Asynchronous steady-state visual evoked potential based BCI control of a 2-DoF artificial upper limb.

PubMed

Horki, Petar; Neuper, Christa; Pfurtscheller, Gert; Müller-Putz, Gernot

2010-12-01

A brain-computer interface (BCI) provides a direct connection between the human brain and a computer. One type of BCI can be realized using steady-state visual evoked potentials (SSVEPs), resulting from repetitive stimulation. The aim of this study was the realization of an asynchronous SSVEP-BCI, based on canonical correlation analysis, suitable for the control of a 2-degrees of freedom (DoF) hand and elbow neuroprosthesis. To determine whether this BCI is suitable for the control of 2-DoF neuroprosthetic devices, online experiments with a virtual and a robotic limb feedback were conducted with eight healthy subjects and one tetraplegic patient. All participants were able to control the artificial limbs with the BCI. In the online experiments, the positive predictive value (PPV) varied between 69% and 83% and the false negative rate (FNR) varied between 1% and 17%. The spinal cord injured patient achieved PPV and FNR values within one standard deviation of the mean for all healthy subjects.

An investigation on effects of amputee's physiological parameters on maximum pressure developed at the prosthetic socket interface using artificial neural network.

PubMed

Nayak, Chitresh; Singh, Amit; Chaudhary, Himanshu; Unune, Deepak Rajendra

2017-10-23

Technological advances in prosthetics have attracted the curiosity of researchers in monitoring design and developments of the sockets to sustain maximum pressure without any soft tissue damage, skin breakdown, and painful sores. Numerous studies have been reported in the area of pressure measurement at the limb/socket interface, though, the relation between amputee's physiological parameters and the pressure developed at the limb/socket interface is still not studied. Therefore, the purpose of this work is to investigate the effects of patient-specific physiological parameters viz. height, weight, and stump length on the pressure development at the transtibial prosthetic limb/socket interface. Initially, the pressure values at the limb/socket interface were clinically measured during stance and walking conditions for different patients using strain gauges placed at critical locations of the stump. The measured maximum pressure data related to patient's physiological parameters was used to develop an artificial neural network (ANN) model. The effects of physiological parameters on the pressure development at the limb/socket interface were examined using the ANN model. The analyzed results indicated that the weight and stump length significantly affects the maximum pressure values. The outcomes of this work could be an important platform for the design and development of patient-specific prosthetic socket which can endure the maximum pressure conditions at stance and ambulation conditions.

Powered Upper Limb Orthosis Actuation System Based on Pneumatic Artificial Muscles

NASA Astrophysics Data System (ADS)

Chakarov, Dimitar; Veneva, Ivanka; Tsveov, Mihail; Venev, Pavel

2018-03-01

The actuation system of a powered upper limb orthosis is studied in the work. To create natural safety in the mutual "man-robot" interaction, an actuation system based on pneumatic artificial muscles (PAM) is selected. Experimentally obtained force/contraction diagrams for bundles, consisting of different number of muscles are shown in the paper. The pooling force and the stiffness of the pneumatic actuators is assessed as a function of the number of muscles in the bundle and the supply pressure. Joint motion and torque is achieved by antagonistic actions through pulleys, driven by bundles of pneumatic muscles. Joint stiffness and joint torques are determined on condition of a power balance, as a function of the joint position, pressure, number of muscles and muscles

Cybernetic prosthesis

NASA Technical Reports Server (NTRS)

Mann, R. W.

1974-01-01

Design and development of a prosthetic device fitted to an above elbow amputee is reported that derives control information from the human to modulate power to an actuator to drive the substitute limb. In turn, the artificial limb generates sensory information feedback to the human nervous system and brain. This synergetic unity feeds efferent or motor control information from the human to the machine, and the machine responds, delivering afferent or sensory information back to the man.

Positional information in axolotl and mouse limb extracellular matrix is mediated via heparan sulfate and fibroblast growth factor during limb regeneration in the axolotl (Ambystoma mexicanum).

PubMed

Phan, Anne Q; Lee, Jangwoo; Oei, Michelle; Flath, Craig; Hwe, Caitlyn; Mariano, Rachele; Vu, Tiffany; Shu, Cynthia; Dinh, Andrew; Simkin, Jennifer; Muneoka, Ken; Bryant, Susan V; Gardiner, David M

2015-08-01

Urodele amphibians are unique among adult vertebrates in their ability to regenerate complex body structures after traumatic injury. In salamander regeneration, the cells maintain a memory of their original position and use this positional information to recreate the missing pattern. We used an in vivo gain-of-function assay to determine whether components of the extracellular matrix (ECM) have positional information required to induce formation of new limb pattern during regeneration. We discovered that salamander limb ECM has a position-specific ability to either inhibit regeneration or induce de novo limb structure, and that this difference is dependent on heparan sulfates that are associated with differential expression of heparan sulfate sulfotransferases. We also discovered that an artificial ECM containing only heparan sulfate was sufficient to induce de novo limb pattern in salamander limb regeneration. Finally, ECM from mouse limbs is capable of inducing limb pattern in axolotl blastemas in a position-specific, developmental-stage-specific, and heparan sulfate-dependent manner. This study demonstrates a mechanism for positional information in regeneration and establishes a crucial functional link between salamander regeneration and mammals.

Positional information in axolotl and mouse limb extracellular matrix is mediated via heparan sulfate and fibroblast growth factor during limb regeneration in the axolotl (Ambystoma mexicanum)

PubMed Central

Phan, Anne Q.; Lee, Jangwoo; Oei, Michelle; Flath, Craig; Hwe, Caitlyn; Mariano, Rachele; Vu, Tiffany; Shu, Cynthia; Dinh, Andrew; Simkin, Jennifer; Muneoka, Ken; Bryant, Susan V.

2015-01-01

Abstract Urodele amphibians are unique among adult vertebrates in their ability to regenerate complex body structures after traumatic injury. In salamander regeneration, the cells maintain a memory of their original position and use this positional information to recreate the missing pattern. We used an in vivo gain‐of‐function assay to determine whether components of the extracellular matrix (ECM) have positional information required to induce formation of new limb pattern during regeneration. We discovered that salamander limb ECM has a position‐specific ability to either inhibit regeneration or induce de novo limb structure, and that this difference is dependent on heparan sulfates that are associated with differential expression of heparan sulfate sulfotransferases. We also discovered that an artificial ECM containing only heparan sulfate was sufficient to induce de novo limb pattern in salamander limb regeneration. Finally, ECM from mouse limbs is capable of inducing limb pattern in axolotl blastemas in a position‐specific, developmental‐stage‐specific, and heparan sulfate‐dependent manner. This study demonstrates a mechanism for positional information in regeneration and establishes a crucial functional link between salamander regeneration and mammals. PMID:27499874

Artificial Limbs

MedlinePlus

... a number of reasons. Common ones include Circulation problems from atherosclerosis or diabetes. They may cause you to need an amputation. Traumatic injuries, including from traffic accidents and military combat Cancer Birth defects If you are missing ...

User intent prediction with a scaled conjugate gradient trained artificial neural network for lower limb amputees using a powered prosthesis.

PubMed

Woodward, Richard B; Spanias, John A; Hargrove, Levi J

2016-08-01

Powered lower limb prostheses have the ability to provide greater mobility for amputee patients. Such prostheses often have pre-programmed modes which can allow activities such as climbing stairs and descending ramps, something which many amputees struggle with when using non-powered limbs. Previous literature has shown how pattern classification can allow seamless transitions between modes with a high accuracy and without any user interaction. Although accurate, training and testing each subject with their own dependent data is time consuming. By using subject independent datasets, whereby a unique subject is tested against a pooled dataset of other subjects, we believe subject training time can be reduced while still achieving an accurate classification. We present here an intent recognition system using an artificial neural network (ANN) with a scaled conjugate gradient learning algorithm to classify gait intention with user-dependent and independent datasets for six unilateral lower limb amputees. We compare these results against a linear discriminant analysis (LDA) classifier. The ANN was found to have significantly lower classification error (P<;0.05) than LDA with all user-dependent step-types, as well as transitional steps for user-independent datasets. Both types of classifiers are capable of making fast decisions; 1.29 and 2.83 ms for the LDA and ANN respectively. These results suggest that ANNs can provide suitable and accurate offline classification in prosthesis gait prediction.

Development of a residuum/socket interface simulator for lower limb prosthetics.

PubMed

McGrath, Michael Paul; Gao, Jianliang; Tang, Jinghua; Laszczak, Piotr; Jiang, Liudi; Bader, Dan; Moser, David; Zahedi, Saeed

2017-03-01

Mechanical coupling at the interface between lower limb residua and prosthetic sockets plays an important role in assessing socket fitting and tissue health. However, most research lab-based lower limb prosthetic simulators to-date have implemented a rigid socket coupling. This study describes the fabrication and implementation of a lower limb residuum/socket interface simulator, designed to reproduce the forces and moments present during the key loading phases of amputee walking. An artificial residuum made with model bones encased in silicone was used, mimicking the compliant mechanical loading of a real residuum/socket interface. A 6-degree-of-freedom load cell measured the overall kinetics, having previously been incorporated into an amputee's prosthesis to collect reference data. The developed simulator was compared to a setup where a rigid pylon replaced the artificial residuum. A maximum uniaxial load of 850 N was applied, comparable to the peak vertical ground reaction force component during amputee walking. Load cell outputs from both pylon and residuum setups were compared. During weight acceptance, when including the artificial residuum, compression decreased by 10%, while during push off, sagittal bending and anterior-posterior shear showed a 25% increase and 34% decrease, respectively. Such notable difference by including a compliant residuum further highlighted the need for such an interface simulator. Subsequently, the simulator was adjusted to produce key load cell outputs briefly aligning with those from amputee walking. Force sensing resistors were deployed at load bearing anatomic locations on the residuum/socket interface to measure pressures and were compared to those cited in the literature for similar locations. The development of such a novel simulator provides an objective adjunct, using commonly available mechanical test machines. It could potentially be used to provide further insight into socket design, fit and the complex load transfer mechanics at the residuum/socket interface, as well as to evaluate the structural performance of prostheses.

Artificial limb representation in amputees

PubMed Central

van den Heiligenberg, Fiona M Z; Orlov, Tanya; Macdonald, Scott N; Duff, Eugene P; Henderson Slater, David; Beckmann, Christian F; Johansen-Berg, Heidi; Culham, Jody C; Makin, Tamar R

2018-01-01

Abstract The human brain contains multiple hand-selective areas, in both the sensorimotor and visual systems. Could our brain repurpose neural resources, originally developed for supporting hand function, to represent and control artificial limbs? We studied individuals with congenital or acquired hand-loss (hereafter one-handers) using functional MRI. We show that the more one-handers use an artificial limb (prosthesis) in their everyday life, the stronger visual hand-selective areas in the lateral occipitotemporal cortex respond to prosthesis images. This was found even when one-handers were presented with images of active prostheses that share the functionality of the hand but not necessarily its visual features (e.g. a ‘hook’ prosthesis). Further, we show that daily prosthesis usage determines large-scale inter-network communication across hand-selective areas. This was demonstrated by increased resting state functional connectivity between visual and sensorimotor hand-selective areas, proportional to the intensiveness of everyday prosthesis usage. Further analysis revealed a 3-fold coupling between prosthesis activity, visuomotor connectivity and usage, suggesting a possible role for the motor system in shaping use-dependent representation in visual hand-selective areas, and/or vice versa. Moreover, able-bodied control participants who routinely observe prosthesis usage (albeit less intensively than the prosthesis users) showed significantly weaker associations between degree of prosthesis observation and visual cortex activity or connectivity. Together, our findings suggest that altered daily motor behaviour facilitates prosthesis-related visual processing and shapes communication across hand-selective areas. This neurophysiological substrate for prosthesis embodiment may inspire rehabilitation approaches to improve usage of existing substitutionary devices and aid implementation of future assistive and augmentative technologies. PMID:29534154

Artificial limb representation in amputees.

PubMed

van den Heiligenberg, Fiona M Z; Orlov, Tanya; Macdonald, Scott N; Duff, Eugene P; Henderson Slater, David; Beckmann, Christian F; Johansen-Berg, Heidi; Culham, Jody C; Makin, Tamar R

2018-05-01

The human brain contains multiple hand-selective areas, in both the sensorimotor and visual systems. Could our brain repurpose neural resources, originally developed for supporting hand function, to represent and control artificial limbs? We studied individuals with congenital or acquired hand-loss (hereafter one-handers) using functional MRI. We show that the more one-handers use an artificial limb (prosthesis) in their everyday life, the stronger visual hand-selective areas in the lateral occipitotemporal cortex respond to prosthesis images. This was found even when one-handers were presented with images of active prostheses that share the functionality of the hand but not necessarily its visual features (e.g. a 'hook' prosthesis). Further, we show that daily prosthesis usage determines large-scale inter-network communication across hand-selective areas. This was demonstrated by increased resting state functional connectivity between visual and sensorimotor hand-selective areas, proportional to the intensiveness of everyday prosthesis usage. Further analysis revealed a 3-fold coupling between prosthesis activity, visuomotor connectivity and usage, suggesting a possible role for the motor system in shaping use-dependent representation in visual hand-selective areas, and/or vice versa. Moreover, able-bodied control participants who routinely observe prosthesis usage (albeit less intensively than the prosthesis users) showed significantly weaker associations between degree of prosthesis observation and visual cortex activity or connectivity. Together, our findings suggest that altered daily motor behaviour facilitates prosthesis-related visual processing and shapes communication across hand-selective areas. This neurophysiological substrate for prosthesis embodiment may inspire rehabilitation approaches to improve usage of existing substitutionary devices and aid implementation of future assistive and augmentative technologies.

Learning about Disabilities.

ERIC Educational Resources Information Center

Popp, Rita Ann

1983-01-01

The author describes lessons provided for regular class elementary students to help them understand disabilities and disabled persons. Objectives, materials needed, and activities are outlined for six lessons focusing on the following topics: individual differences, wheelchairs; devices that help people walk; amputation, artificial limbs, and…

Development of a bone-fixation prosthetic attachment. [with quick-disconnect coupling

NASA Technical Reports Server (NTRS)

Owens, L. J.

1975-01-01

An artificial limb attached directly to the bone by a quick-disconnect coupling was tested in-place at a California medical rehabilitation center. Its design concept and development, made possible by multiple spinoffs of aerospace technology, are discussed.

Real-time and simultaneous control of artificial limbs based on pattern recognition algorithms.

PubMed

Ortiz-Catalan, Max; Håkansson, Bo; Brånemark, Rickard

2014-07-01

The prediction of simultaneous limb motions is a highly desirable feature for the control of artificial limbs. In this work, we investigate different classification strategies for individual and simultaneous movements based on pattern recognition of myoelectric signals. Our results suggest that any classifier can be potentially employed in the prediction of simultaneous movements if arranged in a distributed topology. On the other hand, classifiers inherently capable of simultaneous predictions, such as the multi-layer perceptron (MLP), were found to be more cost effective, as they can be successfully employed in their simplest form. In the prediction of individual movements, the one-vs-one (OVO) topology was found to improve classification accuracy across different classifiers and it was therefore used to benchmark the benefits of simultaneous control. As opposed to previous work reporting only offline accuracy, the classification performance and the resulting controllability are evaluated in real time using the motion test and target achievement control (TAC) test, respectively. We propose a simultaneous classification strategy based on MLP that outperformed a top classifier for individual movements (LDA-OVO), thus improving the state-of-the-art classification approach. Furthermore, all the presented classification strategies and data collected in this study are freely available in BioPatRec, an open source platform for the development of advanced prosthetic control strategies.

A bioinformatics expert system linking functional data to anatomical outcomes in limb regeneration

PubMed Central

Lobo, Daniel; Feldman, Erica B.; Shah, Michelle; Malone, Taylor J.

2014-01-01

Abstract Amphibians and molting arthropods have the remarkable capacity to regenerate amputated limbs, as described by an extensive literature of experimental cuts, amputations, grafts, and molecular techniques. Despite a rich history of experimental effort, no comprehensive mechanistic model exists that can account for the pattern regulation observed in these experiments. While bioinformatics algorithms have revolutionized the study of signaling pathways, no such tools have heretofore been available to assist scientists in formulating testable models of large‐scale morphogenesis that match published data in the limb regeneration field. Major barriers to preventing an algorithmic approach are the lack of formal descriptions for experimental regenerative information and a repository to centralize storage and mining of functional data on limb regeneration. Establishing a new bioinformatics of shape would significantly accelerate the discovery of key insights into the mechanisms that implement complex regeneration. Here, we describe a novel mathematical ontology for limb regeneration to unambiguously encode phenotype, manipulation, and experiment data. Based on this formalism, we present the first centralized formal database of published limb regeneration experiments together with a user‐friendly expert system tool to facilitate its access and mining. These resources are freely available for the community and will assist both human biologists and artificial intelligence systems to discover testable, mechanistic models of limb regeneration. PMID:25729585

Recent advancements in prosthetic hand technology.

PubMed

Saikia, Angana; Mazumdar, Sushmi; Sahai, Nitin; Paul, Sudip; Bhatia, Dinesh; Verma, Suresh; Rohilla, Punit Kumar

2016-07-01

Recently, significant advances over the past decade have been made in robotics, artificial intelligence and other cognitive related fields, allowing development of highly sophisticated bio-mimetic robotics systems. In addition, enormous number of robots have been designed and assembled by explicitly realising their biological oriented behaviours. To enhance skill behaviours and adequate grasping abilities in these devices, a new phase of dexterous hands has been developed recently with bio-mimetically oriented and bio-inspired functionalities. The aim in writing this review paper is to present a detailed insight towards the development of the bio-mimetic based dexterous robotic multi-fingered artificial hand. An "ideal" upper limb prosthesis should be perceived as a part of their natural body by the amputee and should replicate sensory-motor capabilities of the amputated limb. Upper-limb amputations are most often the result of sudden trauma to the body, although they also can be caused by malignancy, congenital deficiencies and vascular diseases. This paper discusses the different bio-mimetic approaches using a framework that permits for a common description of biological and technical based hand manipulation behaviour. In particular, the review focuses on a number of developments in the inspired robotic systems. In conclusion, the study found that a huge amount of research efforts in terms of kinematics, dynamics, modelling and control methodologies are being put in to improve the present hand technology, thereby providing more functionality to the prosthetic limb of the amputee. This would improve their quality-of-life and help in performing activities of daily living (ADL) tasks with comparative ease in the near future.

Fuel-powered artificial muscles.

PubMed

Ebron, Von Howard; Yang, Zhiwei; Seyer, Daniel J; Kozlov, Mikhail E; Oh, Jiyoung; Xie, Hui; Razal, Joselito; Hall, Lee J; Ferraris, John P; Macdiarmid, Alan G; Baughman, Ray H

2006-03-17

Artificial muscles and electric motors found in autonomous robots and prosthetic limbs are typically battery-powered, which severely restricts the duration of their performance and can necessitate long inactivity during battery recharge. To help solve these problems, we demonstrated two types of artificial muscles that convert the chemical energy of high-energy-density fuels to mechanical energy. The first type stores electrical charge and uses changes in stored charge for mechanical actuation. In contrast with electrically powered electrochemical muscles, only half of the actuator cycle is electrochemical. The second type of fuel-powered muscle provides a demonstrated actuator stroke and power density comparable to those of natural skeletal muscle and generated stresses that are over a hundred times higher.

Perceptual drifts of real and artificial limbs in the rubber hand illusion.

PubMed

Fuchs, Xaver; Riemer, Martin; Diers, Martin; Flor, Herta; Trojan, Jörg

2016-04-22

In the rubber hand illusion (RHI), transient embodiment of an artificial hand is induced. An often-used indicator for this effect is the "proprioceptive drift", a localization bias of the real hand towards the artificial hand. This measure suggests that the real hand is attracted by the artificial hand. Principles of multisensory integration, however, rather suggest that conflicting sensory information is combined in a "compromise" fashion and that hands should rather be attracted towards each other. Here, we used a new variant of the RHI paradigm in which participants pointed at the artificial hand. Our results indicate that the perceived positions of the real and artificial hand converge towards each other: in addition to the well-known drift of the real hand towards the artificial hand, we also found an opposite drift of the artificial hand towards the real hand. Our results contradict the notion of perceptual substitution of the real hand by the artificial hand. Rather, they are in line with the view that vision and proprioception are fused into an intermediate percept. This is further evidence that the perception of our body is a flexible multisensory construction that is based on integration principles.

Advances in material design for regenerative medicine, drug delivery and targeting/imaging

USDA-ARS?s Scientific Manuscript database

Many of the major breakthroughs and paradigm shifts in medicine to date have occurred due to innovations and materials and/or application/implementation of materials in clinical medicine. Artificial heart valves, implantable cardiac devices, limb prosthesis, cardiovascular stents, orthopedic implan...

Temporal coding of brain patterns for direct limb control in humans.

PubMed

Müller-Putz, Gernot R; Scherer, Reinhold; Pfurtscheller, Gert; Neuper, Christa

2010-01-01

For individuals with a high spinal cord injury (SCI) not only the lower limbs, but also the upper extremities are paralyzed. A neuroprosthesis can be used to restore the lost hand and arm function in those tetraplegics. The main problem for this group of individuals, however, is the reduced ability to voluntarily operate device controllers. A brain-computer interface provides a non-manual alternative to conventional input devices by translating brain activity patterns into control commands. We show that the temporal coding of individual mental imagery pattern can be used to control two independent degrees of freedom - grasp and elbow function - of an artificial robotic arm by utilizing a minimum number of EEG scalp electrodes. We describe the procedure from the initial screening to the final application. From eight naïve subjects participating online feedback experiments, four were able to voluntarily control an artificial arm by inducing one motor imagery pattern derived from one EEG derivation only.

Temperature-induced changes in neuromuscular function: central and peripheral mechanisms.

PubMed

Goodman, D; Hancock, P A; Runnings, D W; Brown, S L

1984-10-01

Three series of experimental tests were conducted on subjects under both elevated and depressed thermal conditions. Tripartite series consisted of whole-body immersion excepting the head, whole-body immersion excepting the head and response limb, and immersion of the discrete-response limb. Measures of physiological and behavioural responses were made at sequential .4 degrees C changes during whole-body immersions and approximately 5 degrees C changes of water temperature during the immersion of a limb only. Results suggested that velocity of nerve conduction decreased with thermal depression. Premotor, motor, simple, and choice reaction times varied differentially as a function of the hot and cold conditions. Implications of these differential effects on neuromuscular function are examined with respect to person-machine performance in artificially induced or naturally occurring extremes of ambient temperature.

Control of non-linear actuator of artificial muscles for the use in low-cost robotics prosthetics limbs

NASA Astrophysics Data System (ADS)

Anis Atikah, Nurul; Yeng Weng, Leong; Anuar, Adzly; Chien Fat, Chau; Sahari, Khairul Salleh Mohamed; Zainal Abidin, Izham

2017-10-01

Currently, the methods of actuating robotic-based prosthetic limbs are moving away from bulky actuators to more fluid materials such as artificial muscles. The main disadvantages of these artificial muscles are their high cost of manufacturing, low-force generation, cumbersome and complex controls. A recent discovery into using super coiled polymer (SCP) proved to have low manufacturing costs, high force generation, compact and simple controls. Nevertheless, the non-linear controls still exists due to the nature of heat-based actuation, which is hysteresis. This makes position control difficult. Using electrically conductive devices allows for very quick heating, but not quick cooling. This research tries to solve the problem by using peltier devices, which can effectively heat and cool the SCP, hence giving way to a more precise control. The peltier device does not actively introduce more energy to a volume of space, which the coiled heating does; instead, it acts as a heat pump. Experiments were conducted to test the feasibility of using peltier as an actuating method on different diameters of nylon fishing strings. Based on these experiments, the performance characteristics of the strings were plotted, which could be used to control the actuation of the string efficiently in the future.

A novel method of edema fluid drainage in obstructive lymphedema of limbs by implantation of hydrophobic silicone tubes.

PubMed

Olszewski, Waldemar L; Zaleska, Marzanna

2015-10-01

Lymphedema of limbs is caused by partial or total obstruction of lymphatic collectors as a consequence of skin and deep soft tissue inflammation, trauma of soft tissues and bones, lymphadenectomy, and irradiation in cancer therapy. According to the statistics of the World Health Organization, around 300 million people are affected by pathologic edema of limbs. Effective treatment of such large cohorts has been a challenge for centuries. However, none of the conservative and surgical methods applied so far proved to restore the shape and function of limbs to normal conditions. Actually, physiotherapy is the therapy of choice as a main modality or supplementary to surgical procedures divided into two groups: the bridging drainage and excisional techniques. The microsurgical operations can be performed if some parts of the peripheral collecting lymphatics remain patent and partially drain edematous regions. However, in advanced cases of lymphedema, all main lymphatics are obstructed and tissue fluid accumulates in the interstitial spaces, spontaneously forming "blind channels" or "lakes." The only solution would be to create artificial pathways for edema fluid flow away to the nonobstructed regions where absorption of fluid can take place. The aim of this study was to form artificial pathways for edema fluid flow by subcutaneous implantation of silicone tubes placed along the limb from the lower leg to the lumbar or hypogastric region. In a group of 20 patients with obstructive lymphedema of the lower limbs that developed after lymphadenectomy and irradiation of the pelvis because of uterine cancer with unsuccessful conservative therapy, implantation was done, followed by external compression as intermittent pneumatic compression and elastic support of tissues. Postoperative circumference measurements, lymphoscintigraphy, and ultrasonography of tissues were carried out during 2 years of follow-up. There was a fast decrease of calf circumference since the day of implantation during weeks by a mean 3% with stabilization afterward. Patency of tubes and accumulation of fluid around them were seen on ultrasonography and lymphoscintigraphy in all cases. No tissue cellular reaction to silicone tubes was noted. The simplicity of the surgical procedure, decrease of limb edema, and lack of tissue reaction to the implant make the method worth applying in advanced stages of lymphedema with large volumes of accumulated tissue edema fluid. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

The Store Challenge

ERIC Educational Resources Information Center

Roman, Harry T.

2014-01-01

Biomedical and robotic technologies are merging to present a wonderful opportunity to develop artificial limbs and prosthetic devices for humans injured on the job, in the military, or due to disease. In this challenge, students will have the opportunity to design a store or online service that specifically dedicates itself to amputees. Described…

Agile Development of Advanced Prototypes

DTIC Science & Technology

2014-11-01

prostheses: retinal implants, cochlear implants, and neuroprosthetics (EEG controlled artificial limbs); an interactive, virtual experience...demonstrations allowing users to experience, from a patient’s perspective life with three different prostheses: retinal implants, cochlear implants...three experiences were researched and developed. The applications are interactive demonstrations of retinal implants, cochlear implants, and

United States Air Force History. A Guide to Documentary Sources

DTIC Science & Technology

1973-01-01

artificial limbs, crea- tive activity, and delegates to an interallied congress. The areas represented by aerial photographs are only partially identified...Interim Government of Korea, 154 477, 604 See also Korea, Korean War Hoover, J. Edgar, 604 Seas oeKra aHopkins, HEarr 8, 6 84, 3International Aeroplane Co

Limb-state information encoded by peripheral and central somatosensory neurons: Implications for an afferent interface

PubMed Central

Weber, Douglas J.; London, Brian M.; Hokanson, James A.; Ayers, Christopher A.; Gaunt, Robert A.; Torres, Ricardo R.; Zaaimi, Boubker; Miller, Lee E.

2013-01-01

A major issue to be addressed in the development of neural interfaces for prosthetic control is the need for somatosensory feedback. Here, we investigate two possible strategies: electrical stimulation of either dorsal root ganglia (DRG) or primary somatosensory cortex (S1). In each approach, we must determine a model that reflects the representation of limb state in terms of neural discharge. This model can then be used to design stimuli that artificially activate the nervous system to convey information about limb state to the subject. Electrically activating DRG neurons using naturalistic stimulus patterns, modeled on recordings made during passive limb movement, evoked activity in S1 that was similar to that of the original movement. We also found that S1 neural populations could accurately discriminate different patterns of DRG stimulation across a wide range of stimulus pulse-rates. In studying the neural coding of limb-state in S1, we also decoded the kinematics of active limb movement using multi-electrode recordings in the monkey. Neurons having both proprioceptive and cutaneous receptive fields contributed equally to this decoding. Some neurons were most informative of limb state in the recent past, but many others appeared to signal upcoming movements suggesting that they also were modulated by an efference copy signal. Finally, we show that a monkey was able to detect stimulation through a large percentage of electrodes implanted in area 2. We discuss the design of appropriate stimulus paradigms for conveying time-varying limb state information, and the relative merits and limitations of central and peripheral approaches. PMID:21878419

Walking like dinosaurs: chickens with artificial tails provide clues about non-avian theropod locomotion.

PubMed

Grossi, Bruno; Iriarte-Díaz, José; Larach, Omar; Canals, Mauricio; Vásquez, Rodrigo A

2014-01-01

Birds still share many traits with their dinosaur ancestors, making them the best living group to reconstruct certain aspects of non-avian theropod biology. Bipedal, digitigrade locomotion and parasagittal hindlimb movement are some of those inherited traits. Living birds, however, maintain an unusually crouched hindlimb posture and locomotion powered by knee flexion, in contrast to the inferred primitive condition of non-avian theropods: more upright posture and limb movement powered by femur retraction. Such functional differences, which are associated with a gradual, anterior shift of the centre of mass in theropods along the bird line, make the use of extant birds to study non-avian theropod locomotion problematic. Here we show that, by experimentally manipulating the location of the centre of mass in living birds, it is possible to recreate limb posture and kinematics inferred for extinct bipedal dinosaurs. Chickens raised wearing artificial tails, and consequently with more posteriorly located centre of mass, showed a more vertical orientation of the femur during standing and increased femoral displacement during locomotion. Our results support the hypothesis that gradual changes in the location of the centre of mass resulted in more crouched hindlimb postures and a shift from hip-driven to knee-driven limb movements through theropod evolution. This study suggests that, through careful experimental manipulations during the growth phase of ontogeny, extant birds can potentially be used to gain important insights into previously unexplored aspects of bipedal non-avian theropod locomotion.

Walking Like Dinosaurs: Chickens with Artificial Tails Provide Clues about Non-Avian Theropod Locomotion

PubMed Central

Grossi, Bruno; Iriarte-Díaz, José; Larach, Omar; Canals, Mauricio; Vásquez, Rodrigo A.

2014-01-01

Birds still share many traits with their dinosaur ancestors, making them the best living group to reconstruct certain aspects of non-avian theropod biology. Bipedal, digitigrade locomotion and parasagittal hindlimb movement are some of those inherited traits. Living birds, however, maintain an unusually crouched hindlimb posture and locomotion powered by knee flexion, in contrast to the inferred primitive condition of non-avian theropods: more upright posture and limb movement powered by femur retraction. Such functional differences, which are associated with a gradual, anterior shift of the centre of mass in theropods along the bird line, make the use of extant birds to study non-avian theropod locomotion problematic. Here we show that, by experimentally manipulating the location of the centre of mass in living birds, it is possible to recreate limb posture and kinematics inferred for extinct bipedal dinosaurs. Chickens raised wearing artificial tails, and consequently with more posteriorly located centre of mass, showed a more vertical orientation of the femur during standing and increased femoral displacement during locomotion. Our results support the hypothesis that gradual changes in the location of the centre of mass resulted in more crouched hindlimb postures and a shift from hip-driven to knee-driven limb movements through theropod evolution. This study suggests that, through careful experimental manipulations during the growth phase of ontogeny, extant birds can potentially be used to gain important insights into previously unexplored aspects of bipedal non-avian theropod locomotion. PMID:24505491

Upper Extremity Artificial Limb Control as an Issue Related to Movement and Mobility in Daily Living

ERIC Educational Resources Information Center

Wallace, Steve; Anderson, David I.; Trujillo, Michael; Weeks, Douglas L.

2005-01-01

The 1992 NIH Research Planning Conference on Prosthetic and Orthotic Research for the 21st Century (Childress, 1992) recognized that the field of prosthetics lacks theoretical understanding and empirical studies on learning to control an upper-extremity prosthesis. We have addressed this problem using a novel approach in which persons without…

The importance of aerodynamics for prosthetic limb design used by competitive cyclists with an amputation: An introduction.

PubMed

Dyer, Bryce

2015-06-01

This study introduces the importance of the aerodynamics to prosthetic limb design for athletes with either a lower-limb or upper-limb amputation. The study comprises two elements: 1) An initial experiment investigating the stability of outdoor velodrome-based field tests, and 2) An experiment evaluating the application of outdoor velodrome aerodynamic field tests to detect small-scale changes in aerodynamic drag respective of prosthetic limb componentry changes. An outdoor field-testing method is used to detect small and repeatable changes in the aerodynamic drag of an able-bodied cyclist. These changes were made at levels typical of alterations in prosthetic componentry. The field-based test method of assessment is used at a smaller level of resolution than previously reported. With a carefully applied protocol, the field test method proved to be statistically stable. The results of the field test experiments demonstrate a noticeable change in overall athlete performance. Aerodynamic refinement of artificial limbs is worthwhile for athletes looking to maximise their competitive performance. A field-testing method illustrates the importance of the aerodynamic optimisation of prosthetic limb components. The field-testing protocol undertaken in this study gives an accessible and affordable means of doing so by prosthetists and sports engineers. Using simple and accessible field-testing methods, this exploratory experiment demonstrates how small changes to riders' equipment, consummate of the scale of a small change in prosthetics componentry, can affect the performance of an athlete. Prosthetists should consider such opportunities for performance enhancement when possible. © The International Society for Prosthetics and Orthotics 2014.

Static and dynamic pressure prediction for prosthetic socket fitting assessment utilising an inverse problem approach.

PubMed

Sewell, Philip; Noroozi, Siamak; Vinney, John; Amali, Ramin; Andrews, Stephen

2012-01-01

It has been recognised in a review of the developments of lower-limb prosthetic socket fitting processes that the future demands new tools to aid in socket fitting. This paper presents the results of research to design and clinically test an artificial intelligence approach, specifically inverse problem analysis, for the determination of the pressures at the limb/prosthetic socket interface during stance and ambulation. Inverse problem analysis is based on accurately calculating the external loads or boundary conditions that can generate a known amount of strain, stresses or displacements at pre-determined locations on a structure. In this study a backpropagation artificial neural network (ANN) is designed and validated to predict the interfacial pressures at the residual limb/socket interface from strain data collected from the socket surface. The subject of this investigation was a 45-year-old male unilateral trans-tibial (below-knee) traumatic amputee who had been using a prosthesis for 22 years. When comparing the ANN predicted interfacial pressure on 16 patches within the socket with actual pressures applied to the socket there is shown to be 8.7% difference, validating the methodology. Investigation of varying axial load through the subject's prosthesis, alignment of the subject's prosthesis, and pressure at the limb/socket interface during walking demonstrates that the validated ANN is able to give an accurate full-field study of the static and dynamic interfacial pressure distribution. To conclude, a methodology has been developed that enables a prosthetist to quantitatively analyse the distribution of pressures within the prosthetic socket in a clinical environment. This will aid in facilitating the "right first time" approach to socket fitting which will benefit both the patient in terms of comfort and the prosthetist, by reducing the time and associated costs of providing a high level of socket fit. Copyright © 2011 Elsevier B.V. All rights reserved.

Biotic - Abiotic Interface Between they Body and the Artificial Limb

DTIC Science & Technology

2008-09-29

transcutaneous amputation prosthesis ; machining; osseointegration; polycaprolactone; surface roughness; tensile strength; tissue adhesion; tissue...centrifuge at 2000 rpm for 5 minutes to remove air bubbles. This solution was then used for scaffold printing. Printing PCL Scaffolds The syringe was...Instron Corp., Norwood, Massachusetts) was used to test breaking strength. Briefly, the skin and underlying disc was removed en-block measuring

Sensory motor systems of artificial and natural hands.

PubMed

Chappell, Paul H; Cranny, Andy; Cotton, Darryl P J; White, Neil M; Beeby, Steve P

2007-12-01

The surgeon Ambroise Paré designed an anthropomorphic hand for wounded soldiers in the 16th century. Since that time, there have been advances in technology through the use of computer-aided design, modern materials, electronic controllers and sensors to realise artificial hands which have good functionality and reliability. Data from touch, object slip, finger position and temperature sensors, mounted in the fingers and on the palm, can be used in feedback loops to automatically hold objects. A study of the natural neuromuscular systems reveals a complexity which can only in part be realised today with technology. Highlights of the parallels and differences between natural and artificial hands are discussed with reference to the Southampton Hand. The anatomical structure of parts of the natural systems can be made artificially such as the antagonist muscles using tendons. Theses solutions look promising as they are based on the natural form but in practice lack the desired physical specification. However, concepts of the lower spinal loops can be mimicked in principle. Some future devices will require greater skills from the surgeon to create the interface between the natural system and an artificial device. Such developments may offer a more natural control with ease of use for the limb deficient person.

Referral of sensation to an advanced humanoid robotic hand prosthesis.

PubMed

Rosén, Birgitta; Ehrsson, H Henrik; Antfolk, Christian; Cipriani, Christian; Sebelius, Fredrik; Lundborg, Göran

2009-01-01

Hand prostheses that are currently available on the market are used by amputees to only a limited extent, partly because of lack of sensory feedback from the artificial hand. We report a pilot study that showed how amputees can experience a robot-like advanced hand prosthesis as part of their own body. We induced a perceptual illusion by which touch applied to the stump of the arm was experienced from the artificial hand. This illusion was elicited by applying synchronous tactile stimulation to the hidden amputation stump and the robotic hand prosthesis in full view. In five people who had had upper limb amputations this stimulation caused referral touch sensation from the stump to the artificial hand, and the prosthesis was experienced more like a real hand. We also showed that this illusion can work when the amputee controls the movements of the artificial hand by recordings of the arm muscle activity with electromyograms. These observations indicate that the previously described "rubber hand illusion" is also valid for an advanced hand prosthesis, even when it has a robotic-like appearance.

Toward a whole-body neuroprosthetic.

PubMed

Lebedev, Mikhail A; Nicolelis, Miguel A L

2011-01-01

Brain-machine interfaces (BMIs) hold promise for the restoration of body mobility in patients suffering from devastating motor deficits caused by brain injury, neurological diseases, and limb loss. Considerable progress has been achieved in BMIs that enact arm movements, and initial work has been done on BMIs for lower limb and trunk control. These developments put Duke University Center for Neuroengineering in the position to develop the first BMI for whole-body control. This whole-body BMI will incorporate very large-scale brain recordings, advanced decoding algorithms, artificial sensory feedback based on electrical stimulation of somatosensory areas, virtual environment representations, and a whole-body exoskeleton. This system will be first tested in nonhuman primates and then transferred to clinical trials in humans. Copyright © 2011 Elsevier B.V. All rights reserved.

Incorrect electrode cable connection during electrocardiographic recording.

PubMed

Batchvarov, Velislav N; Malik, Marek; Camm, A John

2007-11-01

Incorrect electrode cable connections during electrocardiographic (ECG) recording can simulate rhythm or conduction disturbance, myocardial ischaemia and infarction, as well as other clinically important abnormalities. When only precordial or only limb cables, excluding the neutral cable, have been interchanged the waveforms in the different leads are re-arranged, inverted, or unchanged, whereas the duration of intervals is not changed. The mistake can be recognized by the presence of unusual P-QRS patterns (e.g. negative P-QRS in lead I or II, positive in lead AVR, P-QRS complexes of opposite direction in leads I and V6, etc.), change in the P-QRS axis, or abnormal precordial QRS-T wave progression. Interchange of limb cables with the neutral cable distorts Wilson's terminal and the morphology of all precordial and unipolar limb leads. The telltale sign of the mistake is the presence of (almost) a flat line in lead I, II or III. Interchange of even one of the limb cables, except for the neutral cable, with a precordial cable distorts the morphology of most leads and leaves not more than one lead (I, II, or III) unchanged. Computerized algorithms for detection of lead misplacement, such as those based on artificial neural networks, or on correlation between original and reconstructed leads, have been developed.

EMG-Based Estimation of Limb Movement Using Deep Learning With Recurrent Convolutional Neural Networks.

PubMed

Xia, Peng; Hu, Jie; Peng, Yinghong

2017-10-25

A novel model based on deep learning is proposed to estimate kinematic information for myoelectric control from multi-channel electromyogram (EMG) signals. The neural information of limb movement is embedded in EMG signals that are influenced by all kinds of factors. In order to overcome the negative effects of variability in signals, the proposed model employs the deep architecture combining convolutional neural networks (CNNs) and recurrent neural networks (RNNs). The EMG signals are transformed to time-frequency frames as the input to the model. The limb movement is estimated by the model that is trained with the gradient descent and backpropagation procedure. We tested the model for simultaneous and proportional estimation of limb movement in eight healthy subjects and compared it with support vector regression (SVR) and CNNs on the same data set. The experimental studies show that the proposed model has higher estimation accuracy and better robustness with respect to time. The combination of CNNs and RNNs can improve the model performance compared with using CNNs alone. The model of deep architecture is promising in EMG decoding and optimization of network structures can increase the accuracy and robustness. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Assimilation of virtual legs and perception of floor texture by complete paraplegic patients receiving artificial tactile feedback.

PubMed

Shokur, Solaiman; Gallo, Simone; Moioli, Renan C; Donati, Ana Rita C; Morya, Edgard; Bleuler, Hannes; Nicolelis, Miguel A L

2016-09-19

Spinal cord injuries disrupt bidirectional communication between the patient's brain and body. Here, we demonstrate a new approach for reproducing lower limb somatosensory feedback in paraplegics by remapping missing leg/foot tactile sensations onto the skin of patients' forearms. A portable haptic display was tested in eight patients in a setup where the lower limbs were simulated using immersive virtual reality (VR). For six out of eight patients, the haptic display induced the realistic illusion of walking on three different types of floor surfaces: beach sand, a paved street or grass. Additionally, patients experienced the movements of the virtual legs during the swing phase or the sensation of the foot rolling on the floor while walking. Relying solely on this tactile feedback, patients reported the position of the avatar leg during virtual walking. Crossmodal interference between vision of the virtual legs and tactile feedback revealed that patients assimilated the virtual lower limbs as if they were their own legs. We propose that the addition of tactile feedback to neuroprosthetic devices is essential to restore a full lower limb perceptual experience in spinal cord injury (SCI) patients, and will ultimately, lead to a higher rate of prosthetic acceptance/use and a better level of motor proficiency.

Assimilation of virtual legs and perception of floor texture by complete paraplegic patients receiving artificial tactile feedback

PubMed Central

Shokur, Solaiman; Gallo, Simone; Moioli, Renan C.; Donati, Ana Rita C.; Morya, Edgard; Bleuler, Hannes; Nicolelis, Miguel A.L.

2016-01-01

Spinal cord injuries disrupt bidirectional communication between the patient’s brain and body. Here, we demonstrate a new approach for reproducing lower limb somatosensory feedback in paraplegics by remapping missing leg/foot tactile sensations onto the skin of patients’ forearms. A portable haptic display was tested in eight patients in a setup where the lower limbs were simulated using immersive virtual reality (VR). For six out of eight patients, the haptic display induced the realistic illusion of walking on three different types of floor surfaces: beach sand, a paved street or grass. Additionally, patients experienced the movements of the virtual legs during the swing phase or the sensation of the foot rolling on the floor while walking. Relying solely on this tactile feedback, patients reported the position of the avatar leg during virtual walking. Crossmodal interference between vision of the virtual legs and tactile feedback revealed that patients assimilated the virtual lower limbs as if they were their own legs. We propose that the addition of tactile feedback to neuroprosthetic devices is essential to restore a full lower limb perceptual experience in spinal cord injury (SCI) patients, and will ultimately, lead to a higher rate of prosthetic acceptance/use and a better level of motor proficiency. PMID:27640345

Is it Finger or Wrist Dexterity That is Missing in Current Hand Prostheses?

PubMed

Montagnani, Federico; Controzzi, Marco; Cipriani, Christian

2015-07-01

Building prostheses with dexterous motor function equivalent to that of the human hand is one of the ambitious goals of bioengineers. State of art prostheses lack several degrees of freedom (DoF) and force the individuals to compensate for them by changing the motions of their arms and body. However, such compensatory movements often result in residual limb pain and overuse syndromes. Significant efforts were spent in designing artificial hands with multiple allowed grasps but little work has been done with regards to wrist design, regardless the fact that the wrist contributes significantly to the execution of upper limb motor tasks. We hypothesized that a single DoF hand with wrist flexion/extension allowed function comparable to a highly performant multi DoF hand without wrist flexion/extension. To assess this we compared four emulated architectures of hand-wrist prostheses using the Southampton Hand Assessment Procedure and evaluating the extent of compensatory movements with unimpaired subjects wearing ortheses. Our findings show indeed that shifting the dexterity from the hand to the wrist could preserve the ability of transradial amputees in performing common tasks with limited effect on the compensatory movements. Hence, this study invites rehabilitation engineers to focus on novel artificial wrist architectures.

Functional trade-offs in the limb bones of dogs selected for running versus fighting.

PubMed

Kemp, T J; Bachus, K N; Nairn, J A; Carrier, D R

2005-09-01

The physical demands of rapid and economical running differ from the demands of fighting in ways that may prevent the simultaneous evolution of optimal performance in these two behaviors. Here, we test an hypothesis of functional trade-off in limb bones by measuring mechanical properties of limb bones in two breeds of domestic dog (Canis lupus familiaris L.) that have undergone intense artificial selection for running (greyhound) and fighting (pit bull) performance. The bones were loaded to fracture in three-point static bending. To correct for the effect of shear, we estimated the shear stress in the cross section and added energy due to shear stress to the tensile energy. The proximal limb bones of the pit bulls differed from those of the greyhounds in having relatively larger second moments of area of mid-diaphyseal cross sections and in having more circular cross-sectional shape. The pit bulls exhibited lower stresses at yield, had lower elastic moduli and failed at much higher levels of work. The stiffness of the tissue of the humerus, radius, femur and tibia was 1.5-2.4-fold greater in the greyhounds than in the pit bulls. These bones from the pit bulls absorbed 1.9-2.6-fold more energy before failure than did those of the greyhounds. These differences between breeds were not observed in the long bones of the feet, metacarpals and metatarsals. Nevertheless, the results of this analysis suggest that selection for high-speed running is associated with the evolution of relatively stiff, brittle limb bones, whereas selection for fighting performance leads to the evolution of limb bones with relatively high resistance to failure.

Artificial Walking Technologies to Improve Gait in Cerebral Palsy: Multichannel Neuromuscular Stimulation.

PubMed

Rose, Jessica; Cahill-Rowley, Katelyn; Butler, Erin E

2017-11-01

Cerebral palsy (CP) is the most common childhood motor disability and often results in debilitating walking abnormalities, such as flexed-knee and stiff-knee gait. Current medical and surgical treatments are only partially effective in improving gait abnormalities and may cause significant muscle weakness. However, emerging artificial walking technologies, such as step-initiated, multichannel neuromuscular electrical stimulation (NMES), can substantially improve gait patterns and promote muscle strength in children with spastic CP. NMES may also be applied to specific lumbar-sacral sensory roots to reduce spasticity. Development of tablet computer-based multichannel NMES can leverage lightweight, wearable wireless stimulators, advanced control design, and surface electrodes to activate lower-limb muscles. Musculoskeletal models have been used to characterize muscle contributions to unimpaired gait and identify high muscle demands, which can help guide multichannel NMES-assisted gait protocols. In addition, patient-specific NMES-assisted gait protocols based on 3D gait analysis can facilitate the appropriate activation of lower-limb muscles to achieve a more functional gait: stance-phase hip and knee extension and swing-phase sequence of hip and knee flexion followed by rapid knee extension. NMES-assisted gait treatment can be conducted as either clinic-based or home-based programs. Rigorous testing of multichannel NMES-assisted gait training protocols will determine optimal treatment dosage for future clinical trials. Evidence-based outcome evaluation using 3D kinematics or temporal-spatial gait parameters will help determine immediate neuroprosthetic effects and longer term neurotherapeutic effects of step-initiated, multichannel NMES-assisted gait in children with spastic CP. Multichannel NMES is a promising assistive technology to help children with spastic CP achieve a more upright, functional gait. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Park, Byoung Yoon; Roberts, Barry L.

The three-dimensional finite element mesh capturing realistic geometries of Bayou Choctaw site has been constructed using the sonar and seismic survey data obtained from the field. The mesh is consisting of hexahedral elements because the salt constitutive model is coded using hexahedral elements. Various ideas and techniques to construct finite element mesh capturing artificially and naturally formed geometries are provided. The techniques to reduce the number of elements as much as possible to save on computer run time with maintaining the computational accuracy is also introduced. The steps and methodologies could be applied to construct the meshes of Big Hill,more » Bryan Mound, and West Hackberry strategic petroleum reserve sites. The methodology could be applied to the complicated shape masses for not only various civil and geological structures but also biological applications such as artificial limbs.« less

Melatonin Promotes Cheliped Regeneration, Digestive Enzyme Function, and Immunity Following Autotomy in the Chinese Mitten Crab, Eriocheir sinensis

PubMed Central

Zhang, Cong; Yang, Xiao-zhen; Xu, Min-jie; Huang, Gen-yong; Zhang, Qian; Cheng, Yong-xu; He, Long; Ren, Hong-yu

2018-01-01

In the pond culture of juvenile Eriocheir sinensis, a high limb-impairment rate seriously affects the culture success. Therefore, it is particularly important to artificially promote limb regeneration. This study evaluated the effects of melatonin on cheliped regeneration, digestive ability, and immunity, as well as its relationship with the eyestalk. It was found that the injection of melatonin significantly increased the limb regeneration rate compared with the saline group (P < 0.05). The qRT-PCR results of growth-related genes showed that the level of EcR-mRNA (ecdysteroid receptor) and Chi-mRNA (chitinase) expression was significantly increased following the melatonin injection, while the expression of MIH-mRNA (molt-inhibiting hormone) was significantly decreased (P < 0.05). Melatonin significantly increased lipase activity (P < 0.05). We observed that the survival rates of limb-impaired and unilateral eyestalk-ablated crabs were substantially improved following melatonin treatment, whereas the survival of the unilateral eyestalk-ablated crabs was significantly decreased compared with the control group (P < 0.05). Furthermore, the results of serum immune and antioxidant capacity revealed that melatonin significantly increased the total hemocyte counts (THC), hemocyanin content, total antioxidant capacity (T-AOC), acid phosphatase (ACP), and glutathione peroxidase activity (GSH-Px), whereas the immune-related parameters were significantly decreased in eyestalk-ablated crabs (P < 0.05). Therefore, these findings indicate that melatonin exerts a protective effect on organism injury, which could promote limb regeneration by up-regulating the expression of growth-related genes, improve digestive enzyme activity, and strengthen the immune response, particularly antioxidant capacity. PMID:29623051

A novel candidate gene for mouse and human preaxial polydactyly with altered expression in limbs of Hemimelic extra-toes mutant mice.

PubMed

Clark, R M; Marker, P C; Kingsley, D M

2000-07-01

Polydactyly is a common malformation of vertebrate limbs. In humans a major locus for nonsyndromic pre-axial polydactyly (PPD) has been mapped previously to 7q36. The mouse Hemimelic extra-toes (Hx) mutation maps to a homologous chromosome segment and has been proposed to affect a homologous gene. To understand the molecular changes underlying PPD, we used a positional cloning approach to identify the gene or genes disrupted by the Hx mutation and a closely linked limb mutation, Hammertoe (Hm). High resolution genetic mapping identified a small candidate interval for the mouse mutations located 1.2 cM distal to the Shh locus. The nonrecombinant interval was completely cloned in bacterial artificial chromosomes and searched for genes using a combination of exon trapping, sample sequencing, and mapping of known genes. Two novel genes, Lmbr1 and Lmbr2, are entirely within the candidate interval we defined genetically. The open reading frame of both genes is intact in mutant mice, but the expression of the Lmbr1 gene is dramatically altered in developing limbs of Hx mutant mice. The correspondence between the spatial and temporal changes in Lmbr1 expression and the embryonic onset of the Hx mutant phenotype suggests that the mouse Hx mutation may be a regulatory allele of Lmbr1. The human ortholog of Lmbr1 maps within the recently described interval for human PPD, strengthening the possibility that both mouse and human limb abnormalities are due to defects in the same highly conserved gene.

Prosthetic limb sockets from plant-based composite materials.

PubMed

Campbell, Andrew I; Sexton, Sandra; Schaschke, Carl J; Kinsman, Harry; McLaughlin, Brian; Boyle, Martin

2012-06-01

There is a considerable demand for lower limb prostheses globally due to vascular disease, war, conflict, land mines and natural disasters. Conventional composite materials used for prosthetic limb sockets include acrylic resins, glass and carbon fibres, which produce harmful gasses and dust in their manufacture. To investigate the feasibility of using a renewable plant oil-based polycarbonate-polyurethane copolymer resin and plant fibre composite, instead of conventional materials, to improve safety and accessibility of prosthetic limb manufacture. Experimental, bench research. Test pieces of the resin with a range of plant fibres (10.0% by volume) were prepared and tensile strengths were tested. Test sockets of both conventional composite materials and plant resin with plant fibres were constructed and tested to destruction. Combinations of plant resin and either banana or ramie fibres gave high tensile strengths. The conventional composite material socket and plant resin with ramie composite socket failed at a similar loading, exceeding the ISO 10328 standard. Both wall thickness and fibre-matrix adhesion played a significant role in socket strength. From this limited study we conclude that the plant resin and ramie fibre composite socket has the potential to replace the standard layup. Further mechanical and biocompatibility testing as well as a full economic analysis is required. Using readily sourced and renewable natural fibres and a low-volatile bio-resin has potential to reduce harm to those involved in the manufacture of artificial limb sockets, without compromising socket strength and benefitting clinicians working in poorer countries where safety equipment is scarce. Such composite materials will reduce environmental impact.

Paré and prosthetics: the early history of artificial limbs.

PubMed

Thurston, Alan J

2007-12-01

There is evidence for the use of prostheses from the times of the ancient Egyptians. Prostheses were developed for function, cosmetic appearance and a psycho-spiritual sense of wholeness. Amputation was often feared more than death in some cultures. It was believed that it not only affected the amputee on earth, but also in the afterlife. The ablated limbs were buried and then disinterred and reburied at the time of the amputee's death so the amputee could be whole for eternal life. One of the earliest examples comes from the 18th dynasty of ancient Egypt in the reign of Amenhotep II in the fifteenth century bc. A mummy in the Cairo Museum has clearly had the great toe of the right foot amputated and replaced with a prosthesis manufactured from leather and wood. The first true rehabilitation aids that could be recognized as prostheses were made during the civilizations of Greece and Rome. During the Dark Ages prostheses for battle and hiding deformity were heavy, crude devices made of available materials - wood, metal and leather. Such were the materials available to Ambroise Paré who invented both upper-limb and lower-limb prostheses. His 'Le Petit Lorrain', a mechanical hand operated by catches and springs, was worn by a French Army captain in battle. Subsequent refinements in medicine, surgery and prosthetic science greatly improved amputation surgery and the function of prostheses. What began as a modified crutch with a wooden or leather cup and progressed through many metamorphoses has now developed into a highly sophisticated prosthetic limb made of space-age materials.

Cataracts and strabismus associated with hand rearing using artificial milk formulas in Bengal tiger (Panthera tigris spp tigris) cubs

PubMed Central

Lange, Rogério Ribas; Lima, Leandro; Frühvald, Erika; da Silva, Vera Sônia Nunes; de Souza, Aparecida Sônia; Montiani-Ferreira, Fabiano

2017-01-01

The aim of this investigation is to describe the potential contributing nutritional factors involved in the development of ophthalmic and dermatologic changes in four Bengal tiger (Panthera tigris spp tigris) cubs fed an artificial milk formula. The affected animals were compared with two other tiger cubs that had been nursed by their dam naturally. After the first clinical signs appeared, the tiger cubs underwent ophthalmic evaluation. Severe symmetric generalized alopecia over the trunk, sparing the head and distal portion of the front and rear limbs, bilateral cataracts and strabismus were noticed. Milk and blood from the mother, as well as blood from the healthy and affected cubs were collected in order to evaluate complete blood counts, serum chemistry values, and amino acid levels. The amino acid concentrations in the artificial formula were also evaluated for comparison to the milk from the dam. The concentration of taurine, arginine, phenylalanine, tryptophan and histidine were very low in the artificial formulas as compared to the dam´s milk. The tiger cubs that received the artificial formula had lower levels of the amino acids listed previously as compared to those that nursed from the dam naturally. Taurine, as well as arginine, phenylalanine, tryptophan and histidine deficiency appeared to be possible causes of the development of skin problems, cataracts and strabismus in the tiger cubs fed with these particular artificial milk replacers. In the future, special attention should be given in order to make sure that adequate levels of these amino acids are present in artificial milk for tiger cubs. PMID:28210544

Decoding Lower Limb Muscle Activity and Kinematics from Cortical Neural Spike Trains during Monkey Performing Stand and Squat Movements

PubMed Central

Ma, Xuan; Ma, Chaolin; Huang, Jian; Zhang, Peng; Xu, Jiang; He, Jiping

2017-01-01

Extensive literatures have shown approaches for decoding upper limb kinematics or muscle activity using multichannel cortical spike recordings toward brain machine interface (BMI) applications. However, similar topics regarding lower limb remain relatively scarce. We previously reported a system for training monkeys to perform visually guided stand and squat tasks. The current study, as a follow-up extension, investigates whether lower limb kinematics and muscle activity characterized by electromyography (EMG) signals during monkey performing stand/squat movements can be accurately decoded from neural spike trains in primary motor cortex (M1). Two monkeys were used in this study. Subdermal intramuscular EMG electrodes were implanted to 8 right leg/thigh muscles. With ample data collected from neurons from a large brain area, we performed a spike triggered average (SpTA) analysis and got a series of density contours which revealed the spatial distributions of different muscle-innervating neurons corresponding to each given muscle. Based on the guidance of these results, we identified the locations optimal for chronic electrode implantation and subsequently carried on chronic neural data recordings. A recursive Bayesian estimation framework was proposed for decoding EMG signals together with kinematics from M1 spike trains. Two specific algorithms were implemented: a standard Kalman filter and an unscented Kalman filter. For the latter one, an artificial neural network was incorporated to deal with the nonlinearity in neural tuning. High correlation coefficient and signal to noise ratio between the predicted and the actual data were achieved for both EMG signals and kinematics on both monkeys. Higher decoding accuracy and faster convergence rate could be achieved with the unscented Kalman filter. These results demonstrate that lower limb EMG signals and kinematics during monkey stand/squat can be accurately decoded from a group of M1 neurons with the proposed algorithms. Our findings provide new insights for extending current BMI design concepts and techniques on upper limbs to lower limb circumstances. Brain controlled exoskeleton, prostheses or neuromuscular electrical stimulators for lower limbs are expected to be developed, which enables the subject to manipulate complex biomechatronic devices with mind in more harmonized manner. PMID:28223914

Artificial grasping system for the paralyzed hand.

PubMed

Ferrari de Castro, M C; Cliquet, A

2000-03-01

Neuromuscular electrical stimulation has been used in upper limb rehabilitation towards restoring motor hand function. In this work, an 8 channel microcomputer controlled stimulator with monophasic square voltage output was used. Muscle activation sequences were defined to perform palmar and lateral prehension and power grip (index finger extension type). The sequences used allowed subjects to demonstrate their ability to hold and release objects that are encountered in daily living, permitting activities such as drinking, eating, writing, and typing.

Functional Performance Evaluation of the Northwestern University Flexible Subischial Vacuum (NU-FlexSIV) Socket for Persons with Transfemoral Amputation

DTIC Science & Technology

2016-10-01

satisfaction with device’’ (i.e. prosthesis) than the IC Socket. During year 1, we received all required IRB approvals, registered the clinical... satisfaction with device” (i.e. prosthesis) than the IC Socket. 2. KEYWORDS: Prosthetic Socket, Artificial Limbs, Prosthesis, Transfemoral Amputee, Gait...FlexSIV Socket will result in better quality of life and “ satisfaction with device” (i.e. prosthesis) than the IC socket. Accomplishments under

Artificial redirection of sensation from prosthetic fingers to the phantom hand map on transradial amputees: vibrotactile versus mechanotactile sensory feedback.

PubMed

Antfolk, Christian; D'Alonzo, Marco; Controzzi, Marco; Lundborg, Göran; Rosén, Birgitta; Sebelius, Fredrik; Cipriani, Christian

2013-01-01

This work assesses the ability of transradial amputees to discriminate multi-site tactile stimuli in sensory discrimination tasks. It compares different sensory feedback modalities using an artificial hand prosthesis in: 1) a modality matched paradigm where pressure recorded on the five fingertips of the hand was fed back as pressure stimulation on five target points on the residual limb; and 2) a modality mismatched paradigm where the pressures were transformed into mechanical vibrations and fed back. Eight transradial amputees took part in the study and were divided in two groups based on the integrity of their phantom map; group A had a complete phantom map on the residual limb whereas group B had an incomplete or nonexisting map. The ability in localizing stimuli was compared with that of 10 healthy subjects using the vibration feedback and 11 healthy subjects using the pressure feedback (in a previous study), on their forearms, in similar experiments. Results demonstrate that pressure stimulation surpassed vibrotactile stimulation in multi-site sensory feedback discrimination. Furthermore, we demonstrate that subjects with a detailed phantom map had the best discrimination performance and even surpassed healthy participants for both feedback paradigms whereas group B had the worst performance overall. Finally, we show that placement of feedback devices on a complete phantom map improves multi-site sensory feedback discrimination, independently of the feedback modality.

Embedded System for Prosthetic Control Using Implanted Neuromuscular Interfaces Accessed Via an Osseointegrated Implant.

PubMed

Mastinu, Enzo; Doguet, Pascal; Botquin, Yohan; Hakansson, Bo; Ortiz-Catalan, Max

2017-08-01

Despite the technological progress in robotics achieved in the last decades, prosthetic limbs still lack functionality, reliability, and comfort. Recently, an implanted neuromusculoskeletal interface built upon osseointegration was developed and tested in humans, namely the Osseointegrated Human-Machine Gateway. Here, we present an embedded system to exploit the advantages of this technology. Our artificial limb controller allows for bioelectric signals acquisition, processing, decoding of motor intent, prosthetic control, and sensory feedback. It includes a neurostimulator to provide direct neural feedback based on sensory information. The system was validated using real-time tasks characterization, power consumption evaluation, and myoelectric pattern recognition performance. Functionality was proven in a first pilot patient from whom results of daily usage were obtained. The system was designed to be reliably used in activities of daily living, as well as a research platform to monitor prosthesis usage and training, machine-learning-based control algorithms, and neural stimulation paradigms.

Acute organophosphorus poisoning complicated by acute coronary syndrome.

PubMed

Pankaj, Madhu; Krishna, Kavita

2014-07-01

We report a case of 30 year old alcoholic male admitted with vomiting, drowsiness, limb weakness and fasciculations after alleged history of consumption of 30 ml of chlorpyriphos insecticide. He had low serum cholinesterase levels. With standard treatment for organophosphorus poisoning (OPP), he improved gradually until day 5, when he developed neck and limb weakness and respiratory distress. This intermediate syndrome was treated with oximes, atropine and artificial ventilation. During treatment, his ECG showed fresh changes of ST elevation. High CPK & CPK-MB levels, septal hypokinesia on 2D echo suggested acute coronary syndrome. Coronary angiography was postponed due to his bedridden and obtunded status. The patient finally recovered fully by day 15 and was discharged. Acute coronary syndrome is a rare occurrence in OP poisoning. The present case thus emphasises the need for careful electrocardiographic and enzymatic monitoring of all patients of organophosphorus poisoning to prevent potential cardiac complication which can prove fatal.

Osseocutaneous integration of an intraosseous transcutaneous amputation prosthesis implant used for reconstruction of a transhumeral amputee: case report.

PubMed

Kang, Norbert V; Pendegrass, Catherine; Marks, Linda; Blunn, Gordon

2010-07-01

Exoprosthetic replacement with an artificial limb is the main option for reconstruction after traumatic amputation of an upper limb. Direct skeletal attachment using an osseointegrated implant improves the ease of fixation of the exoprosthesis to the amputation stump. We now report the use of an intraosseous transcutaneous amputation prosthesis that is designed to achieve osseocutaneous integration. Osseocutaneous integration differs from osseointegration because the aim is to create a stable interface among the implant, the bone, and the soft tissues. This reduces the risk of soft tissue infection and troublesome discharge, which are problems encountered with current osseointegrated implants that focus largely on the bone-implant interface. We describe our experience with an intraosseous transcutaneous amputation prosthesis in a case of transhumeral amputation with 2 years of follow-up. Copyright 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Online human training of a myoelectric prosthesis controller via actor-critic reinforcement learning.

PubMed

Pilarski, Patrick M; Dawson, Michael R; Degris, Thomas; Fahimi, Farbod; Carey, Jason P; Sutton, Richard S

2011-01-01

As a contribution toward the goal of adaptable, intelligent artificial limbs, this work introduces a continuous actor-critic reinforcement learning method for optimizing the control of multi-function myoelectric devices. Using a simulated upper-arm robotic prosthesis, we demonstrate how it is possible to derive successful limb controllers from myoelectric data using only a sparse human-delivered training signal, without requiring detailed knowledge about the task domain. This reinforcement-based machine learning framework is well suited for use by both patients and clinical staff, and may be easily adapted to different application domains and the needs of individual amputees. To our knowledge, this is the first my-oelectric control approach that facilitates the online learning of new amputee-specific motions based only on a one-dimensional (scalar) feedback signal provided by the user of the prosthesis. © 2011 IEEE

[Surface electromyography signal classification using gray system theory].

PubMed

Xie, Hongbo; Ma, Congbin; Wang, Zhizhong; Huang, Hai

2004-12-01

A new method based on gray correlation was introduced to improve the identification rate in artificial limb. The electromyography (EMG) signal was first transformed into time-frequency domain by wavelet transform. Singular value decomposition (SVD) was then used to extract feature vector from the wavelet coefficient for pattern recognition. The decision was made according to the maximum gray correlation coefficient. Compared with neural network recognition, this robust method has an almost equivalent recognition rate but much lower computation costs and less training samples.

System integration of pattern recognition, adaptive aided, upper limb prostheses

NASA Technical Reports Server (NTRS)

Lyman, J.; Freedy, A.; Solomonow, M.

1975-01-01

The requirements for successful integration of a computer aided control system for multi degree of freedom artificial arms are discussed. Specifications are established for a system which shares control between a human amputee and an automatic control subsystem. The approach integrates the following subsystems: (1) myoelectric pattern recognition, (2) adaptive computer aiding; (3) local reflex control; (4) prosthetic sensory feedback; and (5) externally energized arm with the functions of prehension, wrist rotation, elbow extension and flexion and humeral rotation.

New control strategies for neuroprosthetic systems.

PubMed

Crago, P E; Lan, N; Veltink, P H; Abbas, J J; Kantor, C

1996-04-01

The availability of techniques to artificially excite paralyzed muscles opens enormous potential for restoring both upper and lower extremity movements with neuroprostheses. Neuroprostheses must stimulate muscle, and control and regulate the artificial movements produced. Control methods to accomplish these tasks include feedforward (open-loop), feedback, and adaptive control. Feedforward control requires a great deal of information about the biomechanical behavior of the limb. For the upper extremity, an artificial motor program was developed to provide such movement program input to a neuroprosthesis. In lower extremity control, one group achieved their best results by attempting to meet naturally perceived gait objectives rather than to follow an exact joint angle trajectory. Adaptive feedforward control, as implemented in the cycle-to-cycle controller, gave good compensation for the gradual decrease in performance observed with open-loop control. A neural network controller was able to control its system to customize stimulation parameters in order to generate a desired output trajectory in a given individual and to maintain tracking performance in the presence of muscle fatigue. The authors believe that practical FNS control systems must exhibit many of these features of neurophysiological systems.

Three-Dimensional Human iPSC-Derived Artificial Skeletal Muscles Model Muscular Dystrophies and Enable Multilineage Tissue Engineering.

PubMed

Maffioletti, Sara Martina; Sarcar, Shilpita; Henderson, Alexander B H; Mannhardt, Ingra; Pinton, Luca; Moyle, Louise Anne; Steele-Stallard, Heather; Cappellari, Ornella; Wells, Kim E; Ferrari, Giulia; Mitchell, Jamie S; Tyzack, Giulia E; Kotiadis, Vassilios N; Khedr, Moustafa; Ragazzi, Martina; Wang, Weixin; Duchen, Michael R; Patani, Rickie; Zammit, Peter S; Wells, Dominic J; Eschenhagen, Thomas; Tedesco, Francesco Saverio

2018-04-17

Generating human skeletal muscle models is instrumental for investigating muscle pathology and therapy. Here, we report the generation of three-dimensional (3D) artificial skeletal muscle tissue from human pluripotent stem cells, including induced pluripotent stem cells (iPSCs) from patients with Duchenne, limb-girdle, and congenital muscular dystrophies. 3D skeletal myogenic differentiation of pluripotent cells was induced within hydrogels under tension to provide myofiber alignment. Artificial muscles recapitulated characteristics of human skeletal muscle tissue and could be implanted into immunodeficient mice. Pathological cellular hallmarks of incurable forms of severe muscular dystrophy could be modeled with high fidelity using this 3D platform. Finally, we show generation of fully human iPSC-derived, complex, multilineage muscle models containing key isogenic cellular constituents of skeletal muscle, including vascular endothelial cells, pericytes, and motor neurons. These results lay the foundation for a human skeletal muscle organoid-like platform for disease modeling, regenerative medicine, and therapy development. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

Active tactile exploration using a brain-machine-brain interface.

PubMed

O'Doherty, Joseph E; Lebedev, Mikhail A; Ifft, Peter J; Zhuang, Katie Z; Shokur, Solaiman; Bleuler, Hannes; Nicolelis, Miguel A L

2011-10-05

Brain-machine interfaces use neuronal activity recorded from the brain to establish direct communication with external actuators, such as prosthetic arms. It is hoped that brain-machine interfaces can be used to restore the normal sensorimotor functions of the limbs, but so far they have lacked tactile sensation. Here we report the operation of a brain-machine-brain interface (BMBI) that both controls the exploratory reaching movements of an actuator and allows signalling of artificial tactile feedback through intracortical microstimulation (ICMS) of the primary somatosensory cortex. Monkeys performed an active exploration task in which an actuator (a computer cursor or a virtual-reality arm) was moved using a BMBI that derived motor commands from neuronal ensemble activity recorded in the primary motor cortex. ICMS feedback occurred whenever the actuator touched virtual objects. Temporal patterns of ICMS encoded the artificial tactile properties of each object. Neuronal recordings and ICMS epochs were temporally multiplexed to avoid interference. Two monkeys operated this BMBI to search for and distinguish one of three visually identical objects, using the virtual-reality arm to identify the unique artificial texture associated with each. These results suggest that clinical motor neuroprostheses might benefit from the addition of ICMS feedback to generate artificial somatic perceptions associated with mechanical, robotic or even virtual prostheses.

Neuro-fuzzy decoding of sensory information from ensembles of simultaneously recorded dorsal root ganglion neurons for functional electrical stimulation applications

NASA Astrophysics Data System (ADS)

Rigosa, J.; Weber, D. J.; Prochazka, A.; Stein, R. B.; Micera, S.

2011-08-01

Functional electrical stimulation (FES) is used to improve motor function after injury to the central nervous system. Some FES systems use artificial sensors to switch between finite control states. To optimize FES control of the complex behavior of the musculo-skeletal system in activities of daily life, it is highly desirable to implement feedback control. In theory, sensory neural signals could provide the required control signals. Recent studies have demonstrated the feasibility of deriving limb-state estimates from the firing rates of primary afferent neurons recorded in dorsal root ganglia (DRG). These studies used multiple linear regression (MLR) methods to generate estimates of limb position and velocity based on a weighted sum of firing rates in an ensemble of simultaneously recorded DRG neurons. The aim of this study was to test whether the use of a neuro-fuzzy (NF) algorithm (the generalized dynamic fuzzy neural networks (GD-FNN)) could improve the performance, robustness and ability to generalize from training to test sets compared to the MLR technique. NF and MLR decoding methods were applied to ensemble DRG recordings obtained during passive and active limb movements in anesthetized and freely moving cats. The GD-FNN model provided more accurate estimates of limb state and generalized better to novel movement patterns. Future efforts will focus on implementing these neural recording and decoding methods in real time to provide closed-loop control of FES using the information extracted from sensory neurons.

Engineering platform and experimental protocol for design and evaluation of a neurally-controlled powered transfemoral prosthesis.

PubMed

Zhang, Fan; Liu, Ming; Harper, Stephen; Lee, Michael; Huang, He

2014-07-22

To enable intuitive operation of powered artificial legs, an interface between user and prosthesis that can recognize the user's movement intent is desired. A novel neural-machine interface (NMI) based on neuromuscular-mechanical fusion developed in our previous study has demonstrated a great potential to accurately identify the intended movement of transfemoral amputees. However, this interface has not yet been integrated with a powered prosthetic leg for true neural control. This study aimed to report (1) a flexible platform to implement and optimize neural control of powered lower limb prosthesis and (2) an experimental setup and protocol to evaluate neural prosthesis control on patients with lower limb amputations. First a platform based on a PC and a visual programming environment were developed to implement the prosthesis control algorithms, including NMI training algorithm, NMI online testing algorithm, and intrinsic control algorithm. To demonstrate the function of this platform, in this study the NMI based on neuromuscular-mechanical fusion was hierarchically integrated with intrinsic control of a prototypical transfemoral prosthesis. One patient with a unilateral transfemoral amputation was recruited to evaluate our implemented neural controller when performing activities, such as standing, level-ground walking, ramp ascent, and ramp descent continuously in the laboratory. A novel experimental setup and protocol were developed in order to test the new prosthesis control safely and efficiently. The presented proof-of-concept platform and experimental setup and protocol could aid the future development and application of neurally-controlled powered artificial legs.

Characterisation of dynamic couplings at lower limb residuum/socket interface using 3D motion capture.

PubMed

Tang, Jinghua; McGrath, Michael; Laszczak, Piotr; Jiang, Liudi; Bader, Dan L; Moser, David; Zahedi, Saeed

2015-12-01

Design and fitting of artificial limbs to lower limb amputees are largely based on the subjective judgement of the prosthetist. Understanding the science of three-dimensional (3D) dynamic coupling at the residuum/socket interface could potentially aid the design and fitting of the socket. A new method has been developed to characterise the 3D dynamic coupling at the residuum/socket interface using 3D motion capture based on a single case study of a trans-femoral amputee. The new model incorporated a Virtual Residuum Segment (VRS) and a Socket Segment (SS) which combined to form the residuum/socket interface. Angular and axial couplings between the two segments were subsequently determined. Results indicated a non-rigid angular coupling in excess of 10° in the quasi-sagittal plane and an axial coupling of between 21 and 35 mm. The corresponding angular couplings of less than 4° and 2° were estimated in the quasi-coronal and quasi-transverse plane, respectively. We propose that the combined experimental and analytical approach adopted in this case study could aid the iterative socket fitting process and could potentially lead to a new socket design. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

Virtual Instrumentation for a Fiber-Optics-Based Artificial Nerve

NASA Technical Reports Server (NTRS)

Lyons, Donald R.; Kyaw, Thet Mon; Griffin, DeVon (Technical Monitor)

2001-01-01

A LabView-based computer interface for fiber-optic artificial nerves has been devised as a Masters thesis project. This project involves the use of outputs from wavelength multiplexed optical fiber sensors (artificial nerves), which are capable of producing dense optical data outputs for physical measurements. The potential advantages of using optical fiber sensors for sensory function restoration is the fact that well defined WDM-modulated signals can be transmitted to and from the sensing region allowing networked units to replace low-level nerve functions for persons desirous of "intelligent artificial limbs." Various FO sensors can be designed with high sensitivity and the ability to be interfaced with a wide range of devices including miniature shielded electrical conversion units. Our Virtual Instrument (VI) interface software package was developed using LabView's "Laboratory Virtual Instrument Engineering Workbench" package. The virtual instrument has been configured to arrange and encode the data to develop an intelligent response in the form of encoded digitized signal outputs. The architectural layout of our nervous system is such that different touch stimuli from different artificial fiber-optic nerve points correspond to gratings of a distinct resonant wavelength and physical location along the optical fiber. Thus, when an automated, tunable diode laser sends scans, the wavelength spectrum of the artificial nerve, it triggers responses that are encoded with different touch stimuli by way wavelength shifts in the reflected Bragg resonances. The reflected light is detected and a resulting analog signal is fed into ADC1 board and DAQ card. Finally, the software has been written such that the experimenter is able to set the response range during data acquisition.

Self-Organizing Map With Time-Varying Structure to Plan and Control Artificial Locomotion.

PubMed

Araujo, Aluizio F R; Santana, Orivaldo V

2015-08-01

This paper presents an algorithm, self-organizing map-state trajectory generator (SOM-STG), to plan and control legged robot locomotion. The SOM-STG is based on an SOM with a time-varying structure characterized by constructing autonomously close-state trajectories from an arbitrary number of robot postures. Each trajectory represents a cyclical movement of the limbs of an animal. The SOM-STG was designed to possess important features of a central pattern generator, such as rhythmic pattern generation, synchronization between limbs, and swapping between gaits following a single command. The acquisition of data for SOM-STG is based on learning by demonstration in which the data are obtained from different demonstrator agents. The SOM-STG can construct one or more gaits for a simulated robot with six legs, can control the robot with any of the gaits learned, and can smoothly swap gaits. In addition, SOM-STG can learn to construct a state trajectory form observing an animal in locomotion. In this paper, a dog is the demonstrator agent.

Biological and bionic hands: natural neural coding and artificial perception.

PubMed

Bensmaia, Sliman J

2015-09-19

The first decade and a half of the twenty-first century brought about two major innovations in neuroprosthetics: the development of anthropomorphic robotic limbs that replicate much of the function of a native human arm and the refinement of algorithms that decode intended movements from brain activity. However, skilled manipulation of objects requires somatosensory feedback, for which vision is a poor substitute. For upper-limb neuroprostheses to be clinically viable, they must therefore provide for the restoration of touch and proprioception. In this review, I discuss efforts to elicit meaningful tactile sensations through stimulation of neurons in somatosensory cortex. I focus on biomimetic approaches to sensory restoration, which leverage our current understanding about how information about grasped objects is encoded in the brain of intact individuals. I argue that not only can sensory neuroscience inform the development of sensory neuroprostheses, but also that the converse is true: stimulating the brain offers an exceptional opportunity to causally interrogate neural circuits and test hypotheses about natural neural coding.

