Minimum toe clearance events in divided attention treadmill walking in older and young adults: a cross-sectional study.

PubMed

Santhiranayagam, Braveena K; Lai, Daniel T H; Sparrow, W A; Begg, Rezaul K

2015-07-12

Falls in older adults during walking frequently occur while performing a concurrent task; that is, dividing attention to respond to other demands in the environment. A particularly hazardous fall-related event is tripping due to toe-ground contact during the swing phase of the gait cycle. The aim of this experiment was to determine the effects of divided attention on tripping risk by investigating the gait cycle event Minimum Toe Clearance (MTC). Fifteen older adults (mean 73.1 years) and 15 young controls (mean 26.1 years) performed three walking tasks on motorized treadmill: (i) at preferred walking speed (preferred walking), (ii) while carrying a glass of water at a comfortable walking speed (dual task walking), and (iii) speed-matched control walking without the glass of water (control walking). Position-time coordinates of the toe were acquired using a 3 dimensional motion capture system (Optotrak NDI, Canada). When MTC was present, toe height at MTC (MTC_Height) and MTC timing (MTC_Time) were calculated. The proportion of non-MTC gait cycles was computed and for non-MTC gait cycles, toe-height was extracted at the mean MTC_Time. Both groups maintained mean MTC_Height across all three conditions. Despite greater MTC_Height SD in preferred gait, the older group reduced their variability to match the young group in dual task walking. Compared to preferred speed walking, both groups attained MTC earlier in dual task and control conditions. The older group's MTC_Time SD was greater across all conditions; in dual task walking, however, they approximated the young group's SD. Non-MTC gait cycles were more frequent in the older group across walking conditions (for example, in preferred walking: young - 2.9 %; older - 18.7 %). In response to increased attention demands older adults preserve MTC_Height but exercise greater control of the critical MTC event by reducing variability in both MTC_Height and MTC_Time. A further adaptive locomotor control strategy to reduce

Effects of Walking Speed and Visual-Target Distance on Toe Trajectory During Swing Phase

NASA Technical Reports Server (NTRS)

Miller, Chris; Peters, Brian; Brady, Rachel; Warren, Liz; Richards, Jason; Mulavara, Ajitkumar; Sung, Hsi-Guang; Bloomberg, Jacob

2006-01-01

After spaceflight, astronauts experience disturbances in their ability to walk and maintain postural stability (Bloomberg, et al., 1997). One of the post-flight neurovestibular assessments requires that the astronaut walk on a treadmill at 1.8 m/sec (4.0 mph), while performing a visual acuity test, set at two different distances ( far and near ). For the first few days after landing, some crewmembers can not maintain the required pace, so a lower speed may be used. The slower velocity must be considered in the kinematic analysis, because Andriacchi, et al. (1977) showed that in clinical populations, changes in gait parameters may be attributable more to slower gait speed than pathology. Studying toe trajectory gives a global view of control of the leg, since it involves coordination of muscles and joints in both the swing and stance legs (Karst, et al., 1999). Winter (1992) and Murray, et al. (1984) reported that toe clearance during overground walking increased slightly as speed increased, but not significantly. Also, toe vertical peaks in both early and late swing phase did increase significantly with increasing speed. During conventional testing of overground locomotion, subjects are usually asked to fix their gaze on the end of the walkway a far target. But target (i.e., visual fixation) distance has been shown to affect head and trunk motion during treadmill walking (Bloomberg, et al., 1992; Peters, et al., in review). Since the head and trunk can not maintain stable gaze without proper coordination with the lower body (Mulavara & Bloomberg, 2003), it would stand to reason that lower body kinematics may be altered as well when target distance is modified. The purpose of this study was to determine changes in toe vertical trajectory during treadmill walking due to changes in walking speed and target distance.

Severity of spine malalignment on center of pressure progression during level walking in subjects with adolescent idiopathic scoliosis.

PubMed

Chern, Jen-Suh; Kao, Chia-Chi; Lai, Po-Lian; Lung, Chi-Wen; Chen, Wen-Jer

2014-01-01

Center of pressure (CoP) progression during level walking in subjects with Adolescents Idiopathic Scoliosis (AIS) was measured. Participants were divided into three groups according to scoliosis severity. CoP progression among groups was compared quantitatively and qualitatively. The results showed that scoliosis severity affects CoP progression significantly in the hind-foot and forefoot areas. This result indicated that spine alignment might affect the control of heel, ankle and toe rockers in the ankle-foot complex. The effects of scoliosis severity is mainly on the CoP of right foot plantar surface, indicating asymmetrical influence of IS on bilateral lower limb coordination during walking. These results might contribute to musculoskeletal complains over the apparatus within trunk-foot in the later lives of this population.

[Do children with attention deficit and hyperactivity disorder (ADHD) have a diferent gait pattern? Relationship between idiopathic toe-walking and ADHD].

PubMed

Soto Insuga, Víctor; Moreno Vinués, Beatriz; Losada Del Pozo, Rebeca; Rodrigo Moreno, María; Martínez González, Marta; Cutillas Ruiz, Raquel; Mateos Carmen, Carmen

2018-04-01

Idiopathic toe-walking (ITW) is described as a gait pattern with no contact between the heels and the ground in children older than 3years. The diagnosis is clinical, making it necessary to rule out other neurological and orthopaedic conditions. A relationship between ITW and vestibular dysfunction and/or proprioceptive sensibility has been proposed. Children with neurodevelopmental disorders (autism, language and cognitive disorders) often have ITW. To determine the frequency of ITW in children with attention deficit disorder and hyperactivity (ADHD). A study was conducted on children diagnosed with ADHD, with normal neurological examination, with no alterations in MRI scan, cognitive disorder or autism. A complete clinical anamnesis was performed and Achilles shortening was measured with a goniometer. The study included 312 children with a mean age of 11 years (73.7% boys). The ADHD combined subtype was the most frequent (53.8%), followed by the inattentive (44.9%), and hyperactive (1.3%). ITW was observed in 20.8% of patients, particularly in the combined subtype (P=.054). Only 32 of them (49.2%) had Achilles shortening. ITW was associated with sociability disorders (P=.01), absence of pain in legs (P=.022), and family history of ITW (P=.004). Only 11% had previously visited a doctor for this reason. As in other neurodevelopmental disorders, children with ADHD have frequently more ITW and Achilles shortening than controls, especially if they presented with a social communication disorder or a family history of ITW. An early diagnosis is essential to establish effective treatments. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Effects of Long-duration Space Flight on Toe Clearance During Treadmill Walking

NASA Technical Reports Server (NTRS)

Miller, Chris; Peters, Brian; Brady, Rachel; Mulavara, Ajitkumar; Richards, Jason; Hayat, Matthew; Bloomberg, Jacob

2008-01-01

Upon returning from long-duration space flight, astronauts and cosmonauts must overcome physiologic and sensorimotor changes induced by prolonged exposure to microgravity as they readapt to a gravitational environment. Their compromised balance and coordination lead to an altered and more variable walking pattern (Bloomberg & Mulavara, 2003; McDonald, et al., 1996). Toe trajectory during the swing phase of locomotion has been identified as a precise motor control task (Karst, et al., 1999), thus providing an indication of the coordination of the lower limbs (Winter, 1992). Failure to achieve sufficient toe clearance may put the crew member at a greater risk of tripping and falling, especially if an emergency egress from the vehicle should be necessary upon landing. The purpose of this study was to determine the pre- to post-flight changes in toe clearance in crew members returning from long-duration missions and the recovery thereafter.

Determinants of 6-minute walk distance in patients with idiopathic pulmonary fibrosis undergoing lung transplant evaluation.

PubMed

Porteous, Mary K; Rivera-Lebron, Belinda N; Kreider, Maryl; Lee, James; Kawut, Steven M

2016-03-01

Little is known about the physiologic determinants of 6-minute walk distance in idiopathic pulmonary fibrosis. We investigated the demographic, pulmonary function, echocardiographic, and hemodynamic determinants of 6-minute walk distance in patients with idiopathic pulmonary fibrosis evaluated for lung transplantation. We performed a cross-sectional analysis of 130 patients with idiopathic pulmonary fibrosis who completed a lung transplantation evaluation at the Hospital of the University of Pennsylvania between 2005 and 2010. Multivariable linear regression analysis was used to generate an explanatory model for 6-minute walk distance. After adjustment for age, sex, race, height, and weight, the presence of right ventricular dilation was associated with a decrease of 50.9 m (95% confidence interval [CI], 8.4-93.3) in 6-minute walk distance ([Formula: see text]). For each 200-mL reduction in forced vital capacity, the walk distance decreased by 15.0 m (95% CI, 9.0-21.1; [Formula: see text]). For every increase of 1 Wood unit in pulmonary vascular resistance, the walk distance decreased by 17.3 m (95% CI, 5.1-29.5; [Formula: see text]). Six-minute walk distance in idiopathic pulmonary fibrosis depends in part on circulatory impairment and the degree of restrictive lung disease. Future trials that target right ventricular morphology, pulmonary vascular resistance, and forced vital capacity may potentially improve exercise capacity in patients with idiopathic pulmonary fibrosis.

Non-MTC gait cycles: An adaptive toe trajectory control strategy in older adults.

PubMed

Santhiranayagam, Braveena K; Sparrow, W A; Lai, Daniel T H; Begg, Rezaul K

2017-03-01

Minimum-toe-clearance (MTC) above the walking surface is a critical representation of toe-trajectory control due to its association with tripping risk. Not all gait cycles exhibit a clearly defined MTC within the swing phase but there have been few previous accounts of the biomechanical characteristics of non-MTC gait cycles. The present report investigated the within-subject non-MTC gait cycle characteristics of 15 older adults (mean 73.1 years) and 15 young controls (mean 26.1 years). Participants performed the following tasks on a motorized treadmill: preferred speed walking, dual task walking (carrying a glass of water) and a dual-task speed-matched control. Toe position-time coordinates were acquired using a 3 dimensional motion capture system. When MTC was present, toe height at MTC (MTC height ) was extracted. The proportion of non-MTC gait cycles was computed for the age groups and individuals. For non-MTC gait cycles an 'indicative' toe height at the individual's average swing phase time (MTC time ) for observed MTC cycles was averaged across multiple non-MTC gait cycles. In preferred-speed walking Young demonstrated 2.9% non-MTC gait cycles and Older 18.7%. In constrained walking conditions both groups increased non-MTC gait cycles and some older adults revealed over 90%, confirming non-MTC gait cycles as an ageing-related phenomenon in lower limb trajectory control. For all participants median indicative toe-height on non-MTC gait cycles was greater than median MTC height . This result suggests that eliminating the biomechanically hazardous MTC event by adopting more of the higher-clearance non-MTC gait cycles, is adaptive in reducing the likelihood of toe-ground contact. Copyright © 2017 Elsevier B.V. All rights reserved.

Early reduction in toe flexor strength is associated with physical activity in elderly men.

PubMed

Suwa, Masataka; Imoto, Takayuki; Kida, Akira; Yokochi, Takashi

2016-05-01

[Purpose] To compare the toe flexor, hand grip and knee extensor strengths of young and elderly men, and to examine the association between toe flexor strength and physical activity or inactivity levels. [Subjects and Methods] Young (n=155, 18-23 years) and elderly (n=60, 65-88 years) men participated in this study. Toe flexor, hand grip, and knee extensor strength were measured. Physical activity (time spent standing/walking per day) and inactivity (time spent sitting per day) were assessed using a self-administered questionnaire. [Results] Toe flexor, hand grip, and knee extensor strength of the elderly men were significantly lower than those of the young men. Standing/walking and sitting times of the elderly men were lower than those of the young men. Toe flexor strength correlated with hand grip and knee extensor strength in both groups. In elderly men, toe flexor strength correlated with standing/walking time. In comparison to the young men's mean values, toe flexor strength was significantly lower than knee extensor and hand grip strength in the elderly group. [Conclusion] The results suggest that age-related reduction in toe flexor strength is greater than those of hand grip and knee extensor strengths. An early loss of toe flexor strength is likely associated with reduced physical activity in elderly men.

Early reduction in toe flexor strength is associated with physical activity in elderly men

PubMed Central

Suwa, Masataka; Imoto, Takayuki; Kida, Akira; Yokochi, Takashi

2016-01-01

[Purpose] To compare the toe flexor, hand grip and knee extensor strengths of young and elderly men, and to examine the association between toe flexor strength and physical activity or inactivity levels. [Subjects and Methods] Young (n=155, 18–23 years) and elderly (n=60, 65–88 years) men participated in this study. Toe flexor, hand grip, and knee extensor strength were measured. Physical activity (time spent standing/walking per day) and inactivity (time spent sitting per day) were assessed using a self-administered questionnaire. [Results] Toe flexor, hand grip, and knee extensor strength of the elderly men were significantly lower than those of the young men. Standing/walking and sitting times of the elderly men were lower than those of the young men. Toe flexor strength correlated with hand grip and knee extensor strength in both groups. In elderly men, toe flexor strength correlated with standing/walking time. In comparison to the young men’s mean values, toe flexor strength was significantly lower than knee extensor and hand grip strength in the elderly group. [Conclusion] The results suggest that age-related reduction in toe flexor strength is greater than those of hand grip and knee extensor strengths. An early loss of toe flexor strength is likely associated with reduced physical activity in elderly men. PMID:27313353

Comparison of Two Alternate Methods for Tracking Toe Clearance

NASA Technical Reports Server (NTRS)

Miller, Christopher A.; Feiveson, Alan H.; Bloomberg, Jacob J.

2007-01-01

Analyses of toe clearance during the swing phase of locomotion has often been utilized in determining a subject s propensity to trip while either walking or stepping over an obstacle. In the literature, toe clearance has been studied using a marker on the superior aspect of the second toe (rtoe), a marker on the lateral aspect of the fifth metatarsal head (mth5), or a virtual marker positioned at the anterior tip of the toe (vtoe). The purpose of this study was to compute toe clearance and associated parameters using a fifth metatarsal marker and a virtual toe marker, and compare the results with those of the standard toe marker. Subjects walked on a motorized treadmill at five different speeds while performing a visual acuity task at two separate target distances (ten 60-second trials). The minimum vertical height (TCl) was determined for each stride, along with its point of occurence in the gait cycle, and the angles of the foot and ankle at that time. A regression analysis was performed on the vtoe and mth5 results versus rtoe individually. For all TCl parameters, the mth5 marker did not correlate well with rtoe; the vtoe marker showed better agreement. Most importantly, the mth5 marker predicted a later occurence of TCl than rtoe and vtoe - thereby missing the most dangerous point in swing phase for a trip. From this analysis, the vtoe marker proved to be a better analog to rtoe than mth5, especially for determining a subject s propensity to trip.

