicians in a variety of settings. PMID:24877089

Sman, Amy D.; Hiller, Claire E.; Ocsing, Aldrin; Refshauge, Kathryn M.

2014-01-01

227

The heel of achilles: calcaneal avulsion fracture from a gunshot wound.  

PubMed

Greek mythology relates that the legendary warrior Achilles was made invincible by his mother Thetis, who dipped him in the River Styx while holding him by his heel. Because his heel was never immersed, it remained his one area of vulnerability. After the fall of Troy, Achilles met his demise when he was shot in the heel by Paris, whose arrow was guided by the Greek god Apollo. This is the derivation of the term "Achilles tendon." Avulsion fractures of the tuberosity of the calcaneus are rare injuries. Schonbauer reviewed a series of 870,000 accident cases treated at the Vienna Trauma Hospital and found only four such cases in addition to 151 cases of subcutaneous Achilles tendon rupture. In Bohler's series of 182 calcaneal fractures, avulsion of the calcaneal tuberosity accounted for less than 1% of these injuries. Rowe reported four Achilles avulsion fractures in his series of 154 calcaneal fractures. Three basic mechanisms of injury have been described: (1) dorsiflexion violence against the maximally plantarflexed foot, typically occurring in a fall from a height; (2) powerful contraction of the triceps surae muscle with simultaneous extension of the knee such as when a person is about to sprint in a race; (3) a direct blunt blow to the hindfoot. We are describing a case of avulsion of the calcaneal tuberosity due to direct penetrating trauma from a gunshot wound, a mechanism not previously reported. PMID:2731830

Cooper, D E; Heckman, J D

1989-02-01

228

Difference in plantar pressure between the preferred and non-preferred feet in four soccer-related movements  

Microsoft Academic Search

Objective and participants: The present study measured the difference in plantar pressure between the preferred and non-preferred foot in four soccer-related movements in 15 male university soccer players (mean (SD) age 20.9 (1.3) years, mean (SD) height 173 (4) cm and mean (SD) weight 61.7 (3.6) kg).Design: To record plantar pressure distribution, players randomly wore three types of soccer shoes

Pui-lam Wong; Karim Chamari; Anis Chaouachi; De Wei Mao; Ulrik Wisløff; Youlian Hong

2007-01-01

229

Yield of the sural/radial ratio versus the medial plantar nerve in sensory neuropathies with a normal sural response.  

PubMed

The electrodiagnostic yield of the medial plantar nerve action potential (NAP) amplitude versus the sural/radial amplitude ratio (SRAR) was determined in 110 consecutive patients with clinically diagnosed distal sensory polyneuropathy (SN) and normal sural responses. Forty-five consecutive patients with clinically diagnosed lumbosacral radiculopathy served as disease controls. Of the 110 SN patients, 32 were classified clinically as SN with large-fiber involvement (SN-LFI), whereas 78 had clinically pure small-fiber SN. Plantar NAP amplitudes were abnormal in 18 of 32 patients (56%) with SN-LFI, and 15 of 78 (19%) with small-fiber SN. A SRAR <0.21 (fifth percentile of normal) was found in 7 of 32 patients (22%) with SN-LFI and 8 of 78 (10%) with small-fiber SN. In the control group, the medial plantar NAP was normal in all 45 subjects (100%), whereas the SRAR was >0.21 in 43 subjects (96%). Thus, for a 50% pretest probability of SN-LFI, the positive predictive value of an abnormal medial plantar was 100% versus 85% for a SRAR <0.21. The medial plantar NAP amplitude is a more useful measure of SN, than is the SRAR, in patients under age 70, with suspected SN-LFI. The yield of the SRAR and plantar NAP amplitude is poor when clinical signs of large-fiber sensory dysfunction are lacking. PMID:18340276

Sullivan, John P; Logigian, Eric L; Kocharian, Naira; Herrmann, David N

2008-04-01

230

Comparison of the Plantar Pressure Distributions at Different Degrees of Tilting: A Preliminary Report  

PubMed Central

[Purpose] The purpose of this study was to investigate the amount of plantar pressures on the lower limb during tilt table standing and to indicate the ideal degree of tilting for partial weight bearing. [Subjects and Methods] Fifteen healthy subjects between the ages of 20 and 30 were recruited as volunteers for this study. All the measurements were taken while standing on a tilt table according to different inclination angles. [Results] The plantar pressures for 60° tilt table standing were lower by 7–9% of total body weight than the pressures during tilt table standing at 90°, and the pressures for 30° tilt table standing were lower by 18–20% of total body weight than the pressures for tilt table standing at 90°. [Conclusion] Standing training on a 60° tilt table might be equivalent to 80% of full weight bearing training, and tilt table standing training at 30° might be equivalent to 60% of full weight bearing training. PMID:24707092

Son, Sung-Min; Lee, Jun-Ho; Cha, Yong-Jun

2014-01-01

231

Effect of muscle model parameter scaling for isometric plantar flexion torque prediction  

Microsoft Academic Search

This paper uses a EMG-driven Hill-type muscle model to estimate individual muscle forces of the triceps surae in isometric plantar flexion contractions. A uniform group of 20 young physical-active adult males was instructed to follow a specific contraction protocol with low (20%MVC) and medium-high (60%MVC) contractions, separated by relaxing intervals. The torque calculated by summing the individual muscle forces multiplied

Luciano Luporini Menegaldo; Liliam Fernandes de Oliveira

2009-01-01

232

Gender Differences in Human Muscle and Joint Mechanical Properties During Plantar Flexion in Old Age  

Microsoft Academic Search

Muscle and joint mechanical properties during plantar flexion were investigated in 13 elderly women (EW) (age range 73-83 years) and 15 elderly men (EM) (age range 74-81 years). Maximal torque, at several angular velocities, was measured to construct torque-velocity relationship. This led to the calculation of an index of maximal shortening velocity (VImax )a t 10% of maximal isometric torque.

Julien Ochala; Denis Valour; Michel Pousson; Daniel Lambertz; Jacques Van Hoecke

2004-01-01

233

Multi-plug insole design to reduce peak plantar pressure on the diabetic foot during walking  

Microsoft Academic Search

There is evidence that appropriate footwear is an important factor in the prevention of foot pain in otherwise healthy people\\u000a or foot ulcers in people with diabetes and peripheral neuropathy. A standard care for reducing forefoot plantar pressure is\\u000a the utilization of orthotic devices such as total contact inserts (TCI) with therapeutic footwear. Most neuropathic ulcers\\u000a occur under the metatarsal

Ricardo L. Actis; Liliana B. Ventura; Donovan J. Lott; Kirk E. Smith; Paul K. Commean; Mary K. Hastings; Michael J. Mueller

2008-01-01

234

Inexpensive color evaluation of dye-based pressure-sensitive films for plantar studies  

Microsoft Academic Search

Dye-based pressure-sensitive films are advantageous in plantar pressure studies due to their ease of use, cost-effectiveness, and ability to produce measurements within the shoe. To circumvent the use of proprietary equipment and software to relate the dye-stained film to load, an alternative approach of using a conventional flatbed scanner and generic image processing software is attempted here instead. The technique

T. W. Ng; W. K. Yeong

2005-01-01

235

Multi-plug insole design to reduce peak plantar pressure on the diabetic foot during walking.  

PubMed

There is evidence that appropriate footwear is an important factor in the prevention of foot pain in otherwise healthy people or foot ulcers in people with diabetes and peripheral neuropathy. A standard care for reducing forefoot plantar pressure is the utilization of orthotic devices such as total contact inserts (TCI) with therapeutic footwear. Most neuropathic ulcers occur under the metatarsal heads, and foot deformity combined with high localized plantar pressure, appear to be the most significant factors contributing to these ulcers. In this study, patient-specific finite element models of the second ray of the foot were developed to study the influence of TCI design on peak plantar pressure (PPP) under the metatarsal heads. A typical full contact insert was modified based on the results of finite element analyses, by inserting 4 mm diameter cylindrical plugs of softer material in the regions of high pressure. Validation of the numerical model was addressed by comparing the numerical results obtained by the finite element method with measured pressure distribution in the region of the metatarsal heads for a shoe and TCI condition. Two subjects, one with a history of forefoot pain and one with diabetes and peripheral neuropathy, were tested in the laboratory while wearing therapeutic shoes and customized inserts. The study showed that customized inserts with softer plugs distributed throughout the regions of high plantar pressure reduced the PPP over that of the TCI alone. This supports the outcome as predicted by the numerical model, without causing edge effects as reported by other investigators using different plug designs, and provides a greater degree of flexibility for customizing orthotic devices than current practice allows. PMID:18266017

Actis, Ricardo L; Ventura, Liliana B; Lott, Donovan J; Smith, Kirk E; Commean, Paul K; Hastings, Mary K; Mueller, Michael J

2008-04-01

236

A walking monitoring shoe system for simultaneous plantar-force measurement and gait-phase detection  

Microsoft Academic Search

This paper presents a walking-monitoring-shoe (WMS) system capable of simultaneous performing accurate plantar-force measurement and reliable gait-phase detection for continuous monitoring of human walking on treadmill. Based on anatomical information, the WMS employs four strain-gauges embedded in a homemade sole to accurately measure the contact force of the human foot exerted on the shoe-pad, and an efficient classification algorithm to

Hui Yu; Dong-hai Wang; Can-Jun Yang; Kok-Meng Lee

2010-01-01

237

Location specificity of plantar cutaneous reflexes involving lower limb muscles in humans  

Microsoft Academic Search

It is known that cutaneous reflexes in human hand muscles show strong location-specificity dependent on the digit stimulated. We hypothesized that in lower leg muscles the cutaneous reflex following tactile sensation of the plantar surface of the foot is also organized in a location-specific manner. The purpose of the present study was to test this hypothesis. Middle latency reflexes (?70–110 ms,

Tsuyoshi Nakajima; Masanori Sakamoto; Toshiki Tazoe; Takashi Endoh; Tomoyoshi Komiyama

2006-01-01

238

Case study: Epidermoid cyst following percutaneous Topaz coblation for plantar fasciitis.  

PubMed

An epidermoid cyst is formed when there is proliferation of epidermal cells within an area of the dermis. They may be formed by the traumatic implantation of epidermal cells within the dermis as well as many other mechanisms. We present a case of epidermoid cyst formation following Topaz coblation for plantar fasciitis; a complication we believe is yet to be reported in the literature. PMID:22265448

Ferguson, Kim; Thomson, Allan George; Moir, John Stuart

2012-03-01

239

The effects of dynamic stretching on plantar flexor muscle-tendon tissue properties  

Microsoft Academic Search

Dynamic stretching is commonly used in warm-up routines for athletic activities. Even though several positive effects of dynamic stretching on athletic performance have been reported, the effects on the muscle–tendon unit (MTU) itself are still unclear. The objective of this study is to determine the effects of dynamic stretching on the ankle plantar flexor muscle–tendon properties by use of ultrasonography.

Mina Samukawa; Masaki Hattori; Naoko Sugama; Naoki Takeda

2011-01-01

240

Randomized trial - oxybutynin for treatment of persistent plantar hyperhidrosis in women after sympathectomy  

PubMed Central

OBJECTIVE: Hyperhidrosis is a common disease, and thoracoscopic sympathectomy improves its symptoms in up to 95% of cases. Unfortunately, after surgery, plantar hyperhidrosis may remain in 50% of patients, and compensatory sweating may be observed in 70%. This clinical scenario remains a challenge. Our objective was to evaluate the effectiveness of oxybutynin in the treatment of persistent plantar hyperhidrosis and compensatory sweating and its effects on quality of life in women after thoracoscopic sympathectomy. METHOD: We conducted a prospective, randomized study to compare the effects of oxybutynin at 10 mg daily and placebo in women with persistent plantar hyperhidrosis. The assessment was performed using a quality-of-life questionnaire for hyperhidrosis and sweating measurement with a device for quantifying transepidermal water loss. Clinicaltrials.gov: NCT01328015. RESULTS: Sixteen patients were included in each group (placebo and oxybutynin). There were no significant differences between the groups prior to treatment. After oxybutynin treatment, there was a decrease in symptoms and clinical improvement based on the quality-of-life questionnaire (before treatment, 40.4 vs. after treatment, 17.5; p?=?0.001). The placebo group showed modest improvement (p?=?0.09). The outcomes of the transepidermal water loss measurements in the placebo group showed no differences (p?=?0.95), whereas the oxybutynin group revealed a significant decrease (p?=?0.001). The most common side effect was dry mouth (100% in the oxybutynin group vs. 43.8% in the placebo group; p?=?0.001). CONCLUSION: Oxybutynin was effective in the treatment of persistent plantar hyperhidrosis, resulting in a better quality of life in women who had undergone thoracoscopic sympathectomy. PMID:24519200

da Silva Costa, Altair; Leao, Luiz Eduardo Villaca; Succi, Jose Ernesto; Perfeito, Joao Alessio Juliano; Filho, Adauto Castelo; Rymkiewicz, Erika; Filho, Marco Aurelio Marchetti

2014-01-01

241

Conservative therapy for plantar fasciitis: a narrative review of randomized controlled trials  

PubMed Central

A narrative literature review of RCTs only, was conducted to ascertain which conservative treatments provide the best results for plantar fasciitis patients. Stretching, prefabricated and custom-made orthotics and night splints have all been scrutinized in numerous studies with mixed results. Chiropractic manipulative therapy has been examined in one study, with favorable results. Therapeutic ultrasound and low intensity laser therapy have been examined in one study apiece with unsatisfactory results. Based on the trials reviewed a trial of therapy beginning with low-cost, patient-centered treatments is recommended, particularly stretching, over-the-counter orthotics, and patient education. Several (but not all) of the reviewed articles indicated that custom-made orthoses are more beneficial for plantar fasciitis than over-the-counter orthotics. In the event these treatments do not provide satisfactory results, use of night splints should be considered. Based on this review, there is no support for the use of magnetic insoles for plantar fasciitis. Most of the studies were found to have at least one methodological flaw, including inadequate sample sizes, high drop-out rates, comparing multiple interventions to multiple interventions (thus making it difficult to determine the effect of each individual intervention) and lack of long-term follow-up. Outcome measure use between studies was inconsistent. PMID:17549177

Stuber, Kent; Kristmanson, Kevyn

2006-01-01

242

Age changes in the tibial and plantar nerves of the rat.  

PubMed Central

Observations have been made on the changes in the myelinated fibres of the rat tibial and plantar nerves between 2 and 24 months of age. There is an initial rapid increase in fibre diameter followed by a later more gradual increase, which ceases after approximately 9 months of age in the tibial nerve but which continues for longer in the medial plantar nerve. The fibre size distribution remains substantially unimodal throughout. In both nerves maximal and average fibre diameter become reduced by 24 months. Total fibre number shows considerable variability between animals, but no definite systematic alteration with age is detectable. Teased fibre preparations demonstrate a low level of abnormality in the tibial nerve until after 18 months of age, but by 24 months approximately 30% of fibres display abnormalities. Although both paranodal and segmental demyelination and remyelination, and axonal degeneration and regeneration occur, the latter type of change predominates. By contrast, in the lateral plantar nerve paranodal and segmental demyelination become detectable to a significant extent from 6 months of age. Axonal degeneration and regeneration also become evident after 15 months, and by 24 months of age 55% of fibres show abnormalities. The possible explanation of these changes is discussed, as is their relevance to the frequent use of the tibial nerve for studies on experimental neuropathies. PMID:7400044

Sharma, A K; Bajada, S; Thomas, P K

1980-01-01

243

Effects of the lapidus arthrodesis and chevron bunionectomy on plantar forefoot pressures.  

PubMed

Hallux valgus with or without first ray insufficiency has been strongly implicated as a contributing factor in lesser metatarsal overload. The principle goals of a bunionectomy are to relieve the pain, correct the deformity, and restore first metatarsophalangeal joint congruity. Until now, little evidence has been available to assess the effects of bunionectomy procedures on forefoot pressure. The primary aim of the present prospective study was to evaluate the preoperative and postoperative plantar pressures after 2 specific bunionectomies: the chevron bunionectomy and Lapidus arthrodesis. A total of 68 subjects, 34 in each group, were included for radiographic and pedographic evaluation. Both procedures demonstrated radiographic improvements in the mean intermetatarsal and hallux abductus angles. The mean hallux plantar pressure decreased significantly in both procedure groups (p < .001). However, Lapidus group exhibited an increase in the mean fifth metatarsal head plantar pressure (p = .008) and pressure under the fifth metatarsal as a percentage of the total forefoot pressure (p = .01). Furthermore, the pressure under the second metatarsal as a percentage of the total forefoot pressure decreased significantly (p = .01). This study suggests that the Lapidus arthrodesis and chevron bunionectomy both provide correction for hallux valgus deformity, but when comparing forefoot load sharing pressures, the Lapidus arthrodesis appeared to have greater influence on the load sharing distribution of forefoot pressure than did the bunionectomy employing the chevron osteotomy. PMID:24958073

King, Christy M; Hamilton, Graham A; Ford, Lawrence A

2014-01-01

244

Biochemical response to chronic shortening in unloaded soleus muscles  

NASA Technical Reports Server (NTRS)

One leg of tail-casted suspended rats was immobilized in a plantar-flexed position to test whether chronic shortening of posterior leg muscles affected the metabolic response to unloading. The immobilized plantaris and gastrocnemius muscles of these animals showed approximately 20 percent loss of muscle mass in contrast to simply a slower growth rate with unloading. Loss of mass of the soleus muscle during suspension was not accentuated by chronic shortening. Although protein degradation in the isolated soleus muscle of the plantar-flexed limb was slightly faster than in the contralateral free limb, this difference was offset by faster synthesis of the myofibrillar protein fraction of the chronically shortened muscle. Total adenine nucleotides were 17 percent lower (P less than 0.005) in the chronically shortened soleus muscle following incubation. Glutamate, glutamine, and alanine metabolism showed little response to chronic shortening. These results suggest that, in the soleus muscle, chronic shortening did not alter significantly the metabolic responses to unloading and reduced activity.

Jaspers, S. R.; Fagan, J. M.; Tischler, M. E.

1985-01-01

245

Methods for heel retrieval for tanks C-101, C-102, and C-111 at the Hanford Site  

SciTech Connect

The purpose of this paper is to evaluate the prospects of using bulk waste characteristics to determine the most appropriate heel retrieval technology. If the properties of hard to remove heels can be determined before bulk retrieval, then a heel retrieval technology can be selected before bulk retrieval is complete. This would save substantially on sampling costs and would allow the deployment of the heel retrieval technology immediately after bulk retrieval. The latter would also accelerate the heel removal schedule. A number of C-farm retrievals have been fully or partially completed at the time of this writing. Thus, there is already substantial information on the success of different technologies and the composition of the heels. There is also substantial information on the waste types in each tank based on historical records. Therefore, this study will correlate the performance of technologies used so far and compare them to the known waste types in the tanks. This will be used to estimate the performance of future C Farm heel retrievals. An initial decision tree is developed and employed on tanks C-101, C-102, and C 111. An assumption of this study is that no additional characterization information would be available, before or after retrieval. Note that collecting additional information would substantially increase the probability of success. Deploying some in-situ testing technologies, such as a water lance or an in-situ Raman probe, might substantially increase the probability of successfully selecting the process conditions without having to take samples from the tanks for laboratory analysis.

Sams, Terry L. [Washington River Protection Solutions, LLC, Richland, WA (United States); Kirch, N. W. [Washington River Protection Solutions, LLC, Richland, WA (United States); Reynolds, Jacob G. [Washington River Protection Solutions, LLC, Richland, WA (United States)

2013-01-11

246

Effect of Neutral-Cushioned Running Shoes on Plantar Pressure Loading and Comfort in Athletes With Cavus FeetA Crossover Randomized Controlled Trial  

Microsoft Academic Search

Background: High injury rates observed in athletes with cavus feet are thought to be associated with elevated plantar pressure loading. Neutral-cushioned running shoes are often recommended to manage and prevent such injuries.Purpose: To investigate in-shoe plantar pressure loading and comfort during running in 2 popular neutral-cushioned running shoes recommended for athletes with cavus feet.Study Design: Controlled laboratory study.Methods: Plantar pressures

Caleb Wegener; Joshua Burns; Stefania Penkala

2008-01-01

247

Ground reaction force and plantar pressure reduction in an incremental weight bearing system.  

PubMed

INTRODUCTION:: With increasing frequency, harness-supported treadmill ambulation has been advocated in patient use in order to provide reduction in weight-bearing to healing tissues and as a method which reduces the energy cost of treadmill ambulation. The purpose of this study was to analyse the ability of one of these devices (Zuni Exercise System) to support a percentage of a subject's body weight during walking and running and to explore the relationship of unloading to pressure reduction in selected plantar surface regions of the foot. METHODS:: Ten healthy male volunteers with no known foot pathology participated in this study. In-shoe plantar pressure (PEDAR) and vertical ground reaction force (GRF) were measured during walking and running at full body weight and at a 20% body[Figure: see text][Figure: see text] weight supported setting. Statistical evaluation used a one way ANOVA and a post-hoc paired t-test with significance set at p < 0.05. RESULTS:: Walking with a setting of 20% body weight supported was achieved with a reduction of the first and second vertical force peaks of 23.8+/-7.3% and 27.2+/-4.1% respectively, somewhat greater than the selected setting (Figure 1). The total force time integral during walking unloaded was 22.8+/-3.3%, which was only slightly greater than the selected 20% reduction. During running the active vertical force peak and total force time integral were reduced by 19.9+/-6.0% and 20.0+/-3.3% respectively during the unloaded condition (Figure 2). Plantar pressures were reduced from 6.8 - 27.8% during body weight supported conditions. The reduction in plantar pressure was variable across different regions of the foot with the toes in walking and the medial forefoot region in running being the least unloaded. DISCUSSION AND CONCLUSIONS:: The Zuni Exercise System appears to be a valid device to predictably reduce the vertical component of the GRF during walking and running with 20% body weight supported. Plantar pressures were reduced during body weight supported conditions but the reduction varied at different regions of the foot. However, the variability of the reduction across subjects was substantial, implying that a given regional pressure may not be as predictably reduced during a body weight supported condition. This highlights the difficulty a practitioner has in the ability to confidently reduce pressure by a set amount in a selected foot region by using assistive devices without direct in-shoe measurements. PMID:11415712

Flynn, TW; Canavan, PK; Chiang, JH; Cavanagh, PR

1997-04-01

248

Botulinum toxin effects on gasatrocnemius strength and plantar pressure in diabetics with peripheral neuropathy and forefoot ulceration  

PubMed Central

Background High forefoot plantar pressure is associated with plantar ulcers in people with diabetes and peripheral neuropathy. The purpose of this pilot study is to determine safety and efficacy of botulinum toxin A injected into the gastrocnemius-soleus muscles to reduce muscle strength and plantar pressure. Materials and Methods This double blind, randomized clinical trial studied 17 people with diabetes mellitus, peripheral neuropathy and forefoot plantar ulcer. Subjects were randomized into one of three groups receiving gastrocnemius-soleus muscle injections on the involved side with; 1) Saline (n=5, weight = 99 ± 21 kg), 2) 200 units of Botox® (n=7, weight = 101 ± 5 kg), or 3) 300 units of Botox® (n=5, weight=129 ± 22 kg). Botox® dose was converted to units/kg, the majority received between 1.9 and 2.4 units/kg (n=11) and one 3.2 units/kg. Plantarflexor peak torque and forefoot peak plantar pressure were quantified prior and two weeks post injection. Results There were no complications from the injections. Plantarflexor peak torque on the involved side increased in the placebo and 300 groups (3 ± 4 Nm and 6 ± 10 Nm respectively) and decreased ?8 ± 11 Nm in the 200 group. There was no relationship between units/kg of Botox® for each subject and change in plantarflexor peak torque. Forefoot peak plantar pressure did not change in the placebo and 300 groups (0 ± 11 and 0 ± 5 N/cm2 respectively) and decreased ?4 ± 16 N/cm2 (4%) for the 200 group. Conclusions There were no adverse events associated with the Botox® injections. This study was unable to determine the dose to consistently reduce plantarflexor strength and forefoot plantar pressure. Additional research is needed to investigate diabetes mellitus specific physiological changes and their impact of BoNT-A effectiveness in order to guide appropriate dosing. PMID:22735277

Hastings, Mary K.; Mueller, Michael J.; Sinacore, David R.; Strube, Michael J.; Crowner, Beth; Johnson, Jeffrey E.; Racette, Brad A.

2013-01-01

249

Incidental findings of massive heel spurs in a veteran with a variant of psoriatic arthritis.  

PubMed

A middle-aged man presented for left foot diabetic ulcer care. Pedal radiographs were negative for signs of osteomyelitis. However, asymptomatic incidental osseous findings demonstrated significant plantar and posterior calcaneal spurring possibly consistent with diffuse idiopathic skeletal hyperostosis (DISH). A differential of DISH, psoriatic arthritis, Reiter's, and ankylosing spondylitis was developed. Subsequent spinal imaging and laboratory work-up did not satisfy the diagnostic criteria for DISH. This case illustrates radiographic changes characteristic of multiple seronegative arthropathies. On initial presentation a diagnosis of DISH was most likely, but with further imaging studies a diagnosis of a variant of psoriatic arthritis may be more correct. PMID:23001738

Lowell, Danae L; Osher, Lawrence S; Grady, Angela F

2012-01-01

250

The relationship of heel contact in ascent and descent from jumps to the incidence of shin splints in ballet dancers.  

PubMed

I conducted a study to determine whether ballet dancers with a history of shin splints make heel contact on ascent and descent from jumps less often than dancers without this history. Sixteen dancers were filmed as they executed a sequence of jumps at two different speeds. Eight of the subjects had a history of shin-splint pain; eight had no such history. The film was viewed on a Super 8 movie projector. Heel contacts on ascent and descent from jumps were counted. Double heel strikes (heel rise between landing and pushing off) were also counted. A nonparametric t test showed no differences between the two groups in the number of contacts on ascent or descent. The dancers with a history of shin splints, however, demonstrated more double heel strikes (p = .02) than the other group. Clinically, this finding may represent a lack of control or a tight Achilles tendon or both. Further study is necessary to confirm these theories. For treatment and prevention of shin splints, a clinician must evaluate a dancer's jumping technique and then provide systematic training to develop the skin strength, flexibility, and coordination that make up control. PMID:4023066

Gans, A

1985-08-01

251

The comparison of manual lymph drainage and ultrasound therapy on the leg swelling caused by wearing high heels.  

PubMed

One of the major symptoms when women are wearing high heels for a long time is leg swelling. The purpose of this study was to compare the effect of manual lymph drainage with ultrasound therapy. The forty-five healthy women of twenties were participated in this study and divided randomly into three groups; manual lymph drainage group (n=15), ultrasound therapy group (n=15) and control group (n=15). Swelling was measured before wearing the high heels (10 cm-height), after one-hour of wearing the high heels, wearing the high heels of one-hour after the intervention of 15 minutes. Also swelling was calculated by using a tape measure, volumeter and body composition analyzer. Statistical analysis of the comparison between the three groups was performed by one-way ANOVA. Also comparison to the mean value in swelling according to the time was performed by repeated measure ANOVA. As the result of this study, a significant changes have emerged within each of manual lymph drainage, ultrasound therapy and control group (p< 0.05). However, there were no significant differences between each group (p> 0.05). But the mean value of manual lymph drainage group showed the tendency of fast recovering before causing swelling. Therefore, we consider that the clinical treatment of manual lymph drainage and ongoing studies will be made since manual lymph drainage is very effective in releasing the leg swelling caused by wearing high heels and standing for a long time at work. PMID:24704645

Lee, Dong-Yeop; Han, Ji-Su; Jang, Eun-Ji; Seo, Dong-Kwon; Hong, Ji-Heon; Lee, Sang-Sook; Lee, Dong-Geol; Yu Lee, Jae-Ho

2014-01-01

252

How does the heel-off posture modify gait initiation parameter programming?  