Affordance Realization in Climbing: Learning and Transfer.

PubMed

Seifert, Ludovic; Orth, Dominic; Mantel, Bruno; Boulanger, Jérémie; Hérault, Romain; Dicks, Matt

2018-01-01

The aim of this study was to investigate how the affordances of an indoor climbing wall changed for intermediate climbers following a period of practice during which hold orientation was manipulated within a learning and transfer protocol. The learning protocol consisted of four sessions, in which eight climbers randomly ascended three different routes of fixed absolute difficulty (5c on the French scale), as fluently as possible. All three routes were 10.3 m in height and composed of 20 hand-holds at the same locations on an artificial climbing wall; only hold orientations were altered: (i) a horizontal-edge route (H) was designed to afford horizontal hold grasping, (ii) a vertical-edge route (V) afforded vertical hold grasping, and (iii), a double-edge route (D) was designed to afford both horizontal and vertical hold grasping. Five inertial measurement units (IMU) (3D accelerometer, 3D gyroscope, 3D magnetometer) were attached to the hip, feet and forearms to analyze the vertical acceleration and direction (3D unitary vector) of each limb and hip in ambient space during the entire ascent. Segmentation and classification processes supported detection of movement and stationary phases for each IMU. Depending on whether limbs and/or hip were moving, a decision tree distinguished four states of behavior: stationary (absence of limb and hip motion), hold exploration (absence of hip motion but at least one limb in motion), hip movement (hip in motion but absence of limb motion) and global motion (hip in motion and at least one limb in motion). Results showed that with practice, the learners decreased the relative duration of hold exploration, suggesting that they improved affordance perception of hold grasp-ability. The number of performatory movements also decreased as performance increased during learning sessions, confirming that participants' climbing efficacy improved as a function of practice. Last, the results were more marked for the H route, while the D route led to longer relative stationary duration and a shorter relative duration of performatory states. Together, these findings emphasized the benefit of manipulating task constraints to promote safe exploration during learning, which is particularly relevant in extreme sports involving climbing tasks.

Double nerve intraneural interface implant on a human amputee for robotic hand control.

PubMed

Rossini, Paolo M; Micera, Silvestro; Benvenuto, Antonella; Carpaneto, Jacopo; Cavallo, Giuseppe; Citi, Luca; Cipriani, Christian; Denaro, Luca; Denaro, Vincenzo; Di Pino, Giovanni; Ferreri, Florinda; Guglielmelli, Eugenio; Hoffmann, Klaus-Peter; Raspopovic, Stanisa; Rigosa, Jacopo; Rossini, Luca; Tombini, Mario; Dario, Paolo

2010-05-01

The principle underlying this project is that, despite nervous reorganization following upper limb amputation, original pathways and CNS relays partially maintain their function and can be exploited for interfacing prostheses. Aim of this study is to evaluate a novel peripheral intraneural multielectrode for multi-movement prosthesis control and for sensory feed-back, while assessing cortical reorganization following the re-acquired stream of data. Four intrafascicular longitudinal flexible multielectrodes (tf-LIFE4) were implanted in the median and ulnar nerves of an amputee; they reliably recorded output signals for 4 weeks. Artificial intelligence classifiers were used off-line to analyse LIFE signals recorded during three distinct hand movements under voluntary order. Real-time control of motor output was achieved for the three actions. When applied off-line artificial intelligence reached >85% real-time correct classification of trials. Moreover, different types of current stimulation were determined to allow reproducible and localized hand/fingers sensations. Cortical organization was observed via TMS in parallel with partial resolution of symptoms due to the phantom-limb syndrome (PLS). tf-LIFE4s recorded output signals in human nerves for 4 weeks, though the efficacy of sensory stimulation decayed after 10 days. Recording from a number of fibres permitted a high percentage of distinct actions to be classified correctly. Reversal of plastic changes and alleviation of PLS represent corollary findings of potential therapeutic benefit. This study represents a breakthrough in robotic hand use in amputees. Copyright 2010 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

A physical control interface with proprioceptive feedback and multiple degrees of freedom

NASA Technical Reports Server (NTRS)

Creasey, G. H.; Gow, D.; Sloan, Y.; Meadows, B.

1991-01-01

The use of the drug thalidomide by pregnant mothers in Britain resulted in a variety of deformities including the birth of children having no arms. Such children were provided with powered artificial arms with up to five degrees of freedom simultaneously controlled in real time by shoulder movement. The physiological sense of proprioception was extended from the user into the device, reducing the need for visual feedback and conscious control. With the banning of thalidomide, this technique fell into disuse but it is now being re-examined as a control mechanism for other artificial limbs and it may have other medical applications to allow patients to control formerly paralyzed limbs moved by electrical stimulation. It may also have commercial applications in robotic manipulation or physical interaction with virtual environments. To allow it to be investigated further, the original pneumatic control system has recently been converted to an electrical analogue to allow interfacing to electronic and computer-assisted systems. A harness incorporates force-sensitive resistors and linear potentiomenters for sensing position and force at the interface with the skin, and miniature electric motors and lead screws for feeding back to the user the position of the robotic arm and the forces applied to it. In the present system, control is applied to four degrees of freedom using elevation/depression and protraction/reaction of each shoulder so that each collar bone emulates a joystick. However, both electrical and mechanical components have been built in modular form to allow rapid replication and testing of a variety of force and position control strategies.

Applying Space Technology to Enhance Control of an Artificial Arm for Children and Adults With Amputations

NASA Technical Reports Server (NTRS)

Atkins, Diane J.

1998-01-01

The first single function myoelectric prosthetic hand was introduced in the 1960's. This hand was controlled by the electric fields generated by muscle contractions in the residual limb of the amputee user. Electrodes and amplifiers, embedded in the prosthetic socket, measured these electric fields across the skin, which increase in amplitude as the individual contracts their muscle. When the myoelectric signal reached a certain threshold amplitude, the control unit activated a motor which opened or closed a hand-like prosthetic terminal device with a pincher grip. Late in the 1990's, little has changed. Most current myoelectric prostheses still operate in this same, single-function way. To better understand the limitations of the current single-function myoelectric hand and the needs of those who use them, The Institute for Rehabilitation and Research (TIRR), sponsored by the National Institutes of Health (NUH), surveyed approximately 2,500 individuals with upper limb loss [1]. When asked to identify specific features of their current myoelectric prostheses that needed improvement, the survey respondents overwhelmingly identified the lack of wrist and finger movement, as well as poor control capability. However, simply building a mechanism with individual finger and wrist motion is not enough. In the 1960's and 1970's, engineers built a number of more dexterous prosthetic hands. Unfortunately, these were rejected during clinical trials due to a difficult and distracting control interface. The goal of this project, "Applying Space Technology to Enhance Control of an Artificial Arm for Children and Adults with Amputations," was to lay the foundation for a multi-function, intuitive myoelectric control system which requires no conscious thought to move the hand. We built an extensive myoelectric signal database for six motions from ten amputee volunteers, We also tested a control system based on new artificial intelligence techniques on the data from two of these subjects. This data is available to anyone doing myoelectric control research. Its availability is an important contribution to the prosthetics research community, as many researchers do not have access to amputee subjects. Since we collected myoelectric data from subjects' sound arms as well as their residual arms, this database will also prove useful to virtual reality and robotics researchers who want to explore myoelectric-based interfaces between any user and a machine. Currently, one small company (Intelligenta, Inc.) and one university (University of New Brunswick, Canada) are using this myoelectric database under other funding to develop multifunction control systems for prostheses. A prosthetics manufacturer (Liberty Technology, Inc.) is making plans to incorporate the results of their work into an artificial hand capable of several different movements to provide functionality only dreamed of by current myoelectric users. Methods Six adults and four children, all with unilateral, below-elbow amputations served as subjects. Five of the adults (3 male, 2 female, average age 34 years) had amputations due to traumatic injury, while one adult (female, age 32 years) and the four children (3 male, 1 female, average age 13 years) had congenital (i.e. from birth) limb deficiencies.

Refeeding enteroclysis as an alternative to parenteral nutrition for enteric fistula.

PubMed

Coetzee, E; Rahim, Z; Boutall, A; Goldberg, P

2014-10-01

Refeeding enteroclysis is one method of giving artificial nutritional support to patients with enterocutaneous fistula. This study compares the results of this technique with parenteral nutrition or nutrition given via a proximal stoma. All patients admitted to our intestinal failure unit with a proximal enteric fistula and managed with refeeding enteroclysis over a 4-year period were included and compared with a matched group of patients managed without using this technique. Twenty patients (15 men) with a proximal enteric fistula received chyme refeeding down the distal limb of the fistula. This was established at a mean of 14 days after admission to the unit and total parenteral nutrition could be weaned off by 20 days. The mean output from the proximal limb was 1800 ml and the mean volume refed down the distal limb was 1220 ml per day. Additional enteric feed was given to 12 patients. No patient was given pharmacological agents to delay gastrointestinal transit or additional intravenous water and electrolyte for most of the time after refeeding was established. There were no complications or deaths related to chyme refeeding. Refeeding enteroclysis is feasible in selected patients with a proximal enteric fistula or stoma. Adequate nutrition, water and electrolyte balance can be achieved without resorting to parenteral infusions. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

Design and Optimization of a Hybrid-Driven Waist Rehabilitation Robot

PubMed Central

Zi, Bin; Yin, Guangcai; Zhang, Dan

2016-01-01

In this paper a waist rehabilitation robot driven by cables and pneumatic artificial muscles (PAMs) has been conceptualized and designed. In the process of mechanism design, the human body structure, the waist movement characteristics, and the actuators’ driving characteristics are the main considerable factors to make the hybrid-driven waist rehabilitation robot (HWRR) cost-effective, safe, flexible, and well-adapted. A variety of sensors are chosen to measure the position and orientation of the recovery patient to ensure patient safety at the same time as the structure design. According to the structure specialty and function, the HWRR is divided into two independent parallel robots: the waist twist device and the lower limb traction device. Then these two devices are analyzed and evaluated, respectively. Considering the characters of the human body in the HWRR, the inverse kinematics and statics are studied when the waist and the lower limb are considered as a spring and link, respectively. Based on the inverse kinematics and statics, the effect of the contraction parameter of the PAM is considered in the optimization of the waist twist device, and the lower limb traction device is optimized using particle swarm optimization (PSO) to minimize the global conditioning number over the feasible workspace. As a result of the optimization, an optimal rehabilitation robot design is obtained and the condition number of the Jacobian matrix over the feasible workspace is also calculated. PMID:27983626

Design and Optimization of a Hybrid-Driven Waist Rehabilitation Robot.

PubMed

Zi, Bin; Yin, Guangcai; Zhang, Dan

2016-12-14

In this paper a waist rehabilitation robot driven by cables and pneumatic artificial muscles (PAMs) has been conceptualized and designed. In the process of mechanism design, the human body structure, the waist movement characteristics, and the actuators' driving characteristics are the main considerable factors to make the hybrid-driven waist rehabilitation robot (HWRR) cost-effective, safe, flexible, and well-adapted. A variety of sensors are chosen to measure the position and orientation of the recovery patient to ensure patient safety at the same time as the structure design. According to the structure specialty and function, the HWRR is divided into two independent parallel robots: the waist twist device and the lower limb traction device. Then these two devices are analyzed and evaluated, respectively. Considering the characters of the human body in the HWRR, the inverse kinematics and statics are studied when the waist and the lower limb are considered as a spring and link, respectively. Based on the inverse kinematics and statics, the effect of the contraction parameter of the PAM is considered in the optimization of the waist twist device, and the lower limb traction device is optimized using particle swarm optimization (PSO) to minimize the global conditioning number over the feasible workspace. As a result of the optimization, an optimal rehabilitation robot design is obtained and the condition number of the Jacobian matrix over the feasible workspace is also calculated.

[Daedalus sive mechanicus--automated equipment and machines at the interface between mechanics and medicine].

PubMed

Bondio, Mariacarla Gadebusch

2009-01-01

Automata have always held a particular fascination. Their history leads back to their mythical ancestors, whose destinies raise considerable ethical questions about the sense of technology and about the boundaries between nature and art. In the 16th century engineers, architects and also physicians discussed the status of the ,artes mechanicae' and the machines they produced or used. Useful, sometimes dangerous, amusing and elaborate artefacts liven up their texts. Together with wonderful automata we find there also orthopaedic stretching machines and artificial limbs, whose acceptance by medical practice was anything but a matter of course.

Struggling to be Fit: Identity, Integrity, and the Law

PubMed Central

Harmon, Shawn HE; Brown, Abbe; Popat, Sita; Whatley, Sarah; O’Connor, Rory

2017-01-01

This interdisciplinary co-authored Analysis piece introduces identity and integrity, which are argued to sit at the core of the person. It analyses approaches taken to these concepts by legal regimes, particularly in the context of individuals using artificial limbs or digital avatars. The piece concludes that law engages with identity and integrity to a limited and incomplete extent; and that law is thus inadequate in its engagement with the person, and its meaning making in this respect. This piece draws on two interdisciplinary funded projects, funded by the Wellcome Trust and the Arts and Humanities Research Council. PMID:29271979

A Novel Intronic Single Nucleotide Polymorphism in the Myosin heavy polypeptide 4 Gene Is Responsible for the Mini-Muscle Phenotype Characterized by Major Reduction in Hind-Limb Muscle Mass in Mice

PubMed Central

Kelly, Scott A.; Bell, Timothy A.; Selitsky, Sara R.; Buus, Ryan J.; Hua, Kunjie; Weinstock, George M.; Garland, Theodore; Pardo-Manuel de Villena, Fernando; Pomp, Daniel

2013-01-01

Replicated artificial selection for high levels of voluntary wheel running in an outbred strain of mice favored an autosomal recessive allele whose primary phenotypic effect is a 50% reduction in hind-limb muscle mass. Within the High Runner (HR) lines of mice, the numerous pleiotropic effects (e.g., larger hearts, reduced total body mass and fat mass, longer hind-limb bones) of this hypothesized adaptive allele include functional characteristics that facilitate high levels of voluntary wheel running (e.g., doubling of mass-specific muscle aerobic capacity, increased fatigue resistance of isolated muscles, longer hind-limb bones). Previously, we created a backcross population suitable for mapping the responsible locus. We phenotypically characterized the population and mapped the Minimsc locus to a 2.6-Mb interval on MMU11, a region containing ∼100 known or predicted genes. Here, we present a novel strategy to identify the genetic variant causing the mini-muscle phenotype. Using high-density genotyping and whole-genome sequencing of key backcross individuals and HR mice with and without the mini-muscle mutation, from both recent and historical generations of the HR lines, we show that a SNP representing a C-to-T transition located in a 709-bp intron between exons 11 and 12 of the Myosin heavy polypeptide 4 (Myh4) skeletal muscle gene (position 67,244,850 on MMU11; assembly, December 2011, GRCm38/mm10; ENSMUSG00000057003) is responsible for the mini-muscle phenotype, Myh4Minimsc. Using next-generation sequencing, our approach can be extended to identify causative mutations arising in mouse inbred lines and thus offers a great avenue to overcome one of the most challenging steps in quantitative genetics. PMID:24056412

A novel intronic single nucleotide polymorphism in the myosin heavy polypeptide 4 gene is responsible for the mini-muscle phenotype characterized by major reduction in hind-limb muscle mass in mice.

PubMed

Kelly, Scott A; Bell, Timothy A; Selitsky, Sara R; Buus, Ryan J; Hua, Kunjie; Weinstock, George M; Garland, Theodore; Pardo-Manuel de Villena, Fernando; Pomp, Daniel

2013-12-01

Replicated artificial selection for high levels of voluntary wheel running in an outbred strain of mice favored an autosomal recessive allele whose primary phenotypic effect is a 50% reduction in hind-limb muscle mass. Within the High Runner (HR) lines of mice, the numerous pleiotropic effects (e.g., larger hearts, reduced total body mass and fat mass, longer hind-limb bones) of this hypothesized adaptive allele include functional characteristics that facilitate high levels of voluntary wheel running (e.g., doubling of mass-specific muscle aerobic capacity, increased fatigue resistance of isolated muscles, longer hind-limb bones). Previously, we created a backcross population suitable for mapping the responsible locus. We phenotypically characterized the population and mapped the Minimsc locus to a 2.6-Mb interval on MMU11, a region containing ∼100 known or predicted genes. Here, we present a novel strategy to identify the genetic variant causing the mini-muscle phenotype. Using high-density genotyping and whole-genome sequencing of key backcross individuals and HR mice with and without the mini-muscle mutation, from both recent and historical generations of the HR lines, we show that a SNP representing a C-to-T transition located in a 709-bp intron between exons 11 and 12 of the Myosin heavy polypeptide 4 (Myh4) skeletal muscle gene (position 67,244,850 on MMU11; assembly, December 2011, GRCm38/mm10; ENSMUSG00000057003) is responsible for the mini-muscle phenotype, Myh4(Minimsc). Using next-generation sequencing, our approach can be extended to identify causative mutations arising in mouse inbred lines and thus offers a great avenue to overcome one of the most challenging steps in quantitative genetics.

On Design and Implementation of Neural-Machine Interface for Artificial Legs

PubMed Central

Zhang, Xiaorong; Liu, Yuhong; Zhang, Fan; Ren, Jin; Sun, Yan (Lindsay); Yang, Qing

2011-01-01

The quality of life of leg amputees can be improved dramatically by using a cyber physical system (CPS) that controls artificial legs based on neural signals representing amputees’ intended movements. The key to the CPS is the neural-machine interface (NMI) that senses electromyographic (EMG) signals to make control decisions. This paper presents a design and implementation of a novel NMI using an embedded computer system to collect neural signals from a physical system - a leg amputee, provide adequate computational capability to interpret such signals, and make decisions to identify user’s intent for prostheses control in real time. A new deciphering algorithm, composed of an EMG pattern classifier and a post-processing scheme, was developed to identify the user’s intended lower limb movements. To deal with environmental uncertainty, a trust management mechanism was designed to handle unexpected sensor failures and signal disturbances. Integrating the neural deciphering algorithm with the trust management mechanism resulted in a highly accurate and reliable software system for neural control of artificial legs. The software was then embedded in a newly designed hardware platform based on an embedded microcontroller and a graphic processing unit (GPU) to form a complete NMI for real time testing. Real time experiments on a leg amputee subject and an able-bodied subject have been carried out to test the control accuracy of the new NMI. Our extensive experiments have shown promising results on both subjects, paving the way for clinical feasibility of neural controlled artificial legs. PMID:22389637

Cochlear Implant Using Neural Prosthetics

NASA Astrophysics Data System (ADS)

Gupta, Shweta; Singh, Shashi kumar; Dubey, Pratik Kumar

2012-10-01

This research is based on neural prosthetic device. The oldest and most widely used of these electrical, and often computerized, devices is the cochlear implant, which has provided hearing to thousands of congenitally deaf people in this country. Recently, the use of the cochlear implant is expanding to the elderly, who frequently suffer major hearing loss. More cutting edge are artificial retinas, which are helping dozens of blind people see, and ìsmartî artificial arms and legs that amputees can maneuver by thoughts alone, and that feel more like real limbs.Research, which curiosity led to explore frog legs dancing during thunderstorms, a snail shapedorgan in the inner ear, and how various eye cells react to light, have fostered an understanding of how to ìtalkî to the nervous system. That understanding combined with the miniaturization of electronics and enhanced computer processing has enabled prosthetic devices that often can bridge the gap in nerve signaling that is caused by disease or injury.

An artificial EMG generation model based on signal-dependent noise and related application to motion classification

PubMed Central

Hayashi, Hideaki; Nakamura, Go; Chin, Takaaki; Tsuji, Toshio

2017-01-01

This paper proposes an artificial electromyogram (EMG) signal generation model based on signal-dependent noise, which has been ignored in existing methods, by introducing the stochastic construction of the EMG signals. In the proposed model, an EMG signal variance value is first generated from a probability distribution with a shape determined by a commanded muscle force and signal-dependent noise. Artificial EMG signals are then generated from the associated Gaussian distribution with a zero mean and the generated variance. This facilitates representation of artificial EMG signals with signal-dependent noise superimposed according to the muscle activation levels. The frequency characteristics of the EMG signals are also simulated via a shaping filter with parameters determined by an autoregressive model. An estimation method to determine EMG variance distribution using rectified and smoothed EMG signals, thereby allowing model parameter estimation with a small number of samples, is also incorporated in the proposed model. Moreover, the prediction of variance distribution with strong muscle contraction from EMG signals with low muscle contraction and related artificial EMG generation are also described. The results of experiments conducted, in which the reproduction capability of the proposed model was evaluated through comparison with measured EMG signals in terms of amplitude, frequency content, and EMG distribution demonstrate that the proposed model can reproduce the features of measured EMG signals. Further, utilizing the generated EMG signals as training data for a neural network resulted in the classification of upper limb motion with a higher precision than by learning from only measured EMG signals. This indicates that the proposed model is also applicable to motion classification. PMID:28640883

Toward an artificial sensory feedback system for prosthetic mobility rehabilitation: examination of sensorimotor responses.

PubMed

Sharma, Aman; Torres-Moreno, Ricardo; Zabjek, Karl; Andrysek, Jan

2014-01-01

People with lower-limb amputation have reduced mobility due to loss of sensory information, which may be restored by artificial sensory feedback systems built into prostheses. For an effective system, it is important to understand how humans sense, interpret, and respond to the feedback that would be provided. The goal of this study was to examine sensorimotor responses to mobility-relevant stimuli. Three experiments were performed to examine the effects of location of stimuli, frequency of stimuli, and means for providing the response. Stimuli, given as vibrations, were applied to the thigh region, and responses involved leg movements. Sensorimotor reaction time (RT) was measured as the duration between application of the stimulus and initiation of the response. Accuracy of response was also measured. Overall average RTs for one response option were 0.808 +/- 0.142 s, and response accuracies were >90%. Higher frequencies (220 vs 140 Hz) of vibration stimulus provided in anterior regions of the thigh produced the fastest RTs. When participants were presented with more than one stimulus and response option, RTs increased. Findings suggest that long sensorimotor responses may be a limiting factor in the development of an artificial feedback system for mobility rehabilitation applications; however, feed-forward techniques could potentially help to address these limitations.

Modeling the benefits of an artificial gravity countermeasure coupled with exercise and vibration

NASA Astrophysics Data System (ADS)

Goel, Rahul; Kaderka, Justin; Newman, Dava

2012-01-01

The current, system-specific countermeasures to space deconditioning have limited success with the musculoskeletal system in long duration missions. Artificial gravity (AG) that is produced by short radius centrifugation has been hypothesized as an effective countermeasure because it reintroduces an acceleration field in space; however, AG alone might not be enough stimuli to preserve the musculoskeletal system. A novel combination of AG coupled with one-legged squats on a vibrating platform may preserve muscle and bone in the lower limbs to a greater extent than the current exercise paradigm. The benefits of the proposed countermeasure have been analyzed through the development of a simulation platform. Ground reaction force data and motion data were collected using a motion capture system while performing one-legged and two-legged squats in 1-G. The motion was modeled in OpenSim, an open-source software, and inverse dynamics were applied in order to determine the muscle and reaction forces of lower limb joints. Vibration stimulus was modeled by adding a 20 Hz sinusoidal force of 0.5 body weight to the force plate data. From the numerical model in a 1-G acceleration field, muscle forces for quadriceps femoris, plantar flexors and glutei increased substantially for one-legged squats with vibration compared to one- or two-legged squats without vibration. Additionally, joint reaction forces for one-legged squats with vibration also increased significantly compared to two-legged squats with or without vibration. Higher muscle forces and joint reaction forces might help to stimulate muscle activation and bone modeling and thus might reduce musculoskeletal deconditioning. These results indicate that the proposed countermeasure might surpass the performance of the current space countermeasures and should be further studied as a method of mitigating musculoskeletal deconditioning.

Nighttime medium scale traveling ionospheric disturbances in southern hemisphere using FORMOSAT-2/ISUAL 630.0 nm airglow images

NASA Astrophysics Data System (ADS)

Rajesh, P. K.; Lin, C. C. H.; Liu, T. J. Y.; Chen, A. B. C.; Hsu, R. R.; Chen, C. H.; Huba, J. D.

2017-12-01

In this work characteristics of nighttime medium-scale travelling ionospheric disturbances (MSTID) are investigated using 630.0 nm limb images by Imager of Sprites and Upper Atmospheric Lightnings (ISUAL), onboard FORMOSAT-2 satellite. The limb integrated measurements, when projected to a horizontal plane, reveal bands of intensity perturbation with distinct southwest to northeast orientation in the southern hemisphere. Airglow simulations are carried out by artificially introducing MSTID fluctuations in model electron density to confirm if such azimuthally oriented features could be identified in the ISUAL viewing geometry. Further statistical analysis shows more MSTID occurrence in solstices with peak in June-July months. The wavelengths of the observed perturbations were in the range 150-300 km. The wave fronts were oriented about 30°-50° from the east-west plane, indicating that coupled Perkins and Es-layer instability might be important in the MSTID generation. The results demonstrate that space based airglow imaging is an effective method for global investigation of MSTID events that are appropriately aligned with the viewing geometry.

New Lower-Limb Gait Asymmetry Indices Based on a Depth Camera

PubMed Central

Auvinet, Edouard; Multon, Franck; Meunier, Jean

2015-01-01

Background: Various asymmetry indices have been proposed to compare the spatiotemporal, kinematic and kinetic parameters of lower limbs during the gait cycle. However, these indices rely on gait measurement systems that are costly and generally require manual examination, calibration procedures and the precise placement of sensors/markers on the body of the patient. Methods: To overcome these issues, this paper proposes a new asymmetry index, which uses an inexpensive, easy-to-use and markerless depth camera (Microsoft Kinect™) output. This asymmetry index directly uses depth images provided by the Kinect™ without requiring joint localization. It is based on the longitudinal spatial difference between lower-limb movements during the gait cycle. To evaluate the relevance of this index, fifteen healthy subjects were tested on a treadmill walking normally and then via an artificially-induced gait asymmetry with a thick sole placed under one shoe. The gait movement was simultaneously recorded using a Kinect™ placed in front of the subject and a motion capture system. Results: The proposed longitudinal index distinguished asymmetrical gait (p < 0.001), while other symmetry indices based on spatiotemporal gait parameters failed using such Kinect™ skeleton measurements. Moreover, the correlation coefficient between this index measured by Kinect™ and the ground truth of this index measured by motion capture is 0.968. Conclusion: This gait asymmetry index measured with a Kinect™ is low cost, easy to use and is a promising development for clinical gait analysis. PMID:25719863

An analytical approach to test and design upper limb prosthesis.

PubMed

Veer, Karan

2015-01-01

In this work the signal acquiring technique, the analysis models and the design protocols of the prosthesis are discussed. The different methods to estimate the motion intended by the amputee from surface electromyogram (SEMG) signals based on time and frequency domain parameters are presented. The experiment proposed that the used techniques can help significantly in discriminating the amputee's motions among four independent activities using dual channel set-up. Further, based on experimental results, the design and working of an artificial arm have been covered under two constituents--the electronics design and the mechanical assembly. Finally, the developed hand prosthesis allows the amputated persons to perform daily routine activities easily.

Curvature measurement with photonic crystal fiber based Mach-Zehnder interferometer

NASA Astrophysics Data System (ADS)

Deng, Ming; Tang, Chang-Ping; Zhu, Tao; Rao, Yun-Jiang

2011-05-01

A PCF-based MZI with regular and high-contrast fringe pattern is fabricated by splicing a section of PCF in between two SMFs with a commercial available fusion splicer. Its resonant wavelength is sensitive to external bending with a sensitivity of 3.046nm/m but independent on temperature. To that end, we also propose another kind of bending sensor with higher sensitivity of 5.129nm/m. This device is constructed by combining an LPG and an MZI with zero offset at the second splice. It is anticipated that the high sensitive structures will find applications in robot arms and artificial limbs.

Artificial neural networks in knee injury risk evaluation among professional football players

NASA Astrophysics Data System (ADS)

Martyna, Michałowska; Tomasz, Walczak; Krzysztof, Grabski Jakub; Monika, Grygorowicz

2018-01-01

Lower limb injury risk assessment was proposed, based on isokinetic examination that is a part of standard athlete's biomechanical evaluation performed mainly twice a year. Information about non-contact knee injury (or lack of the injury) sustained within twelve months after isokinetic test, confirmed in USG were verified. Three the most common types of football injuries were taken into consideration: anterior cruciate ligament (ACL) rupture, hamstring and quadriceps muscles injuries. 22 parameters, obtained from isokinetic tests were divided into 4 groups and used as input parameters of five feedforward artificial neural networks (ANNs). The 5th group consisted of all considered parameters. The networks were trained with the use of Levenberg-Marquardt backpropagation algorithm to return value close to 1 for the sets of parameters corresponding injury event and close to 0 for parameters with no injury recorded within 6 - 12 months after isokinetic test. Results of this study shows that ANN might be useful tools, which simplify process of simultaneous interpretation of many numerical parameters, but the most important factor that significantly influence the results is database used for ANN training.

Silicone Molding and Lifetime Testing of Peripheral Nerve Interfaces for Neuroprostheses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gupte, Kimaya; Tolosa, Vanessa

Implantable peripheral nerve cuffs have a large application in neuroprostheses as they can be used to restore sensation to those with upper limb amputations. Modern day prosthetics, while lessening the pain associated with phantom limb syndrome, have limited fine motor control and do not provide sensory feedback to patients. Sensory feedback with prosthetics requires communication between the nervous system and limbs, and is still a challenge to accomplish with amputees. Establishing this communication between the peripheral nerves in the arm and artificial limbs is vital as prosthetics research aims to provide sensory feedback to amputees. Peripheral nerve cuffs restore sensationmore » by electrically stimulating certain parts of the nerve in order to create feeling in the hand. Cuff electrodes have an advantage over standard electrodes as they have high selective stimulation by bringing the electrical interface close to the neural tissue in order to selectively activate targeted regions of a peripheral nerve. In order to further improve the selective stimulation of these nerve cuffs, there is need for finer spatial resolution among electrodes. One method to achieve a higher spatial resolution is to increase the electrode density on the cuff itself. Microfabrication techniques can be used to achieve this higher electrode density. Using L-Edit, a layout editor, microfabricated peripheral nerve cuffs were designed with a higher electrode density than the current model. This increase in electrode density translates to an increase in spatial resolution by at least one order of magnitude. Microfabricated devices also have two separate components that are necessary to understand before implantation: lifetime of the device and assembly to prevent nerve damage. Silicone molding procedures were optimized so that devices do not damage nerves in vivo, and lifetime testing was performed on test microfabricated devices to determine their lifetime in vivo. Future work of this project would include fabricating some of the designed devices and seeing how they compare to the current cuffs in terms of their electrical performance, lifetime, shape, and mechanical properties.« less

Bioelectric analyses of an osseointegrated intelligent implant design system for amputees.

PubMed

Isaacson, Brad M; Stinstra, Jeroen G; MacLeod, Rob S; Webster, Joseph B; Beck, James P; Bloebaum, Roy D

2009-07-15

The projected number of American amputees is expected to rise to 3.6 million by 2050. Many of these individuals depend on artificial limbs to perform routine activities, but prosthetic suspensions using traditional socket technology can prove to be cumbersome and uncomfortable for a person with limb loss. Moreover, for those with high proximal amputations, limited residual limb length may prevent exoprosthesis attachment all together. Osseointegrated implant technology is a novel operative procedure which allows firm skeletal attachment between the host bone and an implant. Preliminary results in European amputees with osseointegrated implants have shown improved clinical outcomes by allowing direct transfer of loads to the bone-implant interface. Despite the apparent advantages of osseointegration over socket technology, the current rehabilitation procedures require long periods of restrictive load bearing prior which may be reduced with expedited skeletal attachment via electrical stimulation. The goal of the osseointegrated intelligent implant design (OIID) system is to make the implant part of an electrical system to accelerate skeletal attachment and help prevent periprosthetic infection. To determine optimal electrode size and placement, we initiated proof of concept with computational modeling of the electric fields and current densities that arise during electrical stimulation of amputee residual limbs. In order to provide insure patient safety, subjects with retrospective computed tomography scans were selected and three dimensional reconstructions were created using customized software programs to ensure anatomical accuracy (Seg3D and SCIRun) in an IRB and HIPAA approved study. These software packages supported the development of patient specific models and allowed for interactive manipulation of electrode position and size. Preliminary results indicate that electric fields and current densities can be generated at the implant interface to achieve the homogenous electric field distributions required to induce osteoblast migration, enhance skeletal fixation and may help prevent periprosthetic infections. Based on the electrode configurations experimented with in the model, an external two band configuration will be advocated in the future.

Intention detection of gait initiation using EMG and kinematic data.

PubMed

Wentink, E C; Beijen, S I; Hermens, H J; Rietman, J S; Veltink, P H

2013-02-01

Gait initiation in transfemoral amputees (TFA) is different from non-amputees. This is mainly caused by the lack of stability and push-off from the prosthetic leg. Adding control and artificial push-off to the prosthesis may therefore be beneficial to TFA. In this study the feasibility of real-time intention detection of gait initiation was determined by mimicking the TFA situation in non-amputees. EMG and inertial sensor data was measured in 10 non-amputees. Only data available in TFA was used to determine if gait initiation can be predicted in time to control a transfemoral prosthesis to generate push-off and stability. Toe-off and heel-strike of the leading limb are important parameters to be detected, to control a prosthesis and to time push-off. The results show that toe-off and heel-strike of the leading limb can be detected using EMG and kinematic data in non-amputees 130-260 ms in advance. This leaves enough time to control a prosthesis. Based on these results we hypothesize that similar results can be found in TFA, allowing for adequate control of a prosthesis during gait initiation. Copyright © 2012 Elsevier B.V. All rights reserved.

The production and measurement of sub-bandage pressure: Laplace's Law revisited.

PubMed

Thomas, S

2014-05-01

The present study was undertaken to demonstrate that the pressures produced by multiple layers of compression bandages applied to artificial limbs of known circumference with predetermined levels of tension can be predicted accurately using the modified Laplace equation. Up to four layers of different bandage types were applied in a carefully controlled fashion to cylinders of known circumference, with tensions ranging from around 200-2000 grams/10cm width. The pressures generated were measured using pneumatic pressure sensors previously shown to possess the required degree of accuracy for this type of experimental system. Good correlation was observed between the mean and standard deviation of each pair of experimental and calculated pressure values for all combinations of bandage type, application tension and cylinder circumference. Over the clinically relevant range of pressures, the difference between data sets was generally less than 1.0mmHg. The results of this experimental study unequivocally prove that provided accurate values for all the relevant variables are known, it is possible to predict the pressure that will be developed by a compression bandage on a limb of known size. However, it is important to recognise that other factors such as the elastomeric properties of the fabric will have a major effect upon the ability of a bandage system to sustain initial compression values. Furthermore, the variation in radius of curvature around a limb will mean that point pressures readings recorded at individual locations around the circumference may vary dramatically from the average value predicted by the modified Laplace equation, calling into question the value of sub-bandage pressure measuring devices for this application.

Relationship and significance of gait deviations associated with limb length discrepancy: A systematic review.

PubMed

Khamis, Sam; Carmeli, Eli

2017-09-01

Controversy still exists as to the clinical significance of leg length discrepancy (LLD) in spite of the fact that further evidence has been emerging regarding the relationship between several clinical conditions and LLD. The objectives of our study were to review the available research with regard to LLD as a cause of clinically significant gait deviations, to determine if there is a relationship between the magnitude of LLD and the presence of gait deviations and to identify the most common gait deviations associated with LLD. In line with the PRISMA guidelines, a literature search was carried out throughout the Medline, CINAHL and EMBASE databases. Twelve articles met the predetermined inclusion criteria and were included in the review. Quality assessment using the Methodological Index for Non-Randomized Studies (MINORS) scale was completed for all included studies. Two main methodologies were found in 4 studies evaluating gait asymmetry in patients or healthy participants with anatomic LLD and 8 studies evaluating gait deviations while simulating LLD by employing artificial lifts of 1-5cm on healthy subjects. A significant relationship was found between anatomic LLD and gait deviation. Evidence suggests that gait deviations may occur with discrepancies of >1cm, with greater impact seen as the discrepancy increases. Compensatory strategies were found to occur in both the shorter and longer limb, throughout the lower limb. As the discrepancy increases, more compensatory strategies occur. Sagittal plane deviations seem to be the most effective deviations, although, frontal plane compensations also occur in the pelvis, hip and foot. Copyright © 2017 Elsevier B.V. All rights reserved.

Development of regenerative peripheral nerve interfaces for motor control of neuroprosthetic devices

NASA Astrophysics Data System (ADS)

Kemp, Stephen W. P.; Urbanchek, Melanie G.; Irwin, Zachary T.; Chestek, Cynthia A.; Cederna, Paul S.

2017-05-01

Traumatic peripheral nerve injuries suffered during amputation commonly results in debilitating neuropathic pain in the affected limb. Modern prosthetic technologies allow for intuitive, simultaneous control of multiple degrees of freedom. However, these state-of-the-art devices require separate, independent control signals for each degree of freedom, which is currently not possible. As a result, amputees reject up to 75% of myoelectric devices preferring instead to use body-powered artificial limbs which offer subtle sensory feedback. Without meaningful and intuitive sensory feedback, even the most advanced myoelectric prostheses remain insensate, burdensome, and are associated with enormous cognitive demand and mental fatigue. The ideal prosthetic device is one which is capable of providing intuitive somatosensory feedback essential for interaction with the environment. Critical to the design of such a bioprosthetic device is the development of a reliable biologic interface between human and machine. This ideal patient-prosthetic interface allows for transmission of both afferent somatosensory information and efferent motor signals for a closed-loop feedback system of neural control. Our lab has developed the Regenerative Peripheral Nerve Interface (RPNI) as a biologic nerve interface designed for stable integration of a prosthetic device with transected peripheral nerves in a residual limb. The RPNI is constructed by surgically implanting the distal end of a transected peripheral nerve into an autogenous muscle graft. Animal experiments in our lab have shown recording of motor signals from RPNI's implanted into both rodents and monkeys. Here, we achieve high amplitude EMG signals with a high signal to noise (SNR) ratio.

Astronomers, Transits of Venus, and the Birth of Experimental Psychology

NASA Astrophysics Data System (ADS)

Sheehan, William; Thurber, S.

2012-01-01

The eighteenth century transits of Venus were regarded as the most important astronomical events of their era. Halley's expectation was that by observing the contact points between the limbs of Venus and the Sun, this distance could be determined to an accuracy of one part in 500. But in the event, it proved otherwise. But, as the British historian Agnes Clerke wrote in 1902: "A transit of Venus seems, at first sight, full of promise for solving the problem of the sun's distance. For nothing would appear easier than to determine exactly either the duration of the passage of a small, dark orb across a large brilliant disc, or the instant of its entry upon or exit from it". But in that word `exactly' what snares and pitfalls lie hid!” In the post-mortem analysis of the disappointing results, astronomers devoted a great deal of effort to understand the sources of errors. They rehearsed their observational techniques by observing, under strictly controlled conditions, transits of artificial planets across artificial Suns, and studied such parameters as attention and reflex reaction. In the process, the transits of Venus provided an important impetus to the early development of experimental psychology.

Minimally invasive monitoring of skeletal muscle hypermetabolism induced by the phosphodiesterase-III-inhibitor milrinone and sodium fluoride.

PubMed

Schuster, Frank; Johannsen, Stephan; Roewer, Norbert; Anetseder, Martin

2013-04-01

We hypothesized that the phosphodiesterase-III-inhibitor milrinone and the non-specific G-protein activator sodium fluoride increase the skeletal muscular lactate levels as a sign of a hypermetabolic response. With approval of the local animal care committee Sprague-Dawley rats were killed and artificially perfused either with Ringer's solution or sodium fluoride 110 mM, while milrinone 1.32 mM or Ringer's solution at 1 μl/min was applied via microdialysis probes in both hind limbs. Lactate was measured spectrophotometrically in the dialysate. Baseline lactate levels before drug application did not differ between hind limbs. Local infusion of milrinone via microdialysis did not significantly increase intramuscular lactate concentrations compared with the Ringer control group. Muscular perfusion with sodium fluoride resulted in a significant increase of lactate and was potentiated by combination with local milrinone. Phosphodiesterase-III-inhibition alone does not significantly influence the lactate levels in skeletal muscle of sacrificed rats. Sodium fluoride infusion leads to an intramuscular lactate increase, which was further potentiated by local inhibition of phosphodiesterase-III. The fluoride-mediated hypermetabolic response following sodium fluoride could be a possible explanation for the observed myotoxic adverse effects in individuals treated by fluoride-containing agents. © 2012 The Authors. JPP © 2012. Royal Pharmaceutical Society.

Active upper limb prosthesis based on natural movement trajectories.

PubMed

Ramírez-García, Alfredo; Leija, Lorenzo; Muñoz, Roberto

2010-03-01

The motion of the current prostheses is sequential and does not allow natural movements. In this work, complex natural motion patterns from a healthy upper limb were characterized in order to be emulated for a trans-humeral prosthesis with three degrees of freedom at the elbow. Firstly, it was necessary to define the prosthesis workspace, which means to establish a relationship using an artificial neural network (ANN), between the arm-forearm (3-D) angles allowed by the prosthesis, and its actuators length. The 3-D angles were measured between the forearm and each axis of the reference system attached at the elbow. Secondly, five activities of daily living (ADLs) were analyzed by means of the elbow flexion (EF), the forearm prono-supination (FPS) and the 3-D angles, from healthy subjects, by using a video-based motion analysis system. The 3-D angles were fed to the prosthesis model (ANN) in order to analyze which ADLs could be emulated by the prosthesis. As a result, a prosthesis kinematics approximation was obtained. In conclusion, in spite of the innovative mechanical configuration of the actuators, it was possible to carry out only three of the five ADLs considered. Future work will include improvement of the mechanical configuration of the prosthesis to have greater range of motion.

Electrically stimulated signals from a long-term Regenerative Peripheral Nerve Interface.

PubMed

Langhals, Nicholas B; Woo, Shoshana L; Moon, Jana D; Larson, John V; Leach, Michelle K; Cederna, Paul S; Urbanchek, Melanie G

2014-01-01

Despite modern technological advances, the most widely available prostheses provide little functional recovery beyond basic grasping. Although sophisticated upper extremity prostheses are available, optimal prosthetic interfaces which give patients high-fidelity control of these artificial limbs are limited. We have developed a novel Regenerative Peripheral Nerve Interface (RPNI), which consists of a unit of free muscle that has been neurotized by a transected peripheral nerve. In conjunction with a biocompatible electrode on the muscle surface, the RPNI facilitates signal transduction from a residual peripheral nerve to a neuroprosthetic limb. The purpose of this study was to explore signal quality and reliability in an RPNI following an extended period of implantation. Following a 14-month maturation period, electromyographic signal generation was evaluated via electrical stimulation of the innervating nerve. The long-term RPNI was viable and healthy, as demonstrated by evoked compound muscle action potentials as well as histological tissue analysis. Signals exceeding 4 mV were successfully acquired and amplitudes were consistent across multiple repetitions of applied stimuli. There were no evident signs of muscle denervation, significant scar tissue, or muscle necrosis. This study provides further evidence that after a maturation period exceeding 1 year, reliable and consistent signals can still be acquired from an RPNI.

Spatial asymmetry in tactile sensor skin deformation aids perception of edge orientation during haptic exploration.

PubMed

Ponce Wong, Ruben D; Hellman, Randall B; Santos, Veronica J

2014-01-01

Upper-limb amputees rely primarily on visual feedback when using their prostheses to interact with others or objects in their environment. A constant reliance upon visual feedback can be mentally exhausting and does not suffice for many activities when line-of-sight is unavailable. Upper-limb amputees could greatly benefit from the ability to perceive edges, one of the most salient features of 3D shape, through touch alone. We present an approach for estimating edge orientation with respect to an artificial fingertip through haptic exploration using a multimodal tactile sensor on a robot hand. Key parameters from the tactile signals for each of four exploratory procedures were used as inputs to a support vector regression model. Edge orientation angles ranging from -90 to 90 degrees were estimated with an 85-input model having an R (2) of 0.99 and RMS error of 5.08 degrees. Electrode impedance signals provided the most useful inputs by encoding spatially asymmetric skin deformation across the entire fingertip. Interestingly, sensor regions that were not in direct contact with the stimulus provided particularly useful information. Methods described here could pave the way for semi-autonomous capabilities in prosthetic or robotic hands during haptic exploration, especially when visual feedback is unavailable.

Effects of Electric Shock on Respiration in the Rabbit*

PubMed Central

Lee, W. R.; Zoledziowski, S.

1964-01-01

Death from electric shock has been investigated on and off for just over 200 years. By the turn of the present century the three main methods of immediate death had been described. They are tetanic contraction of the respiratory muscles, ventricular fibrillation, and respiratory arrest. Since then there has been controversy over the relative importance of the last two as modes of death. For over half a century the first-aid treatment advised has been artificial respiration, based on the assumption that respiratory arrest is common in the usual limb to limb shock. The evidence for this assumption is reviewed and found to be open to question. An experimental investigation of the effect of forelimb to forelimb electric shock on respiration in rabbits has shown that, with currents up to about 200 mA, respiratory arrest appears to be due solely to muscular contraction. Larger currents produce respiratory arrest, usually followed by a delay before spontaneous resumption of respiration. The experimental currents have been taken up to 1 ampere, and at this level they resulted in considerable heating of the tissues. This resulted in marked macroscopic and histological changes in the forelimbs, despite which the animal breathed again spontaneously if ventricular fibrillation had not occurred. Images PMID:14142518

Experiencing Functional Electrical Stimulation Roots on Education, and Clinical Developments in Paraplegia and Tetraplegia With Technological Innovation.

PubMed

Varoto, Renato; Cliquet, Alberto

2015-10-01

Cybernetics-based concepts can allow for complete independence for paralyzed individuals, including sensory motor recovery. Spinal cord injuries are responsible for a huge stress on health and a financial burden to society. This article focuses on novel procedures such as functional diagnosis for paraplegics and tetraplegics, cybertherapies toward lessening comorbidities such as cardiovascular diseases, osteoporosis, etc., and the production of new technology for upper and lower limb control. Functional electrical stimulation reflects a unique opportunity for bipedal gait to be achieved by paraplegics and tetraplegics. Education and training of undergraduates and postgraduates in engineering and life sciences have also been a major aim of this work. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Bioengineered nerve regeneration and muscle reinnervation

PubMed Central

Kingham, Paul J; Terenghi, Giorgio

2006-01-01

The peripheral nervous system has the intrinsic capacity to regenerate but the reinnervation of muscles is often suboptimal and results in limited recovery of function. Injuries to nerves that innervate complex organs such as the larynx are particularly difficult to treat. The many functions of the larynx have evolved through the intricate neural regulation of highly specialized laryngeal muscles. In this review, we examine the responses of nerves and muscles to injury, focusing on changes in the expression of neurotrophic factors, and highlight differences between the skeletal limb and laryngeal muscle systems. We also describe how artificial nerve conduits have become a useful tool for delivery of neurotrophic factors as therapeutic agents to promote peripheral nerve repair and might eventually be useful in the treatment of laryngeal nerve injury. PMID:17005023

Functional electrical stimulation controlled by artificial neural networks: pilot experiments with simple movements are promising for rehabilitation applications.

PubMed

Ferrante, Simona; Pedrocchi, Alessandra; Iannò, Marco; De Momi, Elena; Ferrarin, Maurizio; Ferrigno, Giancarlo

2004-01-01

This study falls within the ambit of research on functional electrical stimulation for the design of rehabilitation training for spinal cord injured patients. In this context, a crucial issue is the control of the stimulation parameters in order to optimize the patterns of muscle activation and to increase the duration of the exercises. An adaptive control system (NEURADAPT) based on artificial neural networks (ANNs) was developed to control the knee joint in accordance with desired trajectories by stimulating quadriceps muscles. This strategy includes an inverse neural model of the stimulated limb in the feedforward line and a neural network trained on-line in the feedback loop. NEURADAPT was compared with a linear closed-loop proportional integrative derivative (PID) controller and with a model-based neural controller (NEUROPID). Experiments on two subjects (one healthy and one paraplegic) show the good performance of NEURADAPT, which is able to reduce the time lag introduced by the PID controller. In addition, control systems based on ANN techniques do not require complicated calibration procedures at the beginning of each experimental session. After the initial learning phase, the ANN, thanks to its generalization capacity, is able to cope with a certain range of variability of skeletal muscle properties.

Flow Rate Through Pigtail Catheter Used for Left Heart Decompression in an Artificial Model of Extracorporeal Membrane Oxygenation Circuit.

PubMed

Kim, Won Ho; Hong, Tae Hee; Byun, Joung Hun; Kim, Jong Woo; Kim, Sung Hwan; Moon, Sung Ho; Park, Hyun Oh; Choi, Jun Young; Yang, Jun Ho; Jang, In Seok; Lee, Chung Eun; Yun, Jeong Hee

In refractory cardiogenic shock, veno-arterial extracorporeal membrane oxygenation (ECMO) can be initiated. Although left heart decompression can be accomplished by insertion of a left atrial (LA) or left ventricular (LV) cannula using a percutaneous pigtail catheter, the venting flow rate according to catheter size and ECMO flow rate is unknown. We developed an artificial ECMO circuit. One liter saline bag with its pressure set to 20 mm Hg was connected to ECMO to mimic LV failure. A pigtail catheter was inserted into the 1 L saline bag to simulate LV unloading. For each pigtail catheter size (5-8 Fr) and ECMO flow rate (2.0-4.0 L/min), the moving distance of an air bubble that was injected through a three-way stopcock was measured in the arterial pressure line between the pigtail catheter and ECMO inflow limb. The flow rate was then calculated. We obtained the following equation to estimate the pigtail catheter flow rate.Pigtail vent catheter flow rate (ml/min) = 8×ECMOflow rate(L /min)+9×pigtail catheter size(Fr)- 57This equation would aid in designing of a further study to determine optimal venting flow rate. To achieve optimal venting flow, our equation would enable selection of an adequate catheter size.

PEGylated carboxyhemoglobin bovine (SANGUINATE): results of a phase I clinical trial.

PubMed

Misra, Hemant; Lickliter, Jason; Kazo, Friedericke; Abuchowski, Abraham

2014-08-01

PEGylated carboxyhemoglobin bovine (SANGUINATE) is a dual action carbon monoxide releasing (CO)/oxygen (O2 ) transfer agent for the treatment of hypoxia. Its components inhibit vasoconstriction, decrease extravasation, limit reactive oxygen species production, enhance blood rheology, and deliver oxygen to the tissues. Animal models of cerebral ischemia, peripheral ischemia, and myocardial ischemia demonstrated SANGUINATE's efficacy in reducing myocardial infarct size, limiting necrosis from cerebral ischemia, and promoting more rapid recovery from hind limb ischemia. In a Phase I trial, three cohorts of eight healthy volunteers received single ascending doses of 80, 120, or 160 mg/kg of SANGUINATE. Two volunteers within each cohort served as a saline control. There were no serious adverse events. Serum haptoglobin decreased, but did not appear to be dose related. The T1/2 was dose dependent and ranged from 7.9 to 13.8 h. In addition to the Phase I trial, SANGUINATE was used under an expanded access emergency Investigational New Drug. SANGUINATE was found to be safe and well tolerated in a Phase I clinical trial, and therefore it will advance into further clinical trials in patients. © 2014 The Authors. Artificial Organs published by Wiley Periodicals, Inc. on behalf of International Center for Artificial Organs and Transplantation (ICAOT).

Linking clinical measurements and kinematic gait patterns of toe-walking using fuzzy decision trees.

PubMed

Armand, Stéphane; Watelain, Eric; Roux, Emmanuel; Mercier, Moïse; Lepoutre, François-Xavier

2007-03-01

Toe-walking is one of the most prevalent gait deviations and has been linked to many diseases. Three major ankle kinematic patterns have been identified in toe-walkers, but the relationships between the causes of toe-walking and these patterns remain unknown. This study aims to identify these relationships. Clearly, such knowledge would increase our understanding of this gait deviation, and could help clinicians plan treatment. The large quantity of data provided by gait analysis often makes interpretation a difficult task. Artificial intelligence techniques were used in this study to facilitate interpretation as well as to decrease subjective interpretation. Of the 716 limbs evaluated, 240 showed signs of toe-walking and met inclusion criteria. The ankle kinematic pattern of the evaluated limbs during gait was assigned to one of three toe-walking pattern groups to build the training data set. Toe-walker clinical measurements (range of movement, muscle spasticity and muscle strength) were coded in fuzzy modalities, and fuzzy decision trees were induced to create intelligible rules allowing toe-walkers to be assigned to one of the three groups. A stratified 10-fold cross validation situated the classification accuracy at 81%. Twelve rules depicting the causes of toe-walking were selected, discussed and characterized using kinematic, kinetic and EMG charts. This study proposes an original approach to linking the possible causes of toe-walking with gait patterns.

A neural interface provides long-term stable natural touch perception.

PubMed

Tan, Daniel W; Schiefer, Matthew A; Keith, Michael W; Anderson, James Robert; Tyler, Joyce; Tyler, Dustin J

2014-10-08

Touch perception on the fingers and hand is essential for fine motor control, contributes to our sense of self, allows for effective communication, and aids in our fundamental perception of the world. Despite increasingly sophisticated mechatronics, prosthetic devices still do not directly convey sensation back to their wearers. We show that implanted peripheral nerve interfaces in two human subjects with upper limb amputation provided stable, natural touch sensation in their hands for more than 1 year. Electrical stimulation using implanted peripheral nerve cuff electrodes that did not penetrate the nerve produced touch perceptions at many locations on the phantom hand with repeatable, stable responses in the two subjects for 16 and 24 months. Patterned stimulation intensity produced a sensation that the subjects described as natural and without "tingling," or paresthesia. Different patterns produced different types of sensory perception at the same location on the phantom hand. The two subjects reported tactile perceptions they described as natural tapping, constant pressure, light moving touch, and vibration. Changing average stimulation intensity controlled the size of the percept area; changing stimulation frequency controlled sensation strength. Artificial touch sensation improved the subjects' ability to control grasping strength of the prosthesis and enabled them to better manipulate delicate objects. Thus, electrical stimulation through peripheral nerve electrodes produced long-term sensory restoration after limb loss. Copyright © 2014, American Association for the Advancement of Science.

Toward Dendrite-Free Lithium Deposition via Structural and Interfacial Synergistic Effects of 3D Graphene@Ni Scaffold.

PubMed

Xie, Keyu; Wei, Wenfei; Yuan, Kai; Lu, Wei; Guo, Min; Li, Zhihua; Song, Qiang; Liu, Xingrui; Wang, Jian-Gan; Shen, Chao

2016-10-05

Owing to its ultrahigh specific capacity and low electrochemical potential, lithium (Li) metal is regarded as one of the most attractive anode materials for next-generation lithium batteries. Nevertheless, the commercialization of Li-metal-based rechargeable batteries (LiMBs) has been retarded by the uncontrollable growth of Li dendrites, as well as the resulting poor cycle stability and safety hazards. In this work, a 3D graphene@Ni scaffold has been proposed to accomplish dendrite-free Li deposition via structural and interfacial synergistic effects. Due to the intrinsic high surface area used to reduce the effective electrode current density and the surface-coated graphene working as an artificial protection layer to provide high cycle stability as well as suppress the growth of Li dendrites, the Coulombic efficiencies of Li deposition on 3D graphene@Ni foam after 100 cycles can be sustained as high as 96, 98, and 92% at the current densities of 0.25, 0.5, and 1.0 mA cm -2 , respectively, which shows more excellent cycle stability than that of its planar Cu foil and bare Ni foam counterparts. The results obtained here demonstrate that the comprehensive consideration of multiaspect factors could be more help to enhance the performance of Li metal anode so as to achieve its real application in next-generation LiMBs.

A neural interface provides long-term stable natural touch perception

PubMed Central

Tan, Daniel W.; Schiefer, Matthew A.; Keith, Michael W.; Anderson, James Robert; Tyler, Joyce; Tyler, Dustin J.

2017-01-01

Touch perception on the fingers and hand is essential for fine motor control, contributes to our sense of self, allows for effective communication, and aids in our fundamental perception of the world. Despite increasingly sophisticated mechatronics, prosthetic devices still do not directly convey sensation back to their wearers. We show that implanted peripheral nerve interfaces in two human subjects with upper limb amputation provided stable, natural touch sensation in their hands for more than 1 year. Electrical stimulation using implanted peripheral nerve cuff electrodes that did not penetrate the nerve produced touch perceptions at many locations on the phantom hand with repeatable, stable responses in the two subjects for 16 and 24 months. Patterned stimulation intensity produced a sensation that the subjects described as natural and without “tingling,” or paresthesia. Different patterns produced different types of sensory perception at the same location on the phantom hand. The two subjects reported tactile perceptions they described as natural tapping, constant pressure, light moving touch, and vibration. Changing average stimulation intensity controlled the size of the percept area; changing stimulation frequency controlled sensation strength. Artificial touch sensation improved the subjects’ ability to control grasping strength of the prosthesis and enabled them to better manipulate delicate objects. Thus, electrical stimulation through peripheral nerve electrodes produced long-term sensory restoration after limb loss. PMID:25298320

["Bionic" arm prostheses. State of the art in research and development].

PubMed

Pylatiuk, C; Döderlein, L

2006-11-01

A new generation of arm prostheses is being developed worldwide. These so-called bionic prostheses are intended to offer additional functions, such as sensory feedback, extended range of possible movement, intuitive movement control as far as possible, and a more natural cosmetic appearance. In recent years, prosthetic components with much enhanced performance have been developed for use at various levels of the upper limb. Artificial hands that allow for additional grips are are being tested in clinical settings. Innovative methods of signal acquisition and communication with the patient are being intensively researched. Several patients have been provided with prototypes of new arm prostheses. At the moment, the results are limited by the restricted communication between patient and prosthesis. However, we can expect the options for prosthesis control to be extended in the near future.

Developmental Design of Synthetic Bacterial Architectures by Morphogenetic Engineering.

PubMed

Pascalie, Jonathan; Potier, Martin; Kowaliw, Taras; Giavitto, Jean-Louis; Michel, Olivier; Spicher, Antoine; Doursat, René

2016-08-19

Synthetic biology is an emerging scientific field that promotes the standardized manufacturing of biological components without natural equivalents. Its goal is to create artificial living systems that can meet various needs in health care or energy domains. While most works are focused on the individual bacterium as a chemical reactor, our project, SynBioTIC, addresses a novel and more complex challenge: shape engineering; that is, the redesign of natural morphogenesis toward a new kind of developmental 3D printing. Potential applications include organ growth, natural computing in biocircuits, or future vegetal houses. To create in silico multicellular organisms that exhibit specific shapes, we construe their development as an iterative process combining fundamental collective phenomena such as homeostasis, patterning, segmentation, and limb growth. Our numerical experiments rely on the existing Escherichia coli simulator Gro, a physicochemical computation platform offering reaction-diffusion and collision dynamics solvers. The synthetic bioware of our model executes a set of rules, or genome, in each cell. Cells can differentiate into several predefined types associated with specific actions (divide, emit signal, detect signal, die). Transitions between types are triggered by conditions involving internal and external sensors that detect various protein levels inside and around the cell. Indirect communication between bacteria is relayed by morphogen diffusion and the mechanical constraints of 2D packing. Starting from a single bacterium, the overall architecture emerges in a purely endogenous fashion through a series of developmental stages, inlcuding proliferation, differentiation, morphogen diffusion, and synchronization. The genome can be parametrized to control the growth and features of appendages individually. As exemplified by the L and T shapes that we obtain, certain precursor cells can be inhibited while others can create limbs of varying size (divergence of the homology). Such morphogenetic phenotypes open the way to more complex shapes made of a recursive array of core bodies and limbs and, most importantly, to an evolutionary developmental exploration of unplanned functional forms.

Changes in surface solar UV irradiances and total ozone during the solar eclipse of August 11, 1999

NASA Astrophysics Data System (ADS)

Zerefos, C. S.; Balis, D. S.; Meleti, C.; Bais, A. F.; Tourpali, K.; Kourtidis, K.; Vanicek, K.; Cappellani, F.; Kaminski, U.; Colombo, T.; Stübi, R.; Manea, L.; Formenti, P.; Andreae, M. O.

2000-11-01

During the solar eclipse of August 11, 1999, intensive measurements of UV solar irradiance and total ozone were performed at a number of observatories located near the path of the Moon's shadow. At the Laboratory of Atmospheric Physics (LAP) of the Aristotle University of Thessaloniki, Greece, global and direct spectra of UV solar irradiances (285-365 nm) were recorded with a double monochromator, and erythemal irradiances were measured with broadband pyranometers. In addition, higher-frequency measurements of global and direct irradiances at six UV wavelengths were performed with a single Brewer spectrophotometer. Total ozone measurements were also performed with Dobson and Brewer spectrophotometers at Hradec Kralove (Czech Republic), Ispra (Italy), Sestola (Italy), Hohenpeissenberg (Germany), Bucharest (Romania), Arosa (Switzerland), and Thessaloniki (Greece). From the spectral UV measurements the limb darkening effect of the solar disk was tentatively quantified from differences of measured solar spectral irradiances at the peak of the eclipse (near to limb conditions) and before the eclipse. Two blackbody curves were fit to the preeclipse and peak eclipse spectra, which have shown a difference in effective temperatures of about 165°K between the limb and the whole of the solar disk. The limb darkening effect is larger at the shorter UV wavelengths. The ratio of the diffuse to direct solar irradiances during the eclipse shows that the diffuse component is reduced much less compared to the decline of the direct solar irradiance at the shorter wavelengths. Moreover, a 20-min oscillation of erythemal UV-B solar irradiance was observed before and after the time of the eclipse maximum under clear skies, indicating a possible 20-min fluctuation in total ozone, presumably caused by the eclipse-induced gravity waves. This work also shows that routine total ozone measurements with a Brewer or a Dobson spectrophotometer should be used with caution during a solar eclipse. This is because the diffuse light increases by more than 30% with respect to the direct solar radiation, increasing more at the shorter wavelength side of the UV spectrum. This plausible mechanism introduces an artificial decrease in total ozone during solar eclipse of more than 30 Dobson units (DU), which is confirmed by all Brewer and Dobson measurements. Changes in total ozone cited earlier in the refereed literature have not been confirmed in the present study.

Multi-functional dielectric elastomer artificial muscles for soft and smart machines

NASA Astrophysics Data System (ADS)

Anderson, Iain A.; Gisby, Todd A.; McKay, Thomas G.; O'Brien, Benjamin M.; Calius, Emilio P.

2012-08-01

Dielectric elastomer (DE) actuators are popularly referred to as artificial muscles because their impressive actuation strain and speed, low density, compliant nature, and silent operation capture many of the desirable physical properties of muscle. Unlike conventional robots and machines, whose mechanisms and drive systems rapidly become very complex as the number of degrees of freedom increases, groups of DE artificial muscles have the potential to generate rich motions combining many translational and rotational degrees of freedom. These artificial muscle systems can mimic the agonist-antagonist approach found in nature, so that active expansion of one artificial muscle is taken up by passive contraction in the other. They can also vary their stiffness. In addition, they have the ability to produce electricity from movement. But departing from the high stiffness paradigm of electromagnetic motors and gearboxes leads to new control challenges, and for soft machines to be truly dexterous like their biological analogues, they need precise control. Humans control their limbs using sensory feedback from strain sensitive cells embedded in muscle. In DE actuators, deformation is inextricably linked to changes in electrical parameters that include capacitance and resistance, so the state of strain can be inferred by sensing these changes, enabling the closed loop control that is critical for a soft machine. But the increased information processing required for a soft machine can impose a substantial burden on a central controller. The natural solution is to distribute control within the mechanism itself. The octopus arm is an example of a soft actuator with a virtually infinite number of degrees of freedom (DOF). The arm utilizes neural ganglia to process sensory data at the local "arm" level and perform complex tasks. Recent advances in soft electronics such as the piezoresistive dielectric elastomer switch (DES) have the potential to be fully integrated with actuators and sensors. With the DE switch, we can produce logic gates, oscillators, and a memory element, the building blocks for a soft computer, thus bringing us closer to emulating smart living structures like the octopus arm. The goal of future research is to develop fully soft machines that exploit smart actuation networks to gain capabilities formerly reserved to nature, and open new vistas in mechanical engineering.

Visual Reliance for Balance Control in Older Adults Persists When Visual Information Is Disrupted by Artificial Feedback Delays

PubMed Central

Balasubramaniam, Ramesh

2014-01-01

Sensory information from our eyes, skin and muscles helps guide and correct balance. Less appreciated, however, is that delays in the transmission of sensory information between our eyes, limbs and central nervous system can exceed several 10s of milliseconds. Investigating how these time-delayed sensory signals influence balance control is central to understanding the postural system. Here, we investigate how delayed visual feedback and cognitive performance influence postural control in healthy young and older adults. The task required that participants position their center of pressure (COP) in a fixed target as accurately as possible without visual feedback about their COP location (eyes-open balance), or with artificial time delays imposed on visual COP feedback. On selected trials, the participants also performed a silent arithmetic task (cognitive dual task). We separated COP time series into distinct frequency components using low and high-pass filtering routines. Visual feedback delays affected low frequency postural corrections in young and older adults, with larger increases in postural sway noted for the group of older adults. In comparison, cognitive performance reduced the variability of rapid center of pressure displacements in young adults, but did not alter postural sway in the group of older adults. Our results demonstrate that older adults prioritize vision to control posture. This visual reliance persists even when feedback about the task is delayed by several hundreds of milliseconds. PMID:24614576

Decreased Corticospinal Excitability after the Illusion of Missing Part of the Arm.

PubMed

Kilteni, Konstantina; Grau-Sánchez, Jennifer; Veciana De Las Heras, Misericordia; Rodríguez-Fornells, Antoni; Slater, Mel

2016-01-01

Previous studies on body ownership illusions have shown that under certain multimodal conditions, healthy people can experience artificial body-parts as if they were part of their own body, with direct physiological consequences for the real limb that gets 'substituted.' In this study we wanted to assess (a) whether healthy people can experience 'missing' a body-part through illusory ownership of an amputated virtual body, and (b) whether this would cause corticospinal excitability changes in muscles associated with the 'missing' body-part. Forty right-handed participants saw a virtual body from a first person perspective but for half of them the virtual body was missing a part of its right arm. Single pulse transcranial magnetic stimulation was applied before and after the experiment to left and right motor cortices. Motor evoked potentials (MEPs) were recorded from the first dorsal interosseous (FDI) and the extensor digitorum communis (EDC) of each hand. We found that the stronger the illusion of amputation and arm ownership, the more the reduction of MEP amplitudes of the EDC muscle for the contralateral sensorimotor cortex. In contrast, no association was found for the EDC amplitudes in the ipsilateral cortex and for the FDI amplitudes in both contralateral and ipsilateral cortices. Our study provides evidence that a short-term illusory perception of missing a body-part can trigger inhibitory effects on corticospinal pathways and importantly in the absence of any limb deafferentation or disuse.

Solar Magnetism eXplorer (Solme X)

NASA Technical Reports Server (NTRS)

Peter, Hardi; Abbo, L.; Andretta, V.; Auchere, F.; Bemporad, A.; Berrilli, F.; Bommier, V.; Cassini, R.; Curdt, W.; Davila, J.;

Modifying upper-limb inter-joint coordination in healthy subjects by training with a robotic exoskeleton.

PubMed

Proietti, Tommaso; Guigon, Emmanuel; Roby-Brami, Agnès; Jarrassé, Nathanaël

2017-06-12

The possibility to modify the usually pathological patterns of coordination of the upper-limb in stroke survivors remains a central issue and an open question for neurorehabilitation. Despite robot-led physical training could potentially improve the motor recovery of hemiparetic patients, most of the state-of-the-art studies addressing motor control learning, with artificial virtual force fields, only focused on the end-effector kinematic adaptation, by using planar devices. Clearly, an interesting aspect of studying 3D movements with a robotic exoskeleton, is the possibility to investigate the way the human central nervous system deals with the natural upper-limb redundancy for common activities like pointing or tracking tasks. We asked twenty healthy participants to perform 3D pointing or tracking tasks under the effect of inter-joint velocity dependant perturbing force fields, applied directly at the joint level by a 4-DOF robotic arm exoskeleton. These fields perturbed the human natural inter-joint coordination but did not constrain directly the end-effector movements and thus subjects capability to perform the tasks. As a consequence, while the participants focused on the achievement of the task, we unexplicitly modified their natural upper-limb coordination strategy. We studied the force fields direct effect on pointing movements towards 8 targets placed in the 3D peripersonal space, and we also considered potential generalizations on 4 distinct other targets. Post-effects were studied after the removal of the force fields (wash-out and follow up). These effects were quantified by a kinematic analysis of the pointing movements at both end-point and joint levels, and by a measure of the final postures. At the same time, we analysed the natural inter-joint coordination through PCA. During the exposition to the perturbative fields, we observed modifications of the subjects movement kinematics at every level (joints, end-effector, and inter-joint coordination). Adaptation was evidenced by a partial decrease of the movement deviations due to the fields, during the repetitions, but it occurred only on 21% of the motions. Nonetheless post-effects were observed in 86% of cases during the wash-out and follow up periods (right after the removal of the perturbation by the fields and after 30 minutes of being detached from the exoskeleton). Important inter-individual differences were observed but with small variability within subjects. In particular, a group of subjects showed an over-shoot with respect to the original unexposed trajectories (in 30% of cases), but the most frequent consequence (in 55% of cases) was the partial persistence of the modified upper-limb coordination, adopted at the time of the perturbation. Temporal and spatial generalizations were also evidenced by the deviation of the movement trajectories, both at the end-effector and at the intermediate joints and the modification of the final pointing postures towards targets which were never exposed to any field. Such results are the first quantified characterization of the effects of modification of the upper-limb coordination in healthy subjects, by imposing modification through viscous force fields distributed at the joint level, and could pave the way towards opportunities to rehabilitate pathological arm synergies with robots.

[Hand transplantation and implantation of nerve chips. New developments within hand surgery].

PubMed

Dahlin, L; Fridén, J; Hagberg, L; Lundborg, G

1999-10-06

Injuries and diseases of the hand naturally have an enormous impact on hand function and on quality of life, both occupational and social. The majority of hand-injury patients are under 30 years of age. Hand surgery, an established specialty in Sweden since 1969, is of great importance in terms of clinical developments, education and research. In the coming decade, scientific and clinical advances are to be expected in several fields such as nerve injuries including brachial plexus lesion, microsurgery, flexor tendon injuries and tendon transfer. Bioimplant research and new advances at the biotechnological interface will yield new options in nerve reconstruction, microchip implants in the nervous system, and the restoration of muscle-tendon function following injury. Artificial limbs with advanced motor and sensory functions will be important future aids in the rehabilitation of amputees. Transplantation of human hands is another promising reconstructive procedure which may open up new perspectives in the coming millennium.

[Hand transplantation and implantation of nerve chips. New developments within hand surgery].

PubMed

Dahlin, L; Fridén, J; Hagberg, L; Lundborg, G

2000-03-20

Injuries and diseases of the hand naturally have an enormous impact on hand function and on quality of life, both occupational and social. The majority of hand-injury patients are under 30 years of age. Hand surgery, an established specialty in Sweden since 1969, is of great importance in terms of clinical developments, education and research. In the coming decade, scientific and clinical advances are to be expected in several fields such as nerve injuries including brachial plexus lesion, microsurgery, flexor tendon injuries and tendon transfer. Bioimplant research and new advances at the biotechnological interface will yield new options in nerve reconstruction, microchip implants in the nervous system, and the restoration of muscle-tendon function following injury. Artificial limbs with advanced motor and sensory functions will be important future aids in the rehabilitation of amputees. Transplantation of human hands is another promising reconstructive procedure which may open iup new perspectives in the coming millennium.

Prosthetic Manhood in the Soviet Union at the End of World War II.

PubMed

Bernstein, Frances

2015-01-01

Millions of Soviet soldiers were disabled as a direct consequence of their service in the Second World War. Yet despite its expressions of gratitude for their sacrifices, the state evinced a great deal of discomfort regarding their damaged bodies. The countless armless and legless veterans were a constant reminder of the destruction suffered by the country as a whole, an association increasingly incompatible with the postwar agenda of wholesale reconstruction. This article focuses on a key strategy for erasing the scars of war, one with ostensibly unambiguous benefit for the disabled themselves: the development of prostheses. In addition to fostering independence from others and ultimately from the state, artificial limbs would facilitate the veterans' return to the kinds of socially useful labor by which the country defined itself. In so doing, this strategy engendered the establishment of a new model of masculinity: a prosthetic manhood.

Smart Carriers and Nanohealers: A Nanomedical Insight on Natural Polymers

PubMed Central

Raveendran, Sreejith; Rochani, Ankit K.; Maekawa, Toru; Kumar, D. Sakthi

2017-01-01

Biodegradable polymers are popularly being used in an increasing number of fields in the past few decades. The popularity and favorability of these materials are due to their remarkable properties, enabling a wide range of applications and market requirements to be met. Polymer biodegradable systems are a promising arena of research for targeted and site-specific controlled drug delivery, for developing artificial limbs, 3D porous scaffolds for cellular regeneration or tissue engineering and biosensing applications. Several natural polymers have been identified, blended, functionalized and applied for designing nanoscaffolds and drug carriers as a prerequisite for enumerable bionano technological applications. Apart from these, natural polymers have been well studied and are widely used in material science and industrial fields. The present review explains the prominent features of commonly used natural polymers (polysaccharides and proteins) in various nanomedical applications and reveals the current status of the polymer research in bionanotechnology and science sectors. PMID:28796191

A review of supernumerary and absent limbs and digits of the upper limb.

PubMed

Klaassen, Zachary; Choi, Monica; Musselman, Ruth; Eapen, Deborah; Tubbs, R Shane; Loukas, Marios

2012-03-01

For years people have been enamored by anomalies of the human limbs, particularly supernumerary and absent limbs and digits. Historically, there are a number of examples of such anomalies, including royal families of ancient Chaldea, tribes from Arabia, and examples from across nineteenth century Europe. The development of the upper limbs in a growing embryo is still being elucidated with the recent advent of homeobox genes, but researchers agree that upper limbs develop between stages 12-23 through a complex embryological process. Maternal thalidomide intake during limb development is known to cause limb reduction and subsequent amelia or phocomelia. Additionally, a number of clinical reports have illustrated different limb anomaly cases, with each situation unique in phenotype and developmental abnormality. Supernumerary and absent limbs and digits are not unique to humans, and a number of animal cases have also been reported. This review of the literature illustrates the historical, anatomical, and clinical aspects of supernumerary and absent limbs and digits for the upper limb.

Prevalence and Characteristics of Phantom Limb Pain and Residual Limb Pain in the Long Term after Upper Limb Amputation

ERIC Educational Resources Information Center

Desmond, Deirdre M.; MacLachlan, Malcolm

2010-01-01

This study aims to describe the prevalence and characteristics of phantom limb pain and residual limb pain after upper limb amputation. One-hundred and forty-one participants (139 males; mean age 74.8 years; mean time since amputation 50.1 years) completed a self-report questionnaire assessing residual and phantom limb pain experience. Prevalence…

Standardized Approach to Quantitatively Measure Residual Limb Skin Health in Individuals with Lower Limb Amputation.

PubMed

Rink, Cameron L; Wernke, Matthew M; Powell, Heather M; Tornero, Mark; Gnyawali, Surya C; Schroeder, Ryan M; Kim, Jayne Y; Denune, Jeffrey A; Albury, Alexander W; Gordillo, Gayle M; Colvin, James M; Sen, Chandan K

2017-07-01

Objective: (1) Develop a standardized approach to quantitatively measure residual limb skin health. (2) Report reference residual limb skin health values in people with transtibial and transfemoral amputation. Approach: Residual limb health outcomes in individuals with transtibial ( n  = 5) and transfemoral ( n  = 5) amputation were compared to able-limb controls ( n  = 4) using noninvasive imaging (hyperspectral imaging and laser speckle flowmetry) and probe-based approaches (laser doppler flowmetry, transcutaneous oxygen, transepidermal water loss, surface electrical capacitance). Results: A standardized methodology that employs noninvasive imaging and probe-based approaches to measure residual limb skin health are described. Compared to able-limb controls, individuals with transtibial and transfemoral amputation have significantly lower transcutaneous oxygen tension, higher transepidermal water loss, and higher surface electrical capacitance in the residual limb. Innovation: Residual limb health as a critical component of prosthesis rehabilitation for individuals with lower limb amputation is understudied in part due to a lack of clinical measures. Here, we present a standardized approach to measure residual limb health in people with transtibial and transfemoral amputation. Conclusion: Technology advances in noninvasive imaging and probe-based measures are leveraged to develop a standardized approach to quantitatively measure residual limb health in individuals with lower limb loss. Compared to able-limb controls, resting residual limb physiology in people that have had transfemoral or transtibial amputation is characterized by lower transcutaneous oxygen tension and poorer skin barrier function.

Anthropometric correlations between parts of the upper and lower limb: models for personal identification in a Sudanese population.

PubMed

Ahmed, Altayeb Abdalla

2016-09-01

Identification of a deceased individual is an essential component of medicolegal practice. However, personal identification based on commingled limbs or parts of limbs, necessary in investigations of mass disasters or some crimes, is a difficult task. Limb measurements have been utilized in the development of biological parameters for personal identification, but the possibility to estimate the dimensions of parts of limbs other than hands and feet has not been assessed. The present study proposes an approach to estimate the dimensions of various parts of limbs based on other limb measurements. The study included 320 Sudanese adults, with equal representation of men and women. Nine limb dimensions were measured (five based on the upper limb, four based on the lower limb), and extensive statistical analysis of the distribution of values was performed. The results showed that all of the measured dimensions were sexually dimorphic and that there was a significant positive correlation between the dimensions of various parts of limbs. Regression models (direct and stepwise) were developed to estimate the dimensions of parts of limbs based on measurements pertaining to one or more other parts of limbs. The study revealed that the dimensions of parts of the upper and lower limb can be estimated from one another. These findings can be used in medicolegal practice and extended to constructive surgery, orthopedics, and prosthesis design for lost limbs.

Chronic pain associated with upper-limb loss.