Biofeedback training effects on minimum toe clearance variability during treadmill walking.

PubMed

Tirosh, Oren; Cambell, Amity; Begg, Rezaul K; Sparrow, W A

2013-08-01

A number of variability analysis techniques, including Poincaré plots and detrended fluctuation analysis (DFA) were used to investigate minimum toe clearance (MTC) control during walking. Ten young adults walked on a treadmill for 10 min at preferred speed in three conditions: (i) no-intervention baseline, (ii) with biofeedback of MTC within a target range, and (iii) no-biofeedback retention. Mean, median, standard deviation (SD), and inter quartile range of MTC during biofeedback (45.57 ± 11.65, 44.98 ± 11.57, 7.08 ± 2.61, 8.58 ± 2.77 mm, respectively) and retention (56.95 ± 20.31, 56.69 ± 20.94, 10.68 ± 5.41, 15.38 ± 10.19 mm) were significantly greater than baseline (30.77 ± 9.49, 30.51 ± 9.49, 3.04 ± 0.77, 3.66 ± 0.91 mm). Relative to baseline, skewness was reduced in biofeedback and retention but only significantly for retention (0.88 ± 0.51, 0.63 ± 0.55, and 0.40 ± 0.40, respectively). Baseline Poincaré measures (SD1 = 0.25, SD2 = 0.34) and DFA (α1 = 0.72 and α2 = 0.64) were lower than biofeedback (SD1 = 0.58, SD2 = 0.83, DFA α1 = 0.76 and α2 = 0.92) with significantly greater variability in retention compared to biofeedback only in the long-term SD2 and α2 analyses. Increased DFA longer-term correlations α2 in retention confirm that a novel gait pattern was acquired with a longer-term variability structure. Short- and long-term variability analyses were both useful in quantifying gait adaptations with biofeedback. The findings provide evidence that MTC can be modified with feedback, suggesting future applications in gait training procedures for impaired populations designed to reduce tripping risk.

Clinical and biomechanical changes following a 4-month toe-out gait modification program for people with medial knee osteoarthritis: a randomized controlled trial.

PubMed

Hunt, M A; Charlton, J M; Krowchuk, N M; Tse, C T F; Hatfield, G L

2018-04-27

To compare changes in knee pain, function, and loading following a 4-month progressive walking program with or without toe-out gait modification in people with medial tibiofemoral knee osteoarthritis. Individuals with medial knee osteoarthritis were randomized to a 4-month program to increase walking activity with (toe-out) or without (progressive walking) concomitant toe-out gait modification. The walking program was similar between the two groups, except that the gait modification group was trained to walk with 15° more toe-out. Primary outcomes included: knee joint pain (WOMAC), foot progression angles and knee joint loading during gait (knee adduction moment (KAM)). Secondary outcomes included WOMAC function, timed stair climb, and knee flexion moments during gait. Seventy-nine participants (40 in toe-out group, 39 in progressive walking group) were recruited. Intention-to-treat analysis showed no between-group differences in knee pain, function, or timed stair climb. However, the toe-out group exhibited significantly greater changes in foot progression angle (mean difference = -9.04° (indicating more toe-out), 95% CI: -11.22°, -6.86°; P < 0.001), late stance KAM (mean difference = -0.26 %BW*ht, 95% CI: -0.39 %BW*ht, -0.12 %BW*ht, P < 0.001) and KAM impulse (-0.06 %BW*ht*s, 95% CI: -0.11 %BW*ht*s, -0.01 %BW*ht*s; P = 0.031) compared to the progressive walking group at follow-up. The only between-group difference that remained at a 1-month retention assessment was foot progression angle, with greater changes in the toe-out group (mean difference = -6.78°, 95% CI: -8.82°, -4.75°; P < 0.001). Though both groups experienced improvements in self-reported pain and function, only the toe-out group experienced biomechanical improvements. NCT02019108. Copyright © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Modeling and analysis of passive dynamic bipedal walking with segmented feet and compliant joints

NASA Astrophysics Data System (ADS)

Huang, Yan; Wang, Qi-Ning; Gao, Yue; Xie, Guang-Ming

2012-10-01

Passive dynamic walking has been developed as a possible explanation for the efficiency of the human gait. This paper presents a passive dynamic walking model with segmented feet, which makes the bipedal walking gait more close to natural human-like gait. The proposed model extends the simplest walking model with the addition of flat feet and torsional spring based compliance on ankle joints and toe joints, to achieve stable walking on a slope driven by gravity. The push-off phase includes foot rotations around the toe joint and around the toe tip, which shows a great resemblance to human normal walking. This paper investigates the effects of the segmented foot structure on bipedal walking in simulations. The model achieves satisfactory walking results on even or uneven slopes.

Walking speed and peak plantar pressure distribution during barefoot walking in persons with diabetes.

PubMed

Ko, Mansoo; Hughes, Lynne; Lewis, Harriet

2012-03-01

The impact of walking speed has not been evaluated as a feasible outcome measure associated with peak plantar pressure (PPP) distribution, which may result in tissue damage in persons with diabetic foot complications. The objective of this pilot study was to determine the walking speed and PPP distribution during barefoot walking in persons with diabetes.   Nine individuals with diabetes and nine age-gender matched individuals without diabetes participated in this study. Each individual was marked at 10 anatomical landmarks for vibration and tactile pressure sensation tests to determine the severity of sensory deficits on the plantar surface of the dominant limb foot. A steady state walking speed, PPP, the fore and rear foot (F/R) PPP ratio and gait variables were measured during barefoot walking.   Persons with diabetes had a significantly slower walking speed than the age-gender matched group resulting in a significant reduction of PPP at the F/R foot during barefoot walking (p < 0.05). There was no significant difference in F/R foot PPP ratio in the diabetic group compared with the age-gender matched group during barefoot walking (p > 0.05). There was a significant difference between the diabetic and non-diabetic groups for cadence, step time, toe out angle and the anterior-posterior excursion (APE) for centre of force (p < 0.05).   Walking speed may be a potential indicator for persons with diabetes to identify PPP distribution during barefoot walking in a diabetic foot. However, the diabetic group demonstrated a more cautious walking pattern than the age-gender matched group by decreasing cadence, step length and APE, and increasing step time and toe in/out angle. People with diabetes may reduce the risk of foot ulcerations as long as they are able to prevent severe foot deformities such as callus, hammer toe or charcot foot. Copyright © 2011 John Wiley & Sons, Ltd.

Metabolic Rate and Perceived Exertion of Walking in Older Adults With Idiopathic Chronic Fatigue

PubMed Central

Corbett, Duane B.; Knaggs, Jeffrey D.; Manini, Todd M.

2016-01-01

Abstract Background: Fatigue is a common complaint in older adults, often not associated with underlying medical conditions. The purpose of this study was to investigate metabolic rate (MR) of walking, walking performance, and perception-based exertion during walking in older adults with and without idiopathic chronic fatigue (ICF). Methods: 20 older adults (aged 70.8±4.9 years), reporting 2 SD above normative values of the Functional Assessment of Chronic Illness Therapy-Fatigue scale and without overt health conditions that explained their symptoms, were compared with 25 age-matched older adults (73.2±5.1 years) without fatigue symptoms. Participants walked 400 m at a rapid pace on a 20-m course. On a separate visit, oxygen consumption was measured during treadmill test at standard (40.2 m/min), preferred paces (40–83 m/min) and peak capacity. Ratings of perceived exertion (RPE) were measured at each treadmill stage and after each lap of the 400-m walk test. Results: During the 400-m walk test, individuals with ICF showed lower overall walking speed and reported a steady increase in RPE with no change observed in non-fatigued group (1.63±1.72 vs 0.27±0.68, p < .01). Similar findings on RPE were noted on treadmill test. Gross MR, mass-specific MR, mass-specific net MR, and MR as a percent of peak oxygen consumption of walking were similar between groups during standard, preferred paces and peak capacity on treadmill. Conclusions: This study suggests that ICF in older adults is not related to elevated metabolic cost of walking. Higher RPE without concomitant decreases in performance indicate a potential disconnect between metabolic output and sensations during movement. PMID:27271253

Technology-Based Programs to Promote Walking Fluency or Improve Foot-Ground Contact during Walking: Two Case Studies of Adults with Multiple Disabilities

ERIC Educational Resources Information Center

Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; La Martire, Maria L.; Oliva, Doretta; Groeneweg, Jop

2012-01-01

These two case studies assessed technology-based programs for promoting walking fluency and improving foot-ground contact during walking with a man and a woman with multiple disabilities, respectively. The man showed breaks during walking and the woman presented with toe walking. The technology used in the studies included a microprocessor with…

Walking abnormalities

MedlinePlus

... walking. People with this problem are likely to fall because they have poor balance and are always trying to catch up. Provide ... a walker is recommended for those with poor balance. Medicines (muscle ... a person to stub a toe and fall. Leg braces and in-shoe splints can help ...

21 CFR 888.3730 - Toe joint phalangeal (hemi-toe) polymer prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Toe joint phalangeal (hemi-toe) polymer prosthesis. 888.3730 Section 888.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... (hemi-toe) polymer prosthesis. (a) Identification. A toe joint phalangeal (hemi-toe) polymer prosthesis...

21 CFR 888.3730 - Toe joint phalangeal (hemi-toe) polymer prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Toe joint phalangeal (hemi-toe) polymer prosthesis. 888.3730 Section 888.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... (hemi-toe) polymer prosthesis. (a) Identification. A toe joint phalangeal (hemi-toe) polymer prosthesis...

21 CFR 888.3730 - Toe joint phalangeal (hemi-toe) polymer prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Toe joint phalangeal (hemi-toe) polymer prosthesis. 888.3730 Section 888.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... (hemi-toe) polymer prosthesis. (a) Identification. A toe joint phalangeal (hemi-toe) polymer prosthesis...

21 CFR 888.3730 - Toe joint phalangeal (hemi-toe) polymer prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Toe joint phalangeal (hemi-toe) polymer prosthesis. 888.3730 Section 888.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... (hemi-toe) polymer prosthesis. (a) Identification. A toe joint phalangeal (hemi-toe) polymer prosthesis...

21 CFR 888.3730 - Toe joint phalangeal (hemi-toe) polymer prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Toe joint phalangeal (hemi-toe) polymer prosthesis. 888.3730 Section 888.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... (hemi-toe) polymer prosthesis. (a) Identification. A toe joint phalangeal (hemi-toe) polymer prosthesis...

Broken Toe

MedlinePlus

... fracture is severe — particularly if it involves your big toe — you may need a cast or even surgery to ensure proper healing. Most broken toes heal well, usually within four to six weeks. Sometimes, a broken toe may become infected ...

A prototype wireless inertial-sensing device for measuring toe clearance.

PubMed

Lai, Daniel T H; Charry, E; Begg, R; Palaniswami, M

2008-01-01

Tripping and slipping are serious health concerns for the elderly because they result in life threatening injuries i.e., fractures and high medical costs. Our recent work in detection of tripping gait patterns has demonstrated that minimum toe clearance (MTC) is a sensitive falls risk predictor. MTC measurement has previously been done in gait laboratories and on treadmills which potentially imposes controlled walking conditions. In this paper, we describe a prototype design of a wireless device for monitoring vertical toe clearance. The sensors consists of a tri-axis accelerometer and dual-axis gyroscope connected to Crossbow sensor motes for wireless data transmission. Sensor data are transmitted to a laptop and displayed on a Matlab graphic user interface (GUI). We have performed zero base and treadmill experiments to investigate sensor performance to environmental variations and compared the calculated toe clearance against measurements made by an Optotrak motion system. It was found that device outputs were approximately independent of small ambient temperature variations, had a reliable range of 20m indoors and 50m outdoors and a maximum transmission rate of 20 packets/s. Toe clearance measurements were found to follow the Optotrak measurement trend but could be improved further by dealing with double integration errors and improving data transmission rates.

Locomotor skills and balance strategies in adolescents idiopathic scoliosis.

PubMed

Mallau, Sophie; Bollini, Gérard; Jouve, Jean-Luc; Assaiante, Christine

2007-01-01

Locomotor balance control assessment was performed to study the effect of idiopathic scoliosis on head-trunk coordination in 17 patients with adolescent idiopathic scoliosis (AIS) and 16 control subjects. The aim of this study was to explore the functional effects of structural spinal deformations like idiopathic scoliosis on the balance strategies used during locomotion. Up to now, the repercussion of the idiopathic scoliosis on head-trunk coordination and balance strategies during locomotion is relatively unknown. Seventeen patients with AIS (mean age 14 years 3 months, 10 degrees < Cobb angle > 30 degrees) and 16 control subjects (mean age 14 years 1 month) were tested during various locomotor tasks: walking on the ground, walking on a line, and walking on a beam. Balance control was examined in terms of rotation about the vertical axis (yaw) and on a frontal plane (roll). Kinematics of foot, pelvis, trunk, shoulder, and head rotations were measured with an automatic optical TV image processor in order to calculate angular dispersions and segmental stabilizations. Decreasing the walking speed is the main adaptive strategy used in response to balance problems in control subjects as well as patients with AIS. However, patients with AIS performed walking tasks more slowly than normal subjects (around 15%). Moreover, the pelvic stabilization is preserved, despite the structural changes affecting the spine. Lastly, the biomechanical defect resulting from idiopathic scoliosis mainly affects the yaw head stabilization during locomotion. Patients with AIS show substantial similarities with control subjects in adaptive strategies relative to locomotor velocity as well as balance control based on segmental stabilization. In contrast, the loss of the yaw head stabilization strategies, mainly based on the use of vestibular information, probably reflects the presence of vestibular deficits in the patients with AIS.

Broken toe - self-care

MedlinePlus

Fractured toe - self-care; Broken bone - toe - self-care; Fracture - toe - self-care; Fracture phalanx - toe ... often treated without surgery and can be taken care of at home. Severe injuries include: Breaks that ...

At similar angles, slope walking has a greater fall risk than stair walking.