PubMed

The authors studied the adjustment of the 2 distinct known expressions of gait velocity, the velocity of the center of gravity (CG) and the velocity of the center of foot pressure (CP) at the end of the 1st step in 2 experimental situations: natural gait initiation (the control situation, CS) and heel-off gait initiation (the test situation, TS). Gait was initiated by 7 healthy participants, from an erect spontaneous posture in the CS and from a posture with heels raised in the TS, on a force platform at 3 self-selected speed conditions. Biomechanical data from the force platform were collected in both experimental situations, and the authors used a particular gait analysis based on the differential method of Y. Brenière (2003) in order to approach velocity modulation by means of step length and frequency. Results showed that CG and CP velocities were adjusted differently during heel-off gait initiation than during natural gait initiation. CP velocity, as compared with CG velocity, was overestimated in TS. Results also established the relevance of the expression of step velocity by means of step length and frequency: The central nervous system, taking into account the specific postural constraints of each experimental situation, uses a reference value and a regulating parameter to modulate step velocity. Moreover, the contributions of 1st step length and frequency to the expression of step velocity in TS and CS were different. Thus, a specific locomotor behavior corresponds to a given experimental situation that is characterized by its own initial biomechanical constraints. PMID:12873838

Couillandre, Annabelle; Brenière, Yvon

2003-09-01

253

Is there an association between the use of heeled footwear and schizophrenia?  

PubMed

Existing etiological and pathogenetical theories of schizophrenia have only been able to find support in some epidemiological, clinical, and pathophysiological facts. A selective literature review and synthesis is used to present a hypothesis that finds support in all facts and is contradicted by none. Heeled footwear began to be used more than a 1000 years ago, and led to the occurrence of the first cases of schizophrenia. Industrialization of shoe production increased schizophrenia prevalence. Mechanization of the production started in Massachusetts, spread from there to England and Germany, and then to the rest of Western Europe. A remarkable increase in schizophrenia prevalence followed the same pattern. In Baden in Germany the increasing stream of young patients more or less hastily progrediating to a severe state of cognitive impairment made it possible for Kraepelin to delineate dementia praecox as a nosological entity. The patients continued to use heeled shoes after they were admitted to the hospitals and the disease progrediated. High rates of schizophrenia are found among first-generation immigrants from regions with a warmer climate to regions with a colder climate, where the use of shoes is more common. Still higher rates among second-generation immigrants are caused by the use of shoes during the onset of walking at an age of about 11-12 months. Other findings point to the importance of this in the later development of schizophrenia. A child born in January-March begins to walk in December-March, when it's cold outside and the chances of going barefoot are smaller. They are also smaller in urban settings. During walking synchronised stimuli from mechanoreceptors in the lower extremities increase activity in cerebello-thalamo-cortico-cerebellar loops through their action on NMDA-receptors. Using heeled shoes leads to weaker stimulation of the loops. Reduced cortical activity changes dopaminergic function which involves the basal ganglia-thalamo-cortical-nigro-basal ganglia loops. Bicycle riding reduces depression in schizophrenia due to stronger stimulation by improved lengthening contractions of the triceps surae muscles. Electrode stimulation of cerebellar loops normally stimulated by mechanoreceptors in the lower extremities could improve functioning in schizophrenia. Cross-sectional prevalence studies of the association between the use of heeled footwear and schizophrenia should be made in immigrants from regions with a warmer climate or in groups of people who began to wear shoes at different ages. PMID:15325026

Flensmark, Jarl

2004-01-01

254

Solitary erythematous, tender plaque of the heel in a young infant.  

PubMed

Calcinosis cutis is a rare disorder resulting from the precipitation and deposition of insoluble calcium and phosphate salts (hydroxyapatite crystals) in the dermis and subcutaneous tissue. It is generally divided into four main groups on the basis of etiology and pathogenesis. Clinical presentation of cutaneous calcinosis cutis varies according to the diagnosis and the underlying process. We report a case of calcinosis cutis of the heel in which both the extravasation of a calcium gluconate infusion and renal failure could have promoted the development of calcinosis cutis. PMID:24050291

Vaccari, Sabina; Ismaili, Alma; Barisani, Alessia; Neri, Iria; Patrizi, Annalisa

2013-09-01

255

Results of Characterization and Retrieval Testing on Tank 241-C-110 Heel Solids  

SciTech Connect

Nine samples of heel solids from tank 241-C-110 were delivered to the 222-S Laboratory for characterization and dissolution testing. After being drained thoroughly, the sample solids were primarily white to light-brown with minor dark-colored inclusions. The maximum dimension of the majority of the solids was <2 mm; however, numerous pieces of aggregate, microcrystalline, and crystalline solids with maximum dimensions ranging from 5-70 mm were observed. In general, the larger pieces of aggregate solids were strongly cemented. Natrophosphate [Na{sub 7}F(PO{sub 4}){sub 2}?19H{sub 2}O] was the dominant solid phase identified in the heel solids. Results of chemical analyses suggested that 85-87 wt% of the heel solids were the fluoridephosphate double salt. The average bulk density measured for the heel solids was 1.689 g/mL; the reference density of natrophosphate is 1.71 g/mL. Dissolution tests on composite samples indicate that 94 to 97 wt% of the tank 241-C-110 heel solids can be retrieved by dissolution in water. Dissolution and recovery of the soluble components in 1 kg (0.59 L) of the heel solids required the addition of ≈9.5 kg (9.5 L) of water at 15 ?C and ≈4.4 kg (4.45 L) of water at 45 ?C. Calculations performed using the Environmental Simulation Program indicate that dissolution of the ≈0.86 kg of natrophosphate in each kilogram of the tank 241-C-110 heel solids would require ≈9.45 kg of water at 15 ?C and ≈4.25 kg of water at 45 ?C. The slightly larger quantities of water determined to be required to retrieve the soluble components in 1 kg of the heel solids are consistent with that required for the dissolution of solids composed mainly of natrophosphate with a major portion of the balance consisting of highly soluble sodium salts. At least 98% of the structural water, soluble phosphate, sodium, fluoride, nitrate, carbonate, nitrite, sulfate, oxalate, and chloride in the test composites was dissolved and recovered in the dissolution tests. Most of the {sup 99}Tc and {sup 137}Cs present in the initial heel solids composites was removed in the water dissolution tests. The estimated activities/weights of {sup 129}I, {sup 234}U, {sup 235}U, {sup 236}U, and {sup 238}U in the dry residual solids were <25% of the weights/activities in the initial composite solids. Gibbsite and nordstrandite [both Al(OH){sub 3}] were the major solid phases identified in the solids remaining after completion of the dissolution tests. Chemical analysis indicated that the residual solids may have contained up to 62 wt% Al(OH){sub 3}. Significant quantities of unidentified phosphate-, iron-, bismuth-, silicon-, and strontium- bearing species were also present in the residual solids. The reference density of gibbsite (and nordstrandite) is 2.42 g/mL. The measured density of the residual solids, 2.65 g/mL, would be a reasonable value for solids containing gibbsite as the major component with minor quantities of other, higher density solids. Sieve analysis indicated that 22.2 wt% of the residual solids were discrete particles >710 μm in size, and 77.8 wt% were particulates <710 μm in size. Light-scattering measurements suggested that nearly all of the <710-μm particulates with diameters >12 μm were weakly bound aggregates of particles with diameters <2 μm. The <710-μm residual solids settled very slowly when dispersed in reagent water. The physical appearance of a suspension containing ≈0.4 vol% of the solids in pure water changed very little over a period of 46.5 hours. It should be noted that the distribution of particle sizes in the residual solids and the observed settling behavior were both strongly influenced by the procedures followed in the dissolution tests.

Callaway, William S.

2013-09-30

256

Musculoskeletal modelling deconstructs the paradoxical effects of elastic ankle exoskeletons on plantar-flexor mechanics and energetics during hopping.  

PubMed

Experiments have shown that elastic ankle exoskeletons can be used to reduce ankle joint and plantar-flexor muscle loading when hopping in place and, in turn, reduce metabolic energy consumption. However, recent experimental work has shown that such exoskeletons cause less favourable soleus (SO) muscle-tendon mechanics than is observed during normal hopping, which might limit the capacity of the exoskeleton to reduce energy consumption. To directly link plantar-flexor mechanics and energy consumption when hopping in exoskeletons, we used a musculoskeletal model of the human leg and a model of muscle energetics in simulations of muscle-tendon dynamics during hopping with and without elastic ankle exoskeletons. Simulations were driven by experimental electromyograms, joint kinematics and exoskeleton torque taken from previously published data. The data were from seven males who hopped at 2.5 Hz with and without elastic ankle exoskeletons. The energetics model showed that the total rate of metabolic energy consumption by ankle muscles was not significantly reduced by an ankle exoskeleton. This was despite large reductions in plantar-flexor force production (40-50%). The lack of larger metabolic reductions with exoskeletons was attributed to increases in plantar-flexor muscle fibre velocities and a shift to less favourable muscle fibre lengths during active force production. This limited the capacity for plantar-flexors to reduce activation and energy consumption when hopping with exoskeleton assistance. PMID:25278469

Farris, Dominic James; Hicks, Jennifer L; Delp, Scott L; Sawicki, Gregory S

2014-11-15

257

Influence of the calcaneus morphology on the risk of posterior heel ulcer creation Vincent Luboz, Antoine Perrier, Marek Bucki, Bruno Diot, Francis Cannard, Nicolas Vuillerme,  

E-print Network

Influence of the calcaneus morphology on the risk of posterior heel ulcer creation Vincent Luboz percent of the reanimation or geriatric patients develop a pressure ulcer, of which 40 % are posterior heel ulcers. The main suspected causes are the excessive pressure intensity (leading to internal

Payan, Yohan

258

Plantar thermography is useful in the early diagnosis of diabetic neuropathy  

PubMed Central

OBJECTIVES: This study evaluated plantar thermography sensitivity and specificity in diagnosing diabetic polyneuropathy using cardiac tests (heart rate variability) as a reference standard because autonomic small fibers are affected first by this disease. METHODS: Seventy-nine individuals between the ages of 19 and 79 years old (28 males) were evaluated and divided into three groups: control (n?=?37), pre-diabetics (n?=?13) and type 2 diabetics (n?=?29). The plantar images were recorded at baseline and then minutes after a provocative maneuver (Cold Stress Test) using an infrared camera that is appropriate for clinical use. Two thermographic variables were studied: the thermal recovery index and the interdigital anisothermal technique. Heart rate variability was measured in a seven-test battery that included three spectral indexes (in the frequency domain) and four Ewing tests (the Valsalva maneuver, the orthostatic test, a deep breathing test, and the orthostatic hypotension test). Other classically recommended tests were applied, including electromyography (EMG), Michigan inventory, and a clinical interview that included a neurological physical examination. RESULTS: Among the diabetic patients, the interdigital anisothermal technique alone performed better than the thermal recovery index alone, with a better sensitivity (81.3%) and specificity (46.2%). For the pre-diabetic patients, the three tests performed equally well. None of the control subjects displayed abnormal interdigital anisothermal readouts or thermal recovery indices, which precluded the sensitivity estimation in this sample of subjects. However, the specificity (70.6%) was higher in this group. CONCLUSION: In this study, plantar thermography, which predominately considers the small and autonomic fibers that are commonly associated with a sub-clinical condition, proved useful in diagnosing diabetic neuropathy early. The interdigital anisothermal test, when used alone, performed best. PMID:23295596

Balbinot, Luciane Fachin; Canani, Luis Henrique; Robinson, Caroline Cabral; Achaval, Matilde; Zaro, Milton Antonio

2012-01-01

259

CHEMICAL SLUDGE HEEL REMOVAL AT THE SAVANNAH RIVER SITE F TANK FARM CLOSURE PROJECT 8183  

SciTech Connect

Chemical Sludge Removal (CSR) is the final waste removal activity planned for some of the oldest nuclear waste tanks located at the Savannah River Site (SRS) in Aiken, SC. In 2008, CSR will be used to empty two of these waste tanks in preparation for final closure. The two waste tanks chosen to undergo this process have previously leaked small amounts of nuclear waste from the primary tank into an underground secondary containment pan. CSR involves adding aqueous oxalic acid to the waste tank in order to dissolve the remaining sludge heel. The resultant acidic waste solution is then pumped to another waste tank where it will be neutralized and then stored awaiting further processing. The waste tanks to be cleaned have a storage capacity of 2.84E+06 liters (750,000 gallons) and a target sludge heel volume of 1.89E+04 liters (5,000 gallons) or less for the initiation of CSR. The purpose of this paper is to describe the CSR process and to discuss the most significant technical issues associated with the development of CSR.

Thaxton, D; Timothy Baughman, T

2008-01-16

260

Effect of repeated doses of sucrose during heel stick procedure in preterm neonates.  

PubMed

The purpose of this randomized clinical trial was to test the efficacy of repeated versus single dose sucrose to decrease pain from routine heel stick procedures in preterm neonates. Infants (n = 48) in the first week of life with a mean gestational age of 31 weeks received 0.05 ml of 24% sucrose solution or sterile water by mouth (1) 2 min prior to actual lancing of the heel; (2) just prior to lancing, and (3) 2 min after lancing. The single-dose group received sucrose for the first dose and water for the second and third dose; the repeated-dose group received sucrose three times, and the placebo group received only water. The Premature Infant Pain Profile (PIPP) scores were obtained for five 30-second blocks from lancing. Both sucrose groups had lower PIPP scores (single sucrose pain scores, 6.8-8.2, p = 0.07; repeated sucrose pain scores, 5.3-6. 2, p < 0.01) than water (pain scores 7.9-9.1), and in the last block, the repeated dose had lower scores than the single dose (6.2 vs. 8. 2, p < 0.05). PMID:9925903

Johnston, C C; Stremler, R; Horton, L; Friedman, A

1999-03-01

261

At Home Diabe,c Plantar Ulcer Detec,on Device Mri%ka Bhaumik, Ma-Biegler, Mark Loh, Robert Mohard, Allison Tran and Alex Yoshikawa  

E-print Network

At Home Diabe,c Plantar Ulcer Detec,on Device Mri%ka Bhaumik, Ma- Biegler The objec%ve of the project was to develop an at home diabe%c plantar ulcer detec the forma%on of ulcers. Our device would reduce the number of required doctor

McGaughey, Alan

262

Anatomy and Biomechanical Properties of the Plantar Aponeurosis: A Cadaveric Study  

PubMed Central

Objectives To explore the anatomy of the plantar aponeurosis (PA) and its biomechanical effects on the first metatarsophalangeal (MTP) joint and foot arch. Methods Anatomic parameters (length, width and thickness of each central PA bundle and the main body of the central part) were measured in 8 cadaveric specimens. The ratios of the length and width of each bundle to the length and width of the central part were used to describe these bundles. Six cadaveric specimens were used to measure the range of motion of the first MTP joint before and after releasing the first bundle of the PA. Another 6 specimens were used to evaluate simulated static weight-bearing. Changes in foot arch height and plantar pressure were measured before and after dividing the first bundle. Results The average width and thickness of the origin of the central part at the calcaneal tubercle were 15.45 mm and 2.79 mm respectively. The ratio of the length of each bundle to the length of the central part was (from medial to lateral) 0.29, 0.30, 0.28, 0.25, and 0.27, respectively. Similarly, the ratio of the widths was 0.26, 0.25, 0.23, 0.19 and 0.17. The thickness of each bundle at the bifurcation of the PA into bundles was (from medial to lateral) 1.26 mm, 1.04 mm, 0.91 mm, 0.84 mm and 0.72 mm. The average dorsiflexion of the first MTP joint increased 10.16° after the first bundle was divided. Marked acute changes in the foot arch height and the plantar pressure were not observed after division. Conclusions The first PA bundle was not the longest, widest, or the thickest bundle. Releasing the first bundle increased the range of motion of the first MTP joint, but did not acutely change foot arch height or plantar pressure during static load testing. PMID:24392127

Chen, Da-wei; Li, Bing; Aubeeluck, Ashwin; Yang, Yun-feng; Huang, Yi-gang; Zhou, Jia-qian; Yu, Guang-rong

2014-01-01

263

The effects of fatigue of the plantar flexors on peak torque and voluntary activation in untrained and resistance-trained men.  

PubMed

The purpose of this study was to compare the effects of fatigue of the plantar flexors on peak torque and voluntary activation in untrained (UT) and resistance-trained (RT) men. Six men with no previous resistance training experience and 8 men with similar histories of chronic resistance training (9.8 ± 5.9 years, 3.8 ± 0.7 days/week) volunteered for this study. Subjects performed isometric maximal voluntary contractions (MVCs) before and immediately after unilateral dynamic isotonic contractions performed at 40% of MVC until volitional exhaustion. Voluntary activation of the plantar flexors was assessed using the interpolated twitch method (ITT) and central activation ratio (CAR). Surface electromyographic (EMG) amplitude of the soleus and medial gastrocnemius (MG) was measured during the MVC. There were significant reductions in MVC torque in both UT and RT groups after the fatiguing exercise (-10.7 ± 6.8%, p < 0.02; -9.1 ± 8.7%, p < 0.02, respectively), with no difference in the number of repetitions performed between groups. The UT and RT men experienced a significant decrease in ITT after the fatiguing exercise bout (-14.2 ± 11.8%, p = 0.03; -7.8 ± 9.3%, p = 0.045, respectively). The UT group experienced a significant decrease in CAR (99.5 ± 0.8% to 91.4 ± 6.4%, p = 0.025) with no change (p > 0.05) in the RT group. There was also a fatigue-induced decrease in normalized EMG amplitude for the soleus and MG muscles in both groups (p < 0.05). However, no differences were determined between groups for ITT, CAR, or EMG. Despite similar reductions in MVC torque postexercise, the UT men had a significant decrease in CAR and experienced nearly twice the decline in ITT than the RT men. These results indicate that the neural adaptations associated with chronic resistance training may lead to less susceptibility to central fatigue as measured by ITT and CAR. PMID:20512071

Hartman, Michael J; Ryan, Eric D; Cramer, Joel T; Bemben, Michael G

2011-02-01

264

Healthy older adults have insufficient hip range of motion and plantar flexor strength to walk like healthy young adults.  

PubMed

Limited plantar flexor strength and hip extension range of motion (ROM) in older adults are believed to underlie common age-related differences in gait. However, no studies of age-related differences in gait have quantified the percentage of strength and ROM used during gait. We examined peak hip angles, hip torques and plantar flexor torques, and corresponding estimates of functional capacity utilized (FCU), which we define as the percentage of available strength or joint ROM used, in 10 young and 10 older healthy adults walking under self-selected and controlled (slow and fast) conditions. Older adults walked with about 30% smaller hip extension angle, 28% larger hip flexion angle, 34% more hip extensor torque in the slow condition, and 12% less plantar flexor torque in the fast condition than young adults. Older adults had higher FCU than young adults for hip flexion angle (47% vs. 34%) and hip extensor torque (48% vs. 27%). FCUs for plantar flexor torque (both age groups) and hip extension angle (older adults in all conditions; young adults in self-selected gait) were not significantly <100%, and were higher than for other measures examined. Older adults lacked sufficient hip extension ROM to walk with a hip extension angle as large as that of young adults. Similarly, in the fast gait condition older adults lacked the strength to match the plantar flexor torque produced by young adults. This supports the hypothesis that hip extension ROM and plantar flexor strength are limiting factors in gait and contribute to age-related differences in gait. PMID:24461576

Anderson, Dennis E; Madigan, Michael L

2014-03-21

265

Larger plantar flexion torque variability implies less stable balance in the young: an association affected by knee position.  

PubMed

The present study examined the association between plantar flexion torque variability during isolated isometric contractions and during quiet bipedal standing. For plantar flexion torque measurements in quiet stance (QS), subjects stood still over a force plate. The mean plantar flexion torque level exerted by each subject in QS (divided by 2 to give the torque due to a single leg) served as the target torque level for right leg force-matching tasks in extended knee (KE) and flexed knee (KF) conditions. Muscle activation levels (EMG amplitudes) of the triceps surae and mean, standard deviation and coefficient of variation of plantar flexion torque were computed from signals acquired during periods with and without visual feedback. No significant correlations were found between EMG amplitudes and torque variability, regardless of the condition and muscle being analyzed. A significant correlation was found between torque variability in QS and KE, whereas no significant correlation was found between torque variability in QS and KF, regardless of vision availability. Therefore, torque variability measured in a controlled extended knee plantar flexion contraction is a predictor of torque variability in the anterior-posterior direction when the subjects are in quiet standing. In other words, larger plantar flexion torque variability in KE (but not in KF) implies less stable balance. The mechanisms underlying the findings above are probably associated with the similar proprioceptive feedback from the triceps surae in QS and KE and poorer proprioceptive feedback from the triceps surae in KF due to the slackening of the gastrocnemii. An additional putative mechanism includes the different torque contributions of each component of the triceps surae in the two knee angles. From a clinical and research standpoint, it would be advantageous to be able to estimate changes in balance ability by means of simple measurements of torque variability in a force matching task. PMID:24060221

Mello, Emanuele Moraes; Magalhães, Fernando Henrique; Kohn, André Fabio

2013-12-01

266

A comparison of two night ankle-foot orthoses used in the treatment of inferior heel pain: A preliminary investigation  

Microsoft Academic Search

BackgroundNon-operative treatment for plantar fasciitis varies widely and includes the use of night ankle-foot orthoses (AFOs). This study compares the effectiveness of a posterior AFO, which dorsiflexes the foot, with an anterior AFO, which maintains the foot in a plantigrade position.

J. Attard; D. Singh

267

PLANTAR PRESSURE MEASUREMENTS DURING BAREFOOT AND SHOD RUNNING - RELATIONSHIPS TO LOWER LIMB KINEMATICS  

Microsoft Academic Search

METHODS Seven male subjects (age 27.50±11.33years, height 1.75±0.72m, mass 72.86±8.26kg) all with size 9 feet participated and completed ten trials of BF and SH (cushioned running shoe) running at 4-4.5m.s-1. A six-degrees of freedom, multi segment foot model was produced with heel, midfoot and forefoot segments along with motion of the tibia. Kinematic data (Qualysis, Sweden) was collected simultaneously with

Mark Robinson; Mark Lake

268

Passive resistive torque of the plantar flexors following eccentric loading as assessed by isokinetic dynamometry.  

PubMed

Isokinetic dynamometers may provide a useful means of measuring muscle stiffness resulting from eccentric exercise because they can measure torque from computer-controlled passive movements of joints (passive resistive torque; PRT). In this study, a Biodex measured increased ankle PRT (52%; p <.001) following heel drop exercise in nine young women. Therefore, isokinetic dynamometers can provide a means to study group changes as a result of eccentric exercise. Future studies are required to determine the reliability of this protocol before it can be advocated in studying single cases. PMID:12500999

Porter, Michelle M; Andersson, Maria; Hellström, Ulrika; Miller, Michael

2002-12-01

269

Results of Characterization and Retrieval Testing on Tank 241-C-109 Heel Solids  

SciTech Connect

Eight samples of heel solids from tank 241-C-109 were delivered to the 222-S Laboratory for characterization and dissolution testing. After being drained thoroughly, one-half to two-thirds of the solids were off-white to tan solids that, visually, were fairly evenly graded in size from coarse silt (30-60 μm) to medium pebbles (8-16 mm). The remaining solids were mostly strongly cemented aggregates ranging from coarse pebbles (16-32 mm) to fine cobbles (6-15 cm) in size. Solid phase characterization and chemical analysis indicated that the air-dry heel solids contained ≈58 wt% gibbsite [Al(OH){sub 3}] and ≈37 wt% natrophosphate [Na{sub 7}F(PO{sub 4}){sub 2}?19H{sub 2}O]. The strongly cemented aggregates were mostly fine-grained gibbsite cemented with additional gibbsite. Dissolution testing was performed on two test samples. One set of tests was performed on large pieces of aggregate solids removed from the heel solids samples. The other set of dissolution tests was performed on a composite sample prepared from well-drained, air-dry heel solids that were crushed to pass a ?-in. sieve. The bulk density of the composite sample was 2.04 g/mL. The dissolution tests included water dissolution followed by caustic dissolution testing. In each step of the three-step water dissolution tests, a volume of water approximately equal to 3 times the initial volume of the test solids was added. In each step, the test samples were gently but thoroughly mixed for approximately 2 days at an average ambient temperature of 25 ?C. The caustic dissolution tests began with the addition of sufficient 49.6 wt% NaOH to the water dissolution residues to provide ≈3.1 moles of OH for each mole of Al estimated to have been present in the starting composite sample and ≈2.6 moles of OH for each mole of Al potentially present in the starting aggregate sample. Metathesis of gibbsite to sodium aluminate was then allowed to proceed over 10 days of gentle mixing of the test samples at temperatures ranging from 26-30 ?C. The metathesized sodium aluminate was then dissolved by addition of volumes of water approximately equal to 1.3 times the volumes of caustic added to the test slurries. Aluminate dissolution was allowed to proceed for 2 days at ambient temperatures of ≈29 ?C. Overall, the sequential water and caustic dissolution tests dissolved and removed 80.0 wt% of the tank 241-C-109 crushed heel solids composite test sample. The 20 wt% of solids remaining after the dissolution tests were 85-88 wt% gibbsite. If the density of the residual solids was approximately equal to that of gibbsite, they represented ≈17 vol% of the initial crushed solids composite test sample. In the water dissolution tests, addition of a volume of water ≈6.9 times the initial volume of the crushed solids composite was sufficient to dissolve and recover essentially all of the natrophosphate present. The ratio of the weight of water required to dissolve the natrophosphate solids to the estimated weight of natrophosphate present was 8.51. The Environmental Simulation Program (OLI Systems, Inc., Morris Plains, New Jersey) predicts that an 8.36 w/w ratio would be required to dissolve the estimated weight of natrophosphate present in the absence of other components of the heel solids. Only minor amounts of Al-bearing solids were removed from the composite solids in the water dissolution tests. The caustic metathesis/aluminate dissolution test sequence, executed at temperatures ranging from 27-30 ?C, dissolved and recovered ≈69 wt% of the gibbsite estimated to have been present in the initial crushed heel solids composite. This level of gibbsite recovery is consistent with that measured in previous scoping tests on the dissolution of gibbsite in strong caustic solutions. Overall, the sequential water and caustic dissolution tests dissolved and removed 80.3 wt% of the tank 241-C-109 aggregate solids test sample. The residual solids were 92-95 wt% gibbsite. Only a minor portion (≈4.

Callaway, William S.

2013-09-26

270

Decreased foot inversion force and increased plantar surface after maximal incremental running exercise.  

PubMed

Formulating the hypothesis that a maximal running exercise could induce fatigue of some foot muscles, we searched for electromyographic (EMG) signs of fatigue in the tibialis anterior (TA), peroneus longus (PL), and gastrocnemius medialis (GM) muscles. We also searched for post-exercise alterations of the stationary upright standing in normal-arched feet subjects. Healthy subjects performed a maximal running exercise. Surface EMGs of the TA, PL, and GM muscles were analysed during maximal dynamic efforts. Before and after the running bout, we measured the evoked compound muscle potential (M-wave) in TA, the maximal force into inversion (MIF), and the repartition of the plantar and barycentre surfaces with a computerised stationary platform. During maximal running exercise, the median frequency of the EMG spectra declined in TA while it remained stable in the PL and GM muscles. After the exercise, MIF decreased, and both the rearfoot plantar surface and the barycentre surface increased. We concluded that a maximal running bout elicits EMG signs of fatigue, though only in the TA muscle. It also elicits post-exercise changes in the foot position during stationary upright standing which indicates a foot eversion. These data solely concern a maximal running test and they can not be extrapolated to walking or running at a low speed. PMID:23313412

Vie, Bruno; Brerro-Saby, Christelle; Weber, Jean Paul; Jammes, Yves

2013-06-01

271

Influence of backpack load and gait speed on plantar forces during walking.  

PubMed

The purpose of this study is to examine the differences in plantar force associated with changes in backpack load and gait speed during walking. The F-scan tethered system was used to collect plantar pressure data. Subjects were asked to walk on a treadmill with varied levels of backpack load (0%, 10%, 20%, and 30% of body mass) and gait speed (4, 5, and 6 km/h). We found that an increase in gait speed and backpack load lead to increase in the magnitude of the first vertical ground reaction force (vGRF) peak. Greater magnitudes of the second vGRF peak were only associated with an increase when gait speeds were 4 km/h and 5 km/h. There was no speed-related change in the magnitudes of the second vGRF peak at the speed of 6 km/h. The results of this study may be important for the purpose of constituting a load-bearing walking program for protecting against osteoporosis. PMID:24067124

Watanabe, Kazuhiko; Wang, Yun

2013-01-01

272

Radial forearm free flap for coverage of postoperative lateral heel wounds after open reduction and internal fixation of the calcaneus  

Microsoft Academic Search

For intraarticular calcaneus fractures, open reduction and internal fixation has become commonplace for the reduction of morbidity of postinjury arthritis. Despite adequate surgical results, there are often associated postoperative wound complications. The purpose of this study was to describe a unique application of the radial forearm free flap for coverage of lateral postoperative heel defects seen after calcaneal fixation. Seven

Jody T Jachna; E. Bruce Toby; Greg A Horton

2003-01-01

273

Management of pain from heel lance with lidocaine-prilocaine (EMLA) cream: is it safe and efficacious in preterm infants?  