PubMed

Hanley, Marisol A; Ehde, Dawn M; Jensen, Mark; Czerniecki, Joseph; Smith, Douglas G; Robinson, Lawrence R

2009-09-01

To describe the prevalence, intensity, and functional impact of the following types of pain associated with upper-limb loss: phantom limb, residual limb, back, neck, and nonamputated-limb pain. Cross-sectional survey; 104 respondents with upper-limb loss at least 6 months postamputation completed measures of pain intensity, interference, disability, and health-related quality-of-life. Nearly all (90%) of the respondents reported pain, with 76% reporting more than one pain type. Phantom-limb pain and residual-limb pain were the most prevalent (79% and 71%, respectively), followed by back (52%), neck (43%), and nonamputated-limb pain (33%). Although nonamputated-limb pain was least prevalent, it was reported to cause the highest levels of interference and pain-related disability days. Self-reported quality-of-life was significantly lower for individuals with each type of pain compared with those without any pain. Age, time since amputation, and cause of amputation were not associated with pain. In addition to pain in the phantom and residual limb, back, neck, and nonamputated-limb pain are also common after upper-limb loss. All of these pain types are associated with significant disability and activity interference for some individuals, suggesting that assessment of multiple pain types in persons with upper-limb amputation may be important.

Thoracic limb alignment in healthy labrador retrievers: evaluation of standing versus recumbent frontal plane radiography.

PubMed

Goodrich, Zachary J; Norby, Bo; Eichelberger, Bunita M; Friedeck, Wade O; Callis, Hollye N; Hulse, Don A; Kerwin, Sharon C; Fox, Derek B; Saunders, W Brian

2014-10-01

To report thoracic limb alignment values in healthy dogs; to determine if limb alignment values are significantly different when obtained from standing versus recumbent radiographic projections. Prospective cross-sectional study. Labrador Retrievers (n = 45) >15 months of age. Standing and recumbent radiographs were obtained and limb montages were randomized before analysis by a single investigator blinded to dog, limb, and limb position. Twelve limb alignment values were determined using the CORA methodology. Measurements were performed in triplicate and intra-observer variability was evaluated by intra-class correlation coefficient (ICC). Limb alignment values were reported as mean ± SD and 95% confidence intervals. Linear mixed models were used to determine if significant associations existed between limb alignment values and limb, limb position, gender, age, weight, and body condition score. There were significant differences in standing and recumbent limb alignment values for all values except elbow mechanical axis deviation (eMAD). Limb, gender, age, body weight, and body condition score had no effect. ICC values ranged from 0.522 to 0.758, indicating moderate to substantial agreement for repeated measurements by a single investigator. Limb alignment values are significantly different when determined from standing versus recumbent radiographs in healthy Labrador Retrievers. © Copyright 2014 by The American College of Veterinary Surgeons.

Mobile-bearing medial unicompartmental knee arthroplasty restores limb alignment comparable to that of the unaffected contralateral limb

PubMed Central

Mullaji, Arun B; Shah, Siddharth; Shetty, Gautam M

2017-01-01

Background and purpose — Medial unicompartmental knee arthroplasty (UKA) is undertaken in patients with a passively correctable varus deformity. We investigated whether restoration of natural soft tissue tension would result in a lower limb alignment similar to that of the contralateral unaffected lower limb after mobile-bearing medial UKA. Patients and methods — In this retrospective study, hip-knee-ankle (HKA) angle, position of the weight-bearing axis (WBA), and knee joint line obliquity (KJLO) after mobile-bearing medial UKA was compared with that of the unaffected (clinically and radiologically) contralateral lower limb in 123 patients. Results — Postoperatively, HKA angle was restored to within ±3° of the contralateral lower limb in 87% of the patients and the WBA passed within ±1 Kennedy and White’s tibial zone of the unaffected contralateral lower limb in 95% of the patients. The mean KJLO in the operated limbs was not significantly different from that in the unaffected lower limbs (p = 0.07) and the KJLO in the operated limb was restored to within ±3° of that in the contralateral lower limb in 96% of the patients. Interpretation — Lower limb alignment and knee joint line obliquity after mobile-bearing medial UKA were comparable to that of the unaffected contralateral limb in most patients. Comparison with the contralateral unaffected lower limb is a reliable method for evaluation and validation of limb mechanical alignment after mobile-bearing medial UKA. PMID:27794622

Agency over Phantom Limb Enhanced by Short-Term Mirror Therapy

PubMed Central

Imaizumi, Shu; Asai, Tomohisa; Koyama, Shinichi

2017-01-01

Most amputees experience phantom limb, whereby they feel that the amputated limb is still present. In some cases, these experiences include pain that can be alleviated by “mirror therapy.” Mirror therapy consists of superimposing a mirrored image of the moving intact limb onto the phantom limb. This therapy provides a closed loop between the motor command to the amputated limb and its predicted visual feedback. This loop is also involved in the sense of agency, a feeling of controlling one’s own body. However, it is unclear how mirror therapy is related to the sense of agency over a phantom limb. Using mirror therapy, we investigated phantom limb pain and the senses of agency and ownership (i.e., a feeling of having one’s own body) of the phantom limb. Nine upper-limb amputees, five of whom reported recent phantom limb pain, underwent a single 15-min trial of mirror therapy. Before and after the trial, the participants completed a questionnaire regarding agency, ownership, and pain related to their phantom limb. They reported that the sense of agency over the phantom limb increased following the mirror therapy trial, while the ownership slightly increased but not as much as did the agency. The reported pain did not change; that is, it was comparably mild before and after the trial. These results suggest that short-term mirror therapy can, at least transiently, selectively enhance the sense of agency over a phantom limb, but may not alleviate phantom limb pain. PMID:29046630

Agency over Phantom Limb Enhanced by Short-Term Mirror Therapy.

PubMed

Imaizumi, Shu; Asai, Tomohisa; Koyama, Shinichi

2017-01-01

Most amputees experience phantom limb, whereby they feel that the amputated limb is still present. In some cases, these experiences include pain that can be alleviated by "mirror therapy." Mirror therapy consists of superimposing a mirrored image of the moving intact limb onto the phantom limb. This therapy provides a closed loop between the motor command to the amputated limb and its predicted visual feedback. This loop is also involved in the sense of agency, a feeling of controlling one's own body. However, it is unclear how mirror therapy is related to the sense of agency over a phantom limb. Using mirror therapy, we investigated phantom limb pain and the senses of agency and ownership (i.e., a feeling of having one's own body) of the phantom limb. Nine upper-limb amputees, five of whom reported recent phantom limb pain, underwent a single 15-min trial of mirror therapy. Before and after the trial, the participants completed a questionnaire regarding agency, ownership, and pain related to their phantom limb. They reported that the sense of agency over the phantom limb increased following the mirror therapy trial, while the ownership slightly increased but not as much as did the agency. The reported pain did not change; that is, it was comparably mild before and after the trial. These results suggest that short-term mirror therapy can, at least transiently, selectively enhance the sense of agency over a phantom limb, but may not alleviate phantom limb pain.

Position Sense in Chronic Pain: Separating Peripheral and Central Mechanisms in Proprioception in Unilateral Limb Pain.

PubMed

Tsay, Anthony J; Giummarra, Melita J

2016-07-01

Awareness of limb position is derived primarily from muscle spindles and higher-order body representations. Although chronic pain appears to be associated with motor and proprioceptive disturbances, it is not clear if this is due to disturbances in position sense, muscle spindle function, or central representations of the body. This study examined position sense errors, as an indicator of spindle function, in participants with unilateral chronic limb pain. The sample included 15 individuals with upper limb pain, 15 with lower limb pain, and 15 sex- and age-matched pain-free control participants. A 2-limb forearm matching task in blindfolded participants, and a single-limb pointer task, with the reference limb hidden from view, was used to assess forearm position sense. Position sense was determined after muscle contraction or stretch, intended to induce a high or low spindle activity in the painful and nonpainful limbs, respectively. Unilateral upper and lower limb chronic pain groups produced position errors comparable with healthy control participants for position matching and pointer tasks. The results indicate that the painful and nonpainful limb are involved in limb-matching. Lateralized pain, whether in the arm or leg, does not influence forearm position sense. Painful and nonpainful limbs are involved in bilateral limb-matching. Muscle spindle function appears to be preserved in the presence of chronic pain. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Hyperinnervation improves Xenopus laevis limb regeneration.

PubMed

Mitogawa, Kazumasa; Makanae, Aki; Satoh, Akira

2018-01-15

Xenopus laevis (an anuran amphibian) shows limb regeneration ability between that of urodele amphibians and that of amniotes. Xenopus frogs can initiate limb regeneration but fail to form patterned limbs. Regenerated limbs mainly consist of cone-shaped cartilage without any joints or branches. These pattern defects are thought to be caused by loss of proper expressions of patterning-related genes. This study shows that hyperinnervation surgery resulted in the induction of a branching regenerate. The hyperinnervated blastema allows the identification and functional analysis of the molecules controlling this patterning of limb regeneration. This paper focuses on the nerve affects to improve Xenopus limb patterning ability during regeneration. The nerve molecules, which regulate limb patterning, were also investigated. Blastemas grown in a hyperinnervated forelimb upregulate limb patterning-related genes (shh, lmx1b, and hoxa13). Nerves projecting their axons to limbs express some growth factors (bmp7, fgf2, fgf8, and shh). Inputs of these factors to a blastema upregulated some limb patterning-related genes and resulted in changes in the cartilage patterns in the regenerates. These results indicate that additional nerve factors enhance Xenopus limb patterning-related gene expressions and limb regeneration ability, and that bmp, fgf, and shh are candidate nerve substitute factors. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Combining two open source tools for neural computation (BioPatRec and Netlab) improves movement classification for prosthetic control.

PubMed

Prahm, Cosima; Eckstein, Korbinian; Ortiz-Catalan, Max; Dorffner, Georg; Kaniusas, Eugenijus; Aszmann, Oskar C

2016-08-31

Controlling a myoelectric prosthesis for upper limbs is increasingly challenging for the user as more electrodes and joints become available. Motion classification based on pattern recognition with a multi-electrode array allows multiple joints to be controlled simultaneously. Previous pattern recognition studies are difficult to compare, because individual research groups use their own data sets. To resolve this shortcoming and to facilitate comparisons, open access data sets were analysed using components of BioPatRec and Netlab pattern recognition models. Performances of the artificial neural networks, linear models, and training program components were compared. Evaluation took place within the BioPatRec environment, a Matlab-based open source platform that provides feature extraction, processing and motion classification algorithms for prosthetic control. The algorithms were applied to myoelectric signals for individual and simultaneous classification of movements, with the aim of finding the best performing algorithm and network model. Evaluation criteria included classification accuracy and training time. Results in both the linear and the artificial neural network models demonstrated that Netlab's implementation using scaled conjugate training algorithm reached significantly higher accuracies than BioPatRec. It is concluded that the best movement classification performance would be achieved through integrating Netlab training algorithms in the BioPatRec environment so that future prosthesis training can be shortened and control made more reliable. Netlab was therefore included into the newest release of BioPatRec (v4.0).

Solar magnetism eXplorer (SolmeX). Exploring the magnetic field in the upper atmosphere of our closest star

NASA Astrophysics Data System (ADS)

Peter, Hardi; Abbo, L.; Andretta, V.; Auchère, F.; Bemporad, A.; Berrilli, F.; Bommier, V.; Braukhane, A.; Casini, R.; Curdt, W.; Davila, J.; Dittus, H.; Fineschi, S.; Fludra, A.; Gandorfer, A.; Griffin, D.; Inhester, B.; Lagg, A.; Landi Degl'Innocenti, E.; Maiwald, V.; Sainz, R. Manso; Martínez Pillet, V; Matthews, S.; Moses, D.; Parenti, S.; Pietarila, A.; Quantius, D.; Raouafi, N.-E.; Raymond, J.; Rochus, P.; Romberg, O.; Schlotterer, M.; Schühle, U.; Solanki, S.; Spadaro, D.; Teriaca, L.; Tomczyk, S.; Trujillo Bueno, J.; Vial, J.-C.

2012-04-01

The magnetic field plays a pivotal role in many fields of Astrophysics. This is especially true for the physics of the solar atmosphere. Measuring the magnetic field in the upper solar atmosphere is crucial to understand the nature of the underlying physical processes that drive the violent dynamics of the solar corona—that can also affect life on Earth. SolmeX, a fully equipped solar space observatory for remote-sensing observations, will provide the first comprehensive measurements of the strength and direction of the magnetic field in the upper solar atmosphere. The mission consists of two spacecraft, one carrying the instruments, and another one in formation flight at a distance of about 200 m carrying the occulter to provide an artificial total solar eclipse. This will ensure high-quality coronagraphic observations above the solar limb. SolmeX integrates two spectro-polarimetric coronagraphs for off-limb observations, one in the EUV and one in the IR, and three instruments for observations on the disk. The latter comprises one imaging polarimeter in the EUV for coronal studies, a spectro-polarimeter in the EUV to investigate the low corona, and an imaging spectro-polarimeter in the UV for chromospheric studies. SOHO and other existing missions have investigated the emission of the upper atmosphere in detail (not considering polarization), and as this will be the case also for missions planned for the near future. Therefore it is timely that SolmeX provides the final piece of the observational quest by measuring the magnetic field in the upper atmosphere through polarimetric observations.

Representing high-dimensional data to intelligent prostheses and other wearable assistive robots: A first comparison of tile coding and selective Kanerva coding.

PubMed

Travnik, Jaden B; Pilarski, Patrick M

2017-07-01

Prosthetic devices have advanced in their capabilities and in the number and type of sensors included in their design. As the space of sensorimotor data available to a conventional or machine learning prosthetic control system increases in dimensionality and complexity, it becomes increasingly important that this data be represented in a useful and computationally efficient way. Well structured sensory data allows prosthetic control systems to make informed, appropriate control decisions. In this study, we explore the impact that increased sensorimotor information has on current machine learning prosthetic control approaches. Specifically, we examine the effect that high-dimensional sensory data has on the computation time and prediction performance of a true-online temporal-difference learning prediction method as embedded within a resource-limited upper-limb prosthesis control system. We present results comparing tile coding, the dominant linear representation for real-time prosthetic machine learning, with a newly proposed modification to Kanerva coding that we call selective Kanerva coding. In addition to showing promising results for selective Kanerva coding, our results confirm potential limitations to tile coding as the number of sensory input dimensions increases. To our knowledge, this study is the first to explicitly examine representations for realtime machine learning prosthetic devices in general terms. This work therefore provides an important step towards forming an efficient prosthesis-eye view of the world, wherein prompt and accurate representations of high-dimensional data may be provided to machine learning control systems within artificial limbs and other assistive rehabilitation technologies.

Getting around when you're round: quantitative analysis of the locomotion of the blunt-spined brittle star, Ophiocoma echinata.

PubMed

Astley, Henry C

2012-06-01

Brittle stars (Ophiuroidea, Echinodermata) are pentaradially symmetrical echinoderms that use five multi-jointed limbs to locomote along the seafloor. Prior qualitative descriptions have claimed coordinated movements of the limbs in a manner similar to tetrapod vertebrates, but this has not been evaluated quantitatively. It is uncertain whether the ring-shaped nervous system, which lacks an anatomically defined anterior, is capable of generating rhythmic coordinated movements of multiple limbs. This study tested whether brittle stars possess distinct locomotor modes with strong inter-limb coordination as seen in limbed animals in other phyla (e.g. tetrapods and arthropods), or instead move each limb independently according to local sensory feedback. Limb tips and the body disk were digitized for 56 cycles from 13 individuals moving across sand. Despite their pentaradial anatomy, all individuals were functionally bilateral, moving along the axis of a central limb via synchronous motions of contralateral limbs (±~13% phase lag). Two locomotor modes were observed, distinguishable mainly by whether the central limb was directed forwards or backwards. Turning was accomplished without rotation of the body disk by defining a different limb as the center limb and shifting other limb identities correspondingly, and then continuing locomotion in the direction of the newly defined anterior. These observations support the hypothesis that, in spite of their radial body plan, brittle stars employ coordinated, bilaterally symmetrical locomotion.

Management of the multiple limb amputee.

PubMed

Davidson, J H; Jones, L E; Cornet, J; Cittarelli, T

2002-09-10

Multiple limb amputations involving at least one upper extremity are very uncommon. The amputation of both an upper and lower limb is even more uncommon. Due to the rarity of these amputations therapists are uncertain regarding the most appropriate treatment methods. While the majority of the protocols used for single limb amputations are appropriate for these multiple limb amputees, there are differences. Loss of multiple limbs creates a problem of overheating for the individual. Loss of an arm and leg results in difficulty donning the prostheses and difficulty using crutches and parallel bars during mobilization. A review is given of 16 multiple limb amputees seen in our rehabilitation centre in the last 15 years. Return to work was seen in one third and was not related to the number of the amputations. A higher proportion of these multiple limb amputations occur through alcoholism or attempted suicide behaviour than occurs with either single upper limb amputations or lower limb amputations. This existing behaviour can create a management problem for the rehabilitation team during rehabilitation. Guidelines as to appropriate prosthetic and preprosthetic care are provided to assist the practitioner who has the acute and long term care of these patients. All multiple limb amputees should be referred to a specialized rehabilitation centre to discuss prosthetic options and long term rehabilitation requirements. This paper does not discuss bilateral lower limb amputations when not combined with an upper limb amputation.

Collagen reconstitution is inversely correlated with induction of limb regeneration in Ambystoma mexicanum.

PubMed

Satoh, Akira; Hirata, Ayako; Makanae, Aki

2012-03-01

Amphibians can regenerate missing body parts, including limbs. The regulation of collagen has been considered to be important in limb regeneration. Collagen deposition is suppressed during limb regeneration, so we investigated collagen deposition and apical epithelial cap (AEC) formation during axolotl limb regeneration. The accessory limb model (ALM) has been developed as an alternative model for studying limb regeneration. Using this model, we investigated the relationship between nerves, epidermis, and collagen deposition. We found that Sp-9, an AEC marker gene, was upregulated by direct interaction between nerves and epidermis. However, collagen deposition hindered this interaction, and resulted in the failure of limb regeneration. During wound healing, an increase in deposition of collagen caused a decrease in the blastema induction rate in ALM. Wound healing and limb regeneration are alternate processes.

Vertical head and pelvic movement symmetry at the trot in dogs with induced supporting limb lameness.

PubMed

Gómez Álvarez, C B; Gustås, P; Bergh, A; Rhodin, M

2017-11-01

Compensatory limb loading has been studied in lame dogs; however, little is known about how these compensations relate to motion of the head and pelvis, assessment of which is an important component of lameness examinations. The aim of this study was to describe the patterns of vertical head and pelvic motion symmetry at the trot in dogs with induced supporting limb lameness in the forelimbs or hind limbs. Ten sound dogs were trotted on a treadmill before and after temporary induction of moderate lameness (grade 2/5) in each limb. Reflective markers were located on the head, pelvis and right forelimb, and kinematic data were captured with a motion capture system. Upper body symmetry parameters were calculated, including differences in the highest (HDmax) and in the lowest (HDmin) positions of the head, and in the highest (PDmax) and in the lowest (PDmin) positions of the mid-pelvis, with a value of zero indicating symmetry. The head was lowered more during the sound limb stance phase and lowered less during the lame limb stance phase in supporting forelimb lameness (HDmin: 4.6mm in dogs when sound, -18.3mm when left limb lameness was induced and 20.5mm when right limb lameness was induced). The mid-pelvis was lowered more during the sound limb stance phase and lowered and lifted less during the lame limb stance phase in supporting hind limb lameness (PDmin: 1mm in dogs when sound, -10.1mm in left limb lameness and 8.4mm in right limb lameness). The hip of the lame side, measured at the level of the greater trochanter, had an increased downwards displacement during the lame limb swing phase (-21mm in left hind limb lameness, P=0.005; 23.4mm in right hind limb lameness, P=0.007). Asymmetry in the lowering of the head or mid-pelvis is a more sensitive indicator of supporting forelimb and hind limb lameness, respectively, than asymmetry in the raising of the head. Increased displacement of the hip ('hip drop' of the lame side during its swing phase) is a good indicator of hind limb lameness in dogs. Copyright © 2017. Published by Elsevier Ltd.

RESIDUAL LIMB VOLUME CHANGE: SYSTEMATIC REVIEW OF MEASUREMENT AND MANAGEMENT

PubMed Central

Sanders, JE; Fatone, S

2014-01-01

Management of residual limb volume affects decisions regarding timing of fit of the first prosthesis, when a new prosthetic socket is needed, design of a prosthetic socket, and prescription of accommodation strategies for daily volume fluctuations. The purpose of this systematic review was to assess what is known about measurement and management of residual limb volume change in persons with lower-limb amputation. Publications that met inclusion criteria were grouped into three categories: (I) descriptions of residual limb volume measurement techniques; (II) studies on people with lower-limb amputation investigating the effect of residual limb volume change on clinical care; and (III) studies of residual limb volume management techniques or descriptions of techniques for accommodating or controlling residual limb volume. The review showed that many techniques for the measurement of residual limb volume have been described but clinical use is limited largely because current techniques lack adequate resolution and in-socket measurement capability. Overall, there is limited evidence regarding the management of residual limb volume, and the evidence available focuses primarily on adults with trans-tibial amputation in the early post-operative phase. While we can draw some insights from the available research about residual limb volume measurement and management, further research is required. PMID:22068373

[Venous tone of the limbs. Methods and comparison of 2 areas].

PubMed

Journo, H; London, G; Pannier, B; Safar, M

1989-07-01

The limb venous tone, index of local venous compliance, was studied with mercury strain gauge plethysmography on 28 male normal subjects (40 +/- 17 years, +/- SD) simultaneously on upper and lower limbs. Measurements were done after 20 mn rest in supine position. Venous tone (VT) equals the slope of the pressure-volume curve established by simultaneous recording of the forearm and calf relative volumes for successive steps of pressure lower than or equal to 30 mmHg. Limb venous capacitance was expressed by means of the maximal limb relative volume (V30) reached for a pressure of 30 mmHg applied through cuffs in standardized conditions. The upper limb venous tone was greater than the lower limb venous tone: 24.3 +/- 8.2 mmHg/ml/100 vs 17.5 +/- 7.9 mmHg/ml/100, p = 0.001. V30 was greater in lower limb than in upper limb: 1.5 +/- 0.5 ml/100 vs 1.1 +/- 0.4 ml/100, p = 0.001. In conclusion, it appears that upper and lower limbs venous distensibility and capacitance are different. They are greater in the lower limb in baseline conditions. Thus simultaneous studies of both these limb venous systems seems important for physiological experiments because of their baseline differences.

Upper limb injury in rugby union football: results of a cohort study.

PubMed

Usman, Juliana; McIntosh, Andrew Stuart

2013-04-01

There have been few in-depth studies of upper limb injury epidemiology in rugby union football, despite reports that they accounted for between 14% and 28% of all rugby injuries. To report on upper limb injury incidence, injury severity and to identify the risk factors associated with upper limb injuries, for example, level of play, season (years) and playing position. Prospective cohort study across five rugby seasons from 2004 to 2008. Formal rugby competitions-suburban, provincial and international. 1475 adult male rugby players in Colts, Grade and Elite competitions. An upper limb injury resulting in a missed game and its characteristics. A total of 61 598 athletic exposures (AE) and 606 upper limb injuries were recorded. About 66% of the injuries were to the shoulder. The overall upper limb injury incidence rate (IIR) was 9.84 injuries/1000 AE (95% CI 9.06 to 10.62). Statistically significant associations were found between upper limb injuries and level of play; and between shoulder injuries and playing position (p<0.05). No association was found between upper limb and shoulder injuries and study year. The overall upper limb IIR decreased as the level of play increased; 10.74 upper limb injuries/1000 AE (95% CI 9.93 to 11.56) in Colts to 6.07 upper limb injuries/1000 AE (95% CI 5.46 to 6.69) in Elite. The upper limb IIR decreased as the level of play increased indicating that age, level of skill and playing experience may be risk factors for upper limb injury.

The Effect of Sliding Humeral Osteotomy (SHO) on Frontal Plane Thoracic Limb Alignment: An Ex Vivo Canine Cadaveric Study.

PubMed

Breiteneicher, Adam H; Norby, Bo; Schulz, Kurt S; Kerwin, Sharon C; Hulse, Don A; Fox, Derek B; Saunders, W Brian

2016-11-01

To determine the effect of sliding humeral osteotomy (SHO) on frontal plane thoracic limb alignment in standing and recumbent limb positions. Canine cadaveric study. Canine thoracic limbs (n=15 limb pairs). Limbs acquired from healthy Labrador Retrievers euthanatized for reasons unrelated to this study were mounted in a limb press and aligned in a standing position followed by axial loading at 30% body weight. Frontal plane radiography was performed in standing and recumbent positions pre- and post-SHO. In the standing position, lateralization of the foot was measured pre- and post-SHO using a textured grid secured to the limb press base plate. Twelve thoracic limb alignment values (mean ± SD and 95% CI) were determined using the center of rotation of angulation (CORA) method were compared using linear mixed models to determine if significant differences existed between limb alignment values pre- or post-SHO, controlling for dog, limb, and limb position. Six of 12 standing or recumbent alignment values were significantly different pre- and post-SHO. SHO resulted in decreased mechanical lateral distal humeral angle and movement of the mechanical humeral radio-ulnar angle, radio-ulnar metacarpal angle, thoracic humeral angle, and elbow mechanical axis deviation toward coaxial limb alignment. In the standing position, the foot underwent significant lateralization post-SHO. SHO resulted in significant alteration in frontal plane thoracic limb alignment. Additional studies are necessary to determine if the changes reported using our ex vivo model occur following SHO in vivo. © Copyright 2016 by The American College of Veterinary Surgeons.

Phosphorylation of Lbx1 controls lateral myoblast migration into the limb.

PubMed

Masselink, Wouter; Masaki, Megumi; Sieiro, Daniel; Marcelle, Christophe; Currie, Peter D

2017-10-15

The migration of limb myogenic precursors from limb level somites to their ultimate site of differentiation in the limb is a paradigmatic example of a set of dynamic and orchestrated migratory cell behaviours. The homeobox containing transcription factor ladybird homeobox 1 (Lbx1) is a central regulator of limb myoblast migration, null mutations of Lbx1 result in severe disruptions to limb muscle formation, particularly in the distal region of the limb in mice (Gross et al., 2000). As such Lbx1 has been hypothesized to control lateral migration of myoblasts into the distal limb anlage. It acts as a core regulator of the limb myoblast migration machinery, controlled by Pax3. A secondary role for Lbx1 in the differentiation and commitment of limb musculature has also been proposed (Brohmann et al., 2000; Uchiyama et al., 2000). Here we show that lateral migration, but not differentiation or commitment of limb myoblasts, is controlled by the phosphorylation of three adjacent serine residues of LBX1. Electroporation of limb level somites in the chick embryo with a dephosphomimetic form of Lbx1 results in a specific defect in the lateral migration of limb myoblasts. Although the initial delamination and migration of myoblasts is unaffected, migration into the distal limb bud is severely disrupted. Interestingly, myoblasts undergo normal differentiation independent of their migratory status, suggesting that the differentiation potential of hypaxial muscle is not regulated by the phosphorylation state of LBX1. Furthermore, we show that FGF8 and ERK mediated signal transduction, both critical regulators of the developing limb bud, have the capacity to induce the phosphorylation of LBX1 at these residues. Overall, this suggests a mechanism whereby the phosphorylation of LBX1, potentially through FGF8 and ERK signalling, controls the lateral migration of myoblasts into the distal limb bud. Copyright © 2017. Published by Elsevier Inc.

Is Atherectomy the Best First-Line Therapy for Limb Salvage in Patients With Critical Limb Ischemia?

PubMed Central

Loor, Gabriel; Skelly, Christopher L.; Wahlgren, Carl-Magnus; Bassiouny, Hisham S.; Piano, Giancarlo; Shaalan, Wael

2010-01-01

Objective To determine the efficacy of atherectomy for limb salvage compared with open bypass in patients with critical limb ischemia. Methods Ninety-nine consecutive bypass and atherectomy procedures performed for critical limb ischemia between January 2003 and October 2006 were reviewed. Results A total of 99 cases involving TASC C (n = 43, 44%) and D (n = 56, 56%) lesions were treated with surgical bypass in 59 patients and atherectomy in 33 patients. Bypass and atherectomy achieved similar 1-year primary patency (64% vs 63%; P = .2). However, the 1-year limb salvage rate was greater in the bypass group (87% vs 69%; P = .004). In the tissue loss subgroup, there was a greater limb salvage rate for bypass patients versus atherectomy (79% vs 60%; P = .04). Conclusions Patients with critical limb ischemia may do better with open bypass compared with atherectomy as first-line therapy for limb salvage. PMID:19640919

Functional specialisation of pelvic limb anatomy in horses (Equus caballus)

PubMed Central

Payne, RC; Hutchinson, JR; Robilliard, JJ; Smith, NC; Wilson, AM

2005-01-01

We provide quantitative anatomical data on the muscle–tendon units of the equine pelvic limb. Specifically, we recorded muscle mass, fascicle length, pennation angle, tendon mass and tendon rest length. Physiological cross sectional area was then determined and maximum isometric force estimated. There was proximal-to-distal reduction in muscle volume and fascicle length. Proximal limb tendons were few and, where present, were relatively short. By contrast, distal limb tendons were numerous and long in comparison to mean muscle fascicle length, increasing potential for elastic energy storage. When compared with published data on thoracic limb muscles, proximal pelvic limb muscles were larger in volume and had shorter fascicles. Distal limb muscle architecture was similar in thoracic and pelvic limbs with the exception of flexor digitorum lateralis (lateral head of the deep digital flexor), the architecture of which was similar to that of the pelvic and thoracic limb superficial digital flexors, suggesting a functional similarity. PMID:15960766

Developmental origin of limb size variation in lizards.

PubMed

Andrews, Robin M; Skewes, Sable A

2017-05-01

In many respects, reptile hatchlings are fully functional, albeit miniature, adults. This means that the adult morphology must emerge during embryonic development. This insight emphasizes the connection between the mechanisms that generate phenotypic variation during embryonic development and the action of selection on post-hatching individuals. To determine when species-specific differences in limb and tail lengths emerge during embryonic development, we compared allometric patterns of early limb growth of four distantly related species of lizards. The major questions addressed were whether early embryonic limb and tail growth is characterized by the gradual (continuous allometry) or by the abrupt emergence (transpositional allometry) of size differences among species. Our observations supported transpositional allometry of both limbs and tails. Species-specific differences in limb and tail length were exhibited when limb and tail buds first protruded from the body wall. Genes known to be associated with early limb development of tetrapods are obvious targets for studies on the genetic mechanisms that determine interspecific differences in relative limb length. Broadly comparative studies of gene regulation would facilitate understanding of the mechanisms underlying adaptive variation in limb size, including limb reduction and loss, of squamate reptiles. © 2017 Wiley Periodicals, Inc.

An attempt to detect lameness in galloping horses by use of body-mounted inertial sensors.

PubMed

Lopes, Marco A F; Dearo, Antonio C O; Lee, Allen; Reed, Shannon K; Kramer, Joanne; Pai, P Frank; Yonezawa, Yoshiharu; Maki, Hiromitchi; Morgan, Terry L; Wilson, David A; Keegan, Kevin G

2016-10-01

OBJECTIVE To evaluate head, pelvic, and limb movement to detect lameness in galloping horses. ANIMALS 12 Thoroughbreds. PROCEDURES Movement data were collected with inertial sensors mounted on the head, pelvis, and limbs of horses trotting and galloping in a straight line before and after induction of forelimb and hind limb lameness by use of sole pressure. Successful induction of lameness was determined by measurement of asymmetric vertical head and pelvic movement during trotting. Differences in gallop strides before and after induction of lameness were evaluated with paired-sample statistical analysis and neural network training and testing. Variables included maximum, minimum, range, and time indices of vertical head and pelvic acceleration, head rotation in the sagittal plane, pelvic rotation in the frontal plane, limb contact intervals, stride durations, and limb lead preference. Difference between median standardized gallop strides for each limb lead before and after induction of lameness was calculated as the sum of squared differences at each time index and assessed with a 2-way ANOVA. RESULTS Head and pelvic acceleration and rotation, limb timing, stride duration measurements, and limb lead preference during galloping were not significantly different before and after induction of lameness in the forelimb or hind limb. Differences between limb leads before induction of lameness were similar to or greater than differences within limb leads before and after lameness induction. CONCLUSIONS AND CLINICAL RELEVANCE Galloping horses maintained asymmetry of head, pelvic, and limb motion between limb leads that was unrelated to lameness.

Does a balance deficit persist in Australian Football players with previous lower limb ligament injury?

PubMed

Hrysomallis, C; McLaughlin, P; Goodman, C

2005-03-01

A history of lower limb ligament injury is a commonly-cited risk factor for another similar injury. During the acute phase of injury, there is a balancing skill deficit in the injured limb. It has been unclear as to whether this deficit persists in the medium-to-long term for previously injured Australian footballers, contributing to the risk of re-injury. This study compared the balance ability of footballers with and without previous lower limb ligament injury and, for previously injured players, the balance ability of the previously injured limb to the opposite uninjured limb. A total of 216 players from 6 teams from the Australian Football League were tested. The balance task comprised stepping on to a foam mat on top of a force plate and maintaining one-legged balance. The subjects were divided into 4 groups based on their injury history: all ankle injuries to only one limb, recent ankle injuries to only one limb (within the last 12 months), knee ligament injury only to one limb, and no previous ankle or knee ligament injury. Statistical analysis revealed that there was no significant difference between the balance scores of any of the previously injured players and those with no previous lower limb ligament injury. There was no significant difference between the balance score of the previously injured limb with the opposite uninjured limb. It appears that a balance deficit does not persist in Australian Football players with previous lower limb ligament injury.

Long-term outcome of dogs treated with ulnar rollover transposition for limb-sparing of distal radial osteosarcoma: 27 limbs in 26 dogs.

PubMed

Séguin, Bernard; O'Donnell, Matthew D; Walsh, Peter J; Selmic, Laura E

2017-10-01

To determine outcomes in dogs with distal radial osteosarcoma treated with ulnar rollover transposition (URT) limb-sparing surgery including: viability of the ulnar graft, complications, subjective limb function, disease-free interval (DFI), and survival time (ST). Retrospective case series. Twenty-six client-owned dogs with distal radial osteosarcoma and no involvement of the ulna. Data of dogs treated with URT were collected at the time of surgery and retrospectively from medical records and by contacting owners and referring veterinarians. URT technique was performed on 27 limbs in 26 dogs. The ulnar graft was determined to be viable in 17 limbs, nonviable in 3, and unknown in 7. Complications occurred in 20 limbs. Infection was diagnosed in 12 limbs. Biomechanical complications occurred in 15 and local recurrence in 2 limbs. Limb function graded by veterinarians or owners was poor in 2 limbs, fair in 4, good in 14, excellent in 3, and unknown in 4. Median DFI was 245 days and median ST was 277 days. The URT technique maintained the viability of the ulnar graft. The complication rate was high but limb function appeared acceptable. Although sufficient length of the distal aspect of the ulna must be preserved to perform this technique, local recurrence was not increased compared to other limb-sparing techniques when cases were appropriately selected. © 2017 The American College of Veterinary Surgeons.

Trunk and Shank Position Influences Patellofemoral Joint Stress in the Lead and Trail Limbs During the Forward Lunge Exercise.

PubMed

Hofmann, Cory L; Holyoak, Derek T; Juris, Paul M

2017-01-01

Study Design Controlled laboratory study, repeated-measures design. Background The effects of trunk and shank position on patellofemoral joint stress of the lead limb have been well studied; however, the effects on the trail limb are not well understood. Objectives To test the hypothesis that trunk and shank position may influence patellofemoral joint stress in both limbs during the forward lunge exercise. Methods Patellofemoral kinetics were quantified from 18 healthy participants performing the lunge exercise with different combinations of trunk and shank positions (vertical or forward). A 2-by-3 (limb-by-lunge variation) repeated-measures analysis of variance was performed, using paired t tests for post hoc comparisons. Results The trail limb experienced greater total patellofemoral joint stress relative to the lead limb, regardless of trunk and shank position (P<.0001). The lunge variation with a vertical shank position resulted in significantly greater peak patellofemoral joint stress in the trail limb relative to the lead limb (P<.0001). A forward trunk and shank position resulted in the highest patellofemoral stress in the lead limb (P<.0001). Conclusion Trunk and shank positions have a significant influence on patellofemoral joint loading of both limbs during the forward lunge, with the trail limb generally experiencing greater total joint stress. Restricting forward translation of the lead-limb shank may reduce patellofemoral joint stress at the expense of increased stress in the trail limb. Technique recommendations should consider the demands imposed on both knees during this exercise. J Orthop Sports Phys Ther 2017;47(1):31-40. Epub 4 Nov 2016. doi:10.2519/jospt.2017.6336.

Gait termination on a declined surface in trans-femoral amputees: Impact of using microprocessor-controlled limb system.

PubMed

Abdulhasan, Zahraa M; Scally, Andy J; Buckley, John G

2018-05-30

Walking down ramps is a demanding task for transfemoral-amputees and terminating gait on ramps is even more challenging because of the requirement to maintain a stable limb so that it can do the necessary negative mechanical work on the centre-of-mass in order to arrest (dissipate) forward/downward velocity. We determined how the use of a microprocessor-controlled limb system (simultaneous control over hydraulic resistances at ankle and knee) affected the negative mechanical work done by each limb when transfemoral-amputees terminated gait during ramp descent. Eight transfemoral-amputees completed planned gait terminations (stopping on prosthesis) on a 5-degree ramp from slow and customary walking speeds, with the limb's microprocessor active or inactive. When active the limb operated in its 'ramp-descent' mode and when inactive the knee and ankle devices functioned at constant default levels. Negative limb work, determined as the integral of the negative mechanical (external) limb power during the braking phase, was compared across speeds and microprocessor conditions. Negative work done by each limb increased with speed (p < 0.001), and on the prosthetic limb it was greater when the microprocessor was active compared to inactive (p = 0.004). There was no change in work done across microprocessor conditions on the intact limb (p = 0.35). Greater involvement of the prosthetic limb when the limb system was active indicates its ramp-descent mode effectively altered the hydraulic resistances at the ankle and knee. Findings highlight participants became more assured using their prosthetic limb to arrest centre-of-mass velocity. Copyright © 2018 Elsevier Ltd. All rights reserved.

Surgical Tourniquets in Orthopaedics

DTIC Science & Technology

2009-12-01

occlusion pressure and the ratio of the cuff width to the limb circumference23. This relationship is shown in Figure 4, indicating that, for a given limb...measured limb occlusion pressure to account for physiologic Fig. 3 a: A normal node of Ranvier of a nerve in a limb, showing a nodal gap 1 to 2 mm in ...limb occlusion pressure an additional pressure safety margin that is selected to be greater than the magnitude of any increase in limb occlusion

Energetic benefits and adaptations in mammalian limbs: Scale effects and selective pressures.

PubMed

Kilbourne, Brandon M; Hoffman, Louwrens C

2015-06-01

Differences in limb size and shape are fundamental to mammalian morphological diversity; however, their relevance to locomotor costs has long been subject to debate. In particular, it remains unknown if scale effects in whole limb morphology could partially underlie decreasing mass-specific locomotor costs with increasing limb length. Whole fore- and hindlimb inertial properties reflecting limb size and shape-moment of inertia (MOI), mass, mass distribution, and natural frequency-were regressed against limb length for 44 species of quadrupedal mammals. Limb mass, MOI, and center of mass position are negatively allometric, having a strong potential for lowering mass-specific locomotor costs in large terrestrial mammals. Negative allometry of limb MOI results in a 40% reduction in MOI relative to isometry's prediction for our largest sampled taxa. However, fitting regression residuals to adaptive diversification models reveals that codiversification of limb mass, limb length, and body mass likely results from selection for differing locomotor modes of running, climbing, digging, and swimming. The observed allometric scaling does not result from selection for energetically beneficial whole limb morphology with increasing size. Instead, our data suggest that it is a consequence of differing morphological adaptations and body size distributions among quadrupedal mammals, highlighting the role of differing limb functions in mammalian evolution. © 2015 The Author(s). Evolution © 2015 The Society for the Study of Evolution.

Gender differences in asymmetrical limb support patterns between subjects with and without recurrent low back pain.

PubMed

Sung, Paul S; Zipple, J Tim; Danial, Pamela

2017-04-01

New insight regarding limb-dominance effects on temporal-spatial gait parameters is needed to further investigate subjects with recurrent low back pain (LBP). Although an asymmetrical gait pattern was found to reflect natural functional differences, there is a lack of information regarding gender differences on dominant limb support patterns in subjects with LBP. The purpose of this study was to investigate temporal-spatial gait parameters based on limb dominance and gender between subjects with and without LBP. One hundred and ten right limb dominant older adults (51 subjects with LBP and 59 control subjects) participated in the study. A three-dimensional motion capture system was utilized to measure temporal-spatial gait parameters, including initial double, single, and terminal double limb support times and walking speed. The gender differences between subjects with and without LBP were analyzed based on dominance for those parameters. Overall, limb dominance demonstrated significant differences on single and terminal double limb support times as well as walking speed. Limb dominance also demonstrated interactions on group x gender for single limb support time and walking speed. The male subjects with LBP demonstrated significantly increased single limb support times on the non-dominant limb. The significant gender and group interactions based on limb dominance account for a possible pain avoidance, asymmetrical limb support pattern. The causal pathway in dominance dependency gait by unweighted ambulation might be considered as an intervention for correcting these gait deviations in subjects with LBP. The specific modification recovery profiles of the subjects with LBP could shed light on variability of current LBP experiences of the subjects and reasons for gait deviations. Clinicians need to consider the mechanism of dominant limb dependency, which requires postural control strategies in male subjects with recurrent LBP. Copyright © 2017 Elsevier B.V. All rights reserved.

Customization of biliopancreatic limb length to modulate and sustain antidiabetic effect of gastric bypass surgery.

PubMed

Pal, A; Rhoads, D B; Tavakkoli, A

2018-02-01

Although Roux-en-Y Gastric Bypass (RYGB) remains the most effective treatment for obesity and type 2 diabetes (T2D), many patients fail to achieve remission, or relapse. Increasing intestinal limb lengths of RYGB may improve outcomes, but the mechanistic basis for this remains unclear. We hypothesize biliopancreatic (BP) limb length modulates the antidiabetic effect of RYGB. Rats underwent RYGB with a 20-cm (RYGB-20cm) or 40-cm (RYGB-40cm) BP limb and were compared with control animals. After 2 and 4 wk, portal and systemic blood was sampled during intestinal glucose infusion. Portosystemic gradient was used to calculate intestinal glucose utilization (G util ), absorption (G absorp ), and hormone secretion. Intestinal morphology and gene expression were assessed. At 2 wk, G absorp progressively decreased with increasing BP limb length; this pattern persisted at 4 wk. G util increased ≈70% in both RYGB-20cm and -40cm groups at 2 wk. At 4 wk, G util progressively increased with limb length. Furthermore, Roux limb weight, and expression of hexokinase and preproglucagon, exhibited a similar progressive increase. At 4 wk, glucagon-like peptide-1 and -2 levels were higher after RYGB-40cm, with associated increased secretion. We conclude that BP limb length modulates multiple antidiabetic mechanisms, analogous to the dose-response relationship of a drug. Early postoperatively, a longer BP limb reduces G absorp . Later, G util , Roux limb hypertrophy, hormone secretion, and hormone levels are increased with longer BP limb. Sustained high incretin levels may prevent weight regain and T2D relapse. These data provide the basis for customizing BP limb length according to patient characteristics and desired metabolic effect. NEW & NOTEWORTHY Biliopancreatic limb length in gastric bypass modulates multiple antidiabetic mechanisms, analogous to the dose-response relationship of a drug. With a longer biliopancreatic limb, Roux limb hypertrophy, increased glucose utilization, reduced glucose absorption, and sustained high incretin levels may prevent weight regain and diabetes relapse.

Aggressive intraosseous lipoma of the intermediate phalanges of the thumb.

PubMed

Hashimoto, Kazuhiko; Nishimura, Shunji; Kakinoki, Ryosuke; Akagi, Masao

2018-07-01

Intraosseous lipomas occurring in the bones of the upper limbs are very rare. The tumor often occurs in long bones, especially the calcaneus. Usually patients with intraosseous lipomas present with mild clinical features. Thus far, bone destruction caused by the tumor has not been reported. The present study reported a case of an aggressive intraosseous lipoma that developed in the intermediate phalanges of the thumb. This is an extremely rare case with extraosseous development, which occurred at a rare site. A 47-year old woman presented to us with right thumb pain and swelling. Computed tomography and magnetic resonance imaging revealed a mass extending to the outer edge of the phalangeal bone. The patient was treated with surgery the remove the tumor. Artificial bone was used to refill the area due to the lack of cancellous bone. During the clinical management of lipomas, it is important to consider that intraosseous lipomas may spread out of the bone; moreover, the tumor should be removed immediately to help reduce the possibility of bone destruction.

Estimation of continuous multi-DOF finger joint kinematics from surface EMG using a multi-output Gaussian Process.

PubMed

Ngeo, Jimson; Tamei, Tomoya; Shibata, Tomohiro

2014-01-01

Surface electromyographic (EMG) signals have often been used in estimating upper and lower limb dynamics and kinematics for the purpose of controlling robotic devices such as robot prosthesis and finger exoskeletons. However, in estimating multiple and a high number of degrees-of-freedom (DOF) kinematics from EMG, output DOFs are usually estimated independently. In this study, we estimate finger joint kinematics from EMG signals using a multi-output convolved Gaussian Process (Multi-output Full GP) that considers dependencies between outputs. We show that estimation of finger joints from muscle activation inputs can be improved by using a regression model that considers inherent coupling or correlation within the hand and finger joints. We also provide a comparison of estimation performance between different regression methods, such as Artificial Neural Networks (ANN) which is used by many of the related studies. We show that using a multi-output GP gives improved estimation compared to multi-output ANN and even dedicated or independent regression models.

Neural network classification of myoelectric signal for prosthesis control.

PubMed

Kelly, M F; Parker, P A; Scott, R N

1991-12-01

An alternate approach to deriving control for multidegree of freedom prosthetic arms is considered. By analyzing a single-channel myoelectric signal (MES), we can extract information that can be used to identify different contraction patterns in the upper arm. These contraction patterns are generated by subjects without previous training and are naturally associated with specific functions. Using a set of normalized MES spectral features, we can identify contraction patterns for four arm functions, specifically extension and flexion of the elbow and pronation and supination of the forearm. Performing identification independent of signal power is advantageous because this can then be used as a means for deriving proportional rate control for a prosthesis. An artificial neural network implementation is applied in the classification task. By using three single-layer perceptron networks, the MES is classified, with the spectral representations as input features. Trials performed on five subjects with normal limbs resulted in an average classification performance level of 85% for the four functions. Copyright © 1991. Published by Elsevier Ltd.

Structural Integration and Control of Peerless Human-like Prosthetic Hand

NASA Astrophysics Data System (ADS)

Dave, Ankit; Muthu, P.; Karthikraj, V.; Latha, S.

2018-04-01

Limb damage can create severe disturbance in movement and operative abilities wherein the prosthetic rehabilitation has the potential to replace function and enhance the quality of life. This paper presents a humanlike prosthetic hand using such unique design concept of hand model using artificial bones, ligaments, and tendons controlled using Arduino. Amongst various platforms available, Arduino is known for its adaptability, adoration and low cost. The design of prosthetic hand has a unique structure with all carpal, metacarpal, and phalanges which are bones of the hand. These bones are attached to each other following the pattern of human hand using the polymeric rubber as a functioning ligament. Furthermore, this structure of finger is driven by tendons attached to all fingers and passes through the ligaments working as pulley resulting in more degrees of freedom. The motor can twitch the tendons to achieve the action of fingers. Thus the servos, controlled by an Arduino, are used to regulate the movement mechanism of the prosthetic hand.

New Technique of Applying Topical Oxygen Therapy as a Cost-Effective Procedure.

PubMed

Agarwal, Vivek; Aroor, Shashank; Gupta, Nikhil; Gupta, Arun; Agarwal, Nitin; Kaur, Navneet

2015-12-01

To describe the newly designed technique of applying topical oxygen therapy for large wounds. C arm sterile disposable cover is used for covering the wound. For abdominal and pelvis wounds, two artificial holes are created at one end of the cover for the inclusion of the limb. Free end of the cover is secured with adhesive, and a hole is created for the insertion of the suction catheter. Oxygen cylinder is connected to the suction catheter, and oxygen is supplied at the rate of 10 L/min. Three patients were treated with topical oxygen therapy. These patients were cases of necrotizing soft tissue infections and large post traumatic wounds. There were less requirements of debridement and granulation tissue appeared earlier. The cost of one cycle of the therapy is less than 500 INR. Topical oxygen therapy is the recent modality for improved wound healing. The novel method of applying topical oxygen devised by us is effective, feasible, and cost-effective as compared to standard devices.

Temper Foam

NASA Technical Reports Server (NTRS)

1981-01-01

Fabricated by Expanded Rubber & Plastics Corporation, Temper Foam provides better impact protection for airplane passengers and enhances passenger comfort on long flights because it distributes body weight and pressure evenly over the entire contact area. Called a "memory foam" it matches the contour of the body pressing against it and returns to its original shape once the pressure is removed. As a shock absorber, a three-inch foam pad has the ability to absorb the impact of a 10-foot fall by an adult. Applications include seat cushioning for transportation vehicles, padding for furniture and a variety of athletic equipment medical applications including wheelchair padding, artificial limb socket lining, finger splint and hand padding for burn patients, special mattresses for the bedridden and dental stools. Production and sales rights are owned by Temper Foam, Inc. Material is manufactured under license by the Dewey and Almy Division of Grace Chemical Corporation. Distributors of the product are Kees Goebel Medical Specialties, Inc. and Alimed, Inc. They sell Temper Foam in bulk to the fabricators who trim it to shapes required by their customers.

Advances in selective activation of muscles for non-invasive motor neuroprostheses.

PubMed

Koutsou, Aikaterini D; Moreno, Juan C; Del Ama, Antonio J; Rocon, Eduardo; Pons, José L

2016-06-13

Non-invasive neuroprosthetic (NP) technologies for movement compensation and rehabilitation remain with challenges for their clinical application. Two of those major challenges are selective activation of muscles and fatigue management. This review discusses how electrode arrays improve the efficiency and selectivity of functional electrical stimulation (FES) applied via transcutaneous electrodes. In this paper we review the principles and achievements during the last decade on techniques for artificial motor unit recruitment to improve the selective activation of muscles. We review the key factors affecting the outcome of muscle force production via multi-pad transcutaneous electrical stimulation and discuss how stimulation parameters can be set to optimize external activation of body segments. A detailed review of existing electrode array systems proposed by different research teams is also provided. Furthermore, a review of the targeted applications of existing electrode arrays for control of upper and lower limb NPs is provided. Eventually, last section demonstrates the potential of electrode arrays to overcome the major challenges of NPs for compensation and rehabilitation of patient-specific impairments.

Electroencephalography(EEG)-based instinctive brain-control of a quadruped locomotion robot.

PubMed

Jia, Wenchuan; Huang, Dandan; Luo, Xin; Pu, Huayan; Chen, Xuedong; Bai, Ou

2012-01-01

Artificial intelligence and bionic control have been applied in electroencephalography (EEG)-based robot system, to execute complex brain-control task. Nevertheless, due to technical limitations of the EEG decoding, the brain-computer interface (BCI) protocol is often complex, and the mapping between the EEG signal and the practical instructions lack of logic associated, which restrict the user's actual use. This paper presents a strategy that can be used to control a quadruped locomotion robot by user's instinctive action, based on five kinds of movement related neurophysiological signal. In actual use, the user drives or imagines the limbs/wrists action to generate EEG signal to adjust the real movement of the robot according to his/her own motor reflex of the robot locomotion. This method is easy for real use, as the user generates the brain-control signal through the instinctive reaction. By adopting the behavioral control of learning and evolution based on the proposed strategy, complex movement task may be realized by instinctive brain-control.

Human dignity and transhumanism: do anthro-technological devices have moral status?

PubMed

Jotterand, Fabrice

2010-07-01

In this paper, I focus on the concept of human dignity and critically assess whether such a concept, as used in the Universal Declaration on Bioethics and Human Rights, is indeed a useful tool for bioethical debates. However, I consider this concept within the context of the development of emerging technologies, that is, with a particular focus on transhumanism. The question I address is not whether attaching artificial limbs or enhancing particular traits or capacities would dehumanize or undignify persons but whether nonbiological entities introduced into or attached to the human body contribute to the "augmentation" of human dignity. First, I outline briefly how the Universal Declaration on Bioethics and Human Rights uses the concept of dignity. Second, I look at the possibility of a universal bioethics in relation to the concept of human dignity. Third, I examine the concept of posthuman dignity and whether the concept of human dignity as construed in the declaration has any relevance to posthuman dignity.

Simultaneous strain and temperature sensor based on polarization maintaining fiber and multimode fiber

NASA Astrophysics Data System (ADS)

Xing, Rui; Dong, Changbin; Wang, Zixiao; Wu, Yue; Yang, Yuguang; Jian, Shuisheng

2018-06-01

A novel, simultaneous strain and temperature sensor utilizing polarization maintaining fiber (PMF) and multimode fiber (MMF) is proposed and experimentally demonstrated in this paper. The sensing head of this sensor can be obtained by splicing PMF and MMF in the structure of PMF-MMF-PMF. The extinction ratio of the transmission spectrum can be over 30 dB. The strain sensitivities of sensor by two spectrum dips can be 1.01 pm/με and 1.27 pm/με in the range from 0 to 2000 με. Meanwhile, the temperature sensitivities of 49 pm/°C and 41 pm/°C can be achieved by two spectrum dips in the range from 30 °C to 70 °C. The sensitivity difference between the two spectrum dips can be used to realize dual parameters fiber sensing. This sensor exhibits the advantages of simple fabrication, compact structure and multi-purpose measuring. It may have the great potential in fields of robot arms and artificial limbs.

Apparatus for determining changes in limb volume

NASA Technical Reports Server (NTRS)

Bhagat, P. K.; Wu, V. C. (Inventor)

1981-01-01

Measuring apparatus for determining changes in the volume of limbs or other boty extremities by determining the cross-sectional area of such limbs many comprise a transmitter including first and second transducers for positioning on the surface of the limb at a predetermined distance there between, and a receiver including a receiver crystal for positioning on the surface of the limb. The distance between the receiver crystal and the first and second transducers are represented by respective first and second chords of the cross-section of the limb and the predetermined distance between the first and second transducers is represented by a third chord of the limb cross section.

The Floating Upper Limb: Multiple Injuries Involving Ipsilateral, Proximal, Humeral, Supracondylar, and Distal Radial Limb

PubMed Central

Manaan, Qazi; Bashir, Adil; Zahoor, Adnan; Mokhdomi, Taseem A.

2016-01-01

Floating arm injury represents a common yet complicated injury of the childhood severely associated with limb deformation and even morbidity, if not precisely addressed and credibly operated. Here, we report a rare floating upper limb case of a 9-year-old boy with multiple injuries of ipsilateral proximal humeral, supracondylar and distal radial limb. This is the first report to document such a combined floating elbow and floating arm injury in the same limb. In this report, we discuss the surgical procedures used and recovery of the patient monitored to ascertain the effectiveness of the method in limb reorganisation. PMID:27583121

The Floating Upper Limb: Multiple Injuries Involving Ipsilateral, Proximal, Humeral, Supracondylar, and Distal Radial Limb.

PubMed

Manaan, Qazi; Bashir, Adil; Zahoor, Adnan; Mokhdomi, Taseem A; Danish, Qazi

2016-09-01

Floating arm injury represents a common yet complicated injury of the childhood severely associated with limb deformation and even morbidity, if not precisely addressed and credibly operated. Here, we report a rare floating upper limb case of a 9-year-old boy with multiple injuries of ipsilateral proximal humeral, supracondylar and distal radial limb. This is the first report to document such a combined floating elbow and floating arm injury in the same limb. In this report, we discuss the surgical procedures used and recovery of the patient monitored to ascertain the effectiveness of the method in limb reorganisation.

Suppression of morphogenesis in embryonic mouse limbs exposed in vitro to excess gravity

NASA Technical Reports Server (NTRS)

Duke, Jackie C.

1983-01-01

The effect of excess gravity on in vitro mammalian limb chondrogenesis is studied. Limb buds from mice of various gestational stages were exposed to excess gravity (2.6G) using a culture centrifuge. Both forelimbs and hind limbs were cultured, and the development of various limb elements was scored after four to six days. The 2.6G force significantly depressed the development of limb elements when applied during the teratogen-sensitive period of chondrogenesis.

Limb length inequality: clinical implications for assessment and intervention.

PubMed

Brady, Rebecca J; Dean, John B; Skinner, T Marc; Gross, Michael T

2003-05-01

The purpose of this paper is to review relevant literature concerning limb length inequalities in adults and to make recommendations for assessment and intervention based on the literature and our own clinical experience. Literature searches were conducted in the MEDLINE, PubMed, and CINAHL databases. Limb length inequality and common classification criteria are defined and etiological factors are presented. Common methods of detecting limb length inequality include direct (tape measure methods), indirect (pelvic leveling), and radiological techniques. Interventions include shoe inserts or external shoe lift therapy for mild cases. Surgery may be appropriate in severe cases. Little agreement exists regarding the prevalence of limb length inequality, the degree of limb length inequality that is considered clinically significant, and the reliability and validity of assessment methods. Based on correlational studies, the relationship between limb length inequality and orthopaedic pathologies is questionable. Stronger support for the link between low back pain (LBP) and limb length inequality is provided by intervention studies. Methods involving palpation of pelvic landmarks with block correction have the most support for clinical assessment of limb length inequality. Standing radiographs are suggested when clinical assessment methods are unsatisfactory. Clinicians should exercise caution when undertaking intervention strategies for limb length inequality of less than 5 mm when limb length inequality has been identified with clinical techniques. Recommendations are provided regarding intervention strategies.

Electromyographic analysis of trunk and hip muscles during resisted lateral band walking.

PubMed

Youdas, James W; Foley, Brooke M; Kruger, BreAnna L; Mangus, Jessica M; Tortorelli, Alis M; Madson, Timothy J; Hollman, John H

2013-02-01

The purpose of this study was to simultaneously quantify bilateral activation/recruitment levels (% maximum voluntary isometric contraction [MVIC]) for trunk and hip musculature on both moving and stance lower limbs during resisted lateral band walking. Differential electromyographic (EMG) activity was recorded in neutral, internal, and external hip rotation in 21 healthy participants. EMG signals were collected with DE-3.1 double-differential surface electrodes at a sampling frequency of 1,000 Hz during three consecutive lateral steps. Gluteus medius average EMG activation was greater (p = 0.001) for the stance limb (52 SD 18% MVIC) than moving limb (35 SD 16% MVIC). Gluteus maximus EMG activation was greater (p = 0.002) for the stance limb (19 SD 13% MVIC) than moving limb (13 SD 9% MVIC). Erector spinae activation was greater (p = 0.007) in hip internal rotation (30 SD 13% MVIC) than neutral rotation (26 SD 10% MVIC) and the moving limb (31 SD 15% MVIC) was greater (p = 0.039) than the stance limb (23 SD 11% MVIC). Gluteus medius and maximus muscle activation were greater on the stance limb than moving limb during resisted lateral band walking. Therefore, clinicians may wish to consider using the involved limb as the stance limb during resisted lateral band walking exercise.

Society for Vascular Surgery Wound, Ischemia, foot Infection (WIfI) score correlates with the intensity of multimodal limb treatment and patient-centered outcomes in patients with threatened limbs managed in a limb preservation center.

PubMed

Robinson, William P; Loretz, Lorraine; Hanesian, Colleen; Flahive, Julie; Bostrom, John; Lunig, Nicholas; Schanzer, Andres; Messina, Louis

2017-08-01

The Society for Vascular Surgery Wound, Ischemia, foot Infection (WIfI) system aims to stratify threatened limbs according to their anticipated natural history and estimate the likelihood of benefit from revascularization, but whether it accurately stratifies outcomes in limbs undergoing aggressive treatment for limb salvage is unknown. We investigated whether the WIfI stage correlated with the intensity of limb treatment required and patient-centered outcomes. We stratified limbs from a prospectively maintained database of consecutive patients referred to a limb preservation center according to WIfI stage (October 2013-May 2015). Comorbidities, multimodal limb treatment, including foot operations and revascularization, and patient-centered outcomes (wound healing, limb salvage, amputation-free survival, maintenance of ambulatory and independent living status, and mortality) were compared among WIfI stages. Multivariate analysis was performed to identify predictors of wound healing and limb salvage. We identified 280 threatened limbs encompassing all WIfI stages in 257 consecutive patients: stage 1, 48 (17%); stage 2, 67 (24%); stage 3, 64 (23%); stage 4, 83 (30%); and stage 5 (unsalvageable), 18 (6%). Operative foot débridement, minor amputation, and use of revascularization increased with increasing WIfI stage (P ≤ .04). Revascularization was performed in 106 limbs (39%), with equal use of open and endovascular procedures. Over a median follow-up of 209 days (interquartile range, 95, 340) days, 1-year Kaplan-Meier wound healing cumulative incidence was 71%, and the proportion with complete wound healing decreased with increasing WIfI stage. Major amputation was required in 26 stage 1 to 4 limbs (10%). Increasing WIfI stage was associated with decreased 1-year Kaplan-Meier limb salvage (stage 1: 96%, stage 2: 84%, stage 3: 90%, and stage 4: 78%; P = .003) and amputation-free survival (P = .006). Stage 4 WIfI independently predicted amputation (hazard ratio, 12; 95% confidence interval, 1.6-94). Amputation rates in patients with severe Ischemia grade 3 were lower in those who underwent revascularization than in those who did not (14% vs 41%; P = .01) Ambulatory and independent living status at follow-up deteriorated significantly from baseline in stage 4 but not stage 1 to 3 patients. Mortality was not different between WIfI stages. In patients treated aggressively for limb salvage, WIfI stage correlated with intensity of multimodal limb treatment and with limb salvage and patient-centered outcomes at 1 year. Revascularization improved limb salvage in severe ischemia. These data support the Society for Vascular Surgery WIfI system as a powerful tool to risk-stratify patients with threatened limbs and guide treatment. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Spatial Coupling Affects Both Homologous and Non-Homologous Limbs

ERIC Educational Resources Information Center

Huh, Carey Y.

2004-01-01

The present study examined the interaction between limb movements in space. The amount of interaction was measured by how much moving one limb affected the movement of another limb. Participants were 24 right-handed university students (19 female, mean AGE=19 years). The task was to draw lines with the right hand while moving another limb in lines…

Isolated primary lymphedema tarda of the upper limb.

PubMed

Shariati, Farzaneh; Ravari, Hasan; Kazemzadeh, Gholamhossein; Sadeghi, Ramin

2013-03-01

Primary lymphedema tarda is considered as a congenital disease with late presentation. Primary lymphedema tarda usually affects lower limbs, and primary lymphedema tarda of the upper limbs usually accompanies lower limb lymphedema. In the current case report, we present an 80-year-old male patient with isolated left upper limb swelling that lymphoscintigraphy imaging proved to be lymphedema.

Evaluation of Limb-Girdle Muscular Dystrophy

ClinicalTrials.gov

2014-03-06

Becker Muscular Dystrophy; Limb-Girdle Muscular Dystrophy, Type 2A (Calpain-3 Deficiency); Limb-Girdle Muscular Dystrophy, Type 2B (Miyoshi Myopathy, Dysferlin Deficiency); Limb-Girdle Muscular Dystrophy, Type 2I (FKRP-deficiency)

Probability of Regenerating a Normal Limb After Bite Injury in the Mexican Axolotl (Ambystoma mexicanum).

PubMed

Thompson, Sierra; Muzinic, Laura; Muzinic, Christopher; Niemiller, Matthew L; Voss, S Randal

2014-06-01

Multiple factors are thought to cause limb abnormalities in amphibian populations by altering processes of limb development and regeneration. We examined adult and juvenile axolotls ( Ambystoma mexicanum ) in the Ambystoma Genetic Stock Center (AGSC) for limb and digit abnormalities to investigate the probability of normal regeneration after bite injury. We observed that 80% of larval salamanders show evidence of bite injury at the time of transition from group housing to solitary housing. Among 717 adult axolotls that were surveyed, which included solitary-housed males and group-housed females, approximately half presented abnormalities, including examples of extra or missing digits and limbs, fused digits, and digits growing from atypical anatomical positions. Bite injury likely explains these limb defects, and not abnormal development, because limbs with normal anatomy regenerated after performing rostral amputations. We infer that only 43% of AGSC larvae will present four anatomically normal looking adult limbs after incurring a bite injury. Our results show regeneration of normal limb anatomy to be less than perfect after bite injury.

Limb Dominance and Its Effects on the Benefits of Intralimb Transfer of Learning: A Visuomotor Aiming Task.

PubMed

Aiken, Christopher A; Pan, Zhujun; Van Gemmert, Arend W A

2015-01-01

Research has attempted to address what characteristics benefit from transfer of learning; however, it is still unclear which characteristics are effector dependent or independent. Furthermore, it is not clear if intralimb transfer shows, similarly to interlimb transfer, an asymmetry of benefits between the upper limbs. The purpose of the current study is to examine if effector independence effects emerge, as observed in interlimb transfer studies, when transfer to new effector group within the same limb occurs, and whether the pattern of intralimb transfer benefits differ between the limbs. Our results suggest that a visuomotor task transfers within both limbs, even though the transfer benefits within the limbs seem to differ. This was supported by more transfer occurring in the dominant limb than the nondominant limb. Potential control mechanisms used for intralimb transfer are discussed.

Movement patterns of limb coordination in infant rolling.

PubMed

Kobayashi, Yoshio; Watanabe, Hama; Taga, Gentaro

2016-12-01

Infants must perform dynamic whole-body movements to initiate rolling, a key motor skill. However, little is known regarding limb coordination and postural control in infant rolling. To address this lack of knowledge, we examined movement patterns and limb coordination during rolling in younger infants (aged 5-7 months) that had just begun to roll and in older infants (aged 8-10 months) with greater rolling experience. Due to anticipated difficulty in obtaining measurements over the second half of the rolling sequence, we limited our analysis to the first half. Ipsilateral and contralateral limbs were identified on the basis of rolling direction and were classified as either a stationary limb used for postural stability or a moving limb used for controlled movement. We classified the observed movement patterns by identifying the number of stationary limbs and the serial order of combinational limb movement patterns. Notably, older infants performed more movement patterns that involved a lower number of stationary limbs than younger infants. Despite the wide range of possible movement patterns, a small group of basic patterns dominated in both age groups. Our results suggest that the fundamental structure of limb coordination during rolling in the early acquisition stages remains unchanged until at least 8-10 months of age. However, compared to younger infants, older infants exhibited a greater ability to select an effective rotational movement by positioning themselves with fewer stationary limbs and performing faster limb movements.

Limb deficiency and prosthetic management. 2. Aging with limb loss.

PubMed

Flood, Katherine M; Huang, Mark E; Roberts, Toni L; Pasquina, Paul F; Nelson, Virginia S; Bryant, Phillip R

2006-03-01

This self-directed learning module highlights the issues faced by people aging with limb loss. It is part of the study guide on limb deficiency and vascular rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the impact that limb loss has on health and physical function throughout the life span. Case examples are used to illustrate what effect limb loss in childhood or young adulthood has on the incidence and management of new impairments or disease processes commonly associated with aging. To discuss the impact of early-life limb loss on the incidence and management of physiologic and functional changes associated with aging.

Upper Limb Posture Estimation in Robotic and Virtual Reality-Based Rehabilitation

PubMed Central

Cortés, Camilo; Ardanza, Aitor; Molina-Rueda, F.; Cuesta-Gómez, A.; Ruiz, Oscar E.

2014-01-01

New motor rehabilitation therapies include virtual reality (VR) and robotic technologies. In limb rehabilitation, limb posture is required to (1) provide a limb realistic representation in VR games and (2) assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a) the mathematical formulation and solution to the problem, (b) the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c) its integration into a rehabilitation VR game platform, and (d) the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i) animate avatars that represent the patient in VR games and (ii) obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation. PMID:25110698

Effects of varying inter-limb spacing to limb length ratio in metachronal swimming

NASA Astrophysics Data System (ADS)

Lai, Hong Kuan; Merkel, Rachael; Santhanakrishnan, Arvind

2016-11-01

Crustaceans such as shrimp, krill and crayfish swim by rhythmic paddling of four to five pairs of closely spaced limbs. Each pair is phase-shifted in time relative to the neighboring pair, resulting in a metachronal wave that travels in the direction of animal motion. The broad goal of this study is to investigate how the mechanical design of the swimming limbs affect scalability of metachronal swimming in terms of limb-based Reynolds number (Re). A scaled robotic model of metachronal paddling was developed, consisting of four pairs of hinged acrylic plates actuated using stepper motors that were immersed in a rectangular tank containing water-glycerin fluid medium. 2D PIV measurements show that the propulsive jets transition from being primarily horizontal (thrust-producing direction) at Re of order 10 to angled vertically at Re of order 100. The ratio of inter-limb spacing to limb length among metachronal swimming organisms ranges between 0.2 to 0.65. 2D PIV will be used to examine the jets generated between adjacent limbs for varying inter-limb spacing to limb length ratios. The effect of increasing this ratio to beyond the biologically observed range will be discussed.

Ectodermal Wnt6 is an early negative regulator of limb chondrogenesis in the chicken embryo

PubMed Central

2010-01-01

Background Pattern formation of the limb skeleton is regulated by a complex interplay of signaling centers located in the ectodermal sheath and mesenchymal core of the limb anlagen, which results, in the forelimb, in the coordinate array of humerus, radius, ulna, carpals, metacarpals and digits. Much less understood is why skeletal elements form only in the central mesenchyme of the limb, whereas muscle anlagen develop in the peripheral mesenchyme ensheathing the chondrogenic center. Classical studies have suggested a role of the limb ectoderm as a negative regulator of limb chondrogenesis. Results In this paper, we investigated the molecular nature of the inhibitory influence of the ectoderm on limb chondrogenesis in the avian embryo in vivo. We show that ectoderm ablation in the early limb bud leads to increased and ectopic expression of early chondrogenic marker genes like Sox9 and Collagen II, indicating that the limb ectoderm inhibits limb chondrogenesis at an early stage of the chondrogenic cascade. To investigate the molecular nature of the inhibitory influence of the ectoderm, we ectopically expressed Wnt6, which is presently the only known Wnt expressed throughout the avian limb ectoderm, and found that Wnt6 overexpression leads to reduced expression of the early chondrogenic marker genes Sox9 and Collagen II. Conclusion Our results suggest that the inhibitory influence of the ectoderm on limb chondrogenesis acts on an early stage of chondrogenesis upsteam of Sox9 and Collagen II. We identify Wnt6 as a candidate mediator of ectodermal chondrogenic inhibition in vivo. We propose a model of Wnt-mediated centripetal patterning of the limb by the surface ectoderm. PMID:20334703

Neural Adaptations Associated with Interlimb Transfer in a Ballistic Wrist Flexion Task

PubMed Central

Ruddy, Kathy L.; Rudolf, Anne K.; Kalkman, Barbara; King, Maedbh; Daffertshofer, Andreas; Carroll, Timothy J.; Carson, Richard G.

2016-01-01

Cross education is the process whereby training of one limb gives rise to increases in the subsequent performance of its opposite counterpart. The execution of many unilateral tasks is associated with increased excitability of corticospinal projections from primary motor cortex (M1) to the opposite limb. It has been proposed that these effects are causally related. Our aim was to establish whether changes in corticospinal excitability (CSE) arising from prior training of the opposite limb determine levels of interlimb transfer. We used three vision conditions shown previously to modulate the excitability of corticospinal projections to the inactive (right) limb during wrist flexion movements performed by the training (left) limb. These were: (1) mirrored visual feedback of the training limb; (2) no visual feedback of either limb; and (3) visual feedback of the inactive limb. Training comprised 300 discrete, ballistic wrist flexion movements executed as rapidly as possible. Performance of the right limb on the same task was assessed prior to, at the mid point of, and following left limb training. There was no evidence that variations in the excitability of corticospinal projections (assessed by transcranial magnetic stimulation (TMS)) to the inactive limb were associated with, or predictive of, the extent of interlimb transfer that was expressed. There were however associations between alterations in muscle activation dynamics observed for the untrained limb, and the degree of positive transfer that arose from training of the opposite limb. The results suggest that the acute adaptations that mediate the bilateral performance gains realized through unilateral practice of this ballistic wrist flexion task are mediated by neural elements other than those within M1 that are recruited at rest by single-pulse TMS. PMID:27199722

Minor Morbidity with Emergency Tourniquet Use to Stop Bleeding in Severe Limb Trauma: Research, History, and Reconciling Advocates and Abolitionists

DTIC Science & Technology

2011-07-01

unknown. If we say these 13 limbs had only one tourniquet per limb, then the total number of tourniquets was 875. The body regions ( forearm , arm ...leg, thigh) where the tourniquets were applied to the 651 limbs included 436 thighs, 162 arms , 46 legs, 13 forearms , 8 limbs where the tourniquets...I body region ( forearm 0113, thigh 2/436, leg, 1146, and arm : 6/162). The overall rate of side-by-side use was 20% (93 • of 461 limbs). There

Managing residual limb hyperhidrosis in wounded warriors.

PubMed

Pace, Sarah; Kentosh, Joshua

2016-06-01

Residual limb dermatologic problems are a common concern among young active traumatic amputee patients who strive to maintain an active lifestyle. Hyperhidrosis of residual limbs is a recognized inciting factor that often contributes to residual limb dermatoses and is driven by the design of the prosthetic liner covering the residual limb. Treatment of hyperhidrosis in this population presents a unique challenge. Several accepted treatments of hyperhidrosis can offer some relief but have been limited by lack of results or side-effect profiles. Microwave thermal ablation has presented an enticing potential for residual limb hyperhidrosis.

In vivo locomotor strain in the hindlimb bones of alligator mississippiensis and iguana iguana: implications for the evolution of limb bone safety factor and non-sprawling limb posture

PubMed

Blob; Biewener

1999-05-01

Limb postures of terrestrial tetrapods span a continuum from sprawling to fully upright; however, most experimental investigations of locomotor mechanics have focused on mammals and ground-dwelling birds that employ parasagittal limb kinematics, leaving much of the diversity of tetrapod locomotor mechanics unexplored. This study reports measurements of in vivo locomotor strain from the limb bones of lizard (Iguana iguana) and crocodilian (Alligator mississippiensis) species, animals from previously unsampled phylogenetic lineages with non-parasagittal limb posture and kinematics. Principal strain orientations and shear strain magnitudes indicate that the limb bones of these species experience considerable torsion during locomotion. This contrasts with patterns commonly observed in mammals, but matches predictions from kinematic observations of axial rotation in lizard and crocodilian limbs. Comparisons of locomotor load magnitudes with the mechanical properties of limb bones in Alligator and Iguana indicate that limb bone safety factors in bending for these species range from 5.5 to 10.8, as much as twice as high as safety factors previously calculated for mammals and birds. Limb bone safety factors in shear (3.9-5.4) for Alligator and Iguana are also moderately higher than safety factors to yield in bending for birds and mammals. Finally, correlations between limb posture and strain magnitudes in Alligator show that at some recording locations limb bone strains can increase during upright locomotion, in contrast to expectations based on size-correlated changes in posture among mammals that limb bone strains should decrease with the use of an upright posture. These data suggest that, in some lineages, strain magnitudes may not have been maintained at constant levels through the evolution of a non-sprawling posture unless the postural change was accompanied by a shift to parasagittal kinematics or by an evolutionary decrease in body size.

Interlimb coordination during the stance phase of gait in subjects with stroke.

PubMed

Sousa, Andreia S P; Silva, Augusta; Santos, Rubim; Sousa, Filipa; Tavares, João Manuel R S

2013-12-01

To analyze the relation between contralesional and ipsilesional limbs in subjects with stroke during step-to-step transition of walking. Observational, transversal, analytical study with a convenience sample. Physical medicine and rehabilitation clinic. Subjects (n=16) with poststroke hemiparesis with the ability to walk independently and healthy controls (n=22). Not applicable. Bilateral lower limbs electromyographic activity of the soleus (SOL), gastrocnemius medialis, tibialis anterior, biceps femoris, rectus femoris, and vastus medialis (VM) muscles and the ground reaction force were analyzed during double-support and terminal stance phases of gait. The propulsive impulse of the contralesional trailing limb was negatively correlated with the braking impulse of the leading limb during double support (r=-.639, P=.01). A moderate functional relation was observed between thigh muscles (r=-.529, P=.035), and a strong and moderate dysfunctional relation was found between the plantar flexors of the ipsilesional limb and the vastus medialis of the contralesional limb, respectively (SOL-VM, r=-.80, P<.001; gastrocnemius medialis-VM, r=-.655, P=.002). Also, a functional moderate negative correlation was found between the SOL and rectus femoris muscles of the ipsilesional limb during terminal stance and between the SOL (r=-.506, P=.046) and VM (r=-.518, P=.04) muscles of the contralesional limb during loading response, respectively. The trailing limb relative impulse contribution of the contralesional limb was lower than the ipsilesional limb of subjects with stroke (P=.02) and lower than the relative impulse contribution of the healthy limb (P=.008) during double support. The findings obtained suggest that the lower performance of the contralesional limb in forward propulsion during gait is related not only to contralateral supraspinal damage but also to a dysfunctional influence of the ipsilesional limb. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Cryopreservation and replantation of amputated rat hind limbs

PubMed Central

2014-01-01

Background In spite of the relatively high success rate of limb replantation, many patients cannot undergo replantation surgery because the preservation time of an amputated limb is only about six hours. In addition, although allotransplantation of composite tissues is being performed more commonly with increasingly greater success rates, the shortage of donors limits the number of patients that can be treated. So the purpose of this study is to examine the feasibility of cryopreservation and replantation of limbs in a rat model. Methods Twelve five-month-old Sprague-Dawley rats were divided evenly into group A (above-knee amputation) and group B (Syme’s amputation). One hind limb was amputated from each rat. The limbs were irrigated with cryoprotectant, cooled in a controlled manner to -140°C, and placed in liquid nitrogen. Thawing and replantation were performed 14 days later. Results In group A, the limbs became swollen after restoration of blood flow resulting in blood vessel compression and all replantations failed. In group B, restoration of blood flow was noted in all limbs after replantation. In one case, the rat chewed the replanted limb and replantation failed. The other five rats were followed for three months with no abnormalities noted in the replanted limbs. Conclusions Limbs with a minimal amount of muscle tissue can be successfully cryopreserved and replanted. PMID:24886622

Suppression of morphogenesis in embryonic mouse limbs exposed in vitro to excess gravity.