PubMed

Sheehan, Riley C; Gottschall, Jinger S

2012-05-01

According to the CDC, falls are the leading cause of injury for all age groups with over half of the falls occurring during slope and stair walking. Consequently, the purpose of this study was to compare and contrast the different factors related to fall risk as they apply to these walking tasks. More specifically, we hypothesized that compared to level walking, slope and stair walking would have greater speed standard deviation, greater ankle dorsiflexion, and earlier peak activity of the tibialis anterior. Twelve healthy, young male participants completed level, slope, and stair trials on a 25-m walkway. Overall, during slope and stair walking, medial-lateral stability was less, anterior-posterior stability was less, and toe clearance was greater in comparison to level walking. In addition, there were fewer differences between level and stair walking than there were between level and slope walking, suggesting that at similar angles, slope walking has a greater fall risk than stair walking. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Foot trajectory approximation using the pendulum model of walking.

PubMed

Fang, Juan; Vuckovic, Aleksandra; Galen, Sujay; Conway, Bernard A; Hunt, Kenneth J

2014-01-01

Generating a natural foot trajectory is an important objective in robotic systems for rehabilitation of walking. Human walking has pendular properties, so the pendulum model of walking has been used in bipedal robots which produce rhythmic gait patterns. Whether natural foot trajectories can be produced by the pendulum model needs to be addressed as a first step towards applying the pendulum concept in gait orthosis design. This study investigated circle approximation of the foot trajectories, with focus on the geometry of the pendulum model of walking. Three able-bodied subjects walked overground at various speeds, and foot trajectories relative to the hip were analysed. Four circle approximation approaches were developed, and best-fit circle algorithms were derived to fit the trajectories of the ankle, heel and toe. The study confirmed that the ankle and heel trajectories during stance and the toe trajectory in both the stance and the swing phases during walking at various speeds could be well modelled by a rigid pendulum. All the pendulum models were centred around the hip with pendular lengths approximately equal to the segment distances from the hip. This observation provides a new approach for using the pendulum model of walking in gait orthosis design.

Treatment of idiopathic pulmonary fibrosis with losartan: a pilot project.

PubMed

Couluris, Marisa; Kinder, Brent W; Xu, Ping; Gross-King, Margaret; Krischer, Jeffrey; Panos, Ralph J

2012-10-01

Idiopathic pulmonary fibrosis is a progressive interstitial lung disease with no current effective therapies. Treatment has focused on antifibrotic agents to stop proliferation of fibroblasts and collagen deposition in the lung. We present the first clinical trial data on the use of losartan, an antifibrotic agent, to treat idiopathic pulmonary fibrosis. The primary objective was to evaluate the effect of losartan on progression of idiopathic pulmonary fibrosis measured by the change in percentage of predicted forced vital capacity (%FVC) after 12 months. Secondary outcomes included the change in forced expiratory volume at 1 second, diffusing capacity of carbon monoxide, 6-minute walk test distance, and baseline/transition dyspnea index. Patients with idiopathic pulmonary fibrosis and a baseline %FVC of ≥50 % were treated with losartan 50 mg by mouth daily for 12 months. Pulmonary function testing, 6-minute walk, and breathlessness indices were measured every 3 months. Twenty participants with idiopathic pulmonary fibrosis were enrolled and 17 patients were evaluable for response. Twelve patients had a stable or improved %FVC at study month 12. Similar findings were observed in secondary end-point measures, including 58, 71, and 65 % of patients with stable or improved forced expiratory volume at 1 second, diffusing capacity for carbon monoxide, and 6-minute walk test distance, respectively. No treatment-related adverse events that resulted in early study discontinuation were reported. Losartan stabilized lung function in patients with idiopathic pulmonary fibrosis over 12 months. Losartan is a promising agent for the treatment of idiopathic pulmonary fibrosis and has a low toxicity profile.

EMG and force production of the flexor hallucis longus muscle in isometric plantarflexion and the push-off phase of walking.

PubMed

Péter, Annamária; Hegyi, András; Stenroth, Lauri; Finni, Taija; Cronin, Neil J

2015-09-18

Large forces are generated under the big toe in the push-off phase of walking. The largest flexor muscle of the big toe is the flexor hallucis longus (FHL), which likely contributes substantially to these forces. This study examined FHL function at different levels of isometric plantarflexion torque and in the push-off phase at different speeds of walking. FHL and calf muscle activity were measured with surface EMG and plantar pressure was recorded with pressure insoles. FHL activity was compared to the activity of the calf muscles. Force and impulse values were calculated under the big toe, and were compared to the entire pressed area of the insole to determine the relative contribution of big toe flexion forces to the ground reaction force. FHL activity increased with increasing plantarflexion torque level (F=2.8, P=0.024) and with increasing walking speed (F=11.608, P<0.001). No differences were observed in the relative contribution of the force under the big toe to the entire sole between different plantarflexion torque levels (F=0.836, P=0.529). On the contrary, in the push-off phase of walking, peak force under the big toe increased at a higher rate than force under the other areas of the plantar surface (F=3.801, P=0.018), implying a greater relative contribution to total force at faster speeds. Moreover, substantial differences were found between isometric plantarflexion and walking concerning FHL activity relative to that of the calf muscles, highlighting the task-dependant behaviour of FHL. Copyright © 2015 Elsevier Ltd. All rights reserved.

Three-Axis Ground Reaction Force Distribution during Straight Walking.

PubMed

Hori, Masataka; Nakai, Akihito; Shimoyama, Isao

2017-10-24

We measured the three-axis ground reaction force (GRF) distribution during straight walking. Small three-axis force sensors composed of rubber and sensor chips were fabricated and calibrated. After sensor calibration, 16 force sensors were attached to the left shoe. The three-axis force distribution during straight walking was measured, and the local features of the three-axis force under the sole of the shoe were analyzed. The heel area played a role in receiving the braking force, the base area of the fourth and fifth toes applied little vertical or shear force, the base area of the second and third toes generated a portion of the propulsive force and received a large vertical force, and the base area of the big toe helped move the body's center of mass to the other foot. The results demonstrate that measuring the three-axis GRF distribution is useful for a detailed analysis of bipedal locomotion.

Accuracy of the Microsoft Kinect for measuring gait parameters during treadmill walking.

PubMed

Xu, Xu; McGorry, Raymond W; Chou, Li-Shan; Lin, Jia-Hua; Chang, Chien-Chi

2015-07-01

The measurement of gait parameters normally requires motion tracking systems combined with force plates, which limits the measurement to laboratory settings. In some recent studies, the possibility of using the portable, low cost, and marker-less Microsoft Kinect sensor to measure gait parameters on over-ground walking has been examined. The current study further examined the accuracy level of the Kinect sensor for assessment of various gait parameters during treadmill walking under different walking speeds. Twenty healthy participants walked on the treadmill and their full body kinematics data were measured by a Kinect sensor and a motion tracking system, concurrently. Spatiotemporal gait parameters and knee and hip joint angles were extracted from the two devices and were compared. The results showed that the accuracy levels when using the Kinect sensor varied across the gait parameters. Average heel strike frame errors were 0.18 and 0.30 frames for the right and left foot, respectively, while average toe off frame errors were -2.25 and -2.61 frames, respectively, across all participants and all walking speeds. The temporal gait parameters based purely on heel strike have less error than the temporal gait parameters based on toe off. The Kinect sensor can follow the trend of the joint trajectories for the knee and hip joints, though there was substantial error in magnitudes. The walking speed was also found to significantly affect the identified timing of toe off. The results of the study suggest that the Kinect sensor may be used as an alternative device to measure some gait parameters for treadmill walking, depending on the desired accuracy level. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

In-Toeing and Out-Toeing in Children

PubMed Central

Wiley, James J.

1987-01-01

In-toeing and out-toeing problems are generally physiologic variants that arise from in utero posturing, and that gradually correct spontaneously during the active growing years of the child. Few torsional deformities result in genuine problems. Most residual effects are cosmetic, compounded by the anguish of concerned relatives and friends. Rarely is operative correction warranted. If corrective surgery comes under consideration, it is usually deferred until the patient reaches the age of 10. PMID:21263851

Impaired heel to toe progression during gait is related to reduced ankle range of motion in people with Multiple Sclerosis.

PubMed

Psarakis, Michael; Greene, David; Moresi, Mark; Baker, Michael; Stubbs, Peter; Brodie, Matthew; Lord, Stephen; Hoang, Phu

2017-11-01

Gait impairment in people with Multiple Sclerosis results from neurological impairment, muscle weakness and reduced range of motion. Restrictions in passive ankle range of motion can result in abnormal heel-to-toe progression (weight transfer) and inefficient gait patterns in people with Multiple Sclerosis. The purpose of this study was to determine the associations between gait impairment, heel-to-toe progression and ankle range of motion in people with Multiple Sclerosis. Twelve participants with Multiple Sclerosis and twelve healthy age-matched participants were assessed. Spatiotemporal parameters of gait and individual footprint data were used to investigate group differences. A pressure sensitive walkway was used to divide each footprint into three phases (contact, mid-stance, propulsive) and calculate the heel-to-toe progression during the stance phase of gait. Compared to healthy controls, people with Multiple Sclerosis spent relatively less time in contact phase (7.8% vs 25.1%) and more time in the mid stance phase of gait (57.3% vs 33.7%). Inter-limb differences were observed in people with Multiple Sclerosis between the affected and non-affected sides for contact (7.8% vs 15.3%) and mid stance (57.3% and 47.1%) phases. Differences in heel-to-toe progression remained significant after adjusting for walking speed and were correlated with walking distance and ankle range of motion. Impaired heel-to-toe progression was related to poor ankle range of motion in people with Multiple Sclerosis. Heel-to-toe progression provided a sensitive measure for assessing gait impairments that were not detectable using standard spatiotemporal gait parameters. Copyright © 2017 Elsevier Ltd. All rights reserved.

Wavelet-based multiscale analysis of minimum toe clearance variability in the young and elderly during walking.

PubMed

Khandoker, Ahsan H; Karmakar, Chandan K; Begg, Rezaul K; Palaniswami, Marimuthu

2007-01-01

As humans age or are influenced by pathology of the neuromuscular system, gait patterns are known to adjust, accommodating for reduced function in the balance control system. The aim of this study was to investigate the effectiveness of a wavelet based multiscale analysis of a gait variable [minimum toe clearance (MTC)] in deriving indexes for understanding age-related declines in gait performance and screening of balance impairments in the elderly. MTC during walking on a treadmill for 30 healthy young, 27 healthy elderly and 10 falls risk elderly subjects with a history of tripping falls were analyzed. The MTC signal from each subject was decomposed to eight detailed signals at different wavelet scales by using the discrete wavelet transform. The variances of detailed signals at scales 8 to 1 were calculated. The multiscale exponent (beta) was then estimated from the slope of the variance progression at successive scales. The variance at scale 5 was significantly (p<0.01) different between young and healthy elderly group. Results also suggest that the Beta between scales 1 to 2 are effective for recognizing falls risk gait patterns. Results have implication for quantifying gait dynamics in normal, ageing and pathological conditions. Early detection of gait pattern changes due to ageing and balance impairments using wavelet-based multiscale analysis might provide the opportunity to initiate preemptive measures to be undertaken to avoid injurious falls.

Tactile Toe Agnosia and Percept of a "Missing Toe" in Healthy Humans.

PubMed

Cicmil, Nela; Meyer, Achim P; Stein, John F

2016-03-01

A disturbance of body representation is central to many neurological and psychiatric conditions, but the mechanisms by which body representations are constructed by the brain are not fully understood. We demonstrate a directional disturbance in tactile identification of the toes in healthy humans. Nineteen young adult participants underwent tactile stimulation of the digits with the eyes closed and verbally reported the identity of the stimulated digit. In the majority of individuals, responses to the second and third toes were significantly biased toward the laterally neighboring digit. The directional bias was greater for the nondominant foot and was affected by the identity of the immediately preceding stimulated toe. Unexpectedly, 9/19 participants reported the subjective experience of a "missing toe" or "missing space" during the protocol. These findings challenge current models of somatosensory localization, as they cannot be explained simply by a lack of distinct representations for toes compared with fingers, or by overt toe-finger correspondences. We present a novel theory of equal spatial representations of digit width combined with a "preceding neighbor" effect to explain the observed phenomena. The diagnostic implications for neurological disorders that involve "digit agnosia" are discussed. © The Author(s) 2015.

[Double toe to hand transfer in children with symbrachydactyly].

PubMed

Rivas, S; López-Gutiérrez, J C; Lovic, A; Díaz, M; Andrés, A M; Ros, Z

2006-07-01

Symbrachydactyly is fairly frequent congenital malformation that appears during first weeks of pregnancy. The range of clinical presentations goes from hypoplastic fingers to true agenesis. Although it usually appears in a random fashion, sometimes it is associated to other systemic malformations. The aim of this study is to check the functional, cosmetic and psychological results of those patients affected of grade IV symbrachydactyly treated using a double second toe transfer. The method employed is a retrospective study of the clinical records from 6 patients (5 males and 1 female) operated in our Department during the last five years. The follow up period was from 3 months to five years. Transfer from the second toe to the first ray was performed during the first surgical period, while transfer to the fourth ray was done in a second procedure. The mean age for the first operation was 19 months, and 30 months for the second one. There were no flap failure or major surgical complications. Tenolysis and tenoplasty was done in two patients to improve flap function and position. Motion rehabilitation was installed during the postoperative period. Functional, opposing pinch, and cosmetic results were satisfactory. Parents "and patients" psychological acceptance was also good. No walk disturbance was observed. Double second toe to hand transfer is a good option for the symbrachydactyly treatment in cases of thumb agenesis. Rehabilitation is the key clue for functional recovery. Surgery improves social and family relationships.

2D trajectory estimation during free walking using a tiptoe-mounted inertial sensor.

PubMed

Sagawa, Koichi; Ohkubo, Kensuke

2015-07-16

An estimation method for a two-dimensional walking trajectory during free walking, such as forward walking, side stepping and backward walking, was investigated using a tiptoe-mounted inertial sensor. The horizontal trajectory of the toe-tip is obtained by double integration of toe-tip acceleration during the moving phase in which the sensor is rotated before foot-off or after foot-contact, in addition to the swing phase. Special functions that determine the optimum moving phase as the integral duration in every one step are developed statistically using the gait cycle and the resultant angular velocity of dorsi/planter flexion, pronation/supination and inversion/eversion so that the difference between the estimated trajectory and actual one gives a minimum value during free walking with several cadences. To develop the functions, twenty healthy volunteers participated in free walking experiments in which subjects performed forward walking, side stepping to the right, side stepping to the left, and backward walking at 39 m down a straight corridor with several predetermined cadences. To confirm the effect of the developed functions, five healthy subjects participated in the free walking experiment in which each subject performed free walking with different velocities of normal, fast, and slow based on their own assessment in a square course with 7 m side. The experimentally obtained results of free walking with a combination of forward walking, backward walking, and side stepping indicate that the proposed method produces walking trajectory with high precision compared with the constant threshold method which determines swing phase using the size of the angular velocity. Copyright © 2015 Elsevier Ltd. All rights reserved.