PubMed

Hospitalized preterm infants undergo multiple painful heel lances. A two-phase, randomized, controlled trial was undertaken to determine the safety and efficacy of lidocaine-prilocaine 5% cream (EMLA, Astra Pharmaceuticals, L.P, Westborough, MA) for relieving pain from heel lance. One hundred twenty infants were randomly assigned to receive 0.5 g of EMLA or placebo cream for 30 minutes (Phase 1) or 60 minutes (Phase 2) before a routine heel lance. Efficacy was assessed using the Premature Infant Pain Profile (PIPP). Safety was determined by methemoglobin concentration 8 hours after EMLA application and by clinical signs of methemoglobinemia. No significant differences existed on PIPP scores between EMLA and placebo groups in Phase 1 (p < .480) or Phase 2 (p < .831). No infant had any clinical signs of methemoglobinemia. The mean methemoglobin concentration was 1.19% (.47). Approximately 10% of infants had minor skin reactions, and approximately 20% of EMLA-treated infants had blanching at the application site. The authors conclude that EMLA is safe but not efficacious for relieving pain from heel lance in preterm infants. PMID:10475595

Stevens, B; Johnston, C; Taddio, A; Jack, A; Narciso, J; Stremler, R; Koren, G; Aranda, J

1999-08-01

274

Excision of a dermatobia hominis larva from the heel of a south american traveler: A case report  

Microsoft Academic Search

Although foot and ankle specialists are well versed in treating insect bites and foreign bodies, many physicians in the United States are unfamiliar with parasitic organisms that are common in other parts of the world. This article presents a case of a patient inoculated in the posterior heel with the larva of a Dermatobia hominis, or human bot fly. Excision

Donald W Adams; Ryan T Cooney

2004-01-01

275

Topical amethocaine gel for pain relief of heel prick blood sampling: a randomised double blind controlled trial  

PubMed Central

BACKGROUND—Heel prick blood sampling is a commonly performed and painful procedure in the newborn infant. Use of a topical local anaesthetic does not relieve this pain. A 4% w/w amethocaine gel (Ametop) reduces the pain of venepuncture in the newborn but has not been tried with heel pricks.?AIM—To investigate the effect of topical amethocaine gel on the pain of heel prick in the newborn infant.?DESIGN—Randomised, double blind, placebo controlled trial.?SUBJECTS—Sixty newborn infants, gestation 28-42 weeks (median 36), postnatal age 1-16 days (median 5) undergoing routine heel prick blood sampling.?METHODS—A 1.5 g portion of 4% w/w amethocaine gel or placebo was applied to the skin under occlusion for one hour, then wiped away. Heel prick blood sampling with a spring loaded lance was performed five minutes later. The procedure was videotaped and pain assessed at one second intervals using an adaptation of the neonatal facial coding system (NFCS). No or minimal pain was defined as a cumulative score of less than 5 (out of 15) in the three seconds after firing of the lance and as lack of a cry in the first five seconds.?RESULTS—In terms of a low NFCS core and lack of cry (p = 0.12) 20 of 30 (67%) in the amethocaine group and 13 of 29 (45%) in the placebo group had no or minimal pain in response to the heel prick. The median cumulative NFCS score over the three seconds after firing the lance was 3 (interquartile range 0-6) in the amethocaine group compared with 5 (interquartile range 1-10) in the placebo group (p = 0.07). These differences are not significant.?CONCLUSIONS—Topical amethocaine gel does not have a clinically important effect on the pain of heel prick blood sampling and its use for this purpose cannot therefore be recommended. Alternative approaches to the relief of pain from this procedure should be explored.?? PMID:11124928

Jain, A; Rutter, N; Ratnayaka, M

2001-01-01

276

Safety of Noninvasive Electrical Stimulation of Acupuncture Points During a Routine Neonatal Heel Stick  

PubMed Central

Abstract Background Hospitalized infants may undergo frequent painful procedures with inadequate pain relief. Alternative pain relief interventions are needed. Objective The aim of this research was to determine the safety of noninvasive electrical stimulation of acupuncture points (NESAP) in neonates who were receiving routine heel sticks. Design This was a descriptive study performed to assess the safety of using a transcutaneous electrical nerve stimulation (TENS) unit to deliver NESAP to neonates. Setting/Subjects The subjects were healthy newborn infants<3 days old before hospital discharge. Intervention The intervention was NESAP delivered via a TENS unit, administered before, during, and after heel stick. The electrodes of the TENS unit were applied at four acupuncture points. Settings were gradually increased: 6 infants received 1.0 mA, 2 Hz; the second 6 infants received 2.0 mA, 10 Hz; and the last 18 infants received 3.5 mA, 10?Hz. Main Outcome Measures Three main measures were used: (1) skin assessment (2) vital signs; (3) pain scores using the Premature Infant Pain Profile (PIPP). Results There were no significant changes in vital signs during and after NESAP. There were no changes in PIPP scores in the first 12 infants after initiation of NESAP. A slight but nonsignificant increase in PIPP scores (from 2.65 to 3.5 on a scale of 0–18) occurred in the last 18 infants. There were no adverse events during or after NESAP. Conclusions NESAP is safe for infants with low settings on a TENS unit. PMID:24761178

Mitchell, Anita J.; Lowe, Leah M.; Lee, Amy; Hall, Richard W.

2013-01-01

277

Acute passive stretching alters the mechanical properties of human plantar flexors and the optimal angle for maximal voluntary contraction  

Microsoft Academic Search

The purpose of this study was to investigate whether acute passive stretching (APS) reduced maximal isometric voluntary contraction (MVC) of the plantar flexors (PF) and if so, by what mechanisms. The PF in 15 female volunteers were stretched for 10 min (5×120 s) by a torque motor to within 2° of maximum dorsiflexion (D) range of motion (ROM). MVC with twitch interpolation,

Derek E. Weir; Jill Tingley; Geoffrey C. B. Elder

2005-01-01

278

Differences in plantar loading between training shoes and racing flats at a self-selected running speed  

Microsoft Academic Search

The purpose of this study was to examine the difference in plantar loading between two different running shoe types. We hypothesized that a higher maximum force, peak pressure, and contact area would exist beneath the entire foot while running in a racing flat when compared to a training shoe. 37 athletes (17 male and 20 female) were recruited for this

Johannes I. Wiegerinck; Jennifer Boyd; Jordan C. Yoder; Alicia N. Abbey; James A. Nunley; Robin M. Queen

2009-01-01

279

The Offset V Osteotomy versus the Modified Austin with a Longer Plantar Arm: A Comparison of Mechanical Stability  

Microsoft Academic Search

Several studies have tested the strength and various fixation modalities of the long dorsal arm offset V osteotomy, and have proven it to be a stable construct when fixated properly. We believe that a modification of the traditional Austin cuts, with a slightly longer plantar arm, lends itself to greater stability because instead of ground reactive forces applying a distraction

Rahn A. Ravenell; Carl A. Kihm; Angela S. Lin; Francis X. Garing

2011-01-01

280

An MRI compatible loading device for the reconstruction of clinically relevant plantar pressure distributions and loading scenarios of the forefoot.  

PubMed

The purpose of this study is to demonstrate a new MRI compatible loading device capable of reconstructing realistic loading scenarios of the human foot for research in the field of foot biomechanics. This device has two different configurations: one used to compress the forefoot and one to bend the metatarsophalangeal joints. Required plantar pressure distribution under the metatarsal heads can be achieved by modifying the distribution of the dorsally applied forces. To validate the device, subject-specific plantar pressures were measured and then reconstructed using the device. For quiet stance the peak pressure reconstruction error was 3% while for mid-stance phase of gait it was 8%. The device was also used to measure the passive bending stiffness of the metatarsophalangeal joints of one subject with low intra-subject variability. A series of preliminary MRI scans confirmed that the loading device can be used to produce static weight-bearing images of the foot (voxel size: 0.23 mm × 0.23 mm × 1.00 mm). The results indicate that the device presented here can accurately reconstruct subject specific plantar pressure distributions and measure the foot's metatarsophalangeal passive stiffness. Possible future applications include the validation of finite element models, the investigation of the relationship between plantar pressure and internal stresses/strains and the study of the foot's inter-segmental passive stiffness. PMID:25012640

Chatzistergos, Panagiotis E; Naemi, Roozbeh; Chockalingam, Nachiappan

2014-09-01

281

Plantar Wart  

MedlinePLUS

... counter wart removers have a high percentage of salicylic acid and work by dissolving away the layer of ... if it touches unaffected skin around it; 40% salicylic acid self-stick pads appear to be one of ...

282

Chronic Pain  

MedlinePLUS

MENU Return to Web version Chronic Pain Overview What is chronic pain? There are 2 types of pain: acute and chronic. Acute pain lets you know that your ... It should go away as your body heals. Chronic pain lasts much longer. Chronic pain may last months ...

283

A comparison of hallux valgus angles assessed with computerised plantar pressure measurements, clinical examination and radiography in patients with diabetes  

PubMed Central

Background Hallux valgus deformity is a common musculoskeletal foot disorder with a prevalence of 3.5% in adolescents to 35.7% in adults aged over 65 years. Radiographic measurements of hallux valgus angles (HVA) are considered to be the most reproducible and accurate assessment of HVA. However, in European countries, many podiatrists do not have direct access to radiographic facilities. Therefore, alternative measurements are desired. Such measurements are computerised plantar pressure measurement and clinical goniometry. The purpose of this study was to establish the agreement of these techniques and radiographic assessments. Methods HVA was determined in one hundred and eighty six participants suffering from diabetes. Radiographic measurements of HVA were performed with standardised static weight bearing dorsoplantar foot radiographs. The clinical goniometry for HVA was measured with a universal goniometer. Computerised plantar pressure measurement for HVA was executed with the EMED SF-4® pressure platform and Novel-Ortho-Geometry software. The intra-class correlation coefficients (ICC) and levels of agreement were analysed using Bland & Altman plots. Results Comparison of radiographic measurements to clinical goniometry for HVA showed an intraclass correlation coefficient (ICC) of 0.81 (95% confidence interval, 0.76 to 0.86; p<0.001). Radiographic measurement versus computerised plantar pressure measurement showed an ICC of 0.59 (95% confidence interval, 0.49 to 0.68; p<0.001). In addition, clinical goniometry versus computerised plantar pressure measurement showed an ICC of 0.77 (95% confidence interval, 0.70 to 0.82; p<0.001). The systematic difference of the computerised plantar pressure measurement compared with radiographic measurement and clinical goniometry was 7.0 degrees (SD 6.8) and 5.2 degrees (SD 5.0), respectively. The systemic difference of radiographic measurements compared with clinical goniometry was 1.8 degrees (SD 5.0). Conclusions The agreement of computerised plantar pressure measurement and clinical goniometry for HVA compared to radiographic measurement of HVA is unsatisfactory. Radiographic measurements of HVA and clinical goniometry for HVA yield better agreement compared to radiographic measurements and computerised plantar pressure measurement. The traditional radiographic measurement techniques are strongly recommended for the assessment of HVA. PMID:25075224

2014-01-01

284

Knee extensor and plantar flexor muscle size and function following 90 days of bed rest with or without resistance exercise.  

PubMed

Skeletal muscle atrophy and strength loss induced by short-term simulated spaceflight are offset or attenuated by resistance exercise (RE). This study compared the effects of plantar flexor and knee extensor RE on muscle size and function in 17 healthy men (aged 26-41years) subjected to 90 days 6 degrees head-down-tilt bed rest with (BRE; n = 8) or without (BR; n = 9) RE. The RE program consisted of coupled maximal concentric and eccentric actions in the supine squat (4 sets of 7 repetitions) and calf press (4 x 14) every third day employing a gravity-independent flywheel ergometer (FW). Prior to, and following bed rest, muscle volume was assessed using magnetic resonance imaging. Similarly, muscle strength and power and surface electromyographic (EMG) activity were determined during maximal actions using FW or isokinetic dynamometry. In BR, knee extensor and plantar flexor muscle volume decreased (P < 0.05) 18% and 29%, respectively. Torque or force and power decreased (P < 0.05) 31 60% (knee extension) and 37-56% (plantar flexion) while knee extensor and plantar flexor EMG activity decreased 31-38% and 28-35%, respectively following BR. Muscle atrophy in BRE was prevented (P > 0.05; knee extensors) or attenuated (-15%; plantar flexors). BRE maintained task-specific force, power and EMG activity. The decrease in non-task-specific torque was less (P < 0.05) than in BR. The present data imply that the triceps surae and quadriceps muscles show different responsiveness to long-term bed rest with or without resistance exercise. The results also suggest that designing in-flight resistance exercise protocols for space travellers is complex and must extend beyond preserving muscle only. PMID:15338217

Alkner, Björn A; Tesch, Per A

2004-12-01

285

Difference in plantar pressure between the preferred and non-preferred feet in four soccer-related movements  

PubMed Central

Objective and participants The present study measured the difference in plantar pressure between the preferred and non?preferred foot in four soccer?related movements in 15 male university soccer players (mean (SD) age 20.9 (1.3)?years, mean (SD) height 173 (4)?cm and mean (SD) weight 61.7 (3.6)?kg). Design To record plantar pressure distribution, players randomly wore three types of soccer shoes (classical 6?stud and 12?stud, and specially designed 12?stud) embedded with an insole pressure recorder device with 99 sensors, divided into 10 areas for analysis. Plantar pressure was recorded in five successful trials in each of the four soccer?related movements: running (at 3.3?m/s), sideward cutting, 45° cutting and landing from a vertical jump. Results Plantar pressures of the preferred and non?preferred foot were different in 115 of 120 comparisons. The overall plantar pressure of the preferred foot was higher than that of the non?preferred foot. Specifically, in each of the four movements, higher pressure was found in the preferred foot during the take?off phase, whereas this was found in the non?preferred foot during the landing phase. This would suggest a tendency of the preferred foot for higher motion force and of the non?preferred foot for a greater role in body stabilisation. Conclusions The data indicate that the preferred and non?preferred foot should be treated independently with regard to strength/power training to avoid unnecessary injuries. Different shoes/insoles and different muscular strengthening programmes are thus suggested for each of the soccer player's feet. PMID:17138639

Wong, Pui-lam; Chamari, Karim; Chaouachi, Anis; De Wei Mao; Wisl?ff, Ulrik; Hong, Youlian

2007-01-01

286

[Can plantar ulcers associated with leprosy be treated in the field. Results of experience in Senegal].  

PubMed

The introduction of a program for the treatment of plantar ulcers (PU) in field conditions in Senegal was studied. The program was complementary to the Health Education and Protective Footwear to Prevent Disability (POD) initiatives within the Senegalese anti-leprosy program. The wound care given in health centers was coded and simplified. Access to hospitals was made easier for those patients requiring surgery. More than 30% of patients with PU were treated each year, with a mean of 62% cured. An increasing number of leprosy patients have been admitted to regional hospitals for surgery. Never before have patients with signs of leprosy had access to general hospitals. This study emphasizes the need for regular supervision of the individuals treating wounds. PMID:9690320

Grauwin, M Y; Ndiaye, A; Sylla, P M; Gaye, A B; Mane, I; Cartel, J L; Lepers, J P

1998-01-01

287

Supermicrosurgical free sensate intercostal artery perforator flap based on the lateral cutaneous branch for plantar reconstruction.  

PubMed

The use of an intercostal artery perforator (ICAP) flap has recently become popular in reconstructive surgery. We have developed a novel free sensate ICAP flap based on the lateral cutaneous branch (LCB) and applied it to a case with a plantar defect. To the best of our knowledge, this case is the first to describe a free sensate ICAP flap based on the LCB. This method has several advantages: (1) a sensate flap is possible because the LCB neurovascular bundle is consistently available; (2) the long neurovascular pedicle can be harvested in the supine position without the risk of pneumothorax; (3) the donor-site morbidity is low; and (4) conversion or combination with a superficial circumflex iliac artery perforator (SCIP) or a superficial inferior epigastric artery (SIEA) flap is readily possible. We believe that this method represents a new option for soft-tissue reconstruction. PMID:24491457

Iida, Takuya; Narushima, Mitsunaga; Hara, Hisako; Yamamoto, Takumi; Yoshimatsu, Hidehiko; Morizaki, Yutaka; Uehara, Kosuke; Koshima, Isao

2014-07-01

288

Use of locally made off-loading techniques for diabetic plantar foot ulcer in Karachi, Pakistan.  

PubMed

The aim of this study was to evaluate the effectiveness of applying locally made pressure off-loading techniques on plantar foot ulcer in individuals with diabetes. This prospective study of 70 diabetic patients was conducted at the foot clinic of Baqai Institute of Diabetology & Endocrinology. Plantar foot ulcer, stages 1A and 2A according to the University of Texas classification, was treated by using three off-loading techniques: modified foot wear (sandal), modified plaster of Paris cast with plywood platform and Scotchcast boot. The outcome was assessed at either complete wound healing (defined as complete epithelialisation) or at 12 weeks, whichever came first. Of the 70 patients, 24 were in modified foot wear group, 23 in modified plaster of Paris cast and 23 in Scotchcast boot group. There was almost equal proportion of patients healed within 12 weeks period treated with these three off-loading techniques, i.e. 22 (95·7%) for modified foot wear group, 19 (95%) for modified plaster cast and 18 (94·7%) for Scotchcast boot group. No significant difference was observed in median healing time and cumulative wound survival at 12 weeks in the three off-loading techniques. Modified foot wear group was the most cost effective ($7) amongst the three off-loading techniques. It is concluded that in this cohort, no significant difference in healing time was observed in the three off-loading techniques, although modified foot wear (sandal) was found to be a more cost-effective treatment modality. PMID:23369009

Miyan, Zahid; Ahmed, Jameel; Zaidi, Syed I; Ahmedani, Muhammad Y; Fawwad, Asher; Basit, Abdul

2014-12-01

289

Ambulatory assessment of 3D ground reaction force using plantar pressure distribution.  

PubMed

This study aimed to use the plantar pressure insole for estimating the three-dimensional ground reaction force (GRF) as well as the frictional torque (T(F)) during walking. Eleven subjects, six healthy and five patients with ankle disease participated in the study while wearing pressure insoles during several walking trials on a force-plate. The plantar pressure distribution was analyzed and 10 principal components of 24 regional pressure values with the stance time percentage (STP) were considered for GRF and T(F) estimation. Both linear and non-linear approximators were used for estimating the GRF and T(F) based on two learning strategies using intra-subject and inter-subjects data. The RMS error and the correlation coefficient between the approximators and the actual patterns obtained from force-plate were calculated. Our results showed better performance for non-linear approximation especially when the STP was considered as input. The least errors were observed for vertical force (4%) and anterior-posterior force (7.3%), while the medial-lateral force (11.3%) and frictional torque (14.7%) had higher errors. The result obtained for the patients showed higher error; nevertheless, when the data of the same patient were used for learning, the results were improved and in general slight differences with healthy subjects were observed. In conclusion, this study showed that ambulatory pressure insole with data normalization, an optimal choice of inputs and a well-trained nonlinear mapping function can estimate efficiently the three-dimensional ground reaction force and frictional torque in consecutive gait cycle without requiring a force-plate. PMID:20576436

Rouhani, H; Favre, J; Crevoisier, X; Aminian, K

2010-07-01

290

REMOVING SLUDGE HEELS FROM SAVANNAH RIVER SITE WASTE TANKS BY OXALIC ACID DISSOLUTION  

SciTech Connect

The Savannah River Site (SRS) will remove sludge as part of waste tank closure operations. Typically the bulk sludge is removed by mixing it with supernate to produce a slurry, and transporting the slurry to a downstream tank for processing. Experience shows that a residual heel may remain in the tank that cannot be removed by this conventional technique. In the past, SRS used oxalic acid solutions to disperse or dissolve the sludge heel to complete the waste removal. To better understand the actual conditions of oxalic acid cleaning of waste from carbon steel tanks, the authors developed and conducted an experimental program to determine its effectiveness in dissolving sludge, the hydrogen generation rate, the generation rate of other gases, the carbon steel corrosion rate, the impact of mixing on chemical cleaning, the impact of temperature, and the types of precipitates formed during the neutralization process. The test samples included actual SRS sludge and simulated SRS sludge. The authors performed the simulated waste tests at 25, 50, and 75 C by adding 8 wt % oxalic acid to the sludge over seven days. They conducted the actual waste tests at 50 and 75 C by adding 8 wt % oxalic acid to the sludge as a single batch. Following the testing, SRS conducted chemical cleaning with oxalic acid in two waste tanks. In Tank 5F, the oxalic acid (8 wt %) addition occurred over seven days, followed by inhibited water to ensure the tank contained enough liquid to operate the mixer pumps. The tank temperature during oxalic acid addition and dissolution was approximately 45 C. The authors analyzed samples from the chemical cleaning process and compared it with test data. The conclusions from the work are: (1) Oxalic acid addition proved effective in dissolving sludge heels in the simulant demonstration, the actual waste demonstration, and in SRS Tank 5F. (2) The oxalic acid dissolved {approx} 100% of the uranium, {approx} 100% of the iron, and {approx} 40% of the manganese during a single contact in the simulant demonstration. (The iron dissolution may be high due to corrosion of carbon steel coupons.) (3) The oxalic acid dissolved {approx} 80% of the uranium, {approx} 70% of the iron, {approx} 50% of the manganese, and {approx} 90% of the aluminum in the actual waste demonstration for a single contact. (4) The oxalic acid dissolved {approx} 100% of the uranium, {approx} 15% of the iron, {approx} 40% of the manganese, and {approx} 80% of the aluminum in Tank 5F during the first contact cycle. Except for the iron, these results agree well with the demonstrations. The data suggest that a much larger fraction of the iron in the sludge dissolved, but it re-precipitated with the oxalate added to Tank 5F. (5) The demonstrations produced large volumes (i.e., 2-14 gallons of gas/gallon of oxalic acid) of gas (primarily carbon dioxide) by the reaction of oxalic acid with sludge and carbon steel. (6) The reaction of oxalic acid with carbon steel produced hydrogen in the simulant and actual waste demonstrations. The volume produced varied from 0.00002-0.00100 ft{sup 3} hydrogen/ft{sup 2} carbon steel. The hydrogen production proved higher in unmixed tanks than in mixed tanks.

Poirier, M; David Herman, D; Fernando Fondeur, F; John Pareizs, J; Michael Hay, M; Bruce Wiersma, B; Kim Crapse, K; Thomas Peters, T; Samuel Fink, S; Donald Thaxton, D

2009-03-01

291

Relationship between self-reported high-heeled shoe use and bone mineral density using quantitative ultrasound at a community health fair.  

PubMed

This is the first known study to examine the relationship between high-heel use and bone mineral density (BMD). Because women are disproportionately affected by osteoporosis, it is important to identify possible modifiable behaviors of women that may adversely affect bone health. Many studies have shown changes in body mechanics when wearing high-heeled shoes in comparison to normal gait. Because the composition of bone changes according to mechanical load and muscle activity, this study investigates whether wearing high heels may alter BMD. Two hundred and twenty-one participants at a community health fair in Lansing, Michigan, were surveyed on high-heel use and bone health risk (gender, thin/small frame, fair skin, family history of fracture, smoking history, walking, dairy consumption, and early menopause or oopherectomy at <45 years old). Quantitative ultrasound (QUS) of the heel by Hologic's Sahara Sonometer was used to measure BMD. The mean age was 45.2 (SD 13.7)?years, and the majority of participants were female (208, 94 %). A significant difference between mean BMD and high-heel use was not found. Independent correlations existed between fair skinned/sunburn easily and BMD, r(212)?=?-0.14, p?=?0.038, as well as history of smoking and BMD, r(212)?=?-0.14, p?=?0.042. Bone health risk score was strongly correlated with heel use binary variable "yes/no," r(210)?=?0.21, p?=?0.003. Our study suggests that wearing high-heeled shoes does not lead to appreciable differences in BMD among community health fair participants as assessed by QUS. PMID:22983265

Glassy, Crystal M; Glassy, Matthew S; Guggenheim, Carla

2013-01-01

292

Heel ultrasound in women after long-term ERT compared with bone densities in the forearm, spine and hip  

Microsoft Academic Search

To compare heel ultrasound values with bone densitites at different measurement sites as determined by single photon absorptiometry (SPA) and dual-energy X-ray absorptiometry (DXA) in long-term users of estrogen replacement therapy (ERT), we analyzed data from 30 users of estradiol implants (mean duration of treatment 16 years) and 32 non-users, comprising 28 complete age-matched pairs. The precision errors in vivo

T. Naessén; H. Mallmin; S. Ljunghall

1995-01-01

293

Management of heel ulcers in insensate foot by using free prefabricated radial fascial flap — a new flap  

Microsoft Academic Search

Heel ulcers are common in insensate foot. The management of such ulcers require tissue not only to resurface the skin defect,\\u000a which is small in most of the cases; but also well vascularised tissue to fill the cavity which results after excision of\\u000a the ulcer. We have described a new flap prefabricated radial fascial flap, by which both aims are

Vishwa Prakash

2010-01-01

294

Plantar Pressure in Diabetic Peripheral Neuropathy Patients with Active Foot Ulceration, Previous Ulceration and No History of Ulceration: A Meta-Analysis of Observational Studies  

PubMed Central

Aims Elevated dynamic plantar pressures are a consistent finding in diabetes patients with peripheral neuropathy with implications for plantar foot ulceration. This meta-analysis aimed to compare the plantar pressures of diabetes patients that had peripheral neuropathy and those with neuropathy with active or previous foot ulcers. Methods Published articles were identified from Medline via OVID, CINAHL, SCOPUS, INFORMIT, Cochrane Central EMBASE via OVID and Web of Science via ISI Web of Knowledge bibliographic databases. Observational studies reporting barefoot dynamic plantar pressure in adults with diabetic peripheral neuropathy, where at least one group had a history of plantar foot ulcers were included. Interventional studies, shod plantar pressure studies and studies not published in English were excluded. Overall mean peak plantar pressure (MPP) and pressure time integral (PTI) were primary outcomes. The six secondary outcomes were MPP and PTI at the rear foot, mid foot and fore foot. The protocol of the meta-analysis was published with PROPSERO, (registration number CRD42013004310). Results Eight observational studies were included. Overall MPP and PTI were greater in diabetic peripheral neuropathy patients with foot ulceration compared to those without ulceration (standardised mean difference 0.551, 95% CI 0.290–0.811, p<0.001; and 0.762, 95% CI 0.303–1.221, p?=?0.001, respectively). Sub-group analyses demonstrated no significant difference in MPP for those with neuropathy with active ulceration compared to those without ulcers. A significant difference in MPP was found for those with neuropathy with a past history of ulceration compared to those without ulcers; (0.467, 95% CI 0.181– 0.753, p?=?0.001). Statistical heterogeneity between studies was moderate. Conclusions Plantar pressures appear to be significantly higher in patients with diabetic peripheral neuropathy with a history of foot ulceration compared to those with diabetic neuropathy without a history of ulceration. More homogenous data is needed to confirm these findings. PMID:24915443

Fernando, Malindu Eranga; Crowther, Robert George; Pappas, Elise; Lazzarini, Peter Anthony; Cunningham, Margaret; Sangla, Kunwarjit Singh; Buttner, Petra; Golledge, Jonathan

2014-01-01

295

Evaluation of age-related plantar-surface insensitivity and onset age of advanced insensitivity in older adults using vibratory and touch sensation tests  

Microsoft Academic Search

Age-related decline in plantar-surface sensitivity has been cited as one of the reasons for balance problems in older adults. This study investigated the level of plantar-surface sensitivity in older adults compared to young adults. Additionally, this study attempted to identify the onset age of advanced insensitivity in older adults and how well monofilament testing was able to predict insensitivity and

Stephen D. Perry

2006-01-01

296

A comparison of the effectiveness of extracorporeal shock wave and ultrasound therapy in the management of heel pain  

NASA Astrophysics Data System (ADS)

The aim of this study was to compare the effectiveness of extracorporeal shock wave therapy (ESWT) and ultrasound therapy (US) for managing heel pain. Thirty-seven subjects received either: ESWT (once a week), US (three times a week), or CONTROL (no treatment) for 3 consecutive weeks and were followed-up for 3 more weeks. A visual analogue scale (VAS), the maximum tolerable duration for prolonged walking or standing, and the Mayo clinical scoring system (MCSS) were evaluated. Mixed models treating baseline measures as covariates were adopted for statistical analysis. By week 3, intensity of heel pain on palpation was reduced by 37% (VAS score from 7.5 to 4.6) in the ESWT group, 24% (from 5.3 to 4.2) in the US group, and increased by 3% (5.6-5.7) in the control group; this difference was significant after adjusting for baseline VAS scores ( p = 0.022). The improvements in the maximum tolerable duration of prolonged walking or standing was only significant in the ESWT group (157% increase, p = 0.043) but not the other two groups. Both active treatment groups maintained the treatment effect at the three-week follow-up. We conclude that ESWT is potentially more effective in reducing heel pain than ultrasound therapy but additional evidence is needed due to the various limitations of the study.