PubMed

Duke, J C

1983-06-01

This paper is a report of the first investigation of the effect of excess gravity on in vitro mammalian limb chondrogenesis. Limb buds from mice of various gestational stages were exposed to excess gravity (2.6G) using a culture centrifuge. Both forelimbs and hind limbs were cultured and the development of various limb elements was scored after four to six days. The 2.6G force significantly depressed the development of limb elements when applied during the teratogen-sensitive period of chondrogenesis. There was a proximodistal gradient of sensitivity to excess gravity in the limb with proximal structures being less susceptible than distal ones. In some cases, proximal limb elements present prior to explantation disappeared upon exposure to excess gravity. Hypergravity's teratogenic effect is assumed to operate via changes in tension and/or pressure on the cells, accompanied by alterations in cell morphometry and membrane properties.

Automatic limb identification and sleeping parameters assessment for pressure ulcer prevention.

PubMed

Baran Pouyan, Maziyar; Birjandtalab, Javad; Nourani, Mehrdad; Matthew Pompeo, M D

2016-08-01

Pressure ulcers (PUs) are common among vulnerable patients such as elderly, bedridden and diabetic. PUs are very painful for patients and costly for hospitals and nursing homes. Assessment of sleeping parameters on at-risk limbs is critical for ulcer prevention. An effective assessment depends on automatic identification and tracking of at-risk limbs. An accurate limb identification can be used to analyze the pressure distribution and assess risk for each limb. In this paper, we propose a graph-based clustering approach to extract the body limbs from the pressure data collected by a commercial pressure map system. A robust signature-based technique is employed to automatically label each limb. Finally, an assessment technique is applied to evaluate the experienced stress by each limb over time. The experimental results indicate high performance and more than 94% average accuracy of the proposed approach. Copyright © 2016 Elsevier Ltd. All rights reserved.

Successful limb salvage through staged bypass combined with free gracilis muscle transfer for critical limb ischemia with osteomyelitis after failed endovascular therapy.

PubMed

Miyake, Keisuke; Kikuchi, Shinsuke; Okuda, Hiroko; Koya, Atsuhiro; Abe, Satomi; Sawa, Yoshiki; Ota, Tetsuo; Azuma, Nobuyoshi

2018-05-02

Critical limb ischemia with osteomyelitis is so difficult to treat that even appropriate revascularization and wound therapy cannot achieve limb salvage because of uncontrollable infection. It is still difficult to judge the possibility of limb salvage before revascularization. A 73-year-old male complained of a small ulcer on his left toe, which was treated with multiple endovascular therapy. After failed endovascular therapy, he suffered extensive tissue loss with tibial osteomyelitis. We carried out staged surgery that was composed of dual bypass to the sural artery and posterior tibial artery. After intensive debridement and wound care, insertion of a subsequent free gracilis muscle flap to cover the exposed tibial bone was performed, achieving functional limb salvage. Even in the threatened limb with extensive tissue loss and osteomyelitis, intensive and multidisciplinary treatment with staged revascularization, muscle transfer, and appropriate wound care achieved functional limb salvage.

Effect of Upper Limb Deformities on Gross Motor and Upper Limb Functions in Children with Spastic Cerebral Palsy

ERIC Educational Resources Information Center

Park, Eun Sook; Sim, Eun Geol; Rha, Dong-wook

2011-01-01

The aims of this study were to investigate the nature and extent of upper limb deformities via the use of various classifications, and to analyze the relationship between upper limb deformities and gross motor or upper limb functionality levels. Upper extremity data were collected from 234 children with spastic cerebral palsy (CP) who were…

Epidemiology of race-day distal limb fracture in flat racing Thoroughbreds in Great Britain (2000 to 2013).

PubMed

Rosanowski, S M; Chang, Y M; Stirk, A J; Verheyen, K L P

2018-05-28

A key focus of the racing industry is to minimise the number of race-day distal limb fractures, although no studies have identified risk factors for both fatal and non-fatal distal limb fractures. To determine risk factors for race-day distal limb fractures experienced by Thoroughbred racehorses participating in flat racing in Great Britain (GB). Retrospective cohort. Information was collected from all flat racing starts occurring on GB racecourses between 2000 and 2013, including horse, race, course, trainer and jockey data for each horse start and race-day injury data as reported by on-course veterinarians. Associations between exposure variables and cases of distal limb fracture were assessed using mixed effects logistic regression analyses using data from all starts, and turf starts only. A total of 806,764 starts and 624 cases of distal limb fracture were included, of which 548,571 starts and 379 cases of distal limb fracture occurred on turf surfaces. In both models, increasing firmness of the going, increasing racing distance and horses in their first year of racing were at a higher risk of distal limb fracture, while increasing number of previous race starts were protective. Trainer performance was associated with distal limb fracture. Generally, the risk of distal limb fracture increased with increasing horse age. Starts in selling or claiming races or Group 1, Group 3 or claiming races were at higher odds of distal limb fracture in the all starts and turf models, respectively. Clinical diagnosis of distal limb fracture and all types of distal limb fracture considered as one outcome. This study confirmed previously identified risk factors for distal limb fracture including going, race distance and number of horse starts. Novel risk factors were related to trainer and horse performance, and race type. Identification of at risk groups will help inform interventions to reduce distal limb fracture occurrence in flat racing horses. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Scale effects between body size and limb design in quadrupedal mammals.

PubMed

Kilbourne, Brandon M; Hoffman, Louwrens C

2013-01-01

Recently the metabolic cost of swinging the limbs has been found to be much greater than previously thought, raising the possibility that limb rotational inertia influences the energetics of locomotion. Larger mammals have a lower mass-specific cost of transport than smaller mammals. The scaling of the mass-specific cost of transport is partly explained by decreasing stride frequency with increasing body size; however, it is unknown if limb rotational inertia also influences the mass-specific cost of transport. Limb length and inertial properties--limb mass, center of mass (COM) position, moment of inertia, radius of gyration, and natural frequency--were measured in 44 species of terrestrial mammals, spanning eight taxonomic orders. Limb length increases disproportionately with body mass via positive allometry (length ∝ body mass(0.40)); the positive allometry of limb length may help explain the scaling of the metabolic cost of transport. When scaled against body mass, forelimb inertial properties, apart from mass, scale with positive allometry. Fore- and hindlimb mass scale according to geometric similarity (limb mass ∝ body mass(1.0)), as do the remaining hindlimb inertial properties. The positive allometry of limb length is largely the result of absolute differences in limb inertial properties between mammalian subgroups. Though likely detrimental to locomotor costs in large mammals, scale effects in limb inertial properties appear to be concomitant with scale effects in sensorimotor control and locomotor ability in terrestrial mammals. Across mammals, the forelimb's potential for angular acceleration scales according to geometric similarity, whereas the hindlimb's potential for angular acceleration scales with positive allometry.

Transcriptomic insights into the genetic basis of mammalian limb diversity.

PubMed

Maier, Jennifer A; Rivas-Astroza, Marcelo; Deng, Jenny; Dowling, Anna; Oboikovitz, Paige; Cao, Xiaoyi; Behringer, Richard R; Cretekos, Chris J; Rasweiler, John J; Zhong, Sheng; Sears, Karen E

2017-03-23

From bat wings to whale flippers, limb diversification has been crucial to the evolutionary success of mammals. We performed the first transcriptome-wide study of limb development in multiple species to explore the hypothesis that mammalian limb diversification has proceeded through the differential expression of conserved shared genes, rather than by major changes to limb patterning. Specifically, we investigated the manner in which the expression of shared genes has evolved within and among mammalian species. We assembled and compared transcriptomes of bat, mouse, opossum, and pig fore- and hind limbs at the ridge, bud, and paddle stages of development. Results suggest that gene expression patterns exhibit larger variation among species during later than earlier stages of limb development, while within species results are more mixed. Consistent with the former, results also suggest that genes expressed at later developmental stages tend to have a younger evolutionary age than genes expressed at earlier stages. A suite of key limb-patterning genes was identified as being differentially expressed among the homologous limbs of all species. However, only a small subset of shared genes is differentially expressed in the fore- and hind limbs of all examined species. Similarly, a small subset of shared genes is differentially expressed within the fore- and hind limb of a single species and among the forelimbs of different species. Taken together, results of this study do not support the existence of a phylotypic period of limb development ending at chondrogenesis, but do support the hypothesis that the hierarchical nature of development translates into increasing variation among species as development progresses.

Deep-time evolution of regeneration and preaxial polarity in tetrapod limb development.

PubMed

Fröbisch, Nadia B; Bickelmann, Constanze; Olori, Jennifer C; Witzmann, Florian

2015-11-12

Among extant tetrapods, salamanders are unique in showing a reversed preaxial polarity in patterning of the skeletal elements of the limbs, and in displaying the highest capacity for regeneration, including full limb and tail regeneration. These features are particularly striking as tetrapod limb development has otherwise been shown to be a highly conserved process. It remains elusive whether the capacity to regenerate limbs in salamanders is mechanistically and evolutionarily linked to the aberrant pattern of limb development; both are features classically regarded as unique to urodeles. New molecular data suggest that salamander-specific orphan genes play a central role in limb regeneration and may also be involved in the preaxial patterning during limb development. Here we show that preaxial polarity in limb development was present in various groups of temnospondyl amphibians of the Carboniferous and Permian periods, including the dissorophoids Apateon and Micromelerpeton, as well as the stereospondylomorph Sclerocephalus. Limb regeneration has also been reported in Micromelerpeton, demonstrating that both features were already present together in antecedents of modern salamanders 290 million years ago. Furthermore, data from lepospondyl 'microsaurs' on the amniote stem indicate that these taxa may have shown some capacity for limb regeneration and were capable of tail regeneration, including re-patterning of the caudal vertebral column that is otherwise only seen in salamander tail regeneration. The data from fossils suggest that salamander-like regeneration is an ancient feature of tetrapods that was subsequently lost at least once in the lineage leading to amniotes. Salamanders are the only modern tetrapods that retained regenerative capacities as well as preaxial polarity in limb development.

Scale Effects between Body Size and Limb Design in Quadrupedal Mammals

PubMed Central

Kilbourne, Brandon M.; Hoffman, Louwrens C.

2013-01-01

Recently the metabolic cost of swinging the limbs has been found to be much greater than previously thought, raising the possibility that limb rotational inertia influences the energetics of locomotion. Larger mammals have a lower mass-specific cost of transport than smaller mammals. The scaling of the mass-specific cost of transport is partly explained by decreasing stride frequency with increasing body size; however, it is unknown if limb rotational inertia also influences the mass-specific cost of transport. Limb length and inertial properties – limb mass, center of mass (COM) position, moment of inertia, radius of gyration, and natural frequency – were measured in 44 species of terrestrial mammals, spanning eight taxonomic orders. Limb length increases disproportionately with body mass via positive allometry (length ∝ body mass0.40); the positive allometry of limb length may help explain the scaling of the metabolic cost of transport. When scaled against body mass, forelimb inertial properties, apart from mass, scale with positive allometry. Fore- and hindlimb mass scale according to geometric similarity (limb mass ∝ body mass1.0), as do the remaining hindlimb inertial properties. The positive allometry of limb length is largely the result of absolute differences in limb inertial properties between mammalian subgroups. Though likely detrimental to locomotor costs in large mammals, scale effects in limb inertial properties appear to be concomitant with scale effects in sensorimotor control and locomotor ability in terrestrial mammals. Across mammals, the forelimb's potential for angular acceleration scales according to geometric similarity, whereas the hindlimb's potential for angular acceleration scales with positive allometry. PMID:24260117

The effects of laterality on obstacle crossing performance in unilateral trans-tibial amputees.

PubMed

De Asha, Alan R; Buckley, John G

2015-05-01

Unilateral trans-tibial amputees have bilaterally reduced toe clearance, and an increased risk of foot contact, while crossing obstacles compared to the able-bodied. While the able-bodied tend to lead with a 'preferred' limb it is equivocal whether amputees prefer to lead with the intact or prosthetic limb. This study determined the effects of laterality, compared to side of amputation, on amputees' obstacle crossing performance. To help understand why laterality could affect performance we also assessed knee proprioception for both limbs. Foot placement and toe clearance parameters were recorded while nine amputees crossed obstacles of varying heights leading with both their intact and prosthetic limbs. Joint-position sense was also assessed. Participants self-reported which limb was their preferred (dominant) limb. There were no significant differences in foot placements or toe clearance variability across lead-limb conditions. There were no significant differences in toe clearance between intact and prosthetic lead-limbs (p=0.28) but toe clearance was significantly higher when amputees led with their preferred compared to non-preferred limb (p=0.025). There was no difference in joint-position sense between the intact and residual knees (p=0.34) but joint-position sense tended to be more accurate for the preferred, compared to non-preferred limb (p=0.08). Findings suggest that, despite the mechanical constraints imposed by use of a prosthesis, laterality may be as important in lower-limb amputees as it is in the able bodied. This suggests that amputees should be encouraged to cross obstacles leading with their preferred limb. Copyright © 2015. Published by Elsevier Ltd.

Hind limb malformations in free-living northern leopard frogs (Rana pipiens) from Maine, Minnesota, and Vermont suggest multiple etiologies

USGS Publications Warehouse

Meteyer, C.U.; Loeffler, I.K.; Fallon, J.F.; Converse, K.A.; Green, E.; Helgen, J.C.; Kersten, S.; Levey, R.; Eaton-Poole, L.; Burkhart, J.G.

2000-01-01

Background Reports of malformed frogs have increased throughout the North American continent in recent years. Most of the observed malformations have involved the hind limbs. The goal of this study was to accurately characterize the hind limb malformations in wild frogs as an important step toward understanding the possible etiologies. Methods During 1997 and 1998, 182 recently metamorphosed northern leopard frogs (Rana pipiens) were collected from Minnesota, Vermont, and Maine. Malformed hind limbs were present in 157 (86%) of these frogs, which underwent necropsy and radiographic evaluation at the National Wildlife Health Center. These malformations are described in detail and classified into four major categories: (1) no limb (amelia); (2) multiple limbs or limb elements (polymelia, polydactyly, polyphalangy); (3) reduced limb segments or elements (phocomelia, ectromelia, ectrodactyly, and brachydactyly; and (4) distally complete but malformed limb (bone rotations, bridging, skin webbing, and micromelia). Results Amelia and reduced segments and/or elements were the most common finding. Frogs with bilateral hind limb malformations were not common, and in only eight of these 22 frogs were the malformations symmetrical. Malformations of a given type tended to occur in frogs collected from the same site, but the types of malformations varied widely among all three states, and between study sites within Minnesota. Conclusions Clustering of malformation type suggests that developmental events may produce a variety of phenotypes depending on the timing, sequence, and severity of the environmental insult. Hind limb malformations in free-living frogs transcend current mechanistic explanations of tetrapod limb development.

Genetics Home Reference: limb-girdle muscular dystrophy

MedlinePlus

... age of onset, and features of limb-girdle muscle dystrophy vary among the many subtypes of this condition ... occurs in some people with limb-girdle muscular dystrophy . Weakening of the heart muscle (cardiomyopathy) occurs in some forms of limb-girdle ...

Re-membering the body: applications of computational neuroscience to the top-down control of regeneration of limbs and other complex organs.

PubMed

Pezzulo, G; Levin, M

2015-12-01

A major goal of regenerative medicine and bioengineering is the regeneration of complex organs, such as limbs, and the capability to create artificial constructs (so-called biobots) with defined morphologies and robust self-repair capabilities. Developmental biology presents remarkable examples of systems that self-assemble and regenerate complex structures toward their correct shape despite significant perturbations. A fundamental challenge is to translate progress in molecular genetics into control of large-scale organismal anatomy, and the field is still searching for an appropriate theoretical paradigm for facilitating control of pattern homeostasis. However, computational neuroscience provides many examples in which cell networks - brains - store memories (e.g., of geometric configurations, rules, and patterns) and coordinate their activity towards proximal and distant goals. In this Perspective, we propose that programming large-scale morphogenesis requires exploiting the information processing by which cellular structures work toward specific shapes. In non-neural cells, as in the brain, bioelectric signaling implements information processing, decision-making, and memory in regulating pattern and its remodeling. Thus, approaches used in computational neuroscience to understand goal-seeking neural systems offer a toolbox of techniques to model and control regenerative pattern formation. Here, we review recent data on developmental bioelectricity as a regulator of patterning, and propose that target morphology could be encoded within tissues as a kind of memory, using the same molecular mechanisms and algorithms so successfully exploited by the brain. We highlight the next steps of an unconventional research program, which may allow top-down control of growth and form for numerous applications in regenerative medicine and synthetic bioengineering.

[Counteracting effects of intermittent head-up tilt on simulated-weightlessness induced atrophy of anti-gravity muscles].

PubMed

Liu, C; Zhang, L F; Zhang, L N; Ni, H Y; Zhang, Y Q; Sun, L

2000-12-01

Objective. To study the efficacy of intermittent + Gz (45 degrees head-up tilt, HUT) exposures in preventing or alleviating atrophic changes in hind limb muscles induced by simulated weightlessness. Method. Male Sprague-Dawley (SD) rats were assigned randomly to one of three groups: simultaneous control (CON), simulated weightlessness (SUS), and SUS plus 6 h/d HUT (SUS + HUT). Muscles examined included soleus (SOL), medial gastrocnemius (correction from grastrocnemius) (MG), lateral gastrocnemius (LG) and extensor digitorum longus (EDL). Sections were treated with an adenosinetriphosphatase (ATPase) stain or alkaline phosphatase stain. The cross-sectional areas (CSA) of fibers, the relative proportion of type I fiber and the ratio of capillaries/fibers (C/F) were measured using Leica image analysis system. Result. Compared with CON, the wet weight of hind limb muscles in SUS were significantly reduced. The changes of wet weight in different groups were various. The C/F ratios of all muscles were significantly reduced. SUS + HUT rats showed significant increases in SOL and MG wet weight, and the relative counter-effects of intermittent HUT were 93.4% and 34.8%, respectively. In SUS + HUT group, the CSA of both type I and II fibers and relative proportion of type I fibers were completely recovered in SOL, and partially recovered in MG, while the counter-effects were much less obvious in the fibers of LG and EDL. However, HUT resulted in a significant recovery of the C/F ratios in all muscles. Conclusion. The present study demonstrated that intermittent HUT is effective in counteracting the atrophy induced by simulated weightlessness. The result that reactivity to HUT varied among different muscles suggests that the intermittent artificial gravity should be complemented with other countermeasures.

Cardiovascular response to lower body negative pressure stimulation before, during, and after space flight

NASA Technical Reports Server (NTRS)

Baisch, F.; Beck, L.; Blomqvist, G.; Wolfram, G.; Drescher, J.; Rome, J. L.; Drummer, C.

2000-01-01

BACKGROUND: It is well known that space travel cause post-flight orthostatic hypotension and it was assumed that autonomic cardiovascular control deteriorates in space. Lower body negative pressure (LBNP) was used to assess autonomic function of the cardiovascular system. METHODS: LBNP tests were performed on six crew-members before and on the first days post-flight in a series of three space missions. Additionally, two of the subjects performed LBNP tests in-flight. LBNP mimics fluid distribution of upright posture in a gravity independent way. It causes an artificial sequestration of blood, reduces preload, and filtrates plasma into the lower part of the body. Fluid distribution was assessed by bioelectrical impedance and anthropometric measurements. RESULTS: Heart rate, blood pressure, and total peripheral resistance increased significantly during LBNP experiments in-flight. The decrease in stroke volume, the increased pooling of blood, and the increased filtration of plasma into the lower limbs during LBNP indicated that a plasma volume reduction and a deficit of the interstitial volume of lower limbs rather than a change in cardiovascular control was responsible for the in-flight response. Post-flight LBNP showed no signs of cardiovascular deterioration. The still more pronounced haemodynamic changes during LBNP reflected the expected behaviour of cardiovascular control faced with less intravascular volume. In-flight, the status of an intra-and extravascular fluid deficit increases sympathetic activity, the release of vasoactive substances and consequently blood pressure. Post-flight, blood pressure decreases significantly below pre-flight values after restoration of volume deficits. CONCLUSION: We conclude that the cardiovascular changes in-flight are a consequence of a fluid deficit rather than a consequence of changes in autonomic signal processing.

Combined analysis of cortical (EEG) and nerve stump signals improves robotic hand control.

PubMed

Tombini, Mario; Rigosa, Jacopo; Zappasodi, Filippo; Porcaro, Camillo; Citi, Luca; Carpaneto, Jacopo; Rossini, Paolo Maria; Micera, Silvestro

2012-01-01

Interfacing an amputee's upper-extremity stump nerves to control a robotic hand requires training of the individual and algorithms to process interactions between cortical and peripheral signals. To evaluate for the first time whether EEG-driven analysis of peripheral neural signals as an amputee practices could improve the classification of motor commands. Four thin-film longitudinal intrafascicular electrodes (tf-LIFEs-4) were implanted in the median and ulnar nerves of the stump in the distal upper arm for 4 weeks. Artificial intelligence classifiers were implemented to analyze LIFE signals recorded while the participant tried to perform 3 different hand and finger movements as pictures representing these tasks were randomly presented on a screen. In the final week, the participant was trained to perform the same movements with a robotic hand prosthesis through modulation of tf-LIFE-4 signals. To improve the classification performance, an event-related desynchronization/synchronization (ERD/ERS) procedure was applied to EEG data to identify the exact timing of each motor command. Real-time control of neural (motor) output was achieved by the participant. By focusing electroneurographic (ENG) signal analysis in an EEG-driven time window, movement classification performance improved. After training, the participant regained normal modulation of background rhythms for movement preparation (α/β band desynchronization) in the sensorimotor area contralateral to the missing limb. Moreover, coherence analysis found a restored α band synchronization of Rolandic area with frontal and parietal ipsilateral regions, similar to that observed in the opposite hemisphere for movement of the intact hand. Of note, phantom limb pain (PLP) resolved for several months. Combining information from both cortical (EEG) and stump nerve (ENG) signals improved the classification performance compared with tf-LIFE signals processing alone; training led to cortical reorganization and mitigation of PLP.

Regenerative Engineering and Bionic Limbs.

PubMed

James, Roshan; Laurencin, Cato T

2015-03-01

Amputations of the upper extremity are severely debilitating, current treatments support very basic limb movement, and patients undergo extensive physiotherapy and psychological counselling. There is no prosthesis that allows the amputees near-normal function. With increasing number of amputees due to injuries sustained in accidents, natural calamities and international conflicts, there is a growing requirement for novel strategies and new discoveries. Advances have been made in technological, material and in prosthesis integration where researchers are now exploring artificial prosthesis that integrate with the residual tissues and function based on signal impulses received from the residual nerves. Efforts are focused on challenging experts in different disciplines to integrate ideas and technologies to allow for the regeneration of injured tissues, recording on tissue signals and feed-back to facilitate responsive movements and gradations of muscle force. A fully functional replacement and regenerative or integrated prosthesis will rely on interface of biological process with robotic systems to allow individual control of movement such as at the elbow, forearm, digits and thumb in the upper extremity. Regenerative engineering focused on the regeneration of complex tissue and organ systems will be realized by the cross-fertilization of advances over the past thirty years in the fields of tissue engineering, nanotechnology, stem cell science, and developmental biology. The convergence of toolboxes crated within each discipline will allow interdisciplinary teams from engineering, science, and medicine to realize new strategies, mergers of disparate technologies, such as biophysics, smart bionics, and the healing power of the mind. Tackling the clinical challenges, interfacing the biological process with bionic technologies, engineering biological control of the electronic systems, and feed-back will be the important goals in regenerative engineering over the next two decades.

A novel model of motor learning capable of developing an optimal movement control law online from scratch.

PubMed

Shimansky, Yury P; Kang, Tao; He, Jiping

2004-02-01

A computational model of a learning system (LS) is described that acquires knowledge and skill necessary for optimal control of a multisegmental limb dynamics (controlled object or CO), starting from "knowing" only the dimensionality of the object's state space. It is based on an optimal control problem setup different from that of reinforcement learning. The LS solves the optimal control problem online while practicing the manipulation of CO. The system's functional architecture comprises several adaptive components, each of which incorporates a number of mapping functions approximated based on artificial neural nets. Besides the internal model of the CO's dynamics and adaptive controller that computes the control law, the LS includes a new type of internal model, the minimal cost (IM(mc)) of moving the controlled object between a pair of states. That internal model appears critical for the LS's capacity to develop an optimal movement trajectory. The IM(mc) interacts with the adaptive controller in a cooperative manner. The controller provides an initial approximation of an optimal control action, which is further optimized in real time based on the IM(mc). The IM(mc) in turn provides information for updating the controller. The LS's performance was tested on the task of center-out reaching to eight randomly selected targets with a 2DOF limb model. The LS reached an optimal level of performance in a few tens of trials. It also quickly adapted to movement perturbations produced by two different types of external force field. The results suggest that the proposed design of a self-optimized control system can serve as a basis for the modeling of motor learning that includes the formation and adaptive modification of the plan of a goal-directed movement.

Additional in-series compliance reduces muscle force summation and alters the time course of force relaxation during fixed-end contractions.

PubMed

Mayfield, Dean L; Launikonis, Bradley S; Cresswell, Andrew G; Lichtwark, Glen A

2016-11-15

There are high mechanical demands placed on skeletal muscles in movements requiring rapid acceleration of the body or its limbs. Tendons are responsible for transmitting muscle forces, but, because of their elasticity, can manipulate the mechanics of the internal contractile apparatus. Shortening of the contractile apparatus against the stretch of tendon affects force generation according to known mechanical properties; however, the extent to which differences in tendon compliance alter force development in response to a burst of electrical impulses is unclear. To establish the influence of series compliance on force summation, we studied electrically evoked doublet contractions in the cane toad peroneus muscle in the presence and absence of a compliant artificial tendon. Additional series compliance reduced tetanic force by two-thirds, a finding predicted based on the force-length property of skeletal muscle. Doublet force and force-time integral expressed relative to the twitch were also reduced by additional series compliance. Active shortening over a larger range of the ascending limb of the force-length curve and at a higher velocity, leading to a progressive reduction in force-generating potential, could be responsible. Muscle-tendon interaction may also explain the accelerated time course of force relaxation in the presence of additional compliance. Our findings suggest that a compliant tendon limits force summation under constant-length conditions. However, high series compliance can be mechanically advantageous when a muscle-tendon unit is actively stretched, permitting muscle fibres to generate force almost isometrically, as shown during stretch-shorten cycles in locomotor activities. Restricting active shortening would likely favour rapid force development. © 2016. Published by The Company of Biologists Ltd.

Regenerative Engineering and Bionic Limbs

PubMed Central

James, Roshan; Laurencin, Cato T.

2015-01-01

Amputations of the upper extremity are severely debilitating, current treatments support very basic limb movement, and patients undergo extensive physiotherapy and psychological counselling. There is no prosthesis that allows the amputees near-normal function. With increasing number of amputees due to injuries sustained in accidents, natural calamities and international conflicts, there is a growing requirement for novel strategies and new discoveries. Advances have been made in technological, material and in prosthesis integration where researchers are now exploring artificial prosthesis that integrate with the residual tissues and function based on signal impulses received from the residual nerves. Efforts are focused on challenging experts in different disciplines to integrate ideas and technologies to allow for the regeneration of injured tissues, recording on tissue signals and feed-back to facilitate responsive movements and gradations of muscle force. A fully functional replacement and regenerative or integrated prosthesis will rely on interface of biological process with robotic systems to allow individual control of movement such as at the elbow, forearm, digits and thumb in the upper extremity. Regenerative engineering focused on the regeneration of complex tissue and organ systems will be realized by the cross-fertilization of advances over the past thirty years in the fields of tissue engineering, nanotechnology, stem cell science, and developmental biology. The convergence of toolboxes crated within each discipline will allow interdisciplinary teams from engineering, science, and medicine to realize new strategies, mergers of disparate technologies, such as biophysics, smart bionics, and the healing power of the mind. Tackling the clinical challenges, interfacing the biological process with bionic technologies, engineering biological control of the electronic systems, and feed-back will be the important goals in regenerative engineering over the next two decades. PMID:25983525

Postoperative limb alignment and its determinants after minimally invasive Oxford medial unicompartmental knee arthroplasty.

PubMed

Mullaji, Arun B; Shetty, Gautam M; Kanna, Raj

2011-09-01

One hundred twenty-two consecutive minimally invasive Oxford phase 3 medial unicompartmental knee arthroplasties in 109 patients were evaluated for postoperative limb alignment and the influence of factors such as preoperative limb alignment, age, body mass index, sex, insert thickness, and surgeon's experience. The mean mechanical preoperative hip-knee-ankle (HKA) angle of 172.2° ± 3.1° improved to 177.1° ± 2.9° postoperatively. In 75% of the limbs, the HKA angle was restored to within an acceptable alignment of 177° ± 3°, 14% of the limbs were in excessive varus (<174°), and 11% were in valgus (>180°). Only preoperative HKA angle was predictive of postoperative HKA angle. Although most of the limbs had acceptable limb alignment after unicompartmental knee arthroplasty, limbs with more severe preoperative varus deformity had a tendency to remain in excessive varus, and limbs with lesser preoperative varus deformity had a greater tendency to go into valgus postoperatively. Copyright © 2011 Elsevier Inc. All rights reserved.

Probability of regenerating a normal limb after bite injury in the Mexican axolotl (Ambystoma mexicanum)

PubMed Central

Thompson, Sierra; Muzinic, Laura; Muzinic, Christopher; Niemiller, Matthew L.

2014-01-01

Abstract Multiple factors are thought to cause limb abnormalities in amphibian populations by altering processes of limb development and regeneration. We examined adult and juvenile axolotls (Ambystoma mexicanum) in the Ambystoma Genetic Stock Center (AGSC) for limb and digit abnormalities to investigate the probability of normal regeneration after bite injury. We observed that 80% of larval salamanders show evidence of bite injury at the time of transition from group housing to solitary housing. Among 717 adult axolotls that were surveyed, which included solitary‐housed males and group‐housed females, approximately half presented abnormalities, including examples of extra or missing digits and limbs, fused digits, and digits growing from atypical anatomical positions. Bite injury probably explains these limb defects, and not abnormal development, because limbs with normal anatomy regenerated after performing rostral amputations. We infer that only 43% of AGSC larvae will present four anatomically normal looking adult limbs after incurring a bite injury. Our results show regeneration of normal limb anatomy to be less than perfect after bite injury. PMID:25745564

Comparison of 2-limb versus 3-limb electrodiagnostic studies in the evaluation of chronic inflammatory demyelinating polyneuropathy.

PubMed

Vo, Mary L; Hanineva, Aneliya; Chin, Russell L; Carey, Bridget T; Latov, Norman; Langsdorf, Jennifer A

2015-04-01

European Federation of Neurological Societies/Peripheral Nerve Society electrodiagnostic (EDx) criteria for the definite diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) require the presence of demyelinating findings (DF) in at least 2 nerves. Data are lacking, however, regarding the optimal number of nerves to test. We retrospectively reviewed EDx data from 53 patients with CIDP and compared the number of DF found on 2- and 3-limb testing. A median of 3 (range 2-5) DF were found on 2-limb testing compared with 5 (range 4-7) DF when 3 limbs were evaluated. Two-limb EDx studies were sufficient to diagnose definite CIDP in 92.3% of typical, 84.2% of asymmetric, and 66.7% of distal phenotypes. Testing a third limb increased diagnostic certainty in 11 patients (20.8%) to definite CIDP. Three-limb testing may increase diagnostic sensitivity of definite CIDP, especially in patients with atypical phenotypes. Larger prospective studies are needed to better assess the benefit of performing 3-limb EDx studies. © 2014 Wiley Periodicals, Inc.

Regeneration and repair of human digits and limbs: fact and fiction

PubMed Central

Cheng, Tsun‐Chih

2015-01-01

Abstract A variety of digit and limb repair and reconstruction methods have been used in different clinical settings, but regeneration remains an item on every plastic surgeon's “wish list.” Although surgical salvage techniques are continually being improved, unreplantable digits and limbs are still abundant. We comprehensively review the structural and functional salvage methods in clinical practice, from the peeling injuries of small distal fingertips to multisegmented amputated limbs, and the developmental and tissue engineering approaches for regenerating human digits and limbs in the laboratory. Although surgical techniques have forged ahead, there are still situations in which digits and limbs are unreplantable. Advances in the field are delineated, and the regeneration processes of salamander limbs, lizard tails, and mouse digits and each component of tissue engineering approaches for digit‐ and limb‐building are discussed. Although the current technology is promising, there are many challenges in human digit and limb regeneration. We hope this review inspires research on the critical gap between clinical and basic science, and leads to more sophisticated digit and limb loss rescue and regeneration innovations. PMID:27499873

The effect of limb amputation on standing weight distribution in the remaining three limbs in dogs.

PubMed

Cole, Grayson Lee; Millis, Darryl

2017-01-16

Despite the fact that limb amputation is a commonly performed procedure in veterinary medicine, quantitative data regarding outcomes are lacking. The intention of this study was to evaluate the effect of limb amputation on weight distribution to the remaining three limbs at a stance in dogs. Ten dogs with a prior forelimb amputation and ten dogs with a prior hindlimb amputation; all of which had no history of orthopaedic or neural disease in the remaining three limbs were included in the study. Standing weight bearing was evaluated with a commercial stance analyzer in all dogs. Five valid trials were obtained and a mean percentage of weight bearing was calculated for each remaining limb. The dogs with a previous forelimb amputation, and also those with a previous hindlimb amputation, had the largest mean increase in weight bearing in the contralateral forelimb. In conclusion, proactive monitoring of orthopaedic disease in the contralateral forelimb may be advisable in dogs with a previous limb amputation. In addition, when determining candidacy for a limb amputation, disease of the contralateral forelimb should be thoroughly evaluated.

Shared Enhancer Activity in the Limbs and Phallus and Functional Divergence of a Limb-Genital cis-Regulatory Element in Snakes.

PubMed

Infante, Carlos R; Mihala, Alexandra G; Park, Sungdae; Wang, Jialiang S; Johnson, Kenji K; Lauderdale, James D; Menke, Douglas B

2015-10-12

The amniote phallus and limbs differ dramatically in their morphologies but share patterns of signaling and gene expression in early development. Thus far, the extent to which genital and limb transcriptional networks also share cis-regulatory elements has remained unexplored. We show that many limb enhancers are retained in snake genomes, suggesting that these elements may function in non-limb tissues. Consistent with this, our analysis of cis-regulatory activity in mice and Anolis lizards reveals that patterns of enhancer activity in embryonic limbs and genitalia overlap heavily. In mice, deletion of HLEB, an enhancer of Tbx4, produces defects in hindlimbs and genitalia, establishing the importance of this limb-genital enhancer for development of these different appendages. Further analyses demonstrate that the HLEB of snakes has lost hindlimb enhancer function while retaining genital activity. Our findings identify roles for Tbx4 in genital development and highlight deep similarities in cis-regulatory activity between limbs and genitalia. Copyright © 2015 Elsevier Inc. All rights reserved.

Towards the application of one-dimensional sonomyography for powered upper-limb prosthetic control using machine learning models.

PubMed

Guo, Jing-Yi; Zheng, Yong-Ping; Xie, Hong-Bo; Koo, Terry K

2013-02-01

The inherent properties of surface electromyography limit its potential for multi-degrees of freedom control. Our previous studies demonstrated that wrist angle could be predicted by muscle thickness measured from B-mode ultrasound, and hence, it could be an alternative signal for prosthetic control. However, an ultrasound imaging machine is too bulky and expensive. We aim to utilize a portable A-mode ultrasound system to examine the feasibility of using one-dimensional sonomyography (i.e. muscle thickness signals detected by A-mode ultrasound) to predict wrist angle with three different machine learning models - (1) support vector machine (SVM), (2) radial basis function artificial neural network (RBF ANN), and (3) back-propagation artificial neural network (BP ANN). Feasibility study using nine healthy subjects. Each subject performed wrist extension guided at 15, 22.5, and 30 cycles/minute, respectively. Data obtained from 22.5 cycles/minute trials was used to train the models and the remaining trials were used for cross-validation. Prediction accuracy was quantified by relative root mean square error (RMSE) and correlation coefficients (CC). Excellent prediction was noted using SVM (RMSE = 13%, CC = 0.975), which outperformed the other methods. It appears that one-dimensional sonomyography could be an alternative signal for prosthetic control. Clinical relevance Surface electromyography has inherent limitations that prohibit its full functional use for prosthetic control. Research that explores alternative signals to improve prosthetic control (such as the one-dimensional sonomyography signals evaluated in this study) may revolutionize powered prosthesis design and ultimately benefit amputee patients.

A Limb Action Detector Enabling People with Multiple Disabilities to Control Environmental Stimulation through Limb Action with a Nintendo Wii Remote Controller

ERIC Educational Resources Information Center

Shih, Ching-Hsiang; Chang, Man-Ling; Shih, Ching-Tien

2010-01-01

This study assessed whether two persons with multiple disabilities would be able to control environmental stimulation using limb action with a Nintendo Wii Remote Controller and a newly developed limb action detection program (LADP, i.e., a new software program that turns a Wii Remote Controller into a precise limb action detector). This study was…

Visual Feedback of the Non-Moving Limb Improves Active Joint-Position Sense of the Impaired Limb in Spastic Hemiparetic Cerebral Palsy

ERIC Educational Resources Information Center

Smorenburg, Ana R. P.; Ledebt, Annick; Deconinck, Frederik J. A.; Savelsbergh, Geert J. P.

2011-01-01

This study examined the active joint-position sense in children with Spastic Hemiparetic Cerebral Palsy (SHCP) and the effect of static visual feedback and static mirror visual feedback, of the non-moving limb, on the joint-position sense. Participants were asked to match the position of one upper limb with that of the contralateral limb. The task…

A New Limb Movement Detector Enabling People with Multiple Disabilities to Control Environmental Stimulation through Limb Swing with a Gyration Air Mouse

ERIC Educational Resources Information Center

Shih, Ching-Hsiang; Chang, Man-Ling; Shih, Ching-Tien

2010-01-01

This study assessed whether two persons with multiple disabilities would be able to control environmental stimulation using limb swing with a gyration air mouse and a newly developed limb movement detection program (LMDP, i.e., a new software program that turns a gyration air mouse into a precise limb movement detector). The study was performed…

Elevated vacuum suspension preserves residual-limb skin health in people with lower-limb amputation: Randomized clinical trial.

PubMed

Rink, Cameron; Wernke, Matthew M; Powell, Heather M; Gynawali, Surya; Schroeder, Ryan M; Kim, Jayne Y; Denune, Jeffrey A; Gordillo, Gayle M; Colvin, James M; Sen, Chandan K

2016-01-01

A growing number of clinical trials and case reports support qualitative claims that use of an elevated vacuum suspension (EVS) prosthesis improves residual-limb health on the basis of self-reported questionnaires, clinical outcomes scales, and wound closure studies. Here, we report first efforts to quantitatively assess residual-limb circulation in response to EVS. Residual-limb skin health and perfusion of people with lower-limb amputation (N = 10) were assessed during a randomized crossover study comparing EVS with nonelevated vacuum suspension (control) over a 32 wk period using noninvasive probes (transepidermal water loss, laser speckle imaging, transcutaneous oxygen measurement) and functional hyperspectral imaging approaches. Regardless of the suspension system, prosthesis donning decreased perfusion in the residual limb under resting conditions. After 16 wk of use, EVS improved residual-limb oxygenation during treadmill walking. Likewise, prosthesis-induced reactive hyperemia was attenuated with EVS following 16 wk of use. Skin barrier function was preserved with EVS but disrupted after control socket use. Taken together, outcomes suggest chronic EVS use improves perfusion and preserves skin barrier function in people with lower-limb amputation. ClinicalTrials.gov; "Evaluation of limb health associated with a prosthetic vacuum socket system": NCT01839123; https://clinicaltrials.gov/ct2/show/NCT01839123?term=NCT01839123&rank=1.

ATHLETE: A Limbed Vehicle for Solar System Exploration

NASA Technical Reports Server (NTRS)

Wilcox, Brian H.

2012-01-01

As part of the Human-Robot Systems project funded by NASA, the Jet Propulsion Laboratory has developed a vehicle called ATHLETE: the All-Terrain Hex-Limbed Extra-Terrestrial Explorer. Each vehicle is based on six wheels at the ends of six multi-degree-of-freedom limbs. Because each limb has enough degrees of freedom for use as a general-purpose leg, the wheels can be locked and used as feet to walk out of excessively soft or other extreme terrain. Since the vehicle has this alternative mode of traversing through or at least out of extreme terrain, the wheels and wheel actuators can be sized for nominal terrain. There are substantial mass savings in the wheel and wheel actuators associated with designing for nominal instead of extreme terrain. These mass savings are comparable-to or larger-than the extra mass associated with the articulated limbs. As a result, the entire mobility system, including wheels and limbs, can be about 25% lighter than a conventional mobility chassis. A side benefit of this approach is that each limb has sufficient degrees-of-freedom to use as a general-purpose manipulator (hence the name "limb" instead of "leg"). Our prototype ATHLETE vehicles have quick-disconnect tool adapters on the limbs that allow tools to be drawn out of a "tool belt" and maneuvered by the limb.

Leaping lopsided: a review of the current hypotheses regarding etiologies of limb malformations in frogs.

PubMed

Loeffler, I K; Stocum, D L; Fallon, J F; Meteyer, C U

2001-10-15

Recent progress in the investigation of limb malformations in free-living frogs has underlined the wide range in the types of limb malformations and the apparent spatiotemporal clustering of their occurrence. Here, we review the current understanding of normal and abnormal vertebrate limb development and regeneration and discuss some of the molecular events that may bring about limb malformation. Consideration of the differences between limb development and regeneration in amphibians has led us to the hypothesis that some of the observed limb malformations come about through misdirected regeneration. We report the results of a pilot study that supports this hypothesis. In this study, the distal aspect of the right hindlimb buds of X. laevis tadpoles was amputated at the pre-foot paddle stage. The tadpoles were raised in water from a pond in Minnesota at which 7% of surveyed newly metamorphosed feral frogs had malformations. Six percent (6 of 100) of the right limbs of the tadpoles raised in pond water developed abnormally. One truncated right limb was the only malformation in the control group, which was raised in dechlorinated municipal water. All unamputated limbs developed normally in both groups. Three major factors under consideration for effecting the limb malformations are discussed. These factors include environmental chemicals (primarily agrichemicals), encysted larvae (metacercariae) of trematode parasites, and increased levels of ultraviolet light. Emphasis is placed on the necessary intersection of environmental stressors and developmental events to bring about the specific malformations that are observed in free-living frog populations.

Kinematic adaptations to tripedal locomotion in dogs.

PubMed

Goldner, B; Fuchs, A; Nolte, I; Schilling, N

2015-05-01

Limb amputation often represents the only treatment option for canine patients with certain diseases or injuries of the appendicular system. Previous studies have investigated adaptations to tripedal locomotion in dogs but there is a lack of understanding of biomechanical compensatory mechanisms. This study evaluated the kinematic differences between quadrupedal and tripedal locomotion in nine healthy dogs running on a treadmill. The loss of the right pelvic limb was simulated using an Ehmer sling. Kinematic gait analysis included spatio-temporal comparisons of limb, joint and segment angles of the remaining pelvic and both thoracic limbs. The following key parameters were compared between quadrupedal and tripedal conditions: angles at touch-down and lift-off, minimum and maximum joint angles, plus range of motion. Significant differences in angular excursion were identified in several joints of each limb during both stance and swing phases. The most pronounced differences concerned the remaining pelvic limb, followed by the contralateral thoracic limb and, to a lesser degree, the ipsilateral thoracic limb. The thoracic limbs were, in general, more retracted, consistent with pelvic limb unloading and previous observations of bodyweight re-distribution in amputees. Proximal limb segments showed more distinct changes than distal ones. Particularly, the persistently greater anteversion of the pelvis probably affects the axial system. Overall, tripedal locomotion requires concerted kinematic adjustments of both the appendicular and axial systems, and consequently preventive, therapeutic and rehabilitative care of canine amputees should involve the whole musculoskeletal apparatus. Copyright © 2015 Elsevier Ltd. All rights reserved.

Leaping lopsided: a review of the current hypotheses regarding etiologies of limb malformations in frogs

USGS Publications Warehouse

Loeffler, I.K.; Stocum, D.L.; Fallon, J.F.; Meteyer, C.U.

2001-01-01

Recent progress in the investigation of limb malformations in free-living frogs has underlined the wide range in the types of limb malformations and the apparent spatiotemporal clustering of their occurrence. Here, we review the current understanding of normal and abnormal vertebrate limb development and regeneration and discuss some of the molecular events that may bring about limb malformation. Consideration of the differences between limb development and regeneration in amphibians has led us to the hypothesis that some of the observed limb malformations come about through misdirected regeneration. We report the results of a pilot study that supports this hypothesis. In this study, the distal aspect of the right hindlimb buds of X. laevis tadpoles was amputated at the pre-foot paddle stage. The tadpoles were raised in water from a pond in Minnesota at which 7% of surveyed newly metamorphosed feral frogs had malformations. Six percent (6 of 100) of the right limbs of the tadpoles raised in pond water developed abnormally. One truncated right limb was the only malformation in the control group, which was raised in dechlorinated municipal water. All unamputated limbs developed normally in both groups. Three major factors under consideration for effecting the limb malformations are discussed. These factors include environmental chemicals (primarily agrichemicals), encysted larvae (metacercariae) of trematode parasites, and increased levels of ultraviolet light. Emphasis is placed on the necessary intersection of environmental stressors and developmental events to bring about the specific malformations that are observed in free-living frog populations.

Society for Vascular Surgery limb stage and patient risk correlate with outcomes in an amputation prevention program.

PubMed

Causey, Marlin W; Ahmed, Ayman; Wu, Bian; Gasper, Warren J; Reyzelman, Alex; Vartanian, Shant M; Hiramoto, Jade S; Conte, Michael S

2016-06-01

Clinical decision making and accurate outcomes comparisons in advanced limb ischemia require improved staging systems. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System (Wound extent, Ischemia, and foot Infection [WIfI]) was designed to stratify limb outcomes based on three major factors-wound extent, ischemia, and foot infection. The Project or Ex-Vivo vein graft Engineering via Transfection III (PREVENT) III (PIII) risk score was developed to stratify patients by expected amputation-free survival (AFS) after surgical revascularization. This study was designed to prospectively assess limb and patient-based staging for predicting outcomes of hospitalized patients in an amputation prevention program. This study undertook a retrospective analysis of prospectively gathered registry data of consecutive patients with limb-threatening conditions admitted to a fully integrated vascular/podiatry service over a 16-month period. Upon admission, limb risk was stratified using the WIfI system and patient risk was categorized using PIII classification. Patients were assessed for perioperative and postdischarge outcomes, and their relationship to staging at admission was analyzed. There were 174 threatened limbs (143 hospitalized patients) stratified by WIfI stage (1%-12%, 2%-28%, 3%-24%, 4%-28%, 5%-3%, unstaged-5%) and PIII risk (34% low, 49% moderate, and 17% high risk). Diabetes and end-stage renal disease were associated with WIfI stage (P = .006 and P = .018) and PIII risk (P = .003 and P < .001). Perioperative (30-day) events included 3% mortality, 8% major adverse cardiovascular events and 2.4% major amputation. There were 119 limbs (71%) that underwent revascularization, including 108 infrainguinal reconstructions (endovascular or open revascularization). Rate of revascularization increased with WIfI stage (P < .001), concomitant with the number of podiatric procedures, minor amputations, and initial hospital duration of stay (all P < .001). Increased WIfI stage was associated with major adverse limb events (P = .018), reduced limb salvage (P = .037), and decreased AFS (P = .048). In contrast, PIII risk category was associated with mortality (P < .001) and AFS (P < .001). Among infrainguinal reconstruction procedures, there was a similar distribution of endovascular (46%) and surgical (54%) interventions. Freedom from major adverse limb events was best for autogenous vein bypass (P = .025), and surgical revascularization was associated with improved limb salvage among the most severely threatened limbs (WIfI stage 4: 95% limb salvage for open bypass vs 68% limb salvage for endovascular; P = .026). Among patients hospitalized with limb-threatening conditions and treated by a multidisciplinary amputation prevention team, PIII risk correlates with mortality whereas WIfI stage strongly predicts initial hospital duration of stay, and key mid-term limb outcomes. Surgical revascularization performed best in the limbs at greatest risk (WIfI stage 4), and autogenous vein bypass was the preferred conduit for open bypass. These data support the use of WIfI and PIII as complementary staging tools in the management of chronic limb-threatening ischemia. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

The Effect of Prosthetic Foot Push-off on Mechanical Loading Associated with Knee Osteoarthritis in Lower Extremity Amputees

PubMed Central

Morgenroth, David C.; Segal, Ava D.; Zelik, Karl E.; Czerniecki, Joseph M.; Klute, Glenn K.; Adamczyk, Peter G.; Orendurff, Michael S.; Hahn, Michael E.; Collins, Steven H.; Kuo, Art D.

2011-01-01

Lower extremity amputation not only limits mobility, but also increases the risk of knee osteoarthritis of the intact limb. Dynamic walking models of non-amputees suggest that pushing-off from the trailing limb can reduce collision forces on the leading limb. These collision forces may determine the peak knee external adduction moment (EAM), which has been linked to the development of knee OA in the general population. We therefore hypothesized that greater prosthetic push-off would lead to reduced loading and knee EAM of the intact limb in unilateral transtibial amputees. Seven unilateral transtibial amputees were studied during gait under three prosthetic foot conditions that were intended to vary push-off. Prosthetic foot-ankle push-off work, intact limb knee EAM and ground reaction impulses for both limbs during step-to-step transition were measured. Overall, trailing limb prosthetic push-off work was negatively correlated with leading intact limb 1st peak knee EAM (slope = −0.72 +/− 0.22; p=0.011). Prosthetic push-off work and 1st peak intact knee EAM varied significantly with foot type. The prosthetic foot condition with the least push-off demonstrated the largest knee EAM, which was reduced by 26% with the prosthetic foot producing the most push-off. Trailing prosthetic limb push-off impulse was negatively correlated with leading intact limb loading impulse (slope = −0.34 +/− 0.14; p=.001), which may help explain how prosthetic limb push-off can affect intact limb loading. Prosthetic feet that perform more prosthetic push-off appear to be associated with a reduction in 1st peak intact knee EAM, and their use could potentially reduce the risk and burden of knee osteoarthritis in this population. PMID:21803584

The effect of prosthetic foot push-off on mechanical loading associated with knee osteoarthritis in lower extremity amputees.

PubMed

Morgenroth, David C; Segal, Ava D; Zelik, Karl E; Czerniecki, Joseph M; Klute, Glenn K; Adamczyk, Peter G; Orendurff, Michael S; Hahn, Michael E; Collins, Steven H; Kuo, Art D

2011-10-01

Lower extremity amputation not only limits mobility, but also increases the risk of knee osteoarthritis of the intact limb. Dynamic walking models of non-amputees suggest that pushing-off from the trailing limb can reduce collision forces on the leading limb. These collision forces may determine the peak knee external adduction moment (EAM), which has been linked to the development of knee OA in the general population. We therefore hypothesized that greater prosthetic push-off would lead to reduced loading and knee EAM of the intact limb in unilateral transtibial amputees. Seven unilateral transtibial amputees were studied during gait under three prosthetic foot conditions that were intended to vary push-off. Prosthetic foot-ankle push-off work, intact limb knee EAM and ground reaction impulses for both limbs during step-to-step transition were measured. Overall, trailing limb prosthetic push-off work was negatively correlated with leading intact limb 1st peak knee EAM (slope=-.72±.22; p=.011). Prosthetic push-off work and 1st peak intact knee EAM varied significantly with foot type. The prosthetic foot condition with the least push-off demonstrated the largest knee EAM, which was reduced by 26% with the prosthetic foot producing the most push-off. Trailing prosthetic limb push-off impulse was negatively correlated with leading intact limb loading impulse (slope=-.34±.14; p=.001), which may help explain how prosthetic limb push-off can affect intact limb loading. Prosthetic feet that perform more prosthetic push-off appear to be associated with a reduction in 1st peak intact knee EAM, and their use could potentially reduce the risk and burden of knee osteoarthritis in this population. Published by Elsevier B.V.

The effects of body proportions on thermoregulation: an experimental assessment of Allen's rule.

PubMed

Tilkens, Michael J; Wall-Scheffler, Cara; Weaver, Timothy D; Steudel-Numbers, Karen

2007-09-01

Numerous studies have discussed the influence of thermoregulation on hominin body shape concluding, in accordance with Allen's rule, that the presence of relatively short limbs on both extant as well as extinct hominin populations offers an advantage for survival in cold climates by reducing the limb's surface area to volume ratio. Moreover, it has been suggested that shortening the distal limb segment compared to the proximal limb segment may play a larger role in thermoregulation due to a greater relative surface area of the shank. If longer limbs result in greater heat dissipation, we should see higher resting metabolic rates (RMR) in longer-limbed individuals when temperature conditions fall, since the resting rate will need to replace the lost heat. We collected resting oxygen consumption on volunteer human subjects to assess the correlation between RMR and lower limb length in human subjects, as well as to reexamine the prediction that shortening the distal segment would have a larger effect on heat loss and, thus, RMR than the shortening of the proximal segment. Total lower limb length exhibits a statistically significant relationship with resting metabolic rate (p<0.001; R(2)=0.794). While this supports the hypothesis that as limb length increases, resting metabolic rate increases, it also appears that thigh length, rather than the length of the shank, drives this relationship. The results of the present study confirm the widely-held expectation of Allen's rule, that short limbs reduce the metabolic cost of maintaining body temperature, while long limbs result in greater heat dissipation regardless of the effect of mass. The present results suggest that the shorter limbs of Neandertals, despite being energetically disadvantageous while walking, would indeed have been advantageous for thermoregulation.

The influence of asymmetric force requirements on a multi-frequency bimanual coordination task.

PubMed

Kennedy, Deanna M; Rhee, Joohyun; Jimenez, Judith; Shea, Charles H

2017-01-01

An experiment was designed to determine the impact of the force requirements on the production of bimanual 1:2 coordination patterns requiring the same (symmetric) or different (asymmetric) forces when Lissajous displays and goal templates are provided. The Lissajous displays have been shown to minimize the influence of attentional and perceptual constraints allowing constraints related to neural crosstalk to be more clearly observed. Participants (N=20) were randomly assigned to a force condition in which the left or right limb was required to produce more force than the contralateral limb. In each condition participants were required to rhythmically coordinate the pattern of isometric forces in a 1:2 coordination pattern. Participant performed 13 practice trials and 1 test trial per force level. The results indicated that participants were able to effectively coordinate the 1:2 multi-frequency goal patterns under both symmetric and asymmetric force requirements. However, consistent distortions in the force and force velocity time series were observed for one limb that appeared to be associated with the production of force in the contralateral limb. Distortions in the force produced by the left limb occurred regardless of the force requirements of the task (symmetric, asymmetric) or whether the left or right limb had to produce more force than the contralateral limb. However, distinct distortions in the right limb occurred only when the left limb was required to produce 5 times more force than the right limb. These results are consistent with the notion that neural crosstalk can influence both limbs, but may manifest differently for each limb depending on the force requirements of the task. Copyright © 2016 Elsevier B.V. All rights reserved.

Ertl and Non-Ertl amputees exhibit functional biomechanical differences during the sit-to-stand task.

PubMed

Ferris, Abbie E; Christiansen, Cory L; Heise, Gary D; Hahn, David; Smith, Jeremy D

2017-05-01

People with transtibial amputation stand ~50times/day. There are two general approaches to transtibial amputation: 1) distal tibia and fibula union using a "bone-bridge" (Ertl), 2) non-union of the tibia and fibula (Non-Ertl). The Ertl technique may improve functional outcomes by increasing the end-bearing ability of the residual limb. We hypothesized individuals with an Ertl would perform a five-time sit-to-stand task faster through greater involvement/end-bearing of the affected limb. Ertl (n=11) and Non-Ertl (n=7) participants sat on a chair with each foot on separate force plates and performed the five-time sit-to-stand task. A symmetry index (intact vs affected limbs) was calculated using peak ground reaction forces. The Ertl group performed the task significantly faster (9.33s (2.66) vs 13.27 (2.83)s). Symmetry index (23.33 (23.83)% Ertl, 36.53 (13.51)% Non-Ertl) indicated the intact limb for both groups produced more force than the affected limb. Ertl affected limb peak ground reaction forces were significantly larger than the Non-Ertl affected limb. Peak knee power and net work of the affected limb were smaller than their respective intact limb for both groups. The Ertl intact limb produced significantly greater peak knee power and net work than the Non-Ertl intact knee. Although loading asymmetries existed between the intact and affected limb of both groups, the Ertl group performed the task ~30% faster. This was driven by greater power and work production of the Ertl intact limb knee. Our results suggest that functional differences exist between the procedures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Postural control strategies during single limb stance following acute lateral ankle sprain.

PubMed

Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Delahunt, Eamonn

2014-06-01

Single-limb stance is maintained via the integration of visual, vestibular and somatosensory afferents. Musculoskeletal injury challenges the somatosensory system to reweight distorted sensory afferents. This investigation supplements kinetic analysis of eyes-open and eyes-closed single-limb stance tasks with a kinematic profile of lower limb postural orientation in an acute lateral ankle sprain group to assess the adaptive capacity of the sensorimotor system to injury. Sixty-six participants with first-time acute lateral ankle sprain completed a 20-second eyes-open single-limb stance task on their injured and non-injured limbs (task 1). Twenty-three of these participants successfully completed the same 20-second single-limb stance task with their eyes closed (task 2). A non-injured control group of 19 participants completed task 1, with 16 completing task 2. 3-dimensional kinematics of the hip, knee and ankle joints, as well as associated fractal dimension of the center-of-pressure path were determined for each limb during these tasks. Between trial analyses revealed significant differences in stance limb kinematics and fractal dimension of the center-of-pressure path for task 2 only. The control group bilaterally assumed a position of greater hip flexion compared to injured participants on their side-matched "involved"(7.41 [6.1°] vs 1.44 [4.8]°; η(2)=.34) and "uninvolved" (9.59 [8.5°] vs 2.16 [5.6°]; η(2)=.31) limbs, with a greater fractal dimension of the center-of-pressure path (involved limb=1.39 [0.16°] vs 1.25 [0.14°]; uninvolved limb=1.37 [0.21°] vs 1.23 [0.14°]). Bilateral impairment in postural control strategies present following a first time acute lateral ankle sprain. Copyright © 2014 Elsevier Ltd. All rights reserved.

Environmental monitoring for the DOE coolside and LIMB demonstration extension projects

DOE Office of Scientific and Technical Information (OSTI.GOV)

White, T.; Contos, L.; Adams, L.

1992-02-01

The purpose of this document is to present environmental monitoring data collected during the US DOE Limestone Injection Multistage Burner (LIMB) Demonstration Project Extension. The objective of the LIMB program is to demonstrate the sulfur dioxide (SO{sub 2}) and nitrogen oxide (NO{sub x}) emission reduction capabilities of the LIMB system. The LIMB system is a retrofit technology to be used for existing coal-fired boilers equipped with electrostatic precipitators. (VC)

Tissue dielectric constant and circumference measurement in the follow-up of treatment-related changes in lower-limb lymphedema.

PubMed

Tugral, Alper; Viren, Tuomas; Bakar, Yesim

2018-02-01

Lymphedema of lower limbs is a chronic condition that requires life-long management. Therapeutic effect of complex decongestive physiotherapy (CDP) is most often followed by circumference measurements (CM). However, the CM measurements are not specific to interstitial tissue fluid and have problems in sensitivity and objectivity. The aim of present study was to evaluate the therapeutic effect of CDP with a new tissue water specific measurement technique, in patients with lower limb lymphedema (LLL). A total of 17 patients with unilateral LLL (11 primary, 6 secondary lymphedema) were recruited in this study. CDP was applied for 5 days a week for 4 weeks. CM measurement of both limbs was performed at nine sites along limb by tape measure. Percentage skin water content (PWC) of thigh, calf and ankle was measured in affected lymphedema limb and contralateral limb with MoistureMeterD Compact (MMDC) device. Inter-limb PWC ratio was calculated by dividing affected side's PWC value with PWC of contralateral limb. Patients were asked to fullfill the Lymph Quality of Life Questionnaire. Significant reduction of circumference after CDP was detected at all nine measurement sites along lower limb (P<0.01). PWC measurements showed a significant decrease of skin tissue water at thigh, calf and ankle measurement sites after CDP (P<0.001). Inter-limb PWC ratios demonstrated significant reduction of edema between affected and contraletral limbs post-treatment (P<0.003). CDP also increased the quality of life (P=0.006). CM and PWC measurements reflected a positive effect of CDP in patients with LLL. Both absolute PWC values and inter-limb PWC ratios were meaningful tools to follow the effect of therapautic intervention. Compared with CM measurements the TDC technique offered easier, quicker, objective and more practical measurements for routine assessments of LLL.

Restoring movement representation and alleviating phantom limb pain through short-term neurorehabilitation with a virtual reality system.

PubMed

Osumi, M; Ichinose, A; Sumitani, M; Wake, N; Sano, Y; Yozu, A; Kumagaya, S; Kuniyoshi, Y; Morioka, S

2017-01-01

We developed a quantitative method to measure movement representations of a phantom upper limb using a bimanual circle-line coordination task (BCT). We investigated whether short-term neurorehabilitation with a virtual reality (VR) system would restore voluntary movement representations and alleviate phantom limb pain (PLP). Eight PLP patients were enrolled. In the BCT, they repeatedly drew vertical lines using the intact hand and intended to draw circles using the phantom limb. Drawing circles mentally using the phantom limb led to the emergence of an oval transfiguration of the vertical lines ('bimanual-coupling' effect). We quantitatively measured the degree of this bimanual-coupling effect as movement representations of the phantom limb before and immediately after short-term VR neurorehabilitation. This was achieved using an 11-point numerical rating scale (NRS) for PLP intensity and the Short-Form McGill Pain Questionnaire (SF-MPQ). During VR neurorehabilitation, patients wore a head-mounted display that showed a mirror-reversed computer graphic image of an intact arm (the virtual phantom limb). By intending to move both limbs simultaneously and similarly, the patients perceived voluntary execution of movement in their phantom limb. Short-term VR neurorehabilitation promptly restored voluntary movement representations in the BCT and alleviated PLP (NRS: p = 0.015; 39.1 ± 28.4% relief, SF-MPQ: p = 0.015; 61.5 ± 48.5% relief). Restoration of phantom limb movement representations and reduced PLP intensity were linearly correlated (p < 0.05). VR rehabilitation may encourage patient's motivation and multimodal sensorimotor re-integration of a phantom limb and subsequently have a potent analgesic effect. There was no objective evidence that restoring movement representation by neurorehabilitation with virtual reality alleviated phantom limb pain. This study revealed quantitatively that restoring movement representation with virtual reality rehabilitation using a bimanual coordination task correlated with alleviation of phantom limb pain. © 2016 European Pain Federation - EFIC®.

Apparent motion perception in lower limb amputees with phantom sensations: "obstacle shunning" and "obstacle tolerance".

PubMed

Saetta, Gianluca; Grond, Ilva; Brugger, Peter; Lenggenhager, Bigna; Tsay, Anthony J; Giummarra, Melita J

2018-03-21

Phantom limbs are the phenomenal persistence of postural and sensorimotor features of an amputated limb. Although immaterial, their characteristics can be modulated by the presence of physical matter. For instance, the phantom may disappear when its phenomenal space is invaded by objects ("obstacle shunning"). Alternatively, "obstacle tolerance" occurs when the phantom is not limited by the law of impenetrability and co-exists with physical objects. Here we examined the link between this under-investigated aspect of phantom limbs and apparent motion perception. The illusion of apparent motion of human limbs involves the perception that a limb moves through or around an object, depending on the stimulus onset asynchrony (SOA) for the two images. Participants included 12 unilateral lower limb amputees matched for obstacle shunning (n = 6) and obstacle tolerance (n = 6) experiences, and 14 non-amputees. Using multilevel linear models, we replicated robust biases for short perceived trajectories for short SOA (moving through the object), and long trajectories (circumventing the object) for long SOAs in both groups. Importantly, however, amputees with obstacle shunning perceived leg stimuli to predominantly move through the object, whereas amputees with obstacle tolerance perceived leg stimuli to predominantly move around the object. That is, in people who experience obstacle shunning, apparent motion perception of lower limbs was not constrained to the laws of impenetrability (as the phantom disappears when invaded by objects), and legs can therefore move through physical objects. Amputees who experience obstacle tolerance, however, had stronger solidity constraints for lower limb apparent motion, perhaps because they must avoid co-location of the phantom with physical objects. Phantom limb experience does, therefore, appear to be modulated by intuitive physics, but not in the same way for everyone. This may have important implications for limb experience post-amputation (e.g., improving prosthesis embodiment when limb representation is constrained by the same limits as an intact limb). Copyright © 2018 Elsevier Ltd. All rights reserved.

Medial knee joint contact force in the intact limb during walking in recently ambulatory service members with unilateral limb loss: a cross-sectional study

PubMed Central

Krupenevich, Rebecca L.; Pruziner, Alison L.; Wolf, Erik J.; Schnall, Barri L.

2017-01-01

Background Individuals with unilateral lower limb amputation have a high risk of developing knee osteoarthritis (OA) in their intact limb as they age. This risk may be related to joint loading experienced earlier in life. We hypothesized that loading during walking would be greater in the intact limb of young US military service members with limb loss than in controls with no limb loss. Methods Cross-sectional instrumented gait analysis at self-selected walking speeds with a limb loss group (N = 10, age 27 ± 5 years, 170 ± 36 days since last surgery) including five service members with transtibial limb loss and five with transfemoral limb loss, all walking independently with their first prosthesis for approximately two months. Controls (N = 10, age 30 ± 4 years) were service members with no overt demographical risk factors for knee OA. 3D inverse dynamics modeling was performed to calculate joint moments and medial knee joint contact forces (JCF) were calculated using a reduction-based musculoskeletal modeling method and expressed relative to body weight (BW). Results Peak JCF and maximum JCF loading rate were significantly greater in limb loss (184% BW, 2,469% BW/s) vs. controls (157% BW, 1,985% BW/s), with large effect sizes. Results were robust to probabilistic perturbations to the knee model parameters. Discussion Assuming these data are reflective of joint loading experienced in daily life, they support a “mechanical overloading” hypothesis for the risk of developing knee OA in the intact limb of limb loss subjects. Examination of the evolution of gait mechanics, joint loading, and joint health over time, as well as interventions to reduce load or strengthen the ability of the joint to withstand loads, is warranted. PMID:28168120

Imparting regenerative capacity to limbs by progenitor cell transplantation

PubMed Central

Lin, Gufa; Chen, Ying; Slack, Jonathan M.W.

2012-01-01

Summary The frog Xenopus can normally regenerate its limbs at early developmental stages but loses the ability during metamorphosis. This behavior provides a potential gain-of-function model for measures that can enhance limb regeneration. Here we show that frog limbs can be caused to form multidigit regenerates after receiving transplants of larval limb progenitor cells. It is necessary to activate Wnt/β -catenin signaling in the cells, and to add Sonic hedgehog, FGF10 and thymosin β4. These factors promote survival and growth of the grafted cells and also provide pattern information. The eventual regenerates are not composed solely of donor tissue; the host cells also make a substantial contribution despite their lack of regeneration-competence. Cells from adult frog legs or from regenerating tadpole tails do not promote limb regeneration, demonstrating the necessity for limb progenitor cells. These findings have obvious implications for the development of a technology to promote limb regeneration in mammals. PMID:23273877

The Dependence of Solar Flare Limb Darkening on Emission Peak Formation Temperature

NASA Astrophysics Data System (ADS)

Thiemann, Edward; Epp, Luke; Eparvier, Francis; Chamberlin, Phillip C.

2017-08-01

Solar limb effects are local brightening or darkening of an emission that depend on where in the Sun's atmosphere it forms. Near the solar limb, optically thick (thin) emissions will darken (brighten) as the column of absorbers (emitters) along the line-of-sight increases. Note that in limb brightening, emission sources are re-arranged whereas in limb darkening they are obscured. Thus, only limb darkening is expected to occur in disk integrated observations. Limb darkening also results in center-to-limb variations of disk-integrated solar flare spectra, with important consequences for how planetary atmospheres are affected by flares. Flares are typically characterized by their flux in the optically thin 0.1-0.8 nm band measured by the X-ray Sensor (XRS) on board the Geostationary Operational Environmental Satellite (GOES). On the other hand, Extreme Ultraviolet (EUV) line emissions can limb darken because they are sensitive to resonant scattering, resulting in a flare's location on the solar disk controlling the amount of ionizing radiation that reaches a planet. For example, an X-class flare originating from disk center may significantly heat a planet's thermosphere, whereas the same flare originating near the limb may have no effect because much of the effective emissions are scattered in the solar corona.To advance the relatively poor understanding of flare limb darkening, we use over 300 M-class or larger flares observed by the EUV Variability Experiment (EVE) onboard the Solar Dynamics Observatory (SDO) to characterize limb darkening as a function of emission peak formation temperature, Tf. For hot coronal emissions (Tf>2 MK), these results show a linear relationship between the degree of limb darkening and Tf where lines with Tf=2 MK darken approximately 7 times more than lines with Tf=16 MK. Because the extent of limb darkening is dependent on the height of the source plasma, we use simple Beer-Lambert radiative transfer analysis to interpret these results and characterize the average thermal structure of the flares considered. As such, these results can be used to constrain both empirical flare irradiance models and more sophisticated flare loop hydrodynamic models.

The solar XUV He I and He II emission lines. I - Intensities and gross center-to-limb behavior

NASA Technical Reports Server (NTRS)

Mango, S. A.; Bohlin, J. D.; Glackin, D. L.; Linsky, J. L.

1978-01-01

The center-to-limb variation of the He II 304- and 256-A lines and He I 584- and 537-A lines is derived for different solar features, but averaged over the chromospheric supergranulation structure. The general trend is for limb brightening in quiet-sun regions, limb neutrality in unipolar magnetic regions (UMR), and limb darkening in polar coronal holes. The center-to-limb behavior in these optically thick emission lines indicates collisional excitation and decreasing transition-region temperature gradients with respect to optical depth in the sequence quiet sun to UMR to coronal hole.

HOW DOES ADDING AND REMOVING LIQUID FROM SOCKET BLADDERS AFFECT RESIDUAL LIMB FLUID VOLUME?

PubMed Central

Sanders, JE; Cagle, JC; Harrison, DS; Myers, TR; Allyn, KJ

2015-01-01

Adding and removing liquid from socket bladders is a means for people with limb loss to accommodate residual limb volume change. Nineteen people with trans-tibial amputation using their regular prosthetic socket fitted with fluid bladders on the inside socket surface underwent cycles of bladder liquid addition and removal. In each cycle, subjects sat, stood, and walked for 90s with bladder liquid added and then sat, stood, and walking for 90s again with the bladder liquid removed. The amount of bladder liquid added was increased in each cycle. Bioimpedance analysis was implemented to measure residual limb fluid volume. Results showed that the preferred bladder liquid volume was 16.8 mL (s.d.8.4), corresponding to 1.7% (s.d.0.8%) of the average socket volume between the bioimpedance voltage-sensing electrodes. Limb fluid volume driven out of the residual limb when bladder liquid was added was typically not recovered upon subsequent bladder liquid removal. Fifteen of nineteen subjects experienced a gradual limb fluid volume loss over the test session. Care should be taken when implementing adjustable socket technologies in people with limb amputation. Reducing socket volume may accentuate limb fluid volume loss. PMID:24203546

Limb Correction of Polar-Orbiting Imagery for the Improved Interpretation of RGB Composites

NASA Technical Reports Server (NTRS)

Jedlovec, Gary J.; Elmer, Nicholas

2016-01-01

Red-Green-Blue (RGB) composite imagery combines information from several spectral channels into one image to aid in the operational analysis of atmospheric processes. However, infrared channels are adversely affected by the limb effect, the result of an increase in optical path length of the absorbing atmosphere between the satellite and the earth as viewing zenith angle increases. This paper reviews a newly developed technique to quickly correct for limb effects in both clear and cloudy regions using latitudinally and seasonally varying limb correction coefficients for real-time applications. These limb correction coefficients account for the increase in optical path length in order to produce limb-corrected RGB composites. The improved utility of a limb-corrected Air Mass RGB composite from the application of this approach is demonstrated using Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) imagery. However, the limb correction can be applied to any polar-orbiting sensor infrared channels, provided the proper limb correction coefficients are calculated. Corrected RGB composites provide multiple advantages over uncorrected RGB composites, including increased confidence in the interpretation of RGB features, improved situational awareness for operational forecasters, and the ability to use RGB composites from multiple sensors jointly to increase the temporal frequency of observations.

Chemical activation of Wnt/β-catenin signalling inhibits innervation and causes skeletal tissue malformations during axolotl limb regeneration.

PubMed

Wischin, Sabina; Castañeda-Patlán, Cristina; Robles-Flores, Martha; Chimal-Monroy, Jesús

2017-04-01

Limb regeneration involves several interrelated physiological processes in which a particular signalling pathway may play a variety of functions. Blocking the function of Wnt/β-catenin signalling during limb regeneration inhibits regeneration in axolotls (Ambystoma mexicanum). Limb development shares many features with limb regeneration, and Wnt/β-catenin activation has different effects depending on the developmental stage. The aim of this study was to evaluate whether Wnt/β-catenin signalling activation during axolotl limb regeneration has different effects when activated at different stages of regeneration. To evaluate this hypothesis, we treated amputated axolotls with a Wnt agonist chemical at different stages of limb regeneration. The results showed that limb regeneration was inhibited when the treatment began before blastema formation. Under these conditions, blastema formation was hindered, possibly due to the lack of innervation. On the other hand, when axolotls were treated after blastema formation and immediately before the onset of morphogenesis, we observed structural disorganization in skeletal formation. In conclusion, we found that limb regeneration was differentially affected depending on the stage at which the Wnt signalling pathway was activated. Copyright © 2017 Elsevier B.V. All rights reserved.

Detection of Genes Regulated by Lmx1b During Limb Dorsalization

PubMed Central

Feenstra, Jennifer M.; Kanaya, Kohei; Pira, Charmaine U; Hoffman, Sarah E.; Eppey, Richard J.; Oberg, Kerby C.

2012-01-01

Lmx1b is a homeodomain transcription factor that regulates dorsal identity during limb development. Lmx1b knockout (KO) mice develop distal ventral-ventral limbs. Although induction of Lmx1b is linked to Wnt7a expression in the dorsal limb ectoderm, the downstream targets of Lmx1b that accomplish limb dorsalization are unknown. To identify genes targeted by Lmx1b, we compared gene arrays from Lmx1b KO and wildtype mouse limbs during limb dorsalization, i.e., 11.5, 12.5, and 13.5 days post coitum. We identified 54 target genes differentially expressed in all three stages. Several skeletal targets, including Emx2, Matrilin1 and Matrilin4, demonstrated a loss of scapular expression in the Lmx1b KO mice, supporting a role for Lmx1b in scapula development. Furthermore, the relative abundance of extracellular matrix-related soft tissue targets regulated by Lmx1b, such as collagens and proteoglycans, suggests a mechanism which includes changes in the extracellular matrix composition to accomplish limb dorsalization. Our study provides the most comprehensive characterization of genes regulated by Lmx1b during limb development to-date and provides targets for further investigation. PMID:22417325

CRISM Limb Observations of Aerosols and Water Vapor

NASA Technical Reports Server (NTRS)

Smith, Michael D.; Wolff, M.J.; Clancy, R.T.; Seelos, F.; Murchie, S.L.

2009-01-01

Near-infrared spectra taken in a limb-viewing geometry by the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) on-board the Mars Reconnaissance Orbiter (MRO) provide a useful tool for probing atmospheric structure. Here we describe preliminary work on the retrieval of vertical profiles of aerosols and water vapor from the CRISM limb observations. The first full set of CRISM limb observations was taken in July 2009, with subsequent limb observations planned once every two months. Each set of limb observations contains about four dozen scans across the limb giving pole-to-pole coverage for two orbits at roughly 100 and 290 W longitude. Radiative transfer modeling taking account of aerosol scattering in the limb-viewing geometry is used to model the observations. The retrievals show the height to which dust and water vapor extend and the location and height of water ice clouds. Results from the First set of CRISM limb observations (July 2009, Ls=300) show dust aerosol well-mixed to about three scale heights above the surface with thin water ice clouds above the dust near the equator and at mid-northern latitudes. Water vapor is concentrated at high southern latitudes.

Neural mechanisms of limb position estimation in the primate brain.

PubMed

Shi, Ying; Buneo, Christopher A

2011-01-01

Understanding the neural mechanisms of limb position estimation is important both for comprehending the neural control of goal directed arm movements and for developing neuroprosthetic systems designed to replace lost limb function. Here we examined the role of area 5 of the posterior parietal cortex in estimating limb position based on visual and somatic (proprioceptive, efference copy) signals. Single unit recordings were obtained as monkeys reached to visual targets presented in a semi-immersive virtual reality environment. On half of the trials animals were required to maintain their limb position at these targets while receiving both visual and non-visual feedback of their arm position, while on the other trials visual feedback was withheld. When examined individually, many area 5 neurons were tuned to the position of the limb in the workspace but very few neurons modulated their firing rates based on the presence/absence of visual feedback. At the population level however decoding of limb position was somewhat more accurate when visual feedback was provided. These findings support a role for area 5 in limb position estimation but also suggest that visual signals regarding limb position are only weakly represented in this area, and only at the population level.

Intralimb and Interlimb Cutaneous Reflexes during Locomotion in the Intact Cat.

PubMed

Hurteau, Marie-France; Thibaudier, Yann; Dambreville, Charline; Danner, Simon M; Rybak, Ilya A; Frigon, Alain

2018-04-25

When the foot contacts an obstacle during locomotion, cutaneous inputs activate spinal circuits to ensure dynamic balance and forward progression. In quadrupeds, this requires coordinated reflex responses between the four limbs. Here, we investigated the patterns and phasic modulation of cutaneous reflexes in forelimb and hindlimb muscles evoked by inputs from all four limbs. Five female cats were implanted to record muscle activity and to stimulate the superficial peroneal and superficial radial nerves during locomotion. Stimulating these nerves evoked short-, mid-, and longer-latency excitatory and/or inhibitory responses in all four limbs that were phase-dependent. The largest responses were generally observed during the peak activity of the muscle. Cutaneous reflexes during mid-swing were consistent with flexion of the homonymous limb and accompanied by modification of the stance phases of the other three limbs, by coactivating flexors and extensors and/or by delaying push-off. Cutaneous reflexes during mid-stance were consistent with stabilizing the homonymous limb by delaying and then facilitating its push-off and modifying the support phases of the homolateral and diagonal limbs, characterized by coactivating flexors and extensors, reinforcing extensor activity and/or delaying push-off. The shortest latencies of homolateral and diagonal responses were consistent with fast-conducting disynaptic or trisynaptic pathways. Descending homolateral and diagonal pathways from the forelimbs to the hindlimbs had a higher probability of eliciting responses compared with ascending pathways from the hindlimbs to the forelimbs. Thus, in quadrupeds, intralimb and interlimb reflexes activated by cutaneous inputs ensure dynamic coordination of the four limbs, producing a whole-body response. SIGNIFICANCE STATEMENT The skin contains receptors that, when activated, send inputs to spinal circuits, signaling a perturbation. Rapid responses, or reflexes, in muscles of the contacted limb and opposite homologous limb help maintain balance and forward progression. Here, we investigated reflexes during quadrupedal locomotion in the cat by electrically stimulating cutaneous nerves in each of the four limbs. Functionally, responses appear to modify the trajectory or stabilize the movement of the stimulated limb while modifying the support phase of the other limbs. Reflexes between limbs are mediated by fast-conducting pathways that involve excitatory and inhibitory circuits controlling each limb. The comparatively stronger descending pathways from cervical to lumbar circuits controlling the forelimbs and hindlimbs, respectively, could serve a protective function. Copyright © 2018 the authors 0270-6474/18/384104-19$15.00/0.