Hammertoe and Mallet Toe

MedlinePlus

... hammertoe and mallet toe may involve changing your footwear and wearing shoe inserts. If you have a ... linked to: Certain shoes. High-heeled shoes or footwear that's too tight in the toe box can ...

Neuromuscular activation patterns during treadmill walking after space flight

NASA Technical Reports Server (NTRS)

Layne, C. S.; McDonald, P. V.; Bloomberg, J. J.

1997-01-01

Astronauts adopt a variety of neuromuscular control strategies during space flight that are appropriate for locomoting in that unique environment, but are less than optimal upon return to Earth. We report here the first systematic investigation of potential adaptations in neuromuscular activity patterns associated with postflight locomotion. Astronaut-subjects were tasked with walking on a treadmill at 6.4 km/h while fixating a visual target 30 cm away from their eyes after space flights of 8-15 days. Surface electromyography was collected from selected lower limb muscles and normalized with regard to mean amplitude and temporal relation to heel strike. In general, high correlations (more than 0.80) were found between preflight and postflight activation waveforms for each muscle and each subject: however relative activation amplitude around heel strike and toe off was changed as a result of flight. The level of muscle cocontraction and activation variability, and the relationship between the phasic characteristics of the ankle musculature in preparation for toe off also were altered by space flight. Subjects also reported oscillopsia during treadmill walking after flight. These findings indicate that, after space flight, the sensory-motor system can generate neuromuscular-activation strategies that permit treadmill walking, but subtle changes in lower-limb neuromuscular activation are present that may contribute to increased lower limb kinematic variability and oscillopsia also present during postflight walking.

Effects of Knee Alignments and Toe Clip on Frontal Plane Knee Biomechanics in Cycling.

PubMed

Shen, Guangping; Zhang, Songning; Bennett, Hunter J; Martin, James C; Crouter, Scott E; Fitzhugh, Eugene C

2018-06-01

Effects of knee alignment on the internal knee abduction moment (KAM) in walking have been widely studied. The KAM is closely associated with the development of medial knee osteoarthritis. Despite the importance of knee alignment, no studies have explored its effects on knee frontal plane biomechanics during stationary cycling. The purpose of this study was to examine the effects of knee alignment and use of a toe clip on the knee frontal plane biomechanics during stationary cycling. A total of 32 participants (11 varus, 11 neutral, and 10 valgus alignment) performed five trials in each of six cycling conditions: pedaling at 80 rpm and 0.5 kg (40 Watts), 1.0 kg (78 Watts), and 1.5 kg (117 Watts) with and without a toe clip. A motion analysis system and a customized instrumented pedal were used to collect 3D kinematic and kinetic data. A 3 × 2 × 3 (group × toe clip × workload) mixed design ANOVA was used for statistical analysis (p < 0.05). There were two different knee frontal plane loading patterns, internal abduction and adduction moment, which were affected by knee alignment type. The knee adduction angle was 12.2° greater in the varus group compared to the valgus group (p = 0.001), yet no difference was found for KAM among groups. Wearing a toe clip increased the knee adduction angle by 0.95º (p = 0.005). The findings of this study indicate that stationary cycling may be a safe exercise prescription for people with knee malalignments. In addition, using a toe clip may not have any negative effects on knee joints during stationary cycling.

Long-Term Follow-Up on the Donor Foot After Thumb Reconstruction Using Big Toe Wrap-Around Flap in Two Different Operation Methods.

PubMed

Ma, Zhi-Guo; Guo, Yong-Jun; Yan, Hou-Jun; Li, Qi-Ming; Ma, Bin

2017-02-01

The function of the donor foot has been affected after using big toe wrap-around flap for thumb reconstruction. A modified operation method has been developed to reduce the adverse effect on the donor foot. The current study compared the long-term effect of the classic and the modified operation methods on the donor foot. Gait analysis was carried out, including how the patient walked, the walking speed and walking distance, and how the patient jumped and ran. Plantar pressure was measured while the patient was standing and moving. A total of 45 patients who received the 2 different operation methods were included. The follow-up time was 4-10 years with a mean of 6.5 years. Various degrees of complications occurred for the 21 patients who received the classic operation method. For these patients, plantar pressure of the donor foot was obviously different comparing with the healthy unaffected foot while the patient was standing or walking. For the 24 patients who received the modified operation method, no obvious complications were observed and the plantar pressure of the donor foot and the healthy unaffected foot was similar while the patient was standing or walking. In conclusion, both the classic and the modified operation methods have affected the function of the donor foot after using the big toe wrap-around flap for thumb reconstruction. However, the donor foot was less affected when the modified operation method was used.

Toe-to-hand transfer.

PubMed

Yoshimura, M

1980-07-01

Toe-to-hand transfer was performed in 28 patients, involving 33 fingers, using microvascular technique. Of this number, 26 patients (31 fingers) had experienced trauma, and the remaining 2 patients (2 fingers) had a congenital deformity. The toew used for grafting were the great toe (1), the second tow (30), and third toe (2). Success was achieved in all cases, sensory recovery was good, and remarkable improvement was attained in function and cosmetic appearance. Metacarpal hand, amputation of thumb, and amputation thumb and three fingers were good indications for this procedure, which gave satisfactory aesthetic results, even in patients with amputation of single digits.

The effect of shoe toe box shape and volume on forefoot interdigital and plantar pressures in healthy females

PubMed Central

2013-01-01

Background Ill-fitting footwear can be detrimental to foot health with the forefoot being an area for most discomfort. Studies on footwear have primarily examined sports or orthopaedic prescription shoes and little is known about the effects that everyday flat shoes have on the forefoot. The aim of this study was to investigate the effect of toe box shape in a popular slip-on pump on dorsal and plantar pressures with particular interest around the forefoot in a healthy female population. Method A convenience sample of 27 female participants with no known foot pathologies was recruited. After assessment of foot size, plantar foot pressure and interdigital pressures were recorded for each of the 3 different toe box styles; round, square and pointed. Participants walked at a self-selected speed over a 10 m walkway whilst wearing each of the 3 styles of shoe and also whilst barefoot. Processed and analysed data extracted included peak pressure, time to peak pressure, contact time and pressure time integral. ANOVA and Freidman analysis was used to test for statistical significance. Results Shoes with a round toe showed least pressure around the medial aspect of the toes whilst the pointed shoe had least pressure on the lateral toes. Contact times for the plantar regions were not altered in any shoe condition yet contact around the medial aspect of the toes was highest in the pointed shoe. Conclusion This study highlights that the shape of the toe box in footwear can significantly influence the amount of pressure applied to the forefoot. Furthermore, the contours of the shoe also have an impact on the contact time and pressure time integral around the forefoot and also the peak plantar pressure in the toe region. The changes observed could be significant in the development of pathology in certain footwear toe box shapes. Consideration should be given to footwear design around the toe box to improve fit and reduce pressure. Further work is required to investigate the

Relationships Between Simple Toe Elevation Angle in the Standing Position and Dynamic Balance and Fall Risk Among Community-Dwelling Older Adults.

PubMed

Takatori, Katsuhiko; Matsumoto, Daisuke

2015-10-01

To investigate the relationships between toe elevation ability in the standing position and dynamic balance and fall risk among community-dwelling older adults. Cross-sectional survey. General community. Community-dwelling older adults (N = 287). Toe elevation angles in the standing position. Intra-rater and inter-rater reliability of measurements of the toe elevation angle was high (internal coefficient of correlation [ICC] (1,2) = 0.94 for the former and ICC (2,1) = 0.90 for the latter). Significant correlations were found between the toe elevation angle and age (r = -0.20, P < .01), 5-m walking time (r = -0.31, P < .01), Functional Reach Test (r = 0.36, P < .01), Timed Up and Go Test (r = -0.36, P < .01), and Chair Stand Test (r = 0.26, P < .01). Subjects who experienced a fall in the previous 6 months had a significantly lower toe elevation angle compared with subjects who did not experience a fall (t = 2.19, P < .05). Multiple regression analysis revealed that results of the Functional Reach Test (β = .22, P < .001) and Timed Up and Go Test (β = -0.74, P < .001) were significantly associated with the toe elevation angle. Toe elevation angle was an index of dynamic balance ability and appears to be a simple screening test for fall risk in community-dwelling older adults. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

The Effects of Walking Workstations on Biomechanical Performance.

PubMed

Grindle, Daniel M; Baker, Lauren; Furr, Mike; Puterio, Tim; Knarr, Brian; Higginson, Jill

2018-04-03

Prolonged sitting has been associated with negative health effects. Walking workstations have become increasingly popular in the workplace. There is a lack of research on the biomechanical effect of walking workstations. This study analyzed whether walking while working alters normal gait patterns. Nine participants completed four walking trials at 2.4 km·h -1 and 4.0 km·h -1 : baseline walking condition, walking while performing a math task, a reading task, and a typing task. Biomechanical data were collected using standard motion capture procedures. The first maximum vertical ground reaction force, stride width, stride length, minimum toe clearance, peak swing hip abduction and flexion angles, peak swing and stance ankle dorsiflexion and knee flexion angles were analyzed. Differences between conditions were evaluated using analysis of variance tests with Bonferroni correction (p ≤ 0.05). Stride width decreased during the reading task at both speeds. Although other parameters exhibited significant differences when multitasking, these changes were within the normal range of gait variability. It appears that for short periods, walking workstations do not negatively impact gait in healthy young adults.

[Hand reconstruction by microsurgical free toe transfer].

PubMed

Stamate, T; Budurcă, A R; Hermeziu, Oana

2003-01-01

Reconstruction of complex hand mutilations with multi-digital or thumb amputations are best treated with microsurgical toe transfers. We present the results of the first 15 cases operated by the first author, of which 12 are thumb reconstructions (6 great toe and 6 second toe transfers) and 3 long fingers reconstructions with combined second and third toe transfers. There were no microsurgical complications. Cortical integration and functional integration was achieved for all transferred toes, with discriminatory sensibility (m2PD between 5 and 13 mm) and active mobility range between 30 and 60 degrees.

Alarm toe switch

DOEpatents

Ganyard, Floyd P.

1982-01-01

An alarm toe switch inserted within a shoe for energizing an alarm circuit n a covert manner includes an insole mounting pad into which a miniature reed switch is fixedly molded. An elongated slot perpendicular to the reed switch is formed in the bottom surface of the mounting pad. A permanent cylindrical magnet positioned in the forward portion of the slot with a diameter greater than the pad thickness causes a bump above the pad. A foam rubber block is also positioned in the slot rearwardly of the magnet and holds the magnet in normal inoperative relation. A non-magnetic support plate covers the slot and holds the magnet and foam rubber in the slot. The plate minimizes bending and frictional forces to improve movement of the magnet for reliable switch activation. The bump occupies the knuckle space beneath the big toe. When the big toe is scrunched rearwardly the magnet is moved within the slot relative to the reed switch, thus magnetically activating the switch. When toe pressure is released the foam rubber block forces the magnet back into normal inoperative position to deactivate the reed switch. The reed switch is hermetically sealed with the magnet acting through the wall so the switch assembly S is capable of reliable operation even in wet and corrosive environments.

Toe transfer in congenital hand malformations.

PubMed

Foucher, G; Medina, J; Navarro, R; Nagel, D

2001-01-01

Fifty-eight patients with congenital hand abnormalities underwent 65 toe-to-hand transfers. Symbrachydactyly (51 cases) was the most frequent indication. Forty-seven second toe-to-hand transfers were performed in 44 patients. The mean follow-up time was 5.2 years. Two failures occurred in cases in which only one artery was anastomosed; no failures were noted when more than one artery fed the transfer. Two patients with a single second-toe transfer presented with lateral instability of the transferred metatarsophalangeal joint. The mean active range of motion was 38 degrees, with a mean extension lag of 25 degrees. The mean two-point discrimination was 5 mm. Forty-one patients used the transferred toe well, when performing activities of daily living and playing games. Toe-to-hand transfer, prior to the establishment of the grip pattern, facilitates integration of the transfer.

Effectiveness of Total Contact Orthosis for Plantar Pressure Redistribution in Neuropathic Diabetic Patients During Different Walking Activities.

PubMed

Nouman, Muhammad; Leelasamran, Wipawan; Chatpun, Surapong

2017-08-01

Using a total contact orthosis (TCO) is an effective method to offload in diabetic patients with foot neuropathy. However, the redistribution of peak plantar pressure is mostly observed during level walking, which may differ from other walking activities. The aim of this study was to investigate the plantar pressure from 4 regions of the foot during different walking activities (level walking, ramp ascending, ramp descending, stair ascending, and stair descending) in neuropathic diabetic patients with and without a TCO. Sixteen neuropathic diabetic patients aged 40 to 60 years with calluses and hallux valgus were included in this study and were provided with TCOs made up of multifoam, Plastazote, and microcellular rubber. The plantar pressure and contact area with the TCO and without the TCO were recorded using the Pedar X system during different walking activities. A significant reduction of plantar pressure during different walking activities at the toes and forefoot regions was observed while walking with the TCO compared with walking without the TCO (control condition). Plantar pressure increased at the midfoot region when walking with the TCO, and no significant difference was observed at the hindfoot region between the control and TCO conditions. Furthermore, maximum contact area was observed during level walking with the TCO compared with other walking activities. The TCO significantly reduced and redistributed the peak plantar pressure from the sites where the ulceration rate is higher at the toes and forefoot compared with the other regions of the foot. Therapeutic level II, lesser quality randomized controlled trial.

Comparison of Two Alternative Methods for Tracking Toe Trajectory

NASA Technical Reports Server (NTRS)

Miller, Chris; Peters, Brian; Brady, Rachel; Mulavara, Ajitkumar; Warren, Liz; Feiveson, Al; Bloomberg, Jacob

2007-01-01

Toe trajectory during the swing phase of locomotion has been identified as a precise motor control task (Karst, et al., 1999). The standard method for tracking toe trajectory is to place a marker on the superior aspect of the distal end of the 2nd toe itself (Karst, et al., 1999; Winter, 1992). However, others have based their toe trajectory results either on a marker positioned on the lateral aspect of the 5th metatarsal head (Dingwell, et al., 1999; Osaki, et al., 2007), or on a virtual toe marker computed at the anterior tip of the second toe based on the positions of other real foot markers (Miller, et al., 2006). While these methods for tracking the toe may seem similar, their results may not be directly comparable. The purpose of this study was to compute toe trajectory parameters using a 5th metatarsal marker and a virtual toe marker, and compare their results with those of the standard toe marker.