Cheing, G. L. Y.; Chang, H.; Lo, S. K.

2007-11-01

297

A novel approach to mapping load transfer from the plantar surface of the foot to the walls of the total contact cast: a proof of concept study  

PubMed Central

Background Total contact casting is regarded as the gold standard treatment for plantar foot ulcers. Load transfer from the plantar surface of the foot to the walls of the total contact cast has previously been assessed indirectly. The aim of this proof of concept study was to determine the feasibility of a new method to directly measure the load between the cast wall and the lower leg interface using capacitance sensors. Methods Plantar load was measured with pedar® sensor insoles and cast wall load with pliance® sensor strips as participants (n=2) walked along a 9 m walkway at 0.4±0.04 m/sec. The relative force (%) on the cast wall was calculated by dividing the mean cast wall force (N) per step by the mean plantar force (N) per step in the shoe-cast condition. Results The combined average measured load per step upon the walls of the TCC equated to 23-34% of the average plantar load on the opposite foot. The highest areas of load on the lower leg were located at the posterior margin of the lateral malleolus and at the anterior ankle/extensor retinaculum. Conclusions These direct measurements of cast wall load are similar to previous indirect assessment of load transfer (30-36%) to the cast walls. This new methodology may provide a more comprehensive understanding of the mechanism of load transfer from the plantar surface of the foot to the cast walls of the total contact cast. PMID:23237261

2012-01-01

298

Maximum toe flexor muscle strength and quantitative analysis of human plantar intrinsic and extrinsic muscles by a magnetic resonance imaging technique  

PubMed Central

Background The aims of this study were to investigate the relationships between the maximum isometric toe flexor muscle strength (TFS) and cross-sectional area (CSA) of the plantar intrinsic and extrinsic muscles and to identify the major determinant of maximum TFS among CSA of the plantar intrinsic and extrinsic muscles. Methods Twenty six young healthy participants (14 men, 12 women; age, 20.4?±?1.6 years) volunteered for the study. TFS was measured by a specific designed dynamometer, and CSA of plantar intrinsic and extrinsic muscles were measured using magnetic resonance imaging (MRI). To measure TFS, seated participants optimally gripped the bar with their toes and exerted maximum force on the dynamometer. For each participant, the highest force produced among three trials was used for further analysis. To measure CSA, serial T1-weighted images were acquired. Results TFS was significantly correlated with CSA of the plantar intrinsic and extrinsic muscles. Stepwise multiple linear regression analyses identified that the major determinant of TFS was CSA of medial parts of plantar intrinsic muscles (flexor hallucis brevis, flexor digitorum brevis, quadratus plantae, lumbricals and abductor hallucis). There was no significant difference between men and women in TFS/CSA. Conclusions CSA of the plantar intrinsic and extrinsic muscles is one of important factors for determining the maximum TFS in humans. PMID:24955128

2014-01-01

299

EM-31 ALTERNATIVE AND ENHANCED CHEMICAL CLEANING PROGRAM FOR SLUDGE HEEL REMOVAL - 11220  

SciTech Connect

Mixtures of oxalic acid with nitric acid have been shown to be superior to oxalic acid alone for the dissolution of iron-rich High Level Waste sludge heels. Optimized conditions resulting in minimal oxalate usage and stoichiometric iron dissolution (based on added oxalate ion) have been determined for hematite (a primary sludge iron phase) in oxalic/nitric acid mixtures. The acid mixtures performed better than expected based on the solubility of hematite in the individual acids through a synergistic effect in which the preferred 1:1 Fe:oxalate complex is formed. This allows for the minimization of oxalate additions to the waste stream. Carbon steel corrosion rates were measured in oxalic/nitric acid mixtures to evaluate the impacts of chemical cleaning with these solutions on waste tank integrity. Manageable corrosion rates were observed in the concentration ranges of interest for an acid contact timescale of 1 month. Kinetics tests involving hematite and gibbsite (a primary sludge aluminum phase) have confirmed that {ge}90% solids dissolution occurs within 3 weeks. Based on these results, the chemical cleaning conditions recommended to promote minimal oxalate usage and manageable corrosion include: 0.5 wt. % oxalic acid/0.175 M nitric acid mixture, 50 C, 2-3 week contact time with agitation.

King, W.; Hay, M.; Wiersma, B.; Pennebaker, F.

2010-12-10

300

Achilles' heel of sociality revealed by energetic poverty trap in cursorial hunters.  

PubMed

This study empirically tests two foundation ecological theories: (1) pack hunting is a driver for the evolution of sociality; and (2) species have a finite energy potential, whereby increased maintenance costs result in decreased reproductive effort. Using activity and prey data from 22 packs of African wild dogs (Lycaon pictus), we parameterized a model detailing the energetic cost/benefit of cooperative hunting. Larger pack size increased foraging time, prey size, and capture probability while reducing chase distance, resulting in a rapidly increasing net rate of energy intake up to a pack size of five, which peaked at 10 individuals and then declined. With a streamlined body plan necessary for hypercursoriality limiting stomach capacity in smaller packs, it was demonstrated that the group hunting benefit will rather accrue to widely foraging predators than to "sit-and-wait" ones. Reproductive effort, measured by the number of pups born, revealed smaller litters with decreasing pack size, validated finite energy theory, and highlighted a "poverty trap" where smaller groups have lower foraging gains, smaller litters, and increased vulnerability to extirpation. Consequently, these results demonstrated a mechanistic example of pervasive selection for maximal body size (Cope's rule), leading to a macroevolutionary ratchet, where sociality linked to hypercursoriality is betrayed by an Achilles' heel. PMID:18729728

Rasmussen, Gregory S A; Gusset, Markus; Courchamp, Franck; Macdonald, David W

2008-10-01

301

Immunoediting and Antigen Loss: Overcoming the Achilles Heel of Immunotherapy with Antigen Non-Specific Therapies  

PubMed Central

Cancer immunotherapy has emerged as a mainstream therapy option in the battle against cancer. Pre-clinical data demonstrates the ability of immunotherapy to harness the immune system to fight disseminated malignancy. Clinical translation has failed to recapitulate the promising results of pre-clinical studies although there have been some successes. In this review we explore some of the short-comings of cancer immunotherapy that have limited successful clinical translation. We will give special consideration to what we consider the most formidable hurdle to successful cancer immunotherapy: tumor-induced immune suppression and immune escape. We will discuss the need for antigen-specific immune responses for successful immunotherapy but also consider the need for antigen specificity as an Achilles heel of immunotherapy given tumor heterogeneity, immune editing, and antigen loss. Finally, we will discuss how combinatorial strategies may overcome some of the pitfalls of antigen specificity and highlight recent studies from our lab which suggest that the induction of antigen non-specific immune responses may also produce robust anti-tumor effects and bypass the need for antigen specificity. PMID:23898464

Monjazeb, Arta Monir; Zamora, Anthony E.; Grossenbacher, Steven K.; Mirsoian, Annie; Sckisel, Gail D.; Murphy, William J.

2013-01-01

302

Kinaesthetic ipsilateral and crossed extensor plantar response: A new way to elicit upgoing toe sign (Babinski response)?  

PubMed

We describe a phenomenon of "kinaesthetic extensor plantar response" in advanced pyramidal dysfunction, an interesting observation noted in a patient with dorsal myelopathy. A 44-year-old woman presented with one-year history of gradually progressive weakness and stiffness of both lower limbs along with urge incontinence of urine. Examination showed spontaneous elicitation of extensor plantar response while assessing the tone by rolling method as well as on noxious stimulation of the thigh. Magnetic resonance imaging (MRI) of the dorsal spine and digital subtraction angiography showed the presence of spinal dural arteriovenous fistula causing myelopathy. This case exemplifies the fact that in advanced pyramidal dysfunction, not only the receptive field of Babinski reflex may extend to the leg or thigh, but may also integrate with other modalities of stimulation, such as the rolling movement. The possible underlying pathophysiology of such a phenomenon is discussed. PMID:22028534

Kuruvilla, Abraham; Wattamwar, Pandurang R

2011-07-01

303

Pedal bone density, strength, orientation, and plantar loads preceding incipient metatarsal fracture after Charcot neuroarthropathy: 2 case reports  

PubMed Central

Study Design Case reports Background Charcot neuroarthropathy (CN) is a progressive, non-infective, inflammatory destruction of bones and joints leading to foot deformities and plantar ulceration. Though individuals with CN typically have low areal bone mineral density (aBMD), little is known regarding changes in volumetric bone mineral density (vBMD), bone geometry, joint mal-alignment, and biomechanical loads preceding fracture. Case Description Two females, aged 45 and 54 years at the onset of an acute non-fracture CN event, received regular physical therapy with wound care and total contact casting. Both enrolled in a larger research study that included plantar pressure assessment and quantitative computed tomography (QCT) at enrollment and 3, 6, and 12 months later. The women sustained mid-diaphyseal fifth metatarsal fracture 10–11 months after enrollment. QCT image analysis techniques were used to measure vBMD; bone geometric indices reflecting strength in compression, bending, and cortical buckling; and 3-dimensional bone-to-bone orientation angles reflecting foot deformity. Outcomes Fifth metatarsal mid-diaphyseal vBMD decreased during off-loading treatment from 0 to 3 months, then increased to above baseline levels by 6 months. All geometric strength indices improved from baseline through 6 months. Plantar loading in the lateral midfoot increased preceding fracture, concomitant with alterations in bone orientation angles which suggest progressive development of metatarsus adductus and equinovarus foot deformity. Discussion Fractures may occur when bone strength decreases or when biomechanical loading increases. Incipient fracture was preceded by increased loading in the lateral midfoot, but not by reductions in vBMD or geometric strength indices, suggesting that loading played a greater role in fracture. Moreover, the progression of foot deformities may be causally linked to the increased plantar loading. Level of evidence Therapy, level 4 PMID:24256173

Gutekunst, David J.; Sinacore, David R.

2014-01-01

304

Calf and shin muscle oxygenation patterns and femoral artery blood flow during dynamic plantar flexion exercise in humans  

Microsoft Academic Search

.   The effects of dynamic plantar flexion exercise [40, 60, and 80 contractions·min–1 (cpm)] on calf and shin muscle oxygenation patterns and common femoral artery blood flow (\\u000a ) were examined in six female subjects [mean age 21 (SD 1) years] who exercised for 1 min at 33% of their maximal voluntary\\u000a contraction at ankle angles between 90° and 100°. Spatially resolved near-infrared spectroscopy was used

V. Quaresima; S. Homma; K. Azuma; S. Shimizu; F. Chiarotti; M. Ferrari; A. Kagaya

2001-01-01

305

Chronic Pain  

MedlinePLUS

... a problem you need to take care of. Chronic pain is different. The pain signals go on for ... there is no clear cause. Problems that cause chronic pain include Headache Low back strain Cancer Arthritis Pain ...

306

Quantitative Estimation of Temperature Variations in Plantar Angiosomes: A Study Case for Diabetic Foot  

PubMed Central

Thermography is a useful tool since it provides information that may help in the diagnostic of several diseases in a noninvasive and fast way. Particularly, thermography has been applied in the study of the diabetic foot. However, most of these studies report only qualitative information making it difficult to measure significant parameters such as temperature variations. These variations are important in the analysis of the diabetic foot since they could bring knowledge, for instance, regarding ulceration risks. The early detection of ulceration risks is considered an important research topic in the medicine field, as its objective is to avoid major complications that might lead to a limb amputation. The absence of symptoms in the early phase of the ulceration is conceived as the main disadvantage to provide an opportune diagnostic in subjects with neuropathy. Since the relation between temperature and ulceration risks is well established in the literature, a methodology that obtains quantitative temperature differences in the plantar area of the diabetic foot to detect ulceration risks is proposed in this work. Such methodology is based on the angiosome concept and image processing. PMID:24688595

Peregrina-Barreto, H.; Morales-Hernandez, L. A.; Rangel-Magdaleno, J. J.; Avina-Cervantes, J. G.; Ramirez-Cortes, J. M.; Morales-Caporal, R.

2014-01-01

307

Effect of muscle model parameter scaling for isometric plantar flexion torque prediction.  

PubMed

This paper uses a EMG-driven Hill-type muscle model to estimate individual muscle forces of the triceps surae in isometric plantar flexion contractions. A uniform group of 20 young physical-active adult males was instructed to follow a specific contraction protocol with low (20%MVC) and medium-high (60%MVC) contractions, separated by relaxing intervals. The torque calculated by summing the individual muscle forces multiplied by the respective moment arms was compared to the torque measured by a dynamometer. Musculoskeletal parameters from the literature were used. Then, three different "correction factors" or bias have been applied on some of the muscle model parameters. These factors were based on anthropometric and dynamometric measurements: moment arm scaled by bimalleolar diameter, tendon slack length by leg length and optimal force by the maximum torque. Model torque agreement with dynamometer was recalculated with the parameter scales. It was observed that the relative torque estimation error decreased slightly but significantly when all factors were applied simultaneously (12.92+/-4.94% without scaling to 10.12+/-1.73%), which resulted mainly from the correction of the maximal muscle force parameter. PMID:19665714

Menegaldo, Luciano Luporini; de Oliveira, Liliam Fernandes

2009-11-13

308

A two-phase model of plantar tissue: a step toward prediction of diabetic foot ulceration.  

PubMed

A new computational model, based on the thermodynamically constrained averaging theory, has been recently proposed to predict tumor initiation and proliferation. A similar mathematical approach is proposed here as an aid in diabetic ulcer prevention. The common aspects at the continuum level are the macroscopic balance equations governing the flow of the fluid phase, diffusion of chemical species, tissue mechanics, and some of the constitutive equations. The soft plantar tissue is modeled as a two-phase system: a solid phase consisting of the tissue cells and their extracellular matrix, and a fluid one (interstitial fluid and dissolved chemical species). The solid phase may become necrotic depending on the stress level and on the oxygen availability in the tissue. Actually, in diabetic patients, peripheral vascular disease impacts tissue necrosis; this is considered in the model via the introduction of an effective diffusion coefficient that governs transport of nutrients within the microvasculature. The governing equations of the mathematical model are discretized in space by the finite element method and in time domain using the ?-Wilson Method. While the full mathematical model is developed in this paper, the example is limited to the simulation of several gait cycles of a healthy foot. Copyright © 2014 John Wiley & Sons, Ltd. PMID:24841993

Sciumè, G; Boso, D P; Gray, W G; Cobelli, C; Schrefler, B A

2014-11-01

309

["Epidemic" of plantar dermatitis during military maneuvers in the rain forest of Guyana].  

PubMed

The purpose of this report is to describe an "epidemic" outbreak of plantar dermatitis that occurred in 30 soldiers on mission in the rain forest of Guyana. The contingent was forced to stop twice and operational readiness was seriously reduced. The first episode affecting 43% (13/30) of the contingent occurred after 4 days of march. In the second episode 70% (21/30) of the contingent was affected. Manifestations were characterized by the appearance of distinct, dry, nonpruriginus, erythematous papules followed a few hours later by quasi-exfoliating, noncoalescing, nonoozing, nonmalodorous lesions measuring several centimeters in diameter. Symptoms regressed quickly within 48 to 72 hours with only symptomatic treatment. A combination of microtrauma and maceration is the most likely mechanism. However identification of an offending microbial, viral or fungal agent or of a cause in the environment, clothing or products could not be made. A tempting hypothesis involves an inflammatory reaction caused by an organism in ground water or the soil. A prospective study could be undertaken at the Rain Forest Training Camp in Regina where similar clinical manifestation have been observed. PMID:12910659

Dampierre, H

2003-01-01

310

A Cross-Sectional Study of the Plantar Flexor Muscle and Tendon during Growth.  

PubMed

The purpose of this study was to investigate growth changes in human plantar flexor muscle and tendons. In addition, we ascertained whether growth changes in muscle and tendon were more closely related to skeletal age than chronological age. 22 elementary school children (ESC), 19 junior high school students (JHS), and 23 young adults (ADT) men participated in this study. Maximal strain and hysteresis of tendon structures and cross-sectional area of Achilles tendon were measured using ultrasonography. In addition, skeletal age was assessed using Tanner-Whitehouse III method. Maximal strain of ESC was significantly greater than that of other groups, while no significant difference was observed between JHS and ADT. There was no difference in hysteresis among 3 groups. Relative cross-sectional area (to body mass(2/3)) of ADT was significantly smaller than that of other groups. For ESC and JHS, measured variables of muscle and tendon were significantly correlated to both chronological and skeletal ages. These results suggested that immature musculoskeletal system was protected by more extensible and larger tendon structures in ESC and only by larger tendon structures in JHS, respectively. Furthermore, there were no differences in correlation coefficient values between measured variables of muscle and tendon and chronological or skeletal ages. PMID:24577863

Kubo, K; Teshima, T; Hirose, N; Tsunoda, N

2014-09-01

311

Dynamic force distribution during level walking under the feet of patients with chronic ankle instability  

PubMed Central

Objectives: To examine changes in the pattern of force transfer between the foot and the floor associated with chronically sprained ankles by measuring the peak forces and their timing under several regions of the feet during level walking. Methods: Twelve young male subjects (mean (SD) age 21 (2) years) with recurrent ankle sprains were studied. Seven of them had unilateral and bilateral chronic instability and laxity, and five had bilateral instability. Twelve healthy men (without orthopaedic or medical disease) served as a control group. Subjects walked at their own pace along a 7 m walkway, which included a Mini-EMED pressure distribution measuring system. The variables measured were relative peak force (fraction of body weight) and relative timing (fraction of stance time). These variables were measured under six regions of interest in each foot print: heel, midfoot, medial, central, and lateral forefoot, and toes. Results: (a) A significant delay to the time of peak force under the central and lateral forefoot and toes in subjects with chronic ankle instability. (b) A significant decrease in the relative forces under the heel and toes and an increase in the relative forces under the midfoot and lateral forefoot in subjects with chronic ankle instability. (c) In the patients with unilateral instability, there were no significant differences in any of the variables between the injured and non-injured foot. Conclusions: In patients with chronic ankle instability, there is a slowing down of weight transfer from heel strike to toe off, a reduced impact at the beginning and end of the stance phase, and a lateral shift of body weight. PMID:14665586

Nyska, M; Shabat, S; Simkin, A; Neeb, M; Matan, Y; Mann, G

2003-01-01

312

Venepuncture is preferable to heel lance for blood sampling in term neonates  

PubMed Central

Background: The analgesic effect of oral sucrose in newborn infants undergoing painful procedures is generally accepted. For blood sampling, some studies have shown that venepuncture (VP) is less painful than heel lance (HL). Objective: To determine the least painful and most effective method among blood sampling by VP or HL with or without sucrose. Design: Randomised, double blind, placebo controlled trial. Subjects: A total of 100 healthy, full term newborn infants being screened for inborn errors of metabolism were randomly allocated to one of four experimental groups (25 infants in each). Intervention and outcome measure: Seven specially trained nurses took turns to carry out blood sampling two minutes after administration of oral sucrose or water. Neonatal pain was assessed by the neonatal facial coding system (NFCS), as well as by crying. Results: Without sucrose, the NFCS score was higher in the HL group than the VP group during blood sampling (median 58 v 23, p<0.001). Oral sucrose significantly reduced the score of the HL group (58 v 47, p<0.01) and also tended to reduce the score of the VP group (23 v 2, p<0.1). However, the HL with sucrose group still had a higher score than the VP without sucrose group (47 v 23, p<0.01). Crying and the total procedure time showed the same trends as the NFCS score. Conclusions: VP is less painful and more effective than HL for blood sampling in newborn infants. Although oral sucrose may have an additive analgesic effect, it is not necessarily required if VP is used for blood sampling. PMID:15871991

Ogawa, S; Ogihara, T; Fujiwara, E; Ito, K; Nakano, M; Nakayama, S; Hachiya, T; Fujimoto, N; Abe, H; Ban, S; Ikeda, E; Tamai, H

2005-01-01

313

Chronic Pain  

MedlinePLUS

NINDS Chronic Pain Information Page Synonym(s): Pain - Chronic Condensed from Pain: Hope Through Research Table of Contents (click to jump ... Trials Organizations Additional resources from MedlinePlus What is Chronic Pain? While acute pain is a normal sensation triggered ...

314

The human foot and heel-sole-toe walking strategy: a mechanism enabling an inverted pendular gait with low isometric muscle force?  

PubMed Central

Mechanically, the most economical gait for slow bipedal locomotion requires walking as an ‘inverted pendulum’, with: I, an impulsive, energy-dissipating leg compression at the beginning of stance; II, a stiff-limbed vault; and III, an impulsive, powering push-off at the end of stance. The characteristic ‘M’-shaped vertical ground reaction forces of walking in humans reflect this impulse–vault–impulse strategy. Humans achieve this gait by dissipating energy during the heel-to-sole transition in early stance, approximately stiff-limbed, flat-footed vaulting over midstance and ankle plantarflexion (powering the toes down) in late stance. Here, we show that the ‘M’-shaped walking ground reaction force profile does not require the plantigrade human foot or heel–sole–toe stance; it is maintained in tip–toe and high-heel walking as well as in ostriches. However, the unusual, stiff, human foot structure—with ground-contacting heel behind ankle and toes in front—enables both mechanically economical inverted pendular walking and physiologically economical muscle loading, by producing extreme changes in mechanical advantage between muscles and ground reaction forces. With a human foot, and heel–sole–toe strategy during stance, the shin muscles that dissipate energy, or calf muscles that power the push-off, need not be loaded at all—largely avoiding the ‘cost of muscle force’—during the passive vaulting phase. PMID:22572024

Usherwood, J. R.; Channon, A. J.; Myatt, J. P.; Rankin, J. W.; Hubel, T. Y.

2012-01-01

315

Experience with extracorporeal shock wave therapy (ESWT) in the United States  

NASA Astrophysics Data System (ADS)

The purpose of this presentation is to summarize the literature and to report on single treatment, high-energy ESWT for the treatment of chronic plantar fasciitis and lateral epicondylitis. Fifty-three patients (60 heels) were treated with 3800 shock waves. Sixteen patients (19 heels) were active, 21 (22 heels), were moderately active, and 16 (19 heels) were sedentary. Twelve weeks post treatment, mean visual analog scores (VAS) for the entire group improved from 9.2 to 2.4 (p<0.05), RAND-Physical Functioning score improved from 40.4 to 91.5 (p<0.05), and RAND-Pain score improved from 33.3 to 90 (p<0.05). Fifty heels (83.3%) were assigned an excellent or good result. Thirty-six patients with chronic lateral epicondylitis were treated with 3200 shock waves. There were 9 workers compensation and 27 non-workers compensation patients. Twelve weeks post treatment, the mean VAS for the entire group improved from 8.0 to 2.5 (p<0.05), and the mean RAND-Physical Functioning score improved from 65.6 to 88.0 (p<0.05). Twenty-eight elbows (77.8%) were assigned an excellent or good result. In both trials, outcome was similar for each subgroup. There were no significant complications in either trial. Using the therapeutic parameters applied, ESWT is a safe and effective treatment for chronic plantar fasciitis and lateral epicondylitis.

Furia, John P.

2005-04-01

316

Influence of pressure-relief insoles developed for loaded gait (backpackers and obese people) on plantar pressure distribution and ground reaction forces.  

PubMed

The aims of this study were to test the effects of two pressure relief insoles developed for backpackers and obese people on the ground reaction forces (GRF) and plantar pressure peaks during gait; and to compare the GRF and plantar pressures among normal-weight, backpackers, and obese participants. Based on GRF, plantar pressures, and finite element analysis two insoles were manufactured: flat cork-based insole with (i) corkgel in the rearfoot and forefoot (SLS1) and with (ii) poron foam in the great toe and lateral forefoot (SLS2). Gait data were recorded from 21 normal-weight/backpackers and 10 obese participants. The SLS1 did not influence the GRF, but it relieved the pressure peaks for both backpackers and obese participants. In SLS2 the load acceptance GRF peak was lower; however, it did not reduce the plantar pressure peaks. The GRF and plantar pressure gait pattern were different among the normal-weight, backpackers and obese participants. PMID:24468683

Peduzzi de Castro, Marcelo; Abreu, Sofia; Pinto, Viviana; Santos, Rubim; Machado, Leandro; Vaz, Mario; Vilas-Boas, João Paulo

2014-07-01

317

Analytical approaches to the determination of pressure distribution under a plantar prominence.  

PubMed

INTRODUCTION:: The purpose of the current research was to develop an analytical model for the interface between the metatarsal head, surrounding soft tissue, and the shoe. Results of 'peak plantar pressures' computed from this model were compared to previous results obtained from clinical data and from a finite element (FE) model. METHODS:: An analytical model for determining the pressure distribution at the interface between the foot and shoe insole was developed based on the solution[Figure: see text] for a rigid cylinder and a single elastic layer mounted on a rigid half-space originally developed by Meijers (see Figure 1). The rigid cylinder was used to represent the metatarsal head region (including bone and soft tissue). Material properties and loading conditions were chosen to reflect those used by Lemmon et al. for 'Normal' and 'Reduced' soft tissue thickness cases. RESULTS:: Peak pressures computed from the analytical model are plotted against insole thickness in Figure 1, alongside experimental and FE model data from Lemmon et al. Correlations between analytical, FE, and experimental results for both the Normal and Reduced soft tissue cases were all highly significant (r(2) = 0.86, p < 0.01). DISCUSSION:: The analytical model produced unrealistically high peak pressures compared to the FE and experimental results, with differences of approximately one order of magnitude. This was not surprising, given that the entire metatarsal head region (soft tissue included) was modelled as a rigid cylinder. The soft tissue on the bottom of the foot, and the much greater surface area over which the loads are carried in the real case, contribute greatly to reducing these peak pressure values. However, the downward trend in peak pressure with increased insole thickness was retained. CONCLUSION:: It is anticipated that the use of more accurate and detailed models will greatly improve the initial results. PMID:11415716

Dingwell, J; Ovaert, T; Lemmon, D; Cavanagh, PR

1997-04-01

318

Does topical amethocaine gel reduce pain from heel prick blood sampling in premature infants? A randomized double-blind cross-over controlled study  

PubMed Central

BACKGROUND: Heel prick blood sampling is the most common painful invasive procedure performed on neonates. Currently, there are no effective ways to provide pain relief from this painful procedure. OBJECTIVE: To assess the efficacy of the topical anesthetic amethocaine 4% gel (Ametop, Smith & Nephew Inc, St Laurent) in reducing the pain of heel prick blood sampling in neonates. METHODS: A randomized, double-blind, placebo controlled, crossover trial was conducted. Neonates between 33 to 37 weeks’ gestational age in their first seven days of life were eligible. Heel prick blood sampling was performed on each participant twice. Each infant was randomly assigned to receive either amethocaine 4% gel or placebo to the heel for the first prick, and then received the alternative agent for the second prick. Prick pain was assessed using both Premature Infant Pain Profile (PIPP) and Neonatal Infant Pain Scale (NIPS). Squeeze pain was assessed by NIPS. RESULTS: Ten babies were recruited. There were no significant differences in the average PIPP and NIPS scores between the treatment and placebo groups for both prick and squeeze pains from heel prick blood sampling. For prick pain, linear-regression showed significant correlation between the PIPP and NIPS scores. No adverse reactions were observed after application of either the active or placebo agents. CONCLUSION: Topical amethocaine 4% gel is not shown to reduce prick and squeeze pains significantly from heel prick blood sampling in neonates between 33 to 37 weeks’ gestational age. Further studies are needed to find ways to provide effective pain relief from this common procedure. PMID:20020001

Patel, Amita; Czerniawski, Barbara; Gray, Shari; Lui, Eric

2003-01-01

319

An automatic incision device for obtaining blood samples from the heels of preterm infants causes less damage than a conventional manual lancet  

PubMed Central

OBJECTIVES—To evaluate in a randomised blind study the effect on puncture site lesions of two different incision devices used to obtain blood samples from preterm infants by repeated heel sticks. ?SETTING—The neonatal intensive care unit at the Hospital for Children and Adolescents and Laboratory, Helsinki University Central Hospital. ?PATIENTS—A total of 100 preterm infants (birth weight below 2500 g) not previously subjected to heel stick sampling. ?INTERVENTIONS—The infants were randomly allocated to blood sampling from the heel with either a conventional manual lancet or an automatic incision device. The same type of lancet was used for any given baby throughout the study (2-21 days).?MAIN OUTCOME MEASURES—The damage caused by sampling was evaluated using four criteria: bruising of the heel, inflammation of the heel, bruising of either the ankle or the leg, and skin healing at the puncture site. The evaluation was based on photographs presenting typical categories of each outcome. ?RESULTS—To obtain a sufficient volume of blood, on average 2.6 times more punctures were needed when the conventional manual lancet was used than when the automatic incision device was used. Heels punctured with the lancet had more bruising (100% v 84%) and more signs of inflammation (79% v 53%), and there was more bruising of the ankle or leg (92% v 53%) than when the automatic incision device was used. Skin healed equally rapidly in the two groups.?CONCLUSION—The use of an automatic incision device for collecting repeated skin puncture samples from preterm infants is less traumatic than the use of a conventional manual lancet.?? PMID:11124927

Vertanen, H; Fellman, V; Brommels, M; Viinikka, L

2001-01-01

320

Impact reduction through long-term intervention in recreational runners: midfoot strike pattern versus low-drop/low-heel height footwear.  