Muscular and functional effects of partitioning exercising muscle mass in patients with chronic obstructive pulmonary disease - a study protocol for a randomized controlled trial.

PubMed

Nyberg, Andrè; Saey, Didier; Martin, Mickaël; Maltais, François

2015-04-27

Low-load, high-repetitive single-limb resistance training may increase limb muscle function and functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD) while minimizing the occurrence of limiting exertional symptoms. Whether high-repetitive single-limb resistance training would perform better than high-repetitive two-limb resistance training is unknown. In addition, the mechanisms underlying possible benefits of high-repetitive resistance training has not been investigated. The aims of this study are to compare single versus two-limb high-repetitive resistance training in patients with COPD and to investigate mechanisms of action of these training modalities. This trial is a prospective, assessor-blind, randomized controlled trial. The participants are patients with stable severe to very severe COPD who are older than 40 years of age and healthy controls. The intervention is single-limb, high-repetitive, resistance training with elastic bands, three times/week for 8 weeks. The control is two-limb high-repetitive resistance training with elastic bands, three times/week for 8 weeks. The primary outcomes is change in the 6-min walking distance after 8 weeks of single-limb or two-limb high-repetitive resistance training. The secondary outcomes are changes in limb muscle strength and endurance capacity, key protein involved in quadriceps anabolic/catabolic signalization, fiber-type distribution and capillarization, subjective dyspnea and muscle fatigue, muscle oxygenation, cardiorespiratory demand and health-related quality-of-life after 8 weeks of single-limb or two-limb high-repetitive resistance training. The acute effects of single-limb versus two-limb high-repetitive resistance training on contractile fatigue, exercise stimulus (the product of number of repetition and load), subjective dyspnea and muscle fatigue, muscle oxygenation, and cardiorespiratory demand during upper and lower limb exercises will also be investigated in patients with COPD and healthy controls. Randomization will be performed using a random number generator by a person independent of the recruitment process, using 1:1 allocation to the intervention and the control group using random block sizes. All outcome assessors will be blinded to group assignment. The results of this project will provide important information to help developing and implementing customized exercise training programs for patients with COPD. ClinicalTrials.gov Identifier NCT02283580 Registration date: 4 November 2014. First participant randomized: 10 November 2014.

Functional anatomy and muscle moment arms of the thoracic limb of an elite sprinting athlete: the racing greyhound (Canis familiaris)

PubMed Central

Williams, S B; Wilson, A M; Daynes, J; Peckham, K; Payne, R C

2008-01-01

We provide quantitative muscle–tendon architecture and geometry data for the racing greyhound thoracic limb. Muscle mass, belly length, fascicle lengths, pennation angles and moment arms were measured, as were tendon masses and lengths. Maximum isometric force and maximum power were estimated for muscles, and maximum stress and strain were estimated for tendons. Results are compared with other fast quadrupedal runners, and to previously published data in mixed-breed dogs. The implications of the functional adaptations of the greyhound thoracic limb for sprinting performance are discussed. The thoracic limb was found to benefit from a similar proportion of locomotor muscle mass to the pelvic limb, suggesting that it may be used to some extent in propulsion, or alternatively that stabilisation is very important in this animal. Extrinsic muscles, especially latissimus dorsi and pectoralis profundus, were predicted to be powerful and important for generating net positive work during accelerations. Proximal biarticular muscles show specialisation toward preventing collapse of the shoulder and elbow joints to enable strut-like limb function, or some form of dynamic control. Distal muscles did not appear specialised for elastic energy storage, a functional difference to pelvic limb muscles, and the equivalents in horse thoracic limbs. The greyhound thoracic limb appears to possess substantial differences from both that of more ‘sub-maximal specialist’ quadrupeds, and from the greyhound pelvic limb. PMID:19034998

Functional anatomy and muscle moment arms of the thoracic limb of an elite sprinting athlete: the racing greyhound (Canis familiaris).

PubMed

Williams, S B; Wilson, A M; Daynes, J; Peckham, K; Payne, R C

2008-10-01

We provide quantitative muscle-tendon architecture and geometry data for the racing greyhound thoracic limb. Muscle mass, belly length, fascicle lengths, pennation angles and moment arms were measured, as were tendon masses and lengths. Maximum isometric force and maximum power were estimated for muscles, and maximum stress and strain were estimated for tendons. Results are compared with other fast quadrupedal runners, and to previously published data in mixed-breed dogs. The implications of the functional adaptations of the greyhound thoracic limb for sprinting performance are discussed. The thoracic limb was found to benefit from a similar proportion of locomotor muscle mass to the pelvic limb, suggesting that it may be used to some extent in propulsion, or alternatively that stabilisation is very important in this animal. Extrinsic muscles, especially latissimus dorsi and pectoralis profundus, were predicted to be powerful and important for generating net positive work during accelerations. Proximal biarticular muscles show specialisation toward preventing collapse of the shoulder and elbow joints to enable strut-like limb function, or some form of dynamic control. Distal muscles did not appear specialised for elastic energy storage, a functional difference to pelvic limb muscles, and the equivalents in horse thoracic limbs. The greyhound thoracic limb appears to possess substantial differences from both that of more 'sub-maximal specialist' quadrupeds, and from the greyhound pelvic limb.

Allometry and apparent paradoxes in human limb proportions: Implications for scaling factors.

PubMed

Auerbach, Benjamin M; Sylvester, Adam D

2011-03-01

It has been consistently demonstrated that human proximal limb elements exhibit negative allometry, while distal elements scale with positive allometry. Such scaling implies that longer limbs will have higher intralimb indices, a phenomenon not borne out by empirical analyses. This, therefore, creates a paradox within the limb allometry literature. This study shows that these apparently conflicting results are the product of two separate phenomena. First, the use of the geometric mean of limb elements produces allometry coefficients that are not independent, and that when using ordinary least squares regression must yield an average slope of one. This phenomenon argues against using the geometric mean as a size variable when examining limb allometry. While the employment of relevant dimensions independent of those under analysis to calculate the geometric mean--as suggested by Coleman (Am J Phys Anthropol 135 (2008) 404-415)--may be a partial method for resolving the problem, an empirically determined, independent and biologically relevant size variable is advocated. If stature is used instead of the geometric mean as an independent size variable, all major limb elements scale with positive allometry. Second, while limb allometry coefficients do indicate differential allometry in limb elements, and thus should lead to some intralimb index allometry, this pattern appears to be attenuated by other sources of limb element length variation. Copyright © 2010 Wiley-Liss, Inc.

Experimental evaluation of rigor mortis. III. Comparative study of the evolution of rigor mortis in different sized muscle groups in rats.

PubMed

Krompecher, T; Fryc, O

1978-01-01

The use of new methods and an appropriate apparatus has allowed us to make successive measurements of rigor mortis and a study of its evolution in the rat. By a comparative examination on the front and hind limbs, we have determined the following: (1) The muscular mass of the hind limbs is 2.89 times greater than that of the front limbs. (2) In the initial phase rigor mortis is more pronounced in the front limbs. (3) The front and hind limbs reach maximum rigor mortis at the same time and this state is maintained for 2 hours. (4) Resolution of rigor mortis is accelerated in the front limbs during the initial phase, but both front and hind limbs reach complete resolution at the same time.

Expression of Msx-2 during development, regeneration, and wound healing in axolotl limbs.

PubMed

Carlson, M R; Bryant, S V; Gardiner, D M

1998-12-15

Msx genes are transcription factors that are expressed during embryogenesis of developing appendages in regions of epithelial-mesenchymal interactions. Various lines of evidence indicate that these genes function to maintain embryonic tissues in an undifferentiated, proliferative state. We have identified the axolotl homolog of Msx-2, and investigated its expression during limb development, limb regeneration, and wound healing. As in limb buds of higher vertebrates, axolotl Msx-2 is expressed in the apical epidermis and mesenchyme; however, its expression domain is more extensive, reflecting the broader region of the apical epidermal cap in amphibians. Msx-2 expression is downregulated at late stages of limb development, but is reexpressed within one hour after limb amputation. Msx-2 is also reexpressed during wound healing, and may be essential in the early stages of initiation of the limb regeneration cascade.

Phantom Limbs, Neuroprosthetics, and the Developmental Origins of Embodiment.

PubMed

Blumberg, Mark S; Dooley, James C

2017-10-01

Amputees who wish to rid themselves of a phantom limb must weaken the neural representation of the absent limb. Conversely, amputees who wish to replace a lost limb must assimilate a neuroprosthetic with the existing neural representation. Whether we wish to remove a phantom limb or assimilate a synthetic one, we will benefit from knowing more about the developmental process that enables embodiment. A potentially critical contributor to that process is the spontaneous activity - in the form of limb twitches - that occurs exclusively and abundantly during active (REM) sleep, a particularly prominent state in early development. The sensorimotor circuits activated by twitching limbs, and the developmental context in which activation occurs, could provide a roadmap for creating neuroprosthetics that feel as if they are part of the body. Copyright © 2017 Elsevier Ltd. All rights reserved.

Growth characteristics of fibroblasts isolated from the trunk and distal aspect of the limb of horses and ponies.

PubMed

Miller, C B; Wilson, D A; Keegan, K G; Kreeger, J M; Adelstein, E H; Ganjam, V K

2000-01-01

To determine if there is a difference in in vitro growth of fibroblasts isolated from the trunk and distal aspect of the limb of horses and ponies. To determine the effects of a corticosteroid and monokine on in vitro growth of fibroblasts isolated from the trunk and distal aspect of the limb of horses and ponies. Growth of fibroblasts from tissues harvested from the trunk and limb were compared from horse and pony samples grown in control media and control media with triamcinolone or monokine added. Dermal and subcutaneous tissue from 22 horses and 17 ponies of various ages and breeds. Fibroblast growth was assessed by tritiated thymidine uptake using standard cell culture techniques. The effect of a monokine or triamcinolone plus control media were compared with control media for fibroblast growth. Fibroblast growth from tissues isolated from the horse limb was significantly less than growth from the horse trunk and the limb and trunk of ponies. Monokine was more effective than triamcinolone in suppressing fibroblast growth from tissues isolated from the trunk and limb in both horses and ponies. There are growth differences in fibroblasts isolated from the limb of horses compared with those isolated from the trunk and from the limb and trunk of ponies. The difference in fibroblast growth from tissues isolated from the trunk and limb of horses and ponies may provide evidence for the difference reported in the healing characteristics of limb wounds in horses and ponies. Influencing fibroblast growth may provide a key to controlling the development of exuberant granulation tissue in horses and ponies.

The Differential Effect of Arm Movements during Gait on the Forward Acceleration of the Centre of Mass in Children with Cerebral Palsy and Typically Developing Children.

PubMed

Meyns, Pieter; Molenaers, Guy; Duysens, Jacques; Jonkers, Ilse

2017-01-01

Background: We aimed to study the contribution of upper limb movements to propulsion during walking in typically developing (TD) children ( n = 5) and children with hemiplegic and diplegic cerebral palsy (CP; n = 5 and n = 4, respectively). Methods: Using integrated three-dimensional motion capture data and a scaled generic musculoskeletal model that included upper limbs, we generated torque driven simulations of gait in OpenSim. Induced acceleration analyses were then used to determine the contributions of the individual actuators located at the relevant degrees of freedoms of the upper and lower limb joints to the forward acceleration of the COM at each time point of the gait simulation. The mean values of the contribution of the actuators of upper limbs, lower limbs, and gravity in different phases of the gait cycle were compared between the three groups. Findings: The results indicated a limited contribution of the upper limb actuators to COM forward acceleration compared to the contribution of lower limbs and gravity, in the three groups. In diplegic CP, the contribution of the upper limbs seemed larger compared to TD during the preswing and swing phases of gait. In hemiplegic CP, the unaffected arm seemed to contribute more to COM deceleration during (pre)swing, while the affected side contributed to COM acceleration. Interpretation: These findings suggest that in the presence of lower limb dysfunction, the contribution of the upper limbs to forward propulsion is altered, although they remain negligible compared to the lower limbs and gravity.

Comparison of transtibial amputee and non-amputee biomechanics during a common turning task.

PubMed

Segal, Ava D; Orendurff, Michael S; Czerniecki, Joseph M; Schoen, Jason; Klute, Glenn K

2011-01-01

The biomechanics of amputee turning gait has been minimally studied, in spite of its integral relationship with the more complex gait required for household or community ambulation. This study compares the biomechanics of unilateral transtibial amputees and non-amputees completing a common turning task. Full body gait analysis was completed for subjects walking at comparable self-selected speeds around a 1m radius circular path. Peak internal and external rotation moments of the hip, knee and ankle, mediolateral ground reaction impulse (ML GRI), peak effective limb length, and stride length were compared across conditions (non-amputee, amputee prosthetic limb, amputee sound limb). Amputees showed decreased internal rotation moments at the prosthetic limb hip and knee compared to non-amputees, perhaps as a protective mechanism to minimize stress on the residual limb. There was also an increase in amputee sound limb hip external rotation moment in early stance compared to non-amputees, which may be a compensation for the decrease in prosthetic limb internal rotation moment during late stance of the prior step. ML GRI was decreased for the amputee inside limb compared to non-amputee, possibly to minimize the body's acceleration in the direction of the turn. Amputees also exhibited a shorter inside limb stride length compared to non-amputees. Both decreased ML GRI and stride length indicate a COM that is more centered over the base of support, which may minimize the risk of falling. Finally, a longer effective limb length was found for the amputee inside limb turning, possibly due to excessive trunk shift. Published by Elsevier B.V.

Objective assessment of the compensatory effect of clinical hind limb lameness in horses: 37 cases (2011-2014).

PubMed

Maliye, Sylvia; Marshall, John F

2016-10-15

OBJECTIVE To characterize and describe the compensatory load redistribution that results from unilateral hind limb lameness in horses. DESIGN Retrospective case series. ANIMALS 37 client-owned horses. PROCEDURES Medical records were reviewed to identify horses with unilateral hind limb lameness that responded positively (by objective assessment) to diagnostic local anesthesia during lameness evaluation and that were evaluated before and after diagnostic local anesthesia with an inertial sensor-based lameness diagnosis system. Horses were grouped as having hind limb lameness only, hind limb and ipsilateral forelimb lameness, or hind limb and contralateral forelimb lameness. Measures of head and pelvic movement asymmetry before (baseline) and after diagnostic local anesthesia were compared. The effect of group on baseline pelvic movement asymmetry variables was analyzed statistically. RESULTS Maximum pelvic height significantly decreased from the baseline value after diagnostic local anesthesia in each of the 3 lameness groups and in all horses combined. Minimum pelvic height significantly decreased after the procedure in all groups except the hind limb and contralateral forelimb lameness group. Head movement asymmetry was significantly decreased after diagnostic local anesthesia for horses with hind limb and ipsilateral forelimb lameness and for all horses combined, but not for those with hind limb lameness only or those with hind limb and contralateral forelimb lameness. CONCLUSIONS AND CLINICAL RELEVANCE Results supported that hind limb lameness can cause compensatory load redistribution evidenced as ipsilateral forelimb lameness. In this population of horses, contralateral forelimb lameness was not compensatory and likely reflected true lameness. Further studies are needed to investigate the source of the contralateral forelimb lameness in such horses.

Lower-Limb Amputation and Effect of Posttraumatic Stress Disorder on Department of Veterans Affairs Outpatient Cost Trends

DTIC Science & Technology

2015-07-01

JRRD Volume 52, Number 7, 2015Pages 827–838Lower-limb amputation and effect of posttraumatic stress disorder on Department of Veterans Affairs...lower- limb amputations and limb injuries. We evaluated the effect of lower-limb injury, amputation(s), and PTSD on outpatient costs, adjusting for...amputation status and significant parameters were tested (p  0.05) and models stratified by significant effect modi- fiers (p  0.05). For cost categories

Environmental monitoring for the DOE coolside and LIMB demonstration extension projects. Quarterly report for the period of February, March and April 1991

DOE Office of Scientific and Technical Information (OSTI.GOV)

White, T.; Contos, L.; Adams, L.

1992-02-01

The purpose of this document is to present environmental monitoring data collected during the US DOE Limestone Injection Multistage Burner (LIMB) Demonstration Project Extension. The objective of the LIMB program is to demonstrate the sulfur dioxide (SO{sub 2}) and nitrogen oxide (NO{sub x}) emission reduction capabilities of the LIMB system. The LIMB system is a retrofit technology to be used for existing coal-fired boilers equipped with electrostatic precipitators. (VC)

Lineage tracing of genome-edited alleles reveals high fidelity axolotl limb regeneration.

PubMed

Flowers, Grant Parker; Sanor, Lucas D; Crews, Craig M

2017-09-16

Salamanders are unparalleled among tetrapods in their ability to regenerate many structures, including entire limbs, and the study of this ability may provide insights into human regenerative therapies. The complex structure of the limb poses challenges to the investigation of the cellular and molecular basis of its regeneration. Using CRISPR/Cas, we genetically labelled unique cell lineages within the developing axolotl embryo and tracked the frequency of each lineage within amputated and fully regenerated limbs. This allowed us, for the first time, to assess the contributions of multiple low frequency cell lineages to the regenerating limb at once. Our comparisons reveal that regenerated limbs are high fidelity replicas of the originals even after repeated amputations.

Disappearance of "phantom limb" and amputated arm usage during dreaming in REM sleep behaviour disorder.

PubMed

Vetrugno, Roberto; Arnulf, Isabelle; Montagna, Pasquale

2009-01-01

Limb amputation is followed, in approximately 90% of patients, by "phantom limb" sensations during wakefulness. When amputated patients dream, however, the phantom limb may be present all the time, part of the time, intermittently or not at all. Such dreaming experiences in amputees have usually been obtained only retrospectively in the morning and, moreover, dreaming is normally associated with muscular atonia so the motor counterpart of the phantom limb experience cannot be observed directly. REM sleep behaviour disorder (RBD), in which muscle atonia is absent during REM sleep and patients act out their dreams, allows a more direct analysis of the "phantom limb" phenomena and their modifications during sleep.

Robotics in Lower-Limb Rehabilitation after Stroke

PubMed Central

2017-01-01

With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots. PMID:28659660

Combined mirror visual and auditory feedback therapy for upper limb phantom pain: a case report

PubMed Central

2011-01-01

Introduction Phantom limb sensation and phantom limb pain is a very common issue after amputations. In recent years there has been accumulating data implicating 'mirror visual feedback' or 'mirror therapy' as helpful in the treatment of phantom limb sensation and phantom limb pain. Case presentation We present the case of a 24-year-old Caucasian man, a left upper limb amputee, treated with mirror visual feedback combined with auditory feedback with improved pain relief. Conclusion This case may suggest that auditory feedback might enhance the effectiveness of mirror visual feedback and serve as a valuable addition to the complex multi-sensory processing of body perception in patients who are amputees. PMID:21272334

Robotics in Lower-Limb Rehabilitation after Stroke.

PubMed

Zhang, Xue; Yue, Zan; Wang, Jing

2017-01-01

With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots.

Exploring the fine structure at the limb in coronal holes

NASA Technical Reports Server (NTRS)

Karovska, Magarita; Blundell, Solon F.; Habbal, Shadia Rifai

1994-01-01

The fine structure of the solar limb in coronal holes is explored at temperatures ranging from 10(exp 4) to 10(exp 6) K. An image enhancement algorithm orignally developed for solar eclipse observations is applied to a number of simultaneous multiwavelength observations made with the Harvard Extreme Ultraviolet Spectrometer experiment on Skylab. The enhanced images reveal the presence of filamentary structures above the limb with a characteristic separation of approximately 10 to 15 sec . Some of the structures extend from the solar limb into the corona to at least 4 min above the solar limb. The brightness of these structures changes as a function of height above the limb. The brightest emission is associated with spiculelike structures in the proximity of the limb. The emission characteristic of high-temperature plasma is not cospatial with the emission at lower temperatures, indicating the presence of different temperature plasmas in the field of view.

Limb immobilization and corticobasal syndrome.

PubMed

Graff-Radford, Jonathan; Boeve, Bradley F; Drubach, Daniel A; Knopman, David S; Ahlskog, J Eric; Golden, Erin C; Drubach, Dina I; Petersen, Ronald C; Josephs, Keith A

2012-12-01

Recently, we evaluated two patients with corticobasal syndrome (CBS) who reported symptom onset after limb immobilization. Our objective was to investigate the association between trauma, immobilization and CBS. The charts of forty-four consecutive CBS patients seen in the Mayo Clinic Alzheimer Disease Research Center were reviewed with attention to trauma and limb immobilization. 10 CBS patients (23%) had immobilization or trauma on the most affected limb preceding the onset or acceleration of symptoms. The median age at onset was 61. Six patients manifested their first symptoms after immobilization from surgery or fracture with one after leg trauma. Four patients had pre-existing symptoms of limb dysfunction but significantly worsened after immobilization or surgery. 23 percent of patients had immobilization or trauma of the affected limb. This might have implications for management of CBS, for avoiding injury, limiting immobilization and increasing movement in the affected limb. Copyright © 2012 Elsevier Ltd. All rights reserved.

Cross-education of wrist extensor strength is not influenced by non-dominant training in right-handers.

PubMed

Coombs, Timothy A; Frazer, Ashlyn K; Horvath, Deanna M; Pearce, Alan J; Howatson, Glyn; Kidgell, Dawson J

2016-09-01

Cross-education of strength has been proposed to be greater when completed by the dominant limb in right handed humans. We investigated whether the direction of cross-education of strength and corticospinal plasticity are different following right or left limb strength training in right-handed participants. Changes in strength, muscle thickness and indices of corticospinal plasticity were analyzed in 23 adults who were exposed to 3-weeks of either right-hand strength training (RHT) or left-hand strength training (LHT). Maximum voluntary wrist extensor strength in both the trained and untrained limb increased, irrespective of which limb was trained, with TMS revealing reduced corticospinal inhibition. Cross-education of strength was not limited by which limb was trained and reduced corticospinal inhibition was not just confined to the trained limb. Critically, from a behavioral perspective, the magnitude of cross-education was not limited by which limb was trained.

Surrogate: A Body-Dexterous Mobile Manipulation Robot with a Tracked Base

NASA Technical Reports Server (NTRS)

Hebert, Paul (Inventor); Borders, James W. (Inventor); Hudson, Nicolas H. (Inventor); Kennedy, Brett A. (Inventor); Ma, Jeremy C. (Inventor); Bergh, Charles F. (Inventor)

2018-01-01

Robotics platforms in accordance with various embodiments of the invention can be utilized to implement highly dexterous robots capable of whole body motion. Robotics platforms in accordance with one embodiment of the invention include: a memory containing a whole body motion application; a spine, where the spine has seven degrees of freedom and comprises a spine actuator and three spine elbow joints that each include two spine joint actuators; at least one limb, where the at least one limb comprises a limb actuator and three limb elbow joints that each include two limb joint actuators; a tracked base; a connecting structure that connects the at least one limb to the spine; a second connecting structure that connects the spine to the tracked base; wherein the processor is configured by the whole body motion application to move the at least one limb and the spine to perform whole body motion.

Pre- and Postoperative Evaluation by Photoplethysmography in Patients Receiving Surgery for Lower-Limb Varicose Veins

PubMed Central

Saliba Júnior, Orlando Adas; Giannini, Mariangela; Mórbio, Ana Paula; Saliba, Orlando; Rollo, Hamilton Almeida

2014-01-01

Objective. To evaluate the effectiveness of surgery in treating primary varicose veins in the lower limbs by photoplethysmography (PPG) and duplex mapping (DM). Method. Forty-eight lower limbs were clinically evaluated according to the CEAP classification system and subjected to PPG and DM exams. Each limb had a venous refill time (VRT) of <20 seconds and a normal deep vein system (DVS) by DM. Results. The mean pre- and postoperative VRTs were 13.79 and 26.43 seconds, respectively (P < 0.0001). After surgery, 42 limbs (87.50%) had normal results by PPG (VRT > 20 seconds). Four limbs (8.33%) showed improved VRTs, but the VRTs did not reach 20 seconds. In the 2 limbs (4.17%) that maintained their original VRTs, the DM exams showed the presence of insufficient perforating veins. Conclusion. In most cases, PPG allows for a satisfactory evaluation of the outcome of varicose vein surgery. PMID:24696783

Normal body scheme and absent phantom limb experience in amputees while dreaming.

PubMed

Alessandria, Maria; Vetrugno, Roberto; Cortelli, Pietro; Montagna, Pasquale

2011-12-01

While dreaming amputees often experience a normal body image and the phantom limb may not be present. However, dreaming experiences in amputees have mainly been collected by questionnaires. We analysed the dream reports of amputated patients with phantom limb collected after awakening from REM sleep during overnight videopolysomnography (VPSG). Six amputated patients underwent overnight VPSG study. Patients were awakened during REM sleep and asked to report their dreams. Three patients were able to deliver an account of a dream. In all dreaming recalls, patients reported that the amputated limbs were intact and completely functional and they no longer experienced phantom limb sensations. Phantom limb experiences, that during wake result from a conflict between a pre-existing body scheme and the sensory information on the missing limb, were suppressed during sleep in our patients in favour of the image of an intact body accessed during dream. Copyright © 2011 Elsevier Inc. All rights reserved.

Age-Related Differences in Bilateral Asymmetry in Cycling Performance

ERIC Educational Resources Information Center

Liu, Ting; Jensen, Jody L.

2012-01-01

Bilateral asymmetry, a form of limb laterality in the context of moving two limbs, emerges in childhood. Children and adults show lateral preference in tasks that involve the upper and lower limbs. The importance of research in limb laterality is the insight it could provide about lateralized functions of the cerebral hemispheres. Analyzing…

7 CFR 51.1220 - Leaf or limb rub injury.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 2 2014-01-01 2014-01-01 false Leaf or limb rub injury. 51.1220 Section 51.1220 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards... Leaf or limb rub injury. “Leaf or limb rub injury” means that the scarring is not smooth, not light...

7 CFR 51.1220 - Leaf or limb rub injury.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 2 2013-01-01 2013-01-01 false Leaf or limb rub injury. 51.1220 Section 51.1220 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards... Leaf or limb rub injury. “Leaf or limb rub injury” means that the scarring is not smooth, not light...

Limb observations of the 12.32 micron solar emission line during the 1991 July total eclipse

NASA Technical Reports Server (NTRS)

Deming, Drake; Jennings, Donald E.; Mccabe, George; Noyes, Robert; Wiedemann, Gunter; Espenak, Fred

1992-01-01

The limb profile of the Mg I 12.32-micron emission line is determined by occultation in the July 11, 1991 total solar eclipse over Mauna Kea. It is shown that the emission peaks are very close to the 12-micron continuum limb, as predicted by recent theory for this line as a non-LTE photospheric emission. The increase in optical depth for this extreme limb-viewing situation indicates that most of the observed emission arises from above the chromospheric temperature minimum, and it is found that this emission is extended to heights well in excess of the model predictions. The line emission can be observed as high as 2000 km above the 12-micron continuum limb, whereas theory predicts it to remain observable no higher than about 500 km above the continuum limb. The substantial limb extension observed in this line is quantitatively consistent with limb extensions seen in the far-IR continuum, and it is concluded that it is indicative of departures from gravitational hydrostatic equilibrium, or spatial inhomogeneities, in the upper solar atmosphere.

Multi-view light-sheet imaging and tracking with the MaMuT software reveals the cell lineage of a direct developing arthropod limb

PubMed Central

Stamataki, Evangelia; Harich, Benjamin; Guignard, Léo; Preibisch, Stephan; Shorte, Spencer; Keller, Philipp J

2018-01-01

During development, coordinated cell behaviors orchestrate tissue and organ morphogenesis. Detailed descriptions of cell lineages and behaviors provide a powerful framework to elucidate the mechanisms of morphogenesis. To study the cellular basis of limb development, we imaged transgenic fluorescently-labeled embryos from the crustacean Parhyale hawaiensis with multi-view light-sheet microscopy at high spatiotemporal resolution over several days of embryogenesis. The cell lineage of outgrowing thoracic limbs was reconstructed at single-cell resolution with new software called Massive Multi-view Tracker (MaMuT). In silico clonal analyses suggested that the early limb primordium becomes subdivided into anterior-posterior and dorsal-ventral compartments whose boundaries intersect at the distal tip of the growing limb. Limb-bud formation is associated with spatial modulation of cell proliferation, while limb elongation is also driven by preferential orientation of cell divisions along the proximal-distal growth axis. Cellular reconstructions were predictive of the expression patterns of limb development genes including the BMP morphogen Decapentaplegic. PMID:29595475

Roux limb volvulus in laparoscopic Roux-en-Y gastric bypass due to Roux limb stabilization suture: case series.

PubMed

Marr, Brendan; Yenumula, Panduranga

2012-01-01

Complications after laparoscopic Roux-en-Y gastric bypass surgery may be related to the type of surgical technique employed. One technique, the placement of a Roux limb stabilization suture, presumably prevents kink at the gastrojejunal anastomosis. However, it can have an adverse effect and we studied a series of cases presenting with intestinal obstruction secondary to this stitch. A retrospective review of a prospectively collected database of laparoscopic Roux-en-Y gastric bypass cases who had reoperations for Roux limb volvulus was performed at a single bariatric center by a single surgeon. Out of 199 patients who underwent laparoscopic Roux en Y gastric bypass with placement of Roux limb stabilization suture, 4 patients (2.01%) presented with Roux limb volvulus postoperatively. BMI was 45.35 ± 2.95. The postoperative time to presentation was 11 ± 10.6 months. All four patients required surgical exploration to reduce the volvulus. In all cases, the Roux limb volvulus was directly attributable to the presence of the stabilization suture. In subsequent 250 cases where this suture was eliminated, there was no volvulus of Roux limb seen. The use of a stabilization suture can result in volvulus of the Roux limb causing intestinal obstruction and this complication can be prevented by avoiding this suture.

The effects of prism glasses and intensive upper limb exercise on hemineglect, upper limb function, and activities of daily living in stroke patients: a case series.

PubMed

Oh, Se-Il; Kim, Jin-Kyung; Park, So-Yeon

2015-12-01

[Purpose] This study aimed to examine the effects of visual field with prism glasses, and intensive upper limb functional training on reduction of hemineglect and improvement in upper limb function and activities of daily living in three stroke patients with hemineglect. [Subjects] This study included three stroke patients hospitalized in a sanatorium. [Methods] Intervention treatment involving prism glass use for 12 hours and 30 minutes and paretic side upper limb training was conducted 5 days a week for 15 weeks. Three upper limb training tasks (hitting a balloon, passing through a ring, and reading a newspaper) were performed for 10 minutes each session, for a total of 30 minutes. Line by Section, Motor-Free Visual Perception Test-3 (MVPT-3), Manual Function Test (MFT), Box & Block Test (BBT), and Assessment of Motor and Process Skills (AMPS) were conducted before and after intervention. [Results] Subjects' hemineglect decreased and upper limb function on the paretic side improved after intervention, which enhanced activities of daily living. [Conclusion] Prism glass use and paretic upper limb functional training effectively ameliorated stroke patients' hemineglect and improved upper limb function. Future research should focus on prism glasses that provide a wide visual field for use in patients with different conditions.

Lower Limb Function in Elderly Korean Adults Is Related to Cognitive Function.

PubMed

Kim, A-Sol; Ko, Hae-Jin

2018-05-01

Patients with cognitive impairment have decreased lower limb function. Therefore, we aimed to investigate the relationship between lower limb function and cognitive disorders to determine whether lower limb function can be screened to identify cognitive decline. Using Korean National Health Insurance Service-National Sample Cohort database data, we assessed the cognitive and lower limb functioning of 66-year-olds who underwent national health screening between 2010 and 2014. Cognitive function was assessed via a questionnaire. Timed Up-and-Go (TUG) and one-leg-standing (OLS) tests were performed to evaluate lower limb function. Associations between cognitive and lower limb functions were analyzed, and optimal cut-off points for these tests to screen for cognitive decline, were determined. Cognitive function was significantly correlated with TUG interval ( r = 0.414, p < 0.001) and OLS duration ( r = −0.237, p < 0.001). Optimal cut-off points for screening cognitive disorders were >11 s and ≤12 s for TUG interval and OLS duration, respectively. Among 66-year-olds who underwent national health screening, a significant correlation between lower limb and cognitive function was demonstrated. The TUG and OLS tests are useful screening tools for cognitive disorders in elderly patients. A large-scale prospective cohort study should be conducted to investigate the causal relationship between cognitive and lower limb function.

Detection of genes regulated by Lmx1b during limb dorsalization.

PubMed

Feenstra, Jennifer M; Kanaya, Kohei; Pira, Charmaine U; Hoffman, Sarah E; Eppey, Richard J; Oberg, Kerby C

2012-05-01

Lmx1b is a homeodomain transcription factor that regulates dorsal identity during limb development. Lmx1b knockout (KO) mice develop distal ventral-ventral limbs. Although induction of Lmx1b is linked to Wnt7a expression in the dorsal limb ectoderm, the downstream targets of Lmx1b that accomplish limb dorsalization are unknown. To identify genes targeted by Lmx1b, we compared gene arrays from Lmx1b KO and wild type mouse limbs during limb dorsalization, i.e., 11.5, 12.5, and 13.5 days post coitum. We identified 54 target genes that were differentially expressed in all three stages. Several skeletal targets, including Emx2, Matrilin1 and Matrilin4, demonstrated a loss of scapular expression in the Lmx1b KO mice, supporting a role for Lmx1b in scapula development. Furthermore, the relative abundance of extracellular matrix-related soft tissue targets regulated by Lmx1b, such as collagens and proteoglycans, suggests a mechanism that includes changes in the extracellular matrix composition to accomplish limb dorsalization. Our study provides the most comprehensive characterization of genes regulated by Lmx1b during limb development to-date and provides targets for further investigation. © 2012 The Authors. Development, Growth & Differentiation © 2012 Japanese Society of Developmental Biologists.

Expression of Msx genes in regenerating and developing limbs of axolotl.

PubMed

Koshiba, K; Kuroiwa, A; Yamamoto, H; Tamura, K; Ide, H

1998-12-15

Msx genes, homeobox-containing genes, have been isolated as homologues of the Drosophila msh gene and are thought to play important roles in the development of chick or mouse limb buds. We isolated two Msx genes, Msx1 and Msx2, from regenerating blastemas of axolotl limbs and examined their expression patterns using Northern blot and whole mount in situ hybridization during regeneration and development. Northern blot analysis revealed that the expression level of both Msx genes increased during limb regeneration. The Msx2 expression level increased in the blastema at the early bud stage, and Msx1 expression level increased at the late bud stage. Whole mount in situ hybridization revealed that Msx2 was expressed in the distal mesenchyme and Msx1 in the entire mesenchyme of the blastema at the late bud stage. In the developing limb bud, Msx1 was expressed in the entire mesenchyme, while Msx2 was expressed in the distal and peripheral mesenchyme. The expression patterns of Msx genes in the blastemas and limb buds of the axolotl were different from those reported for chick or mouse limb buds. These expression patterns of axolotl Msx genes are discussed in relation to the blastema or limb bud morphology and their possible roles in limb patterning.

Bilateral electromyogram response latency following platform perturbation in unilateral transtibial prosthesis users: influence of weight distribution and limb position.

PubMed

Rusaw, David; Hagberg, Kerstin; Nolan, Lee; Ramstrand, Nerrolyn

2013-01-01

Appropriate muscular response following an external perturbation is essential in preventing falls. Transtibial prosthesis users lack a foot-ankle complex and associated sensorimotor structures on the side with the prosthesis. The effect of this lack on rapid responses of the lower limb to external surface perturbations is unknown. The aim of the present study was to compare electromyogram (EMG) response latencies of otherwise healthy, unilateral, transtibial prosthesis users (n = 23, mean +/- standard deviation [SD] age = 48 +/- 14 yr) and a matched control group (n = 23, mean +/- SD age = 48 +/- 13 yr) following sudden support-surface rotations in the pitch plane (toes-up and toes-down). Perturbations were elicited in various weight-bearing and limb-perturbed conditions. The results indicated that transtibial prosthesis users have delayed responses of multiple muscles of the lower limb following perturbation, both in the intact and residual limbs. Weight-bearing had no influence on the response latency in the residual limb, but did on the intact limb. Which limb received the perturbation was found to influence the muscular response, with the intact limb showing a significantly delayed response when the perturbation was received only on the side with a prosthesis. These delayed responses may represent an increased risk of falling for individuals who use transtibial prostheses.

Motor exam of patients with spinal cord injury: a terminological imbroglio.

PubMed

Figueiredo, Nicandro

2017-07-01

The description of the motor deficit of patients with spinal cord injury (SCI) varies significantly, leading to confusion within the neurological terminology. This paper proposes a concise and easy to use terminology to describe the motor deficit of patients with SCI. A broad review of the origin of the nomenclature used to describe the motor deficit of patients with SCI was performed and discussed. The prefix: "hemi" should be used to describe paralysis of one half of the body; "mono" for one limb; "para" for lower limbs, di" for two symmetrical segments and/or parts in both sides of the body; "tri" for three limbs, or two limbs and one side of the face; and "tetra" for four limbs. The suffix: "plegia" should be used for total paralysis of a limb or part of the body, and "paresis" for partial paralysis. The term "brachial" refers to the upper limbs; and "podal" to the lower limbs. According to the spinal cord origin of the main key muscles for the limbs, patients with complete injury affecting spinal cord segments C1-5 usually presents with "tetraplegia"; C6-T1 presents with "paraplegia and brachial diparesis"; T2-L2 with "paraplegia"; and L3-S1 with "paraparesis".

Delayed amputation following trauma increases residual lower limb infection.

PubMed

Jain, Abhilash; Glass, Graeme E; Ahmadi, Hootan; Mackey, Simon; Simmons, Jon; Hettiaratchy, Shehan; Pearse, Michael; Nanchahal, Jagdeep

2013-04-01

Residual limb infection following amputation is a devastating complication, resulting in delayed rehabilitation, repeat surgery, prolonged hospitalisation and poor functional outcome. The aim of this study was to identify variables predicting residual limb infection following non-salvageable lower limb trauma. All cases of non-salvageable lower limb trauma presenting to a specialist centre over 5 years were evaluated from a prospective database and clinical and management variables correlated with the development of deep infection. Forty patients requiring 42 amputations were identified with a mean age of 49 years (±19.9, 1SD). Amputations were performed for 21 Gustilo IIIB injuries, 12 multi-planar degloving injuries, seven IIIC injuries and one open Schatzker 6 fracture. One limb was traumatically amputated at the scene and surgically revised. Amputation level was transtibial in 32, through-knee in one and transfemoral in nine. Median time from injury to amputation was 4 days (range 0-30 days). Amputation following only one debridement and within 5 days resulted in significantly fewer stump infections (p = 0.026 and p = 0.03, respectively, Fisher's exact test). The cumulative probability of infection-free residual limb closure declined steadily from day 5. Multivariate analyses revealed that neither the nature of the injury nor pre-injury patient morbidity independently influenced residual limb infection. Avoiding residual limb infection is critically dependent on prompt amputation of non-salvageable limbs. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Assessment of radial torsion using computed tomography in dogs with and without antebrachial limb deformity.

PubMed

Kroner, Kevin; Cooley, Katie; Hoey, Seamus; Hetzel, Scott J; Bleedorn, Jason A

2017-01-01

To evaluate the reliability of radial torsion assessment in dogs using computed tomography (CT). Cadaveric and retrospective observational clinical study. Thoracic limbs (n = 40) from bilateral normal cadaveric canine specimens (10 pairs) and unilateral antebrachial angular limb deformity (ALD) dogs (10 uniapical and 10 biapical deformities). Limbs were evaluated using CT. Frontal, sagittal, and axial plane (torsion) values were obtained using published guidelines and compared between groups and limbs. Radial torsion reliability was assessed among 3 observers using intraclass correlation coefficients (ICC). The mean (±SD) radial torsion of normal dogs was 3.6° ± 6.4° and contained a significant right to left limb variation of 2.6°. Mean radial torsion in uniapical ALD limbs (3.6° ± 18.7°) was not significantly different from biapical ALD limbs (8.9° ± 17.9°). There was a wide range of torsion values in normal and ALD limbs. The interobserver reliability was excellent (ICC > 0.8) for normal dogs, good (0.73) for uniapical, and excellent (0.89) for biapical ALD limbs. The intraobserver reliability was excellent (>0.8) for all groups. There was a small side-to-side variation of radial torsion in normal dogs. With directed training, torsion assessment using CT is reliable in dogs with and without antebrachial bone deformity. © 2016 The American College of Veterinary Surgeons.

Manipulated Changes in Limb Mass and Rotational Inertia in Trotting Dogs (Canis lupus familiaris) and Their Effect on Limb Kinematics.

PubMed

Kilbourne, Brandon M; Carrier, David R

2016-12-01

While the mass distribution of limbs is known to influence the metabolic energy consumed during locomotion, it remains unknown how the mass distribution of limbs may influence overall limb kinematics and whether the influence of limb mass distribution on limb kinematics differs between fore- and hindlimbs. To examine limb mass distribution's influence upon fore- and hindlimb kinematics, temporal stride parameters and swing phase joint kinematics were recorded from four dogs trotting on a treadmill with 0.5% and 1.0% body mass added to each limb, forelimbs alone, and hindlimbs alone, as well as with no added mass. Under all loading conditions, stride period did not differ between fore- and hindlimbs; however, forelimbs exhibited greater duty factors and stance durations, whereas hindlimbs exhibited greater swing durations, which may be related to the hindlimb's greater mass. Changes in forelimb joint and hip range of motion (RoM), flexion, and extension were subject to a high amount of kinematic plasticity among dogs. In contrast, for the knee and ankle, distally loading all four limbs or hindlimbs alone substantially increased joint RoM and flexion. Increased flexion of the knee and ankle has the potential to reduce the hindlimb's rotational inertia during swing phase. The differing response of fore- and hindlimbs with regard to joint kinematics is likely due to differences in their mass and mass distribution and differences in the physiological traits of fore- and hindlimb protractors and joint flexors. © 2017 Wiley Periodicals, Inc.

Acute limb heating improves macro- and microvascular dilator function in the leg of aged humans.

PubMed

Romero, Steven A; Gagnon, Daniel; Adams, Amy N; Cramer, Matthew N; Kouda, Ken; Crandall, Craig G

2017-01-01

Local heating of an extremity increases blood flow and vascular shear stress throughout the arterial tree. Local heating acutely improves macrovascular dilator function in the upper limbs of young healthy adults through a shear stress-dependent mechanism but has no such effect in the lower limbs of this age group. The effect of acute limb heating on dilator function within the atherosclerotic prone vasculature of the lower limbs of aged adults is unknown. Therefore, the purpose of this study was to test the hypothesis that acute lower limb heating improves macro- and microvascular dilator function within the leg vasculature of aged adults. Nine young and nine aged adults immersed their lower limbs at a depth of ~33 cm into a heated (~42°C) circulated water bath for 45 min. Before and 30 min after heating, macro (flow-mediated dilation)- and microvascular (reactive hyperemia) dilator functions were assessed in the lower limb, following 5 min of arterial occlusion, via Doppler ultrasound. Compared with preheat, macrovascular dilator function was unchanged following heating in young adults (P = 0.6) but was improved in aged adults (P = 0.04). Similarly, microvascular dilator function, as assessed by peak reactive hyperemia, was unchanged following heating in young adults (P = 0.1) but was improved in aged adults (P < 0.01). Taken together, these data suggest that acute lower limb heating improves both macro- and microvascular dilator function in an age dependent manner. We demonstrate that lower limb heating acutely improves macro- and microvascular dilator function within the atherosclerotic prone vasculature of the leg in aged adults. These findings provide evidence for a potential therapeutic use of chronic lower limb heating to improve vascular health in primary aging and various disease conditions. Copyright © 2017 the American Physiological Society.

Influence of maturation on instep kick biomechanics in female soccer athletes.

PubMed

Lyle, Mark A; Sigward, Susan M; Tsai, Liang-Ching; Pollard, Christine D; Powers, Christopher M

2011-10-01

The purpose of this study was to compare kicking biomechanics between young female soccer players at two different stages of physical maturation and to identify biomechanical predictors of peak foot velocity. Swing and stance limb kinematics and kinetics were recorded from 20 female soccer players (10 prepubertal, 10 postpubertal) while kicking a soccer ball using an angled two-step approach. Peak foot velocity as well as hip and knee kinematics and kinetics were compared between groups using independent-samples t-tests. Pearson correlation coefficients and stepwise multiple regression were used to identify predictors of peak foot velocity. Peak foot velocity and the peak swing limb net hip flexor moment was significantly greater in the postpubertal group when compared with the prepubertal group (13.4 vs 11.6 m·s(-1), P = 0.003; 1.22 vs 1.07 N·m·kg(-1)·m(-1), P = 0.03). Peak stance limb hip and knee extensor moments were not different between groups. Although the peak swing limb hip and knee flexion angles were similar between groups, the postpubertal group demonstrated significantly less peak stance limb hip and knee flexion angles when compared with the prepubertal group (P < 0.001 and P = 0.045). Using a linear regression model, swing limb peak hip flexor moment and peak swing limb hip extension range of motion combined to explain 65% of the variance in peak foot velocity. Despite a difference in stance limb kinematics, similar swing limb kinematics between groups indicates that the prepubertal female athletes kicked with a mature swing limb kick pattern. The ability to generate a large hip flexor moment of the swing limb seems to be an important factor for improving kicking performance in young female soccer players.

Reactivation of larval keratin gene (krt62.L) in blastema epithelium during Xenopus froglet limb regeneration.

PubMed

Satoh, Akira; Mitogawa, Kazumasa; Saito, Nanami; Suzuki, Miyuki; Suzuki, Ken-Ichi T; Ochi, Haruki; Makanae, Aki

2017-12-15

Limb regeneration is considered a form of limb redevelopment because of the molecular and morphological similarities. Forming a regeneration blastema is, in essence, creating a developing limb bud in an adult body. This reactivation of a developmental process in a mature body is worth studying. Xenopus laevis has a biphasic life cycle that involves distinct larval and adult stages. These distinct developmental stages are useful for investigating the reactivation of developmental processes in post-metamorphic frogs (froglets). In this study, we focused on the re-expression of a larval gene (krt62.L) during Xenopus froglet limb regeneration. Recently renamed krt62.L, this gene was known as the larval keratin (xlk) gene, which is specific to larval-tadpole stages. During limb regeneration in a froglet, krt62.L was re-expressed in a basal layer of blastema epithelium, where adult-specific keratin (Krt12.6.S) expression was also observable. Nerves produce important regulatory factors for amphibian limb regeneration, and also play a role in blastema formation and maintenance. The effect of nerve function on krt62.L expression could be seen in the maintenance of krt62.L expression, but not in its induction. When an epidermis-stripped limb bud was grafted in a froglet blastema, the grafted limb bud could reach the digit-forming stage. This suggests that krt62.L-positive froglet blastema epithelium is able to support the limb development process. These findings imply that the developmental process is locally reactivated in an postmetamorphic body during limb regeneration. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Structure design of lower limb exoskeletons for gait training

NASA Astrophysics Data System (ADS)

Li, Jianfeng; Zhang, Ziqiang; Tao, Chunjing; Ji, Run

2015-09-01

Due to the close physical interaction between human and machine in process of gait training, lower limb exoskeletons should be safe, comfortable and able to smoothly transfer desired driving force/moments to the patients. Correlatively, in kinematics the exoskeletons are required to be compatible with human lower limbs and thereby to avoid the uncontrollable interactional loads at the human-machine interfaces. Such requirement makes the structure design of exoskeletons very difficult because the human-machine closed chains are complicated. In addition, both the axis misalignments and the kinematic character difference between the exoskeleton and human joints should be taken into account. By analyzing the DOF(degree of freedom) of the whole human-machine closed chain, the human-machine kinematic incompatibility of lower limb exoskeletons is studied. An effective method for the structure design of lower limb exoskeletons, which are kinematically compatible with human lower limb, is proposed. Applying this method, the structure synthesis of the lower limb exoskeletons containing only one-DOF revolute and prismatic joints is investigated; the feasible basic structures of exoskeletons are developed and classified into three different categories. With the consideration of quasi-anthropopathic feature, structural simplicity and wearable comfort of lower limb exoskeletons, a joint replacement and structure comparison based approach to select the ideal structures of lower limb exoskeletons is proposed, by which three optimal exoskeleton structures are obtained. This paper indicates that the human-machine closed chain formed by the exoskeleton and human lower limb should be an even-constrained kinematic system in order to avoid the uncontrollable human-machine interactional loads. The presented method for the structure design of lower limb exoskeletons is universal and simple, and hence can be applied to other kinds of wearable exoskeletons.

Attenuation of bone morphogenetic protein signaling during amphibian limb development results in the generation of stage-specific defects.

PubMed

Jones, Tamsin E M; Day, Robert C; Beck, Caroline W

2013-11-01

The vertebrate limb is one of the most intensively studied organs in the field of developmental biology. Limb development in tetrapod vertebrates is highly conserved and dependent on the interaction of several important molecular pathways. The bone morphogenetic protein (BMP) signaling cascade is one of these pathways and has been shown to be crucial for several aspects of limb development. Here, we have used a Xenopus laevis transgenic line, in which expression of the inhibitor Noggin is under the control of the heat-shock promoter hsp70 to examine the effects of attenuation of BMP signaling at different stages of limb development. Remarkably different phenotypes were produced at different stages, illustrating the varied roles of BMP in development of the limb. Very early limb buds appeared to be refractory to the effects of BMP attenuation, developing normally in most cases. Ectopic limbs were produced by overexpression of Noggin corresponding to a brief window of limb development at about stage 49/50, as recently described by Christen et al. (2012). Attenuation of BMP signaling in stage 51 or 52 tadpoles lead to a reduction in the number of digits formed, resulting in hypodactyly or ectrodactyly, as well as occasional defects in the more proximal tibia-fibula. Finally, inhibition at stage 54 (paddle stage) led to the formation of dramatically shortened digits resulting from loss of distal phalanges. Transcriptome analysis has revealed the possibility that more Noggin-sensitive members of the BMP family could be involved in limb development than previously suspected. Our analysis demonstrates the usefulness of heat-shock-driven gene expression as an effective method for inhibiting a developmental pathway at different times during limb development. © 2013 Anatomical Society.

Sonic Hedgehog Signaling in Limb Development

PubMed Central

Tickle, Cheryll; Towers, Matthew

2017-01-01

The gene encoding the secreted protein Sonic hedgehog (Shh) is expressed in the polarizing region (or zone of polarizing activity), a small group of mesenchyme cells at the posterior margin of the vertebrate limb bud. Detailed analyses have revealed that Shh has the properties of the long sought after polarizing region morphogen that specifies positional values across the antero-posterior axis (e.g., thumb to little finger axis) of the limb. Shh has also been shown to control the width of the limb bud by stimulating mesenchyme cell proliferation and by regulating the antero-posterior length of the apical ectodermal ridge, the signaling region required for limb bud outgrowth and the laying down of structures along the proximo-distal axis (e.g., shoulder to digits axis) of the limb. It has been shown that Shh signaling can specify antero-posterior positional values in limb buds in both a concentration- (paracrine) and time-dependent (autocrine) fashion. Currently there are several models for how Shh specifies positional values over time in the limb buds of chick and mouse embryos and how this is integrated with growth. Extensive work has elucidated downstream transcriptional targets of Shh signaling. Nevertheless, it remains unclear how antero-posterior positional values are encoded and then interpreted to give the particular structure appropriate to that position, for example, the type of digit. A distant cis-regulatory enhancer controls limb-bud-specific expression of Shh and the discovery of increasing numbers of interacting transcription factors indicate complex spatiotemporal regulation. Altered Shh signaling is implicated in clinical conditions with congenital limb defects and in the evolution of the morphological diversity of vertebrate limbs. PMID:28293554

How do somatosensory deficits in the arm and hand relate to upper limb impairment, activity, and participation problems after stroke? A systematic review.

PubMed

Meyer, Sarah; Karttunen, Auli H; Thijs, Vincent; Feys, Hilde; Verheyden, Geert

2014-09-01

The association between somatosensory impairments and outcome after stroke remains unclear. The aim of this study was to systematically review the available literature on the relationship between somatosensory impairments in the upper limb and outcome after stroke. The electronic databases PubMed, CINAHL, EMBASE, Cochrane Library, PsycINFO, and Web of Science were systematically searched from inception until July 2013. Studies were included if adult patients with stroke (minimum n=10) were examined with reliable and valid measures of somatosensation in the upper limb to investigate the relationship with upper limb impairment, activity, and participation measures. Exclusion criteria included measures of somatosensation involving an overall score for upper and lower limb outcome and articles including only lower limb outcomes. Eligibility assessment, data extraction, and quality evaluation were completed by 2 independent reviewers. A cutoff score of ≥65% of the maximal quality score was used for further inclusion in this review. Six articles met all inclusion criteria. Two-point discrimination was shown to be predictive for upper limb dexterity, and somatosensory evoked potentials were shown to have predictive value in upper limb motor recovery. Proprioception was significantly correlated with perceived level of physical activity and social isolation and had some predictive value in functional movements of the upper limb. Finally, the combination of light touch and proprioception impairment was shown to be significantly related to upper limb motor recovery as well as handicap situations during activities of daily living. Heterogeneity of the included studies warrants caution when interpreting results. Large variation in results was found due to heterogeneity of the studies. However, somatosensory deficits were shown to have an important role in upper limb motor and functional performance after stroke. © 2014 American Physical Therapy Association.

[Psychotherapies for the Treatment of Phantom Limb Pain].

PubMed

Cárdenas, Katherine; Aranda, Mariana

The phantom limb pain has been described as a condition in which patients experience a feeling of itching, spasm or pain in a limb or body part that has been previously amputated. Such pain can be induced by a conflict between the representation of the visual and proprioceptive feedback of the previously healthy limb. The phantom limb pain occurs in at least 42 to 90% of amputees. Regular drug treatment of phantom limb pain is almost never effective. A systematic review of the literature was conducted in Medline and Cochrane using the MESH terms "phantom limb pain" and "psychotherapy", published in the last 10 years, in English and Spanish, finding 49 items. After reviewing the abstracts, 25 articles were excluded for not being related to the objective of the research. Additionally cross references of included articles and literature were reviewed. To describe the psychotherapies used in the management of phantom limb pain, their effectiveness and clinical application reported in the literature. The mechanisms underlying phantom limb pain were initially explained, as were the published studies on the usefulness of some psychotherapies such as mirror visual feedback and immersive virtual reality, visual imagery, desensitization and reprocessing eye movements and hypnosis. The phantom limb pain is a complex syndrome that requires pharmacological and psychotherapeutic intervention. The psychotherapies that have been used the most as adjuvants in the treatment of phantom limb pain are mirror visual feedback, desensitization and reprocessing eye movements, imagery and hypnosis. Studies with more representative samples, specifically randomized trials are required. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Periodic Limb Movements during Sleep and Cardiac Arrhythmia in Older Men (MrOS Sleep)

PubMed Central

Koo, Brian B.; Mehra, Reena; Blackwell, Terri; Ancoli-Israel, Sonia; Stone, Katie L.; Redline, Susan

2014-01-01

Study Objectives: To determine if periodic limb movements during sleep (PLMS) are associated with nocturnal cardiac arrhythmia. Methods: 2,793 community-dwelling older men underwent polysomnography with measurement of limb movements and EKG. Logistic regression assessed association of periodic limb movement index and periodic limb movement arousal index with arrhythmia including atrial fibrillation and non-sustained ventricular tachycardia detected by polysomnography. Models were adjusted for age, race, cardiovascular risk factors, and clinic site. Secondary analyses were subset to men without calcium channel/β-adrenergic medication usage, and stratified by congestive heart failure or myocardial infarction history. Results: In the overall cohort, periodic limb movement index, and periodic limb movement arousal index were not associated with ventricular or atrial arrhythmia after considering potential confounders. In men not taking calcium channel/β-blocking medication, increased adjusted odds of non-sustained ventricular tachycardia were observed for periodic limb movement index (OR = 1.30 per SD increase; 95% CI 1.00, 1.68) and periodic limb movement arousal index (OR = 1.29 per SD increase; 95% CI 1.03, 1.62). In men with CHF or MI, there was a suggested association of atrial fibrillation with periodic limb movement index (OR = 1.29, 95% CI 0.96, 1.73 per SD increase; p = 0.09) or periodic limb movement arousal index (OR = 1.21, 95% CI 0.94, 1.57 per SD increase; p = 0.14), although results were not statistically significant. Conclusions: There is not an association between PLMS and cardiac arrhythmia in all older men but in subsets of men, particularly those with structural heart disease and not on calcium channel or β-adrenergic medication, cardiac arrhythmia does associate with PLMS. Citation: Koo BB; Mehra R; Blackwell T; Ancoli-Israel S; Stone KL; Redline S; for the Osteoporotic Fractures in Men (MrOS) Study Group. Periodic limb movements during sleep and cardiac arrhythmia in older men (MrOS sleep). J Clin Sleep Med 2014;10(1):7-11. PMID:24426814

Limb Correction of Infrared Imagery in Cloudy Regions for the Improved Interpretation of RGB Composites

NASA Technical Reports Server (NTRS)

Elmer, Nicholas J.; Berndt, Emily; Jedlovec, Gary J.

2016-01-01

Red-Green-Blue (RGB) composites (EUMETSAT User Services 2009) combine information from several channels into a single composite image. RGB composites contain the same information as the original channels, but presents the information in a more efficient manner. However, RGB composites derived from infrared imagery of both polar-orbiting and geostationary sensors are adversely affected by the limb effect, which interferes with the qualitative interpretation of RGB composites at large viewing zenith angles. The limb effect, or limb-cooling, is a result of an increase in optical path length of the absorbing atmosphere as viewing zenith angle increases (Goldberg et al. 2001; Joyce et al. 2001; Liu and Weng 2007). As a result, greater atmospheric absorption occurs at the limb, causing the sensor to observe anomalously cooler brightness temperatures. Figure 1 illustrates this effect. In general, limb-cooling results in a 4-11 K decrease in measured brightness temperature (Liu and Weng 2007) depending on the infrared band. For example, water vapor and ozone absorption channels display much larger limb-cooling than infrared window channels. Consequently, RGB composites created from infrared imagery not corrected for limb effects can only be reliably interpreted close to nadir, which reduces the spatial coverage of the available imagery. Elmer (2015) developed a reliable, operational limb correction technique for clear regions. However, many RGB composites are intended to be used and interpreted in cloudy regions, so a limb correction methodology valid for both clear and cloudy regions is needed. This paper presents a limb correction technique valid for both clear and cloudy regions, which is described in Section 2. Section 3 presents several RGB case studies demonstrating the improved functionality of limb-corrected RGBs in both clear and cloudy regions, and Section 4 summarizes and presents the key conclusions of this work.

A nationwide analysis of 30-day readmissions related to critical limb ischemia.

PubMed

Masoomi, Reza; Shah, Zubair; Quint, Clay; Hance, Kirk; Vamanan, Karthik; Prasad, Anand; Hoel, Andrew; Dawn, Buddhadeb; Gupta, Kamal

2018-06-01

Objectives There is paucity of information regarding critical limb ischemia-related readmission rates in patients admitted with critical limb ischemia. We studied 30-day critical limb ischemia-related readmission rate, its predictors, and clinical outcomes using a nationwide real-world dataset. Methods We did a secondary analysis of the 2013 Nationwide Readmissions Database. We included all patients with a primary diagnosis of extremity rest pain, ulceration, and gangrene secondary to peripheral arterial disease. From this group, all patients readmitted with similar diagnosis within 30 days were recorded. Results Of the total 25,111 index hospitalization for critical limb ischemia, 1270 (5%) were readmitted with a primary diagnosis of critical limb ischemia within 30 days. The readmission rate was highest (9.5%) for the group that did not have any intervention (revascularization or major amputation) and was lowest for surgical revascularization and major amputation groups (2.6% and 1.3%, P value <0.001 for all groups). Severity of critical limb ischemia at index admission was associated with a significantly higher rate of 30-day readmission. Critical limb ischemia-related readmission was associated with a higher rate of major amputation (29.6% vs. 16.2%, P<0.001), a lower rate of any revascularization procedure (46% vs. 62.6%, P<0.001), and a higher likelihood of discharge to a skilled nursing facility (43.2% vs. 32.2%, P<0.001) compared to index hospitalization. Conclusions In patients with primary diagnosis of critical limb ischemia, 30-day critical limb ischemia-related readmission rate was affected by initial management strategy and the severity of critical limb ischemia. Readmission was associated with a significantly higher rate of amputation, increased length of stay, and a more frequent discharge to an alternate care facility than index admission and thus may serve as a useful quality of care metric in critical limb ischemia patients.

Running stability is enhanced by a proximo-distal gradient in joint neuromechanical control.

PubMed

Daley, M A; Felix, G; Biewener, A A

2007-02-01

We currently know little about how animals achieve dynamic stability when running over uneven and unpredictable terrain, often characteristic of their natural environment. Here we investigate how limb and joint mechanics of an avian biped, the helmeted guinea fowl Numida meleagris, respond to an unexpected drop in terrain during running. In particular, we address how joint mechanics are coordinated to achieve whole limb dynamics. Based on muscle-tendon architecture and previous studies of steady and incline locomotion, we hypothesize a proximo-distal gradient in joint neuromechanical control. In this motor control strategy, (1) proximal muscles at the hip and knee joints are controlled primarily in a feedforward manner and exhibit load-insensitive mechanical performance, and (2) distal muscles at the ankle and tarsometatarso-phalangeal (TMP) joints are highly load-sensitive, due to intrinsic mechanical effects and rapid, higher gain proprioceptive feedback. Limb kinematics and kinetics during the unexpected perturbation reveal that limb retraction, controlled largely by the hip, remains similar to level running throughout the perturbed step, despite altered limb loading. Individual joints produce or absorb energy during both level and perturbed running steps, such that the net limb work depends on the balance of energy among the joints. The hip maintains the same mechanical role regardless of limb loading, whereas the ankle and TMP switch between spring-like or damping function depending on limb posture at ground contact. Initial knee angle sets limb posture and alters the balance of work among the joints, although the knee contributes little work itself. This distribution of joint function results in posture-dependent changes in work performance of the limb, which allow guinea fowl to rapidly produce or absorb energy in response to the perturbation. The results support the hypothesis that a proximo-distal gradient exists in limb neuromuscular performance and motor control. This control strategy allows limb cycling to remain constant, whereas limb posture, loading and energy performance are interdependent. We propose that this control strategy provides simple, rapid mechanisms for managing energy and controlling velocity when running over rough terrain.

Running stability is enhanced by a proximo-distal gradient in joint neuromechanical control

PubMed Central

Daley, M. A.; Felix, G.; Biewener, A. A.

2008-01-01

Summary We currently know little about how animals achieve dynamic stability when running over uneven and unpredictable terrain, often characteristic of their natural environment. Here we investigate how limb and joint mechanics of an avian biped, the helmeted guinea fowl Numida meleagris, respond to an unexpected drop in terrain during running. In particular, we address how joint mechanics are coordinated to achieve whole limb dynamics. Based on muscle–tendon architecture and previous studies of steady and incline locomotion, we hypothesize a proximo-distal gradient in joint neuromechanical control. In this motor control strategy, (1) proximal muscles at the hip and knee joints are controlled primarily in a feedforward manner and exhibit load-insensitive mechanical performance, and (2) distal muscles at the ankle and tarsometatarso-phalangeal (TMP) joints are highly load-sensitive, due to intrinsic mechanical effects and rapid, higher gain proprioceptive feedback. Limb kinematics and kinetics during the unexpected perturbation reveal that limb retraction, controlled largely by the hip, remains similar to level running throughout the perturbed step, despite altered limb loading. Individual joints produce or absorb energy during both level and perturbed running steps, such that the net limb work depends on the balance of energy among the joints. The hip maintains the same mechanical role regardless of limb loading, whereas the ankle and TMP switch between spring-like or damping function depending on limb posture at ground contact. Initial knee angle sets limb posture and alters the balance of work among the joints, although the knee contributes little work itself. This distribution of joint function results in posture-dependent changes in work performance of the limb, which allow guinea fowl to rapidly produce or absorb energy in response to the perturbation. The results support the hypothesis that a proximo-distal gradient exists in limb neuromuscular performance and motor control. This control strategy allows limb cycling to remain constant, whereas limb posture, loading and energy performance are interdependent. We propose that this control strategy provides simple, rapid mechanisms for managing energy and controlling velocity when running over rough terrain. PMID:17234607

Changes in expression of the lysosomal membrane glycoprotein, LAMP-1 in interdigital regions during embryonic mouse limb development, in vivo and in vitro.

PubMed

Stewart, S; Yi, S; Kassabian, G; Mayo, M; Sank, A; Shuler, C

2000-06-01

Syndactyly, a failure of the digits to separate into individual units, affects about 8 to 9 per 1000 newborns and results from an aberration of the normal development of the interdigital tissues. Limb digit separation is the result of programmed cell death (apoptosis). Lysosomes play a role in the process of cell self-destruction. Our experiment was designed to test the hypothesis that the intensity of interdigital lysosomes increases during the separation of digits in vivo and in vitro. The primary mouse monoclonal antibody, 1D4B, detects the presence of lysosomes by identifying the LAMP-1 glycoprotein on the lysosome cell membrane. In our experiment this antibody immunodetected interdigital lysosome proteins in serial sections of limbs from Swiss-Webster mouse embryos, gestational ages E12.5 through E15, key developmental stages for digit separation. Digit separation was associated with an increase in intensity of lysosomal protein staining. In E12.5 limbs, the presence of lysosomes was enriched in the distal aspect of the interdigital tissue. However, the number of lysosomes markedly increased in the E13 and E14 limbs, including the entire length and width of the interdigital tissue in the E14 limbs. This lysosomal protein presence in E14 limbs was significant compared to E12.5, E13, and E15 limbs. By day 12.5, the mouse embryo limb is committed to digit separation. Addition of retinoic acid to the culture medium of limbs earlier in development, such as E12, results in induction of the process of digit separation. Cultured E12 limbs that did not receive an addition of retinoic acid, did not show digit separation. We conclude that in the limb development process, the enrichment in interdigit LAMP-1 proteins, may indicate a relationship between lysosomes, apoptosis, and digit separation. We also conclude that retinoic acid has an important role in digit separation in vivo, as shown in limb development, and demonstrated through the addition of retinoic acid to media of cultured tissues.

Grading sugar pine saw logs in trees.

Treesearch

John W. Henley

1972-01-01

Small limbs and small overgrown limbs cause problems when grading saw logs in sugar pine trees. Surface characteristics and lumber recovery information for 426 logs from 64 sugar pine trees were examined. Resulting modifications in the grading specification that allow a grader to ignore small limbs and small limb indicators do not appear to decrease the performance of...

LIMB DEFECTS INDUCED BY RETINOIC ACID SIGNALING ANTAGONISM AND SYNTHESIS INHIBITION ARE CONSISTENT WITH ETHANOL-INDUCED LIMB DEFECTS

EPA Science Inventory

Limb defects induced by retinoic acid signaling antagonism and synthesis inhibition are consistent with ethanol-induced limb defects

Johnson CS1, Sulik KK1,2, Hunter, ES III3
1Department of Cell and Developmental Biology, University of North Carolina at Chapel Hill, NC....

Motor Impairment Evaluation for Upper Limb in Stroke Patients on the Basis of a Microsensor

ERIC Educational Resources Information Center

Huang, Shuai; Luo, Chun; Ye, Shiwei; Liu, Fei; Xie, Bin; Wang, Caifeng; Yang, Li; Huang, Zhen; Wu, Jiankang

2012-01-01

There has been an urgent need for an effective and efficient upper limb rehabilitation method for poststroke patients. We present a Micro-Sensor-based Upper Limb rehabilitation System for poststroke patients. The wearable motion capture units are attached to upper limb segments embedded in the fabric of garments. The body segment orientation…

7 CFR 51.1220 - Leaf or limb rub injury.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Leaf or limb rub injury. 51.1220 Section 51.1220... STANDARDS) United States Standards for Grades of Peaches Definitions § 51.1220 Leaf or limb rub injury. “Leaf or limb rub injury” means that the scarring is not smooth, not light colored, or aggregates more...

7 CFR 51.1220 - Leaf or limb rub injury.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Leaf or limb rub injury. 51.1220 Section 51.1220... STANDARDS) United States Standards for Grades of Peaches Definitions § 51.1220 Leaf or limb rub injury. “Leaf or limb rub injury” means that the scarring is not smooth, not light colored, or aggregates more...

7 CFR 51.1220 - Leaf or limb rub injury.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 2 2012-01-01 2012-01-01 false Leaf or limb rub injury. 51.1220 Section 51.1220... STANDARDS) United States Standards for Grades of Peaches Definitions § 51.1220 Leaf or limb rub injury. “Leaf or limb rub injury” means that the scarring is not smooth, not light colored, or aggregates more...

The relationship between buccofacial and limb apraxia.

PubMed

Raade, A S; Rothi, L J; Heilman, K M

1991-07-01

There are at least two possible models depicting the relationship between buccofacial and limb apraxia. First, apraxia can be viewed as a unitary motor disorder which transcends the output modalities of both buccofacial and limb output. A high degree of similarity between the two types of apraxia would support this model. Alternatively, the relationship between buccofacial and limb apraxia may not include a unitary mechanism. The presence of quantitative and qualitative differences between buccofacial and limb performance would support this nonunitary model. The results of the present study support the nonunitary model.

cis-Regulatory Mutations Are a Genetic Cause of Human Limb Malformations

PubMed Central

VanderMeer, Julia E.; Ahituv, Nadav

2011-01-01

The underlying mutations that cause human limb malformations are often difficult to determine, particularly for limb malformations that occur as isolated traits. Evidence from a variety of studies shows that cis-regulatory mutations, specifically in enhancers, can lead to some of these isolated limb malformations. Here, we provide a review of human limb malformations that have been shown to be caused by enhancer mutations and propose that cis-regulatory mutations will continue to be identified as the cause of additional human malformations as our understanding of regulatory sequences improves. PMID:21509892

Method and apparatus for simulating gravitational forces on a living organism

NASA Technical Reports Server (NTRS)

Thornton, W. E. (Inventor)

1983-01-01

A method and apparatus for simulating gravitational forces on a living organism wherein a series of negative pressures are externally applied to successive length-wise sections of a lower limb of the organism. The pressures decreasing progressively with distance of said limb sections from the heart of the organism. A casing defines a chamber adapted to contain the limb of the organism and is rigidified to resist collapse upon the application of negative pressures to the interior of the chamber. Seals extend inwardly from the casing for effective engagement with the limb of the organism and, in cooperation with the limb, subdivide the chamber into a plurality of compartments each in negative pressure communicating relation with the limb.

Warfarin-induced Venous Limb Gangrene

PubMed Central

Grim Hostetler, Sarah; Sopkovich, Jennifer; Dean, Steven

2012-01-01

Warfarin is a commonly used anticoagulant that has been associated with several significant cutaneous side effects, most notably warfarin-induced skin necrosis. A lesser known adverse reaction to warfarin is warfarin-induced venous limb gangrene. Both cutaneous adverse effects share the same pathophysiology, but are clinically quite different. The majority of cases of warfarin-induced venous limb gangrene has been in patients with cancer or heparin-induced thrombocytopenia. However, other hypercoagulable disease states, such as the antiphospholipid antibody syndrome, can be associated with venous limb gangrene. In order to increase recognition of this important condition, the authors report a case of warfarin-induced venous limb gangrene in a patient with presumed antiphospholipid antibody syndrome and review the literature on warfarin-induced venous limb gangrene. PMID:23198012

Characterization of interfacial socket pressure in transhumeral prostheses: A case series.

PubMed

Schofield, Jonathon S; Schoepp, Katherine R; Williams, Heather E; Carey, Jason P; Marasco, Paul D; Hebert, Jacqueline S

2017-01-01

One of the most important factors in successful upper limb prostheses is the socket design. Sockets must be individually fabricated to arrive at a geometry that suits the user's morphology and appropriately distributes the pressures associated with prosthetic use across the residual limb. In higher levels of amputation, such as transhumeral, this challenge is amplified as prosthetic weight and the physical demands placed on the residual limb are heightened. Yet, in the upper limb, socket fabrication is largely driven by heuristic practices. An analytical understanding of the interactions between the socket and residual limb is absent in literature. This work describes techniques, adapted from lower limb prosthetic research, to empirically characterize the pressure distribution occurring between the residual limb and well-fit transhumeral prosthetic sockets. A case series analyzing the result of four participants with transhumeral amputation is presented. A Tekscan VersaTek pressure measurement system and FaroArm Edge coordinate measurement machine were employed to capture socket-residual limb interface pressures and geometrically register these values to the anatomy of participants. Participants performed two static poses with their prosthesis under two separate loading conditions. Surface pressure maps were constructed from the data, highlighting pressure distribution patterns, anatomical locations bearing maximum pressure, and the relative pressure magnitudes. Pressure distribution patterns demonstrated unique characteristics across the four participants that could be traced to individual socket design considerations. This work presents a technique that implements commercially available tools to quantitatively characterize upper limb socket-residual limb interactions. This is a fundamental first step toward improved socket designs developed through informed, analytically-based design tools.

Characterization of interfacial socket pressure in transhumeral prostheses: A case series

PubMed Central

Schoepp, Katherine R.; Williams, Heather E.; Carey, Jason P.; Marasco, Paul D.

2017-01-01

One of the most important factors in successful upper limb prostheses is the socket design. Sockets must be individually fabricated to arrive at a geometry that suits the user’s morphology and appropriately distributes the pressures associated with prosthetic use across the residual limb. In higher levels of amputation, such as transhumeral, this challenge is amplified as prosthetic weight and the physical demands placed on the residual limb are heightened. Yet, in the upper limb, socket fabrication is largely driven by heuristic practices. An analytical understanding of the interactions between the socket and residual limb is absent in literature. This work describes techniques, adapted from lower limb prosthetic research, to empirically characterize the pressure distribution occurring between the residual limb and well-fit transhumeral prosthetic sockets. A case series analyzing the result of four participants with transhumeral amputation is presented. A Tekscan VersaTek pressure measurement system and FaroArm Edge coordinate measurement machine were employed to capture socket-residual limb interface pressures and geometrically register these values to the anatomy of participants. Participants performed two static poses with their prosthesis under two separate loading conditions. Surface pressure maps were constructed from the data, highlighting pressure distribution patterns, anatomical locations bearing maximum pressure, and the relative pressure magnitudes. Pressure distribution patterns demonstrated unique characteristics across the four participants that could be traced to individual socket design considerations. This work presents a technique that implements commercially available tools to quantitatively characterize upper limb socket-residual limb interactions. This is a fundamental first step toward improved socket designs developed through informed, analytically-based design tools. PMID:28575012

Limb-girdle muscular dystrophy subtypes: First-reported cohort from northeastern China

PubMed Central

Mahmood, Omar Abdulmonem; Jiang, Xinmei; Zhang, Qi

2013-01-01

The relative frequencies of different subtypes of limb-girdle muscular dystrophies vary widely among different populations. We estimated the percentage of limb-girdle muscular dystrophy subtypes in Chinese people based on 68 patients with limb-girdle muscular dystrophy from the Myology Clinic, Neurology Department, First Hospital of Jilin University, China. A diagnosis of calpainopathy was made in 12 cases (17%), and dysferlin deficiency in 10 cases (15%). Two biopsies revealed α-sarcoglycan deficiency (3%), and two others revealed a lack of caveolin-3 (3%). A diagnosis of unclassified limb-girdle muscular dystrophy was made in the remaining patients (62%). The appearances of calpain 3- and dysferlin-deficient biopsies were similar, though rimmed vacuoles were unique to dysferlinopathy, while inflammatory infiltrates were present in both these limb-girdle muscular dystrophy type 2D biopsies. Macrophages were detected in seven dysferlinopathy biopsies. The results of this study suggest that the distribution of limb-girdle muscular dystrophy subtypes in the Han Chinese population is similar to that reported in the West. The less necrotic, regenerating and inflammatory appearance of limb-girdle muscular dystrophy type 2A, but with more lobulated fibers, supports the idea that calpainopathy is a less active, but more chronic disease than dysferlinopathy. Unusual features indicated an extended limb-girdle muscular dystrophy disease spectrum. The use of acid phosphatase stain should be considered in suspected dysferlinopathies. To the best of our knowledge, this is the first report to define the relative proportions of the various forms of limb-girdle muscular dystrophy in China, based on protein testing. PMID:25206500

Ectopic Fgf signaling induces the intercalary response in developing chicken limb buds.

PubMed

Makanae, Aki; Satoh, Akira

2018-01-01

Intercalary pattern formation is an important regulatory step in amphibian limb regeneration. Amphibian limb regeneration is composed of multiple steps, including wounding, blastema formation, and intercalary pattern formation. Attempts have been made to transfer insights from regeneration-competent animals to regeneration-incompetent animalsat each step in the regeneration process. In the present study, we focused on the intercalary mechanism in chick limb buds. In amphibian limb regeneration, a proximodistal axis is organized as soon as a regenerating blastema is induced. Intermediate structures are subsequently induced (intercalated) between the established proximal and distal identities. Intercalary tissues are derived from proximal tissues. Fgf signaling mediates the intercalary response in amphibian limb regeneration. We attempted to transfer insights into intercalary regeneration from amphibian models to the chick limb bud. The zeugopodial part was dissected out, and the distal and proximal parts were conjunct at st. 24. Delivering ectopic Fgf2 + Fgf8 between the distal and proximal parts resulted in induction of zeugopodial elements. Examination of HoxA11 expression, apoptosis, and cell proliferation provides insights to compare with those in the intercalary mechanism of amphibian limb regeneration. Furthermore, the cellular contribution was investigated in both the chicken intercalary response and that of axolotl limb regeneration. We developed new insights into cellular contribution in amphibian intercalary regeneration, and found consistency between axolotl and chicken intercalary responses. Our findings demonstrate that the same principal of limb regeneration functions between regeneration-competent and -incompetent animals. In this context, we propose the feasibility of the induction of the regeneration response in amniotes.