Plantar pressure changes after long-distance walking.

PubMed

Stolwijk, Niki M; Duysens, Jacques; Louwerens, Jan Willem K; Keijsers, Noël L W

2010-12-01

The popularity of long-distance walking (LDW) has increased in the last decades. However, the effects of LDW on plantar pressure distribution and foot complaints, in particular, after several days of walking, have not been studied. We obtained the plantar pressure data of 62 subjects who had no history of foot complaints and who walked a total distance of 199.8 km for men (n = 30) and 161.5 km for women (n = 32) during four consecutive days. Plantar pressure was measured each day after the finish (posttests I–IV) and compared with the baseline plantar pressure data, which was obtained 1 or 2 d before the march (pretest). Mean, peak, and pressure–time integral per pixel as well as the center of pressure (COP) trajectory of each foot per measurement day were calculated using the normalization method of Keijsers et al. A paired t-test with an adjusted P value was used to detect significant differences between pretest and posttest. Short-term adjustment to LDW resulted in a significant decreased loading on the toes accompanied with an increased loading on the metatarsal head III–V (P < 0.001). At all stages, particularly at later stages, there was significantly more heel loading (P < 0.001). Furthermore, the COP significantly displaced in the posterior direction but not in the mediolateral direction after marching. Contact time increased slightly from 638.5 +/- 24.2 to 675.4 +/- 22.5 ms (P < 0.001). The increased heel loading and decreased function of the toes found after marching indicate a change of walking pattern with less roll-off. It is argued that these changes reflect the effect of fatigue of the lower leg muscles and to avoid loading of the most vulnerable parts of the foot.

Variability in energy cost and walking gait during race walking in competitive race walkers.

PubMed

Brisswalter, J; Fougeron, B; Legros, P

1998-09-01

The aim of this study was to examine the variability of energy cost (Cw) and race walking gait after a 3-h walk at the competition pace in race walkers of the same performance level. Nine competitive race walkers were studied. In the same week, after a first test of VO2max determination, each subject completed two submaximal treadmill walks (6 min length, 0% grade, 12 km X h(-1) speed) before and after a 3-h overground test completed at the individual competition speed of the race walker. During the two submaximal tests, subjects were filmed between the 2nd and the 4th min, and physiological parameters were recorded between the 4th and the 6th min. Results showed two trends. On the one hand, we observed a significant and systematic increase in energy cost of walking (mean deltaCw = 8.4%), whereas no variation in the gait kinematics prescribed by the rules of race walking was recorded. On the other hand, this increase in metabolic energy demand was accompanied by variations of different magnitude and direction of stride length, of the excursion of the heel and of the maximal ankle flexion at toe-off among the race walkers. These results indicated that competitive race walkers are able to maintain their walking gait with exercise duration apart from a systematic increase in energy cost. Moreover, in this form of locomotion the effect of fatigue on the gait variability seems to be an individual function of the race walk constraints and the constraints of the performer.

Six-minute-walk test in idiopathic pulmonary fibrosis: test validation and minimal clinically important difference.

PubMed

du Bois, Roland M; Weycker, Derek; Albera, Carlo; Bradford, Williamson Z; Costabel, Ulrich; Kartashov, Alex; Lancaster, Lisa; Noble, Paul W; Sahn, Steven A; Szwarcberg, Javier; Thomeer, Michiel; Valeyre, Dominique; King, Talmadge E

2011-05-01

The 6-minute-walk test (6MWT) is a practical and clinically meaningful measure of exercise tolerance with favorable performance characteristics in various cardiac and pulmonary diseases. Performance characteristics in patients with idiopathic pulmonary fibrosis (IPF) have not been systematically evaluated. To assess the reliability, validity, and responsiveness of the 6MWT and estimate the minimal clinically important difference (MCID) in patients with IPF. The study population included all subjects completing a 6MWT in a clinical trial evaluating interferon gamma-1b (n = 822). Six-minute walk distance (6MWD) and other parameters were measured at baseline and at 24-week intervals using a standardized protocol. Parametric and distribution-independent correlation coefficients were used to assess the strength of the relationships between 6MWD and measures of pulmonary function, dyspnea, and health-related quality of life. Both distribution-based and anchor-based methods were used to estimate the MCID. Comparison of two proximal measures of 6MWD (mean interval, 24 d) demonstrated good reliability (coefficient = 0.83; P < 0.001). 6MWD was weakly correlated with measures of physiologic function and health-related quality of life; however, values were consistently and significantly lower for patients with the poorest functional status, suggesting good construct validity. Importantly, change in 6MWD was highly predictive of mortality; a 24-week decline of greater than 50 m was associated with a fourfold increase in risk of death at 1 year (hazard ratio, 4.27; 95% confidence interval, 2.57- 7.10; P < 0.001). The estimated MCID was 24-45 m. The 6MWT is a reliable, valid, and responsive measure of disease status and a valid endpoint for clinical trials in IPF.

Lower limb kinematics during treadmill walking after space flight: implications for gaze stabilization

NASA Technical Reports Server (NTRS)

McDonald, P. V.; Basdogan, C.; Bloomberg, J. J.; Layne, C. S.

1996-01-01

We examined the lower limb joint kinematics observed during pre- and postflight treadmill walking performed by seven subjects from three Space Shuttle flights flown between March 1992 and February 1994. Basic temporal characteristics of the gait patterns, such as stride time and duty cycle, showed no significant changes after flight. Evaluation of phaseplane variability across the gait cycle suggests that postflight treadmill walking is more variable than preflight, but the response throughout the course of a cycle is joint dependent and, furthermore, the changes are subject dependent. However, analysis of the phaseplane variability at the specific locomotor events of heel strike and toe off indicated statistically significant postflight increases in knee variability at the moment of heel strike and significantly higher postflight hip joint variability at the moment of toe off. Nevertheless, the observation of component-specific variability was not sufficient to cause a change in the overall lower limb joint system stability, since there was no significant change in an index used to evaluate this at both toe off and heel strike. The implications of the observed lower limb kinematics for head and gaze control during locomotion are discussed in light of a hypothesized change in the energy attenuation capacity of the musculoskeletal system in adapting to weightlessness.

Lower limb kinematics during treadmill walking after space flight: implications for gaze stabilization.

PubMed

McDonald, P V; Basdogan, C; Bloomberg, J J; Layne, C S

1996-11-01

We examined the lower limb joint kinematics observed during pre- and postflight treadmill walking performed by seven subjects from three Space Shuttle flights flown between March 1992 and February 1994. Basic temporal characteristics of the gait patterns, such as stride time and duty cycle, showed no significant changes after flight. Evaluation of phaseplane variability across the gait cycle suggests that postflight treadmill walking is more variable than preflight, but the response throughout the course of a cycle is joint dependent and, furthermore, the changes are subject dependent. However, analysis of the phaseplane variability at the specific locomotor events of heel strike and toe off indicated statistically significant postflight increases in knee variability at the moment of heel strike and significantly higher postflight hip joint variability at the moment of toe off. Nevertheless, the observation of component-specific variability was not sufficient to cause a change in the overall lower limb joint system stability, since there was no significant change in an index used to evaluate this at both toe off and heel strike. The implications of the observed lower limb kinematics for head and gaze control during locomotion are discussed in light of a hypothesized change in the energy attenuation capacity of the musculoskeletal system in adapting to weightlessness.

Effects of Knee Alignments and Toe Clip on Frontal Plane Knee Biomechanics in Cycling

PubMed Central

Shen, Guangping; Zhang, Songning; Bennett, Hunter J.; Martin, James C.; Crouter, Scott E.; Fitzhugh, Eugene C.

2018-01-01

Effects of knee alignment on the internal knee abduction moment (KAM) in walking have been widely studied. The KAM is closely associated with the development of medial knee osteoarthritis. Despite the importance of knee alignment, no studies have explored its effects on knee frontal plane biomechanics during stationary cycling. The purpose of this study was to examine the effects of knee alignment and use of a toe clip on the knee frontal plane biomechanics during stationary cycling. A total of 32 participants (11 varus, 11 neutral, and 10 valgus alignment) performed five trials in each of six cycling conditions: pedaling at 80 rpm and 0.5 kg (40 Watts), 1.0 kg (78 Watts), and 1.5 kg (117 Watts) with and without a toe clip. A motion analysis system and a customized instrumented pedal were used to collect 3D kinematic and kinetic data. A 3 × 2 × 3 (group × toe clip × workload) mixed design ANOVA was used for statistical analysis (p < 0.05). There were two different knee frontal plane loading patterns, internal abduction and adduction moment, which were affected by knee alignment type. The knee adduction angle was 12.2° greater in the varus group compared to the valgus group (p = 0.001), yet no difference was found for KAM among groups. Wearing a toe clip increased the knee adduction angle by 0.95º (p = 0.005). The findings of this study indicate that stationary cycling may be a safe exercise prescription for people with knee malalignments. In addition, using a toe clip may not have any negative effects on knee joints during stationary cycling. Key points Varus or valgus alignment did not cause increased frontal-plane knee joint loading, suggesting stationary cycling is a safe exercise. This study supports that using a toe clip did not lead to abnormal frontal-plane knee loading during stationary cycling. Two different knee frontal plane loading patterns, knee abduction and adduction moment, were observed during stationary cycling, which are likely affected by

Toe pressure determination by audiophotoplethysmography.

PubMed

Fronek, A; Blazek, V; Curran, B

1994-08-01

The purpose of this study was to evaluate the performance of audiophotoplethysmography as a modality to measure toe pressure without the requirement of a recorder. A portable photoplethysmograph with an audio output was used to determine toe pressures, and the results were compared with those obtained by a commercial photoplethysmograph with a recorder. Thirty-one measurements in control subjects and 62 measurements in patients with arterial occlusive disease were performed. The average toe pressure recorded with oscillography with standard photoplethysmography was 103.5 mm Hg +/- 14.7 SD and 95.9 mm Hg +/- 13.4 SD with audio-photoplethysmography. In the patient group the pressure recorded with a commercial photoplethysmograph was 65.3 mm Hg +/- 34.9 SD compared with 61.6 mm Hg +/- 34.8 SD obtained with audio-photoplethysmography. The difference in both groups was insignificant, and the correlation between both methods was very good. A portable hand-held photoplethysmograph equipped with an audio output was used to measure toe pressure in control subjects and in patients with arterial occlusive disease. The results have been compared with the oscillometric method by a standard commercial photoplethysmograph connected to a recorder. The correlation was very good in the control and patient groups, and the difference between both methods was below the level of statistical significance. The fact that no recorder is needed may help in introducing toe pressure measurement into everyday office diagnostic practice.

The potential of toe flexor muscles to enhance performance.

PubMed

Goldmann, Jan-Peter; Sanno, Maximilian; Willwacher, Steffen; Heinrich, Kai; Brüggemann, Gert-Peter

2013-01-01

The metatarsal phalangeal joint (MPJ) and its crossing toe flexor muscles (TFM) represent the link between the large energy generating leg extensor muscles and the ground. The purpose of this study was to examine the functional adaptability of TFM to increased mechanical stimuli and the effects on walking, running and jumping performance. Fifteen men performed a heavy resistance TFM strength training with 90% of the maximal voluntary isometric contraction (MVIC) for 7 weeks (560 contractions) for the left and right foot. Maximal MPJ and ankle plantar flexion moments during MVICs were measured in dynamometers before and after the intervention. Motion analyses (inverse dynamics) were performed during barefoot walking, running, and vertical and horizontal jumping. Athletic performance was determined by measuring jump height and distance. Left (0.21 to 0.38 Nm · kg(-1); P < 0.001) and right (0.24 to 0.40 Nm · kg(-1); P < 0.001) MPJ plantar flexion moments in the dynamometer, external MPJ dorsiflexion moments (0.69 to 0.75 Nm · kg(-1); P = 0.012) and jump distance (2.25 to 2.31 m; P = 0.006) in horizontal jumping increased significantly. TFM responded highly to increased loading within a few weeks. The increased force potential made a contribution to an athlete's performance enhancement.

Alarm toe switch. [Patent application

DOEpatents

Ganyard, F.P.

1980-11-18

An alarm toe switch inserted within a shoe for energizing an alarm circuit in a covert manner includes an insole mounting pad into which a miniature reed switch is fixedly molded. An elongated slot perpendicular to the reed switch is formed in the bottom surface of the mounting pad. A permanent cylindrical magnet positioned in the forward portion of the slot with a diameter greater than the pad thickness causes a bump above the pad. A foam rubber block is also positioned in the slot rearwardly of the magnet and holds the magnet in normal inoperative relation. A non-magnetic support plate covers the slot and holds the magnet and foam rubber in the slot. The plate minimizes bending and frictional forces to improve movement of the magnet for reliable switch activation. The bump occupies the knuckle space beneath the big toe. When the big toe is scrunched rearwardly the magnet is moved within the slot relative to the reed switch, thus magnetically activating the switch. When toe pressure is released the foam rubber block forces the magnet back into normal inoperative position to deactivate the reed switch.

Toe-to-hand transfer: Evolving Indications and Relevant Outcomes

PubMed Central

Waljee, Jennifer F.; Chung, Kevin C.

2014-01-01

In the late 19th century, the first toe to hand transfer was performed in Vienna, Switzerland as a staged procedure by Nicolandi.(1) Since that time, the advent of microsurgery has revolutionized toe to hand transfers. In 1966, Buncke performed the first microvascular toe to thumb transfer in a rhesus monkey.(2) The first toe to thumb transfer using microsurgical techniques in humans was performed by Cobbett in 1969, followed shortly thereafter by the first transfer of a second toe to the thumb position.(3,4) Today, due to expanding microsurgical techniques and surgeon innovation, the indications and techniques for toe-to-hand transfer procedures continue to evolve and now encompass patients with a variety of acquired and congenital hand defects.(5) PMID:23790426

Hammer toe

MedlinePlus

... by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Toe Injuries and Disorders Read more NIH MedlinePlus ...

The effect of footwear adapted with a multi-curved rocker sole in conjunction with knee-ankle-foot orthoses on walking in poliomyelitis subjects: a pilot study.