PubMed

Impact reduction has become a factor of interest in the prevention of running-related injuries such as stress fractures. Currently, the midfoot strike pattern (MFS) is thought as a potential way to decrease impact. The purpose was to test the effects of two long-term interventions aiming to reduce impact during running via a transition to an MFS: a foot strike retraining versus a low-drop/low-heel height footwear. Thirty rearfoot strikers were randomly assigned to two experimental groups (SHOES and TRAIN). SHOES progressively wore low-drop/low-heel height shoes and TRAIN progressively adopted an MFS, over a 3-month period with three 30-min running sessions per week. Measurement sessions (pre-training, 1, 2 and 3 months) were performed during which subjects were equipped with three accelerometers on the shin, heel and metatarsals, and ran for 15 min on an instrumented treadmill. Synchronized acceleration and vertical ground reaction force signals were recorded. Peak heel acceleration was significantly lower as compared to pre-training for SHOES (-33.5 ± 12.8 % at 2 months and -25.3 ± 18.8 % at 3 months, p < 0.001), and so was shock propagation velocity (-12.1 ± 9.3 %, p < 0.001 at 2 months and -11.3 ± 4.6 %, p < 0.05 at 3 months). No change was observed for TRAIN. Important inter-individual variations were noted in both groups and reported pains were mainly located at the shin and calf. Although it induced reversible pains, low-drop/low-heel height footwear seemed to be more effective than foot strike retraining to attenuate heel impact in the long term. PMID:23584279

Giandolini, Marlène; Horvais, Nicolas; Farges, Yohann; Samozino, Pierre; Morin, Jean-Benoît

2013-08-01

321

Equine developmental orthopaedic diseases--a genome-wide association study of first phalanx plantar osteochondral fragments in Standardbred trotters.  

PubMed

Palmar/plantar osteochondral fragments (POF) in fetlock joints commonly affect and influence the athletic performance of horses. In this study, we used the Equine SNP50 BeadChip® to perform a genome-wide association study of metatarsophalangeal POF in 176 Norwegian Standardbred trotter yearlings. Putative quantitative trait loci (QTL) for medial and/or lateral POF, and medial POF only were identified on ECA1, 2, 7, 9 and 31, whereas for lateral POF, only on ECA7, 11, 27 and X. The moderate number of QTL evidences a complex inheritance and suggests various genes controlling POF development in medial and lateral locations. PMID:23742657

Lykkjen, S; Dolvik, N I; McCue, M E; Rendahl, A K; Mickelson, J R; Røed, K H

2013-12-01

322

Chronic leukemia.  

PubMed

The chronic leukemias include chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL). CML is a clonal myeloproliferative hematopoietic stem-cell disorder, and CLL is a monoclonal B-cell disorder. CML is Philadelphia chromosome positive. There are 3 phases of CML: the chronic phase, the accelerated phase, and the blast phase. The primary treatment of CML consists of tyrosine kinase inhibitors. CLL can present as indolent or fulminant disease. Early disease is managed with observation. Fulminant disease is currently treated with alkylating agents, purine analogues, and monoclonal antibodies, but new biotarged therapies are being developed. PMID:24267282

Greenberg, Edythe M Lyn; Probst, Alexandra

2013-12-01

323

Is A163G polymorphism in the osteoprotegerin gene associated with heel velocity of sound in postmenopausal women?  

PubMed

Osteoprotegerin (OPG) plays an important inhibitory role in osteoclastogenesis. Polymorphisms in the OPG gene recently have been associated with various bone phenotypes including fractures. The aim of the present study was to investigate the association between three informative OPG polymorphisms and quantitative ultrasound variables of the heel. In a cohort of 165 perimenopausal women polymorphisms in the OPG promoter (A163G, T245G) and in exon 1 (G1181C) were assessed by PCR-RFLP analysis. The distribution of the investigated genotypes was similar to other Caucasian women (A163G-AA 68 %, AG 30 %, GG 2 %, T245G-TT 84.4 %, TG 15 %, GG 0.6 %, G1181C- GG 22 %, CG 55 %, CC 23 %). After adjustment for body mass index and years since menopause, in a subgroup of 87 postmenopausal subjects, calcaneal velocity of sound (VOS, m/s) was significantly associated with A163G polymorphism (p=0.0102, ANCOVA). Women with the presence of G allele (AG+GG genotypes) had significantly lower VOS than women with AA genotype. Neither T245G nor G1181C were associated with calcaneal ultrasound indices. In conclusion, A163G polymorphism was significantly associated with VOS at the heel in a limited cohort of postmenopausal women. The present study replicated in part the previous findings about OPG gene variations and peripheral bone mass in Caucasian women. PMID:18271681

Zajícková, K; Zemanová, A; Hill, M; Zofková, I

2008-01-01

324

Dynamometric indicators of fatigue from repeated maximal concentric isokinetic plantar flexion contractions are independent of knee flexion angles and age but differ for males and females.  

PubMed

Sex and age are reported to influence the maximal dynamometric performance of major muscle groups, inclusive of ankle plantar flexors. Knee flexion (KF) also impacts plantar flexion function from where stems use of 0° and 45° angles of KF for clinical assessment of gastrocnemius and soleus, respectively. The influence of KF, sex, and age on dynamometric indicators of plantar flexion fatigue was examined in 28 males and 28 females recruited in 2 different age groups (older and younger than 40 years). Each subject performed 50 maximal concentric isokinetic plantar flexions at 60-degree angle per·second with 0° and 45° angles of KF. Maximal voluntary isometric contractions were determined before and after isokinetic trials and maximal, minimal, and normalized linear slopes of peak power during testing. Main effects of and 2-way interactions between KF, sex, age, and order of testing were explored using mixed-effect models and stepwise regressions. At angles of 0° and 45°, the fatigue indicators in younger and older individuals were similar and not influenced by testing order. However, peak isokinetic power and isometric torque declined to greater extents in males than females and, moreover, KF exerted greater impacts on the absolute plantar flexion performance and maximal-to-minimal reduction in isokinetic power in males. Because KF wielded no pronounced effect on fatigue indicators, this test may perhaps be used over time with no major concern regarding the exact knee angle. Our findings indicate that sex, rather than age, should be considered when interpreting dynamometric indicators of fatigue from repeated maximal concentric isokinetic plantar flexions, for example, when establishing normative values or comparing outcomes. PMID:24263655

Hébert-Losier, Kim; Holmberg, Hans-Christer

2014-03-01

325

Differences in plantar loading between training shoes and racing flats at a self-selected running speed.  

PubMed

The purpose of this study was to examine the difference in plantar loading between two different running shoe types. We hypothesized that a higher maximum force, peak pressure, and contact area would exist beneath the entire foot while running in a racing flat when compared to a training shoe. 37 athletes (17 male and 20 female) were recruited for this study. Subjects had no history of lower extremity injuries in the past six months, no history of foot or ankle surgery within the past 3 years, and no history of metatarsal stress fractures. Subjects had to be physically active and run at least 10 miles per week. Each subject ran on a 10m runway 7 times wearing two different running shoe types, the Nike Air Pegasus (training shoe) and the Nike Air Zoom Katana IV (racing flat). A Pedar-X in-shoe pressure measurement system sampling at 50Hz was used to collect plantar pressure data. Peak pressure, maximum force, and contact area beneath eight different anatomical regions of the foot as well as beneath the total foot were obtained. The results of this study demonstrated a significant difference between training shoes and racing flats in terms of peak pressure, maximum force, and contact area. The significant differences measured between the two shoes can be of importance when examining the influence of shoe type on the occurrence of stress fractures in runners. PMID:19147359

Wiegerinck, Johannes I; Boyd, Jennifer; Yoder, Jordan C; Abbey, Alicia N; Nunley, James A; Queen, Robin M

2009-04-01

326

Buy good shoes that fit well. Shoes should fit snugly in the heel so that the foot does not slide back and forth  

E-print Network

Buy good shoes that fit well. Shoes should fit snugly in the heel so that the foot does not slide OF FEET IS AS FOLLOWS: 1. Clean your feet each day and hand dry them being sure to get between the toes in your shoes. 2. As you clean your feet, look for any areas that may be getting red or irritated. Be sure

Virginia Tech

327

The influence of the heel effect in cone-beam computed tomography: artifacts in standard and novel geometries and their correction  

NASA Astrophysics Data System (ADS)

For decades, the heel effect has been known to cause an angular dependence of the emitted spectrum of an x-ray tube. In radiography, artifacts were observed and attributed to the heel effect. However, no problems due to the heel effect were discerned in multi-slice computed tomography (MSCT) so far. With flat-detector CT (FDCT), involving larger cone angles and different system geometries, the heel effect might cause new artifacts. These artifacts were analyzed in this paper for system geometries different from the ones widely used nowadays. Simulations and measurements were performed. Simulations included symmetric as well as asymmetric detector layouts and different x-ray tube orientations with respect to the detector plane. The measurements were performed on a micro-CT system in an asymmetric detector layout. Furthermore, an analytical correction scheme is proposed to overcome heel effect artifacts. It was shown that the type of artifact greatly depends on the orientation of the x-ray tube and also on the type of detector alignment (i.e. symmetric or different types of asymmetric alignment). Certain combinations exhibited almost no significant artifact while others greatly influenced the quality of the reconstructed images. The proposed correction scheme showed good results that were further improved when also applying a scatter correction. When designing CT systems, care should be taken when placing the tube and the detector. Orientation of the x-ray tube like in most MSCT systems seems advisable in asymmetric detector layouts. However, a different type of tube orientation can be overcome with suitable correction schemes.

Braun, H.; Kyriakou, Y.; Kachelrieß, M.; Kalender, W. A.

2010-10-01

328

Advances in Plantar Pressure Measurements in Clinical and Scientific Research, pp. 4468. K. D'Aot, K. Lescrenier, B. Van Gheluwe & D. De Clercq  

E-print Network

-90-423-0339-3 The evolutionary history of the human foot Kristiaan D'Août,1,2 Peter Aerts1,3 1 Laboratory for Functional feet likely differed from modern human feet in details. An overview of the evolutionary history44 Advances in Plantar Pressure Measurements in Clinical and Scientific Research, pp. 44­68. K. D

D'Août, Kristiaan

329

The effect of removing plugs and adding arch support to foam based insoles on plantar pressures in people with diabetic peripheral neuropathy  

PubMed Central

Background Removable plug insoles appear to be beneficial for patients with diabetic neuropathic feet to offload local plantar pressure. However, quantitative evidence of pressure reduction by means of plug removal is limited. The value of additional insole accessories, such as arch additions, has not been tested. The purpose of this study was to evaluate the effect of removing plugs from foam based insoles, and subsequently adding extra arch support, on plantar pressures. Methods In-shoe plantar pressure measurements were performed on 26 patients with diabetic neuropathic feet at a baseline condition, in order to identify the forefoot region with the highest mean peak pressure (MPP). This was defined as the region of interest (ROI) for plug removal.The primary outcome was measurement of MPP using the pedar® system in the baseline and another three insole conditions (pre-plug removal, post-plug removal, and post-plug removal plus arch support). Results Among the 26 ROIs, a significant reduction in MPP (32.3%, P<0.001) was found after removing the insole plugs. With an arch support added, the pressure was further reduced (9.5%, P<0.001). There were no significant differences in MPP at non-ROIs between pre- and post-plug removal conditions. Conclusions These findings suggest that forefoot plantar pressure can be reduced by removing plugs and adding arch support to foam-based insoles. This style of insole may therefore be clinically useful in managing patients with diabetic peripheral neuropathy. PMID:23895323

2013-01-01

330

Chronic Diarrhea  

MedlinePLUS

... Challenges and Resources Hygiene-related Diseases Athlete's Foot (tinea pedis) Body Lice Chronic Diarrhea Dental Caries Head ... Tub Rash Lymphatic Filariasis Pinworms Pubic Lice ("Crabs") Ringworm (Tinea) Swimmer's Ear (otitis externa) Scabies Trachoma Information ...

331

Chronic Pain  

Microsoft Academic Search

\\u000a \\u000a \\u000a \\u000a \\u000a 1. \\u000a \\u000a Non-cancer-related pain that lasts longer than 3 months is considered chronic pain.\\u000a \\u000a \\u000a \\u000a 2. \\u000a \\u000a According to the National Institutes of Health, chronic pain is the third largest health problem in the world.\\u000a \\u000a \\u000a \\u000a 3. \\u000a \\u000a Approximately 25 million Americans are affected by chronic pain.\\u000a \\u000a \\u000a \\u000a 4. \\u000a \\u000a Chronic pain is one of the most common problems seen in primary care clinics. Pain-related problems account

Jim Nuovo

332

[Chronic migraine].  

PubMed

The classification of the International Headache Society (IHS) generally differentiates episodic from chronic headache. Chronic migraine is defined as headache on 15 and more days a month over more than 3 months and headache on 8 days or more fulfils the criteria for migraine or were triptan/ergot-responsive when thought to be migrainous in early stages of the attack. The prevalence of chronic migraine is estimated at 2-4?%. The quality of life is highly compromised in this condition and comorbidities are much more frequent compared to episodic migraine. Data from prospective randomized studies are scarce as most patients with chronic migraine were excluded from previous trials and only few studies were conducted for this condition. The efficacy for prophylactic treatment compared with placebo is proven for topiramate and onabotulinum toxin A. PMID:24337617

Diener, H C; Holle, D; Müller, D; Nägel, S; Rabe, K

2013-12-01

333

Chronic obstructive pulmonary disease  

MedlinePLUS

COPD; Chronic obstructive airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic ... Systems Improvement. Diagnosis and Management of Chronic ... Disease (COPD). Updated March 2013. Available at: https://www. ...

334

Low back pain - chronic  

MedlinePLUS

Nonspecific back pain; Backache - chronic; Lumbar pain - chronic; Pain - back - chronic; Chronic back pain - low ... your waist, leads to pain. Many people with chronic back pain have arthritis. Or they may have extra wear ...

335

Sensory feedback to ankle plantar flexors is not exaggerated during gait in spastic hemiplegic children with cerebral palsy.  

PubMed

It is still widely believed that exaggerated stretch reflexes and increased muscle tone in ankle plantar flexors contribute to reduced ankle joint movement during gait in children with cerebral palsy (CP). However, no study has directly measured stretch reflex activity during gait in these children. We investigated sensory feedback mechanisms during walking in 20 CP children and 41 control children. Stretch responses in plantar flexor muscles evoked in stance showed an age-related decline in control but not CP children. In swing the responses were abolished in control children, but significant responses were observed in 14 CP children. This was related to reduced activation of dorsiflexors in swing. Removal of sensory feedback in stance produced a drop in soleus activity of a similar size in control and CP children. Soleus activity was observed in swing to the same extent in control and CP children. Removal of sensory feedback in swing caused a larger drop in soleus activity in control children than in CP children. The lack of age-related decline in stretch reflexes and the inability to suppress reflexes in swing is likely related to lack of maturation of corticospinal control in CP children. Since soleus activity was not seen more frequently than in control children in swing and since sensory feedback did not contribute more to their soleus activity, spasticity is unlikely to contribute to foot drop and toe walking. We propose that altered central drive to the ankle muscles and increased passive muscle stiffness are the main causes of foot drop and toe walking. PMID:24225545

Willerslev-Olsen, Maria; Andersen, Jacob Buus; Sinkjaer, Thomas; Nielsen, Jens Bo

2014-02-01

336

Chronic myelogenous leukemia (CML)  

MedlinePLUS

CML; Chronic myeloid leukemia; Chronic granulocytic leukemia; Leukemia - chronic granulocytic ... nuclear disaster. It takes many years to develop leukemia from radiation exposure. Most people treated for cancer ...

337

Chronic Cough  

MedlinePLUS

... Risk Factors What can cause chronic cough? Smoking Smoking can cause a cough that doesn't go away. Allergies ... throat. This is called "acid reflux." It can cause heartburn or a cough. Acid reflux is more common when you're lying down. Treatment Smoking If you smoke, you should stop. Talk to ...

338

Heel-strike in walking: assessment of potential sources of intra- and inter-subject variability in the activation patterns of muscles stabilizing the knee joint.  

PubMed

The electromyographic (EMG) signal is known to show large intra-subject and inter-subject variability. Adaptation to, and preparation for, the heel-strike event have been hypothesized to be major sources of EMG variability in walking. The aim of this study was to assess these hypotheses using a principal component analysis (PCA). Two waveform shapes with distinct characteristic features were proposed based on conceptual considerations of how the neuro-muscular system might prepare for, or adapt to, the heel-strike event. PCA waveforms obtained from knee muscle EMG signals were then compared with the predicted characteristic features of the two proposed waveforms. Surface EMG signals were recorded for ten healthy adult female subjects during level walking at a self-selected speed, for the following muscles; rectus femoris, vastus medialis, vastus lateralis, semitendinosus, and biceps femoris. For a period of 200 ms before and after heel-strike, EMG power was extracted using a wavelet transformation (19-395 Hz). The resultant EMG waveforms (18 per subject) were submitted to intra-subject and inter-subject PCA. In all analyzed muscles, the shapes of the first and second principal component (PC-) vectors agreed well with the predicted waveforms. These two PC-vectors accounted for 50-60% of the overall variability, in both inter-subject and intra-subject analyses. It was also found that the shape of the first PC-vector was consistent between subjects, while higher-order PC-vectors differed between subjects. These results support the hypothesis that adaptation to, and preparation for, a variable heel-strike event are both major sources of EMG variability in walking. PMID:23518206

Huber, Cora; Federolf, Peter; Nüesch, Corina; Cattin, Philippe C; Friederich, Niklaus F; Tscharner, Vinzenz von

2013-04-26

339

Chronic Eosinophilic Leukemia  

MedlinePLUS

... vera, essential thrombocythemia, or primary myelofibrosis. Chronic Myelogenous Leukemia Chronic myelogenous leukemia is a disease in which ... other problems related to essential thrombocythemia. Chronic Neutrophilic Leukemia Chronic neutrophilic leukemia is a disease in which ...

340

Chronic Pancreatitis in Children  

MedlinePLUS

Chronic Pancreatitis in Children What symptoms would my child have? Frequent or chronic abdominal pain is the ... pancreatitis will develop diabetes in adolescence. Who gets chronic pancreatitis? Those at risk for chronic pancreatitis are ...

341

Ear infection - chronic  

MedlinePLUS

Middle ear infection - chronic; Otitis media - chronic; Chronic otitis media; Chronic ear infection ... Kerschner JE. Otitis media. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders ...

342

The heel and toe of the cell's foot: A multifaceted approach for understanding the structure and dynamics of focal adhesions  

PubMed Central

Focal adhesions (FAs) are large clusters of transmembrane receptors of the integrin family and a multitude of associated cytoplasmic “plaque” proteins, which connect the extracellular matrix-bound receptors with the actin cytoskeleton. The formation of nearly stationary focal adhesions defines a boundary between dense and highly dynamic actin network in lamellipodium and the sparser and more diverse cytoskeletal organization in the lamella proper, creating a template for the organization of entire actin network. The major “mechanical” and “sensory” functions of FAs, namely, the nucleation and regulation of the contractile, myosin-II-containing, stress fibers and the mechanosensing of external surfaces depend, to a major extent, on the dynamics of molecular components within FAs. A central element in FA regulation concerns the positive feedback loop, based on the most intriguing feature of FAs, namely, their dependence on mechanical tension developing by the growing stress fibers. FAs grow in response to such tension, and rapidly disassemble upon its relaxation. In this article we address the mechanistic relationships between the process of FA development, maturation and dissociation and the dynamic molecular events, which take place in different regions of the FA, primarily in the distal end of this structure (the “toe”) and the proximal “heel”, and discuss the central role of local mechanical forces in orchestrating the complex interplay between FAs and the actin system. PMID:19598236

Wolfenson, Haguy; Henis, Yoav I.; Geiger, Benjamin; Bershadsky, Alexander D.

2010-01-01

343

Genome-Wide Linkage Scan for Quantitative Trait Loci Underlying Normal Variation in Heel Bone Ultrasound Measures  

PubMed Central

Quantitative ultrasound (QUS) traits are correlated with bone mineral density (BMD), but predict risk for future fracture independent of BMD. Only a few studies, however, have sought to identify specific genes influencing calcaneal QUS measures. The aim of this study was to conduct a genome-wide linkage scan to identify quantitative trait loci (QTL) influencing normal variation in QUS traits. QUS measures were collected from a total of 719 individuals (336 males and 383 females) from the Fels Longitudinal Study who have been genotyped and have at least one set of QUS measurements. Participants ranged in age from 18.0 to 96.6 years and were distributed across 110 nuclear and extended families. Using the Sahara ® bone sonometer, broadband ultrasound attenuation (BUA), speed of sound (SOS) and stiffness index (QUI) were collected from the right heel. Variance components based linkage analysis was performed on the three traits using 400 polymorphic short tandem repeat (STR) markers spaced approximately 10 cM apart across the autosomes to identify QTL influencing the QUS traits. Age, sex, and other significant covariates were simultaneously adjusted. Heritability estimates (h2) for the QUS traits ranged from 0.42 to 0.57. Significant evidence for a QTL influencing BUA was found on chromosome 11p15 near marker D11S902 (LOD = 3.11). Our results provide additional evidence for a QTL on chromosome 11p that harbors a potential candidate gene(s) related to BUA and bone metabolism. PMID:22237995

Lee, M.; Choh, A.C.; Williams, K.D.; Schroeder, V.; Dyer, T.D.; Blangero, J.; Cole, S.A.; Chumlea, WM.C.; Duren, D.L.; Sherwood, R.J.; Siervogel, R.M.; Towne, B.; Czerwinski, S.A.

2012-01-01

344

Old proteins and the Achilles heel of mass spectrometry. The role of proteomics in the etiology of human cataract.  

PubMed

Proteomics may have enabled the root cause of a major human-blinding condition, age-related cataract, to be established. Cataract appears to result from the spontaneous decomposition of long-lived macromolecules in the human lens, and recent proteomic analysis has enabled both the particular crystallins, and the specific sites of amino acid modification within each polypeptide, to be identified. Analysis of proteins from cataract lenses has demonstrated that there are key sites on some structural proteins that show a consistently greater degree of deterioration than age-matched normal lenses. Proteomic analysis, using MS, revealed that the most abundant posttranslational modification of aged lens proteins is racemization. This is somewhat ironic, since structural isomers can be viewed as the "Achilles heel" of MS and there are typically few, if any, differences in the MS/MS spectra of tryptic peptides containing one d-amino acid. It is proposed that once a certain level of spontaneous PTM at key sites occurs, that protein-protein interactions are disrupted, and binding of complexes to cell membranes takes place that impairs cell-to-cell communication. These findings may apply more widely to age-related human diseases, in particular where the deterioration of long-lived proteins is a crucial component in the etiology. PMID:24458544

Truscott, Roger J W; Friedrich, Michael G

2014-04-01

345

Genome-wide linkage scan for quantitative trait loci underlying normal variation in heel bone ultrasound measures.  

PubMed

Quantitative ultrasound (QUS) traits are correlated with bone mineral density (BMD), but predict risk for future fracture independent of BMD. Only a few studies, however, have sought to identify specific genes influencing calcaneal QUS measures. The aim of this study was to conduct a genome-wide linkage scan to identify quantitative trait loci (QTL) influencing normal variation in QUS traits. QUS measures were collected from a total of 719 individuals (336 males and 383 females) from the Fels Longitudinal Study who have been genotyped and have at least one set of QUS measurements. Participants ranged in age from 18.0 to 96.6 years and were distributed across 110 nuclear and extended families. Using the Sahara ® bone sonometer, broadband ultrasound attenuation (BUA), speed of sound (SOS) and stiffness index (QUI) were collected from the right heel. Variance components based linkage analysis was performed on the three traits using 400 polymorphic short tandem repeat (STR) markers spaced approximately 10 cM apart across the autosomes to identify QTL influencing the QUS traits. Age, sex, and other significant covariates were simultaneously adjusted. Heritability estimates (h²) for the QUS traits ranged from 0.42 to 0.57. Significant evidence for a QTL influencing BUA was found on chromosome 11p15 near marker D11S902 (LOD = 3.11). Our results provide additional evidence for a QTL on chromosome 11p that harbors a potential candidate gene(s) related to BUA and bone metabolism. PMID:22237995

Lee, M; Choh, A C; Williams, K D; Schroeder, V; Dyer, T D; Blangero, J; Cole, S A; Chumlea, Wm C; Duren, D L; Sherwood, R J; Siervogel, R M; Towne, B; Czerwinski, S A

2012-01-01

346

Chronic urticaria.  

PubMed Central

Urticaria affects 15% to 20% of the population once or more during a lifetime. Chronic urticaria is a frequent recurrent eruption over a period greater than 6 weeks; the cause remains a mystery in more than 75% of cases. Urticaria and angioedema may be produced by immunologic or nonimmunologic means. Urticarial vasculitis, contact urticaria, mastocytosis, physical urticarias, dermatographism, cholinergic urticaria, localized heat urticaria, cold urticaria, aquagenic urticaria, and vibratory angioedema all require specific evaluation and treatment. Chronic idiopathic urticaria is usually controlled by antihistamines; depending on the circadian rhythm of the eruption, sedative or nonsedative antihistamines are prescribed. Some patients will require a combination of H1 and H2 antagonists, or even parenteral corticosteroids. PMID:1970697

Burrall, B. A.; Halpern, G. M.; Huntley, A. C.

1990-01-01

347

Influence of ankle plantar flexor muscle architecture and strength on gait in boys with haemophilia in comparison to typically developing children.  

PubMed

Altered gait patterns, muscle weakness and atrophy have been reported in young boys with severe haemophilia when compared to unaffected peers. The aim of this study was to determine whether lateral gastrocnemius muscle size and architecture influenced biomechanical walking patterns of boys with haemophilia and if these relationships differed from age-matched typically developing boys. Biomechanical function of the knee and ankle during level walking, lateral gastrocnemius anatomical cross-sectional area, thickness, width, fascicle length and pennation angle and ankle plantar flexor muscle strength were recorded in 19 typically developing boys aged 7-12 years and 19 age-matched haemophilic boys with a history of ankle joint bleeding. Associations between gait, strength and architecture were compared using correlations of peak gait values. Haemophilic boys walked with significantly larger (P < 0.05) ankle dorsi flexion angles and knee flexion moments. The ankle plantar flexor muscles of haemophilic boys were significantly weaker and smaller when compared to typically developing peers. In the typically developing boys there was no apparent association between muscle architecture, strength and walking patterns. In haemophilic boys maximum muscle strength and ACSA normalized torque of the ankle plantar flexors together with the muscle width, thickness, fascicle length and angulation (P < 0.05) were associated with motion at the ankle and peak moments at the knee joint. Muscle strength deficits of the ankle plantar flexors and changes in muscle size and architecture may underpin the key biomechanical alterations in walking patterns of haemophilic boys with a history of ankle joint bleeding. PMID:24261822

Stephensen, D; Drechsler, W I; Scott, O M

2014-05-01

348

Frequent alternate muscle activity of plantar flexor synergists and muscle endurance during low-level static contractions as a function of ankle position  

Microsoft Academic Search

We have investigated the appropriate joint angle for detecting frequent alternating activity in synergistic muscles and the\\u000a relationship between muscle activation patterns and endurance during static low-level contractions. Eleven healthy men performed\\u000a prolonged static plantar flexion of the ankle at 10% of the maximal voluntary contraction, with the ankle flexed at 100°,\\u000a 110°, or 120°, while seated with the right

Hiroyuki Tamaki; Hikari Kirimoto; Kengo Yotani; Hiroaki Takekura

349

Chronic Diseases  

Microsoft Academic Search

Although diabetes mellitus, cardiovascular disease, and human immunodeficiency virus infection are three separate entities,\\u000a each has causal and non-causal risk factors that are common in the stage 5 chronic kidney disease population. The medical\\u000a nutrition therapies are similar, which emphasize adequate protein and energy intakes, fluid control, and possibly carbohydrate\\u000a and fat modifications. Each patient requires an individualized evaluation, taking

Sharon R. Schatz

350

Papillon-Lefevre syndrome-like presentation in chronic arsenicosis: A rare mimicry.  