Reasonable classical concepts in human lower limb anatomy from the viewpoint of the primitive persistent sciatic artery and twisting human lower limb.

PubMed

Kawashima, Tomokazu; Sasaki, Hiroshi

2010-11-01

The main aim of this review is (1) to introduce the two previous studies we published human lower limb anatomy based on the conventional macroscopic anatomical [corrected] criteria with hazardous recognition of this description, (2) to activate the discussion whether the limb homology exists, and (3) to contribute to future study filling the gap between the gross anatomy and embryology. One of the topics we discussed was the human persistent sciatic artery. To date, numerous human cases of persistent sciatic artery have been reported in which the anomalous artery was present in the posterior compartment of the thigh alongside the sciatic nerve. As one of the important criteria for assessing the human primitive sciatic artery, its ventral arterial position with respect to the sciatic nerve is reasonable based on the initial positional relationship between ventral arterial and dorsal nervous systems and comparative anatomical findings. We also discuss ways of considering the topography of muscles of the lower limb and their innervations compared to those of the upper limb. We propose a schema of the complex anatomical characteristics of the lower limb based on the vertebrate body plan. According to this reasonable schema, the twisted anatomy of the lower limb can be understood more easily. These two main ideas discussed in this paper will be useful for further understanding of the anatomy of the lower limb and as a first step for future. We hope that the future study in lower limb will be further developed by both viewpoints of the classical gross anatomy and recent embryology.

Phase II Pragmatic Randomized Controlled Trial of Patient-Led Therapies (Mirror Therapy and Lower-Limb Exercises) During Inpatient Stroke Rehabilitation.

PubMed

Tyson, Sarah; Wilkinson, Jack; Thomas, Nessa; Selles, Ruud; McCabe, Candy; Tyrrell, Pippa; Vail, Andy

2015-10-01

Patient-led therapy has the potential to increase the amount of therapy patients undertake during stroke rehabilitation and to enhance recovery. Our objective was to assess the feasibility and acceptability of 2 patient-led therapies during the acute stages of stroke care: mirror therapy for the upper limb and lower-limb exercises for the lower limb. This was a blind assessed, multicenter, pragmatic randomized controlled trial of patient-led upper-limb mirror therapy and patient-led lower leg exercises. Stroke survivors with upper and lower limb limitations, undergoing inpatient rehabilitation and able to consent were recruited at least 1 week poststroke. Both interventions proved feasible, with >90% retention. No serious adverse events were reported. Both groups did less therapy than recommended; typically 5 to 15 minutes for 7 days or less. Participants receiving mirror therapy (n = 63) tended to do less practice than those doing lower-limb exercises (n = 31). Those with neglect did 69% less mirror therapy than those without (P = .02), which was not observed in the exercise group. Observed between-group differences were modest but neglect, upper-limb strength, and dexterity showed some improvement in the mirror therapy group. No changes were seen in the lower-limb group. Both patient-led mirror therapy and lower-limb exercises during inpatient stroke care are safe, feasible, and acceptable and warrant further investigation. Practice for 5 to 15 minutes for 7 days is a realistic prescription unless strategies to enhance adherence are included. © The Author(s) 2015.

Progress Toward Optimizing Prosthetic Socket Fit and Suspension Using Elevated Vacuum to Promote Residual Limb Health.

PubMed

Wernke, Matthew M; Schroeder, Ryan M; Haynes, Michael L; Nolt, Lonnie L; Albury, Alexander W; Colvin, James M

2017-07-01

Objective: Prosthetic sockets are custom made for each amputee, yet there are no quantitative tools to determine the appropriateness of socket fit. Ensuring a proper socket fit can have significant effects on the health of residual limb soft tissues and overall function and acceptance of the prosthetic limb. Previous work found that elevated vacuum pressure data can detect movement between the residual limb and the prosthetic socket; however, the correlation between the two was specific to each user. The overall objective of this work is to determine the relationship between elevated vacuum pressure deviations and prosthetic socket fit. Approach: A tension compression machine was used to apply repeated controlled forces onto a residual limb model with sockets of different internal volume. Results: The vacuum pressure-displacement relationship was dependent on socket fit. The vacuum pressure data were sensitive enough to detect differences of 1.5% global volume and can likely detect differences even smaller. Limb motion was reduced as surface area of contact between the limb model and socket was maximized. Innovation: The results suggest that elevated vacuum pressure data provide information to quantify socket fit. Conclusions: This study provides evidence that the use of elevated vacuum pressure data may provide a method for prosthetists to quantify and monitor socket fit. Future studies should investigate the relationship between socket fit, limb motion, and limb health to define optimal socket fit parameters.

[Range of Hip Joint Motion and Weight of Lower Limb Function under 3D Dynamic Marker].

PubMed

Xia, Q; Zhang, M; Gao, D; Xia, W T

2017-12-01

To explore the range of reasonable weight coefficient of hip joint in lower limb function. When the hip joints of healthy volunteers under normal conditions or fixed at three different positions including functional, flexed and extension positions, the movements of lower limbs were recorded by LUKOtronic motion capture and analysis system. The degree of lower limb function loss was calculated using Fugl-Meyer lower limb function assessment form when the hip joints were fixed at the aforementioned positions. One-way analysis of variance and Tamhane's T2 method were used to proceed statistics analysis and calculate the range of reasonable weight coefficient of hip joint. There were significant differences between the degree of lower limb function loss when the hip joints fixed at flexed and extension positions and at functional position. While the differences between the degree of lower limb function loss when the hip joints fixed at flexed position and extension position had no statistical significance. In 95% confidence interval, the reasonable weight coefficient of hip joint in lower limb function was between 61.05% and 73.34%. Expect confirming the reasonable weight coefficient, the effects of functional and non-functional positions on the degree of lower limb function loss should also be considered for the assessment of hip joint function loss. Copyright© by the Editorial Department of Journal of Forensic Medicine

Cut your losses: self-amputation of injured limbs increases survival.

PubMed

Emberts, Zachary; Miller, Christine W; Kiehl, Daniel; St Mary, Colette M

2017-01-01

Autotomy, self-induced limb loss, is an extreme trait observed throughout the animal kingdom; lizards drop their tails, crickets release their legs, and crabs drop their claws. These repeated evolutionary origins suggest that autotomy is adaptive. Yet, we do not have a firm understanding of the selective pressures that promote and maintain this extreme trait. Although multiple adaptive hypotheses exist, research has generally focused on autotomy's adaptive value as a form of predator escape. However, autotomy could also be selected to reduce the cost of an injured limb, which we investigate here. Previously, this alternative hypothesis has been challenging to directly test because when an injury occurs on an autotomizable limb, that limb is almost always dropped (i.e., autotomy is behaviorally fixed within populations). Recently, however, we have identified a species, Narnia femorata (Insecta: Hemiptera: Coreidae), where some individuals autotomize limbs in response to injury, but some do not. This natural variation allowed us to investigate both the survival costs of retaining an injured limb and the benefits of autotomizing it. In this study, we find a positive association between autotomizing injured limbs and survival, thereby quantifying a new and likely widespread benefit of autotomy-reducing the cost of injury.

Cut your losses: self-amputation of injured limbs increases survival

PubMed Central

Miller, Christine W; Kiehl, Daniel; St. Mary, Colette M

2017-01-01

Abstract Autotomy, self-induced limb loss, is an extreme trait observed throughout the animal kingdom; lizards drop their tails, crickets release their legs, and crabs drop their claws. These repeated evolutionary origins suggest that autotomy is adaptive. Yet, we do not have a firm understanding of the selective pressures that promote and maintain this extreme trait. Although multiple adaptive hypotheses exist, research has generally focused on autotomy’s adaptive value as a form of predator escape. However, autotomy could also be selected to reduce the cost of an injured limb, which we investigate here. Previously, this alternative hypothesis has been challenging to directly test because when an injury occurs on an autotomizable limb, that limb is almost always dropped (i.e., autotomy is behaviorally fixed within populations). Recently, however, we have identified a species, Narnia femorata (Insecta: Hemiptera: Coreidae), where some individuals autotomize limbs in response to injury, but some do not. This natural variation allowed us to investigate both the survival costs of retaining an injured limb and the benefits of autotomizing it. In this study, we find a positive association between autotomizing injured limbs and survival, thereby quantifying a new and likely widespread benefit of autotomy—reducing the cost of injury. PMID:29622925

Isolated limb infusion with fotemustine after dacarbazine chemosensitisation for inoperable loco-regional melanoma recurrence.

PubMed

Bonenkamp, J J; Thompson, J F; de Wilt, J H; Doubrovsky, A; de Faria Lima, R; Kam, P C A

2004-12-01

Isolated limb infusion (ILI) is a simple yet effective alternative to conventional isolated limb perfusion for the treatment of advanced melanoma of the extremities. The study group comprised 13 patients with very advanced limb disease who had failed to achieve a satisfactory response to one or more ILIs with melphalan, and in whom amputation was the only other realistic treatment option. The aim of this study was to evaluate the efficacy and toxicity of ILI with fotemustine after systemic chemosensitisation with dacarbazine (DTIC). Complete remission was achieved in four patients and partial remission in eight patients, with a median response duration of 3 months. Limb salvage was achieved in five of 12 assessable patients (42%). Limb toxicity peaked 9 days after ILI; two patients experienced Wieberdink grade IV (severe) toxicity and four patients had grade V toxicity (requiring early amputation). ILI with fotemustine after DTIC chemosensitisation can be successful when gross limb disease has not been controlled by one or more ILIs with melphalan. However, it cannot be recommended as a routine method of treatment for advanced melanoma of the extremities because of the high incidence of severe limb toxicity.

Interlimb relation during the double support phase of gait: an electromyographic, mechanical and energy-based analysis.

PubMed

Sousa, Andreia S P; Silva, Augusta; Tavares, João Manuel R S

2013-03-01

The purpose of this study is to analyse the interlimb relation and the influence of mechanical energy on metabolic energy expenditure during gait. In total, 22 subjects were monitored as to electromyographic activity, ground reaction forces and VO2 consumption (metabolic power) during gait. The results demonstrate a moderate negative correlation between the activity of tibialis anterior, biceps femoris and vastus medialis of the trailing limb during the transition between mid-stance and double support and that of the leading limb during double support for the same muscles, and between these and gastrocnemius medialis and soleus of the trailing limb during double support. Trailing limb soleus during the transition between mid-stance and double support was positively correlated to leading limb tibialis anterior, vastus medialis and biceps femoris during double support. Also, the trailing limb centre of mass mechanical work was strongly influenced by the leading limbs, although only the mechanical power related to forward progression of both limbs was correlated to metabolic power. These findings demonstrate a consistent interlimb relation in terms of electromyographic activity and centre of mass mechanical work, being the relations occurred in the plane of forward progression the more important to gait energy expenditure.

Stance-phase force on the opposite limb dictates swing-phase afferent presynaptic inhibition during locomotion

PubMed Central

Hayes, Heather Brant; Chang, Young-Hui

2012-01-01

Presynaptic inhibition is a powerful mechanism for selectively and dynamically gating sensory inputs entering the spinal cord. We investigated how hindlimb mechanics influence presynaptic inhibition during locomotion using pioneering approaches in an in vitro spinal cord–hindlimb preparation. We recorded lumbar dorsal root potentials to measure primary afferent depolarization-mediated presynaptic inhibition and compared their dependence on hindlimb endpoint forces, motor output, and joint kinematics. We found that stance-phase force on the opposite limb, particularly at toe contact, strongly influenced the magnitude and timing of afferent presynaptic inhibition in the swinging limb. Presynaptic inhibition increased in proportion to opposite limb force, as well as locomotor frequency. This form of presynaptic inhibition binds the sensorimotor states of the two limbs, adjusting sensory inflow to the swing limb based on forces generated by the stance limb. Functionally, it may serve to adjust swing-phase sensory transmission based on locomotor task, speed, and step-to-step environmental perturbations. PMID:22442562

[Prevention of recurrent varicose veins after surgery caused by phenomenon of neovascularization].

PubMed

Kas'ian, D A; Gutsu, E V; Ivanov, V A; Kuliuk, V S; Dontsu, I I

2010-01-01

The aim of study was to evaluate the effectiveness of surgical "barrier techniques" in prevention of phenomenon of inguinal neovascularization in patients with varicose veins of lower limbs. There were 68 patients (80 limbs) treated with flush ligation of saphenofemoral junction, stripping of great saphenous vein and avulsion of varicosities. Patients were divided in three groups: I (no "barrier techniques")--40 limbs; II (anatomical barrier)--20 limbs and III (synthetic barrier)--20 limbs. Duplex ultrasound was performed at interval of 24 months postoperatively. Signs of neovascularization were found more frequently in group I--22.5% of limbs vs 7.5% of limbs in patients with utilization of "barrier techniques". There were types B1, B2a and B2b of neovascularization only, according to Fischer classification. We conclude that use of a "barrier techniques", either anatomic or synthetic, is associated with a decreased incidence of neovascularization at the level of the saphenofemoral junction compared with a control group.

Msx genes are important apoptosis effectors downstream of the Shh/Gli3 pathway in the limb.

PubMed

Lallemand, Yvan; Bensoussan, Vardina; Cloment, Cécile Saint; Robert, Benoît

2009-07-15

In tetrapods, the anteroposterior (AP) patterning of the limb is under the control of the antagonistic activities of the secreted factor Sonic hedgehog (Shh) and Gli3R, the truncated repressor form of the transcription factor Gli3. In this report, we show that Msx1 and Msx2 are targets and downstream effectors of Gli3R. Consequently, in Shh null mutants, Msx genes are overexpressed and, furthermore, partially responsible for the limb phenotype. This is exemplified by the fact that reducing Msx activity in Shh mutants partially restores a normal limb development. Finally, we show that the main action of the Msx genes, in both normal and Shh(-/-) limb development, is to control cell death in the mesenchyme. We propose that, in the limb, Msx genes act downstream of the Shh/Gli3 pathway by transducing BMP signaling and that, in the absence of Shh signaling, their deregulation contributes to the extensive apoptosis that impairs limb development.

Attenuated sensing of SHH by Ptch1 underlies evolution of bovine limbs.

PubMed

Lopez-Rios, Javier; Duchesne, Amandine; Speziale, Dario; Andrey, Guillaume; Peterson, Kevin A; Germann, Philipp; Unal, Erkan; Liu, Jing; Floriot, Sandrine; Barbey, Sarah; Gallard, Yves; Müller-Gerbl, Magdalena; Courtney, Andrew D; Klopp, Christophe; Rodriguez, Sabrina; Ivanek, Robert; Beisel, Christian; Wicking, Carol; Iber, Dagmar; Robert, Benoit; McMahon, Andrew P; Duboule, Denis; Zeller, Rolf

2014-07-03

The large spectrum of limb morphologies reflects the wide evolutionary diversification of the basic pentadactyl pattern in tetrapods. In even-toed ungulates (artiodactyls, including cattle), limbs are adapted for running as a consequence of progressive reduction of their distal skeleton to symmetrical and elongated middle digits with hoofed phalanges. Here we analyse bovine embryos to establish that polarized gene expression is progressively lost during limb development in comparison to the mouse. Notably, the transcriptional upregulation of the Ptch1 gene, which encodes a Sonic hedgehog (SHH) receptor, is disrupted specifically in the bovine limb bud mesenchyme. This is due to evolutionary alteration of a Ptch1 cis-regulatory module, which no longer responds to graded SHH signalling during bovine handplate development. Our study provides a molecular explanation for the loss of digit asymmetry in bovine limb buds and suggests that modifications affecting the Ptch1 cis-regulatory landscape have contributed to evolutionary diversification of artiodactyl limbs.

Upper limb load as a function of repetitive task parameters: part 1--a model of upper limb load.

PubMed

Roman-Liu, Danuta

2005-01-01

The aim of the study was to develop a theoretical indicator of upper limb musculoskeletal load based on repetitive task parameters. As such the dimensionless parameter, Integrated Cycle Load (ICL) was accepted. It expresses upper limb load which occurs during 1 cycle. The indicator is based on a model of a repetitive task, which consists of a model of the upper limb, a model of basic types of upper limb forces and a model of parameters of a repetitive task such as length of the cycle, length of periods of the cycle and external force exerted during each of the periods of the cycle. Calculations of the ICL parameter were performed for 12 different variants of external load characterised by different values of repetitive task parameters. A comparison of ICL, which expresses external load with a physiological indicator of upper limb load, is presented in Part 2 of the paper.

Upper-limb motor and sensory function in patients with hip fracture: Comparison with community-dwelling older adults.

PubMed

Hayashi, Hiroyuki; Nakashima, Daiki; Matsuoka, Hiroka; Iwai, Midori; Nakamura, Shugo; Kubo, Ayumi; Tomiyama, Naoki

2017-11-06

Upper-limb function is important in patients with hip fracture so they can perform activities of daily living and participate in leisure activities. Upper-limb function of these patients, however, has not been thoroughly investigated. The aim of this study was to evaluate the upper-limb motor and sensory functions in patients with hip fracture by comparing these functions with those of community-dwelling older adults (control group). We compared the results of motor and sensory function tests of upper-limb function - range of motion, strength, sensibility, finger dexterity, comprehensive hand function - between patients with hip fracture (n= 32) and the control group (n= 32). Patients with hip fracture had significantly reduced grip strength, pinch strength, finger dexterity, and comprehensive hand function compared with the control group. Most upper-limb functions are impaired in the patients with hip fracture. Thus, upper-limb function of patients with hip fracture should be considered during treatment.

Age Effects on Upper Limb Kinematics Assessed by the REAplan Robot in Healthy School-Aged Children.

PubMed

Gilliaux, Maxime; Dierckx, Floriane; Vanden Berghe, Lola; Lejeune, Thierry M; Sapin, Julien; Dehez, Bruno; Stoquart, Gaëtan; Detrembleur, Christine

2015-05-01

The use of kinematics is recommended to quantitatively evaluate upper limb movements. The aims of this study were to determine the age effects on upper limb kinematics and establish norms in healthy children. Ninety-three healthy children, aged 3-12 years, participated in this study. Twenty-eight kinematic indices were computed from four tasks. Each task was performed with the REAplan, a distal effector robotic device that allows upper limb displacements in the horizontal plane. Twenty-four of the 28 indices showed an improvement during childhood. Indeed, older children showed better upper limb movements. This study was the first to use a robotic device to show the age effects on upper limb kinematics and establish norms in healthy children.

Postural asymmetries in response to holding evenly and unevenly distributed loads during self-selected stance.

PubMed

Haddad, Jeffrey M; Rietdyk, Shirley; Ryu, Joong Hyun; Seaman, Jessica M; Silver, Tobin A; Kalish, Julia A; Hughes, Charmayne M L

2011-01-01

The authors examined postural asymmetries during quiet stance and while holding evenly or unevenly distributed loads. Right-hand dominant subjects preferentially loaded their right lower limb when holding no load or a load evenly distributed in both hands, but no differences in center of pressure (CoP) were observed between the left and right limbs. However, longer CoP displacement was observed under the preferentially loaded limb, which may reflect a functional asymmetry that allows quick movement of one limb in response to a potential perturbation. When a load was held only in the nondominant hand, sample entropy decreased in the left (loaded) limb but increased in the right (unloaded) limb, suggesting the unloaded foot compensated for a loss of control flexibility in the loaded foot.

A limb action detector enabling people with multiple disabilities to control environmental stimulation through limb action with a Nintendo Wii Remote Controller.

PubMed

Shih, Ching-Hsiang; Chang, Man-Ling; Shih, Ching-Tien

2010-01-01

This study assessed whether two persons with multiple disabilities would be able to control environmental stimulation using limb action with a Nintendo Wii Remote Controller and a newly developed limb action detection program (LADP, i.e., a new software program that turns a Wii Remote Controller into a precise limb action detector). This study was carried out according to an ABAB sequence in which A represented baseline and B represented intervention phases. Data showed that both participants significantly increased their target response, thus increasing the level of environmental stimulation by activating the control system through limb action, during the intervention phases. Practical and developmental implications of the findings are discussed. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

A Special Golden Curve in Human Upper Limbs' Length Proportion: A Functional Partition Which Is Different from Anatomy.

PubMed

Wang, Nan; Ma, Jie; Jin, Dan; Yu, Bin

2017-01-01

Aim . The purpose of this study was to investigate the relationship between upper limbs' three functional partitions and the golden curve. Materials and Methods . We measured 30 subjects' right or left upper limb data and investigate the relationship between them and the golden curve by use of SPSS version 20.0 statistical software (SPSS, Inc., Chicago, Illinois), one-sample t -test. Results . There are four points on human's upper limbs which have no difference with the four points on the golden curve. And there is one point of which the difference is obvious. But we still could draw the conclusion that human upper limbs are accordant with the golden curve. Conclusion . Human upper limbs are accordant with the golden curve.

Sex and the single (-eared) female: leg function, limb autotomy and mating history trade-offs in field crickets (Gryllus bimaculatus)

PubMed Central

Bateman, Philip W; Fleming, Patricia A

2005-01-01

Both male and female field crickets (Gryllus bimaculatus) autotomize front (tympanal) limbs more slowly than hind limbs. Arguably, this pattern could reflect possible differences in the mechanism of limb autotomy. However, we demonstrate that, for females, limb autotomy is also dependent on their mating status: virgin females autotomize front legs significantly more slowly than mated females. This response suggests a central control for leg autotomy in these animals, and less readiness to autotomize a front leg, possibly because the tympanum is crucial for mate location. PMID:17148319

Differentiation of cartilaginous anlagen in entire embryonic mouse limbs cultured in a rotating bioreactor

NASA Astrophysics Data System (ADS)

Montufar-Solis, D.; Oakley, C. R.; Jefferson, Y.; Duke, P. J.

2003-10-01

Mechanisms involved in development of the embryonic limb have remained the same throughout eons of genetic and environmental evolution under Earth gravity (lg). During the spaceflight era it has been of interest to explore the ancient theory that form of the skeleton develops in response to gravity, and that changes in gravitational forces can change the developmental pattern of the limb. This has been shown in vivo and in vitro, allowing the hypergravity of centrifugation and microgravity of space to be used as tools to increase our knowledge of limb development. In recapitulations of spaceflight experiments, premetatarsals were cultured in suspension in a bioreactor, and found to be shorter and less differentiated than those cultured in standard culture dishes. This study only measured length of the metatarsals, and did not account for possible changes due to the skeletal elements having a more in vivo 3D shape while in suspension vs. flattened tissues compressed by their own weight. A culture system with an outcome closer to in vivo and that supports growth of younger limb buds than traditional systems will allow studies of early Hox gene expression, and contribute to the understanding of very early stages of development. The purpose of the current experiment was to determine if entire limb buds could be cultured in the bioreactor, and to compare the growth and differentiation with that of culturing in a culture dish system. Fore and hind limbs from E11-E13 ICR mouse embryos were cultured for six days, either in the bioreactor or in center-well organ culture dishes, fixed, and embedded for histology. E13 specimens grown in culture dishes were flat, while bioreactor culture specimens had a more in vivo-like 3D limb shape. Sections showed excellent cartilage differentiation in both culture systems, with more cell maturation, and hypertrophy in the specimens cultured in the bioreactor. Younger limb buds fused together during culture, so an additional set of El 1.5 limb buds was cultured with and without encapsulation in alginate prior to culturing in the bioreactor. Encapsulated limbs grown in the bioreactor did not fuse together, but developed only the more proximal elements while limbs grown in culture dishes formed proximal and distal elements. Alginate encapsulation may have reduced oxygenation to the progress zone of the developing limb bud resulting in lack of development of the more distal elements. These results show that the bioreactor supports growth and differentiation of skeletal elements in entire E13 limb buds, and that a method to culture younger limb buds without fusing together needs to be developed if any morphometric analysis is to be performed.

Subjective, behavioral, and physiological responses to the rubber hand illusion do not vary with age in the adult phase.

PubMed

Palomo, Priscila; Borrego, Adrián; Cebolla, Ausiàs; Llorens, Roberto; Demarzo, Marcelo; Baños, Rosa M

2018-02-01

The Rubber Hand Illusion (RHI) is a perceptual illusion that enables integration of artificial limbs into the body representation through combined multisensory integration. Most previous studies investigating the RHI have involved young healthy adults within a very narrow age range (typically 20-30 years old). The purpose of this paper was to determine the influence of age on the RHI. The RHI was performed on 93 healthy adults classified into three groups of age (20-35 years old, N = 41; 36-60 years old, N = 28; and 61-80 years old, N = 24), and its effects were measured with subjective (Embodiment of Rubber Hand Questionnaire), behavioral (proprioceptive drift), and physiological (changes in skin temperature and conductance) measures. There were neither significant differences among groups in any response, nor significant covariability or correlation between age and other measures (but for skin temperature), which suggests that the RHI elicits similar responses across different age groups in the adult phase. Copyright © 2017 Elsevier Inc. All rights reserved.

Floral Nectar Guide Patterns Discourage Nectar Robbing by Bumble Bees

PubMed Central

Leonard, Anne S.; Brent, Joshua; Papaj, Daniel R.; Dornhaus, Anna

2013-01-01

Floral displays are under selection to both attract pollinators and deter antagonists. Here we show that a common floral trait, a nectar guide pattern, alters the behavior of bees that can act opportunistically as both pollinators and as antagonists. Generally, bees access nectar via the floral limb, transporting pollen through contact with the plant’s reproductive structures; however bees sometimes extract nectar from a hole in the side of the flower that they or other floral visitors create. This behavior is called “nectar robbing” because bees may acquire the nectar without transporting pollen. We asked whether the presence of a symmetric floral nectar guide pattern on artificial flowers affected bumble bees’ (Bombus impatiens) propensity to rob or access nectar “legitimately.” We discovered that nectar guides made legitimate visits more efficient for bees than robbing, and increased the relative frequency of legitimate visits, compared to flowers lacking nectar guides. This study is the first to show that beyond speeding nectar discovery, a nectar guide pattern can influence bees’ flower handling in a way that could benefit the plant. PMID:23418475

A miniaturized neuroprosthesis suitable for implantation into the brain

NASA Technical Reports Server (NTRS)

Mojarradi, Mohammad; Binkley, David; Blalock, Benjamin; Andersen, Richard; Ulshoefer, Norbert; Johnson, Travis; Del Castillo, Linda

2003-01-01

This paper presents current research on a miniaturized neuroprosthesis suitable for implantation into the brain. The prosthesis is a heterogeneous integration of a 100-element microelectromechanical system (MEMS) electrode array, front-end complementary metal-oxide-semiconductor (CMOS) integrated circuit for neural signal preamplification, filtering, multiplexing and analog-to-digital conversion, and a second CMOS integrated circuit for wireless transmission of neural data and conditioning of wireless power. The prosthesis is intended for applications where neural signals are processed and decoded to permit the control of artificial or paralyzed limbs. This research, if successful, will allow implantation of the electronics into the brain, or subcutaneously on the skull, and eliminate all external signal and power wiring. The neuroprosthetic system design has strict size and power constraints with each of the front-end preamplifier channels fitting within the 400 x 400-microm pitch of the 100-element MEMS electrode array and power dissipation resulting in less than a 1 degree C temperature rise for the surrounding brain tissue. We describe the measured performance of initial micropower low-noise CMOS preamplifiers for the neuroprosthetic.

Measurement of wavefront aberrations in cortex and peripheral nerve using a two-photon excitation guidestar

NASA Astrophysics Data System (ADS)

Futia, Gregory L.; Fontaine, Arjun; McCullough, Connor; Ozbay, Baris N.; George, Nickolas M.; Caldwell, John; Restrepo, Diego; Weir, Richard; Gibson, Emily A.

2018-02-01

Neural-machine interfaces using optogenetics are of interest due to their minimal invasiveness and potential for parallel read in and read out of activity. One possible biological target for such an interface is the peripheral nerve, where axonlevel imaging or stimulation could greatly improve interfacing with artificial limbs or enable neuron/fascicle level neuromodulation in the vagus nerve. Two-photon imaging has been successful in imaging brain activity using genetically encoded calcium or voltage indicators, but in the peripheral nerve, this is severely limited by scattering and aberrations from myelin. We employ a Shack-Hartman wavefront sensor and two-photon excitation guidestar to quantify optical scattering and aberrations in peripheral nerves and cortex. The sciatic and vagus nerves, and cortex from a ChAT-Cre ChR-eYFP transgenic mouse were excised and imaged directly. In peripheral nerves, defocus was the strongest aberration followed by astigmatism and coma. Peripheral nerve had orders of magnitude higher aberration compared with cortex. These results point to the potential of adaptive optics for increasing the depth of two-photon access into peripheral nerves.

Elbow functional compensation using a lightweight magnetorheological clutch.

PubMed

Clemente, Alejandro Martín; Caballero, Antonio Flores; Rojas, Dolores Blanco; Copaci, Dorin-Sabin; Lorente, Luis Moreno

2011-01-01

There are many applications for which a patient needs functional compensation due to motor disorders in daily activities. Classic research has focused on robotics solutions in terms of actuators or motors, but the point of this paper is to analyze new solutions combining both biological and artificial structures, in order to improve standard developments. Nowadays wearable Robots are taking an important role in rehabilitation purposes, due to this issue lots of new designs are emerging, but most of them are not still prepared to be used in terms of autonomy, weight, etc. Under the Hybrid Neuroprosthetic and Neurorobotic devices for Functional Compensation and Rehabilitation (HYPER) project, new actuator technologies have been developed in order to improve the adaptability and portability of rehabilitation devices. The designed device is based on a lightweight magnetorheological (MR) clutch which is able to transmit torque from a motor to the injured joint. Though it is intended to work in human upper limb (elbow mainly), other future designs will also be studied for other human joints. Simulation results using Simulink®, MSC Adams®and MSMS®are reported to illustrate the viability of the proposed device.

Model-based Bayesian signal extraction algorithm for peripheral nerves

NASA Astrophysics Data System (ADS)

Eggers, Thomas E.; Dweiri, Yazan M.; McCallum, Grant A.; Durand, Dominique M.

2017-10-01

Objective. Multi-channel cuff electrodes have recently been investigated for extracting fascicular-level motor commands from mixed neural recordings. Such signals could provide volitional, intuitive control over a robotic prosthesis for amputee patients. Recent work has demonstrated success in extracting these signals in acute and chronic preparations using spatial filtering techniques. These extracted signals, however, had low signal-to-noise ratios and thus limited their utility to binary classification. In this work a new algorithm is proposed which combines previous source localization approaches to create a model based method which operates in real time. Approach. To validate this algorithm, a saline benchtop setup was created to allow the precise placement of artificial sources within a cuff and interference sources outside the cuff. The artificial source was taken from five seconds of chronic neural activity to replicate realistic recordings. The proposed algorithm, hybrid Bayesian signal extraction (HBSE), is then compared to previous algorithms, beamforming and a Bayesian spatial filtering method, on this test data. An example chronic neural recording is also analyzed with all three algorithms. Main results. The proposed algorithm improved the signal to noise and signal to interference ratio of extracted test signals two to three fold, as well as increased the correlation coefficient between the original and recovered signals by 10-20%. These improvements translated to the chronic recording example and increased the calculated bit rate between the recovered signals and the recorded motor activity. Significance. HBSE significantly outperforms previous algorithms in extracting realistic neural signals, even in the presence of external noise sources. These results demonstrate the feasibility of extracting dynamic motor signals from a multi-fascicled intact nerve trunk, which in turn could extract motor command signals from an amputee for the end goal of controlling a prosthetic limb.

Fabrication and assessment of 3D printed anatomical models of the lower limb for anatomical teaching and femoral vessel access training in medicine.

PubMed

O'Reilly, Michael K; Reese, Sven; Herlihy, Therese; Geoghegan, Tony; Cantwell, Colin P; Feeney, Robin N M; Jones, James F X

2016-01-01

For centuries, cadaveric dissection has been the touchstone of anatomy education. It offers a medical student intimate access to his or her first patient. In contrast to idealized artisan anatomical models, it presents the natural variation of anatomy in fine detail. However, a new teaching construct has appeared recently in which artificial cadavers are manufactured through three-dimensional (3D) printing of patient specific radiological data sets. In this article, a simple powder based printer is made more versatile to manufacture hard bones, silicone muscles and perfusable blood vessels. The approach involves blending modern approaches (3D printing) with more ancient ones (casting and lost-wax techniques). These anatomically accurate models can augment the approach to anatomy teaching from dissection to synthesis of 3D-printed parts held together with embedded rare earth magnets. Vascular simulation is possible through application of pumps and artificial blood. The resulting arteries and veins can be cannulated and imaged with Doppler ultrasound. In some respects, 3D-printed anatomy is superior to older teaching methods because the parts are cheap, scalable, they can cover the entire age span, they can be both dissected and reassembled and the data files can be printed anywhere in the world and mass produced. Anatomical diversity can be collated as a digital repository and reprinted rather than waiting for the rare variant to appear in the dissection room. It is predicted that 3D printing will revolutionize anatomy when poly-material printing is perfected in the early 21st century. © 2015 American Association of Anatomists.

Integration of Gravitational Torques in Cerebellar Pathways Allows for the Dynamic Inverse Computation of Vertical Pointing Movements of a Robot Arm

PubMed Central

Gentili, Rodolphe J.; Papaxanthis, Charalambos; Ebadzadeh, Mehdi; Eskiizmirliler, Selim; Ouanezar, Sofiane; Darlot, Christian

2009-01-01

Background Several authors suggested that gravitational forces are centrally represented in the brain for planning, control and sensorimotor predictions of movements. Furthermore, some studies proposed that the cerebellum computes the inverse dynamics (internal inverse model) whereas others suggested that it computes sensorimotor predictions (internal forward model). Methodology/Principal Findings This study proposes a model of cerebellar pathways deduced from both biological and physical constraints. The model learns the dynamic inverse computation of the effect of gravitational torques from its sensorimotor predictions without calculating an explicit inverse computation. By using supervised learning, this model learns to control an anthropomorphic robot arm actuated by two antagonists McKibben artificial muscles. This was achieved by using internal parallel feedback loops containing neural networks which anticipate the sensorimotor consequences of the neural commands. The artificial neural networks architecture was similar to the large-scale connectivity of the cerebellar cortex. Movements in the sagittal plane were performed during three sessions combining different initial positions, amplitudes and directions of movements to vary the effects of the gravitational torques applied to the robotic arm. The results show that this model acquired an internal representation of the gravitational effects during vertical arm pointing movements. Conclusions/Significance This is consistent with the proposal that the cerebellar cortex contains an internal representation of gravitational torques which is encoded through a learning process. Furthermore, this model suggests that the cerebellum performs the inverse dynamics computation based on sensorimotor predictions. This highlights the importance of sensorimotor predictions of gravitational torques acting on upper limb movements performed in the gravitational field. PMID:19384420

Real-time patient-specific finite element analysis of internal stresses in the soft tissues of a residual limb: a new tool for prosthetic fitting.

PubMed

Portnoy, S; Yarnitzky, G; Yizhar, Z; Kristal, A; Oppenheim, U; Siev-Ner, I; Gefen, A

2007-01-01

Fitting of a prosthetic socket is a critical stage in the process of rehabilitation of a trans-tibial amputation (TTA) patient, since a misfit may cause pressure ulcers or a deep tissue injury (DTI: necrosis of the muscle flap under intact skin) in the residual limb. To date, prosthetic fitting typically depends on the subjective skills of the prosthetist, and is not supported by biomedical instrumentation that allows evaluation of the quality of fitting. Specifically, no technology is presently available to provide real-time continuous information on the internal distribution of mechanical stresses in the residual limb during fitting of the prosthesis, or while using it and this severely limits patient evaluations. In this study, a simplified yet clinically oriented patient-specific finite element (FE) model of the residual limb was developed for real-time stress analysis. For this purpose we employed a custom-made FE code that continuously calculates internal stresses in the residual limb, based on boundary conditions acquired in real-time from force sensors, located at the limb-prosthesis interface. Validation of the modeling system was accomplished by means of a synthetic phantom of the residual limb, which allowed simultaneous measurements of interface pressures and internal stresses. Human studies were conducted subsequently in five TTA patients. The dimensions of bones and soft tissues were obtained from X-rays of the residual limb of each patient. An indentation test was performed in order to obtain the effective elastic modulus of the soft tissues of the residual limb. Seven force sensors were placed between the residual limb and the prosthetic liner, and subjects walked on a treadmill during analysis. Generally, stresses under the shinbones were approximately threefold higher than stresses at the soft tissues behind the bones. Usage of a thigh corset decreased the stresses in the residual limb during gait by approximately 80%. Also, the stresses calculated during the trial of a subject who complained about pain and discomfort were the highest, confirming that his socket was not adequately fitted. We conclude that real-time patient-specific FE analysis of internal stresses in deep soft tissues of the residual limb in TTA patients is feasible. This method is promising for improving the fitting of prostheses in the clinical setting and for protecting the residual limb from pressure ulcers and DTI.

Total hip arthroplasty performed in patients with residual poliomyelitis: does it work?

PubMed

Yoon, Byung-Ho; Lee, Young-Kyun; Yoo, Jeong Joon; Kim, Hee Joong; Koo, Kyung-Hoi

2014-03-01

Patients with residual poliomyelitis can have advanced degenerative arthritis of the hip in the paralytic limb or the nonparalytic contralateral limb. Although THA is a treatment option for some of these patients, there are few studies regarding THA in this patient population. We therefore reviewed a group of patients with residual poliomyelitis who underwent cementless THA on either their paralytic limb or nonparalytic limb to assess (1) Harris hip scores, (2) radiographic results, including implant loosening, (3) complications, including dislocation, and (4) limb length discrepancy after recovery from surgery. From January 2000 to December 2009, 10 patients with residual poliomyelitis (10 hips, four paralytic limbs and six nonparalytic contralateral limbs) underwent THA using cementless prostheses. Harris hip scores, complications, and leg length discrepancy were determined by chart review, and confirmed by questionnaire and examination; radiographs were reviewed by two observers for this study. Followup was available for all 10 patients at a minimum of 3 years (median, 7 years; range, 3.4-13 years). Surgery was done at the same side of the paralytic limb in four hips and contralateral to the paralytic limb in six. All patients had pain relief and improvement in function; the Harris hip score improved from mean of 68 preoperatively to 92 at last followup (p = 0.043). However, only three patients had complete pain relief. One hip dislocated, which was treated successfully with closed reduction and a hip spica cast for 2 months. There was no loosening or osteolysis in this series. Leg length discrepancy improved after the index operation, but only in the THAs performed in the paralytic limbs. Cementless THA may be suitable for painful hips in adult patients with residual poliomyelitis. Nonetheless, these patients should be informed of the possibility of mild residual pain and persistent leg length discrepancy, particularly patients whose THA is performed on the limb that was not affected by polio (ie, the nonparalytic contralateral limb). Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.

Limb Symmetry Indexes Can Overestimate Knee Function After Anterior Cruciate Ligament Injury.

PubMed

Wellsandt, Elizabeth; Failla, Mathew J; Snyder-Mackler, Lynn

2017-05-01

Study Design Prospective cohort. Background The high risk of second anterior cruciate ligament (ACL) injuries after return to sport highlights the importance of return-to-sport decision making. Objective return-to-sport criteria frequently use limb symmetry indexes (LSIs) to quantify quadriceps strength and hop scores. Whether using the uninvolved limb in LSIs is optimal is unknown. Objectives To evaluate the uninvolved limb as a reference standard for LSIs utilized in return-to-sport testing and its relationship with second ACL injury rates. Methods Seventy athletes completed quadriceps strength and 4 single-leg hop tests before anterior cruciate ligament reconstruction (ACLR) and 6 months after ACLR. Limb symmetry indexes for each test compared involved-limb measures at 6 months to uninvolved-limb measures at 6 months. Estimated preinjury capacity (EPIC) levels for each test compared involved-limb measures at 6 months to uninvolved-limb measures before ACLR. Second ACL injuries were tracked for a minimum follow-up of 2 years after ACLR. Results Forty (57.1%) patients achieved 90% LSIs for quadriceps strength and all hop tests. Only 20 (28.6%) patients met 90% EPIC levels (comparing the involved limb at 6 months after ACLR to the uninvolved limb before ACLR) for quadriceps strength and all hop tests. Twenty-four (34.3%) patients who achieved 90% LSIs for all measures 6 months after ACLR did not achieve 90% EPIC levels for all measures. Estimated preinjury capacity levels were more sensitive than LSIs in predicting second ACL injuries (LSIs, 0.273; 95% confidence interval [CI]: 0.010, 0.566 and EPIC, 0.818; 95% CI: 0.523, 0.949). Conclusion Limb symmetry indexes frequently overestimate knee function after ACLR and may be related to second ACL injury risk. These findings raise concern about whether the variable ACL return-to-sport criteria utilized in current clinical practice are stringent enough to achieve safe and successful return to sport. Level of Evidence Prognosis, 2b. J Orthop Sports Phys Ther 2017;47(5):334-338. Epub 29 Mar 2017. doi:10.2519/jospt.2017.7285.

Different regulation of limb development by p63 transcript variants.

PubMed

Kawata, Manabu; Taniguchi, Yuki; Mori, Daisuke; Yano, Fumiko; Ohba, Shinsuke; Chung, Ung-Il; Shimogori, Tomomi; Mills, Alea A; Tanaka, Sakae; Saito, Taku

2017-01-01

The apical ectodermal ridge (AER), located at the distal end of each limb bud, is a key signaling center which controls outgrowth and patterning of the proximal-distal axis of the limb through secretion of various molecules. Fibroblast growth factors (FGFs), particularly Fgf8 and Fgf4, are representative molecules produced by AER cells, and essential to maintain the AER and cell proliferation in the underlying mesenchyme, meanwhile Jag2-Notch pathway negatively regulates the AER and limb development. p63, a transcription factor of the p53 family, is expressed in the AER and indispensable for limb formation. However, the underlying mechanisms and specific roles of p63 variants are unknown. Here, we quantified the expression of p63 variants in mouse limbs from embryonic day (E) 10.5 to E12.5, and found that ΔNp63γ was strongly expressed in limbs at all stages, while TAp63γ expression was rapidly increased in the later stages. Fluorescence-activated cell sorting analysis of limb bud cells from reporter mouse embryos at E11.5 revealed that all variants were abundantly expressed in AER cells, and their expression was very low in mesenchymal cells. We then generated AER-specific p63 knockout mice by mating mice with a null and a flox allele of p63, and Msx2-Cre mice (Msx2-Cre;p63Δ/fl). Msx2-Cre;p63Δ/fl neonates showed limb malformation that was more obvious in distal elements. Expression of various AER-related genes was decreased in Msx2-Cre;p63Δ/fl limb buds and embryoid bodies formed by p63-knockdown induced pluripotent stem cells. Promoter analyses and chromatin immunoprecipitation assays demonstrated Fgf8 and Fgf4 as transcriptional targets of ΔNp63γ, and Jag2 as that of TAp63γ. Furthermore, TAp63γ overexpression exacerbated the phenotype of Msx2-Cre;p63Δ/fl mice. These data indicate that ΔNp63 and TAp63 control limb development through transcriptional regulation of different target molecules with different roles in the AER. Our findings contribute to further understanding of the molecular network of limb development.

Limb bone morphology, bone strength, and cursoriality in lagomorphs

PubMed Central

Young, Jesse W; Danczak, Robert; Russo, Gabrielle A; Fellmann, Connie D

2014-01-01

The primary aim of this study is to broadly evaluate the relationship between cursoriality (i.e. anatomical and physiological specialization for running) and limb bone morphology in lagomorphs. Relative to most previous studies of cursoriality, our focus on a size-restricted, taxonomically narrow group of mammals permits us to evaluate the degree to which ‘cursorial specialization’ affects locomotor anatomy independently of broader allometric and phylogenetic trends that might obscure such a relationship. We collected linear morphometrics and μCT data on 737 limb bones covering three lagomorph species that differ in degree of cursoriality: pikas (Ochotona princeps, non-cursorial), jackrabbits (Lepus californicus, highly cursorial), and rabbits (Sylvilagus bachmani, level of cursoriality intermediate between pikas and jackrabbits). We evaluated two hypotheses: cursoriality should be associated with (i) lower limb joint mechanical advantage (i.e. high ‘displacement advantage’, permitting more cursorial species to cycle their limbs more quickly) and (ii) longer, more gracile limb bones, particularly at the distal segments (as a means of decreasing rotational inertia). As predicted, highly cursorial jackrabbits are typically marked by the lowest mechanical advantage and the longest distal segments, non-cursorial pikas display the highest mechanical advantage and the shortest distal segments, and rabbits generally display intermediate values for these variables. Variation in long bone robusticity followed a proximodistal gradient. Whereas proximal limb bone robusticity declined with cursoriality, distal limb bone robusticity generally remained constant across the three species. The association between long, structurally gracile limb bones and decreased maximal bending strength suggests that the more cursorial lagomorphs compromise proximal limb bone integrity to improve locomotor economy. In contrast, the integrity of distal limb bones is maintained with increasing cursoriality, suggesting that the safety factor takes priority over locomotor economy in those regions of the postcranial skeleton that experience higher loading during locomotion. Overall, these findings support the hypothesis that cursoriality is associated with a common suite of morphological adaptations across a range of body sizes and radiations. PMID:25046350

Muscle activation levels of the gluteus maximus and medius during standing hip-joint strengthening exercises using elastic-tubing resistance.

PubMed

Youdas, James W; Adams, Kady E; Bertucci, John E; Brooks, Koel J; Nelson, Meghan M; Hollman, John H

2014-02-01

No published studies have compared muscle activation levels simultaneously for the gluteus maximus and medius muscles of stance and moving limbs during standing hip-joint strengthening while using elastic-tubing resistance. To quantify activation levels bilaterally of the gluteus maximus and medius during resisted lower-extremity standing exercises using elastic tubing for the cross-over, reverse cross-over, front-pull, and back-pull exercise conditions. Repeated measures. Laboratory. 26 active and healthy people, 13 men (25 ± 3 y) and 13 women (24 ± 1 y). Subjects completed 3 consecutive repetitions of lower-extremity exercises in random order. Surface electromyographic (EMG) signals were normalized to peak activity in the maximum voluntary isometric contraction (MVIC) trial and expressed as a percentage. Magnitudes of EMG recruitment were analyzed with a 2 × 4 repeated-measures ANOVA for each muscle (α = .05). For the gluteus maximus an interaction between exercise and limb factor was significant (F3,75 = 21.5; P < .001). The moving-limb gluteus maximus was activated more than the stance limb's during the back-pull exercise (P < .001), and moving-limb gluteus maximus muscle recruitment was greater for the back-pull exercise than for the cross-over, reverse cross-over, and front-pull exercises (P < .001). For the gluteus medius an interaction between exercise and limb factor was significant (F3,75 = 3.7; P < .03). Gluteus medius muscle recruitment (% MVIC) was greater in the stance limb than moving limb when performing the front-pull exercise (P < .001). Moving-limb gluteus medius muscle recruitment was greater for the reverse cross-over exercise than for the cross-over, front-pull, and back-pull exercises (P < .001). From a clinical standpoint there is no therapeutic benefit to selectively activate the gluteus maximus and gluteus medius muscles on the stance limb by resisting sagittal- and frontal-plane hip movements on the moving limb using resistance supplied by elastic tubing.

Constraint-induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review.

PubMed

Chiu, Hsiu-Ching; Ada, Louise

2016-07-01

Does constraint-induced movement therapy improve activity and participation in children with hemiplegic cerebral palsy? Does it improve activity and participation more than the same dose of upper limb therapy without restraint? Is the effect of constraint-induced movement therapy related to the duration of intervention or the age of the children? Systematic review of randomised trials with meta-analysis. Children with hemiplegic cerebral palsy with any level of motor disability. The experimental group received constraint-induced movement therapy (defined as restraint of the less affected upper limb during supervised activity practice of the more affected upper limb). The control group received no intervention, sham intervention, or the same dose of upper limb therapy. Measures of upper limb activity and participation were used in the analysis. Constraint-induced movement therapy was more effective than no/sham intervention in terms of upper limb activity (SMD 0.63, 95% CI 0.20 to 1.06) and participation (SMD 1.21, 95% CI 0.41 to 2.02). However, constraint-induced movement therapy was no better than the same dose of upper limb therapy without restraint either in terms of upper limb activity (SMD 0.05, 95% CI -0.21 to 0.32) or participation (SMD -0.02, 95% CI -0.34 to 0.31). The effect of constraint-induced movement therapy was not related to the duration of intervention or the age of the children. This review suggests that constraint-induced movement therapy is more effective than no intervention, but no more effective than the same dose of upper limb practice without restraint. PROSPERO CRD42015024665. [Chiu H-C, Ada L (2016) Constraint-induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review.Journal of Physiotherapy62: 130-137]. Copyright © 2016 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Growth factors FGF8 and FGF2 and their receptor FGFR1, transcriptional factors Msx-1 and MSX-2, and apoptotic factors p19 and RIP5 participate in the early human limb development.

PubMed

Becic, Tina; Kero, Darko; Vukojevic, Katarina; Mardesic, Snjezana; Saraga-Babic, Mirna

2018-04-01

The expression pattern of fibroblast growth factors FGF8 and FGF2 and their receptor FGFR1, transcription factors MSX-1 and MSX-2, as well as cell proliferation (Ki-67) and cell death associated caspase-3, p19 and RIP5 factors were analyzed in histological sections of eight 4th-9th-weeks developing human limbs by immunohistochemistry and semi-thin sectioning. Increasing expression of all analyzed factors (except FGF8) characterized both the multilayered human apical ectodermal ridge (AER), sub-ridge mesenchyme (progress zone) and chondrocytes in developing human limbs. While cytoplasmic co-expression of MSX-1 and MSX-2 was observed in both limb epithelium and mesenchyme, p19 displayed strong cytoplasmic expression in non-proliferating cells. Nuclear expression of Ki-67 proliferating cells, and partly of MSX-1 and MSX-2 was detected in the whole limb primordium. Strong expression of factors p19 and RIP5, both in the AER and mesenchyme of human developing limbs indicates their possible involvement in control of cell senescence and cell death. In contrast to animal studies, expression of FGFR1 in the surface ectoderm and p19 in the whole limb primordium might reflect interspecies differences in limb morphology. Expression of FGF2 and downstream RIP5 gene, and transcription factors Msx-1 and MSX-2 did not show human-specific changes in expression pattern. Based on their spatio-temporal expression during human limb development, our study indicates role of FGFs and Msx genes in stimulation of cell proliferation, limb outgrowth, digit elongation and separation, and additionally MSX-2 in control of vasculogenesis. The cascade of orchestrated gene expressions, including the analyzed developmental factors, jointly contribute to the complex human limb development. Copyright © 2018 Elsevier GmbH. All rights reserved.

Visualisation of upper limb activity using spirals: A new approach to the assessment of daily prosthesis usage.

PubMed

Chadwell, Alix; Kenney, Laurence; Granat, Malcolm; Thies, Sibylle; Head, John S; Galpin, Adam

2018-02-01

Current outcome measures used in upper limb myoelectric prosthesis studies include clinical tests of function and self-report questionnaires on real-world prosthesis use. Research in other cohorts has questioned both the validity of self-report as an activity assessment tool and the relationship between clinical functionality and real-world upper limb activity. Previously, 1 we reported the first results of monitoring upper limb prosthesis use. However, the data visualisation technique used was limited in scope. Methodology development. To introduce two new methods for the analysis and display of upper limb activity monitoring data and to demonstrate the potential value of the approach with example real-world data. Upper limb activity monitors, worn on each wrist, recorded data on two anatomically intact participants and two prosthesis users over 1 week. Participants also filled in a diary to record upper limb activity. Data visualisation was carried out using histograms, and Archimedean spirals to illustrate temporal patterns of upper limb activity. Anatomically intact participants' activity was largely bilateral in nature, interspersed with frequent bursts of unilateral activity of each arm. At times when the prosthesis was worn prosthesis users showed very little unilateral use of the prosthesis (≈20-40 min/week compared to ≈350 min/week unilateral activity on each arm for anatomically intact participants), with consistent bias towards the intact arm throughout. The Archimedean spiral plots illustrated participant-specific patterns of non-use in prosthesis users. The data visualisation techniques allow detailed and objective assessment of temporal patterns in the upper limb activity of prosthesis users. Clinical relevance Activity monitoring offers an objective method for the assessment of upper limb prosthesis users' (PUs) activity outside of the clinic. By plotting data using Archimedean spirals, it is possible to visualise, in detail, the temporal patterns of upper limb activity. Further work is needed to explore the relationship between traditional functional outcome measures and real-world prosthesis activity.

Air pollution and limb defects: a matched-pairs case-control study in Taiwan.

PubMed

Lin, Yu-Ting; Lee, Yungling Leo; Jung, Chau-Ren; Jaakkola, Jouni J K; Hwang, Bing-Fang

2014-07-01

Air pollution influences the development of limb defects in animals. There is little epidemiologic evidence on the effect of prenatal air pollution exposure on the risk of limb defects. To assess the relations between exposure to ambient air pollutants and the risk of limb defects. We conducted a matched-pairs case-control study in Taiwan from 2001 through 2007. The case group consisted of 1687 limb defects and the control group was density-sampling matched one to ten based on the month and year of conception from 1510,064 live singleton newborns in 2001-2007. Adjusted conditional logistic regression models were used to estimate odds ratios per 10 ppb change for O3, NO2, 1 ppb change for SO2, 10 µg/m(3) change for PM10, and 100 ppb change for CO during the first trimester and first three gestational months. Of the specific limb defects, reduction deformities of limbs (adjusted OR=1.024, 95% CI: 1.000, 1.048) was associated with a 1 ppb increase in SO2 during weeks of 9-12 of gestation as well as the first trimester. Reduction deformities of limbs was also associated with a 10 ppb increase in O3 during weeks of 1-4 of gestation (adjusted OR=1.391, 95% CI: 1.064, 1.818) among preterm births. The present study provides evidence that exposure to outdoor air SO2 during the first trimester of pregnancy may increase the risk of limb defects. Exposure to O3 was associated with reduction deformities of limbs among preterm births. Similar levels of SO2 and O3 are encountered globally by large numbers of pregnant women. Copyright © 2014 Elsevier Inc. All rights reserved.

Genetic Interactions Between Shox2 and Hox Genes During the Regional Growth and Development of the Mouse Limb

PubMed Central

Neufeld, Stanley J.; Wang, Fan; Cobb, John

2014-01-01

The growth and development of the vertebrate limb relies on homeobox genes of the Hox and Shox families, with their independent mutation often giving dose-dependent effects. Here we investigate whether Shox2 and Hox genes function together during mouse limb development by modulating their relative dosage and examining the limb for nonadditive effects on growth. Using double mRNA fluorescence in situ hybridization (FISH) in single embryos, we first show that Shox2 and Hox genes have associated spatial expression dynamics, with Shox2 expression restricted to the proximal limb along with Hoxd9 and Hoxa11 expression, juxtaposing the distal expression of Hoxa13 and Hoxd13. By generating mice with all possible dosage combinations of mutant Shox2 alleles and HoxA/D cluster deletions, we then show that their coordinated proximal limb expression is critical to generate normally proportioned limb segments. These epistatic interactions tune limb length, where Shox2 underexpression enhances, and Shox2 overexpression suppresses, Hox-mutant phenotypes. Disruption of either Shox2 or Hox genes leads to a similar reduction in Runx2 expression in the developing humerus, suggesting their concerted action drives cartilage maturation during normal development. While we furthermore provide evidence that Hox gene function influences Shox2 expression, this regulation is limited in extent and is unlikely on its own to be a major explanation for their genetic interaction. Given the similar effect of human SHOX mutations on regional limb growth, Shox and Hox genes may generally function as genetic interaction partners during the growth and development of the proximal vertebrate limb. PMID:25217052

Genetic interactions between Shox2 and Hox genes during the regional growth and development of the mouse limb.

PubMed

Neufeld, Stanley J; Wang, Fan; Cobb, John

2014-11-01

The growth and development of the vertebrate limb relies on homeobox genes of the Hox and Shox families, with their independent mutation often giving dose-dependent effects. Here we investigate whether Shox2 and Hox genes function together during mouse limb development by modulating their relative dosage and examining the limb for nonadditive effects on growth. Using double mRNA fluorescence in situ hybridization (FISH) in single embryos, we first show that Shox2 and Hox genes have associated spatial expression dynamics, with Shox2 expression restricted to the proximal limb along with Hoxd9 and Hoxa11 expression, juxtaposing the distal expression of Hoxa13 and Hoxd13. By generating mice with all possible dosage combinations of mutant Shox2 alleles and HoxA/D cluster deletions, we then show that their coordinated proximal limb expression is critical to generate normally proportioned limb segments. These epistatic interactions tune limb length, where Shox2 underexpression enhances, and Shox2 overexpression suppresses, Hox-mutant phenotypes. Disruption of either Shox2 or Hox genes leads to a similar reduction in Runx2 expression in the developing humerus, suggesting their concerted action drives cartilage maturation during normal development. While we furthermore provide evidence that Hox gene function influences Shox2 expression, this regulation is limited in extent and is unlikely on its own to be a major explanation for their genetic interaction. Given the similar effect of human SHOX mutations on regional limb growth, Shox and Hox genes may generally function as genetic interaction partners during the growth and development of the proximal vertebrate limb. Copyright © 2014 by the Genetics Society of America.

Energy flow analysis of amputee walking shows a proximally-directed transfer of energy in intact limbs, compared to a distally-directed transfer in prosthetic limbs at push-off.

PubMed

Weinert-Aplin, R A; Howard, D; Twiste, M; Jarvis, H L; Bennett, A N; Baker, R J

2017-01-01

Reduced capacity and increased metabolic cost of walking occurs in amputees, despite advances in prosthetic componentry. Joint powers can quantify deficiencies in prosthetic gait, but do not reveal how energy is exchanged between limb segments. This study aimed to quantify these energy exchanges during amputee walking. Optical motion and forceplate data collected during walking at a self-selected speed for cohorts of 10 controls, 10 unilateral trans-tibial, 10 unilateral trans-femoral and 10 bilateral trans-femoral amputees were used to determine the energy exchanges between lower limb segments. At push-off, consistent thigh and shank segment powers were observed between amputee groups (1.12W/kg vs. 1.05W/kg for intact limbs and 0.97W/kg vs. 0.99W/kg for prosthetic limbs), and reduced prosthetic ankle power, particularly in trans-femoral amputees (3.12W/kg vs. 0.87W/kg). Proximally-directed energy exchange was observed in the intact limbs of amputees and controls, while prosthetic limbs displayed distally-directed energy exchanges at the knee and hip. This study used energy flow analysis to show a reversal in the direction in which energy is exchanged between prosthetic limb segments at push-off. This reversal was required to provide sufficient energy to propel the limb segments and is likely a direct result of the lack of push-off power at the prosthetic ankle, particularly in trans-femoral amputees, and leads to their increased metabolic cost of walking. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

The effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture

PubMed Central

Yang, Si-Dong; Ning, Sheng-Hua; Zhang, Li-Hong; Zhang, Ying-Ze; Ding, Wen-Yuan; Yang, Da-Long

2016-01-01

Abstract The purpose of this study was to explore the effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture after undergoing intramedullary nail fixation surgery. We collected medical records of elderly patients aged ≥ 60 years with femoral shaft fracture between 03/2010 and 03/2015 in Longyao County Hospital. Totally, 160 patients were identified and divided into the intervention group (n = 80) and the control group (n = 80). During the postoperative period, the intervention group received lower limb rehabilitation gymnastics treatment for 3 months, but the control group did not. All patients were routinely asked to return hospital for a check in the 1st postoperative week, as well as the 2nd week, the 1st month, and the 3rd month, after surgery. The clinical rehabilitation effect was evaluated by checking lower limb action ability, detecting the lower limb deep venous thrombosis (DVT), scoring muscle strength of quadriceps and visual analog scale (VAS) score, and performing satisfaction survey. At the 1st week and 2nd week after surgery, the clinical rehabilitation effect in the intervention group was better regarding lower limb action ability, lower limb DVT, muscle strength of quadriceps, VAS score, and patient satisfaction, as compared with the control group. However, there was no significant difference at the 1st month and the 3rd month after surgery when comparing the intervention group to the control group. In the early postoperative stage, lower limb rehabilitation gymnastics can effectively improve the recovery of lower limb function, beneficial to reducing postoperative complications such as lower limb DVT and muscle atrophy, and increasing patient satisfaction rate. PMID:27537579

The effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture: A retrospective case-control study.

PubMed

Yang, Si-Dong; Ning, Sheng-Hua; Zhang, Li-Hong; Zhang, Ying-Ze; Ding, Wen-Yuan; Yang, Da-Long

2016-08-01

The purpose of this study was to explore the effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture after undergoing intramedullary nail fixation surgery.We collected medical records of elderly patients aged ≥ 60 years with femoral shaft fracture between 03/2010 and 03/2015 in Longyao County Hospital. Totally, 160 patients were identified and divided into the intervention group (n = 80) and the control group (n = 80). During the postoperative period, the intervention group received lower limb rehabilitation gymnastics treatment for 3 months, but the control group did not. All patients were routinely asked to return hospital for a check in the 1st postoperative week, as well as the 2nd week, the 1st month, and the 3rd month, after surgery. The clinical rehabilitation effect was evaluated by checking lower limb action ability, detecting the lower limb deep venous thrombosis (DVT), scoring muscle strength of quadriceps and visual analog scale (VAS) score, and performing satisfaction survey.At the 1st week and 2nd week after surgery, the clinical rehabilitation effect in the intervention group was better regarding lower limb action ability, lower limb DVT, muscle strength of quadriceps, VAS score, and patient satisfaction, as compared with the control group. However, there was no significant difference at the 1st month and the 3rd month after surgery when comparing the intervention group to the control group.In the early postoperative stage, lower limb rehabilitation gymnastics can effectively improve the recovery of lower limb function, beneficial to reducing postoperative complications such as lower limb DVT and muscle atrophy, and increasing patient satisfaction rate.

Skin blood flow: a comparison of transcutaneous oximetry and laser Doppler flowmetry.

PubMed

Allen, P I; Goldman, M

1987-10-01

In normal limbs skin blood flow (SBF) falls on standing, but in ischaemic limbs there is a characteristic blush on dependancy. We studied the effect of changing posture in a range of ischaemic limbs, using two non-invasive techniques--laser Doppler (LD) and transcutaneous oximetry (TcPO2). Warmed TcPO2 and LD probes were placed over the first metatarsal cleft and SBF recorded with the limb horizontal, dependant and elevated. Ankle to brachial pressure ratios (A:B) were also measured. Twelve patients with lower limb ischaemia, mean A:B ratio 0.5 +/- 0.21 (+/- S.D.) were compared with 21 asymptomatic controls, mean A:B ratio 1.2 +/- 0.15. In the controls, neither TcPO2 nor LD values changed significantly with limb position. Both flux and oxygen tension were significantly lower in ischaemic limbs in all positions; on lowering the ischaemic limb, flux unexpectedly rose to 23.5 +/- 17.7 V from a mean of 14 + 9.0 V (horizontal). Both TcPO2 and LD correlated well with A:B ratio in two positions: horizontal r (TcPO2) = 0.73, r(LD) = 0.57; elevated r(TcPO2) = 0.78, r(LD) = 0.68. Overall there was a highly significant correlation between LD and TcPO2 (r = 0.6, P less than 0.001, Student's test), but this was strongest in the elevated position (r = 0.87, P less than 0.001). LD and TcPO2 relate to A:B ratio and to each other, particularly in the stressed limb; in the well perfused limb, the poorer correlation suggests skin perfusion is not linearly related to tissue oxygen tension.

Update and validation of the Society for Vascular Surgery wound, ischemia, and foot infection threatened limb classification system.

PubMed

Mills, Joseph L

2014-03-01

The diagnosis of critical limb ischemia, first defined in 1982, was intended to delineate a patient cohort with a threatened limb and at risk for amputation due to severe peripheral arterial disease. The influence of diabetes and its associated neuropathy on the pathogenesis-threatened limb was an excluded comorbidity, despite its known contribution to amputation risk. The Fontaine and Rutherford classifications of limb ischemia severity have also been used to predict amputation risk and the likelihood of tissue healing. The dramatic increase in the prevalence of diabetes mellitus and the expanding techniques of arterial revascularization has prompted modification of peripheral arterial disease classification schemes to improve outcomes analysis for patients with threatened limbs. The diabetic patient with foot ulceration and infection is at risk for limb loss, with abnormal arterial perfusion as only one determinant of outcome. The wound extent and severity of infection also impact the likelihood of limb loss. To better predict amputation risk, the Society for Vascular Surgery Lower Extremity Guidelines Committee developed a classification of the threatened lower extremity that reflects these important clinical considerations. Risk stratification is based on three major factors that impact amputation risk and clinical management: wound, ischemia, and foot infection. This classification scheme is relevant to the patient with critical limb ischemia because many are also diabetic. Implementation of the wound, ischemia, and foot infection classification system in critical limb ischemia patients is recommended and should assist the clinician in more meaningful analysis of outcomes for various forms of wound and arterial revascularizations procedures required in this challenging, patient population. Copyright © 2014 Elsevier Inc. All rights reserved.

Can Video Self-Modeling Improve Affected Limb Reach and Grasp Ability in Stroke Patients?

PubMed

Steel, Kylie Ann; Mudie, Kurt; Sandoval, Remi; Anderson, David; Dogramaci, Sera; Rehmanjan, Mohammad; Birznieks, Ingvars

2018-01-01

The authors examined whether feedforward video self-modeling (FF VSM) would improve control over the affected limb, movement self-confidence, movement self-consciousness, and well-being in 18 stroke survivors. Participants completed a cup transport task and 2 questionnaires related to psychological processes pre- and postintervention. Pretest video footage of the unaffected limb performing the task was edited to create a best-of or mirror-reversed training DVD, creating the illusion that patients were performing proficiently with the affected limb. The training yielded significant improvements for the forward movement of the affected limb compared to the unaffected limb. Significant improvements were also seen in movement self-confidence, movement self-consciousness, and well-being. FF VSM appears to be a viable way to improve motor ability in populations with movement disorders.

Functional analysis of limb enhancers in the developing fin

PubMed Central

Booker, Betty M.; Murphy, Karl K.

2013-01-01

Despite diverging ~365 million years ago, tetrapod limbs and pectoral fins express similar genes that could be regulated by shared regulatory elements. In this study, we set out to analyze the ability of enhancers to maintain tissue specificity in these two divergent structures. We tested 22 human sequences that were previously reported as mouse limb enhancers for their enhancer activity in zebrafish (Danio rerio). Using a zebrafish enhancer assay, we found that 10/22 (45 %) were positive for pectoral fin activity. Analysis of the various criteria that correlated with positive fin activity found that both spatial limb activity and evolutionary conservation are not good predictors of fin enhancer activity. These results suggest that zebrafish enhancer assays may be limited in detecting human limb enhancers, and this limitation does not improve by the use of limb spatial expression or evolutionary conservation. PMID:24068387

Morphogenesis and evolution of vertebrate appendicular muscle

PubMed Central

HAINES, LYNN; CURRIE, PETER D.

2001-01-01

Two different modes are utilised by vertebrate species to generate the appendicular muscle present within fins and limbs. Primitive Chondricthyan or cartilaginous fishes use a primitive mode of muscle formation to generate the muscle of the fins. Direct epithelial myotomal extensions invade the fin and generate the fin muscles while remaining in contact with the myotome. Embryos of amniotes such as chick and mouse use a similar mechanism to that deployed in the bony teleost species, zebrafish. Migratory mesenchymal myoblasts delaminate from fin/limb level somites, migrate to the fin/limb field and differentiate entirely within the context of the fin/limb bud. Migratory fin and limb myoblasts express identical genes suggesting that they possess both morphogenetic and molecular identity. We conclude that the mechanisms controlling tetrapod limb muscle formation arose prior to the Sarcopterygian or tetrapod radiation. PMID:11523824

Slow Movements of Bio-Inspired Limbs

NASA Astrophysics Data System (ADS)

Babikian, Sarine; Valero-Cuevas, Francisco J.; Kanso, Eva

2016-10-01

Slow and accurate finger and limb movements are essential to daily activities, but the underlying mechanics is relatively unexplored. Here, we develop a mathematical framework to examine slow movements of tendon-driven limbs that are produced by modulating the tendons' stiffness parameters. Slow limb movements are driftless in the sense that movement stops when actuations stop. We demonstrate, in the context of a planar tendon-driven system representing a finger, that the control of stiffness suffices to produce stable and accurate limb postures and quasi-static (slow) transitions among them. We prove, however, that stable postures are achievable only when tendons are pretensioned, i.e., they cannot become slack. Our results further indicate that a non-smoothness in slow movements arises because the precision with which individual stiffnesses need to be altered changes substantially throughout the limb's motion.

Progress Toward Optimizing Prosthetic Socket Fit and Suspension Using Elevated Vacuum to Promote Residual Limb Health

PubMed Central

Wernke, Matthew M.; Schroeder, Ryan M.; Haynes, Michael L.; Nolt, Lonnie L.; Albury, Alexander W.; Colvin, James M.

2017-01-01

Objective: Prosthetic sockets are custom made for each amputee, yet there are no quantitative tools to determine the appropriateness of socket fit. Ensuring a proper socket fit can have significant effects on the health of residual limb soft tissues and overall function and acceptance of the prosthetic limb. Previous work found that elevated vacuum pressure data can detect movement between the residual limb and the prosthetic socket; however, the correlation between the two was specific to each user. The overall objective of this work is to determine the relationship between elevated vacuum pressure deviations and prosthetic socket fit. Approach: A tension compression machine was used to apply repeated controlled forces onto a residual limb model with sockets of different internal volume. Results: The vacuum pressure–displacement relationship was dependent on socket fit. The vacuum pressure data were sensitive enough to detect differences of 1.5% global volume and can likely detect differences even smaller. Limb motion was reduced as surface area of contact between the limb model and socket was maximized. Innovation: The results suggest that elevated vacuum pressure data provide information to quantify socket fit. Conclusions: This study provides evidence that the use of elevated vacuum pressure data may provide a method for prosthetists to quantify and monitor socket fit. Future studies should investigate the relationship between socket fit, limb motion, and limb health to define optimal socket fit parameters. PMID:28736683

Computer-assisted kinematic evaluation of induced compensatory movements resembling lameness in horses trotting on a treadmill.

PubMed

Kelmer, Gal; Keegan, Kevin G; Kramer, Joanne; Wilson, David A; Pai, Frank P; Singh, Prableen

2005-04-01

To characterize compensatory movements of the head and pelvis that resemble lameness in horses. 17 adult horses. Kinematic evaluations were performed while horses trotted on a treadmill before and after shoe-induced lameness. Lameness was quantified and the affected limb determined by algorithms that measured asymmetry in vertical movement of the head and pelvis. Induced primary lameness and compensatory movements resembling lameness were assessed by the Friedman test. Association between induced lameness and compensatory movements was examined by regression analysis. Compensatory movements resembling lameness in the ipsilateral forelimb were seen with induced lameness of a hind limb. There was less downward and less upward head movement during and after the stance phase of the ipsilateral forelimb. Doubling the severity of lameness in the hind limb increased severity of the compensatory movements in the ipsilateral forelimb by 50%. Compensatory movements resembling lameness of the hind limb were seen after induced lameness in a forelimb. There was less upward movement of the pelvis after the stance phase of the contralateral hind limb and, to a lesser extent, less downward movement of the pelvis during the stance phase of the ipsilateral hind limb. Doubling the severity of lameness in the forelimb increased compensatory movements of the contralateral hind limb by 5%. Induced lameness in a hind limb causes prominent compensatory movements resembling lameness in the ipsilateral forelimb. Induced lameness in a forelimb causes slight compensatory movements resembling lameness in the ipsilateral and contralateral hind limbs.

Comparative architectural properties of limb muscles in Crocodylidae and Alligatoridae and their relevance to divergent use of asymmetrical gaits in extant Crocodylia.

PubMed

Allen, Vivian; Molnar, Julia; Parker, William; Pollard, Andrea; Nolan, Grant; Hutchinson, John R

2014-12-01

Crocodiles and their kin (Crocodylidae) use asymmetrical (bounding and galloping) gaits when moving rapidly. Despite being morphologically and ecologically similar, it seems alligators and their kin (Alligatoridae) do not. To investigate a possible anatomical basis for this apparent major difference in locomotor capabilities, we measured relative masses and internal architecture (fascicle lengths and physiological cross-sectional areas) of muscles of the pectoral and pelvic limbs of 40 individuals from six representative species of Crocodylidae and Alligatoridae. We found that, relative to body mass, Crocodylidae have significantly longer muscle fascicles (increased working range), particularly in the pectoral limb, and generally smaller muscle physiological cross-sectional areas (decreased force-exerting capability) than Alligatoridae. We therefore hypothesise that the ability of some crocodylians to use asymmetrical gaits may be limited more by the ability to make large, rapid limb motions (especially in the pectoral limb) than the ability to exert large limb forces. Furthermore, analysis of scaling patterns in muscle properties shows that limb anatomy in the two clades becomes more divergent during ontogeny. Limb muscle masses, fascicle lengths and physiological cross-sectional areas scale with significantly larger coefficients in Crocodylidae than Alligatoridae. This combination of factors suggests that inter-clade disparity in maximal limb power is highest in adult animals. Therefore, despite their apparent morphological similarities, both mean values and scaling patterns suggest that considerable diversity exists in the locomotor apparatus of extant Crocodylia. © 2014 Anatomical Society.

Prior nonhip limb fracture predicts subsequent hip fracture in institutionalized elderly people.

PubMed

Nakamura, K; Takahashi, S; Oyama, M; Oshiki, R; Kobayashi, R; Saito, T; Yoshizawa, Y; Tsuchiya, Y

2010-08-01

This 1-year cohort study of nursing home residents revealed that historical fractures of upper limbs or nonhip lower limbs were associated with hip fracture (hazard ratio = 2.14), independent of activities of daily living (ADL), mobility, dementia, weight, and type of nursing home. Prior nonhip fractures are useful for predicting of hip fracture in institutional settings. The aim of this study was to evaluate the utility of fracture history for the prediction of hip fracture in nursing home residents. This was a cohort study with a 1-year follow-up. Subjects were 8,905 residents of nursing homes in Niigata, Japan (mean age, 84.3 years). Fracture histories were obtained from nursing home medical records. ADL levels were assessed by caregivers. Hip fracture diagnosis was based on hospital medical records. Subjects had fracture histories of upper limbs (5.0%), hip (14.0%), and nonhip lower limbs (4.6%). Among historical single fractures, only prior nonhip lower limbs significantly predicted subsequent fracture (adjusted hazard ratio, 2.43; 95% confidence interval (CI), 1.30-4.57). The stepwise method selected the best model, in which a combined historical fracture at upper limbs or nonhip lower limbs (adjusted hazard ratio, 2.14; 95% CI, 1.30-3.52), dependence, ADL levels, mobility, dementia, weight, and type of nursing home independently predicted subsequent hip fracture. A fracture history at upper or nonhip lower limbs, in combination with other known risk factors, is useful for the prediction of future hip fracture in institutional settings.

Peripheral neuropathy reduces asymmetries in inter-limb transfer in a visuo-motor task.

PubMed

Pan, Zhujun; Van Gemmert, Arend W A

2016-01-01

Asymmetry of inter-limb transfer has been associated with the specialization of the dominant and non-dominant motor system. Reductions of asymmetry have been interpreted as behavioural evidence showing a decline of hemispheric lateralization. A previous study showed that ageing did not qualitatively change the inter-limb transfer asymmetry of a visuo-motor task. The current study elaborates on these findings; it examines whether diminished somatosensory information as a result of peripheral neuropathy (PN) adversely affects inter-limb transfer asymmetry. Twenty individuals affected by PN and 20 older controls were recruited and divided equally across two groups. One group trained a visuo-motor task with the right hand while the other group trained it with the left hand. Performance (initial direction error) of the untrained hand before and after training was collected to determine learning effects from inter-limb transfer. Similar to previous studies, the current study showed asymmetric inter-limb transfer in older controls. In contrast, PN showed inter-limb transfer in both directions indicating that PN reduces inter-limb transfer asymmetry. Increased bilateral hemispheric recruitment is suggested to be responsible for this reduced asymmetry which may compensate for deteriorated tactile and/or proprioceptive inputs in PN. Two possible hypotheses are discussed explaining the relationship between declined somatosensory information and increases in bilateral hemispheric recruitment.

Neurotrophic regulation of epidermal dedifferentiation during wound healing and limb regeneration in the axolotl (Ambystoma mexicanum).

PubMed

Satoh, A; Graham, G M C; Bryant, S V; Gardiner, D M

2008-07-15

Adult urodeles (salamanders) are unique in their ability to regenerate complex organs perfectly. The recently developed Accessory Limb Model (ALM) in the axolotl provides an opportunity to identify and characterize the essential signaling events that control the early steps in limb regeneration. The ALM demonstrates that limb regeneration progresses in a stepwise fashion that is dependent on signals from the wound epidermis, nerves and dermal fibroblasts from opposite sides of the limb. When all the signals are present, a limb is formed de novo. The ALM thus provides an opportunity to identify and characterize the signaling pathways that control blastema morphogenesis and limb regeneration. In the present study, we have utilized the ALM to identity the buttonhead-like zinc-finger transcription factor, Sp9, as being involved in the formation of the regeneration epithelium. Sp9 expression is induced in basal keratinocytes of the apical blastema epithelium in a pattern that is comparable to its expression in developing limb buds, and it thus is an important marker for dedifferentiation of the epidermis. Induction of Sp9 expression is nerve-dependent, and we have identified KGF as an endogenous nerve factor that induces expression of Sp9 in the regeneration epithelium.

Three-dimensional contrast-enhanced magnetic resonance angiography for anterolateral thigh flap outlining: A retrospective case series of 68 patients.