PubMed

Mojaver, Ali; Arazpour, Mokhtar; Aminian, Gholamreza; Ahmadi Bani, Monireh; Bahramizadeh, Mahmood; Sharifi, Guive; Sherafatvaziri, Arash

2017-10-01

Knee-ankle-foot orthoses (KAFOs) are used by people with poliomyelitis to ambulate. Whist advances in orthotic knee joint designs for use in KAFOs such the provision of stance control capability have proven efficacy, little attention has been paid to shoe adaptations which may also improve gait. The aim of this study was to evaluate the alteration to the kinematics and temporal-spatial parameters of gait caused by the use of heel-to-toe rocker-soled footwear when ambulating with KAFOs. Nine adults with a history of poliomyelitis who routinely wore KAFOs participated in the study. A heel-to-toe rocker sole was added to footwear and worn on the affected side. A three-dimensional motion capture system was used to quantify the resulting alteration to specific gait parameters. Maximum hip joint extension was significantly increased (p = 0.011), and hip abduction and adduction were both significantly reduced (p = 0.011 and p = 0.007, respectively) when walking with the rocker sole. A significant increase in stride length (p = 0.035) was demonstrated but there were no significant increases in either walking speed or cadence. A heel-to-toe rocker sole adaptation may be useful for walking in patients with poliomyelitis who use KAFOs. Implications for Rehabilitation The poor functionality and difficulty in walking when using an orthotic device such as a KAFO which keeps the knee locked during ambulation, plus the significant energy required to walk, are complications of orthoses using. Little evidence exists regarding the biomechanical effect of walking with a KAFO incorporating fixed knee joints, in conjunction with rocker-soled footwear. The main aim of walking with a heel-to-toe rocker sole is to facilitate forward progression of the tibia when used with an AFO or KAFO or to provide easier walking for patients who have undergone an ankle arthrodesis. In this study, a rocker sole profile adaptation produced no significant alteration to hip joint flexion

Pulmonary hypertension in idiopathic pulmonary fibrosis does not influence six-minute walk distance: results from a retrospective study.

PubMed

Harari, Sergio; Caminati, Antonella; Cassandro, Roberto; Conti, Sara; Madotto, Fabiana; Luisi, Francesca; Cesana, Giancarlo

2015-01-05

The characteristics of the six-minute walk test (6MWT) in patients with idiopathic pulmonary fibrosis (IPF) and pulmonary hypertension (PH) have not yet been described; nevertheless, this test has already been used as a "surrogate end point" in some clinical trials. Goal of this retrospective study was to assess whether the presence of PH in patients with IPF might influence 6MWT performances. We retrospectively reviewed the data of patients with IPF who were referred to our hospital. The study population was divided in two groups according to the presence or absence of PH at right heart catheterization; then, the six-minute walking distance (6MWD) and pulmonary function tests (PFTs) were compared between groups. Study population included 30 IPF patients with a mean age of 59.0 years (± 8.3), most of whom (76.7%) were males. A total of 43.3% of patients had PH. PFTs data were similar in IPF patients of the two groups; the only exception was FVC, which was significantly higher in IPF patients with PH (63.8% ± 16.0 vs. 51.6% ± 13.8 in patients without PH, p<0.05). No difference was detected between groups in 6MWD (222.3m ± 118.5 in PH group and 222.1m ± 118.5 in non-PH group, p>0.05). Our data suggested that 6MWD does not differ between IPF patients with or without PH. Thus, 6MWD should not be used as a surrogate endpoint in clinical study in patients affected by IPF and PH.

Urinary corticosterone responses to capture and toe-clipping in the cane toad (Rhinella marina) indicate that toe-clipping is a stressor for amphibians.

PubMed

Narayan, Edward J; Molinia, Frank C; Kindermann, Christina; Cockrem, John F; Hero, Jean-Marc

2011-11-01

Toe-clipping, the removal of one or more toes, is a common method used to individually mark free-living animals. Whilst this method is widely used in studies of amphibians, the appropriateness of the method, and its potential detrimental effects have been the subject of debate. Here, we provide for the first time, evidence that toe-clipping is a stressor in a wild amphibian. We measured urinary corticosterone responses of male cane toads (Rhinella marina) to capture and handling only, and to toe-clipping under field conditions. Urinary testosterone concentrations and white blood cell proportions were also measured. Urinary corticosterone metabolite concentrations increased 6h after capture and handling only and remained high for 24h; corticosterone returned to baseline levels after 48 h and remained low at 72 h post capture and handling. Corticosterone concentrations in toads subjected to toe-clipping increased at 6h to significantly higher concentrations than after capture and handling only, then decreased more slowly than after capture and handling, and were still elevated (approximately double basal level) 72 h after toe-clipping. Testosterone did not change significantly after capture and handling only, whereas after toe-clipping testosterone decreased at 6h and remained low at 72 h. There were weak short-term effects of toe-clipping compared with capture and handling only on white blood cell proportions. We have clearly shown that toe-clipping is a distinctly stronger stressor than capture and handling alone. This indicates that there is an ethical cost of toe-clipping, and this should be considered when planning studies of amphibians. Copyright © 2011 Elsevier Inc. All rights reserved.

Gait training with partial body weight support during overground walking for individuals with chronic stroke: a pilot study

PubMed Central

2011-01-01

Background It is not yet established if the use of body weight support (BWS) systems for gait training is effective per se or if it is the combination of BWS and treadmill that improves the locomotion of individuals with gait impairment. This study investigated the effects of gait training on ground level with partial BWS in individuals with stroke during overground walking with no BWS. Methods Twelve individuals with chronic stroke (53.17 ± 7.52 years old) participated of a gait training program with BWS during overground walking, and were evaluated before and after the gait training period. In both evaluations, individuals were videotaped walking at a self-selected comfortable speed with no BWS. Measurements were obtained for mean walking speed, step length, stride length and speed, toe-clearance, durations of total double stance and single-limb support, and minimum and maximum foot, shank, thigh, and trunk segmental angles. Results After gait training, individuals walked faster, with symmetrical steps, longer and faster strides, and increased toe-clearance. Also, they displayed increased rotation of foot, shank, thigh, and trunk segmental angles on both sides of the body. However, the duration of single-limb support remained asymmetrical between each side of the body after gait training. Conclusions Gait training individuals with chronic stroke with BWS during overground walking improved walking in terms of temporal-spatial parameters and segmental angles. This training strategy might be adopted as a safe, specific and promising strategy for gait rehabilitation after stroke. PMID:21864373

[Second toe transfer in congenital hand differences].

PubMed

Dautel, G; Barbary, S

2008-12-01

In congenital hand differences, microsurgical toe transfer involves the creation of one or several rays in a child that never possessed them before. Second toe transplantation was uniformly used in this series that include 65 consecutive cases. Etiologies were represented by symbrachydactyly, constriction band syndrome or central cleft hand. Second toe transfer was performed with or without the MTP joint and followed by proximal ray resection of the donor toe. In the vast majority of theses cases, transplantation was performed in adactylic or monodactylic hand, the ultimate functional goal was the creation of a "tip-to-tip" two fingers pinch. Implantation site was chosen according to the situation of the existing finger(s). The existence of a functioning recipient MCP joint was one of the key factors of the final functional outcome. There were two vascular failures in this series with complete necrosis of the transplanted toe. Two additional toes appeared mediocre with respect to the overall transfer integration. The final mobility of the fingers reconstructed was measured using the total active motion score. Average TAM was poor (42 degrees +/-24 degrees ). In 12 out of 15 patients that were evaluated with a follow-up of at least five years, the static two-point discrimination was found to be excellent (less than 6mm). Our series did not allow us to establish a firm correlation between the type of nerve suture used and the quality of sensory recovery. Growth was measured as a percentage of the intact second toe (68 to 95%). All children on a long term basis had a normal gait without any impediment during sports or leisure activities. Clinical results obtained in this series lead to think that the cerebral cortex has got some plasticity which allows the integration of the transplants.

Hammer toe repair

MedlinePlus

... causing: Pain Irritation Sores Problems finding shoes that fit Skin infections Surgery may not be advised if: Treatment with paddings and strapping works You can still straighten your toe Changing to different shoe types can alleviate symptoms

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

Nonvascularized toe phalangeal transfer and distraction lengthening for symbrachydactyly.

PubMed

Patterson, Ryan W; Seitz, William H

2010-04-01

Symbrachydactyly describes a spectrum of congenital hand differences consisting of digital loss resulting in fused short fingers. As the principles for distraction lengthening have evolved, the technique of nonvascularized toe phalangeal transfer to the hand with shortened digits has provided patients with improved outcomes. Nonvascularized toe phalanx to hand transplant with distraction lengthening restores functional length to a skeletally deficient, poorly functioning hand while maintaining an overlying layer of vascular and sensate tissue. The primary goal is improvement of digital length to enhance mechanical advantage and prehension. We describe the technique of nonvascularized toe phalangeal transfer and distraction lengthening for symbrachydactyly, including the following steps: nonvascularized proximal toe phalanx harvest, toe phalanx transfer to hand, pin placement, osteotomy, and closure.

Toe spreading ability in men with chronic pelvic pain syndrome

PubMed Central

Yilmaz, Ugur; Rothman, Ivan; Ciol, Marcia A; Yang, Claire C; Berger, Richard E

2005-01-01

Background We examined toe-spreading ability in subjects with chronic pelvic pain syndrome (CPPS) to test the hypothesis that subjects with CPPS could have deficiencies in lower extremity functions innervated by sacral spinal roots. Methods Seventy two subjects with CPPS and 98 volunteer controls were examined as part of a larger study on CPPS. All the subjects underwent a detailed urologic and neurological examination including a toe-spreading examination with a quantitative scoring system. We compared the groups in terms of ability of toe-spreading as either "complete" (all toes spreading) or "incomplete" (at least one interdigital space not spreading) and also by comparing the number of interdigital spaces. For CPPS subjects only, we also analyzed the variation of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scales by toe-spreading categories. Results CPPS subjects were less often able to spread all toes than subjects without CPPS (p = 0.005). None of the NIH-CPSI sub-scales (pain, urinary symptoms, and quality of life), nor the total score showed an association with toe spreading ability. Conclusion We found toe spreading to be diminished in subjects with CPPS. We hypothesize that incomplete toe spreading in subjects with CPPS may be related to subtle deficits involving the most caudal part of the spinal segments. PMID:15949041

Balance in Astronauts Performing Jumps, Walking and Quiet Stance Following Spaceflight

NASA Technical Reports Server (NTRS)

Reschke, Millard F.; Bloomberg, J. J.; Wood, S. J.; Harm, D. L.

2011-01-01

Introduction: Both balance and locomotor ataxia is severe in astronauts returning from spaceflight with serious implications for unassisted landings. As a part of an ongoing effort to demonstrate the functional significance of the postflight ataxia problem our laboratory has evaluated jumping, walking heel-to-toe and quite stance balance immediately following spaceflight. Methods: Six astronauts from 12-16 day flights and three from 6-month flights were asked to perform three self-initiated two-footed jumps from a 30-cm-high platform, walking for 10 steps (three trials) placing the feet heel to toe in tandem, arms folded across the chest and the eyes closed, and lastly, recover from a simulated fall by standing from a prone position on the floor and with eyes open maintain a quiet stance for 3 min with arms relaxed along the side of the body and feet comfortably positioned on a force plate. Crewmembers were tested twice before flight, on landing day (short-duration), and days 1, 6, and 30 following all flight durations. Results/Conclusions: Many of astronauts tested fell on their first postflight jump but recovered by the third jump showing a rapid learning progression. Changes in take-off strategy were clearly evident in duration of time in the air between the platform and the ground (significant reduction in time to land), and also in increased asymmetry in foot latencies on take-off postflight. During the tandem heel-to-toe walking task there was a significant decrease in percentage of correct steps on landing day (short-duration crew) and on first day following landing (long-duration) with only partial recovery the following day. Astronauts for both short and long duration flight times appeared to be unaware of foot position relative to their bodies or the floor. During quite stance most of crewmembers tested exhibited increased stochastic activity (larger short-term COP diffusion coefficients postflight in all planes and increases in mean sway speed).

Toe-to-hand transfer in symbrachydactyly.

PubMed

Richardson, Philip W F; Johnstone, Bruce R; Coombs, Christopher J

2004-07-01

Symbrachydactyly, or central atypical cleft, is classified as a failure of formation. For the adactylous or monodactylous forms, free toe transfer is the treatment of choice. We present 18 free toe transfers in 13 patients for symbrachydactyly. Despite abnormal anatomy, the functional building blocks have always been available and transfer technically possible. The result has been improved function and high levels of parental satisfaction.

Effects of a 10-week toe-out gait modification intervention in people with medial knee osteoarthritis: a pilot, feasibility study.

PubMed

Hunt, M A; Takacs, J

2014-07-01

To examine the feasibility of a 10-week gait modification program in people with medial tibiofemoral knee osteoarthritis (OA), and to assess changes in clinical and biomechanical outcomes. Fifteen people with medial knee OA completed 10 weeks of gait modification focusing on increasing toe-out angle during stance 10° compared to their self-selected angle measured at baseline. In addition to adherence and performance difficulty outcomes, knee joint symptoms (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and total score, numerical rating scale (NRS) of pain), and knee joint loading during gait (late stance peak knee adduction moment (KAM)) were assessed. Participants were able to perform the toe-out gait modification program with minimal to moderate difficulty, and exhibited significant increases in self-selected toe-out angle during walking (P < 0.001). Joint discomfort was reported by five participants (33%) in the hip or knee joints, though none lasted longer than 2 weeks. Participants reported statistically significant reductions in WOMAC pain (P = 0.02), NRS pain (P < 0.001), WOMAC total score (P = 0.02), and late stance KAM (P = 0.04). These preliminary findings suggest that toe-out gait modification is feasible in people with medial compartment knee OA. Preliminary changes in clinical and biomechanical outcomes provide the impetus for conducting larger scale studies of gait modification in people with knee OA to confirm these findings. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Nailfold Capillaroscopy of Fingers and Toes - Variations of Normal.