PubMed

Chronic arsenicosis is a major health and occupational problem in rural parts of West Bengal such as in parts of the Gangetic plain of India. Chronic arsenicosis occurs due to accidental ingestion of repeated amounts of small doses by those working with metal or by taking food or drink in which there are traces of arsenic. Chronic exposure may result accumulation in the hair, nail, and skin. Arsenic can also cross the placenta. Papillon-Lefèvre syndrome is a rare disease characterized by skin lesions caused by palmar-plantar hyperkeratosis and severe periodontal destruction involving both the primary and permanent dentitions. Until date, more than 200 cases have been reported worldwide. Palmoplantar hyperkeratosis is a major manifestation in both chronic arsenicosis and Papillon-Lefèvre syndrome. We report herein a rare case of chronic arsenicosis in a patient from rural Bengal, whose all features mimic Papillon-Lefèvre syndrome. It is probably the first case of Papillon-Lefevre syndrome-like presentation in chronic arsenicosis from India. PMID:23776326

Das, Somak K; Nath, Tanusree; Ghosal, Anirban; Jana, Chanchal K

2012-09-01

351

The effect of posterior tibialis tendon dysfunction on the plantar pressure characteristics and the kinematics of the arch and the hindfoot  

Microsoft Academic Search

Objective. To study posterior tibialis tendon dysfunction using an in vitro model of the foot and ankle during the heel-off instant of gait.Background. Previous studies have concentrated primarily on the effect of posterior tibialis tendon dysfunction on the kinematics of the hindfoot and the arch.Methods. The specimens were loaded using a custom designed axial and tendon loading system and the

Carl W Imhauser; Sorin Siegler; Nicholas A Abidi; David Z Frankel

2004-01-01

352

Interstitial fluid pressure within the coronary dermis of the horse with chronic laminitis  

E-print Network

with chronic laminitis (Group 2) Mass Number of Mean S. D. Range Number of Mean S. D. Range (kg) measurements measurements 50-80 68 150-180 105 2. 29 3. 17 15. 45 5. 01 5. 23 20. 72 a 84 2. 55b 3. 01 13. 96 111 1'35b 3'75 10 60 HEEL POSITION... OF CATHETER Normal horses (Groupl) Horses with chronic laminitis (Group 2) Mass Number of Mean S. D. Range (kg) measurements Number of Mean S. D. Range measurements 50-80 68 150-180 105 2. 49 5. 91 27. 37 1. 28 7. 69 58. 34 84 1. 36 3. 75 21. 15...

Olivier, Ann

2012-06-07

353

Effects of long-term wearing of high-heeled shoes on the control of the body's center of mass motion in relation to the center of pressure during walking.  

PubMed

High-heeled shoes are associated with instability and falling, leading to injuries such as fracture and ankle sprain. This study investigated the effects of habitual wearing of high-heeled shoes on the body's center of mass (COM) motion relative to the center of pressure (COP) during gait. Fifteen female experienced wearers and 15 matched controls walked with high-heeled shoes (7.3cm) while kinematic and ground reaction force data were measured and used to calculate temporal-distance parameters, joint moments, COM-COP inclination angles (IA) and the rate of IA changes (RCIA). Compared with inexperienced wearers, experienced subjects showed significantly reduced frontal IA with increased ankle pronator moments during single-limb support (p<0.05). During double-limb support (DLS), they showed significantly increased magnitudes of the frontal RCIA at toe-off and contralateral heel-strike, and reduced DLS time (p<0.05) but unaltered mean RCIA over DLS. In the sagittal plane experienced wearers showed significantly increased mean RCIA (p<0.05) and significant differences in the RCIA at toe-off and contralateral heel-strike (p<0.05). Significantly increased hip flexor moments and knee extensor moments at toe-off (p<0.05) were needed for forward motion of the trailing limb. The current results identified the change in the balance control in females after long-term use of high-heeled shoes, providing a basis for future design of strategies to minimize the risk of falling during high-heeled gait. PMID:24508016

Chien, Hui-Lien; Lu, Tung-Wu; Liu, Ming-Wei

2014-04-01

354

Increased peripherin in sympathetic axons innervating plantar metatarsal arteries in STZ-induced type I diabetic rats  

PubMed Central

A common characteristic of axonopathy is the abnormal accumulation of cytoskeletal proteins. We recently reported that streptozotocin (STZ)-induced type 1 diabetes produced a change in the morphology of sympathetic nerve fibers supplying rat plantar metatarsal arteries (PMAs). Here we investigated whether these morphological changes are associated with axonal accumulation of the type III intermediate filament peripherin and the microtubule protein ?-tubulin III, as both are implicated in axonal remodeling. PMAs from hyperglycemic STZ-treated rats receiving a low dose of insulin (STZ-LI) were compared with those from normoglycemic STZ-treated rats receiving a high dose of insulin (STZ-HI) and vehicle-treated controls. Western blotting revealed an increase in protein expression level for peripherin in PMAs from STZ-LI rats but no change in that for ?-tubulin III. In addition, there was an increase in the number of peripherin immunoreactive nerve fibers in the perivascular nerve plexus of PMAs from STZ-LI rats. Co-labeling for peripherin and neuropeptide Y (a marker for sympathetic axons) revealed that peripherin immunoreactivity increased in sympathetic axons. None of these changes were detected in PMAs from STZ-HI rats, indicating that increased peripherin in sympathetic axons of STZ-LI rats is likely due to hyperglycemia and provides a marker of diabetes-induced nerve damage. PMID:24847201

Johansen, Niloufer J.; Frugier, Tony; Hunne, Billie; Brock, James A.

2014-01-01

355

Acute effects of 5 min of plantar flexor static stretching on balance and gait in the elderly.  

PubMed

[Purpose] The purpose of this study was to examine the acute effects of five minutes of plantar flexor static stretching (PSS) on the balance and gait of the elderly. [Subjects and Methods] Twenty-five subjects aged 65?years and above performed 5?min of PSS in the form of wedge board standing. The sway length of each subject's center of mass was measured to examine the subject's static balance. It was measured by one minute of quiet standing with the eyes closed. Functional reach tests (FRTs), timed up and go tests (TUGs), and 10-meter walk tests (10MWTs) were performed to examine dynamic balance and gait before and after PSS. [Results] The outcome showed significant increases in sway distances (6.55 ± 5.03?cm) after stretching. However, in the FRTs, TUGs, and 10MWTs, the reach distance and time did not show any significant changes. [Conclusion] These results suggest that the elderly subjects temporarily experienced difficulties in maintaining balance immediately after the PSS but that their dynamic balance and gait were not adversely affected after a short period of time. Therefore, to prevent falls and perform exercises in a safe way, it is recommended to allow patients to rest after performing PSS. PMID:24567692

Han, Min-Jung; Yuk, Goon-Chang; Gak, Hwangbo; Suh, Soon-Rim; Kim, Seong-Gil

2014-01-01

356

Hypertrophy of chronically unloaded muscle subjected to resistance exercise.  

PubMed

In an effort to simulate the compromised function and atrophy of lower limb muscles experienced by astronauts after spaceflight, 21 men and women age 30-56 yr were subjected to unilateral lower limb unloading for 5 wk. Whereas 10 of these subjects performed unilateral knee extensor resistance exercise (ULRE) two or three times weekly, 11 subjects (UL) refrained from training. The exercise regimen consisted of four sets of seven maximal actions, using an apparatus that offers concentric and eccentric resistance by utilizing the inertia of rotating flywheel(s). Knee extensor muscle strength was measured before and after UL and ULRE, and knee extensor and ankle plantar flexor muscle volumes were determined by means of magnetic resonance imaging. Surface electromyographic activity measured after UL inferred increased muscle use to perform a given motor task. UL induced an 8.8% decrease (P < 0.05) in knee extensor muscle volume. After ULRE and as a result of only approximately 16 min of maximal contractile activity over the 5-wk course, muscle volume increased 7.7% (P < 0.05). Muscle strength decreased 24-32% (P < 0.05) in response to UL. Group ULRE showed maintained (P > 0.05) strength. Ankle plantar flexor muscle volume of the unloaded limb decreased (P < 0.05) in both groups (UL 10.5%; ULRE 11.1%). In neither group did the right weight-bearing limb show any change (P > 0.05) in muscle volume or strength. The results of this study provide evidence that resistance exercise not only may offset muscle atrophy but is in fact capable of promoting marked hypertrophy of chronically unloaded muscle. PMID:14660503

Tesch, P A; Trieschmann, J T; Ekberg, A

2004-04-01

357

Native American lithic procurement along the international border in the boot heel region of southwestern New Mexico  

NASA Astrophysics Data System (ADS)

Multidisciplinary field projects can be very useful to a more fundamental understanding of the world around us, though these projects are not as common as they should be. In particular, the combination of archeology and geology combines our understanding of human behavior and human use of the landscape with an intimate knowledge of geologic processes and the materials available for human use in order to gain a broader understanding of human-Earth interaction. Here we present data from a cross-disciplinary project that uses a common dataset, archeological artifacts, to explore the anthropological and geologic implications of useage patterns. Archeological excavations and surveys conducted by the Office of Contract Archeology in 2007 along the route of the proposed international border fence reveal patterns of use of geologic materials by Archaic, Formative and Protohistoric Native Americans in the Boot Heel of southwestern New Mexico. Thousands of artifacts were recorded in multiple sites from Guadalupe Pass in the southern Peloncillo Mountains to the Carrizalillo Hills west of Columbus. We identified the lithologies of artifacts, ranging from projectile points to groundstones, and then constructed material movement maps based on either known procurement sites ("quarries") or outcrops identified as the closest source to a given site for each lithology. Not unexpectedly, the majority of the rock types utilized by native peoples are local siliceous volcanic materials. However, several artifacts constructed from obsidian were transported into the region from northern Mexico and eastern Arizona, indicating long-distance travel and/or trade routes. We also examine useage pattern difference between Archaic, Formative and Protohistoric sites. Additionally, a dramatic change in distribution of sources for geologic materials occurs between one pre-Spanish site and one post-Spanish site that are adjacent to one another.

Zeigler, K. E.; Hughes, C.; Kurota, A.; Hogan, P.

2010-12-01

358

Native American lithic procurement along the international border in the boot heel region of southwestern New Mexico  

NASA Astrophysics Data System (ADS)

Multidisciplinary field projects can be very useful to a more fundamental understanding of the world around us, though these projects are not as common as they should be. In particular, the combination of archeology and geology combines our understanding of human behavior and human use of the landscape with an intimate knowledge of geologic processes and the materials available for human use in order to gain a broader understanding of human-Earth interaction. Here we present data from a cross-disciplinary project that uses a common dataset, archeological artifacts, to explore the anthropological and geologic implications of useage patterns. Archeological excavations and surveys conducted by the Office of Contract Archeology in 2007 along the route of the proposed international border fence reveal patterns of use of geologic materials by Archaic, Formative and Protohistoric Native Americans in the Boot Heel of southwestern New Mexico. Thousands of artifacts were recorded in multiple sites from Guadalupe Pass in the southern Peloncillo Mountains to the Carrizalillo Hills west of Columbus. We identified the lithologies of artifacts, ranging from projectile points to groundstones, and then constructed material movement maps based on either known procurement sites ("quarries") or outcrops identified as the closest source to a given site for each lithology. Not unexpectedly, the majority of the rock types utilized by native peoples are local siliceous volcanic materials. However, several artifacts constructed from obsidian were transported into the region from northern Mexico and eastern Arizona, indicating long-distance travel and/or trade routes. We also examine useage pattern difference between Archaic, Formative and Protohistoric sites. Additionally, a dramatic change in distribution of sources for geologic materials occurs between one pre-Spanish site and one post-Spanish site that are adjacent to one another.

Zeigler, K. E.; Hogan, P.; Hughes, C.; Kurota, A.

2011-06-01

359

The impact of a systematic reduction in shoe-floor friction on heel contact walking kinematics-- A gait simulation approach.  

PubMed

Falls initiated by slips and trips are a serious health hazard to older adults. Experimental studies have provided important descriptions of postural responses to slipping, but it is difficult to determine why some slips result in falls from experiments alone. Computational modeling and simulation techniques can complement experimental approaches by identifying causes of failed recovery attempts. The purpose of this study was to develop a method to determine the impact of a systematic reduction in the foot-floor friction coefficient (mu) on the kinematics of walking shortly after heel contact (approximately 200 s). A walking model that included foot-floor interactions was utilized to find the set of moments that best tracked the joint angles and measured ground reaction forces obtained from a non-slipping (dry) trial. A "passive" slip was simulated by driving the model with the joint-moments from the dry simulation and by reducing mu. Slip simulations with values of mu greater than the subject-specific peak required coefficient of friction (RCOF), an experimental measure of slip-resistant gait, resulted in only minor deviations in gait kinematics from the dry condition. In contrast, slip simulations run in environments characterized by mu

Mahboobin, A; Cham, R; Piazza, S J

2010-05-28

360

Chronic pancreatitis.  

PubMed

Chronic pancreatitis is a progressive fibroinflammatory disease that exists in large-duct (often with intraductal calculi) or small-duct form. In many patients this disease results from a complex mix of environmental (eg, alcohol, cigarettes, and occupational chemicals) and genetic factors (eg, mutation in a trypsin-controlling gene or the cystic fibrosis transmembrane conductance regulator); a few patients have hereditary or autoimmune disease. Pain in the form of recurrent attacks of pancreatitis (representing paralysis of apical exocytosis in acinar cells) or constant and disabling pain is usually the main symptom. Management of the pain is mainly empirical, involving potent analgesics, duct drainage by endoscopic or surgical means, and partial or total pancreatectomy. However, steroids rapidly reduce symptoms in patients with autoimmune pancreatitis, and micronutrient therapy to correct electrophilic stress is emerging as a promising treatment in the other patients. Steatorrhoea, diabetes, local complications, and psychosocial issues associated with the disease are additional therapeutic challenges. PMID:21397320

Braganza, Joan M; Lee, Stephen H; McCloy, Rory F; McMahon, Michael J

2011-04-01

361

Proximally based sural adipose-cutaneous/scar flap in elimination of ulcerous scar soft-tissue defect over the achilles tendon and posterior heel region: a new approach.  

PubMed

Scar ulcers that spread over the Achilles tendon and posterior heel disturb patients by causing pain, impeding hygiene, and creating difficulty in finding appropriate shoe wear. As this region undergoes pressure, effective reconstruction is based on the flap use. The most popular flaps currently used are distally based sural fasciocutaneous flap, calcaneal artery skin flap, and free flaps. These flaps, however, are insensate, can create soft-tissue excess, and cause donor site morbidity. Ulcerous soft-tissue defects over Achilles tendon and posterior heel after burns, frost, and trauma were studied and reconstructed in 16 patients, using proximally based sural adipose-cutaneous flap, the anatomy of which was studied on lower extremities of 27 cadavers. Ulcerous soft-tissue defect consists of two parts: ulcer and surrounding pathologic scars that should be excised in one block. Resulting soft-tissue defects with exposed tendon and calcaneal bone varied from 6 to 20 cm in length and 6 cm in width. For such wound resurfacing a flap was developed that was sensate, thin, large, and having steady blood circulation. The flap was harvested from the lower third of the leg and lateral foot, consisting of skin and subcutaneous fat layer (without fascia), including the sural nerve and lesser vein. The blood supply was ensured through peroneal and anterior tibial artery perforators, which formed a vascular net in the flap. In 14 of 16 cases excellent and stable functional and good cosmetic results with acceptable donor site morbidity were achieved. In two patients the distal flap loss took place because of arteriitis obliterans (one case) and because of the cross-cutting of the sural nerve and vessels during previous surgeries (another case). Proximally based sural adipose-cutaneous/scar flap is the only flap that satisfies all requirements for Achilles tendon and posterior heel region resurfacing. The author believes that this technique, based on this flap use, is anatomically justified, clinically profitable, and should be considered as the first choice operation. PMID:24043244

Grishkevich, Viktor M

2014-01-01

362

Chronic Pelvic Pain  

MedlinePLUS

... Family > Conditions & Treatments > Pain Disorders > Chronic Pelvic Pain Chronic Pelvic Pain Page Content Pelvic pain is an uncommon but ... and can be injured or weakened causing pain Chronic pain can continue long after tissue injury has healed, ...

363

Musculoskeletal Adaptations in Chronic Spinal Cord Injury: Effects of Long-term Soleus Electrical Stimulation Training  

PubMed Central

Objective The purpose of this study was to determine whether long-term electrical stimulation training of the paralyzed soleus could change this muscle’s physiological properties (torque, fatigue index, potentiation index, torque-time integral) and increase tibia bone mineral density. Methods Four men with chronic (>2 years) complete spinal cord injury (SCI; American Spinal Injury Association classification A) trained 1 soleus muscle using an isometric plantar flexion electrical stimulation protocol. The untrained limb served as a within-subject control. The protocol involved ~30 minutes of training each day, 5 days a week, for a period of 6 to 11 months. Mean compliance over 11 months of training was 91% for 3 subjects. A fourth subject achieved high compliance after only 5 months of training. Mean estimated compressive loads delivered to the tibia were ~110% of body weight. Over the 11 months of training, the muscle plantar flexion torque, fatigue index, potentiation index, and torque-time integral were evaluated periodically. Bone mineral density (dual-energy x-ray absorptiometry) was evaluated before and after the training program. Results The trained limb fatigue index, potentiation index, and torque-time integral showed rapid and robust training effects (P < .05). Soleus electrical stimulation training yielded no changes to the proximal tibia bone mineral density, as measured by dual-energy x-ray absorptiometry. The subject with low compliance experienced fatigue index and torque-time integral improvements only when his compliance surpassed 80%. In contrast, his potentiation index showed adaptations even when compliance was low. Conclusions These findings highlight the persistent adaptive capabilities of chronically paralyzed muscle but suggest that preventing musculoskeletal adaptations after SCI may be more effective than reversing changes in the chronic condition. PMID:17312092

Shields, Richard K.; Dudley-Javoroski, Shauna

2012-01-01

364

5-HT2 and 5-HT7 receptor agonists facilitate plantar stepping in chronic spinal rats through actions on different populations of spinal neurons  

PubMed Central

There is considerable evidence from research in neonatal and adult rat and mouse preparations to warrant the conclusion that activation of 5-HT2 and 5-HT1A/7 receptors leads to activation of the spinal cord circuitry for locomotion. These receptors are involved in control of locomotor movements, but it is not clear how they are implicated in the responses to 5-HT agonists observed after spinal cord injury. Here we used agonists that are efficient in promoting locomotor recovery in paraplegic rats, 8-hydroxy-2-(di-n-propylamino)-tetralin (8-OHDPAT) (acting on 5-HT1A/7 receptors) and quipazine (acting on 5-HT2 receptors), to examine this issue. Analysis of intra- and interlimb coordination confirmed that the locomotor performance was significantly improved by either drug, but the data revealed marked differences in their mode of action. Interlimb coordination was significantly better after 8-OHDPAT application, and the activity of the extensor soleus muscle was significantly longer during the stance phase of locomotor movements enhanced by quipazine. Our results show that activation of both receptors facilitates locomotion, but their effects are likely exerted on different populations of spinal neurons. Activation of 5-HT2 receptors facilitates the output stage of the locomotor system, in part by directly activating motoneurons, and also through activation of interneurons of the locomotor central pattern generator (CPG). Activation of 5-HT7/1A receptors facilitates the activity of the locomotor CPG, without direct actions on the output components of the locomotor system, including motoneurons. Although our findings show that the combined use of these two drugs results in production of well-coordinated weight supported locomotion with a reduced need for exteroceptive stimulation, they also indicate that there might be some limitations to the utility of combined treatment. Sensory feedback and some intraspinal circuitry recruited by the drugs can conflict with the locomotor activation.

Slawinska, Urszula; Miazga, Krzysztof; Jordan, Larry M.

2014-01-01

365

Age-related greater Achilles tendon compliance is not associated with larger plantar flexor muscle fascicle strains in senior women.  

PubMed

The aim of the present study was to test the hypothesis that the age-associated decrease of tendon stiffness would necessitate greater muscle fascicle strains to produce similar levels of force during isometric contraction. Greater fascicle strains could force sarcomeres to operate in less advantageous regions of their force-length and force-velocity relationships, thus impairing the capacity to generate strong and explosive contractions. To test this hypothesis, sagittal-plane dynamic velocity-encoded phase-contrast magnetic resonance images of the gastrocnemius medialis (GM) muscle and Achilles tendon (AT) were acquired in six young (YW; 26.1 ± 2.3 yr) and six senior (SW; 76.7 ± 8.3 yr) women during submaximal isometric contraction (35% maximum voluntary isometric contraction) of the plantar flexor muscles. Multiple GM fascicle lengths were continuously determined by automatically tracking regions of interest coinciding with the end points of muscle fascicles evenly distributed along the muscle's proximo-distal length. AT stiffness and Young's modulus were measured as the slopes of the tendon's force-elongation and stress-strain curves, respectively. Despite significantly lower AT stiffness at older age (YW: 120.2 ± 52.3 N/mm vs. SW: 53.9 ± 44.4 N/mm, P = 0.040), contraction-induced changes in GM fascicle lengths were similar in both age groups at equal levels of absolute muscular force (4-5% fascicle shortening in both groups), and even significantly larger in YW (YW: 11-12% vs. SW: 6-8% fascicle shortening) at equal percentage of maximum voluntary contraction. These results suggest that factors other than AT stiffness, such as age-associated changes in muscle composition or fascicle slack, might serve as compensatory adaptations, limiting the degree of fascicle strains upon contraction. PMID:24505104

Csapo, R; Malis, V; Hodgson, J; Sinha, S

2014-04-15

366

Neuromuscular adjustments of the knee extensors and plantar flexors following match-play tennis in the heat  

PubMed Central

Objectives This study tested the hypothesis that impairments in lower limb maximal strength and voluntary activation (VA) are exacerbated following match-play tennis in hot compared with cool conditions. Methods Torque and VA were evaluated during brief (5?s) and sustained (20?s) maximal voluntary isometric contractions of the knee extensors (KE) and plantar flexors (PF) in 12 male tennis players before (pre) and after (post, 24?h and 48?h) ?115?min of play in hot (?37°C) and cool (?22°C) conditions. Results Rectal temperature was higher following play in hot than in cool (?39.2 vs ?38.5°C; p<0.05). Torque production decreased from prematch to postmatch during the brief and sustained contractions in hot (KE: ?22%; PF: ?13%) and cool (KE: ?9%, PF: ?7%) (p<0.05). KE strength losses in hot were greater than in cool (p<0.05) and persisted for 24?h (p<0.05). Postmatch brief and sustained KE VA was lower in hot than in cool (p<0.05), in which VA was maintained. PF VA was maintained throughout the protocol. Peak twitch torque and maximum rates of torque development and relaxation in the KE and PF were equally reduced postmatch relative to prematch in hot and cool conditions (p<0.05), and were restored near baseline within 24?h. Conclusions Neuromuscular system integrity of the lower limbs is compromised immediately following match-play tennis in hot and cool conditions due to the development of peripheral fatigue. The larger and persistent KE strength losses observed under heat stress are associated with greater levels of central fatigue especially during sustained contractions. PMID:24668379

Periard, Julien D; Girard, Olivier; Racinais, Sebastien

2014-01-01

367

CHRONIC URTICARIA  

PubMed Central

Chronic urticaria (CU) is a disturbing allergic condition of the skin. Although frequently benign, it may sometimes be a red flag sign of a serious internal disease. A multitude of etiologies have been implicated in the causation of CU, including physical, infective, vasculitic, psychological and idiopathic. An autoimmune basis of most of the ‘idiopathic’ forms is now hypothesized. Histamine released from mast cells is the major effector in pathogenesis and it is clinically characterized by wheals that have a tendency to recur. Laboratory investigations aimed at a specific etiology are not always conclusive, though may be suggestive of an underlying condition. A clinical search for associated systemic disease is strongly advocated under appropriate circumstances. The mainstay of treatment remains H1 antihistaminics. These may be combined with complementary pharmacopeia in the form of H2 blockers, doxepin, nifedipine and leukotriene inhibitors. More radical therapy in the form of immunoglobulins, plasmapheresis and cyclophosphamide may be required for recalcitrant cases. Autologous transfusion and alternative remedies like acupuncture have prospects for future. A stepwise management results in favorable outcomes. An update on CU based on our experience with patients at a tertiary care centre is presented. PMID:22345759

Sachdeva, Sandeep; Gupta, Vibhanshu; Amin, Syed Suhail; Tahseen, Mohd

2011-01-01

368

Bursitis of the heel  

MedlinePLUS

... to reduce inflammation. Use physical therapy to improve flexibility and strength around the ankle, which can help ... proper form when exercising, as well as good flexibility and strength around the ankle to help prevent ...

369

Constructions of chronic illness  

Microsoft Academic Search

Interest in chronic illness as an area for research and writing is increasing across a diverse range of disciplines. Initially of interest to medicine, chronic illness is now studied by social scientists, psychologists and health professions (for example, nurses). Predominantly, the individuals affected by particular chronic illnesses have been the central interest in the body of work relating to chronic

Sally Wellard

1998-01-01

370

Life-Course Predictors of Ultrasonic Heel Measurement in a Cross-sectional Study of Immigrant Women from Southeast Asia  

Microsoft Academic Search

Few studies address chronic disease risk for Southeast Asians in the United States. In 1999, the authors conducted a cross-sectional study of bone mineral density (BMD) estimated from ultrasonic calcaneal measurements in women born in Southeast Asia who then lived in Chicago, Illinois. The study addressed three questions: Do Southeast-Asian women have relatively low BMD? What factors before and after

Diane S. Lauderdale; Talya Salant; Katherine L. Han; Phuong L. Tran

371

Chronic Pain and Adherence  

Microsoft Academic Search

\\u000a Chronic pain of non-malignant etiology is a significant problem. Chronic non-malignant pain is typically defined as pain that\\u000a persists for 3 months or longer and that is non-life threatening [1, 2]. Among the most common chronic pain conditions are\\u000a chronic back pain, migraine headaches, and tension headaches. Chronic pain is very common. In the United States, 17% of patients\\u000a seen

Rebecca A. Shelby; Francis J. Keefe

372

Racing performance of Swedish Standardbred trotting horses with proximal palmar/plantar first phalangeal (Birkeland) fragments compared to fragment free controls.  

PubMed

The aim of this study was to determine whether horses with a proximal palmar/plantar first phalangeal osteochondral fragment (POF) had comparable racing careers (prior to and following surgery) to horses without this fracture. A retrospective cohort study included 174 Swedish Standardbred trotters with osteochondral fragmentation in the palmar/plantar fetlock joint and 613 radiographically negative control horses presented for prepurchase examinations. Medical records and radiographs were examined for each horse. Racing data were retrieved from online Swedish Standardbred harness racing records. The effect of having a POF on race speed compared to radiographically negative control horses was examined using generalised estimating equations. Multivariable regression was used to examine differences in money earned and career longevity. The horses raced a total of 16,448 races. Horses gained speed as a function of race number. There was no difference in racing speed between horses with POF fractures that raced before surgery and control horses. Horses did not slow before, nor speed up after, surgery. There was no difference in the number of days between the last race prior to, or the first race after, the hospital visit between POF and control horses. Career earnings and lifetime starts were not significantly different between groups. The results of this study suggest the need to reevaluate the previously reported benefits of surgical intervention for POF. PMID:25163613

Carmalt, James L; Borg, Hanna; Näslund, Hans; Waldner, Cheryl

2014-10-01

373

Plantar rotational flap technique for panmetatarsal head resection and transmetatarsal amputation: a revision approach for second metatarsal head transfer ulcers in patients with previous partial first ray amputation.  