PubMed

Jiang, Chunjing; Lin, Ping; Fu, Xiaoyan; Shu, Jiner; Li, Huimin; Hu, Xiaogang; He, Jianrong; Ding, Mingxing

2016-08-01

Flap transfer is increasingly used for repairing limb defects secondary to trauma or tumor, and appropriate preoperative planning plays a critical role. The present study aimed to examine the use of three-dimensional (3D) contrast-enhanced magnetic resonance angiography (CE-MRA) in evaluating the blood supply distribution and perforating branch pattern of anterolateral thigh (ALT) flaps. Bilateral donor lower limbs were scanned in 68 patients (136 limbs) using a Siemens Avanto 1.5 T magnetic resonance imaging scanner with a 3D fast low-angle shot sequence, following the thin-slab maximum intensity projection (TS-MIP) technique. The lateral femoral circumflex artery (LFCA) was visualized in all patients: 101 limbs (101/136, 74.3%) were type I; 20 limbs (20/136, 14.7%) were type II; 3 limbs (3/136, 2.2%) were type III; and 12 limbs (12/136, 8.8%) were type IV. Tertiary branches were identified in 94 limbs (94/136, 69.1%). Donor flaps were outlined according to MRA TS-MIP findings in 4 patients. All flaps survived uneventfully following the transfer. In donor flap outlining, 3D CE-MRA with the TS-MIP technique allowed an accurate, direct visualization of the branching pattern and distribution profile of the LFCA supplying the ALT flap.

Studies of limb-dislodging forces acting on an ejection seat occupant.

PubMed

Schneck, D J

1980-03-01

A mathematical theory is being developed in order to calculate the aerodynamic loading to which a pilot is exposed during high-speed ejections. Neglecting the initial effects of flow separation, results thus far indicate that a pilot's musculoskeletal system is not likely to withstand the tendency for limb-flailing if he is ejecting at Mach numbers in excess of about 0.7. This tendency depends very strongly upon the angle at which the pilot's limbs intercept a high-speed flow; the forces that cause limb dislodgement increase dramatically with speed of ejection. Examining the time-course of limb-dislodging forces after the initial onset of windblast, the theory further predicts the generation of a double vortex street pattern on the downstream side of the limbs of an ejection seat occupant. This results in the corresponding appearance of oscillating forces tending to cause lateral motion (vibration) of the limbs. The amplitude and frequency of these oscillating forces are also very dependent on the Mach number of ejection and the angle at which the pilot's limbs intercept the flow. However, even at moderate Mach numbers, the frequency can be as high as 100 cycles per second, and the amplitude rapidly exceeds a pilot's musculo-skeletal resistive powers for Mach numbers above 0.7.

Six-degree-of-freedom parallel minimanipulator with three inextensible limbs

NASA Technical Reports Server (NTRS)

Tahmasebi, Farhad (Inventor); Tsai, Lung-Wen (Inventor)

1994-01-01

A Six-Degree-of-Freedom Parallel-Manipulator having three inextensible limbs for manipulating a platform is described. The three inextensible limbs are attached via universal joints to the platform at non-collinear points. Each of the inextensible limbs is also attached via universal joints to a two-degree-of-freedom parallel driver such as a five-bar linkage, a pantograph, or a bidirectional linear stepper motor. The drivers move the lower ends of the limbs parallel to a fixed base and thereby provide manipulation of the platform. The actuators are mounted on the fixed base without using any power transmission devices such as gears or belts.

Facts about Upper and Lower Limb Reduction Defects

MedlinePlus

... its normal size or is missing. What We Know About Upper and Lower Limb Reduction Defects How ... and productive lives. What We Still Do Not Know About Upper and Lower Limb Reduction Defects What ...

Clouds above the Martin Limb: Viking observations

NASA Technical Reports Server (NTRS)

Martin, L. J.; Baum, W. A.; Wasserman, L. H.; Kreidl, T. J.

1984-01-01

Whenever Viking Orbiter images included the limb of Mars, they recorded one or more layers of clouds above the limb. The height above the limb and the brightness (reflectivity) of these clouds were determined in a selected group of these images. Normalized individual brightness profiles of three separate traverses across the limb of each image are shown. The most notable finding is that some of these clouds can be very high. Many reach heights of over 60 km, and several are over 70 km above the limb. Statistically, the reflectivity of the clouds increases with phase angle. Reflectivity and height both appear to vary with season, but the selected images spanned only one Martian year, so the role of seasons cannot be isolated. Limb clouds in red-filter images tend to be brighter than violet-filter images, but both season and phase appear to be more dominant factors. Due to the limited sample available, the possible influences of latitude and longitude are less clear. The layering of these clouds ranges from a single layer to five or more layers. Reflectivity gradients range from smooth and gentle to steep and irregular.

Functional testing of space flight induced changes in tonic motor control by using limb-attached excitation and load devices

NASA Astrophysics Data System (ADS)

Gallasch, Eugen; Kozlovskaya, Inessa

2007-02-01

Long term space flights induce atrophy and contractile changes on postural muscles such effecting tonic motor control. Functional testing of tonic motor control structures is a challenge because of the difficulties to deliver appropriate test forces on crew members. In this paper we propose two approaches for functional testing by using limb attached loading devices. The first approach is based on a frequency and amplitude controllable moving magnet exciter to deliver sinusoidal test forces during limb postures. The responding limb deflection is recorded by an embedded accelerometer to obtain limb impedance. The second approach is based on elastic limb loading to evoke self-excited oscillations during arm extensions. Here the contraction force at the oscillation onset provides information about limb stiffness. The rationale for both testing approaches is based on Feldman's λ-model. An arm expander based on the second approach was probed in a 6-month MIR space flight. The results obtained from the load oscillations, confirmed that this device is well suited to capture space flight induced neuromuscular changes.

Driving ability following upper limb amputation.

PubMed

Burger, Helena; Marincek, Crt

2013-10-01

In the existing literature, there is scarce information about subjects with upper limb amputation and driving. The aim of this study was to find out how frequently subjects following upper limb amputation have problems when driving; most frequently proposed adaptations and, when possible, factors that influence driving ability. Retrospective clinical study. Medical records were reviewed of all subjects following upper limb amputation who had been amputated in the last 5 years and those with congenital upper limb deficiency who in the last 5 years turned 17. Out of 37 subjects, 7 did not attend the clinic for assessment of driving abilities. They were significantly older at the time of the amputation (p < 0.001). To the remaining 30 who attended driving assessment, zero to four car adaptations (two on average) were proposed. There were no correlations between the number of suggested car adaptations and the age at the time of the amputation, amputation level, education and severity of phantom limb pain. Type of prosthesis also did not influence the number of car adaptations. Most people following upper limb amputation need at least one car adaptation for safe driving.

Proximal—distal pattern formation in Drosophila: cell autonomous requirement for Distal-less gene activity in limb development

PubMed Central

Cohen, Stephen M.; Jürgens, Gerd

1989-01-01

Limb development in the Drosophila embryo requires a pattern-forming system to organize positional information along the proximal–distal axis of the limb. This system must function in the context of the well characterized anterior–posterior and dorsal–ventral pattern-forming systems that are required to organize the body plan of the embryo. By genetic criteria the Distal-less gene appears to play a central role in limb development. Lack-of-function Distal-less mutations cause the deletion of a specific subset of embryonic peripheral sense organs that represent the evolutionary remnants of larval limbs. Distal-less activity is also required in the imaginal discs for the development of adult limbs. This requirement is cell autonomous and region specific within the developing limb primordium. Production of genetically mosaic imaginal discs, in which clones of cells lack Distal-less activity, indicates the existence of an organized proximal–distal positional information in very young imaginal disc primordia. We suggest that this graded positional information may depend on the activity of the Distal-less gene. Images PMID:16453891

SPECTRO-POLARIMETRIC SIMULATIONS OF THE SOLAR LIMB: ABSORPTION-EMISSION Fe I 6301.5 Å AND 6302.5 Å LINE PROFILES AND TORSIONAL FLOWS IN THE INTERGRANULAR MAGNETIC FLUX CONCENTRATIONS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shelyag, S.

2015-03-01

Using radiative magnetohydrodynamic simulations of the magnetized solar photosphere and detailed spectro-polarimetric diagnostics with the Fe I 6301.5 Å and 6302.5 Å photospheric lines in the local thermodynamic equilibrium approximation, we model active solar granulation as if it was observed at the solar limb. We analyze general properties of the radiation across the solar limb, such as the continuum and the line core limb darkening and the granulation contrast. We demonstrate the presence of profiles with both emission and absorption features at the simulated solar limb, and pure emission profiles above the limb. These profiles are associated with the regionsmore » of strong linear polarization of the emergent radiation, indicating the influence of the intergranular magnetic fields on the line formation. We analyze physical origins of the emission wings in the Stokes profiles at the limb, and demonstrate that these features are produced by localized heating and torsional motions in the intergranular magnetic flux concentrations.« less

Assisting people with attention deficit hyperactivity disorder by actively reducing limb hyperactive behavior with a gyration air mouse through a controlled environmental stimulation.

PubMed

Shih, Ching-Hsiang

2011-01-01

The latest researches have adopted software technology turning the gyration air mouse into a high performance limb movement detector, and have assessed whether two persons with multiple disabilities would be able to control an environmental stimulation using limb movement. This study extends gyration air mouse functionality by actively reducing limb hyperactive behavior to assess whether two persons with attention deficit hyperactivity disorder (ADHD) would be able to actively reduce their limb hyperactive behavior by controlling their favorite stimulation on/off using a gyration air mouse with a newly developed actively limb hyperactive behavior reducing program (ALHBRP). The study was performed according to an ABAB design, in which A represented the baseline and B represented intervention phases. Data showed that both participants significantly increased their time duration of maintaining a static limb posture (TDMSLP) to activate the control system in order to produce environmental stimulation during the intervention phases. Practical and developmental implications of the findings are discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.

A New Animal Model for Developing a Somatosensory Neural Interface for Prosthetic Limbs

DTIC Science & Technology

2008-02-12

interface for neuroprosthetic limbs . PI: Douglas J. Weber, Ph.D. University of Pittsburgh 1 10/15/2007 Scientific progress and accomplishments. We...information to the brain. A new animal model for developing a somatosensory neural interface for neuroprosthetic limbs . PI: Douglas J. Weber, Ph.D...A new animal model for developing a somatosensory neural interface for neuroprosthetic limbs . PI: Douglas J. Weber, Ph.D. University of Pittsburgh

Influence of Total Knee Arthroplasty on Gait Mechanics of the Replaced and Non-Replaced Limb During Stair Negotiation.

PubMed

Standifird, Tyler W; Saxton, Arnold M; Coe, Dawn P; Cates, Harold E; Reinbolt, Jeffrey A; Zhang, Songning

2016-01-01

This study compared biomechanics during stair ascent in replaced and non-replaced limbs of total knee arthroplasty (TKA) patients with control limbs of healthy participants. Thirteen TKA patients and fifteen controls performed stair ascent. Replaced and non-replaced knees of TKA patients were less flexed at contact compared to controls. The loading response peak knee extension moment was greater in control and non-replaced knees compared with replaced. The push-off peak knee abduction moment was elevated in replaced limbs compared to controls. Loading and push-off peak hip abduction moments were greater in replaced limbs compared to controls. The push-off peak hip abduction moment was greater in non-replaced limbs compared to controls. Future rehabilitation protocols should consider the replaced knee and also the non-replaced knee and surrounding joints. Copyright © 2016 Elsevier Inc. All rights reserved.

Symmetrical upper limb peromelia and lower limb phocomelia associated with a de novo apparently balanced reciprocal translocation: 46,XX,t(2; 12)(p25.1;q24.1).

PubMed

Murray, R S; Keeling, J W; Ellis, P M; FitzPatrick, D R

2002-04-01

We report a female fetus of 20 weeks gestation with severe symmetrical deformity affecting all four limbs. These deformities were unusual in that there was upper limb peromelia and lower limb phocomelia. No additional major malformations were identified on postmortem examination. In particular there was no evidence of splenogonadal fusion or micrognathia and hypoglossia. The limb malformations in this case are associated with a de novo apparently balanced reciprocal translocation 46,XX,t(2;12)(p25.1;q24.1). The cytogenetic features of Roberts-SC phocomelia syndrome were not detected. Unfortunately, the fibroblast line died and no FISH or DNA analysis could be carried out. In spite of this, the case is presented as it may be useful to other researchers in the selection of candidate genes for mendelian forms of peromelia and phocomelia.

Mutations in WNT7A cause a range of limb malformations, including Fuhrmann syndrome and Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndrome.

PubMed

Woods, C G; Stricker, S; Seemann, P; Stern, R; Cox, J; Sherridan, E; Roberts, E; Springell, K; Scott, S; Karbani, G; Sharif, S M; Toomes, C; Bond, J; Kumar, D; Al-Gazali, L; Mundlos, S

2006-08-01

Fuhrmann syndrome and the Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndrome are considered to be distinct limb-malformation disorders characterized by various degrees of limb aplasia/hypoplasia and joint dysplasia in humans. In families with these syndromes, we found homozygous missense mutations in the dorsoventral-patterning gene WNT7A and confirmed their functional significance in retroviral-mediated transfection of chicken mesenchyme cell cultures and developing limbs. The results suggest that a partial loss of WNT7A function causes Fuhrmann syndrome (and a phenotype similar to mouse Wnt7a knockout), whereas the more-severe limb truncation phenotypes observed in Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndrome result from null mutations (and cause a phenotype similar to mouse Shh knockout). These findings illustrate the specific and conserved importance of WNT7A in multiple aspects of vertebrate limb development.

Mutations in WNT7A Cause a Range of Limb Malformations, Including Fuhrmann Syndrome and Al-Awadi/Raas-Rothschild/Schinzel Phocomelia Syndrome

PubMed Central

Woods, C. G.; Stricker, S.; Seemann, P.; Stern, R.; Cox, J.; Sherridan, E.; Roberts, E.; Springell, K.; Scott, S.; Karbani, G.; Sharif, S. M.; Toomes, C.; Bond, J.; Kumar, D.; Al-Gazali, L.; Mundlos, S.

2006-01-01

Fuhrmann syndrome and the Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndrome are considered to be distinct limb-malformation disorders characterized by various degrees of limb aplasia/hypoplasia and joint dysplasia in humans. In families with these syndromes, we found homozygous missense mutations in the dorsoventral-patterning gene WNT7A and confirmed their functional significance in retroviral-mediated transfection of chicken mesenchyme cell cultures and developing limbs. The results suggest that a partial loss of WNT7A function causes Fuhrmann syndrome (and a phenotype similar to mouse Wnt7a knockout), whereas the more-severe limb truncation phenotypes observed in Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndrome result from null mutations (and cause a phenotype similar to mouse Shh knockout). These findings illustrate the specific and conserved importance of WNT7A in multiple aspects of vertebrate limb development. PMID:16826533

[Implementation of control system and software design for limbs rehabilitation training based on PCI-1240].

PubMed

Zhu, Wenchao; Xu, Xiulin; Hu, Xiufang; An, Meijun

2017-06-01

This article presents the design of a motion control system for seated lower-limb rehabilitation training. The system is composed of lower limb exoskeleton, motor drive circuit, program of motion control, and so forth. The power of lower limbs joints is provided by six motors. The PCI-1240 motion control card is used as the core. This study achieved repetitive rotation training and gait trajectory training of lower limbs joints, of which the velocity, angle and time can be accurately controlled and adjusted. The experimental results showed that the motion control system can meet the requirement of repetitive rehabilitation training for patients with lower limb dysfunction. This article provides a new method to the research of motion control system in rehabilitation training, which can promote industrial automation technique to be used for health care, and conducive to the further study of the rehabilitation robot.

Upper extremity prosthesis user perspectives on unmet needs and innovative technology.

PubMed

Benz, Heather L; Jia Yao; Rose, Laura; Olgac, Okan; Kreutz, Karen; Saha, Anindita; Civillico, Eugene F

2016-08-01

The needs of individuals with upper limb amputation and congenital limb difference are not being fully met by current prostheses, as evidenced by prosthesis rejection, non-wear, and user reports of pain and challenging activities. Emerging technologies such as dexterous sensorized robotic limbs, osseointegrated prostheses, implantable EMG electrodes, and electrical stimulation for sensory feedback have the potential to address unmet needs, but pose additional risks. We plan to assess upper limb prosthesis user needs and perspectives on these new benefits and risks using an extensive quantitative survey. In preparation for this survey, we report here on qualitative interviews with seven individuals with upper limb amputation or congenital limb difference. Unstructured text was mined using topic modeling and the results compared with identified themes. A more complete understanding of how novel technologies could address real user concerns will inform implementation of new technologies and regulatory decision-making.

Upper Extremity Prosthesis User Perspectives on Unmet Needs and Innovative Technology

PubMed Central

Benz, Heather L.; Yao, Jia; Rose, Laura; Olgac, Okan; Kreutz, Karen; Saha, Anindita; Civillico, Eugene F.

2017-01-01

The needs of individuals with upper limb amputation and congenital limb difference are not being fully met by current prostheses, as evidenced by prosthesis rejection, non-wear, and user reports of pain and challenging activities. Emerging technologies such as dexterous sensorized robotic limbs, osseointegrated prostheses, implantable EMG electrodes, and electrical stimulation for sensory feedback have the potential to address unmet needs, but pose additional risks. We plan to assess upper limb prosthesis user needs and perspectives on these new benefits and risks using an extensive quantitative survey. In preparation for this survey, we report here on qualitative interviews with seven individuals with upper limb amputation or congenital limb difference. Unstructured text was mined using topic modeling and the results compared with identified themes. A more complete understanding of how novel technologies could address real user concerns will inform implementation of new technologies and regulatory decision-making. PMID:28268333

Environmental monitoring for the DOE coolside and LIMB demonstration extension projects

DOE Office of Scientific and Technical Information (OSTI.GOV)

White, T.; Contos, L.; Adams, L.

1992-03-01

The purpose of this document is to present environmental monitoring data collected during the US Department of Energy Limestone Injection Multistage Burner (DOE LIMB) Demonstration Project Extension at the Ohio Edison Edgewater Generating Station in Lorain, Ohio. The DOE project is an extension of the US Environmental Protection Agency's (EPA's) original LIMB Demonstration. The program is operated nuclear DOE's Clean Coal Technology Program of emerging clean coal technologies'' under the categories of in boiler control of oxides of sulfur and nitrogen'' as well as post-combustion clean-up.'' The objective of the LIMB program is to demonstrate the sulfur dioxide (SO{sub 2})more » and nitrogen oxide (NO{sub x}) emission reduction capabilities of the LIMB system. The LIMB system is a retrofit technology to be used for existing coal-fired boilers equipped with electrostatic precipitators (ESPs).« less

Environmental monitoring for the DOE coolside and LIMB demonstration extension projects. Final report, May--August 1991

DOE Office of Scientific and Technical Information (OSTI.GOV)

White, T.; Contos, L.; Adams, L.

1992-03-01

The purpose of this document is to present environmental monitoring data collected during the US Department of Energy Limestone Injection Multistage Burner (DOE LIMB) Demonstration Project Extension at the Ohio Edison Edgewater Generating Station in Lorain, Ohio. The DOE project is an extension of the US Environmental Protection Agency`s (EPA`s) original LIMB Demonstration. The program is operated nuclear DOE`s Clean Coal Technology Program of ``emerging clean coal technologies`` under the categories of ``in boiler control of oxides of sulfur and nitrogen`` as well as ``post-combustion clean-up.`` The objective of the LIMB program is to demonstrate the sulfur dioxide (SO{sub 2})more » and nitrogen oxide (NO{sub x}) emission reduction capabilities of the LIMB system. The LIMB system is a retrofit technology to be used for existing coal-fired boilers equipped with electrostatic precipitators (ESPs).« less

Glucose uptake and glycogen synthesis in muscles from immobilized limbs

NASA Technical Reports Server (NTRS)

Nicholson, W. F.; Watson, P. A.; Booth, F. W.

1984-01-01

Defects in glucose metabolism in muscles of immobilized limbs of mice were related to alterations in insulin binding, insulin responsiveness, glucose supply, and insulin activation of glycogen synthase. These were tested by in vitro methodology. A significant lessening in the insulin-induced maximal response of 2-deoxyglucose uptake into the mouse soleus muscle occurred between the 3rd and 8th h of limb immobilization, suggesting a decreased insulin responsiveness. Lack of change in the specific binding of insulin to muscles of 24-h immobilized limbs indicates that a change in insulin receptor number did not play a role in the failure of insulin to stimulate glucose metabolism. Its inability to stimulate glycogen synthesis in muscle from immobilized limbs is due, in part, to a lack of glucose supply to glycogen synthesis and also to the ineffectiveness of insulin to increase the percentage of glycogen synthase in its active form in muscles from 24-h immobilized limbs.

Determinants of midterm functional outcomes, wound healing, and resources used in a hospital-based limb preservation program.

PubMed

Ramanan, Bala; Ahmed, Ayman; Wu, Bian; Causey, Marlin W; Gasper, Warren J; Vartanian, Shant M; Reyzelman, Alexander M; Hiramoto, Jade S; Conte, Michael S

2017-12-01

The objective of this study was to assess midterm functional status, wound healing, and in-hospital resource use among a prospective cohort of patients treated in a tertiary hospital, multidisciplinary Center for Limb Preservation. Data were prospectively gathered on all consecutive admissions to the Center for Limb Preservation from July 2013 to October 2014 with follow-up data collection through January 2016. Limbs were staged using the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) threatened limb classification scheme at the time of hospital admission. Patients with nonatherosclerotic vascular disorders, acute limb ischemia, and trauma were excluded. The cohort included 128 patients with 157 threatened limbs; 8 limbs with unstageable disease were excluded. Mean age (±standard deviation [SD]) was 66 (±13) years, and median follow-up duration (interquartile range) was 395 (80-635) days. Fifty percent (n = 64/128) of patients were readmitted at least once, with a readmission rate of 20% within 30 days of the index admission. Mean total number of admissions per patient (±SD) was 1.9 ± 1.2, with mean (±SD) cumulative length of stay (cLOS) of 17.1 (±17.9) days. During follow-up, 25% of limbs required a vascular reintervention, and 45% developed recurrent wounds. There was no difference in the rate of readmission, vascular reintervention, or wound recurrence by initial WIfI stage (P > .05). At the end of the study period, 23 (26%) were alive and nonambulatory; in 20%, functional status was missing. On both univariate and multivariate analysis, end-stage renal disease and prior functional status predicted ability to ambulate independently (P < .05). WIfI stage was associated with major amputation (P = .01) and cLOS (P = .002) but not with time to wound healing. Direct hospital (inpatient) cost per limb saved was significantly higher in stage 4 patients (P < .05 for all time periods). WIfI stage was associated with cumulative in-hospital costs at 1 year and for the overall follow-up period. Among a population of patients admitted to a tertiary hospital limb preservation service, WIfI stage was predictive of midterm freedom from amputation, cLOS, and hospital costs but not of ambulatory functional status, time to wound healing, or wound recurrence. Patients presenting with limb-threatening conditions require significant inpatient care, have a high frequency of repeated hospitalizations, and are at significant risk for recurrent wounds and leg symptoms at later times. Stage 4 patients require the most intensive care and have the highest initial and aggregate hospital costs per limb saved. However, limb salvage can be achieved in these patients with a dedicated multidisciplinary team approach. Published by Elsevier Inc.

Vertical Distribution of Aerosols and Water Vapor Using CRISM Limb Observations

NASA Astrophysics Data System (ADS)

Smith, M. D.; Wolff, M. J.; Clancy, R. T.; CRISM Science; Operations Teams

2011-12-01

Near-infrared spectra taken in a limb-viewing geometry by the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) on-board the Mars Reconnaissance Orbiter (MRO) provide a useful tool for probing atmospheric structure. Specifically, the observed radiance as a function of wavelength and height above the limb allows the vertical distribution of both dust and ice aerosols to be retrieved. These data serve as an important supplement to the aerosol profiling provided by the MRO/MCS instrument allowing independent validation and giving additional information on particle physical and scattering properties through multi-wavelength studies. A total of at least ten CRISM limb observations have been taken so far covering a full Martian year. Each set of limb observations nominally contains about four dozen scans across the limb giving pole-to-pole coverage for two orbits at roughly 100 and 290 W longitude over the Tharsis and Syrtis/Hellas regions, respectively. At each longitude, limb scans are spaced roughly 10 degrees apart in latitude, with a vertical spatial resolution on the limb of roughly 800 m. Radiative transfer modeling is used to model the observations. We compute synthetic CRISM limb spectra using a discrete-ordinates radiative transfer code that accounts for multiple scattering from aerosols and accounts for spherical geometry of the limb observations by integrating the source functions along curved paths in that coordinate system. Retrieved are 14-point vertical profiles for dust and water ice aerosols with resolution of 0.4 scale heights between one and six scale heights above the surface. After the aerosol retrieval is completed, the abundances of CO2 (or surface pressure) and H2O gas are retrieved by matching the depth of absorption bands at 2000 nm for carbon dioxide and at 2600 nm for water vapor. In addition to the column abundance of water vapor, limited information on its vertical structure can also be retrieved depending on the signal available from aerosol scattering. Significant differences are seen in the retrieved vertical profiles of dust and water ice as a function of season. Dust typically extends to higher altitudes during the perihelion season. Ice aerosols are often observed to cap the dust layer during all seasons. Water vapor is observed to be deeply mixed in the perihelion season and confined near the surface in the aphelion season. The CRISM limb-geometry observations support the quantitative retrieval of aerosol and gas vertical profiles. These quantities cannot be retrieved using nadir observations, and they enable the study of important new science questions. The CRISM limbs also serve as a valuable supplement to the MRO/MCS limb profiles, enabling validation and multi-wavelength comparisons. Additional CRISM limb-geometry sets will continue to be taken approximately every two months (~30 degrees of Ls) as operations allow.

Functional expansion of sensorimotor representation and structural reorganization of callosal connections in lower limb amputees.

PubMed

Simões, Elington L; Bramati, Ivanei; Rodrigues, Erika; Franzoi, Ana; Moll, Jorge; Lent, Roberto; Tovar-Moll, Fernanda

2012-02-29

Previous studies have indicated that amputation or deafferentation of a limb induces functional changes in sensory (S1) and motor (M1) cortices, related to phantom limb pain. However, the extent of cortical reorganization after lower limb amputation in patients with nonpainful phantom phenomena remains uncertain. In this study, we combined functional magnetic resonance (fMRI) and diffusion tensor imaging (DTI) to investigate the existence and extent of cortical and callosal plasticity in these subjects. Nine "painless" patients with lower limb amputation and nine control subjects (sex- and age-matched) underwent a 3-T MRI protocol, including fMRI with somatosensory stimulation. In amputees, we observed an expansion of activation maps of the stump in S1 and M1 of the deafferented hemisphere, spreading to neighboring regions that represent the trunk and upper limbs. We also observed that tactile stimulation of the intact foot in amputees induced a greater activation of ipsilateral S1, when compared with controls. These results demonstrate a functional remapping of S1 in lower limb amputees. However, in contrast to previous studies, these neuroplastic changes do not appear to be dependent on phantom pain but do also occur in those who reported only the presence of phantom sensation without pain. In addition, our findings indicate that amputation of a limb also induces changes in the cortical representation of the intact limb. Finally, DTI analysis showed structural changes in the corpus callosum of amputees, compatible with the hypothesis that phantom sensations may depend on inhibitory release in the sensorimotor cortex.

Whole limb kinematics are preferentially conserved over individual joint kinematics after peripheral nerve injury

PubMed Central

Chang, Young-Hui; Auyang, Arick G.; Scholz, John P.; Nichols, T. Richard

2009-01-01

Summary Biomechanics and neurophysiology studies suggest whole limb function to be an important locomotor control parameter. Inverted pendulum and mass-spring models greatly reduce the complexity of the legs and predict the dynamics of locomotion, but do not address how numerous limb elements are coordinated to achieve such simple behavior. As a first step, we hypothesized whole limb kinematics were of primary importance and would be preferentially conserved over individual joint kinematics after neuromuscular injury. We used a well-established peripheral nerve injury model of cat ankle extensor muscles to generate two experimental injury groups with a predictable time course of temporary paralysis followed by complete muscle self-reinnervation. Mean trajectories of individual joint kinematics were altered as a result of deficits after injury. By contrast, mean trajectories of limb orientation and limb length remained largely invariant across all animals, even with paralyzed ankle extensor muscles, suggesting changes in mean joint angles were coordinated as part of a long-term compensation strategy to minimize change in whole limb kinematics. Furthermore, at each measurement stage (pre-injury, paralytic and self-reinnervated) step-by-step variance of individual joint kinematics was always significantly greater than that of limb orientation. Our results suggest joint angle combinations are coordinated and selected to stabilize whole limb kinematics against short-term natural step-by-step deviations as well as long-term, pathological deviations created by injury. This may represent a fundamental compensation principle allowing animals to adapt to changing conditions with minimal effect on overall locomotor function. PMID:19837893

Scintigraphic Tracking of Allogeneic Mesenchymal Stem Cells in the Distal Limb After Intra-Arterial Injection in Standing Horses.

PubMed

Espinosa, Pablo; Spriet, Mathieu; Sole, Albert; Walker, Naomi J; Vaughan, Betsy; Galuppo, Larry D

2016-07-01

To assess the feasibility of intra-arterial administration of allogeneic mesenchymal stem cells (MSC) in the median artery of standing horses and evaluate the distribution and retention of radiolabeled cells. In vivo experimental study. Six research horses. Technetium(99m) -HexaMethyl-Propylene-Amine Oxime-labeled MSC were injected under ultrasound guidance in the median artery of 6 front limbs of 3 horses, standing under sedation. Scintigraphic images were obtained at the time of injection, and at 1, 6, and 24 hours postinjection. Six additional limbs from 3 horses were similarly injected with unlabeled MSC. Ultrasound was performed the following day for assessment of vascular changes. Intra-arterial injection was performed successfully in 11 of 12 limbs. In 1 limb, partial periarterial injection compromised the success of the procedure. Homogeneous distribution of radiolabeled MSC was observed through the entire distal limb, including within the hoof. Partial venous thrombosis was found in both groups of horses, but was subjectively less severe in horses injected with unlabeled MSC. No lameness was observed. Transient swelling of the distal limb occurred in only 1 limb. Intra-arterial injection of MSC can be performed in standing horses under sedation and successfully distribute MSC to the distal limb. A risk of periarterial injection was identified but can be reduced with proper sedation, local anesthesia, and increased experience. Partial venous thrombosis was observed as a complication, but did not cause changes of clinical importance, other than rare transient swelling. © Copyright 2016 by The American College of Veterinary Surgeons.

Failure to activate the in-hospital emergency team: causes and outcomes.

PubMed

Barbosa, Vera; Gomes, Ernestina; Vaz, Senio; Azevedo, Gustavo; Fernandes, Gonçalo; Ferreira, Amélia; Araujo, Rui

2016-01-01

To determine the incidence of afferent limb failure of the in-hospital Medical Emergency Team, characterizing it and comparing the mortality between the population experiencing afferent limb failure and the population not experiencing afferent limb failure. A total of 478 activations of the Medical Emergency Team of Hospital Pedro Hispano occurred from January 2013 to July 2015. A sample of 285 activations was obtained after excluding incomplete records and activations for patients with less than 6 hours of hospitalization. The sample was divided into two groups: the group experiencing afferent limb failure and the group not experiencing afferent limb failure of the Medical Emergency Team. Both populations were characterized and compared. Statistical significance was set at p ≤ 0.05. Afferent limb failure was observed in 22.1% of activations. The causal analysis revealed significant differences in Medical Emergency Team activation criteria (p = 0.003) in the group experiencing afferent limb failure, with higher rates of Medical Emergency Team activation for cardiac arrest and cardiovascular dysfunction. Regarding patient outcomes, the group experiencing afferent limb failure had higher immediate mortality rates and higher mortality rates at hospital discharge, with no significant differences. No significant differences were found for the other parameters. The incidence of cardiac arrest and the mortality rate were higher in patients experiencing failure of the afferent limb of the Medical Emergency Team. This study highlights the need for health units to invest in the training of all healthcare professionals regarding the Medical Emergency Team activation criteria and emergency medical response system operations.

Propulsion and braking in the study of asymmetry in able-bodied men's gaits.

PubMed

Potdevin, François; Gillet, Christophe; Barbier, Franck; Coello, Yann; Moretto, Pierre

2008-12-01

The present study was designed to test functional differences between both lower limbs in able-bodied gait according to fore-aft force impulse analyses and to assess the existence of a preferential lower limb for forward propulsion and braking. The leg that did more of the braking (Most Braking Limb) and the leg that did more of the propulsion (Most Propulsive Limb) were defined by the higher negative and positive impulses calculated from the anterior-posterior component of the ground reaction force. 24 adult men free of pain and injury to their lower extremities (M age =25.9 yr., SD=4.5) performed 10 walking trials on a 10-m walkway with two force plates flush mounted in the middle. The anterior-posterior component of the velocity of the center of mass (V(AP)) was calculated with the VICON system. Results highlighted two forms of asymmetry behaviour: although significant bilateral differences between the legs concerning the propulsive and braking impulses were found in all participants, 70.8% of the participants displayed a different Most Braking Limb than Most Propulsive Limb, whereas 25% used the same leg to produce both more propulsion and braking. High consistency was found in the behavioural strategy. Bilateral differences in V(AP) according to the gait cycle (Most Propulsive Limb vs Most Braking Limb) suggested a functional division of tasks between the two lower limbs for 70.8% of the participants. The study provides support for the relevancy of a functional categorization to highlight different asymmetry strategies in able-bodied gait.

Lower extremity sagittal joint moment production during split-belt treadmill walking

PubMed Central

Roemmich, Ryan T.; Stegemöller, Elizabeth L.; Hass, Chris J.

2012-01-01

The split-belt treadmill (SBT) has recently been used to rehabilitate locomotor asymmetries in clinical populations. However, the joint mechanics produced while walking on a SBT are not well-understood. The purpose of this study was to investigate the lower extremity sagittal joint moments produced by each limb during SBT walking and provide insight as to how these joint moment patterns may be useful in rehabilitating unilateral gait deficits. Thirteen healthy young volunteers walked on the SBT with the belts tied and in a “SPLIT” session in which one belt moved twice as fast as the other. Sagittal lower extremity joint moment and ground reaction force impulses were then calculated over the braking and propulsive phases of the gait cycle. Paired t-tests were performed to analyze magnitude differences between conditions (i.e. the fast and slow limbs during SPLIT vs. the same limb during tied-belt walking) and between the fast and slow limbs during SPLIT. During the SPLIT session, the fast limb produced higher ground reaction force and ankle moment impulses during the propulsive and braking phases, and lower knee moment impulses during the propulsive phase when compared to the slow limb. The knee moment impulse was also significantly higher during braking in the slow limb than in the fast limb. The mechanics of each limb during the SPLIT session also differed from the mechanics observed when the belt speeds were tied. Based on these findings, we suggest that each belt may have intrinsic value in rehabilitating specific unilateral locomotor deficits. PMID:22985473

Conditional inactivation of Has2 reveals a crucial role for hyaluronan in skeletal growth, patterning, chondrocyte maturation and joint formation in the developing limb.

PubMed

Matsumoto, Kazu; Li, Yingcui; Jakuba, Caroline; Sugiyama, Yoshinori; Sayo, Tetsuya; Okuno, Misako; Dealy, Caroline N; Toole, Bryan P; Takeda, Junji; Yamaguchi, Yu; Kosher, Robert A

2009-08-01

The glycosaminoglycan hyaluronan (HA) is a structural component of extracellular matrices and also interacts with cell surface receptors to directly influence cell behavior. To explore functions of HA in limb skeletal development, we conditionally inactivated the gene for HA synthase 2, Has2, in limb bud mesoderm using mice that harbor a floxed allele of Has2 and mice carrying a limb mesoderm-specific Prx1-Cre transgene. The skeletal elements of Has2-deficient limbs are severely shortened, indicating that HA is essential for normal longitudinal growth of all limb skeletal elements. Proximal phalanges are duplicated in Has2 mutant limbs indicating an involvement of HA in patterning specific portions of the digits. The growth plates of Has2-deficient skeletal elements are severely abnormal and disorganized, with a decrease in the deposition of aggrecan in the matrix and a disruption in normal columnar cellular relationships. Furthermore, there is a striking reduction in the number of hypertrophic chondrocytes and in the expression domains of markers of hypertrophic differentiation in the mutant growth plates, indicating that HA is necessary for the normal progression of chondrocyte maturation. In addition, secondary ossification centers do not form in the central regions of Has2 mutant growth plates owing to a failure of hypertrophic differentiation. In addition to skeletal defects, the formation of synovial joint cavities is defective in Has2-deficient limbs. Taken together, our results demonstrate that HA has a crucial role in skeletal growth, patterning, chondrocyte maturation and synovial joint formation in the developing limb.

Gender differences in limited duty time for lower limb injury.

PubMed

Holsteen, K K; Choi, Y S; Bedno, S A; Nelson, D A; Kurina, L M

2018-02-16

Among active-duty military personnel, lower limb musculoskeletal injuries and related conditions (injuries) frequently arise as unintended consequences of physical training. These injuries are particularly common among women. The practical impact of such injuries on temporary military occupational disability has not been estimated with precision on a large scale. To determine the proportion of service time compromised by limited duty days attributable to lower limb injuries, characterize the time affected by these limitations in terms of specific lower limb region and compare the limited duty time between male and female soldiers. Administrative data and individual limited duty assignments (profiles) were obtained for active-duty US Army personnel who served in 2014. Lower limb injury-related profiles were used to calculate the percent of person-time requiring duty limitations by gender and body region. The study group was 568 753 soldiers of whom 14% were women. Nearly 13% of service days for active-duty US Army soldiers required limited duty for lower limb injuries during 2014. Knee injuries were responsible for 45% of those days. Within integrated military occupations, female soldiers experienced 27-57% more time on limited duty for lower limb injuries compared with men. The substantial amount of limited duty for lower limb musculoskeletal injuries among soldiers highlights the need for improvement in training-related injury screening, prevention and timely treatment with particular attention to knee injuries. The excessive impact of lower limb injuries on female soldiers' occupational functions should be a surveillance priority in the current environment of expanding gender-integrated training. Published by Oxford University Press on behalf of The Society of Occupational Medicine 2017.

Predictive Value of Upper Limb Muscles and Grasp Patterns on Functional Outcome in Cervical Spinal Cord Injury.

PubMed

Velstra, Inge-Marie; Bolliger, Marc; Krebs, Jörg; Rietman, Johan S; Curt, Armin

2016-05-01

To determine which single or combined upper limb muscles as defined by the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI); upper extremity motor score (UEMS) and the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), best predict upper limb function and independence in activities of daily living (ADLs) and to assess the predictive value of qualitative grasp movements (QlG) on upper limb function in individuals with acute tetraplegia. As part of a Europe-wide, prospective, longitudinal, multicenter study ISNCSCI, GRASSP, and Spinal Cord Independence Measure (SCIM III) scores were recorded at 1 and 6 months after SCI. For prediction of upper limb function and ADLs, a logistic regression model and unbiased recursive partitioning conditional inference tree (URP-CTREE) were used. Results: Logistic regression and URP-CTREE revealed that a combination of ISNCSCI and GRASSP muscles (to a maximum of 4) demonstrated the best prediction (specificity and sensitivity ranged from 81.8% to 96.0%) of upper limb function and identified homogenous outcome cohorts at 6 months. The URP-CTREE model with the QlG predictors for upper limb function showed similar results. Prediction of upper limb function can be achieved through a combination of defined, specific upper limb muscles assessed in the ISNCSCI and GRASSP. A combination of a limited number of proximal and distal muscles along with an assessment of grasping movements can be applied for clinical decision making for rehabilitation interventions and clinical trials. © The Author(s) 2015.

ATHLETE: Lunar Cargo Unloading from a High Deck

NASA Technical Reports Server (NTRS)

Wilcox, Brian H.

2010-01-01

As part of the NASA Exploration Technology Development Program, the Jet Propulsion Laboratory is developing a vehicle called ATHLETE: the All-Terrain Hex-Limbed Extra-Terrestrial Explorer. Each vehicle is based on six wheels at the ends of six multi-degree-of freedom limbs. Because each limb has enough degrees of freedom for use as a general-purpose leg, the wheels can be locked and used as feet to walk out of excessively soft or other extreme terrain. Since the vehicle has this alternative mode of traversing through or at least out of extreme terrain, the wheels and wheel actuators can be sized for nominal terrain. There are substantial mass savings in the wheel and wheel actuators associated with designing for nominal instead of extreme terrain. These mass savings are at least comparable-to or larger-than the extra mass associated with the articulated limbs. As a result, the entire mobility system, including wheels and limbs, can be lighter than a conventional all-terrain mobility chassis. A side benefit of this approach is that each limb has sufficient degrees-of freedom to be used as a general-purpose manipulator (hence the name "limb" instead of "leg"). Our prototype ATHLETE vehicles have quick-disconnect tool adapters on the limbs that allow tools to be drawn out of a "tool belt" and maneuvered by the limb. A power-take-off from the wheel actuates the tools, so that they can take advantage of the 1+ horsepower motor in each wheel to enable drilling, gripping or other power-tool functions.

ATHLETE: a Cargo and Habitat Transporter for the Moon

NASA Technical Reports Server (NTRS)

Wilcox, Brian H.

2009-01-01

As part of the NASA Exploration Technology Development Program, the Jet Propulsion Laboratory is developing a vehicle called ATHLETE: the All-Terrain Hex-Limbed Extra-Terrestrial Explorer. The vehicle concept is based on six wheels at the ends of six multi-degree-of-freedom limbs. Because each limb has enough degrees of freedom for use as a general-purpose leg, the wheels can be locked and used as feet to walk out of excessively soft or other extreme terrain. Since the vehicle has this alternative mode of traversing through (or at least out of) extreme terrain, the wheels and wheel actuators can be sized only for nominal terrain. There are substantial mass savings in the wheels and wheel actuators associated with designing for nominal instead of extreme terrain. These mass savings are comparable-to or larger-than the extra mass associated with the articulated limbs. As a result, the entire mobility system, including wheels and limbs, can be about 25 percent lighter than a conventional mobility chassis for planetary exploration. A side benefit of this approach is that each limb has sufficient degrees-of-freedom for use as a general-purpose manipulator (hence the name "limb" instead of "leg"). Our prototype ATHLETE vehicles have quick-disconnect tool adapters on the limbs that allow tools to be drawn out of a "tool belt" and maneuvered by the limb. A rotating power-take-off from the wheel actuates the tools, so that they can take advantage of the 1-plus-horsepower motor in each wheel to enable drilling, gripping or other power-tool functions.

Molecular anatomy of the developing limb in the coquí frog, Eleutherodactylus coqui.

PubMed

Gross, Joshua B; Kerney, Ryan; Hanken, James; Tabin, Clifford J

2011-01-01

The vertebrate limb demonstrates remarkable similarity in basic organization across phylogenetically disparate groups. To gain further insight into how this morphological similarity is maintained in different developmental contexts, we explored the molecular anatomy of size-reduced embryos of the Puerto Rican coquí frog, Eleutherodactylus coqui. This animal demonstrates direct development, a life-history strategy marked by rapid progression from egg to adult and absence of a free-living, aquatic larva. Nonetheless, coquí exhibits a basal anuran limb structure, with four toes on the forelimb and five toes on the hind limb. We investigated the extent to which coquí limb bud development conforms to the model of limb development derived from amniote studies. Toward this end, we characterized dynamic patterns of expression for 13 critical patterning genes across three principle stages of limb development. As expected, most genes demonstrate expression patterns that are essentially unchanged compared to amniote species. For example, we identified an EcFgf8-expression domain within the apical ectodermal ridge (AER). This expression pattern defines a putatively functional AER signaling domain, despite the absence of a morphological ridge in coquí embryos. However, two genes, EcMeis2 and EcAlx4, demonstrate altered domains of expression, which imply a potential shift in gene function between coquí frogs and amniote model systems. Unexpectedly, several genes thought to be critical for limb patterning in other systems, including EcFgf4, EcWnt3a, EcWnt7a, and EcGremlin, demonstrated no evident expression pattern in the limb at the three stages we analyzed. The absence of EcFgf4 and EcWnt3a expression during limb patterning is perhaps not surprising, given that neither gene is critical for proper limb development in the mouse, based on knockout and expression analyses. In contrast, absence of EcWnt7a and EcGremlin is surprising, given that expression of these molecules appears to be absolutely essential in all other model systems so far examined. Although this analysis substantiates the existence of a core set of ancient limb-patterning molecules, which likely mediate identical functions across highly diverse vertebrate forms, it also reveals remarkable evolutionary flexibility in the genetic control of a conserved morphological pattern across evolutionary time. © 2011 Wiley Periodicals, Inc.

[Domestic external fixator application in the treatment of limb deformities: 7 289 cases application report].

PubMed

Qin, S H; Guo, B F; Zheng, X J; Jiao, S F; Xia, H T; Peng, A M; Pan, Q; Zang, J C; Wang, Z J

2017-09-01

Objective: To discuss the clinical application and effects of domestic external fixator in the treatment of patients with malformations of limbs. Methods: A total of 7 289 patients with malformation of limbs who had been operated in Qin Sihe orthopedic surgery team from January 1989 to June 2016 were retrospective analyzed. The patients were treated with domestic external fixator, including 4 033 males and 3 256 females, aging from 2 to 82 years with a mean age of 23.4 years. There were 2 732 patients using Ilizarov external fixator, 4 713 patients using hybrid external fixator, 57 patients using monobrachial external fixator, 232 patients using Ilizarov external fixator and hybrid external fixator. The Ilizarov, hybrid and monobrachial external fixator were used in 67, 65 and 0 patients on the upper limbs and in 2 665, 4 616 and 57 patients on the lower limbs. There were 3 028 patients operated on the left limbs, 3 260 patients operated on the right limbs and 1 001 patients operated on the bilateral limbs. The top three types of diseases were sequelae of poliomyelitis, cerebral palsy and post-traumatic stress disorder peromely. Deformity types inclued talipes equinovarus, knee flexion deformity, cavus foot and so on. Results: All the patients were followed up for a period of 2.5 months to 22.4 years, with an average follow-up time of 5.4 years. All of the external fixators were used for single once, and there was no substitute for external fixator quality problem. All the patients were completed surgery goal until removing external fixation except 1 patient gave up treatment and 1 removed the fixator because of metal allergy. The common complications included wire or pin infection and joint movement limitation and so on. Conclusions: The domestic external fixator developed and produced based on the characteristics of Chinese limb deformity disability. The domestic external fixator can be used to treat kinds of limb deformities with the advantages of practical, economical, adjustable, universal and portable. The domestic external fixator could meet the clinical demand for fixation of the osteotomy end of the limbs, the correction of the deformity, the repair of the defects and the limb lengthening.

Vertical distribution of Martian aerosols from SPICAM/Mars-Express limb observations

NASA Astrophysics Data System (ADS)

Fedorova, A.; Korablev, O.; Bertaux, J.-L.; Rodin, A.; Perrier, S.; Moroz, V. I.

Limb spectroscopic observations provide invaluable information about vertical distribution of main atmospheric components in the Martian atmosphere, in particular vertical distribution and structure of aerosols, which play an important role in the heat balance of the planet. Only limited set of successful limb spectroscopic observations have been carried out on Mars so far, including those by MGS/TES spectrometer and Thermoscan and Auguste experiments of Phobos mission. Currently SPICAM instrument onboard Mars-Express spacecraft has accomplished several sequences of limb observations. First analysis of limb sounding data received by SPICAM IR and UV channels, which imply the presence of fine, deep, optically thin aerosol fraction extended over broad range of altitudes, is presented.

Cortical motor activity and reorganization following upper-limb amputation and subsequent targeted reinnervation.

PubMed

Chen, Albert; Yao, Jun; Kuiken, Todd; Dewald, Julius P A

2013-01-01

Previous studies have postulated that the amount of brain reorganization following peripheral injuries may be correlated with negative symptoms or consequences. However, it is unknown whether restoring effective limb function may then be associated with further changes in the expression of this reorganization. Recently, targeted reinnervation (TR), a surgical technique that restores a direct neural connection from amputated sensorimotor nerves to new peripheral targets such as muscle, has been successfully applied to upper-limb amputees. It has been shown to be effective in restoring both peripheral motor and sensory functions via the reinnervated nerves as soon as a few months after the surgery. However, it was unclear whether TR could also restore normal cortical motor representations for control of the missing limb. To answer this question, we used high-density electroencephalography (EEG) to localize cortical activity related to cued motor tasks generated by the intact and missing limb. Using a case study of 3 upper-limb amputees, 2 of whom went through pre and post-TR experiments, we present unique quantitative evidence for the re-mapping of motor representations for the missing limb closer to their original locations following TR. This provides evidence that an effective restoration of peripheral function from TR can be linked to the return of more normal cortical expression for the missing limb. Therefore, cortical mapping may be used as a potential guide for monitoring rehabilitation following peripheral injuries.

Five-Strand versus Four-Strand Hamstring Tendon Graft Technique for Anterior Cruciate Ligament Reconstruction: A Biomechanical Comparison.

PubMed

Vaillant, Eric R; Parks, Brent G; Camire, Lyn M; Hinton, Richard Y

2017-11-01

The aim of this article is to compare diameter and stiffness, displacement, and strain in a five-strand versus four-strand hamstring graft for anterior cruciate ligament reconstruction. Eight matched pairs of lower extremities underwent four-strand or five-strand hamstring graft reconstruction. Diameter was significantly higher in the five-strand versus the four-strand construct ( p  = 0.002). No significant difference was found between the groups in construct displacement or stiffness. Significantly higher strain was observed in the inner limb versus the outer limb in the four-strand construct ( p  = 0.001) and in the inner limb versus the fifth limb in the 5-strand construct ( p  = 0.004). A fifth limb added to a four-strand hamstring graft significantly increased graft diameter but did not significantly change stiffness or displacement, suggesting that attachment of additional graft material via suture did not provide for full incorporation of the added limb into the graft at time zero. The inner limb in both constructs absorbed significantly greater load than did other limbs. The use of suture to attach additional material to a four-strand hamstring graft may not contribute to improved biomechanical qualities of the graft at time zero. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Push-off reactions in recovery after tripping discriminate young subjects, older non-fallers and older fallers.

PubMed

Pijnappels, Mirjam; Bobbert, Maarten F; van Dieën, Jaap H

2005-06-01

Tripping is a major cause for falls, especially in the elderly. This study investigated whether falls in the elderly can be attributed to inadequate push-off reactions by the support limb in the recovery after a trip. Twelve young (20-34 years) and eleven older (65-72 years) men and women walked over a platform and were tripped several times over an obstacle that suddenly appeared from the floor. Kinematics and ground reactions forces of the support limb during push-off were measured of falls and successful recoveries. Young subjects did not fall. The older subjects were divided into a group of four non-fallers and seven fallers. Older fallers showed insufficient reduction of the angular momentum during push-off and less proper placement of the recovery limb. This was due to a lower rate of change of moment generation in all support limb joints and a lower peak ankle moment. Onset of knee moment generation was slightly delayed in older fallers. Improvement over trials was ascribed to better positioning of the recovery limb, as no clear differences were seen in the joint moments of the support limb. In conclusion, the contribution of the support limb to prevent a fall after tripping is decreased in older adults. Lower limb strength could be an underlying factor and strength training might help to reduce fall risk.

The impact of lower limb chronic oedema on patients' quality of life.

PubMed

Greene, Adelene; Meskell, Pauline

2017-06-01

This study aimed to explore patients' perceptions regarding the impact that lower limb chronic oedema has on their quality of life (QoL). A quantitative descriptive design was used to collect data from patients with lower limb chronic oedema. A condition-specific validated questionnaire was distributed to a purposive sample (n = 122) through manual lymphatic drainage/vascular/health clinics in Ireland. Results indicated that patients with lower limb chronic oedema experience a wide range of physical problems such as limb heaviness (74%, n = 66), weakness (44%, n = 40) and pain (38%, n = 34). Additionally, difficulties with walking (53%, n = 48), standing (51%, n = 46) and bending (45%, n = 40) were reported. Concerns regarding poor body image were strongly evident (76%, n = 68). Difficulties finding clothing/footwear to fit oedematous limb(s) were reported (59%, n = 53), in addition to finding clothes that participants would like to wear (64%, n = 58). Emotional symptoms of irritability (42%, n = 38), anxiety (41%, n = 37) and tension (40%, n = 36) were reported. Over half of the participants (55%, n = 49) stated that their chronic swelling affected their social functioning and their ability to engage in leisure activities. This study has identified that lower limb chronic oedema has significant psychological, social and physical implications for persons' QoL. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Gender related Long-term Differences after Open Infrainguinal Surgery for Critical Limb Ischemia.

PubMed

Lejay, A; Schaeffer, M; Georg, Y; Lucereau, B; Roussin, M; Girsowicz, E; Delay, C; Schwein, A; Thaveau, F; Geny, B; Chakfe, N

2015-10-01

The role of gender on long-term infrainguinal open surgery outcomes still remains uncertain in critical limb ischemia patients. The aim of this study is to evaluate the gender-specific differences in patient characteristics and long-term clinical outcomes in terms of survival, primary patency and limb salvage among patients undergoing infrainguinal open surgery for CLI. All consecutive patients undergoing infrainguinal open surgery for critical limb ischemia between 2003 and 2012 were included. Survival, limb salvage and primary patency rates were assessed. Independent outcome determinants were identified by the Cox proportional hazard ratio using age and gender as adjustment factors. 584 patients (269 women and 315 men, mean age 76 and 71 years respectively) underwent 658 infrainguinal open surgery (313 in women and 345 in men). Survival rate at 6 years was lower among women compared to men with 53.5% vs 70.9% (p < 0.001). The same applied to primary patency (35.9% vs 52.4%, p < 0.001) and limb salvage (54.3% vs 81.1%, p < 0.001) at 6 years. Female-gender was an independent factor predicting death (hazard ratio 1.50), thrombosis (hazard ratio 2.37) and limb loss (hazard ratio 7.05) in age and gender-adjusted analysis. Gender-related disparity in critical limb ischemia open surgical revascularization outcomes still remains. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Steady state temperature distribution in dermal regions of an irregular tapered shaped human limb with variable eccentricity.

PubMed

Agrawal, M; Pardasani, K R; Adlakha, N

2014-08-01

The investigators in the past have developed some models of temperature distribution in the human limb assuming it as a regular circular or elliptical tapered cylinder. But in reality the limb is not of regular tapered cylindrical shape. The radius and eccentricity are not same throughout the limb. In view of above a model of temperature distribution in the irregular tapered elliptical shaped human limb is proposed for a three dimensional steady state case in this paper. The limb is assumed to be composed of multiple cylindrical substructures with variable radius and eccentricity. The mathematical model incorporates the effect of blood mass flow rate, metabolic activity and thermal conductivity. The outer surface is exposed to the environment and appropriate boundary conditions have been framed. The finite element method has been employed to obtain the solution. The temperature profiles have been computed in the dermal layers of a human limb and used to study the effect of shape, microstructure and biophysical parameters on temperature distribution in human limbs. The proposed model is one of the most realistic model as compared to conventional models as this can be effectively employed to every regular and nonregular structures of the body with variable radius and eccentricity to study the thermal behaviour. Copyright © 2014 Elsevier Ltd. All rights reserved.

The axolotl limb blastema: cellular and molecular mechanisms driving blastema formation and limb regeneration in tetrapods

PubMed Central

McCusker, Catherine; Bryant, Susan V.

2015-01-01

Abstract The axolotl is one of the few tetrapods that are capable of regenerating complicated biological structures, such as complete limbs, throughout adulthood. Upon injury the axolotl generates a population of regeneration‐competent limb progenitor cells known as the blastema, which will grow, establish pattern, and differentiate into the missing limb structures. In this review we focus on the crucial early events that occur during wound healing, the neural−epithelial interactions that drive the formation of the early blastema, and how these mechanisms differ from those of other species that have restricted regenerative potential, such as humans. We also discuss how the presence of cells from the different axes of the limb is required for the continued growth and establishment of pattern in the blastema as described in the polar coordinate model, and how this positional information is reprogrammed in blastema cells during regeneration. Multiple cell types from the mature limb stump contribute to the blastema at different stages of regeneration, and we discuss the contribution of these types to the regenerate with reference to whether they are “pattern‐forming” or “pattern‐following” cells. Lastly, we explain how an engineering approach will help resolve unanswered questions in limb regeneration, with the goal of translating these concepts to developing better human regenerative therapies. PMID:27499868

Lmx1b-targeted cis-regulatory modules involved in limb dorsalization.

PubMed

Haro, Endika; Watson, Billy A; Feenstra, Jennifer M; Tegeler, Luke; Pira, Charmaine U; Mohan, Subburaman; Oberg, Kerby C

2017-06-01

Lmx1b is a homeodomain transcription factor responsible for limb dorsalization. Despite striking double-ventral (loss-of-function) and double-dorsal (gain-of-function) limb phenotypes, no direct gene targets in the limb have been confirmed. To determine direct targets, we performed a chromatin immunoprecipitation against Lmx1b in mouse limbs at embryonic day 12.5 followed by next-generation sequencing (ChIP-seq). Nearly 84% ( n =617) of the Lmx1b-bound genomic intervals (LBIs) identified overlap with chromatin regulatory marks indicative of potential cis -regulatory modules (PCRMs). In addition, 73 LBIs mapped to CRMs that are known to be active during limb development. We compared Lmx1b-bound PCRMs with genes regulated by Lmx1b and found 292 PCRMs within 1 Mb of 254 Lmx1b-regulated genes. Gene ontological analysis suggests that Lmx1b targets extracellular matrix production, bone/joint formation, axonal guidance, vascular development, cell proliferation and cell movement. We validated the functional activity of a PCRM associated with joint-related Gdf5 that provides a mechanism for Lmx1b-mediated joint modification and a PCRM associated with Lmx1b that suggests a role in autoregulation. This is the first report to describe genome-wide Lmx1b binding during limb development, directly linking Lmx1b to targets that accomplish limb dorsalization. © 2017. Published by The Company of Biologists Ltd.

[Mirror, mirror of the wall: mirror therapy in the treatment of phantom limbs and phantom limb pain].

PubMed

Casale, Roberto; Furnari, Anna; Lamberti, Raul Coelho; Kouloulas, Efthimios; Hagenberg, Annegret; Mallik, Maryam

2015-01-01

Phantom limb and phantom limb pain control are pivotal points in the sequence of intervention to bring the amputee to functional autonomy. The alterations of perception and sensation, the pain of the residual limb and the phantom limb are therefore aspects of amputation that should be taken into account in the "prise en charge" of these patients. Within the more advanced physical therapies to control phantom and phantom limb pain there is the use of mirrors (mirror therapy). This article willfocus on its use and on the possible side effects induced by the lack of patient selection and a conflict of body schema restoration through mirror therapy with concurrent prosthetic training and trauma acceptance. Advice on the need to select patients before treatment decisions, with regard to their psychological as well as clinical profile (including time since amputation and clinical setting), and the need to be aware of the possible adverse effects matching different and somehow conflicting therapeutic approaches, are put forward. Thus a coordinated sequence of diagnostic, prognostic and therapeutic procedures carried out by an interdisciplinary rehabilitation team that works globally on all patients' problems is fundamental in the management of amputees and phantom limb pain. Further studies and the development of a multidisciplinary network to study this and other applications of mirror therapy are needed.

Bilateral Proprioceptive Evaluation in Individuals With Unilateral Chronic Ankle Instability

PubMed Central

Sousa, Andreia S. P.; Leite, João; Costa, Bianca; Santos, Rubim

2017-01-01

Context: Despite extensive research on chronic ankle instability, the findings regarding proprioception have been conflicting and focused only on the injured limb. Also, the different components of proprioception have been evaluated in isolation. Objective: To evaluate bilateral ankle proprioception in individuals with unilateral ankle instability. Design: Cohort study. Setting: Research laboratory center in a university. Patients or Other Participants: Twenty-four individuals with a history of unilateral ankle sprain and chronic ankle instability (mechanical ankle instability group, n = 10; functional ankle instability [FAI] group, n = 14) and 20 controls. Main Outcome Measure(s): Ankle active and passive joint position sense, kinesthesia, and force sense. Results: We observed a significant interaction between the effects of limb and group for kinesthesia (F = 3.27, P = .049). Increased error values were observed in the injured limb of the FAI group compared with the control group (P = .031, Cohen d = 0.47). Differences were also evident for force sense (F = 9.31, P < .001): the FAI group demonstrated increased error versus the control group (injured limb: P < .001, Cohen d = 1.28; uninjured limb: P = .009, Cohen d = 0.89) and the mechanical ankle instability group (uninjured limb: P = .023, Cohen d = 0.76). Conclusions: Individuals with unilateral FAI had increased error ipsilaterally (injured limb) for inversion movement detection (kinesthesia) and evertor force sense and increased error contralaterally (uninjured limb) for evertor force sense. PMID:28318316

FOXO4-Knockdown Suppresses Oxidative Stress-Induced Apoptosis of Early Pro-Angiogenic Cells and Augments Their Neovascularization Capacities in Ischemic Limbs

PubMed Central

Nakayoshi, Takaharu; Sasaki, Ken-ichiro; Kajimoto, Hidemi; Koiwaya, Hiroshi; Ohtsuka, Masanori; Ueno, Takafumi; Chibana, Hidetoshi; Itaya, Naoki; Sasaki, Masahiro; Yokoyama, Shinji; Fukumoto, Yoshihiro; Imaizumi, Tsutomu

2014-01-01

The effects of therapeutic angiogenesis by intramuscular injection of early pro-angiogenic cells (EPCs) to ischemic limbs are unsatisfactory. Oxidative stress in the ischemic limbs may accelerate apoptosis of injected EPCs, leading to less neovascularization. Forkhead transcription factor 4 (FOXO4) was reported to play a pivotal role in apoptosis signaling of EPCs in response to oxidative stress. Accordingly, we assessed whether FOXO4-knockdown EPCs (FOXO4KD-EPCs) could suppress the oxidative stress-induced apoptosis and augment the neovascularization capacity in ischemic limbs. We transfected small interfering RNA targeted against FOXO4 of human EPCs to generate FOXO4KD-EPCs and confirmed a successful knockdown. FOXO4KD-EPCs gained resistance to apoptosis in response to hydrogen peroxide in vitro. Oxidative stress stained by dihydroethidium was stronger for the immunodeficient rat ischemic limb tissue than for the rat non-ischemic one. Although the number of apoptotic EPCs injected into the rat ischemic limb was greater than that of apoptotic EPCs injected into the rat non-ischemic limb, FOXO4KD-EPCs injected into the rat ischemic limb brought less apoptosis and more neovascularization than EPCs. Taken together, the use of FOXO4KD-EPCs with resistance to oxidative stress-induced apoptosis may be a new strategy to augment the effects of therapeutic angiogenesis by intramuscular injection of EPCs. PMID:24663349

Anatomical Network Comparison of Human Upper and Lower, Newborn and Adult, and Normal and Abnormal Limbs, with Notes on Development, Pathology and Limb Serial Homology vs. Homoplasy

PubMed Central

Diogo, Rui; Esteve-Altava, Borja; Smith, Christopher; Boughner, Julia C.; Rasskin-Gutman, Diego

2015-01-01

How do the various anatomical parts (modules) of the animal body evolve into very different integrated forms (integration) yet still function properly without decreasing the individual’s survival? This long-standing question remains unanswered for multiple reasons, including lack of consensus about conceptual definitions and approaches, as well as a reasonable bias toward the study of hard tissues over soft tissues. A major difficulty concerns the non-trivial technical hurdles of addressing this problem, specifically the lack of quantitative tools to quantify and compare variation across multiple disparate anatomical parts and tissue types. In this paper we apply for the first time a powerful new quantitative tool, Anatomical Network Analysis (AnNA), to examine and compare in detail the musculoskeletal modularity and integration of normal and abnormal human upper and lower limbs. In contrast to other morphological methods, the strength of AnNA is that it allows efficient and direct empirical comparisons among body parts with even vastly different architectures (e.g. upper and lower limbs) and diverse or complex tissue composition (e.g. bones, cartilages and muscles), by quantifying the spatial organization of these parts—their topological patterns relative to each other—using tools borrowed from network theory. Our results reveal similarities between the skeletal networks of the normal newborn/adult upper limb vs. lower limb, with exception to the shoulder vs. pelvis. However, when muscles are included, the overall musculoskeletal network organization of the upper limb is strikingly different from that of the lower limb, particularly that of the more proximal structures of each limb. Importantly, the obtained data provide further evidence to be added to the vast amount of paleontological, gross anatomical, developmental, molecular and embryological data recently obtained that contradicts the long-standing dogma that the upper and lower limbs are serial homologues. In addition, the AnNA of the limbs of a trisomy 18 human fetus strongly supports Pere Alberch's ill-named "logic of monsters" hypothesis, and contradicts the commonly accepted idea that birth defects often lead to lower integration (i.e. more parcellation) of anatomical structures. PMID:26452269

Musculoskeletal Complaints in Transverse Upper Limb Reduction Deficiency and Amputation in The Netherlands: Prevalence, Predictors, and Effect on Health.

PubMed

Postema, Sietke G; Bongers, Raoul M; Brouwers, Michael A; Burger, Helena; Norling-Hermansson, Liselotte M; Reneman, Michiel F; Dijkstra, Pieter U; van der Sluis, Corry K

2016-07-01

(1) To determine the prevalence of musculoskeletal complaints (MSCs) in individuals with upper limb absence in The Netherlands, (2) to assess the health status of individuals with upper limb absence in general and in relation to the presence of MSCs, and (3) to explore the predictors of development of MSCs and MSC-related disability in this population. Cross-sectional study: national survey. Twelve rehabilitation centers and orthopedic workshops. Individuals (n=263; mean age, 50.7±16.7y; 60% men) ≥18 years old, with transverse upper limb reduction deficiency (42%) or amputation (58%) at or proximal to the carpal level (response, 45%) and 108 individuals without upper limb reduction deficiency or amputation (n=108; mean age, 50.6±15.7y; 65% men) (N=371). Not applicable. Point and year prevalence of MSCs, MSC-related disability (Pain Disability Index), and general health perception and mental health (RAND-36 subscales). Point and year prevalence of MSCs were almost twice as high in individuals with upper limb absence (57% and 65%, respectively) compared with individuals without upper limb absence (27% and 34%, respectively) and were most often located in the nonaffected limb and upper back/neck. MSCs were associated with decreased general health perception and mental health and higher perceived upper extremity work demands. Prosthesis use was not related to presence of MSCs. Clinically relevant predictors of MSCs were middle age, being divorced/widowed, and lower mental health. Individuals with upper limb absence experienced more MSC-related disability than individuals without upper limb absence. Higher age, more pain, lower general and mental health, and not using a prosthesis were related to higher disability. Presence of MSCs is a frequent problem in individuals with upper limb absence and is associated with decreased general and mental health. Mental health and physical work demands should be taken into account when assessing such a patient. Clinicians should note that MSC-related disability increases with age. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Unilateral Plantar Flexors Static-Stretching Effects on Ipsilateral and Contralateral Jump Measures

PubMed Central

da Silva, Josinaldo Jarbas; Behm, David George; Gomes, Willy Andrade; Silva, Fernando Henrique Domingues de Oliveira; Soares, Enrico Gori; Serpa, Érica Paes; Vilela Junior, Guanis de Barros; Lopes, Charles Ricardo; Marchetti, Paulo Henrique

2015-01-01

The aim of this study was to evaluate the acute effects of unilateral ankle plantar flexors static-stretching (SS) on the passive range of movement (ROM) of the stretched limb, surface electromyography (sEMG) and single-leg bounce drop jump (SBDJ) performance measures of the ipsilateral stretched and contralateral non-stretched lower limbs. Seventeen young men (24 ± 5 years) performed SBDJ before and after (stretched limb: immediately post-stretch, 10 and 20 minutes and non-stretched limb: immediately post-stretch) unilateral ankle plantar flexor SS (6 sets of 45s/15s, 70-90% point of discomfort). SBDJ performance measures included jump height, impulse, time to reach peak force, contact time as well as the sEMG integral (IEMG) and pre-activation (IEMGpre-activation) of the gastrocnemius lateralis. Ankle dorsiflexion passive ROM increased in the stretched limb after the SS (pre-test: 21 ± 4° and post-test: 26.5 ± 5°, p < 0.001). Post-stretching decreases were observed with peak force (p = 0.029), IEMG (P<0.001), and IEMGpre-activation (p = 0.015) in the stretched limb; as well as impulse (p = 0.03), and jump height (p = 0.032) in the non-stretched limb. In conclusion, SS effectively increased passive ankle ROM of the stretched limb, and transiently (less than 10 minutes) decreased muscle peak force and pre-activation. The decrease of jump height and impulse for the non-stretched limb suggests a SS-induced central nervous system inhibitory effect. Key points When considering whether or not to SS prior to athletic activities, one must consider the potential positive effects of increased ankle dorsiflexion motion with the potential deleterious effects of power and muscle activity during a simple jumping task or as part of the rehabilitation process. Since decreased jump performance measures can persist for 10 minutes in the stretched leg, the timing of SS prior to performance must be taken into consideration. Athletes, fitness enthusiasts and therapists should also keep in mind that SS one limb has generalized effects upon contralateral limbs as well. PMID:25983580

Anatomical Network Comparison of Human Upper and Lower, Newborn and Adult, and Normal and Abnormal Limbs, with Notes on Development, Pathology and Limb Serial Homology vs. Homoplasy.

PubMed

Diogo, Rui; Esteve-Altava, Borja; Smith, Christopher; Boughner, Julia C; Rasskin-Gutman, Diego

2015-01-01

How do the various anatomical parts (modules) of the animal body evolve into very different integrated forms (integration) yet still function properly without decreasing the individual's survival? This long-standing question remains unanswered for multiple reasons, including lack of consensus about conceptual definitions and approaches, as well as a reasonable bias toward the study of hard tissues over soft tissues. A major difficulty concerns the non-trivial technical hurdles of addressing this problem, specifically the lack of quantitative tools to quantify and compare variation across multiple disparate anatomical parts and tissue types. In this paper we apply for the first time a powerful new quantitative tool, Anatomical Network Analysis (AnNA), to examine and compare in detail the musculoskeletal modularity and integration of normal and abnormal human upper and lower limbs. In contrast to other morphological methods, the strength of AnNA is that it allows efficient and direct empirical comparisons among body parts with even vastly different architectures (e.g. upper and lower limbs) and diverse or complex tissue composition (e.g. bones, cartilages and muscles), by quantifying the spatial organization of these parts-their topological patterns relative to each other-using tools borrowed from network theory. Our results reveal similarities between the skeletal networks of the normal newborn/adult upper limb vs. lower limb, with exception to the shoulder vs. pelvis. However, when muscles are included, the overall musculoskeletal network organization of the upper limb is strikingly different from that of the lower limb, particularly that of the more proximal structures of each limb. Importantly, the obtained data provide further evidence to be added to the vast amount of paleontological, gross anatomical, developmental, molecular and embryological data recently obtained that contradicts the long-standing dogma that the upper and lower limbs are serial homologues. In addition, the AnNA of the limbs of a trisomy 18 human fetus strongly supports Pere Alberch's ill-named "logic of monsters" hypothesis, and contradicts the commonly accepted idea that birth defects often lead to lower integration (i.e. more parcellation) of anatomical structures.

Nerves and Tissue Repair.

DTIC Science & Technology

1994-07-01

axolotl limbs are transected the concentration of transferrin in the distal limb tissue declines rapidly and limb regeneration stops. These results...transferrin binding and expression of the transferrin gene in cells of axolotl peripheral nerve indicate that both uptake and synthesis of this factor occur

The classification of phocomelia.

PubMed

Tytherleigh-Strong, G; Hooper, G

2003-06-01

We studied 24 patients with 44 phocomelic upper limbs. Only 11 limbs could be grouped in the classification system of Frantz and O' Rahilly. The non-classifiable limbs were further studied and their characteristics identified. It is confirmed that phocomelia is not an intercalary defect.

Psychosomatic treatment of phantom limb pain with post-traumatic stress disorder: a case report.

PubMed

Muraoka, M; Komiyama, H; Hosoi, M; Mine, K; Kubo, C

1996-08-01

The successful treatment of severe left lower limb phantom pain is reported. Hypnosis and antidepressant drugs were the basis for the treatment which controlled the phantom limb pain and an associated post-traumatic stress disorder.

Ectopic expression of Msx-2 in posterior limb bud mesoderm impairs limb morphogenesis while inducing BMP-4 expression, inhibiting cell proliferation, and promoting apoptosis.

PubMed

Ferrari, D; Lichtler, A C; Pan, Z Z; Dealy, C N; Upholt, W B; Kosher, R A

1998-05-01

During early stages of chick limb development, the homeobox-containing gene Msx-2 is expressed in the mesoderm at the anterior margin of the limb bud and in a discrete group of mesodermal cells at the midproximal posterior margin. These domains of Msx-2 expression roughly demarcate the anterior and posterior boundaries of the progress zone, the highly proliferating posterior mesodermal cells underneath the apical ectodermal ridge (AER) that give rise to the skeletal elements of the limb and associated structures. Later in development as the AER loses its activity, Msx-2 expression expands into the distal mesoderm and subsequently into the interdigital mesenchyme which demarcates the developing digits. The domains of Msx-2 expression exhibit considerably less proliferation than the cells of the progress zone and also encompass several regions of programmed cell death including the anterior and posterior necrotic zones and interdigital mesenchyme. We have thus suggested that Msx-2 may be in a regulatory network that delimits the progress zone by suppressing the morphogenesis of the regions of the limb mesoderm in which it is highly expressed. In the present study we show that ectopic expression of Msx-2 via a retroviral expression vector in the posterior mesoderm of the progress zone from the time of initial formation of the limb bud severely impairs limb morphogenesis. Msx-2-infected limbs are typically very narrow along the anteroposterior axis, are occasionally truncated, and exhibit alterations in the pattern of formation of skeletal elements, indicating that as a consequence of ectopic Msx-2 expression the morphogenesis of large portions of the posterior mesoderm has been suppressed. We further show that Msx-2 impairs limb morphogenesis by reducing cell proliferation and promoting apoptosis in the regions of the posterior mesoderm in which it is ectopically expressed. The domains of ectopic Msx-2 expression in the posterior mesoderm also exhibit ectopic expression of BMP-4, a secreted signaling molecule that is coexpressed with Msx-2 during normal limb development in the anterior limb mesoderm, the posterior necrotic zone, and interdigital mesenchyme. This indicates that Msx-2 regulates BMP-4 expression and that the suppressive effects of Msx-2 on limb morphogenesis might be mediated in part by BMP-4. These studies indicate that during normal limb development Msx-2 is a key component of a regulatory network that delimits the boundaries of the progress zone by suppressing the morphogenesis of the regions of the limb mesoderm in which it is highly expressed, thus restricting the outgrowth and formation of skeletal elements and associated structures to the progress zone. We also report that rather large numbers of apoptotic cells as well as proliferating cells are present throughout the AER during all stages of normal limb development we have examined, indicating that many of the cells of the AER are continuously undergoing programmed cell death at the same time that new AER cells are being generated by cell proliferation. Thus, a balance between cell proliferation and programmed cell death may play a very important role in maintaining the activity of the AER. Copyright 1998 Academic Press.

Vertical Distribution of Aersols and Water Vapor Using CRISM Limb Observations

NASA Technical Reports Server (NTRS)

Smith, Michael D.; Wolff, Michael J.; Clancy, R. Todd

2011-01-01

Near-infrared spectra taken in a limb-viewing geometry by the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) on-board the Mars Reconnaissance Orbiter (MRO) provide a useful tool for probing atmospheric structure. Specifically, the observed radiance as a function of wavelength and height above the limb allows the vertical distribution of both dust and ice aerosols to be retrieved. These data serve as an important supplement to the aerosol profiling provided by the MRO/MCS instrument allowing independent validation and giving additional information on particle physical and scattering properties through multi-wavelength studies. A total of at least ten CRISM limb observations have been taken so far covering a full Martian year. Each set of limb observations nominally contains about four dozen scans across the limb giving pole-to-pole coverage for two orbits at roughly 100 and 290 W longitude over the Tharsis and Syrtis/Hellas regions, respectively. At each longitude, limb scans are spaced roughly 10 degrees apart in latitude, with a vertical spatial resolution on the limb of roughly 800 m. Radiative transfer modeling is used to model the observations. We compute synthetic CRISM limb spectra using a discrete-ordinates radiative transfer code that accounts for multiple scattering from aerosols and accounts for spherical geometry of the limb observations by integrating the source functions along curved paths in that coordinate system. Retrieved are 14-point vertical profiles for dust and water ice aerosols with resolution of 0.4 scale heights between one and six scale heights above the surface. After the aerosol retrieval is completed, the abundances of C02 (or surface pressure) and H20 gas are retrieved by matching the depth of absorption bands at 2000 nm for carbon dioxide and at 2600 run for water vapor. In addition to the column abundance of water vapor, limited information on its vertical structure can also be retrieved depending on the signal available from aerosol scattering.

Absence of the genicular arterial anastomosis as generally depicted in textbooks.

PubMed

Sabalbal, M; Johnson, M; McAlister, V

2013-09-01

Textbook representations of the genicular arterial anastomosis show a large direct communication between the descending branch of the lateral circumflex femoral artery (DBLCFA) and a genicular branch of the popliteal artery but this is not compatible with clinical experience. The aim of this study was to determine whether the arterial anastomosis at the knee is sufficient, in the event of traumatic disruption of the superficial femoral artery, to infuse protective agents or to place a stent to restore flow to the lower leg. Dissection of ten cadaveric lower limbs was performed to photograph the arterial anatomy from the inguinal ligament to the tibial tubercle. Anastomosis with branches of the popliteal artery was classified as: 'direct communication', 'approaching communication' or 'no evident communication'. A constant descending artery in the lateral thigh (LDAT) was found to have five types of origin: Type 1 (2/10 limbs) involved the lateral circumflex femoral branch of the femoral artery, Type 2 (3/10 limbs) the lateral circumflex femoral branch of the profunda femoris artery, Type 3 (1/10 limbs) the femoral artery, Type 4 (3/10 limbs) the superficial femoral artery and Type 5 (2/10 limbs) the profunda femoris artery. In one limb, there were two descending arteries (Types 4 and 5). Collateral circulation at the knee was also variable: direct communicating vessels (3/10 limbs); approaching vessels with possible communication via capillaries (5/10 limbs); no evident communication (2/10 limbs). Communicating vessels, if present, are too small to provide immediate collateral circulation. Modern representations of the genicular arterial anastomosis are inaccurate, derived commonly from an idealised image that first appeared Gray's Anatomy in 1910. The afferent vessel is not the DBLCFA. The majority of subjects have the potential to recruit collateral circulation via the LDAT following gradual obstruction to normal arterial flow, which may be important if the LDAT is removed for bypass or flap surgery. A direct communication is rarely present and is never as robust as generally depicted in textbooks.

The benefit of limb cloud imaging for infrared limb sounding of tropospheric trace gases

NASA Astrophysics Data System (ADS)

Adams, S.; Spang, R.; Preusse, P.; Heinemann, G.