PubMed

Lambova, Sevdalina Nikolova; Muller-Ladner, Ulf

2018-04-20

Nailfold capillaroscopy is the only method for morphological assessment of nutritive capillaries. The literature data about capillaroscopic findings in healthy individuals are scarce. To evaluate and compare the capillaroscopic findings of fingers and toes in healthy subjects. 22 healthy individuals were included in the study. Capillaroscopic examination was performed with videocapillaroscope Videocap 3.0 (DS Medica). Exclusion criteria were as follows: history of vasospasm, presence of accompanying diseases, taking any medications, arterial hypertension in first degree relatives, overweight or obesity (body mass index > 25kg/m2) and presence of chronic arterial or venous insufficiency. Poor visibility of nailfold capillaries was found significantly more frequently in the toes (22.7%, 5/22) as compared with fingers (0/22). Slight irregularities in capillary distribution and orientation to their parallel axis were significantly more common in the toes (31.8%, 7/22) as compared with fingers (9%, 2/22), (p<0.05). The mean diameter of the arterial (0.012±0.002mm) and the venous limb (0.017±0.002mm) of the toes did not differ significantly as compared to the respective parameters in the fingers (0.013±0.002mm for the arterial limb, p=0.46 and 0.018±0.002mm for the venous limb, p=0.25). The mean capillary density also did not differ significantly in the fingers and toes. The mean capillary length of the toes (0.165±0.096mm) was shorter as compared with hands (0.220±0.079mm), but the difference was not statistically significant (p=0.37). Presence of tortuous capillaries (>10%) was found significantly more often in the toes (12/22) as compared with fingers (6/22, χ2=6.769, p<0.05). Short capillary loops (length<100µm) were observed significantly more often in the toes (11/22 - toes, 1/22 - fingers, χ2=14.666, p<0.05). Capillaroscopic examination of the toes shows some differences as compared to those of the fingers such as greater number of cases with poor

[Effect of walking speed on pressure distribution of orthopedic shoe technology].

PubMed

Drerup, B; Hafkemeyer, U; Möller, M; Wetz, H H

2001-03-01

Lesions to the diabetic foot have various causes. However, there is broad consensus that excessive plantar pressure plays a major role in the chain of events leading to ulcerations and gangrenes. During walking, on the other hand, peak values of plantar pressure are likely to increase with velocity even in therapeutic shoes. Therefore, the question arises whether a moderate velocity should be recommended to diabetic patients to reduce the risk of foot lesions. In this study, two velocities were compared for different types of therapeutic footwear. The velocities selected were considered moderate (0.7 m/s) and normal (1.3 m/s) for diabetic patients. A specially designed mathematical algorithm (velocity normalization) provided the pressure distributions from a common set of measurements: seven trials at different velocities for each subject and each type of footwear. Ten test subjects with healthy feet were studied. The shoes were ready-made and all had a midfoot rocker. The following four conditions were tested: flexible or rigid outsole respectively in combination with a flat insole or molded foot bed respectively. Pressure distribution measurements were performed with the Pedar in-shoe system, and the Pedar software package was used for analysis. The foot was divided into six regions: first toe, second to fifth toes, metatarsal region, medial midfoot, lateral midfoot, and heel. Only peak pressures were taken into account. Gait velocity was found to have an effect on plantar pressure distribution, mainly in the toes and heel region. Peak pressure in the heels increased significantly by about 20%. In the toe region, the increase was about the same, but was not statistically significant. At a higher velocity, pressure even slightly decreased in the midfoot region. The percentage variation was similar for all four conditions. Thus, walking slowly prevented the foot from high peak pressures, and the combination of rigid outsole and molded foot bed was best suited for

Biomechanical implications of walking with indigenous footwear.

PubMed

Willems, Catherine; Stassijns, Gaetane; Cornelis, Wim; D'Août, Kristiaan

2017-04-01

This study investigates biomechanical implications of walking with indigenous "Kolhapuri" footwear compared to barefoot walking among a population of South Indians. Ten healthy adults from South India walked barefoot and indigenously shod at voluntary speed on an artificial substrate. The experiment was repeated outside, on a natural substrate. Data were collected from (1) a heel-mounted 3D-accelerometer recording peak impact at heel contact, (2) an ankle-mounted 3D-goniometer (plantar/dorsiflexion and inversion/eversion), and (3) sEMG electrodes at the m. tibialis anterior and the m. gastrocnemius medialis. Data show that the effect of indigenous footwear on the measured variables, compared to barefoot walking, is relatively small and consistent between substrates (even though subjects walked faster on the natural substrate). Walking barefoot, compared to shod walking yields higher impact accelerations, but the differences are small and only significant for the artificial substrate. The main rotations of the ankle joint are mostly similar between conditions. Only the shod condition shows a faster ankle rotation over the rapid eversion motion on the natural substrate. Maximal dorsiflexion in late stance differs between the footwear conditions on an artificial substrate, with the shod condition involving a less dorsiflexed ankle, and the plantar flexion at toe-off is more extreme when shod. Overall the activity pattern of the external foot muscles is similar. The indigenous footwear studied (Kolhapuri) seems to alter foot biomechanics only in a subtle way. While offering some degree of protection, walking in this type of footwear resembles barefoot gait and this type of indigenous footwear might be considered "minimal". © 2017 The Authors American Journal of Physical Anthropology Published by Wiley Periodicals, Inc.

Pahoehoe toe dimensions, morphology, and branching relationships at Mauna Ulu, Kilauea Volcano, Hawai'i

NASA Astrophysics Data System (ADS)

Crown, David A.; Baloga, Stephen M.

Pahoehoe toe dimensions, morphology, and branching relationships were analyzed in flows emplaced during 1972 at Mauna Ulu, a satellitic shield on the east rift zone of Kilauea Volcano, Hawai'i. In order to characterize regions within flow fields dominated by networks of pahoehoe toes, measurements of toe length, width, thickness, and orientation were completed for 445 toes at 13 sites. Variations in site characteristics, including slope, substrate, and position in the flow field allow an evaluation of the effects of such parameters on toe dimensions. Toe surface morphology (ropy or smooth), local flow lobe position (interior or margin), and connective relationships between toes were documented in the form of detailed toe maps. These maps show the number of branches connecting a given toe to other toes in its local pahoehoe network and illustrate branching patterns. Statistical analyses of toe dimensions and comparisons of pahoehoe toe study sites and sub-populations combined with field observations, evaluation of toe maps, and qualitative examination of toe dimension size distributions show the following: (a) Although there are significant variations at a given site, toes typically have mean lengths (101cm) greater than mean widths (74cm) and mean widths greater than mean thicknesses (19cm) sites that have mean widths greater than mean lengths are those with lower slopes. (b) Where significant site-to-site variations in mean values of a given toe dimension were apparent, these differences could not be directly related to site characteristics. (c) Ropy toes have significantly larger mean values of length, width, and number of branches than smooth toes, and toes with three or more branches have greater lengths, widths, and thicknesses than toes with two or fewer branches, suggesting concentration of flow in these toe types. (d) The skewness of all size distributions of toe length and width to larger values suggests that toes are transitional to larger sheets and

Efficacy of N-Acetylcysteine in Idiopathic Pulmonary Fibrosis

PubMed Central

Sun, Tong; Liu, Jing; Zhao, De Wei

2016-01-01

Abstract There are a number of conflicting reports describing the clinical outcomes of using N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis. We have, therefore, performed a meta-analysis to evaluate the efficacy of N-acetylcysteine, compared with control, for the treatment of idiopathic pulmonary fibrosis. Original controlled clinical trials evaluating the efficacy of N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis were included in the analysis. Searches for relevant articles were carried out in July 2014 by 2 independent researchers using PubMed, Embase, Cochrane Central, and Google Scholar. Change in forced vital capacity, change in percentage of predicted vital capacity, change in percentage of predicted carbon monoxide diffusing capacity, changes in 6 minutes walking test distance, rate of adverse events, and rate of death were expressed as outcomes using RevMan 5.0.1. Five trials, with a total of 564 patients, were included in this meta-analysis. The meta-analysis showed that the control group had significant decreases in percentage of predicted vital capacity (standardized mean difference [SMD] = 0.37; 95% confidence interval [CI]: 0.13 to −0.62; P = 0.003) and 6 minutes walking test distance (SMD = 0.25; 95% CI: 0.02–0.48; P = 0.04). There were no statistically significant differences in forced vital capacity (SMD = 0.07; 95% CI: −0.13–0.27; P = 0.52), percentage of predicted carbon monoxide diffusing capacity (SMD = 0.12; 95% CI: −0.06–0.30; P = 0.18), rates of adverse events (odd ratio = 4.50; 95% CI: 0.19–106.41; P = 0.35), or death rates (odd ratio = 1.79; 95% CI: 0.3–5.12; P = 0.28) between the N-acetylcysteine group and the control group. N-Acetylcysteine was found to have a significant effect only on decreases in percentage of predicted vital capacity and 6 minutes walking test distance. N-acetylcysteine showed no beneficial effect on changes

Turf Toe

PubMed Central

McCormick, Jeremy J.; Anderson, Robert B.

2010-01-01

Context: Despite an increasing awareness of turf toe injury, confusion still exists regarding the anatomy, mechanism, diagnosis, and treatment of this hyperextension injury to the hallux metatarsophalangeal (MTP) joint. Evidence Acquisition: This article reviews the anatomy, diagnosis, and treatment algorithm for turf toe injury by reviewing relevant studies and presenting information useful to clinicians, therapists, and athletic trainers. A literature search was performed by a review of PubMed and OVID articles published from 1976 to July 2010. Results: Grade I injury is a sprain or attenuation of the plantar capsular ligamentous complex of the hallux MTP joint; athletes are typically able to return to play as tolerated. Grade II injury is a partial rupture of the plantar soft tissue structures of the hallux MTP joint, typically requiring about 2 weeks to recover. Grade III injury is a complete rupture of the plantar structures of the hallux MTP joint, requiring at least 10 to 16 weeks to recover. Some complete ruptures require surgical repair. Conclusion: With accurate diagnosis, athletes can have an appropriate treatment plan, and their expectations can be tempered to the degree of injury. Careful management may allow successful return to play at a preinjury level of participation. PMID:23015979

Elastic modulus of tree frog adhesive toe pads.

PubMed

Barnes, W Jon P; Goodwyn, Pablo J Perez; Nokhbatolfoghahai, Mohsen; Gorb, Stanislav N

2011-10-01

Previous work using an atomic force microscope in nanoindenter mode indicated that the outer, 10- to 15-μm thick, keratinised layer of tree frog toe pads has a modulus of elasticity equivalent to silicone rubber (5-15 MPa) (Scholz et al. 2009), but gave no information on the physical properties of deeper structures. In this study, micro-indentation is used to measure the stiffness of whole toe pads of the tree frog, Litoria caerulea. We show here that tree frog toe pads are amongst the softest of biological structures (effective elastic modulus 4-25 kPa), and that they exhibit a gradient of stiffness, being stiffest on the outside. This stiffness gradient results from the presence of a dense network of capillaries lying beneath the pad epidermis, which probably has a shock absorbing function. Additionally, we compare the physical properties (elastic modulus, work of adhesion, pull-off force) of the toe pads of immature and adult frogs.

Association of spinal deformity and pelvic tilt with gait asymmetry in adolescent idiopathic scoliosis patients: Investigation of ground reaction force.

PubMed

Park, Yang Sun; Lim, Young Tae; Koh, Kyung; Kim, Jong Moon; Kwon, Hyun Joon; Yang, Ji Seung; Shim, Jae Kun

2016-07-01

Adolescent idiopathic scoliosis is a prevalent orthopedic problem in children ages 10 to 16years. Although genetic, physiological and biomechanical factors are considered to contribute to the onset and progression of adolescent idiopathic scoliosis, the underlying mechanisms are not yet clear. The purpose of this study was to investigate the association between spinal deformity and inter-leg ground reaction force asymmetry during walking in adolescent idiopathic scoliosis patients. Fourteen patients (3 males and 11 females) participated in this study. Maximum Cobb's angle, adjusted Cobb's angle, and pelvic tilt were calculated from X-ray images. Asymmetry indices between legs were also calculated from ground reaction force magnitude and time variables from their preferred speed walking. Pearson coefficients of correlation were used to investigate associations of asymmetry indices with angle variables. Asymmetry indices of ground reaction force magnitudes positively correlated with adjusted Cobb's angle and maximum Cobb's angle mainly during the peak of braking phase, average of braking phase, while asymmetry indices of ground reaction force time variables showed no significant correlation with adjusted or maximum Cobb's angle. In contrast, asymmetry indices of ground reaction force time variables positively correlated with pelvic tilt during stance phase. We concluded that the spinal deformity of adolescent idiopathic scoliosis patients estimated using the maximum and adjusted Cobb's angles is generally associated with greater asymmetry of ground reaction force magnitudes in walking, while the pelvic tilt is associated with the greater asymmetry of ground reaction force time variables. Copyright © 2016 Elsevier Ltd. All rights reserved.

A phase 3 trial of pirfenidone in patients with idiopathic pulmonary fibrosis.

PubMed

King, Talmadge E; Bradford, Williamson Z; Castro-Bernardini, Socorro; Fagan, Elizabeth A; Glaspole, Ian; Glassberg, Marilyn K; Gorina, Eduard; Hopkins, Peter M; Kardatzke, David; Lancaster, Lisa; Lederer, David J; Nathan, Steven D; Pereira, Carlos A; Sahn, Steven A; Sussman, Robert; Swigris, Jeffrey J; Noble, Paul W

2014-05-29

In two of three phase 3 trials, pirfenidone, an oral antifibrotic therapy, reduced disease progression, as measured by the decline in forced vital capacity (FVC) or vital capacity, in patients with idiopathic pulmonary fibrosis; in the third trial, this end point was not achieved. We sought to confirm the beneficial effect of pirfenidone on disease progression in such patients. In this phase 3 study, we randomly assigned 555 patients with idiopathic pulmonary fibrosis to receive either oral pirfenidone (2403 mg per day) or placebo for 52 weeks. The primary end point was the change in FVC or death at week 52. Secondary end points were the 6-minute walk distance, progression-free survival, dyspnea, and death from any cause or from idiopathic pulmonary fibrosis. In the pirfenidone group, as compared with the placebo group, there was a relative reduction of 47.9% in the proportion of patients who had an absolute decline of 10 percentage points or more in the percentage of the predicted FVC or who died; there was also a relative increase of 132.5% in the proportion of patients with no decline in FVC (P<0.001). Pirfenidone reduced the decline in the 6-minute walk distance (P=0.04) and improved progression-free survival (P<0.001). There was no significant between-group difference in dyspnea scores (P=0.16) or in rates of death from any cause (P=0.10) or from idiopathic pulmonary fibrosis (P=0.23). However, in a prespecified pooled analysis incorporating results from two previous phase 3 trials, the between-group difference favoring pirfenidone was significant for death from any cause (P=0.01) and from idiopathic pulmonary fibrosis (P=0.006). Gastrointestinal and skin-related adverse events were more common in the pirfenidone group than in the placebo group but rarely led to treatment discontinuation. Pirfenidone, as compared with placebo, reduced disease progression, as reflected by lung function, exercise tolerance, and progression-free survival, in patients with

Evaluation of Fitness and the Balance Levels of Children with a Diagnosis of Juvenile Idiopathic Arthritis: A Pilot Study

PubMed Central

Maggio, Maria Cristina; Corsello, Giovanni; Messina, Giuseppe; Iovane, Angelo; Palma, Antonio

2017-01-01

Background: Juvenile idiopathic arthritis is a main cause of physical disability and has high economic costs for society. The purpose of this study was to assess the fitness levels and the postural and balance deficits with a specific test battery. Methods: Fifty-six subjects were enrolled in this study. Thirty-nine healthy subjects were included in the control group and seventeen in the juvenile idiopathic arthritis group. All subjects were evaluated using a posturography system. The fitness level was evaluated with a battery of tests (Abalakov test, sit-up test, hand grip test, backsaver sit and reach, the toe touch test). An unpaired t-test was used to determine differences. Pearson’s correlation coefficient was used to evaluate the correlation between the tests. Results: The battery of tests demonstrated that subjects in the juvenile idiopathic arthritis group have lower fitness levels compared to the control group. The juvenile idiopathic arthritis group showed low postural control with respect to the control group. Pearson analysis of the juvenile idiopathic arthritis group data showed significant correlations between variables. Pearson’s results from the control group data showed a similar trend. Conclusions: The results suggest that the battery of tests used could be an appropriate tool. However, we highlight that these conclusions need to be supported by other studies with a larger population scale. PMID:28753965

Evaluation of Fitness and the Balance Levels of Children with a Diagnosis of Juvenile Idiopathic Arthritis: A Pilot Study.