PubMed

Transfer ulcers beneath the second metatarsal head are common after diabetes-related partial first ray amputation. Subsequent osteomyelitis of the second ray can further complicate this difficult situation. We present 2 cases depicting our plantar rotational flap technique for revision surgery involving conversion to either panmetatarsal head resection or transmetatarsal amputation (TMA). These cases are presented to demonstrate our indications, procedure selection criteria, flap technique, operative pearls, and staging protocol. The goals of this surgical approach are to excise and close the plantar ulcer beneath the second metatarsal head, remove any infected bone, allow staged surgery if needed, remove all remaining metatarsal heads to decrease the likelihood of repeat transfer ulcers, preserve the toes when practical, avoid excessive shortening of the foot, avoid multiple longitudinal dorsal incisions, and create a functional and cosmetically appealing foot. The flap is equally suited for either panmetatarsal head resection or TMA. The decision to pursue panmetatarsal head resection versus TMA largely depends on the condition of the remaining toes. Involvement of osteomyelitis in the base of the second proximal phalanx, the soft tissue viability of the remaining toes, the presence of a preoperative digital deformity, and the likelihood that saving the lesser toes will be beneficial from a cosmetic or footwear standpoint are factors we consider when deciding between panmetatarsal head resection and TMA. Retrospective chart review identified prompt healing of the flap in both patients. Neither patient experienced recurrent ulcers or required subsequent surgery within the first 12 months postoperatively. PMID:23910736

Boffeli, Troy J; Reinking, Ryan

2014-01-01

374

Test-retest reliability of an insole plantar pressure system to assess gait along linear and curved trajectories  

PubMed Central

Background Previous studies have assessed reliability of insole technology for evaluating foot pressure distribution during linear walking. Since in natural motion straight walking is intermingled with turns, we determined the test-retest reliability of insole assessment for curved as well as linear trajectories, and estimated the minimum number of steps required to obtain excellent reliability for each output variable. Methods Sixteen young healthy participants were recruited. Each performed, two days apart, two sessions of three walking conditions: linear (LIN) and curved, clockwise (CW) and counter-clockwise (CCW). The Pedar-X system was used to collect pressure distribution. Foot print was analyzed both as a whole and as subdivided into eight regions: medial and lateral heel, medial and lateral arch, I metatarsal head, II-V metatarsal heads, hallux, lateral toes. Reliability was assessed by using intraclass correlation coefficient (ICC) for clinically relevant variables from analysis of 50 steps per trajectory: Peak Force (PF); Peak Pressure (PP); Contact Area (CA); Stance Duration (S). Results When considering whole-foot, all variables showed an ICC >0.80, therefore highly reliable. This was true for both LIN and curved trajectories. There was no difference in ICC of the four variables between left and right foot. When collapsing foot and trajectories, S had a lower ICC than PP and CA, and PP lower than CA. Mean percent error between the values of first and second session was <5%. When separately considering the eight foot regions, ICCs of PF, PP and CA for all regions and trajectories were generally >0.90, indicating excellent reliability. In curved trajectories, S showed smaller ICCs. Since the least ICC value for S was 0.60 in LIN trajectory, we estimated that to achieve an ICC ?0.90 more than 200 steps should be collected. Conclusions High reliability of insole dynamic variables (PF, PP, CA) is obtained with 50 steps using the Pedar-X system. On the contrary, high reliability of temporal variable (S) requires a larger step number. The negligible differences in ICC between LIN and curved trajectory allow use of this device for gait assessment along mixed trajectories in both clinical and research setting. PMID:24903003

2014-01-01

375

Ipsi- and contralateral H-reflexes and V-waves after unilateral chronic Achilles tendon vibration.  

PubMed

Chronic Achilles tendon vibration has previously shown its effectiveness in improving plantar flexor's strength and activation capacities. The present study investigated the related neural mechanisms by analyzing H-reflexes and V-waves of the soleus (SOL) and gastrocnemii (GM gastrocnemius medialis; GL gastrocnemius lateralis) muscles under maximal isometric plantar flexion. Moreover, recordings were conducted bilaterally to address potential crossed effects. 11 subjects were engaged in this study. Maximal voluntary contraction and superimposed H-reflexes and V-waves were quantified in both legs at baseline (PRE) and 2 weeks later to verify repeatability of data (CON). Then, subjects were retested after 14 days of daily unilateral Achilles tendon vibration (VIB; 1 h per day; frequency: 50 Hz). No changes were reported between PRE and CON data. In the VIB condition, there was an increase in MVC for both the vibrated (+9.1 %; p = 0.016) and non-vibrated (+10.2 %; p = 0.009) legs. The H-reflex increased by a mean 25 % in the vibrated SOL (p < 0.001), while it remained unchanged for the contralateral side (p = 0.531). The SOL V-wave also increased in the vibrated limb (+43.3 %; p < 0.001), as well as in the non-vibrated one (+41.9 %; p = 0.006). Furthermore, the GM V-wave increased by 37.8 % (p = 0.081) in the vibrated side and by 39.4 % (p = 0.03) in the non-vibrated side. However, no changes were reported for the GL muscles. While the present study confirmed the strength gains induced by chronic Achilles tendon vibration, the results indicated a cross-education phenomenon with differences in neural adaptations between the vibrated leg and non-vibrated leg. PMID:23652708

Lapole, Thomas; Canon, Francis; Pérot, Chantal

2013-09-01

376

Comparaison de la répartition des appuis plantaires entre chaussures d'entraînement et chaussures à pointes chez de jeunes sprinters Comparison of foot plantar distribution between training and spike shoes in young sprinters  

Microsoft Academic Search

Aims. - To compare plantar patterns between training and spikes shoes in young sprinters. Methods and results. - Eleven athletes performed two trials of 2 × 60 m maximal speed with training and spikes shoes, respectively. Contact area was significantly smaller with spikes in total and under the toes; pressure and force were significantly higher with spikes under the forefoot

F. Fourchet; S. Kuitunen; O. Girard; G.-P. Millet

377

The use of specific binding of peptide-nucleic acid to DNA in the {open_quotes}Achilles heel{close_quotes} method  

SciTech Connect

The `Achilles heel` method (AHM) is used in the design of random-cleavage restriction endonucleases. These promising compounds can be widely used in practice, particularly for genomic DNA mapping. DNA is complexed with a site-specific DNA-binding reagent (protein or oligonucleotide) and then treated with methylase. The methylation sites overlapping with or adjacent to the DNA-binding sites of the reagent are protected from methylation. Thereafter, methylase is inactivated, the DNA-binding reagent is removed, and DNA is cleaved by the restriction endonuclease corresponding to the methylase used. As a result, DNA is cleaved only at those restriction sites that were protected by the DNA-binding reagent from methylation. Until now, proteins or oligonucleotides were used as site-specific DNA-binding reagents. Here, we report on the use of a peptide-nucleic acid (PNA) in AHM. 7 refs., 4 figs.

Krasil`nikova, M.M.; Izvol`skii, K.I.; Krupnik, O.V.; Lazurkin, Yu.S. [Institute of Molecular Genetics, Moscow (Russian Federation)

1995-09-01

378

Chronic granulomatous disease  

MedlinePLUS

CGD; Fatal granulomatosis of childhood; Chronic granulomatous disease of childhood; Progressive septic granulomatosis ... Chronic granulomatous disease (CGD) is a genetic disorder in which certain immune system cells are unable to kill some ...

379

Fighting Chronic Pain  

MedlinePLUS

... Navigation Bar Home Current Issue Past Issues Fighting Chronic Pain Past Issues / Fall 2007 Table of Contents For ... diagnose, health care professionals and scientists know that chronic pain is very complex. Below are some of the ...

380

Managing Chronic Pain  

MedlinePLUS

... perform household chores. What can a person with chronic pain do? ? Develop and practice a lifestyle based on ... mind and reduce tensions that aggravate pain. Managing Chronic Pain ® Tips for Living Occupational Therapy: Skills for the ...

381

Genetic variation in sex hormone genes influences heel ultrasound parameters in middle-aged and elderly men: results from the European Male Aging Study (EMAS).  

PubMed

Genes involved in sex hormone pathways are candidates for influencing bone strength. Polymorphisms in these genes were tested for association with heel quantitative ultrasound (QUS) parameters in middle-aged and elderly European men. Men 40-79 yr of age were recruited from population registers in eight European centers for the European Male Aging Study (EMAS). Polymorphisms were genotyped in AR, ESR1, ESR2, CYP19A1, CYP17A1, SHBG, SRD5A2, LHB, and LHCGR. QUS parameters broadband ultrasound attenuation (BUA) and speed of sound (SOS) were measured in the heel and used to derive BMD. The relationships between QUS parameters and polymorphisms were assessed using linear regression adjusting for age and center. A total of 2693 men, with a mean age of 60.1 +/- 11.1 (SD) yr were included in the analysis. Their mean BUA was 80.0 +/- 18.9 dB/Mhz, SOS was 1550.2 +/- 34.1 m/s, and BMD was 0.542 +/- 0.141 g/cm(2). Significant associations were observed between multiple SNPs in a linkage disequilibrium (LD) block within CYP19A1, peaking at the TCT indel with the deletion allele associating with reduced ultrasound BMD in heterozygotes (beta =-0.016, p = -0.005) and homozygotes (beta = -0.029, p = 0.001). The results for BUA and SOS were similar. Significant associations with QUS parameters were also observed for the CAG repeat in AR and SNPs in CYP17A1, LHCGR, and ESR1. Our data confirm evidence of association between bone QUS parameters and polymorphisms in CYP19A1, as well as modest associations with polymorphisms in CYP17A1, ESR1, LHCGR, and AR in a population sample of European men; this supports a role for genetically determined sex hormone actions in influencing male bone health. PMID:18767927

Limer, Kate L; Pye, Stephen R; Thomson, Wendy; Boonen, Steven; Borghs, Herman; Vanderschueren, Dirk; Huhtaniemi, Ilpo T; Adams, Judith E; Ward, Kate A; Platt, Hazel; Payne, Debbie; John, Sally L; Bartfai, Gyorgy; Casanueva, Felipe; Finn, Joseph D; Forti, Gianni; Giwercman, Aleksander; Han, Thang S; Kula, Krzysztof; Lean, Michael E; Pendleton, Neil; Punab, Margus; Silman, Alan J; Wu, Frederick C; O'Neill, Terence W

2009-02-01

382

Attenuating effect of Acorus calamus extract in chronic constriction injury induced neuropathic pain in rats: an evidence of anti-oxidative, anti-inflammatory, neuroprotective and calcium inhibitory effects  

Microsoft Academic Search

Background  \\u000a Acorus calamus (family: Araceae), is an indigenous plant, traditionally it is used as an ingredient of various cocktail preparations and for the management\\u000a of severe inflammatory disorders in Indian system of medicine. Present study investigated the attenuating role of Acorus calamus plant extract in chronic constriction injury (CCI) of sciatic nerve induced peripheral neuropathy in rats.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Hot plate, plantar,

Arunachalam Muthuraman; Nirmal Singh

2011-01-01

383

Effect of six types of footwear on peak plantar pressures in patients with diabetes and transmetatarsal amputation.  

PubMed

INTRODUCTION:: Patients with diabetes (DM) and transmetatarsal amputation (TMA) are at high risk for skin breakdown from excessive peak plantar pressures (PPP). The primary purpose of this study was to determine how footwear (full length shoe or short shoe), a total contact insert, a rigid-rocker bottom (RRB) sole, and an ankle-foot-orthosis (AFO) affect PPP on the distal residuum and contralateral extremity of patients with DM and TMA. A secondary purpose was to monitor various functional measures during use of the footwear. METHODS:: Thirty patients with DM and TMA participated (mean age 62+/-4 years). The mean duration of DM was 19.9+/-10.1 years, and the mean time since TMA was 27.4+/-28.1 months. The following footwear was provided after a check-out from an orthotist and physical therapist (PT); 1) Full length shoe (ie shoe length prior to surgery), with a toe filler, 2) full length shoe, total contact insert, and an AFO, 2) full length shoe, total contact insert, and an AFO, 3) full length shoe, total contact insert, and a RRB sole, 4) full length shoe, total contact insert, RRB sole, and an AFO, 5) short shoe (ie length of residuum), total contact insert, and RRB, 6) short shoe, total contact insert, AFO, and RRB sole. In-shoe PPP during walking at the distal residuum and forefoot of the contralateral extremity were measured using the F-Scan System with established reliability under similar conditions (Generilizability coefficient =.75). Each measurement occurred after a one month adjustment period. Data were analyzed using a univariate repeated measuresANOVA. Individual contrasts were used for post-hoc analysis on those variables showing a significant overall F value (p<.05). RESULTS:: Compared to a regular shoe with a toe-filler, all conditions except the short shoe (#5), resulted in lower PPP on the distal residuum (p<.05). Condition 3, the full length shoe, total contact insert, and RRB resulted in lower pressures on the distal residuum and forefoot of the contralateral extremity compared to a regular shoe and toe-filler, and had few functional complaints as identified by the patient, orthotist or PT (3/27). Footwear using an AFO (Conditions 2,4,6) showed reduced PPP on the residuum, but most patients (16/29) had functional complaints. The short shoe (condition 5) had the fewest[Table: see text] functional complaints (2/26), but did not significantly reduce PPP and had the highest cosmetic refusal rate (5/26). DISCUSSION AND CONCLUSIONS:: Although there are individual patient characteristics which warrant other prescriptions, based on the results of this study, we recommend the full length shoe, total contact insert, and RRB sole for most patients with DM and TMA to reduce PPP. A reduction in PPP should help to lower the high risk of skin breakdown in this patient population. PMID:11415697

Mueller, MJ; Strube, MJ; Allen, BT

1997-04-01

384

Conceptualizing Chronic Poverty  

Microsoft Academic Search

This paper provides a meaning for the term chronic poverty “in a nutshell” and explores the concepts of poverty, vulnerability and poverty dynamics that underpin this meaning. Subsequently, it reviews “who” is chronically poor, “why” they stay poor and what is known about policies to reduce chronic poverty. Despite the limited knowledge available it is clear that hundreds of millions

Andrew Shepherd

2003-01-01

385

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)  

MedlinePLUS

NINDS Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) Information Page Table of Contents (click to jump to sections) What is Chronic ... is being done? Clinical Trials Organizations What is Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)? Chronic inflammatory demyelinating polyneuropathy ( ...

386

What Is Chronic Myeloid Leukemia?  

MedlinePLUS

... about chronic myeloid leukemia? What is chronic myeloid leukemia? Chronic myeloid leukemia (CML), also known as chronic ... and start making antibodies to fight them. How leukemia starts Any blood-forming or lymphoid cells can ...

387

What Is Chronic Myelomonocytic Leukemia?  

MedlinePLUS

... about chronic myelomonocytic leukemia? What is chronic myelomonocytic leukemia? Chronic myelomonocytic (MY-eh-loh-MAH-noh-SIH- ... can bleed and bruise a lot. Chronic myelomonocytic leukemia CMML patients have a high number of monocytes ...

388

The Acute Effects of Unilateral Ankle Plantar Flexors Static- Stretching on Postural Sway and Gastrocnemius Muscle Activity During Single-Leg Balance Tasks  

PubMed Central

The aim of this study was to investigate the acute effects of unilateral ankle plantar flexors static- stretching on surface electromyography (sEMG) and the center of pressure (COP) during a single-leg balance task in both lower limbs. Fourteen young healthy, non-athletic individuals performed unipodal quiet standing for 30s before and after (stretched limb: immediately post-stretch, 10 and 20 minutes and non-stretched limb: immediately post-stretch) a unilateral ankle plantar flexor static- stretching protocol [6 sets of 45s/15s, 70-90% point of discomfort (POD)]. Postural sway was described using the COP area, COP speed (antero-posterior and medio-lateral directions) and COP frequency (antero-posterior and medio-lateral directions). Surface EMG (EMG integral [IEMG] and Median frequency[FM]) was used to describe the muscular activity of gastrocnemius lateralis. Ankle dorsiflexion passive range of motion increased in the stretched limb before and after the static-stretching protocol (mean ± SD: 15.0° ± 6.0 and 21.5° ± 7.0 [p < 0.001]). COP area and IEMG increased in the stretch limb between pre-stretching and immediately post-stretching (p = 0.015 and p = 0.036, respectively). In conclusion, our static- stretching protocol effectively increased passive ankle ROM. The increased ROM appears to increase postural sway and muscle activity; however these finding were only a temporary or transient effect. Key Points The postural control can be affected by static- stretching protocol. The lateral gastrocnemius muscle action was increased after the static- stretching protocol. The static- stretching effects remain for less than 10 minutes. PMID:25177183

Lima, Braulio N.; Lucareli, Paulo R.G.; Gomes, Willy A.; Silva, Josinaldo J.; Bley, Andre S.; Hartigan, Erin H.; Marchetti, Paulo H.

2014-01-01

389

In Vitro Antifungal Activity of KP-103, a Novel Triazole Derivative, and Its Therapeutic Efficacy against Experimental Plantar Tinea Pedis and Cutaneous Candidiasis in Guinea Pigs  

PubMed Central

The in vitro activity of KP-103, a novel triazole derivative, against pathogenic fungi that cause dermatomycoses and its therapeutic efficacy against plantar tinea pedis and cutaneous candidiasis in guinea pigs were investigated. MICs were determined by a broth microdilution method with morpholinepropanesulfonic acid-buffered RPMI 1640 medium for Candida species and with Sabouraud dextrose broth for dermatophytes and by an agar dilution method with medium C for Malassezia furfur. KP-103 was the most active of all the drugs tested against Candida albicans (geometric mean [GM] MIC, 0.002 ?g/ml), other Candida species including Candida parapsilosis and Candida glabrata (GM MICs, 0.0039 to 0.0442 ?g/ml), and M. furfur (GM MIC, 0.025 ?g/ml). KP-103 (1% solution) was highly effective as a treatment for guinea pigs with cutaneous candidiasis and achieved mycological eradication in 8 of the 10 infected animals, whereas none of the imidazoles tested (1% solutions) was effective in even reducing the levels of the infecting fungi. KP-103 was as active as clotrimazole and neticonazole but was less active than lanoconazole and butenafine against Trichophyton rubrum (MIC at which 80% of isolates are inhibited [MIC80], 0.125 ?g/ml) and Trichophyton mentagrophytes (MIC80, 0.25 ?g/ml). However, KP-103 (1% solution) exerted therapeutic efficacy superior to that of neticonazole and comparable to those of lanoconazole and butenafine, yielding negative cultures for all samples from guinea pigs with plantar tinea pedis tested. This suggests that KP-103 has better pharmacokinetic properties in skin tissue than the reference drugs. Because the in vitro activity of KP-103, unlike those of the reference drugs, against T. mentagrophytes was not affected by hair as a keratinic substance, its excellent therapeutic efficacy seems to be attributable to good retention of its antifungal activity in skin tissue, in addition to its potency. PMID:11302816

Tatsumi, Yoshiyuki; Yokoo, Mamoru; Arika, Tadashi; Yamaguchi, Hideyo

2001-01-01

390

Treatment of Severe (Stage III and IV) Chronic Pressure Ulcers Using Pulsed Radio Frequency Energy in a Quadriplegic Patient  

PubMed Central

Objective: To report an adjuvant treatment to basic wound care of stage III and IV pressure ulcers in a patient with quadriplegia. Methods: Pulsed radio frequency energy was used as an adjunct to basic wound care of 3 large, long-standing (6 years) stage III and IV pressure ulcers that were unresponsive to conventional therapy in a 59-year-old man with quadriplegia. Results: The ulcers (on right foot, left heel, and sacrum) markedly decreased in size (16.7, 28.5, and 13.1 mm2 per day, respectively). The ulcer on the right foot healed within 4 weeks, the left heel ulcer reduced in size by 95% at 7 months, and the large sacral ulcer healed to closure in 11 months. Conclusion: Pulsed radio frequency energy treatment with basic wound care, if administered early in the course of pressure ulcer therapy, might avoid the lengthy hospitalizations and repeated surgical procedures necessary for treatment of uncontrolled ulcers, reducing the overall cost of treatment and improving the quality of life for chronically ill or injured patients. PMID:19008935

Porreca, Eugene G.; Giordano-Jablon, Gina M.

2008-01-01

391

[Quantification of gait using insole type foot pressure monitor : clinical application for chronic hemiplegia].  

PubMed

Home-based stroke hemiplegia patients tend to fall easily. Poor toe clearance is reported to be one of the causes of falling, although there are many other related factors. We developed a low-priced insole type portable foot pressure measurement device, and measured the foot pressure distribution and the foot pressure-time curve of 20 chronic hemiplegia patients and compared them with 36 healthy controls. We also analyzed the outdoor gait of a chronic hemiplegia patient on flat ground, on rough terrain, walking up stairs and on a downward slope. The result was that the load rate of the unaffected heel was significantly increased in hemiplegic gait, and there was a significant negative correlation between the affected side stance phase rate and gait time for 10 m distance (r = -0.73, P < 0.01). The primary role of the unaffected side and the poor toe clearance on the affected side were assured in the uneven ground gait, and it was suggested that chronic hemiplegia patients tend to be highly dependent on their unaffected side during indoor and outdoor gait. PMID:24633184

Naito, Yutaro; Kimura, Yoshiko; Hashimoto, Takashi; Mori, Masao; Takemoto, Yoshimi

2014-03-01

392

Chronic Critical Illness  

PubMed Central

Although advances in intensive care have enabled more patients to survive an acute critical illness, they also have created a large and growing population of chronically critically ill patients with prolonged dependence on mechanical ventilation and other intensive care therapies. Chronic critical illness is a devastating condition: mortality exceeds that for most malignancies, and functional dependence persists for most survivors. Costs of treating the chronically critically ill in the United States already exceed $20 billion and are increasing. In this article, we describe the constellation of clinical features that characterize chronic critical illness. We discuss the outcomes of this condition including ventilator liberation, mortality, and physical and cognitive function, noting that comparisons among cohorts are complicated by variation in defining criteria and care settings. We also address burdens for families of the chronically critically ill and the difficulties they face in decision-making about continuation of intensive therapies. Epidemiology and resource utilization issues are reviewed to highlight the impact of chronic critical illness on our health care system. Finally, we summarize the best available evidence for managing chronic critical illness, including ventilator weaning, nutritional support, rehabilitation, and palliative care, and emphasize the importance of efforts to prevent the transition from acute to chronic critical illness. As steps forward for the field, we suggest a specific definition of chronic critical illness, advocate for the creation of a research network encompassing a broad range of venues for care, and highlight areas for future study of the comparative effectiveness of different treatment venues and approaches. PMID:20448093

Nelson, Judith E.; Cox, Christopher E.; Hope, Aluko A.; Carson, Shannon S.

2010-01-01

393

Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema  

MedlinePLUS

... Territorial Data NCHS Home FastStats Home Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema Data are ... Number of noninstitutionalized adults with diagnosed chronic Obstructive Pulmonary Disease in the past year: 6.8 million Percent ...

394

Improving the spectral resolution of a highly pixelated detector by applying a pixel-by-pixel energy calibration for investigating the spectral properties of the anode heel effect  

NASA Astrophysics Data System (ADS)

The energy deposition spectrum measured with highly pixelated photon-counting pixel detectors with a semiconductor sensor layer (e.g. silicon) differs significantly from the impinging X-ray spectrum. This is the main disadvantage compared to commonly known X-ray spectrometers, e.g. high purity Germanium (hpGe) detector. On the other hand, those hpGe-detectors have a lack of spatial resolution and can not be used for energy-resolved imaging. In case of measurements with highly pixelated detectors, a set of monoenergetic detector response functions is needed for the deconvolution of the measured distribution into the impinging spectrum. We have investigated the possibility of applying a pixel-by-pixel calibration on a highly pixelated detector for gaining a higher energy resolution and for lowering the minimal flux needed for the deconvolution. As a result it is now possible to utilize small ROIs of the pixel matrix for the deconvolution. With this analysis method the detector enables spectral X-ray imaging of high photon rates. This is in particular shown for the angular dependency of the anode heel effect on the emitted spectrum.

Sievers, P.; Klammer, J.; Michel, T.; Hupe, O.; Anton, G.

2012-07-01

395

Coping with Chronic Illness  

MedlinePLUS

Having a long-term, or chronic, illness can disrupt your life in many ways. You may often be tired and in pain. Your illness might affect your ... able to work, causing financial problems. For children, chronic illnesses can be frightening, because they may not ...

396

Tips for Chronic Pain  

MedlinePLUS

Chronic pain is defined as “persistent pain” and is a common complaint in Sjögren’s syndrome. For example, Sjögren’s ... mental well-being. Some tips for dealing with chronic pain: Continue caring for the condition causing your pain. • ...

397

Chronic daily headaches  

PubMed Central

Chronic Daily Headache is a descriptive term that includes disorders with headaches on more days than not and affects 4% of the general population. The condition has a debilitating effect on individuals and society through direct cost to healthcare and indirectly to the economy in general. To successfully manage chronic daily headache syndromes it is important to exclude secondary causes with comprehensive history and relevant investigations; identify risk factors that predict its development and recognise its sub-types to appropriately manage the condition. Chronic migraine, chronic tension-type headache, new daily persistent headache and medication overuse headache accounts for the vast majority of chronic daily headaches. The scope of this article is to review the primary headache disorders. Secondary headaches are not discussed except medication overuse headache that often accompanies primary headache disorders. The article critically reviews the literature on the current understanding of daily headache disorders focusing in particular on recent developments in the treatment of frequent headaches. PMID:23024563

Ahmed, Fayyaz; Parthasarathy, Rajsrinivas; Khalil, Modar

2012-01-01

398

Hemodynamic responses during graded and constant-load plantar flexion exercise in middle-aged men and women with type 2 diabetes.  

PubMed

We tested the hypotheses that type 2 diabetes (T2D) impairs the 1) leg hemodynamic responses to an incremental intermittent plantar-flexion exercise and 2) dynamic responses of leg vascular conductance (LVC) during low-intensity (30% maximal voluntary contraction, MVC) and high-intensity (70% MVC) constant-load plantar-flexion exercise in the supine posture. Forty-four middle-aged individuals with T2D (14 women), and 35 healthy nondiabetic (ND) individuals (18 women) were tested. Leg blood flow (LBF) was measured between each contraction using venous occlusion plethysmography. During the incremental test peak force (Fpeak) relative to MVC was significantly reduced (P < 0.05) in men and women with T2D compared with their respective nondiabetic counterparts. Peak LBF and the slope of LBF relative to percentage Fpeak were also reduced (P < 0.05) in women with T2D compared with healthy women (peak blood flow, 460.6 ± 126.8 vs. 628.3 ± 347.7 ml/min; slope, 3.78 ± 1.74 vs. 5.85 ± 3.14 ml·min(-1)·%Fpeak (-1)) and in men with T2D compared with nondiabetic men (peak blood flow, 621.7 ± 241.3 vs. 721.2 ± 359.7 ml/min; slope, 5.75 ± 2.66 vs. 6.33 ± 3.63 ml·min(-1)·%Fpeak (-1)). During constant-load contractions at 30% MVC T2D did not affect the dynamic responses of LVC (LBF/MAP). However, at 70% MVC [completed by a subgroup of participants (20 with T2D, 6 women; 13 ND, 6 women)] the time constant of the second growth phase of LVC was longer and the amplitude of the first growth phase was lower (P < 0.05 for both) in men and women with T2D. The results suggest that the T2D-induced impairments in performance of the leg muscles are related to reductions in blood flow in both men and women. PMID:25123197

Kiely, Catherine; O'Connor, Eamonn; O'Shea, Donal; Green, Simon; Egaña, Mikel

2014-10-01

399

Assessment of forearm and plantar foot load in the elderly using a four-wheeled walker with armrest and the effect of armrest height  

PubMed Central

Background Patients with hand and/or wrist pathology are recommended to have a four-wheeled walker with an arm rest (FWW-AR) rather than a standard walker or a standard four-wheeled walker (FWW). However, only a few quantitative studies have been performed to compare upper and lower extremity weight bearing. The aim of this study was to evaluate forearm and foot weight bearing using a FWW-AR and the effect of the armrest height. Methods Eleven elderly women (mean age 80.1±5.3 years; mean height 148.5±4.0 cm; mean weight 51.2±9.0 kg) were enrolled. The subjects walked with an FWW-AR, with the elbow in either 90 degree (D90) or 130 degree (D130) flexion, for a distance of 10 m. Surface electromyographic signals were recorded for the upper, middle, and lower trapezius, anterior deltoid, and erector spinae muscles; walking velocity was measured with the subjects weight bearing on their feet and forearms while walking. Simultaneously, the maximum plantar and forearm loads during walking with an FWW-AR were measured. Results The normalized foot plantar loads were lower at D90 than at D130, while the normalized forearm load was higher at D90 than at D130 (all P<0.05; left foot, 7.9±0.1 N/kg versus 8.8±0.1 N/kg; right foot, 8.6±0.2 N/kg versus. 9.6±0.1 N/kg; left forearm, 1.8±0.5 N/kg versus 0.8±0.2 N/kg; and right forearm, 2.0±0.5 N/kg versus 1.0±0.2 N/kg, respectively). The surface electromyographic activity of the muscles involved in shoulder elevation and the walking velocity were both lower with the elbow at D90 than at D130 (all P<0.05; left upper trapezius, 98.7%±19.5% versus 132.6%±16.9%; right upper trapezius, 83.4%±10.6% versus 108.1%±10.5%; left anterior deltoid, 94.1%±12.8% versus 158.6%±40.4%; right anterior deltoid, 99.1%±15.0% versus 151.9%±19.4%; and velocity, 0.6±0.1 m/sec versus 0.7±0.1 m/sec, respectively). Conclusion Weight bearing on the lower extremities is significantly reduced when the upper extremities are supported during walking with an FWW-AR. Furthermore, the weight bearing profile is dependent on the armrest height. PMID:25342894

Ko, Chang-Yong; Kim, Sol-Bi; Choi, Hyuk-Jae; Chang, Yunhee; Kang, Sungjae; Heo, Yoon; Ryu, Jeicheong; Kim, Gyoosuk; Mun, Museong

2014-01-01

400

Chronic Obstructive Pulmonary Disease (COPD)  

MedlinePLUS

MENU Return to Web version Chronic Obstructive Pulmonary Disease (COPD) Overview What is chronic obstructive pulmonary disease (COPD)? Chronic obstructive pulmonary disease (also called COPD) is a lung disease that makes it ...