2009-06-01

Advances in detector technology enable a new generation of infrared limb sounders to measure 2-D images of the atmosphere. A proposed limb cloud imager (LCI) mode will detect clouds with a spatial resolution unprecedented for limb sounding. For the inference of temperature and trace gas distributions, detector pixels of the LCI have to be combined into super-pixels which provide the required signal-to-noise and information content for the retrievals. This study examines the extent to which tropospheric coverage can be improved in comparison to limb sounding using a fixed field of view with the size of the super-pixels, as in conventional limb sounders. The study is based on cloud topographies derived from (a) IR brightness temperatures (BT) of geostationary weather satellites in conjunction with ECMWF temperature profiles and (b) ice and liquid water content data of the Consortium for Small-scale Modeling-Europe (COSMO-EU) of the German Weather Service. Limb cloud images are simulated by matching the cloud topography with the limb sounding line of sight (LOS). The analysis of the BT data shows that the reduction of the spatial sampling along the track has hardly any effect on the gain in information. The comparison between BT and COSMO-EU data identifies the strength of both data sets, which are the representation of the horizontal cloud extent for the BT data and the reproduction of the cloud amount for the COSMO-EU data. The results of the analysis of both data sets show the great advantage of the cloud imager. However, because both cloud data sets do not present the complete fine structure of the real cloud fields in the atmosphere it is assumed that the results tend to underestimate the increase in information. In conclusion, real measurements by such an instrument may result in an even higher benefit for tropospheric limb retrievals.

LADEE UVS (UltraViolet Visible Spectrometer) and the Search for Lunar Exospheric Dust: A Detailed Spectral Analysis

NASA Technical Reports Server (NTRS)

Wooden, Diane H.; Cook, Amanda; Colaprete, Anthony; Shirley, Mark; Vargo, Kara; Elphic, Richard C.; Hermalyn, Brendan; Stubbs, Timothy John; Glenar, David A.

2014-01-01

The Lunar Atmosphere and Dust Environment Explorer (LADEE) executed science observations in lunar orbit spanning 2013-Oct-16- 2014-04-18 UT. LADEE's Ultraviolet/Visible Spectrometer (UVS) studies the composition and temporal variations of the tenuous lunar exosphere and dust environment, utilizing two sets of optics: a limb-viewing telescope, and a solar-viewer. The limb-viewing telescope observes illuminated dust and emitting gas species while the Sun is just behind the lunar limb. The solar viewer, with its diffuser, allows UVS to also stare directly at the solar disk as it approaches the limb, sampling progressively lower exosphere altitudes. Solar viewer "Occultation" activities occur at the lunar sunrise limb, as the LADEE spacecraft passes into the lunar night side, facing the Sun (the spacecraft orbit is near-equatorial retrograde). A loss of transmission of sunlight occurs by the occultation of dust grains along the line-of-sight. So-called "Inertial Limb" activities have the limb-viewing telescope pointed at the lit exosphere just after the Sun has set. Inertial Limb activities follow a similar progression of diminishing sampling altitudes but hold the solar elongation angle constant so the zodiacal light contribution remains constant while seeking to observe the weak lunar horizon glow. On the dark side of the moon, "Sodium Tail" activities pointed the limb-viewing telescope in the direction of the Moon's sodium tail (similar to anti-sunward), during different lunar phases. Of the UVS data sets, these show the largest excess of scattered blue light, indicative of the presence of small (approximately 100 nm) dust grains in the tail. Correlations are sought between dust in the sodium tail and meteor streams and magnetotail crossings to investigate impact- versus electrostatic-lofting. Once lofted, nanoparticles can become charged and picked up by the solar wind. The LADEE UVS Occultation, Inertial Limb, and Sodium Tail spectral datasets provide evidence of a lunar dust exosphere.

Cross-bridge kinetics of fast and slow fibres of cat jaw and limb muscles: correlations with myosin subunit composition.

PubMed

Hoh, Joseph F Y; Li, Zhao-Bo; Qin, Han; Hsu, Michael K H; Rossmanith, Gunther H

2007-01-01

Mechanical properties of the jaw-closing muscles of the cat are poorly understood. These muscles are known to differ in myosin and fibre type compositions from limb muscles. This work aims to correlate mechanical properties of single fibres in cat jaw and limb muscles with their myosin subunit compositions. The stiffness minimum frequency, f(min), which reflects isometric cross-bridge kinetics, was measured in Ca(2+)-activated glycerinated fast and slow fibres from cat jaw and limb muscles for temperatures ranging between 15 and 30 degrees C by mechanical perturbation analysis. At 15 degrees C, f(min) was 0.5 Hz for limb-slow fibres, 4-6 Hz for jaw-slow fibres, and 10-13 Hz for limb-fast and jaw-fast fibres. The activation energy for f(min) obtained from the slope of the Arrhenius plot for limb-slow fibres was 30-40% higher than values for the other three types of fibres. SDS-PAGE and western blotting using highly specific antibodies verified that limb-fast fibres contained IIA or IIX myosin heavy chain (MyHC). Jaw-fast fibres expressed masticatory MyHC while both jaw-fast and jaw-slow fibres expressed masticatory myosin light chains (MLCs). The nucleotide sequences of the 3' ends of the slow MyHC cDNAs isolated from cat masseter and soleus cDNA libraries showed identical coding and 3'-untranslated regions, suggesting that jaw-slow and limb-slow fibres express the same slow MyHC gene. We conclude that the isometric cross-bridge cycling kinetics of jaw-fast and limb-fast fibres detected by f(min) are indistinguishable in spite of differences in MyHC and light chain compositions. However, jaw-slow fibres, in which the same slow MyHCs are found in combination with MLCs of the jaw type, show enhanced cross-bridge cycling kinetics and reduced activation energy for cross-bridge detachment.

Geometric Morphometrics on Gene Expression Patterns Within Phenotypes: A Case Example on Limb Development

PubMed Central

Martínez-Abadías, Neus; Mateu, Roger; Niksic, Martina; Russo, Lucia; Sharpe, James

2016-01-01

How the genotype translates into the phenotype through development is critical to fully understand the evolution of phenotypes. We propose a novel approach to directly assess how changes in gene expression patterns are associated with changes in morphology using the limb as a case example. Our method combines molecular biology techniques, such as whole-mount in situ hybridization, with image and shape analysis, extending the use of Geometric Morphometrics to the analysis of nonanatomical shapes, such as gene expression domains. Elliptical Fourier and Procrustes-based semilandmark analyses were used to analyze the variation and covariation patterns of the limb bud shape with the expression patterns of two relevant genes for limb morphogenesis, Hoxa11 and Hoxa13. We devised a multiple thresholding method to semiautomatically segment gene domains at several expression levels in large samples of limb buds from C57Bl6 mouse embryos between 10 and 12 postfertilization days. Besides providing an accurate phenotyping tool to quantify the spatiotemporal dynamics of gene expression patterns within developing structures, our morphometric analyses revealed high, non-random, and gene-specific variation undergoing canalization during limb development. Our results demonstrate that Hoxa11 and Hoxa13, despite being paralogs with analogous functions in limb patterning, show clearly distinct dynamic patterns, both in shape and size, and are associated differently with the limb bud shape. The correspondence between our results and already well-established molecular processes underlying limb development confirms that this morphometric approach is a powerful tool to extract features of development regulating morphogenesis. Such multilevel analyses are promising in systems where not so much molecular information is available and will advance our understanding of the genotype–phenotype map. In systematics, this knowledge will increase our ability to infer how evolution modified a common developmental pattern to generate a wide diversity of morphologies, as in the vertebrate limb. PMID:26377442

Peak knee biomechanics and limb symmetry following unilateral anterior cruciate ligament reconstruction: Associations of walking gait and jump-landing outcomes.

PubMed

Pfeiffer, Steven J; Blackburn, J Troy; Luc-Harkey, Brittney; Harkey, Matthew S; Stanley, Laura E; Frank, Barnett; Padua, Darin; Marshall, Stephen W; Spang, Jeffrey T; Pietrosimone, Brian

2018-03-01

Aberrant walking-gait and jump-landing biomechanics may influence the development of post-traumatic osteoarthritis and increase the risk of a second anterior cruciate ligament injury, respectively. It remains unknown if individuals who demonstrate altered walking-gait biomechanics demonstrate similar altered biomechanics during jump-landing. Our aim was to determine associations in peak knee biomechanics and limb-symmetry indices between walking-gait and jump-landing tasks in individuals with a unilateral anterior cruciate ligament reconstruction. Thirty-five individuals (74% women, 22.1 [3.4] years old, 25 [3.89] kg/m 2 ) with an anterior cruciate ligament reconstruction performed 5-trials of self-selected walking-gait and jump-landing. Peak kinetics and kinematics were extracted from the first 50% of stance phase during walking-gait and first 100 ms following ground contact for jump-landing. Pearson product-moment (r) and Spearman's Rho (ρ) analyses were used to evaluate relationships between outcome measures. Significance was set a priori (P ≤ 0.05). All associations between walking-gait and jump-landing for the involved limb, along with the majority of associations for limb-symmetry indices and the uninvolved limb, were negligible and non-statistically significant. There were weak significant associations for instantaneous loading rate (ρ = 0.39, P = 0.02) and peak knee abduction angle (ρ = 0.36, p = 0.03) uninvolved limb, as well as peak abduction displacement limb-symmetry indices (ρ= - 0.39, p = 0.02) between walking-gait and jump-landing. No systematic associations were found between walking-gait and jump-landing biomechanics for either limb or limb-symmetry indices in people with unilateral anterior cruciate ligament reconstruction. Individuals with an anterior cruciate ligament reconstruction who demonstrate high-involved limb loading or asymmetries during jump-landing may not demonstrate similar biomechanics during walking-gait. Copyright © 2018 Elsevier Ltd. All rights reserved.

An official American Thoracic Society/European Respiratory Society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease.

PubMed

Maltais, François; Decramer, Marc; Casaburi, Richard; Barreiro, Esther; Burelle, Yan; Debigaré, Richard; Dekhuijzen, P N Richard; Franssen, Frits; Gayan-Ramirez, Ghislaine; Gea, Joaquim; Gosker, Harry R; Gosselink, Rik; Hayot, Maurice; Hussain, Sabah N A; Janssens, Wim; Polkey, Micheal I; Roca, Josep; Saey, Didier; Schols, Annemie M W J; Spruit, Martijn A; Steiner, Michael; Taivassalo, Tanja; Troosters, Thierry; Vogiatzis, Ioannis; Wagner, Peter D

2014-05-01

Limb muscle dysfunction is prevalent in chronic obstructive pulmonary disease (COPD) and it has important clinical implications, such as reduced exercise tolerance, quality of life, and even survival. Since the previous American Thoracic Society/European Respiratory Society (ATS/ERS) statement on limb muscle dysfunction, important progress has been made on the characterization of this problem and on our understanding of its pathophysiology and clinical implications. The purpose of this document is to update the 1999 ATS/ERS statement on limb muscle dysfunction in COPD. An interdisciplinary committee of experts from the ATS and ERS Pulmonary Rehabilitation and Clinical Problems assemblies determined that the scope of this document should be limited to limb muscles. Committee members conducted focused reviews of the literature on several topics. A librarian also performed a literature search. An ATS methodologist provided advice to the committee, ensuring that the methodological approach was consistent with ATS standards. We identified important advances in our understanding of the extent and nature of the structural alterations in limb muscles in patients with COPD. Since the last update, landmark studies were published on the mechanisms of development of limb muscle dysfunction in COPD and on the treatment of this condition. We now have a better understanding of the clinical implications of limb muscle dysfunction. Although exercise training is the most potent intervention to address this condition, other therapies, such as neuromuscular electrical stimulation, are emerging. Assessment of limb muscle function can identify patients who are at increased risk of poor clinical outcomes, such as exercise intolerance and premature mortality. Limb muscle dysfunction is a key systemic consequence of COPD. However, there are still important gaps in our knowledge about the mechanisms of development of this problem. Strategies for early detection and specific treatments for this condition are also needed.

An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease

PubMed Central

Maltais, François; Decramer, Marc; Casaburi, Richard; Barreiro, Esther; Burelle, Yan; Debigaré, Richard; Dekhuijzen, P. N. Richard; Franssen, Frits; Gayan-Ramirez, Ghislaine; Gea, Joaquim; Gosker, Harry R.; Gosselink, Rik; Hayot, Maurice; Hussain, Sabah N. A.; Janssens, Wim; Polkey, Micheal I.; Roca, Josep; Saey, Didier; Schols, Annemie M. W. J.; Spruit, Martijn A.; Steiner, Michael; Taivassalo, Tanja; Troosters, Thierry; Vogiatzis, Ioannis; Wagner, Peter D.

2014-01-01

Background: Limb muscle dysfunction is prevalent in chronic obstructive pulmonary disease (COPD) and it has important clinical implications, such as reduced exercise tolerance, quality of life, and even survival. Since the previous American Thoracic Society/European Respiratory Society (ATS/ERS) statement on limb muscle dysfunction, important progress has been made on the characterization of this problem and on our understanding of its pathophysiology and clinical implications. Purpose: The purpose of this document is to update the 1999 ATS/ERS statement on limb muscle dysfunction in COPD. Methods: An interdisciplinary committee of experts from the ATS and ERS Pulmonary Rehabilitation and Clinical Problems assemblies determined that the scope of this document should be limited to limb muscles. Committee members conducted focused reviews of the literature on several topics. A librarian also performed a literature search. An ATS methodologist provided advice to the committee, ensuring that the methodological approach was consistent with ATS standards. Results: We identified important advances in our understanding of the extent and nature of the structural alterations in limb muscles in patients with COPD. Since the last update, landmark studies were published on the mechanisms of development of limb muscle dysfunction in COPD and on the treatment of this condition. We now have a better understanding of the clinical implications of limb muscle dysfunction. Although exercise training is the most potent intervention to address this condition, other therapies, such as neuromuscular electrical stimulation, are emerging. Assessment of limb muscle function can identify patients who are at increased risk of poor clinical outcomes, such as exercise intolerance and premature mortality. Conclusions: Limb muscle dysfunction is a key systemic consequence of COPD. However, there are still important gaps in our knowledge about the mechanisms of development of this problem. Strategies for early detection and specific treatments for this condition are also needed. PMID:24787074

BMP-Mediated Functional Cooperation between Dlx5;Dlx6 and Msx1;Msx2 during Mammalian Limb Development

PubMed Central

Vieux-Rochas, Maxence; Bouhali, Kamal; Mantero, Stefano; Garaffo, Giulia; Provero, Paolo; Astigiano, Simonetta; Barbieri, Ottavia; Caratozzolo, Mariano F.; Tullo, Apollonia; Guerrini, Luisa; Lallemand, Yvan; Robert, Benoît

2013-01-01

The Dlx and Msx homeodomain transcription factors play important roles in the control of limb development. The combined disruption of Msx1 and Msx2, as well as that of Dlx5 and Dlx6, lead to limb patterning defects with anomalies in digit number and shape. Msx1;Msx2 double mutants are characterized by the loss of derivatives of the anterior limb mesoderm which is not observed in either of the simple mutants. Dlx5;Dlx6 double mutants exhibit hindlimb ectrodactyly. While the morphogenetic action of Msx genes seems to involve the BMP molecules, the mode of action of Dlx genes still remains elusive. Here, examining the limb phenotypes of combined Dlx and Msx mutants we reveal a new Dlx-Msx regulatory loop directly involving BMPs. In Msx1;Dlx5;Dlx6 triple mutant mice (TKO), beside the expected ectrodactyly, we also observe the hallmark morphological anomalies of Msx1;Msx2 double mutants suggesting an epistatic role of Dlx5 and Dlx6 over Msx2. In Msx2;Dlx5;Dlx6 TKO mice we only observe an aggravation of the ectrodactyly defect without changes in the number of the individual components of the limb. Using a combination of qPCR, ChIP and bioinformatic analyses, we identify two Dlx/Msx regulatory pathways: 1) in the anterior limb mesoderm a non-cell autonomous Msx-Dlx regulatory loop involves BMP molecules through the AER and 2) in AER cells and, at later stages, in the limb mesoderm the regulation of Msx2 by Dlx5 and Dlx6 occurs also cell autonomously. These data bring new elements to decipher the complex AER-mesoderm dialogue that takes place during limb development and provide clues to understanding the etiology of congenital limb malformations. PMID:23382810

BMP-mediated functional cooperation between Dlx5;Dlx6 and Msx1;Msx2 during mammalian limb development.

PubMed

Vieux-Rochas, Maxence; Bouhali, Kamal; Mantero, Stefano; Garaffo, Giulia; Provero, Paolo; Astigiano, Simonetta; Barbieri, Ottavia; Caratozzolo, Mariano F; Tullo, Apollonia; Guerrini, Luisa; Lallemand, Yvan; Robert, Benoît; Levi, Giovanni; Merlo, Giorgio R

2013-01-01

The Dlx and Msx homeodomain transcription factors play important roles in the control of limb development. The combined disruption of Msx1 and Msx2, as well as that of Dlx5 and Dlx6, lead to limb patterning defects with anomalies in digit number and shape. Msx1;Msx2 double mutants are characterized by the loss of derivatives of the anterior limb mesoderm which is not observed in either of the simple mutants. Dlx5;Dlx6 double mutants exhibit hindlimb ectrodactyly. While the morphogenetic action of Msx genes seems to involve the BMP molecules, the mode of action of Dlx genes still remains elusive. Here, examining the limb phenotypes of combined Dlx and Msx mutants we reveal a new Dlx-Msx regulatory loop directly involving BMPs. In Msx1;Dlx5;Dlx6 triple mutant mice (TKO), beside the expected ectrodactyly, we also observe the hallmark morphological anomalies of Msx1;Msx2 double mutants suggesting an epistatic role of Dlx5 and Dlx6 over Msx2. In Msx2;Dlx5;Dlx6 TKO mice we only observe an aggravation of the ectrodactyly defect without changes in the number of the individual components of the limb. Using a combination of qPCR, ChIP and bioinformatic analyses, we identify two Dlx/Msx regulatory pathways: 1) in the anterior limb mesoderm a non-cell autonomous Msx-Dlx regulatory loop involves BMP molecules through the AER and 2) in AER cells and, at later stages, in the limb mesoderm the regulation of Msx2 by Dlx5 and Dlx6 occurs also cell autonomously. These data bring new elements to decipher the complex AER-mesoderm dialogue that takes place during limb development and provide clues to understanding the etiology of congenital limb malformations.

Limb Preservation With Isolated Limb Infusion for Locally Advanced Nonmelanoma Cutaneous and Soft-Tissue Malignant Neoplasms

PubMed Central

Turaga, Kiran K.; Beasley, Georgia M.; Kane, John M.; Delman, Keith A.; Grobmyer, Stephen R.; Gonzalez, Ricardo J.; Letson, G. Douglas; Cheong, David; Tyler, Douglas S.; Zager, Jonathan S.

2015-01-01

Objective To demonstrate the efficacy of isolated limb infusion (ILI) in limb preservation for patients with locally advanced soft-tissue sarcomas and nonmelanoma cutaneous malignant neoplasms. Background Locally advanced nonmelanoma cutaneous and soft-tissue malignant neoplasms, including soft-tissue sarcomas of the extremities, can pose significant treatment challenges. We report our experience, including responses and limb preservation rates, using ILI in cutaneous and soft-tissue malignant neoplasms. Methods We identified 22 patients with cutaneous and soft-tissue malignant neoplasms who underwent 26 ILIs with melphalan and actinomycin from January 1, 2004, through December 31, 2009, from 5 institutions. Outcome measures included limb preservation and in-field response rates. Toxicity was measured using the Wieberdink scale and serum creatinine phosphokinase levels. Results The median age was 70 years (range, 19-92 years), and 12 patients (55%) were women. Fourteen patients (64%) had sarcomas, 7 (32%) had Merkel cell carcinoma, and 1 (5%) had squamous cell carcinoma. The median length of stay was 5.5 days (interquartile range, 4-8 days). Twenty-five of the 26 ILIs (96%) resulted in Wieberdink grade III or less toxicity, and 1 patient (4%) developed grade IV toxicity. The median serum creatinine phosphokinase level was 127 U/L for upper extremity ILIs and 93 U/L for lower extremity ILIs. Nineteen of 22 patients (86%) underwent successful limb preservation. The 3-month in-field response rate was 79% (21% complete and 58% partial), and the median follow-up was 8.6 months (range, 1-63 months). Five patients underwent resection of disease after an ILI, of whom 80% are disease free at a median of 8.6 months. Conclusions Isolated limb infusion provides an attractive alternative therapy for regional disease control and limb preservation in patients with limb-threatening cutaneous and soft-tissue malignant neoplasms. Short-term response rates appear encouraging, yet durability of response is unknown. PMID:21768436

Lower limb strength in sports-active transtibial amputees.

PubMed

Nolan, Lee

2009-09-01

The aim of this study was to compare hip strength in sports-active transtibial (TT) amputees, sedentary TT amputees and sports-active non-amputees. Three 'active' (exercising recreationally at least three times per week) TT amputees, four 'inactive' or sedentary TT amputees and nine 'active' able-bodied persons (AB) underwent concentric and eccentric hip flexion and extension strength testing on both limbs on an isokinetic dynamometer at 60 and 120 degrees /s. Little strength asymmetry was noted between the limbs of the active TT amputees (8% and 14% at 60 and 120 degrees /s, respectively), their residual limb being slightly stronger. Inactive TT amputees demonstrated up to 49% strength asymmetry, their intact limb being the stronger. Active TT amputees demonstrated greater peak hip torques (Nm/kg) for all conditions and speeds compared to inactive TT amputees. Peak hip torques (Nm/kg), were greater in the active TT amputees' residual limb compared to AB. While inactive TT amputees and AB had similar flexion/extension ratios, active TT amputees exhibited a lower ratio indicating overdeveloped hip extensors with respect to their hip flexors. It is not known whether this is due to the demands of sport or exercise with a prosthetic limb, or remaining residual thigh atrophy.

A comparison of upper limb amputees and patients with upper limb injuries using the Disability of the Arm, Shoulder and Hand (DASH).

PubMed

Davidson, Judith

To use the Disability of the Arm Shoulder and Hand (DASH) scale to measure the disability of patients with upper limb amputation(s) and to compare these to other upper limb injuries. All 274 patients over the age of 18 years presenting to Prince Henry Hospital in Sydney over a 4-year time frame were given the DASH assessment tool and asked to complete it under supervision of the Occupational Therapist. Patients with brachial plexus injuries, Complex Regional Pain Syndrome and bilateral upper limb amputations demonstrated significantly higher levels of disability to patients with unilateral upper limb amputations. Partial hand amputees reported a higher level of disability than major unilateral upper limb amputees. For the 48 patients who completed pre- and post-treatment assessments, there was a significant improvement in their health status. Further research is required to understand the factors that affect a patient's perceptions of their disability. Perhaps the definitive nature of an amputation and the immediate involvement of highly skilled health professionals serve to assist patients to accept their injury and therefore minimizes the level of disability.

Limb-use by foraging marine turtles, an evolutionary perspective

PubMed Central

McLeish, Don; Brooks, Andrew J.; Gaskell, John; Van Houtan, Kyle S.

2018-01-01

The use of limbs for foraging is documented in both marine and terrestrial tetrapods. These behaviors were once believed to be less likely in marine tetrapods due to the physical constraints of body plans adapted to locomotion in a fluid environment. Despite these obstacles, ten distinct types of limb-use while foraging have been previously reported in nine marine tetrapod families. Here, we expand the types of limb-use documented in marine turtles and put it in context with the diversity of marine tetrapods currently known to use limbs for foraging. Additionally, we suggest that such behaviors could have occurred in ancestral turtles, and thus, possibly extend the evolutionary timeline of limb-use behavior in marine tetrapods back approximately 70 million years. Through direct observation in situ and crowd-sourcing, we document the range of behaviors across habitats and prey types, suggesting its widespread occurrence. We argue the presence of these behaviors among marine tetrapods may be limited by limb mobility and evolutionary history, rather than foraging ecology or social learning. These behaviors may also be remnant of ancestral forelimb-use that have been maintained due to a semi-aquatic life history. PMID:29610708

Anti-gravity treadmill can promote aerobic exercise for lower limb osteoarthritis patients

PubMed Central

Kawae, Toshihiro; Mikami, Yukio; Fukuhara, Kouki; Kimura, Hiroaki; Adachi, Nobuo

2017-01-01

[Purpose] The anti-gravity treadmill (Alter-G®) allows the load on the lower limbs to be adjusted, which is considered useful for patients with lower limb osteoarthritis. The aim of the present study was to examine the effects of aerobic exercise using an anti-gravity treadmill in patients with lower limb osteoarthritis by using a cardiopulmonary exercise load monitoring system. [Subjects and Methods] The subjects were 20 patients with lower limb osteoarthritis. These subjects walked naturally for 8 minutes and then walked on the Alter-G for 8 minutes at their fastest speed at a load where lower limb pain was alleviated. [Results] Subjective and objective exercise intensity did not differ significantly between level ground walking and Alter-G walking neither before nor after walking. Pain before walking did not differ significantly between level ground walking and Alter-G walking, but pain after walking was significantly greater with level ground walking than with Alter-G walking. [Conclusion] Exercise therapy using an anti-gravity treadmill was useful for patients with lower limb osteoarthritis in terms of cardiopulmonary function, which suggested that this could become a new form of exercise therapy. PMID:28878480

Effect of Surface Reflectivity Variations On Uv-visible Limb Scattering Measurements of The Atmosphere

NASA Astrophysics Data System (ADS)

Oikarinen, L.

Solar UV and visible radiation scattered at the limb of the Earth's atmosphere is used for measuring density profiles of atmosperic trace gases. For example, the OSIRIS instrument on Odin and SCIAMACHY on Envisat use this technique. A limb-viewing instrument does not see Earth's surface or tropospheric clouds directly. However, in- direct light reflected from the surface or low altitude clouds can make up tens of per cents of the signal. Furthermore, the surface area that contributes to limb intensity ex- tends over 1000 km along the instrument line-of-sight and 200 km across it. Over this area surface reflectivity can vary from almost 0% to 100%. Inaccurate modelling of reflected intensity is a potential source of error in the trace gas retrieval. Generally, radiative transfer models used for analysing limb measure- ments have to assume that the surface has a constant albedo. We have used a three- dimensional Monte Carlo radiative transfer model to study the effects of surface vari- ation to limb radiance. Based on the simulations, we have developed an approximate method for averaging surface albedo for limb scattering measurements with the help of a simple single scattering radiative transfer model.

Upper limb motor function in young adults with spina bifida and hydrocephalus

PubMed Central

Salman, M. S.; Jewell, D.; Hetherington, R.; Spiegler, B. J.; MacGregor, D. L.; Drake, J. M.; Humphreys, R. P.; Gentili, F.

2011-01-01

Objective The objective of the study was to measure upper limb motor function in young adults with spina bifida meningomyelocele (SBM) and typically developing age peers. Method Participants were 26 young adults with SBM, with a Verbal or Performance IQ score of at least 70 on the Wechsler scales, and 27 age- and gender-matched controls. Four upper limb motor function tasks were performed under four different visual and cognitive challenge conditions. Motor independence was assessed by questionnaire. Results Fewer SBM than control participants obtained perfect posture and rebound scores. The SBM group performed less accurately and was more disrupted by cognitive challenge than controls on limb dysmetria tasks. The SBM group was slower than controls on the diadochokinesis task. Adaptive motor independence was related to one upper limb motor task, arm posture, and upper rather than lower spinal lesions were associated with less motor independence. Conclusions Young adults with SBM have significant limitations in upper limb function and are more disrupted by some challenges while performing upper limb motor tasks. Within the group of young adults with SBM, upper spinal lesions compromise motor independence more than lower spinal lesions. PMID:19672605

Local dynamic stability of lower extremity joints in lower limb amputees during slope walking.

PubMed

Chen, Jin-Ling; Gu, Dong-Yun

2013-01-01

Lower limb amputees have a higher fall risk during slope walking compared with non-amputees. However, studies on amputees' slope walking were not well addressed. The aim of this study was to identify the difference of slope walking between amputees and non-amputees. Lyapunov exponents λS was used to estimate the local dynamic stability of 7 transtibial amputees' and 7 controls' lower extremity joint kinematics during uphill and downhill walking. Compared with the controls, amputees exhibited significantly lower λS in hip (P=0.04) and ankle (P=0.01) joints of the sound limb, and hip joints (P=0.01) of the prosthetic limb during uphill walking, while they exhibited significantly lower λS in knee (P=0.02) and ankle (P=0.03) joints of the sound limb, and hip joints (P=0.03) of the prosthetic limb during downhill walking. Compared with amputees level walking, they exhibited significantly lower λS in ankle joints of the sound limb during both uphill (P=0.01) and downhill walking (P=0.01). We hypothesized that the better local dynamic stability of amputees was caused by compensation strategy during slope walking.

Comparative Transcriptional Profiling of the Axolotl Limb Identifies a Tripartite Regeneration-Specific Gene Program

PubMed Central

Knapp, Dunja; Schulz, Herbert; Rascon, Cynthia Alexander; Volkmer, Michael; Scholz, Juliane; Nacu, Eugen; Le, Mu; Novozhilov, Sergey; Tazaki, Akira; Protze, Stephanie; Jacob, Tina; Hubner, Norbert; Habermann, Bianca; Tanaka, Elly M.

2013-01-01

Understanding how the limb blastema is established after the initial wound healing response is an important aspect of regeneration research. Here we performed parallel expression profile time courses of healing lateral wounds versus amputated limbs in axolotl. This comparison between wound healing and regeneration allowed us to identify amputation-specific genes. By clustering the expression profiles of these samples, we could detect three distinguishable phases of gene expression – early wound healing followed by a transition-phase leading to establishment of the limb development program, which correspond to the three phases of limb regeneration that had been defined by morphological criteria. By focusing on the transition-phase, we identified 93 strictly amputation-associated genes many of which are implicated in oxidative-stress response, chromatin modification, epithelial development or limb development. We further classified the genes based on whether they were or were not significantly expressed in the developing limb bud. The specific localization of 53 selected candidates within the blastema was investigated by in situ hybridization. In summary, we identified a set of genes that are expressed specifically during regeneration and are therefore, likely candidates for the regulation of blastema formation. PMID:23658691

Anti-gravity treadmill can promote aerobic exercise for lower limb osteoarthritis patients.

PubMed

Kawae, Toshihiro; Mikami, Yukio; Fukuhara, Kouki; Kimura, Hiroaki; Adachi, Nobuo

2017-08-01

[Purpose] The anti-gravity treadmill (Alter-G ® ) allows the load on the lower limbs to be adjusted, which is considered useful for patients with lower limb osteoarthritis. The aim of the present study was to examine the effects of aerobic exercise using an anti-gravity treadmill in patients with lower limb osteoarthritis by using a cardiopulmonary exercise load monitoring system. [Subjects and Methods] The subjects were 20 patients with lower limb osteoarthritis. These subjects walked naturally for 8 minutes and then walked on the Alter-G for 8 minutes at their fastest speed at a load where lower limb pain was alleviated. [Results] Subjective and objective exercise intensity did not differ significantly between level ground walking and Alter-G walking neither before nor after walking. Pain before walking did not differ significantly between level ground walking and Alter-G walking, but pain after walking was significantly greater with level ground walking than with Alter-G walking. [Conclusion] Exercise therapy using an anti-gravity treadmill was useful for patients with lower limb osteoarthritis in terms of cardiopulmonary function, which suggested that this could become a new form of exercise therapy.

Limb-use by foraging marine turtles, an evolutionary perspective.

PubMed

Fujii, Jessica A; McLeish, Don; Brooks, Andrew J; Gaskell, John; Van Houtan, Kyle S

2018-01-01

The use of limbs for foraging is documented in both marine and terrestrial tetrapods. These behaviors were once believed to be less likely in marine tetrapods due to the physical constraints of body plans adapted to locomotion in a fluid environment. Despite these obstacles, ten distinct types of limb-use while foraging have been previously reported in nine marine tetrapod families. Here, we expand the types of limb-use documented in marine turtles and put it in context with the diversity of marine tetrapods currently known to use limbs for foraging. Additionally, we suggest that such behaviors could have occurred in ancestral turtles, and thus, possibly extend the evolutionary timeline of limb-use behavior in marine tetrapods back approximately 70 million years. Through direct observation in situ and crowd-sourcing, we document the range of behaviors across habitats and prey types, suggesting its widespread occurrence. We argue the presence of these behaviors among marine tetrapods may be limited by limb mobility and evolutionary history, rather than foraging ecology or social learning. These behaviors may also be remnant of ancestral forelimb-use that have been maintained due to a semi-aquatic life history.

Gender-related differences in lower limb alignment, range of joint motion, and the incidence of sports injuries in Japanese university athletes.

PubMed

Mitani, Yasuhiro

2017-01-01

[Purpose] To investigate the gender-related differences in lower limb alignment, range of joint motion, and history of lower limb sports injuries in Japanese university athletes. [Subjects and Methods] The subjects were 224 Japanese university athletes (154 males and 70 females). The quadriceps angle (Q-angle), arch height index, and ranges of internal and external rotation of the hip joints were measured. History of lower limb sports injury was surveyed using a questionnaire. [Results] Females had a significantly higher Q-angle and hip joint internal rotation angle and a significantly lower arch height index than males. The survey revealed that a significantly higher proportion of females had a history of lower limb sports injuries, and that the proportion of those with a history of foot/ankle injuries was particularly high. [Conclusion] These results suggested that females experience more lower limb sports injuries than males, and that a large proportion of these injuries involve the foot/ankle. Reduced lower limb alignment and increased range of joint motion in females may be risk factors for injury because they lead to increased physical stress being exerted on the lower legs during sporting activities.

Major lower extremity lawn mower injuries in children.

PubMed

Dormans, J P; Azzoni, M; Davidson, R S; Drummond, D S

1995-01-01

Between 1983 and 1993, 16 children with 18 lower extremity power lawn mower-related injuries were treated at Children's Hospital of Philadelphia. Eleven of 16 patients (69%) were bystanders or nonoperators. The average age at injury was 4 years 9 months. Length of follow-up averaged 3 years 10 months. There was an average of 4.9 procedures per patient. Fourteen of the 18 limbs injured required eventual amputation (78%). We propose a new classification of lawn mower injuries in children. The most common injury (16 of 18 limbs) was a shredding type injury and was either intercalary or distal. The second was a paucilaceration type (two of 18 limbs). Of the four salvaged limbs, there were two shredding type injuries, and on most recent follow-up are considered to have poor results. The two patients with the paucilaceration type injuries and limb salvage are considered to have excellent results. All patients with a shredding type injury ultimately required amputation or had poor results with the salvaged limb. Limb salvage surgery was associated with prolonged hospitalizations, a higher incidence of surgical problems, a longer treatment course, and more complications than early ablative procedures.

Motor control and learning with lower-limb myoelectric control in amputees.

PubMed

Alcaide-Aguirre, Ramses E; Morgenroth, David C; Ferris, Daniel P

2013-01-01

Advances in robotic technology have recently enabled the development of powered lower-limb prosthetic limbs. A major hurdle in developing commercially successful powered prostheses is the control interface. Myoelectric signals are one way for prosthetic users to provide feedforward volitional control of prosthesis mechanics. The goal of this study was to assess motor learning in people with lower-limb amputation using proportional myoelectric control from residual-limb muscles. We examined individuals with transtibial amputation and nondisabled controls performing tracking tasks of a virtual object. We assessed how quickly the individuals with amputation improved their performance and whether years since amputation correlated with performance. At the beginning of training, subjects with amputation performed much worse than control subjects. By the end of a short training period, tracking error did not significantly differ between subjects with amputation and nondisabled subjects. Initial but not final performance correlated significantly with time since amputation. This study demonstrates that although subjects with amputation may initially have poor volitional control of their residual lower-limb muscles, training can substantially improve their volitional control. These findings are encouraging for the future use of proportional myoelectric control of powered lower-limb prostheses.

Effects of postural changes of the upper limb on reflex transmission in the lower limb. Cervicolumbar reflex interactions in man.

PubMed

Delwaide, P J; Figiel, C; Richelle, C

1977-06-01

The influence of passive changes in upper limb position on the excitability of three myotatic arc reflexes (soleus, quadriceps, and biceps femoris) of the lower limb has been explored on 42 volunteers. The results indicate that the excitability of the three myotatic arcs can be influenced at a distance by postural modifications of the upper limb. When the ipsilateral upper limb is forwards or the contralateral backwards, a facilitation of both soleus and quadriceps tendon reflexes is observed while the biceps femoris reflexes are reduced. This pattern of facilitation and inhibition is reversed when the ipsilateral upper limb is backwards or the contralateral forwards. The facilitations as well as inhibitions of proximal myotatic arc reflexes are quantitatively more marked than that of the soleus reflex. Facilitation and inhibition are not linearly related to the angle of the arm with the trunk. Effects begin at a considerable angle, become maximal at 45 degrees, and progressively disappear for greater values. It is suggested that the distinct pattern of facilitation and inhibition which is exerted in reciprocal fashion on extensor and flexor motor nuclei might depend on the long propriospinal neurones connecting cervical and lumbar enlargements.

EFFECTS OF RETINOIC ACID AND ULTRAVIOLET RADIATION ON LIMB DEVELOPMENT IN ANURANS

EPA Science Inventory

Several recent studies suggest that the prevalence of limb abnormalities in North American anurans is elevated compared to historical records. These obsrvations have caused concern that environmental conditions are responsible for the increase through perturbation of normal limb ...

Recanalisation of Chronically Occluded Remote Superficial Femoral Artery Endarterectomy Through Angioplasty for Limb Salvage

DOE Office of Scientific and Technical Information (OSTI.GOV)

Husainy, Mohammad Ali, E-mail: m.husainy@nhs.net; Slim, Hani; Rashid, Hisham

2017-02-15

We report a novel application of balloon angioplasty to recanalise a chronically occluded remote endarterectomy superficial femoral artery. This patient previously had two occluded surgical bypass grafts in an attempt to revascularise the limb and presented with critical limb ischaemia and necrotic foot ulcerations. Following the angioplasty, the patient showed significant improvement in rest pain and healing of the ulcerations. This technique may be useful for limb salvage in patients where surgical options have been exhausted.

Management of Major Limb Injuries

PubMed Central

Langer, Vijay

2014-01-01

Management of major limb injuries is a daunting challenge, especially as many of these patients have severe associated injuries. In trying to save life, often the limb is sacrificed. The existing guidelines on managing such trauma are often confusing. There is scope to lay down such protocols along with the need for urgent transfer of such patients to a multispecialty center equipped to salvage life and limb for maximizing outcome. This review article comprehensively deals with the issue of managing such major injuries. PMID:24511296

Achondroplasia: Really rhizomelic?

PubMed

Shelmerdine, Susan Cheng; Brittain, Helen; Arthurs, Owen J; Calder, Alistair D

2016-08-01

Achondroplasia is the most common form of short limb dwarfism in humans. The shortening of the limb lengths in achondroplasia is widely described as "rhizomelic." While this appearance may be convincing clinically, the description is not necessarily true or helpful radiologically. The aims of this study, were therefore, to determine whether rhizomelic shortening is a true feature of achondroplasia at diagnosis in infancy. Humeral, radial, femoral, and tibial diaphyseal lengths were recorded by two independent observers from 22 skeletal surveys of infants with achondroplasia and compared with 150 normal age-matched control subjects. Upper and lower limb bone length ratios (radial/humeral and tibial/femoral lengths, respectively) in both groups were compared using an unpaired t-test. Mean upper limb length ratios were statistically higher within the achondroplasia group at 0.87 ± 0.04 (n = 22, mean age 70 ± 94 days) compared to normal controls at 0.79 ± 0.02 (n = 150, mean age 113 days ± 88 days; P < 0.0001). Lower limb length ratios were not significantly different between groups (0.84 ± 0.04 vs. 0.83 ± 0.02, P = 0.46). There was good inter-observer agreement of limb length measurements, with an average measurement difference of 0.1 ± 1.4 mm. In conclusion, infants with achondroplasia demonstrate statistically significant rhizomelic shortening within the upper limbs, but not lower limbs at diagnosis, compared to normal controls. The term "rhizomelic shortening" in relation to achondroplasia should be reserved when describing upper limb proportions. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Risk factors for adverse outcomes after endovascular therapy for critical limb ischemia with tissue loss due to infrainguinal artery disease.

PubMed

Tnishibe, Toshiya; Yamamoto, Kiyohito; Toguchi, Kayo; Seike, Yoshimasa; Ito, Naoki; Nishibe, Masayasu; Koizumi, Jun; Dardik, Alan; Ogino, Hitoshi

2016-10-01

The purpose of this study was to analyze the risk factors for an adverse outcome after endovascular therapy (EVT) for critical limb ischemia (CLI) with tissue loss due to infrainguinal artery disease. We retrospectively reviewed the charts of patients with tissue loss (Rutherford class 5 and 6) due to infrainguinal artery disease who were managed with endovascular therapy (EVT) between January 2006 and December 2013. The primary endpoint was amputation-free survival (AFS), while the secondary endpoints were freedom from a major adverse limb event (MALE) plus perioperative (30 days) death (POD), limb salvage, and survival rates at one year. Multivariable perioperative predictors of AFS were identified using the stepwise Cox proportional hazards regression model. A total of 65 patients underwent EVT for infrainguinal artery disease on 72 limbs. The technical success rate was 94% (68/72), while the clinical success was attained in 54 of 72 limbs (72%). The AFS, MALE + POD, limb salvage, and survival rates at one year were 76%, 86%, 91%, and 81%, respectively. The multivariate analysis demonstrated that major tissue loss classified as Rutherford class 6 (HR, 5.68; 95% CI, 2.29-14.13; P<0.05) was negatively associated with decreased AFS, while clinical success (HR, 0.25; 95% CI, 0.11-0.60; P<0.05) was positively associated with increased AFS. EVT resulted in an acceptable rate of AFS, MALE+POD, limb salvage, and survival. However, we must keep in mind that there are significant limitations to be considered for EVT in patients with major tissue loss, and that, even if revascularization could be successfully performed, a significant number of the treated limbs are still in a critical situation, such as major amputation or death.

Force-velocity properties' contribution to bilateral deficit during ballistic push-off.

PubMed

Samozino, Pierre; Rejc, Enrico; di Prampero, Pietro Enrico; Belli, Alain; Morin, Jean-Benoît

2014-01-01

The objective of this study is to quantify the contribution of the force-velocity (F-v) properties to bilateral force deficit (BLD) in ballistic lower limb push-off and to relate it to individual F-v mechanical properties of the lower limbs. The F-v relation was individually assessed from mechanical measurements for 14 subjects during maximal ballistic lower limb push-offs; its contribution to BLD was then investigated using a theoretical macroscopic approach, considering both the mechanical constraints of movement dynamics and the maximal external capabilities of the lower limb neuromuscular system. During ballistic lower limb push-off, the maximum force each lower limb can produce was lower during bilateral than unilateral actions, thus leading to a BLD of 36.7% ± 5.7%. The decrease in force due to the F-v mechanical properties amounted to 19.9% ± 3.6% of the force developed during BL push-offs, which represents a nonneural contribution to BLD of 43.5% ± 9.1%. This contribution to BLD that cannot be attributed to changes in neural features was negatively correlated to the maximum unloaded extension velocity of the lower limb (r = -0.977, P < 0.001). During ballistic lower limb push-off, BLD is due to both neural alterations and F-v mechanical properties, the latter being associated with the change in movement velocity between bilateral and unilateral actions. The level of the contribution of the F-v properties depends on the individual F-v mechanical profile of the entire lower limb neuromuscular system: the more the F-v profile is oriented toward velocity capabilities, the lower the loss of force from unilateral to bilateral push-offs due to changes in movement velocity.

Hip Strength in Patients with Quadriceps Strength Deficits after ACL Reconstruction.

PubMed

Bell, David R; Trigsted, Stephanie M; Post, Eric G; Walden, Courtney E

2016-10-01

Quadriceps strength deficits persist for years after anterior cruciate ligament (ACL) reconstruction, and patients with these deficits often shift torque demands away from the knee extensors to the hip during functional tasks. However, it is not clear how quadriceps strength deficits may affect hip strength. Therefore, the purpose of this study was to investigate differences in lower extremity strength in individuals with ACL reconstruction with differing levels of quadriceps strength asymmetry. Isometric strength was recorded bilaterally in 135 participants (73 control and 62 with unilateral ACL reconstruction, time from surgery = 30.9 ± 17.6 months) from the knee extensors and flexors, hip extensors and abductors, and hip internal and external rotator muscle groups. Symmetry indices (limb symmetry index (LSI)) were created based on quadriceps strength, and subjects with ACL reconstruction were subdivided (high quadriceps (LSI ≥ 90%), n = 37; low quadriceps (LSI < 85%), n = 18). Individual group (control vs high quadriceps vs low quadriceps) by limb (reconstructed/nondominant vs healthy/dominant) repeated-measures ANOVA was used to compare strength (%BW) for each of the six joint motions of interest (knee extensors/flexors, hip abductors/extensors/external, and internal rotators) while controlling for time from surgery. An interaction was observed for quadriceps strength (P < 0.001), and the reconstructed limb in the low quadriceps group was weaker than all other limbs. A main effect for group was observed with the low quadriceps group having greater hip extension (P = 0.007) strength in both limbs compared with the other groups. Knee flexion strength was weaker in the reconstructed limb of the high quadriceps group (P = 0.047) compared with all other groups and limbs. Individuals with ACL reconstruction and involved limb quadriceps weakness have greater hip extension strength in both limbs compared with patients with bilateral strength symmetry and controls.

Extrinsic Factors as Component Positions to Bone and Intrinsic Factors Affecting Postoperative Rotational Limb Alignment in Total Knee Arthroplasty.

PubMed

Mochizuki, Tomoharu; Sato, Takashi; Tanifuji, Osamu; Watanabe, Satoshi; Kobayashi, Koichi; Endo, Naoto

2018-02-13

This study aimed to identify the factors affecting postoperative rotational limb alignment of the tibia relative to the femur. We hypothesized that not only component positions but also several intrinsic factors were associated with postoperative rotational limb alignment. This study included 99 knees (90 women and 9 men) with a mean age of 77 ± 6 years. A three-dimensional (3D) assessment system was applied under weight-bearing conditions to biplanar long-leg radiographs using 3D-to-2D image registration technique. The evaluation parameters were (1) component position; (2) preoperative and postoperative coronal, sagittal, and rotational limb alignment; (3) preoperative bony deformity, including femoral torsion, condylar twist angle, and tibial torsion; and (4) preoperative and postoperative range of motion (ROM). In multiple linear regression analysis using a stepwise procedure, postoperative rotational limb alignment was associated with the following: (1) rotation of the component position (tibia: β = 0.371, P < .0001; femur: β = -0.327, P < .0001), (2) preoperative rotational limb alignment (β = 0.253, P = .001), (3) postoperative flexion angle (β = 0.195, P = .007), and (4) tibial torsion (β = 0.193, P = .010). In addition to component positions, the intrinsic factors, such as preoperative rotational limb alignment, ROM, and tibial torsion, affected postoperative rotational limb alignment. On a premise of correct component positions, the intrinsic factors that can be controlled by surgeons should be taken care. In particular, ROM is necessary to be improved within the possible range to acquire better postoperative rotational limb alignment. Copyright © 2018 Elsevier Inc. All rights reserved.

Modulation of phase durations, phase variations, and temporal coordination of the four limbs during quadrupedal split-belt locomotion in intact adult cats

PubMed Central

D'Angelo, Giuseppe; Thibaudier, Yann; Telonio, Alessandro; Hurteau, Marie-France; Kuczynski, Victoria; Dambreville, Charline

2014-01-01

Stepping along curvilinear paths produces speed differences between the inner and outer limb(s). This can be reproduced experimentally by independently controlling left and right speeds with split-belt locomotion. Here we provide additional details on the pattern of the four limbs during quadrupedal split-belt locomotion in intact cats. Six cats performed tied-belt locomotion (same speed bilaterally) and split-belt locomotion where one side (constant side) stepped at constant treadmill speed while the other side (varying side) stepped at several speeds. Cycle, stance, and swing durations changed in parallel in homolateral limbs with shorter and longer stance and swing durations on the fast side, respectively, compared with the slow side. Phase variations were quantified in all four limbs by measuring the slopes of the regressions between stance and cycle durations (rSTA) and between swing and cycle durations (rSW). For a given limb, rSTA and rSW were not significantly different from one another on the constant side whereas on the varying side rSTA increased relative to tied-belt locomotion while rSW became more negative. Phase variations were similar for homolateral limbs. Increasing left-right speed differences produced a large increase in homolateral double support on the slow side, while triple-support periods decreased. Increasing left-right speed differences altered homologous coupling, homolateral coupling on the fast side, and coupling between the fast hindlimb and slow forelimb. Results indicate that homolateral limbs share similar control strategies, only certain features of the interlimb pattern adjust, and spinal locomotor networks of the left and right sides are organized symmetrically. PMID:25031257

A difference in systolic blood pressure between arms and between lower limbs is a novel risk marker for diabetic nephropathy in patients with type 2 diabetes.

PubMed

Okada, Hiroshi; Fukui, Michiaki; Tanaka, Muhei; Matsumoto, Shinobu; Mineoka, Yusuke; Nakanishi, Naoko; Asano, Mai; Yamazaki, Masahiro; Hasegawa, Goji; Nakamura, Naoto

2013-05-01

Recent studies have demonstrated that a difference in systolic blood pressure (SBP) between arms is associated with both vascular disease and mortality. The aim of this study was to investigate the relationship between a difference in SBP between arms and between lower limbs and the degree of albuminuria, which is an established marker for cardiovascular disease and diabetic nephropathy in patients with Type 2 diabetes. We measured blood pressure in the arms and lower limbs of 314 consecutive patients with Type 2 diabetes, and we calculated a difference in SBP between arms and between lower limbs. We then evaluated the relationship of the difference in SBP between arms and between lower limbs to the degree of urinary albumin excretion (UAE). The average difference in SBP between arms and between lower limbs was 3.52±3.94 and 9.66±14.1 mm Hg, respectively. Multiple regression analyses demonstrated that a difference in SBP between arms (β=0.172, P=0.0239) and between lower limbs (β=0.238, P=0.0033) independently correlated with the logarithm of the UAE. Multiple logistic regression analyses showed that a difference in SBP of 10 mm Hg between arms (odds ratio 12.23 (95% CI 1.130-132.35), P<0.0393) and a difference in SBP of 15 mm Hg between lower limbs (odds ratio 4.291 (95% CI 1.403-13.123), P<0.0106) correlated with the risk of albuminuria. A difference in SBP between arms and between lower limbs, therefore, could be a novel risk marker for diabetic nephropathy in patients with Type 2 diabetes.

The Organization and Control of Intra-Limb Anticipatory Postural Adjustments and Their Role in Movement Performance

PubMed Central

Cavallari, Paolo; Bolzoni, Francesco; Bruttini, Carlo; Esposti, Roberto

2016-01-01

Anticipatory Postural Adjustments (APAs) are commonly described as unconscious muscular activities aimed to counterbalance the perturbation caused by the primary movement, so as to ensure the whole-body balance, as well as contributing to initiate the displacement of the body center of mass when starting gait or whole-body reaching movements. These activities usually create one or more fixation chains which spread over several muscles of different limbs, and may be thus called inter-limb APAs. However, it has been reported that APAs also precede voluntary movements involving tiny masses, like a flexion/extension of the wrist or even a brisk flexion of the index-finger. In particular, such movements are preceded by an intra-limb APA chain, that involves muscles acting on the proximal joints. Considering the small mass of the moving segments, it is unlikely that the ensuing perturbation could threaten the whole-body balance, so that it is interesting to enquire the physiological role of intra-limb APAs and their organization and control compared to inter-limb APAs. This review is focused on intra-limb APAs and highlights a strict correspondence in their behavior and temporal/spatial organization with respect to inter-limb APAs. Hence it is suggested that both are manifestations of the same phenomenon. Particular emphasis is given to intra-limb APAs preceding index-finger flexion, because their relatively simple biomechanics and the fact that muscular actions were limited to a single arm allowed peculiar investigations, leading to important conclusions. Indeed, such paradigm provided evidence that by granting a proper fixation of those body segments proximal to the moving one APAs are involved in refining movement precision, and also that APAs and prime mover activation are driven by a shared motor command. PMID:27807411

Isolated limb perfusion for the management limb threatening soft tissue sarcomas: The role of histological type on clinical outcomes.

PubMed

Rastrelli, M; Mocellin, S; Stramare, R; Brunello, A; Maruzzo, M; Basso, U; Scarzello, G; Buzzaccarini, M S; Pilati, P; Saadeh, L M; Del Fiore, S P; Tosi, A; Montesco, C; Campana, L G; Tropea, S; Rossi, C R

2017-02-01

Hyperthermic isolated limb perfusion (HILP) is an effective neoadjuvant treatment to avoid amputation in patients with locally advanced extremity soft tissue sarcomas (STS). We aimed to investigate whether STS histological type plays a role in predicting clinical outcomes. This study reports a retrospective analysis of 125 patients with limb threatening STS (liposarcoma, n = 41; malignant peripheral nerve sheath tumor, n = 20; leiomyosarcoma, n = 20; miscellany, n = 44), who underwent HILP from 1990 through 2015 at our institution. The following endpoints were evaluated: tumor response (assessed by radiological imaging and histology), limb sparing rate, local progression-free survival (LPFS) and overall survival (OS). On average, overall (complete + partial) tumor response was significantly greater in patients affected with liposarcoma as compared to those with other histotypes (radiological response rate: 38/41, 92.7% vs 66/84, 78.6%, P-value: 0.048; mean histological necrosis: 83.6% vs 52.9%, P < 0.0001). Limb sparing rate was also higher among patients with liposarcoma as compared to other histotypes (39/41, 95.1% vs 62/84, 73.8%, P-value: 0.005). As regards survival, LPFS was similar across tumor types, whereas OS resulted significantly worse in patients with limb leiomyosarcoma (log-rank P-value: 0.009). HILP is a very effective treatment modality for limb threatening STS. In our series, liposarcoma appears to be the histological type most sensitive to HILP in terms of tumor response and thus limb sparing, which might help clinicians in the patient selection process. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Conditional inactivation of Has2 reveals a crucial role for hyaluronan in skeletal growth, patterning, chondrocyte maturation and joint formation in the developing limb

PubMed Central

Matsumoto, Kazu; Li, Yingcui; Jakuba, Caroline; Sugiyama, Yoshinori; Sayo, Tetsuya; Okuno, Misako; Dealy, Caroline N.; Toole, Bryan P.; Takeda, Junji; Yamaguchi, Yu; Kosher, Robert A.

2009-01-01

Summary The glycosaminoglycan hyaluronan (HA) is a structural component of extracellular matrices and also interacts with cell surface receptors to directly influence cell behavior. To explore functions of HA in limb skeletal development, we conditionally inactivated the gene for HA synthase 2, Has2, in limb bud mesoderm using mice that harbor a floxed allele of Has2 and mice carrying a limb mesoderm-specific Prx1-Cre transgene. The skeletal elements of Has2-deficient limbs are severely shortened, indicating that HA is essential for normal longitudinal growth of all limb skeletal elements. Proximal phalanges are duplicated in Has2 mutant limbs indicating an involvement of HA in patterning specific portions of the digits. The growth plates of Has2-deficient skeletal elements are severely abnormal and disorganized, with a decrease in the deposition of aggrecan in the matrix and a disruption in normal columnar cellular relationships. Furthermore, there is a striking reduction in the number of hypertrophic chondrocytes and in the expression domains of markers of hypertrophic differentiation in the mutant growth plates, indicating that HA is necessary for the normal progression of chondrocyte maturation. In addition, secondary ossification centers do not form in the central regions of Has2 mutant growth plates owing to a failure of hypertrophic differentiation. In addition to skeletal defects, the formation of synovial joint cavities is defective in Has2-deficient limbs. Taken together, our results demonstrate that HA has a crucial role in skeletal growth, patterning, chondrocyte maturation and synovial joint formation in the developing limb. PMID:19633173

Gadolinium and ruthenium red attenuate remote hind limb preconditioning-induced cardioprotection: possible role of TRP and especially TRPV channels.

PubMed

Randhawa, Puneet Kaur; Jaggi, Amteshwar Singh

2016-08-01

Remote ischemic preconditioning is a well reported therapeutic strategy that induces cardioprotective effects but the underlying intracellular mechanisms have not been widely explored. The current study was designed to investigate the involvement of TRP and especially TRPV channels in remote hind limb preconditioning-induced cardioprotection. Remote hind limb preconditioning stimulus (4 alternate cycles of inflation and deflation of 5 min each) was delivered using a blood pressure cuff tied on the hind limb of the anesthetized rat. Using Langendorff's system, the heart was perfused and subjected to 30-min ischemia and 120-min reperfusion. The myocardial injury was assessed by measuring infarct size, lactate dehydrogenase (LDH), creatine kinase (CK), LVDP, +dp/dtmax, -dp/dtmin, heart rate, and coronary flow rate. Gadolinium, TRP blocker, and ruthenium red, TRPV channel blocker, were employed as pharmacological tools. Remote hind limb preconditioning significantly reduced the infarct size, LDH release, CK release and improved coronary flow rate, hemodynamic parameters including LVDP, +dp/dtmax, -dp/dtmin, and heart rate. However, gadolinium (7.5 and 15 mg kg(-1)) and ruthenium red (4 and 8 mg kg(-1)) significantly attenuated the cardioprotective effects suggesting the involvement of TRP especially TRPV channels in mediating remote hind limb preconditioning-induced cardioprotection. Remote hind limb preconditioning stimulus possibly activates TRPV channels on the heart or sensory nerve fibers innervating the heart to induce cardioprotective effects. Alternatively, remote hind limb preconditioning stimulus may also activate the mechanosensitive TRP and especially TRPV channels on the sensory nerve fibers innervating the skeletal muscles to trigger cardioprotective neurogenic signaling cascade. The cardioprotective effects of remote hind limb preconditioning may be mediated via activation of mechanosensitive TRP and especially TRPV channels.

Evaluating optimal superficial limb perfusion at different angles using non-invasive micro-lightguide spectrophotometry.

PubMed

Darmanin, Geraldine; Jaggard, Matthew; Hettiaratchy, Shehan; Nanchahal, Jagdeep; Jain, Abhilash

2013-06-01

It is common practice to elevate the limbs postoperatively to reduce oedema and hence optimise perfusion and facilitate rehabilitation. However, elevation may be counterproductive as it reduces the mean perfusion pressure. There are no clear data on the optimal position of the limbs even in normal subjects. The optimal position of limbs was investigated in 25 healthy subjects using a non-invasive micro-lightguide spectrophotometry system "O2C", which indirectly measures skin and superficial tissue perfusion through blood flow, oxygen saturation and relative haemoglobin concentration. We found a reduction in skin and superficial tissue blood flow of 17% (p=0.0001) on arm elevation (180° shoulder flexion) as compared to heart level and an increase in skin and superficial tissue blood flow of 25% (p=0.02) on forearm elevation of 45°. Lower limb skin and superficial tissue blood flow decreased by 15% (p=0.004) on elevation to 47 cm and by 70% on dependency (p=0.0001) compared to heart level. However, on elevation of the lower limb there was also a 28% reduction in superficial venous pooling (p=0.0001) compared to heart level. In the normal limb, the position for optimal superficial perfusion of the upper limb is with the arm placed at heart level and forearm at 45°. In the lower limb the optimal position for superficial perfusion would be at heart level. However, some degree of elevation may be useful if there is an element of venous congestion. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Evidence for existence of trunk-limb neural interaction in the corticospinal pathway.

PubMed

Sasaki, Atsushi; Milosevic, Matija; Sekiguchi, Hirofumi; Nakazawa, Kimitaka

2018-03-06

In humans, trunk muscles have an essential role in postural control as well as walking. However, little is known about the mechanisms of interaction with different muscles, especially related to how trunk muscles interact with the limbs. Contraction of muscles can modulate the corticospinal excitability not only of the contracted muscle, but also of other muscles even in the remote segments of the body. However, "remote effect" mechanism has only been examined for inter-limb interactions. The aim of our current study was to test if there are trunk-limb interactions in the corticospinal pathways. We examined corticospinal excitability of: (a) trunk muscles at rest when hands, legs and jaw muscles were contracted and; (b) hand, leg, and jaw muscles at rest when trunk muscles were contracted. We measured motor evoked potentials elicited using transcranial magnetic stimulation in the rectus abdominis, flexor digitorum superficialis, masseter, tibialis anterior muscles under the following experimental conditions: (1) participants remained relaxed (Rest); (2) during trunk contraction (Trunk); (3) during bilateral hand clenching (Hands); (4) during jaw clenching (Jaw); and (5) during bilateral ankle dorsiflexion (Legs). Each condition was performed at three different stimulation intensities and conditions were randomized between participants. We found that voluntary contraction of trunk muscle facilitated the corticospinal excitability of upper-limb and lower-limb muscles during rest state. Furthermore, voluntary contraction of upper-limb muscle also facilitated the corticospinal excitability of trunk muscles during rest state. Overall, these results suggest the existence of trunk-limb interaction in the corticospinal pathway, which is likely depended on proximity of the trunk and limb representation in the motor cortex. Copyright © 2018 Elsevier B.V. All rights reserved.

Resveratrol increases nitric oxide production in the rat thick ascending limb via Ca2+/calmodulin.

PubMed

Gonzalez-Vicente, Agustin; Cabral, Pablo D; Garvin, Jeffrey L

2014-01-01

The thick ascending limb of the loop of Henle reabsorbs 30% of the NaCl filtered through the glomerulus. Nitric oxide (NO) produced by NO synthase 3 (NOS3) inhibits NaCl absorption by this segment. Resveratrol, a polyphenol, has beneficial cardiovascular and renal effects, many of which are mediated by NO. Resveratrol increases intracellular Ca2+ (Cai) and AMP kinase (AMPK) and NAD-dependent deacetylase sirtuin1 (SIRT1) activities, all of which could activate NO production. We hypothesized that resveratrol stimulates NO production by thick ascending limbs via a Ca2+/calmodulin-dependent mechanism. To test this, the effect of resveratrol on NO bioavailability was measured in thick ascending limb suspensions. Cai was measured in single perfused thick ascending limbs. SIRT1 activity and expression were measured in thick ascending limb lysates. Resveratrol (100 µM) increased NO bioavailability in thick ascending limb suspensions by 1.3±0.2 AFU/mg/min (p<0.03). The NOS inhibitor L-NAME blunted resveratrol-stimulated NO bioavailability by 96±11% (p<0.03). The superoxide scavenger tempol had no effect. Resveratrol elevated Cai from 48±7 to 135±24 nM (p<0.01) in single tubules. In Ca2+-free media, the resveratrol-induced increase in NO was blunted by 60±20% (p<0.05) and the rise in Cai reduced by 80%. Calmodulin inhibition prevented the resveratrol-induced increase in NO (p<0.002). AMPK inhibition had no effect. Resveratrol did not increase SIRT1 activity. We conclude that resveratrol increases NO production in thick ascending limbs via a Ca2+/calmodulin dependent mechanism, and SIRT1 and AMPK do not participate. Resveratrol-stimulated NO production in thick ascending limbs may account for part of its beneficial effects.

The impact of workplace risk factors on the occurrence of neck and upper limb pain: a general population study.

PubMed

Sim, Julius; Lacey, Rosie J; Lewis, Martyn

2006-09-19

Work-related neck and upper limb pain has mainly been studied in specific occupational groups, and little is known about its impact in the general population. The objectives of this study were to estimate the prevalence and population impact of work-related neck and upper limb pain. A cross-sectional survey was conducted of 10,000 adults in North Staffordshire, UK, in which there is a common local manual industry. The primary outcome measure was presence or absence of neck and upper limb pain. Participants were asked to give details of up to five recent jobs, and to report exposure to six work activities involving the neck or upper limbs. Psychosocial measures included job control, demand and support. Odds ratios (ORs) and population attributable fractions were calculated for these risk factors. The age-standardized one-month period prevalence of neck and upper limb pain was 44%. There were significant independent associations between neck and upper limb pain and: repeated lifting of heavy objects (OR = 1.4); prolonged bending of neck (OR = 2.0); working with arms at/above shoulder height (OR = 1.3); little job control (OR = 1.6); and little supervisor support (OR = 1.3). The population attributable fractions were 0.24 (24%) for exposure to work activities and 0.12 (12%) for exposure to psychosocial factors. Neck and upper limb pain is associated with both physical and psychosocial factors in the work environment. Inferences of cause-and-effect from cross-sectional studies must be made with caution; nonetheless, our findings suggest that modification of the work environment might prevent up to one in three of cases of neck and upper limb pain in the general population, depending on current exposures to occupational risk.

Outcomes of lower extremity bypass performed for acute limb ischemia

PubMed Central

Baril, Donald T.; Patel, Virendra I.; Judelson, Dejah R.; Goodney, Philip P.; McPhee, James T.; Hevelone, Nathanael D.; Cronenwett, Jack L.; Schanzer, Andres

2013-01-01

Objective Acute limb ischemia remains one of the most challenging emergencies in vascular surgery. Historically, outcomes following interventions for acute limb ischemia have been associated with high rates of morbidity and mortality. The purpose of this study was to determine contemporary outcomes following lower extremity bypass performed for acute limb ischemia. Methods All patients undergoing infrainguinal lower extremity bypass between 2003 and 2011 within hospitals comprising the Vascular Study Group of New England were identified. Patients were stratified according to whether or not the indication for lower extremity bypass was acute limb ischemia. Primary end points included bypass graft occlusion, major amputation, and mortality at 1 year postoperatively as determined by Kaplan-Meier life table analysis. Multivariable Cox proportional hazards models were constructed to evaluate independent predictors of mortality and major amputation at 1 year. Results Of 5712 lower extremity bypass procedures, 323 (5.7%) were performed for acute limb ischemia. Patients undergoing lower extremity bypass for acute limb ischemia were similar in age (66 vs 67; P = .084) and sex (68% male vs 69% male; P = .617) compared with chronic ischemia patients, but were less likely to be on aspirin (63% vs 75%; P < .0001) or a statin (55% vs 68%; P < .0001). Patients with acute limb ischemia were more likely to be current smokers (49% vs 39%; P < .0001), to have had a prior ipsilateral bypass (33% vs 24%; P = .004) or a prior ipsilateral percutaneous intervention (41% vs 29%; P = .001). Bypasses performed for acute limb ischemia were longer in duration (270 vs 244 minutes; P = .007), had greater blood loss (363 vs 272 mL; P < .0001), and more commonly utilized prosthetic conduits (41% vs 33%; P = .003). Acute limb ischemia patients experienced increased in-hospital major adverse events (20% vs 12%; P < .0001) including myocardial infarction, congestive heart failure exacerbation, deterioration in renal function, and respiratory complications. Patients who underwent lower extremity bypass for acute limb ischemia had no difference in rates of graft occlusion (18.1% vs 18.5%; P = .77), but did have significantly higher rates of limb loss (22.4% vs 9.7%; P < .0001) and mortality (20.9% vs 13.1%; P < .0001) at 1 year. On multivariable analysis, acute limb ischemia was an independent predictor of both major amputation (hazard ratio, 2.16; confidence interval, 1.38–3.40; P = .001) and mortality (hazard ratio, 1.41; confidence interval, 1.09–1.83; P = .009) at 1 year. Conclusions Patients who present with acute limb ischemia represent a less medically optimized subgroup within the population of patients undergoing lower extremity bypass. These patients may be expected to have more complex operations followed by increased rates of perioperative adverse events. Additionally, despite equivalent graft patency rates, patients undergoing lower extremity bypass for acute ischemia have significantly higher rates of major amputation and mortality at 1 year. PMID:23714364

Outcomes of lower extremity bypass performed for acute limb ischemia.

PubMed

Baril, Donald T; Patel, Virendra I; Judelson, Dejah R; Goodney, Philip P; McPhee, James T; Hevelone, Nathanael D; Cronenwett, Jack L; Schanzer, Andres

2013-10-01

Acute limb ischemia remains one of the most challenging emergencies in vascular surgery. Historically, outcomes following interventions for acute limb ischemia have been associated with high rates of morbidity and mortality. The purpose of this study was to determine contemporary outcomes following lower extremity bypass performed for acute limb ischemia. All patients undergoing infrainguinal lower extremity bypass between 2003 and 2011 within hospitals comprising the Vascular Study Group of New England were identified. Patients were stratified according to whether or not the indication for lower extremity bypass was acute limb ischemia. Primary end points included bypass graft occlusion, major amputation, and mortality at 1 year postoperatively as determined by Kaplan-Meier life table analysis. Multivariable Cox proportional hazards models were constructed to evaluate independent predictors of mortality and major amputation at 1 year. Of 5712 lower extremity bypass procedures, 323 (5.7%) were performed for acute limb ischemia. Patients undergoing lower extremity bypass for acute limb ischemia were similar in age (66 vs 67; P = .084) and sex (68% male vs 69% male; P = .617) compared with chronic ischemia patients, but were less likely to be on aspirin (63% vs 75%; P < .0001) or a statin (55% vs 68%; P < .0001). Patients with acute limb ischemia were more likely to be current smokers (49% vs 39%; P < .0001), to have had a prior ipsilateral bypass (33% vs 24%; P = .004) or a prior ipsilateral percutaneous intervention (41% vs 29%; P = .001). Bypasses performed for acute limb ischemia were longer in duration (270 vs 244 minutes; P = .007), had greater blood loss (363 vs 272 mL; P < .0001), and more commonly utilized prosthetic conduits (41% vs 33%; P = .003). Acute limb ischemia patients experienced increased in-hospital major adverse events (20% vs 12%; P < .0001) including myocardial infarction, congestive heart failure exacerbation, deterioration in renal function, and respiratory complications. Patients who underwent lower extremity bypass for acute limb ischemia had no difference in rates of graft occlusion (18.1% vs 18.5%; P = .77), but did have significantly higher rates of limb loss (22.4% vs 9.7%; P < .0001) and mortality (20.9% vs 13.1%; P < .0001) at 1 year. On multivariable analysis, acute limb ischemia was an independent predictor of both major amputation (hazard ratio, 2.16; confidence interval, 1.38-3.40; P = .001) and mortality (hazard ratio, 1.41; confidence interval, 1.09-1.83; P = .009) at 1 year. Patients who present with acute limb ischemia represent a less medically optimized subgroup within the population of patients undergoing lower extremity bypass. These patients may be expected to have more complex operations followed by increased rates of perioperative adverse events. Additionally, despite equivalent graft patency rates, patients undergoing lower extremity bypass for acute ischemia have significantly higher rates of major amputation and mortality at 1 year. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

[A Case of Middle Cerebral Artery Stenosis Presented with Limb-Shaking TIA].

PubMed

Uno, Junji; Mineta, Haruyuki; Ren, Nice; Takagishi, Sou; Nagaoka, Shintarou; Kameda, Katsuharu; Maeda, Kazushi; Ikai, Yoshiaki; Gi, Hidefuku

2016-07-01

Involuntary movement is a rare clinical manifestation of transient ischemic attack (TIA). However, limb-shaking TIA is well described presentation of carotid occlusive disease. We present the case of a patient who developed limb-shaking TIA associated with high-grade stenosis of middle cerebral artery (M1), which was treated with percutaneous transluminal angioplasty (PTA). The procedure was performed successfully without complication and the symptom disappeared immediately after the procedure. The patient remained free of symptoms at the 38-month follow-up. There was no tendency of restenosis of M1. In this case, PTA was technically feasible and beneficial for limb-shaking TIA with M1 stenosis. Limb-shaking TIA can be a symptom of high-grade stenosis of M1.

Temperature-salinity structure of the AMOC in high-resolution ocean simulations and in CMIP5 models

NASA Astrophysics Data System (ADS)

Wang, F.; Xu, X.; Chassignet, E.

2017-12-01

On average, the CMIP5 models represent the AMOC structure, water properties, Heat transport and Freshwater transport reasonably well. For temperature, CMIP5 models exhibit a colder northward upper limb and a warmer southward lower limb. the temperature contrast induces weaker heat transport than observation. For salinity, CMIP5 models exhibit saltier southward lower limb, thus contributes to weaker column freshwater transport. Models have large spread, among them, AMOC strength contributes to Heat transport but not freshwater transport. AMOC structure (the overturning depth) contributes to transport-weighted temperature not transport-weighted salinity in southward lower limb. The salinity contrast in upper and lower limb contributes to freshwater transport, but temperature contrast do not contribute to heat transport.

Concentrations and loads of cadmium, lead, and zinc measured on the ascending and descending limbs of the 1999 snowmelt-runoff hydrographs for nine water-quality stations, Coeur d'Alene River basin, Idaho

USGS Publications Warehouse

Woods, Paul F.

2001-01-01

Hysteresis effects on concentrations and loads over the ascending and descending limbs of the snowmelt-runoff hydrograph were quite apparent, especially for whole-water recoverable constituents. Hysteresis is present when a property, such as constituent concentration or load, has different values for a given discharge over the ascending and descending limbs of a hydrograph. During this study, loads of whole-water recoverable constituents on the ascending limb were between 1.5 and 3.6 times larger than those mea- sured on the descending limb at nearly equal discharge. In contrast, dissolved constituents showed minimal hysteresis effects.

Prevention of Kinked Stent Graft Limb Due to Severe Angulated Proximal Neck during Endovascular Repair for Abdominal Aortic Aneurysm.

PubMed

Oh, Pyung Chun; Kim, Minsu; Shin, Eak Kyun; Kang, Woong Chol

2018-04-20

Although the technology of endovascular aortic repair (EVAR) for abdominal aortic aneurysm (AAA) is evolving that make it appealing for challenging anatomy, proximal aortic neck morphology, especially severe angulation, is still one of the most determinants for a successful procedure. We describe a patient of AAA with severely angulated proximal neck, in whom kinked stent graft limb occurred against severe angulation of proximal neck. Then, we suggested how to prevent this complication in the second patient. Our case demonstrated the stent graft limb could be kinked by severe aortic neck angulation, making it challenging. However, the kinked stent graft limb could be prevented by deploying stent graft limbs below the most severely angulated aortic neck intentionally.

Hang Them High: A Hands-Free Technique for Upper Extremity Limb Holding During Surgical Preparation.

PubMed

Aneja, Arun; Leung, Patrick; Marquez-Lara, Alejandro

Lifting and holding upper and lower limbs during the "prep and drape" portion of certain orthopaedic procedures exert strong forces on the holder and may lead to musculoskeletal disorders. To address these challenges during upper extremity procedures, this article describes a hand-free elevation and traction technique of the upper limbs during preoperative skin preparation with the use of items readily available within the operating room (OR). This technique is particularly useful for heavy or fractured limbs that may impose a physical challenge to lift and maintain in a stable position. Implementation of this technique reduces the risk to nurses, OR personnel, and caregivers of developing work-related musculoskeletal injuries while lifting and holding limbs in the orthopaedic OR.

ENGINEERING APPLICATION AND ECONOMICS OF LIMB (LIMESTONE INJECTION/MULTISTAGE BURNERS)

EPA Science Inventory

The paper describes the use of an EPA LIMB cost model, in conjunction with cost and performance models for flue gas desulfurization (FGD), to compare these two technologies under similar premises. (NOTE: The performance goals of LIMB, EPA's acronym for Limestone Injection/Multist...

A cortical-spinal prosthesis for targeted limb movement in paralyzed primate avatars

PubMed Central

Shanechi, Maryam M.; Hu, Rollin C.; Williams, Ziv M.

2014-01-01

Motor paralysis is among the most disabling aspects of injury to the central nervous system. Here we develop and test a target-based cortical-spinal neural prosthesis that employs neural activity recorded from pre-motor neurons to control limb movements in functionally paralyzed primate avatars. Given the complexity by which muscle contractions are naturally controlled, we approach the problem of eliciting goal-directed limb movement in paralyzed animals by focusing on the intended targets of movement rather than their intermediate trajectories. We then match this information in real-time with spinal cord and muscle stimulation parameters that produce free planar limb movements to those intended target locations. We demonstrate that both the decoded activities of pre-motor populations and their adaptive responses can be used, after brief training, to effectively direct an avatar’s limb to distinct targets variably displayed on a screen. These findings advance the future possibility of reconstituting targeted limb movement in paralyzed subjects. PMID:24549394

Upper limb dysfunction following selective neck dissection: a retrospective questionnaire study.

PubMed

Carr, Simon D; Bowyer, Duncan; Cox, Graham

2009-06-01

To determine total upper limb function following selective neck dissection over a mean follow-up of 1.6 years. A retrospective questionnaire study in a tertiary head and neck surgical unit. One hundred forty-eight patients who underwent selective neck dissection for head and neck cancer from January 2000 to December 2005 were invited to participate. The main outcome measure was ipsilateral upper limb dysfunction as measured by the Disability of Arm, Shoulder and Hand (DASH) questionnaire. Sixty-five patients responded to the invitation to join the study from 148 invited. Despite accessory nerve conserving surgery for all the selective neck dissections studied, 23% reported no upper limb dysfunction, 54% reported mild upper limb dysfunction, 15% reported moderate, and 8% reported a severe dysfunction. Long-term upper limb dysfunction is common following nerve preserving surgery. The DASH questionnaire is a useful preoperative and postoperative clinical tool for those patients undergoing selective neck dissections. (c) 2009 Wiley Periodicals, Inc.

Dimeric combinations of MafB, cFos and cJun control the apoptosis-survival balance in limb morphogenesis.

PubMed

Suda, Natsuno; Itoh, Takehiko; Nakato, Ryuichiro; Shirakawa, Daisuke; Bando, Masashige; Katou, Yuki; Kataoka, Kohsuke; Shirahige, Katsuhiko; Tickle, Cheryll; Tanaka, Mikiko

2014-07-01

Apoptosis is an important mechanism for sculpting morphology. However, the molecular cascades that control apoptosis in developing limb buds remain largely unclear. Here, we show that MafB was specifically expressed in apoptotic regions of chick limb buds, and MafB/cFos heterodimers repressed apoptosis, whereas MafB/cJun heterodimers promoted apoptosis for sculpting the shape of the limbs. Chromatin immunoprecipitation sequencing in chick limb buds identified potential target genes and regulatory elements controlled by Maf and Jun. Functional analyses revealed that expression of p63 and p73, key components known to arrest the cell cycle, was directly activated by MafB and cJun. Our data suggest that dimeric combinations of MafB, cFos and cJun in developing chick limb buds control the number of apoptotic cells, and that MafB/cJun heterodimers lead to apoptosis via activation of p63 and p73. © 2014. Published by The Company of Biologists Ltd.