401

What Is Chronic Lymphocytic Leukemia?  

MedlinePLUS

... for chronic lymphocytic leukemia? What is chronic lymphocytic leukemia? Chronic lymphocytic leukemia (CLL) is a type of ... in the body from functioning normally. Types of leukemia Not all leukemias are the same. There are ...

402

[Management of chronic cough].  

PubMed

Chronic cough, defined as lasting more than 8 weeks, is a frequent and difficult problem. Since 1981, the north American group of Irwin and coworkers has proposed a diagnostic algorithm with chronic cough being explained in a vast majority of cases by three possible diagnoses: asthma, chronic rhino-sinusitis and gastrooesophageal reflux. This algorithm has been amended in order to include eosinophilic bronchitis and has further been severely criticized because of frequent failure in clinical practice. In 2008, Pavord and Chung have proposed to put the emphasis in chronic cough on non specific cough hyperreactivity, with the aetiological factors suggested by the Irwin group acting at most as modulating agents. Severe or persistent chronic cough should be quantitatively assessed, using for instance a visual analogue scale or a cough specific quality of life questionnaire. Where treatment for chronic cough is concerned, the sole definitely effective interventions are smoking cessation and discontinuation of a converting enzyme inhibitor. Long term inhaled steroids are also effective in case of eosinophilic cough (defined on basis of eosinophilia in induced sputum or increased level of exhaled NO). In case of chronic cough unresponsive to the hereinabove described management, an antitussive agent should be considered. As codeine is relatively ineffective, research about new antitussive agents should be encouraged. PMID:21089400

Noseda, A

2010-09-01

403

Assessment of the Medial Dorsal Cutaneous, Dorsal Sural, and Medial Plantar Nerves in Impaired Glucose Tolerance and Diabetic Patients With Normal Sural and Superficial Peroneal Nerve Responses  

PubMed Central

OBJECTIVE This study evaluated the nerve conduction study (NCS) parameters of the most distal sensory nerves of the lower extremities—namely, the medial dorsal cutaneous (MDC), dorsal sural (DS), and medial plantar (MP) nerves—in diabetic (DM) and impaired glucose tolerance (IGT) patients who displayed normal findings on their routine NCSs. RESEARCH DESIGN AND METHODS Standard NCSs were performed on healthy control (HC), DM, and IGT groups (N = 147). The bilateral NCS parameters of the MDC, DS, and MP nerves were investigated. The Toronto Clinical Scoring System (TCSS) was assessed for the DM and IGT groups. RESULTS The mean TCSS scores of the IGT and DM groups were 2.5 ± 2.3 and 2.8 ± 2.2, respectively. No significant differences between the two groups were observed. After adjustment of age and BMI, the DM group showed significant NCS differences in DS and MDC nerves compared with the HC group (P < 0.05). These differences were also exhibited in the left DS of the IGT group (P = 0.0003). More advanced NCS findings were observed in the DM group. Bilateral abnormal NCS responses in these distal sensory nerves were found in 40 and 16% of DM and IGT patients, respectively. CONCLUSIONS These results showed that the simultaneous assessment of the most distal sensory nerves allowed the detection of early NCS changes in the IGT and DM groups, even when the routine NCS showed normal findings. PMID:22100966

Im, Sun; Kim, Sung-Rae; Park, Joo Hyun; Kim, Yang Soo; Park, Geun-Young

2012-01-01

404

American Chronic Pain Association  

MedlinePLUS

... of their pain. To raise awareness among the health care community, policy makers, and the public at large about issues of living with chronic pain. Recent News View All News OTC ... Verify here Certified by: Independent Charities of ...

405

EXPERIMENTAL CHRONIC GLOMERULITIS  

PubMed Central

Three of 16 rabbits injected (intravenously) daily with crystalline bovine serum albumin (BSA) for periods in excess of 10 wk developed chronic glomerulonephritis. In vivo, animals with chronic proteinuria formed variable quantities of soluble complex after injection of antigen while animals without proteinuria exhibited rapid removal of the injected BSA. In vitro studies demonstrated that a major part of the antibodies produced by rabbits with chronic nephritis lacked precipitating properties. Interpretations of these observations were presented in the discussion. It is suggested that, in addition to quantity, quality of antibody plays an important role in the development of chronic serum sickness. Complexes formed with nonprecipitating antibody, which are less rapidly removed from circulation, would have a greater opportunity to deposit in glomeruli and induce inflammation. PMID:4171055

Pincus, Theodore; Haberkern, Roy; Christian, Charles L.

1968-01-01

406

Anemia of chronic disease  

MedlinePLUS

Anemia of inflammation; AOCD; ACD ... Anemia is a lower-than-normal number of red blood cells in the blood. Some conditions can lead to anemia of chronic disease include: Autoimmune disorders , such as ...

407

Chronic Beryllium Disease  

MedlinePLUS

... LS. Epidemiology of beryllium sensitizations and disease in nuclear workers. Am Rev Respir Dis 1993; 148:985- ... chronic beryllium disease. In: Rossman MD, Preuss OP, Powers MB, eds. Beryllium: Biomedical and Environmental Aspects. Baltimore: ...

408

Chronic Fatigue Syndrome  

MedlinePLUS

Chronic fatigue syndrome (CFS) is a disorder that causes extreme fatigue. This fatigue is not the kind of tired feeling that ... activities. The main symptom of CFS is severe fatigue that lasts for 6 months or more. You ...

409

Chronic lymphocytic leukemia (CLL)  

MedlinePLUS

... called staging. Tests that look at changes in DNA inside the cancer cells may also be done. Results from these ... PDQ Chronic Lymphocytic Leukemia Treatment. Bethesda, Md: National ... last modified: April 19, 2013. Available at: http://www.cancer. ...

410

Chronic inflammation and asthma  

PubMed Central

Allergic asthma is a complex and chronic inflammatory disorder which is associated with airway hyper-responsiveness and tissue remodelling of the airway structure. Although originally thought to be a Th2-driven inflammatory response to inhaled innocuous allergen, the immune response in asthma is now considered highly heterogeneous. There are now various in vivo systems which have been designed to examine the pathways leading to the development of this chronic immune response and reflect, in part this heterogeneity. Furthermore, the emergence of endogenous immunoregulatory pathways and active pro-resolving mediators hold great potential for future therapeutic intervention. In this review, the key cellular and molecular mediators relating to chronic allergic airway disease are discussed, as well as emerging players in the regulation of chronic allergic inflammation. PMID:19769993

Murdoch, Jenna R.; Lloyd, Clare M.

2010-01-01

411

Employees with Chronic Pain  

MedlinePLUS

Accommodation and Compliance Series: Employees with Chronic Pain By Beth Loy, Ph.D. Preface Introduction Information About Americans with Disabilities Act Accommodating Employees Resources References PDF Version DOC Version Share ...

412

Chronic dysimmune neuropathies: Beyond chronic demyelinating polyradiculoneuropathy  

PubMed Central

The spectrum of chronic dysimmune neuropathies has widened well beyond chronic demyelinating polyradiculoneuropathy (CIDP). Pure motor (multifocal motor neuropathy), sensorimotor with asymmetrical involvement (multifocal acquired demylinating sensory and motor neuropathy), exclusively distal sensory (distal acquired demyelinating sensory neuropathy) and very proximal sensory (chronic immune sensory polyradiculopathy) constitute the variants of CIDP. Correct diagnosis of these entities is of importance in terms of initiation of appropriate therapy as well as prognostication of these patients. The rates of detection of immune-mediated neuropathies with monoclonal cell proliferation (monoclonal gammopathy of unknown significance, multiple myeloma, etc.) have been facilitated as better diagnostic tools such as serum immunofixation electrophoresis are being used more often. Immune neuropathies associated with malignancies and systemic vasculitic disorders are being defined further and treated early with better understanding of the disease processes. As this field of dysimmune neuropathies will evolve in the future, some of the curious aspects of the clinical presentations and response patterns to different immunosuppressants or immunomodulators will be further elucidated. This review also discusses representative case studies. PMID:21808468

Khadilkar, Satish V.; Deshmukh, Shrikant S.; Dhonde, Pramod D.

2011-01-01

413

Chronic anal fissure  

Microsoft Academic Search

Opinion statement  Diagnosis of chronic anal fissure is easy and common in clinical practice. Little is known about the etiology and pathogenesis\\u000a of this disorder. Current investigations consider anal sphincteric hypertonia and ischemia as primary factors in the appearance\\u000a and maintenance of this lesion. Recurrence rate after healing is high, so anal fissure may be a chronic disease that evolves\\u000a depending

Miguel Minguez; Belen Herreros; Adolfo Benages

2003-01-01

414

Chronic Renal Failure  

PubMed Central

If a patient's serum creatinine level is elevated and chronic renal insufficiency is suspected, it is important to determine whether the problem is acute or chronic; to determine the cause; to identify secondary causes (including multiple myeloma, renal vascular disease, diabetes mellitus, reflux nephropathy, stone disease with infection, and hypertension); to institute measures to slow the disease; and to control hypertension, hyperphosphatemia, and acidosis. PMID:21229096

Hirsch, David J.

1991-01-01

415

Idiopathic chronic eosinophilic pneumonia  

Microsoft Academic Search

Idiopathic chronic eosinophilic pneumonia (ICEP) is characterized by subacute or chronic respiratory and general symptoms,\\u000a alveolar and\\/or blood eosinophilia, and peripheral pulmonary infiltrates on chest imaging. Eosinophilia is present in most\\u000a cases, usually in excess of 1000\\/mm3. In absence of significant blood eosinophilia, a diagnosis of ICEP is supported by the demonstration of bronchoalveolar lavage\\u000a eosinophilia. ICEP is typically associated

Eric Marchand; Jean-François Cordier

2006-01-01

416

Chronic myeloid lukemia cells  

Microsoft Academic Search

Chronic myelogenous leukemia (CML) is characterized by Philadelphia chromosome that fuses genetic sequences of the BCR gene on chromosome 22. AG 957, a member of the tyrphostin compound produces a selective inhibition of P 210 BCR\\/ABL tyrosine phosphorylation. A group of ten patients with CML in chronic phase were treated after CD34 separation with 1 to 100 umol\\/L of AG

V. Rizzoli; L. Mangoni; C. Caramatti; E. Regazzi; G. Sammarelli; S. Colla

2000-01-01

417

Significance of including field non-uniformities such as the heel effect and beam scatter in the determination of the skin dose distribution during interventional fluoroscopic procedures  

NASA Astrophysics Data System (ADS)

The current version of the real-time skin-dose-tracking system (DTS) we have developed assumes the exposure is contained within the collimated beam and is uniform except for inverse-square variation. This study investigates the significance of factors that contribute to beam non-uniformity such as the heel effect and backscatter from the patient to areas of the skin inside and outside the collimated beam. Dose-calibrated Gafchromic film (XR-RV3, ISP) was placed in the beam in the plane of the patient table at a position 15 cm tube-side of isocenter on a Toshiba Infinix C-Arm system. Separate exposures were made with the film in contact with a block of 20-cm solid water providing backscatter and with the film suspended in air without backscatter, both with and without the table in the beam. The film was scanned to obtain dose profiles and comparison of the profiles for the various conditions allowed a determination of field non-uniformity and backscatter contribution. With the solid-water phantom and with the collimator opened completely for the 20-cm mode, the dose profile decreased by about 40% on the anode side of the field. Backscatter falloff at the beam edge was about 10% from the center and extra-beam backscatter decreased slowly with distance from the field, being about 3% of the beam maximum at 6 cm from the edge. Determination of the magnitude of these factors will allow them to be included in the skin-dose-distribution calculation and should provide a more accurate determination of peak-skin dose for the DTS.

Rana, Vijay; Gill, Kamaljit; Rudin, Stephen; Bednarek, Daniel R.

2012-03-01

418

Is 1,25-dihydroxyvitamin D3 receptor expression a potential Achilles' heel of CD44+ oral squamous cell carcinoma cells?  

PubMed

The aim of this study was to analyse the expression of 1,25-dihydroxyvitamin D3 receptor (VDR) in oral cancers are squamous cell carcinomas (OSCC) to evaluate whether oral tissue may be a new potential target for biologically active 1,25-(OH)2D3 or its analogues. Expression of VDR was analysed in OSCC specimen (n=191) and cancer cell lines (BICR3, BICR56) by immunohistochemistry, real-time polymerase chain reaction (RT-PCR) analysis, and Western blotting. Scanned images were digitally analysed using ImageJ and the immunomembrane plug-in. VDR expression on protein level was correlated with proliferation marker Ki-67, clinical characteristics and impact on survival. VDR was co-labelled with CD44 and Ki-67 in double labeling experiments. Expression subgroups were identified by receiver operating characteristics (ROC) analysis. Low VDR expression was significantly associated with recurrence of the tumour. Multivariate analysis demonstrated low VDR expression as an independent prognostic factor (p=0.0005). Immunohistochemical double staining revealed VDR expression by CD44+ cancer cells. An inverse correlation of VDR+ expressing cancer cells with Ki-67 has been found, which was indicated by immunofluorescence double labeling. VDR specificity was confirmed by Western blot and RT-PCR analysis. For the first time, our study provides evidence that decreased VDR expression in OSCC might be associated with tumour relapse. Tumour cells of a putative CD44+ cancer stem cell compartment express VDR indicating a potential Achilles' heel for the treatment of OSCC although, our results do not allow any conclusion on the function of VDR. Adjuvant chemoprevention by using 1,25-(OH)2D3 or its analogues can be a successful tool targeting adjuvant residual tumour cells and will likely help therapeutic optimization for cancer patients in the clinic. However, this hypothesis requires further in vitro and in vivo studies. PMID:23314953

Grimm, Martin; Alexander, Dorothea; Munz, Adelheid; Hoffmann, Juergen; Reinert, Siegmar

2013-09-01

419

Comparison between the Klemetti index and heel DXA BMD measurements in the diagnosis of reduced skeletal bone mineral density in the elderly.  

PubMed

Osteopenia/osteoporosis affect many elderly people and might not be detected until symptoms of fractures occur. Early detection of osteopenia/osteoporosis is important and would allow preventive measures and treatment. Access to screening for osteopenia/osteoporosis is often limited, whereas panoramic radiography is commonly used in dentistry. The aim of this study was to determine the validity of the Klemetti index (KI), measured on panoramic radiographs, in the diagnosis of osteopenia/osteoporosis as defined by a bone mineral density (BMD) measurement below -1.5 standard deviations (SDs) of a community based sample. In total, 211 consecutive participants (102 men and 109 women) 60-96 years in the SNAC-Blekinge study (Swedish National Study on Ageing and Care) underwent bone densitometry [by dual-energy X-ray absorptiometry (DXA)] of both heels. A panoramic radiograph was taken of each participant, and mandibular cortex on a panoramic radiograph was classified as '0' or normal (even and sharp endosteal margin), '1', moderately eroded (evidence of lacunar resorption or endosteal cortical residues), or '2', severely eroded (unequivocal porosity). From logistic regression, the odds ratio of having a BMD measurement below -1.5 SD was 8.04 (95% CI 2.39 to 27.12, P<0.001) in the 'osteopenic' (KI category 2), compared with the 'normal' group (KI categories 0 and 1). Receiver operating characteristic (ROC) curve analysis was used to measure the validity of the KI indicating osteopenia (KI category 2) in predicting reduced BMD. This point provided a sensitivity of 50% and a specificity of 89%. Positive and negative predictive values were 21% and 97%, respectively. There were 87% correctly classified subjects. The area under the ROC curve was 0.64. The present study demonstrated that a negative finding (KI category <2) is highly predictive of the absence of osteopenia/osteoporosis as defined by the DXA measurements. PMID:15605191

Halling, Anders; Persson, G Rutger; Berglund, Johan; Johansson, Owe; Renvert, Stefan

2005-08-01

420

[Chronic exertional compartment syndrome].  

PubMed

Chronic exertional compartment syndrome is an uncommon phenomenon first reported in the mid 50's. This condition is characterized by sharp pain during physical activity, causing reduction in activity frequency or intensity and even abstention. This syndrome is caused by elevation of the intra-compartmental pressure which leads to decreased tissue perfusion, thus ischemic damage to the tissue ensues. Chronic exertional syndrome is usually related to repetitive physical activity, usually in young people and athletes. The physical activity performed by the patient causes a rise in intra-compartmental pressure and thereby causes pain. The patient discontinues the activity and the pain subsides within minutes of rest. Chronic exertional syndrome is reported to occur in the thigh, shoulder, arm, hand, foot and gluteal region, but most commonly in the leg, especially the anterior compartment. The diagnosis of chronic exertional syndrome is primarily based on patients' medical history, supported by intramuscular pressure measurement of the specific compartment involved. Treatment of chronic exertional syndrome, especially the anterior and lateral compartment of the leg is mainly by surgery i.e. fasciotomy. If the patient is reluctant to undergo a surgical procedure, the conservative treatment is based on abstention from the offending activity, changing footwear or using arch support. However, the conservative approach is not as successful as surgical treatment. PMID:24450036

Rom, Eyal; Tenenbaum, Shay; Chechick, Ofir; Burstein, Gideon; Amit, Yehuda; Thein, Ran

2013-10-01

421

Effects of approach and injection volume on diffusion of mepivacaine hydrochloride during local analgesia of the deep branch of the lateral plantar nerve in horses.  

PubMed

Objective-To compare the effects of 2 approaches and 2 injection volumes on diffusion of mepivacaine hydrochloride for local analgesia of the deep branch of the lateral plantar nerve (DBLPN) in horses. Design-Experimental study. Animals-16 adult horses. Procedures-Either 2 mL (low volume) or 8 mL (high volume) of mepivacaine hydrochloride-iohexol (50:50 mixture) was injected by means of 1 of 2 techniques to produce analgesia of the DBLPN. For technique 1, the needle was inserted 15 mm distal to the head of the fourth metatarsal bone and directed perpendicular to the limb. For technique 2, the needle was inserted 20 mm distal to the head of the fourth metatarsal bone and was directed in a proximodorsal direction. Lateromedial radiographs were obtained before and 5, 15, 30, and 60 minutes after injection. Radiographs were evaluated to determine the proximal and distal extent of diffusion of the contrast solution and presumably anesthetic agent and whether contrast agent appeared to be present in the tarsal sheath or tarsometatarsal joint. Results-A high degree of variability in contrast solution diffusion was noted among injections. High-volume injections diffused significantly further proximally and distally than did low-volume injections. Contrast agent was documented within the tarsal sheath in 5 of 32 (16%) injections and within the tarsometatarsal joint in 2 of 32 (6%) injections. No significant difference was found for risk of inadvertent tarsal sheath or tarsometatarsal joint injection between the 2 techniques or the 2 volumes of anesthetic used. Mepivacaine diffused significantly further distally with technique 1 than with technique 2 but diffused significantly further proximally with technique 2 than with technique 1. For both techniques, diffusion in the distal but not the proximal direction significantly increased over time. Conclusions and Clinical Relevance-Results indicated that the proximal and distal diffusion of the mepivacaine-iohexol solution was quite variable following either DBLPN nerve block technique. PMID:25356717

Claunch, Kevin M; Eggleston, Randy B; Baxter, Gary M

2014-11-15

422

Chronic Inflammatory Demyelinating Polyneuropathy  

PubMed Central

Opinion statement Chronic Inflammatory polyneuropathies are an important group of neuromuscular disorders that present chronically and progress over more than 8 weeks, being referred to as chronic inflammatory demyelinating polyneuropathy (CIDP). Despite tremendous progress in elucidating disease pathogenesis, the exact triggering event remains unknown. Our knowledge regarding diagnosis and management of CIDP and its variants continues to expand, resulting in improved opportunities for identification and treatment. Most clinical neurologists will be involved in the management of patients with these disorders, and should be familiar with available therapies for CIDP. We review the distinctive clinical, laboratory, and electro-diagnostic features that aid in diagnosis. We emphasize the importance of clinical patterns that define treatment responsiveness and the most appropriate therapies in order to improve prognosis. PMID:23564314

Dimachkie, Mazen M.; Barohn, Richard J.

2014-01-01

423

EBV Chronic Infections  

PubMed Central

The infection from Epstein-Barr virus (EBV) or virus of infectious mononucleosis, together with other herpes viruses’ infections, represents a prototype of persistent viral infections characterized by the property of the latency. Although the reactivations of the latent infection are associated with the resumption of the viral replication and eventually with the “shedding”, it is still not clear if this virus can determine chronic infectious diseases, more or less evolutive. These diseases could include some pathological conditions actually defined as “idiopathic”and characterized by the “viral persistence” as the more credible pathogenetic factor. Among the so-called idiopathic syndromes, the “chronic fatigue syndrome” (CFS) aroused a great interest around the eighties of the last century when, just for its relationship with EBV, it was called “chronic mononucleosis” or “chronic EBV infection”. Today CFS, as defined in 1994 by the CDC of Atlanta (USA), really represents a multifactorial syndrome characterized by a chronic course, where reactivation and remission phases alternate, and by a good prognosis. The etiopathogenetic role of EBV is demonstrated only in a well-examined subgroup of patients, while in most of the remaining cases this role should be played by other infectious agents - able to remain in a latent or persistent way in the host – or even by not infectious agents (toxic, neuroendocrine, methabolic, etc.). However, the pathogenetic substrate of the different etiologic forms seems to be the same, much probably represented by the oxidative damage due to the release of pro-inflammatory cytokines as a response to the triggering event (infectious or not infectious). Anyway, recently the scientists turned their’s attention to the genetic predisposition of the subjects affected by the syndrome, so that in the last years the genetic studies, together with those of molecular biology, received a great impulse. Thanks to both these studies it was possibile to confirm the etiologic links between the syndrome and EBV or other herpesviruses or other persistent infectious agents. The mechanisms of EBV latency have been carefully examined both because they represent the virus strategy to elude the response of the immune system of the host, and because they are correlated with those oncologic conditions associated to the viral persistence, particularly lymphomas and lymphoproliferative disorders. Just these malignancies, for which a pathogenetic role of EBV is clearly documented, should represent the main clinical expression of a first group of chronic EBV infections characterized by a natural history where the neoplastic event aroused from the viral persistence in the resting B cells for all the life, from the genetic predisposition of the host and from the oncogenic potentialities of the virus that chronically persists and incurs reactivations. Really, these oncological diseases should be considered more complications than chronic forms of the illness, as well as other malignancies for which a viral – or even infectious - etiology is well recognized. The chronic diseases, in fact, should be linked in a pathogenetic and temporal way to the acute infection, from whom start the natural history of the following disease. So, as for the chronic liver diseases from HBV and HCV, it was conied the acronym of CAEBV (Chronic Active EBV infection), distinguishing within these pathologies the more severe forms (SCAEBV) mostly reported in Far East and among children or adolescents. Probably only these forms have to be considered expressions of a chronic EBV infection “sensu scrictu”, together with those forms of CFS where the etiopathogenetic and temporal link with the acute EBV infection is well documented. As for CFS, also for CAEBV the criteria for a case definition were defined, even on the basis of serological and virological findings. However, the lymphoproliferative disorders are excluded from these for

Eligio, Pizzigallo; Delia, Racciatti; Valeria, Gorgoretti

2010-01-01

424

[Chronic recurrent paraproctitis].  

PubMed

The authors analyze the problem of prophylaxis of chronic paraproctitis (rectum fistulas). One of its links is the correct understanding of etiology and treatment of recurring pararectal abscesses. This form of inflammation with recurring abscesses without fistulas in the stage of remission is considered to be chronical. The authors propose to name it the chronic recurring paraproctitis. The experience with the treatment of 202 patients showed the usual opening the abscess to be not radical. To prevent further recurrings it is necessary to eliminate the altered crypt and the latent infection in the scar tissues. A two-step operation was used with the displacement of the mucous coat. Radical operations were made on 119 patients. All of them showed complete recovery. PMID:7222397

Blinnichev, N M; Buttaev, R M

1980-12-01

425

CYBERWAR-2012/13: Siegel 2011 Predicted Cyberwar Via ACHILLES-HEEL DIGITS BEQS BEC ZERO-DIGIT BEC of/in ACHILLES-HEEL DIGITS Log-Law Algebraic-Inversion to ONLY BEQS BEC Digit-Physics U Barabasi Network/Graph-Physics BEQS BEC JAMMING Denial-of-Access(DOA) Attacks 2012-Instantiations  

NASA Astrophysics Data System (ADS)

Newcomb-Benford(NeWBe)-Siegel log-law BEC Digit-Physics Network/Graph-Physics Barabasi et.al. evolving-``complex''-networks/graphs BEC JAMMING DOA attacks: Amazon(weekends: Microsoft I.E.-7/8(vs. Firefox): Memorial-day, Labor-day,), MANY U.S.-Banks:WF,BoA,UB,UBS,instantiations AGAIN militate for MANDATORY CONVERSION to PARALLEL ANALOG FAULT-TOLERANT but slow(er) SECURITY-ASSURANCE networks/graphs in parallel with faster ``sexy'' DIGITAL-Networks/graphs:``Cloud'', telecomm: n-G,, because of common ACHILLES-HEEL VULNERABILITY: DIGITS!!! ``In fast-hare versus slow-tortoise race, Slow-But-Steady ALWAYS WINS!!!'' (Zeno). Euler [#s(1732)] ?-( )-Riemann[Monats. Akad. Berlin (1859)] ?-( )- Kummer-Bernoulli (#s)-Newcomb [Am.J.Math.4(1),39 (81) discovery of the QUANTUM!!!]-Planck (01)]-Einstein (05)]-Poincar e [Calcul Probabilités,313(12)]-Weyl[Goett. Nach.(14); Math.Ann.77,313(16)]-(Bose (24)-Einstein(25)]-VS. --Fermi (27)-Dirac(27))-Menger [Dimensiontheorie(29)]-Benford [J.Am. Phil.Soc.78,115(38)]-Kac[Maths Stats.-Reason. (55)]- Raimi [Sci.Am.221,109(69)]-Jech-Hill [Proc.AMS,123,3,887(95)] log-function

Race Huffmann, Master; Carl-Ludwig Siegel, Edward

2013-03-01

426

Chronic hand infections.  

PubMed

Chronic infections of the hand are uncommon, and a high index of suspension is required for their early diagnosis. These can be grouped based on the microorganism. Mycobacterial infections include tuberculosis, atypical mycobacterial infections, and leprosy. Other bacterial infections include actinomycosis, cat-scratch disease, syphilis, tularemia, bacillary angioma