PubMed

Patti, Antonino; Maggio, Maria Cristina; Corsello, Giovanni; Messina, Giuseppe; Iovane, Angelo; Palma, Antonio

2017-07-19

Background: Juvenile idiopathic arthritis is a main cause of physical disability and has high economic costs for society. The purpose of this study was to assess the fitness levels and the postural and balance deficits with a specific test battery. Methods: Fifty-six subjects were enrolled in this study. Thirty-nine healthy subjects were included in the control group and seventeen in the juvenile idiopathic arthritis group. All subjects were evaluated using a posturography system. The fitness level was evaluated with a battery of tests (Abalakov test, sit-up test, hand grip test, backsaver sit and reach, the toe touch test). An unpaired t -test was used to determine differences. Pearson's correlation coefficient was used to evaluate the correlation between the tests. Results: The battery of tests demonstrated that subjects in the juvenile idiopathic arthritis group have lower fitness levels compared to the control group. The juvenile idiopathic arthritis group showed low postural control with respect to the control group. Pearson analysis of the juvenile idiopathic arthritis group data showed significant correlations between variables. Pearson's results from the control group data showed a similar trend. Conclusions: The results suggest that the battery of tests used could be an appropriate tool. However, we highlight that these conclusions need to be supported by other studies with a larger population scale.

Cardiorespiratory adaptation in a 6-minute walk test by fibrotic idiopathic interstitial pneumonia patients who did or did not respond to pulmonary rehabilitation.

PubMed

Chéhère, Baptiste; Bougault, Valérie; Chenivesse, Cécile; Grosbois, Jean-Marie; Wallaert, Benoit

2018-06-14

Pulmonary rehabilitation (PR) improves performance in the 6-min walk test (6MWT) in a subset of patients with fibrotic idiopathic interstitial pneumonia (f-IIP); however, a large proportion of patients do not respond to PR. To investigate the effects of a PR program on cardiorespiratory responses during a 6MWT and to identify the characteristics of patients who do not show improved performance after PR. An observational study. Patients were recruited from the Competence Centre for Rare Pulmonary Diseases at Lille University Hospital, France and completed an 8-week home-based PR program. A total of 19 patients with f-IIP; 12 with idiopathic pulmonary fibrosis (IPF) and 7 with fibrotic non-specific interstitial pneumonia. Patients underwent spirometry and completed a 6MWT before and after an 8- week PR program. Gas exchange, heart rate, and pulse O2 saturation were measured continuously during the 6MWT. Quality of life, dyspnoea, and anxiety/depression were assessed using the Short-Form 36 (SF-36), the baseline/transition dyspnoea index (BDI/TDI), and the Hospital Anxiety and Depression Scale (HADS) questionnaires. Patients who did and did not improve the distance walked in the 6MWT by at least 30 m after PR were classified as responders (n=9) and non-responders (n=10), respectively. O2 uptake, ventilation rate, and distance covered during the 6MWT were significantly improved only in the responder group (p<0.05). Changes in SF-36, BDI/TDI, and HADS scores did not differ significantly between responders and non-responders. The non-responder group contained significantly more patients with IPF (p<0.05) and experienced greater arterial oxygen desaturation during the 6MWT compared with the responder group. Failure to improve performance in the 6MWT after PR was associated with a diagnosis of IPF, non-improvement in gas exchange, and greater arterial oxygen desaturation. Most f-IIP patients who did not respond to PR were diagnosed with IPF and displayed greater hypoxemia

Long-term donor site morbidity after free nonvascularized toe phalangeal transfer.

PubMed

Garagnani, Lorenzo; Gibson, Marc; Smith, Paul J; Smith, Gillian D

2012-04-01

Free nonvascularized toe phalangeal transfer is an established surgical option for the reconstruction of hypoplastic digits. This study assessed long-term morbidity in the feet using this technique. We reviewed 40 children treated between 1991 and 2007 by free nonvascularized toe phalangeal transfer. The diagnosis was digital hypoplasia resulting from symbrachydactyly in 33 cases, constriction ring syndrome in 3 cases, thumb hypoplasia in 3 cases, and perinatal subclavian venous thrombosis in 1 case. The patients were followed up after surgery for a mean of 10 years (range, 3-19 y). The Oxford Ankle Foot Questionnaire was administered to patients and families to assess patient symptoms and patient and parental satisfaction. We assessed toe length ratio, the presence of visible deformity, and distal hypoplasia of the donor toes clinically and radiographically. Emotional problems related to foot appearance were common. We also found functional problems with footwear in some patients. All patients had floppy unstable toes with visible deformity. Increasing foot deformity was seen with growth, which led to deterioration in foot aesthetics, particularly where multiple donor toes had been harvested. We identified distal and middle phalangeal and metatarsal hypoplasia in the donor toes. Donor site morbidity for free toe phalangeal transfer is greater than previously documented. This should be considered during surgical decision making for reconstruction of hypoplastic digits. Preoperative counseling should include discussion regarding possible consequences of phalangeal harvest on donor toes and options for donor site reconstruction. Long-term follow-up of the donor site is essential to accurately assess results. Therapeutic III. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

A Midterm Review of Lesser Toe Arthrodesis With an Intramedullary Implant.

PubMed

Harmer, James Lee; Wilkinson, Anthony; Maher, Anthony John

2017-10-01

Lesser toe deformities are one of the most common conditions encountered by podiatric surgeons. When conservative treatments fail surgical correction is indicated. Many surgical options have been described to address the complex nature of these deformities but no perfect solution has been reported to date. However, with the continued advancement of internal fixation technology, interphalangeal joint (IPJ) arthrodesis with an intramedullary implant may be a good option. This retrospective study presents patient reported outcomes and complications at 6 months and 3 years following lesser toe proximal interphalangeal joint (PIPJ) arthrodesis with a polyketone intrameduallary implant (Toe Grip, Orthosolutions, UK). Between September 2011 and November 2012, a total of 38 patients attended for second toe PIPJ arthrodesis by means of the Toe Grip device. At 6 months postoperation, 94.7% of patients and at 3 years postoperation, 92.8% of patients felt that their original complaint was better or much better. Health-related quality of life scores continued to improve overtime as measured by the Manchester Oxford Foot Questionnaire. Complications were generally observational and asymptomatic. The most common complications were floating toes (17.8%), mallet deformities (14.2%), metatarsalgia (17.8%), and transverse plane deformity of the toe (10.7%). This study demonstrates excellent patient-eported outcomes with minimal symptomatic complications making the "Toe Grip" implant a safe and effective alternative fixation device for IPJ arthrodesis when dealing with painful digital deformities. Therapeutic, Level IV: Case series.

Capsulitis of the Second Toe

MedlinePlus

... second toe is a result of abnormal foot mechanics, where the ball of the foot beneath the ... options for early treatment of capsulitis: Rest and ice. Staying off the foot and applying ice packs ...

Modeling the effect of toe clipping on treefrog survival: Beyond the return rate

USGS Publications Warehouse

Waddle, J.H.; Rice, K.G.; Mazzotti, F.J.; Percival, H.F.

2008-01-01

Some studies have described a negative effect of toe clipping on return rates of marked anurans, but the return rate is limited in that it does not account for heterogeneity of capture probabilities. We used open population mark-recapture models to estimate both apparent survival (ϕ) and the recapture probability (p) of two treefrog species individually marked by clipping 2–4 toes. We used information-theoretic model selection to examine the effect of toe clipping on survival while accounting for variation in capture probability. The model selection results indicate strong support for an effect of toe clipping on survival of Green Treefrogs (Hyla cinerea) and only limited support for an effect of toe clipping on capture probability. We estimate there was a mean absolute decrease in survival of 5.02% and 11.16% for Green Treefrogs with three and four toes removed, respectively, compared to individuals with just two toes removed. Results for Squirrel Treefrogs (Hyla squirella) indicate little support for an effect of toe clipping on survival but may indicate some support for a negative effect on capture probability. We believe that the return rate alone should not be used to examine survival of marked animals because constant capture probability must be assumed, and our examples demonstrate how capture probability may vary over time and among groups. Mark-recapture models provide a method for estimating the effect of toe clipping on anuran survival in situations where unique marks are applied.

Age-related reduction and independent predictors of toe flexor strength in middle-aged men.

PubMed

Suwa, Masataka; Imoto, Takayuki; Kida, Akira; Iwase, Mitsunori; Yokochi, Takashi

2017-01-01

Toe flexor muscles play an important role in posture and locomotion, and poor toe flexor strength is a risk factor for falls. In this cross-sectional study, we estimated the age-related change in toe flexor strength and compared it with that of handgrip strength. Independent factors predicting toe flexor and handgrip strength were also determined. A total of 1401 male (aged 35-59 years) study participants were divided into five groups according to their chronological age; 35-39, 40-44, 45-49, 50-54, and 55-59 years. Toe flexor and handgrip strength, anthropometry, and resting blood pressure were measured. Fasting blood samples were collected to measure blood glucose, triglycerides, high- and low-density lipoprotein-cholesterols, and albumin. A self-administered lifestyle questionnaire was conducted. Decline in absolute toe flexor and handgrip strength began in the age groups 50-55 and 55-59 years, respectively. In comparison to the mean values of the youngest group, relative toe flexor strength (87.0 ± 26.6%) was significantly lower than handgrip strength (94.4 ± 13.1%) for the oldest group. Multiple regression analyses showed that independent factors predicting both toe flexor and handgrip strength were lean body mass, age, serum albumin, drinking habit, and fat mass. Additionally, fasting blood glucose, diastolic blood pressure, sleeping time and exercise habit were predicting factors of toe flexor strength but not of handgrip strength. Age-related reduction in toe flexor strength was earlier and greater than handgrip strength, and toe flexor strength reflects body composition and metabolic status.

Interventions for treating osteoarthritis of the big toe joint.

PubMed

Zammit, Gerard V; Menz, Hylton B; Munteanu, Shannon E; Landorf, Karl B; Gilheany, Mark F

2010-09-08

Osteoarthritis affecting of the big toe joint of the foot (hallux limitus or rigidus) is a common and painful condition. Although several treatments have been proposed, few have been adequately evaluated. To identify controlled trials evaluating interventions for osteoarthritis of the big toe joint and to determine the optimum intervention(s). Literature searches were conducted across the following electronic databases: CENTRAL; MEDLINE; EMBASE; CINAHL; and PEDro (to 14th January 2010). No language restrictions were applied. Randomised controlled trials, quasi-randomised trials, or controlled clinical trials that assessed treatment outcomes for osteoarthritis of the big toe joint. Participants of any age or gender with osteoarthritis of the big toe joint (defined either radiographically or clinically) were included. Two authors examined the list of titles and abstracts identified by the literature searches. One content area expert and one methodologist independently applied the pre-determined inclusion and exclusion criteria to the full text of identified trials. To minimise error and reduce potential bias, data were extracted independently by two content experts. Only one trial satisfactorily fulfilled the inclusion criteria and was included in this review. This trial evaluated the effectiveness of two physical therapy programs in 20 individuals with osteoarthritis of the big toe joint. Assessment outcomes included pain levels, big toe joint range of motion and plantar flexion strength of the hallux. Mean differences at four weeks follow up were 3.80 points (95% CI 2.74 to 4.86) for self reported pain, 28.30 degrees (95% CI 21.37 to 35.23) for big toe joint range of motion, and 2.80 kg (95% CI 2.13 to 3.47) for muscle strength. Although differences in outcomes between treatment and control groups were reported, the risk of bias was high. The trial failed to employ appropriate randomisation or adequate allocation concealment, used a relatively small sample and

Fatigue Magnification Factors of Arc-Soft-Toe Bracket Joints

NASA Astrophysics Data System (ADS)

Fu, Qiang; Li, Huajun; Wang, Hongqing; Wang, Shuqing; Li, Dejiang; Li, Qun; Fang, Hui

2018-06-01

Arc-soft-toe bracket (ASTB), as a joint structure in the marine structure, is the hot spot with significant stress concentration, therefore, fatigue behavior of ASTBs is an important point of concern in their design. Since macroscopic geometric factors obviously influence the stress flaws in joints, the shapes and sizes of ASTBs should represent the stress distribution around cracks in the hot spots. In this paper, we introduce a geometric magnification factor for reflecting the macroscopic geometric effects of ASTB crack features and construct a 3D finite element model to simulate the distribution of stress intensity factor (SIF) at the crack endings. Sensitivity analyses with respect to the geometric ratio H t / L b , R/ L b , L t / L b are performed, and the relations between the geometric factor and these parameters are presented. A set of parametric equations with respect to the geometric magnification factor is obtained using a curve fitting technique. A nonlinear relationship exists between the SIF and the ratio of ASTB arm to toe length. When the ratio of ASTB arm to toe length reaches a marginal value, the SIF of crack at the ASTB toe is not influenced by ASTB geometric parameters. In addition, the arc shape of the ASTB slope edge can transform the stress flowing path, which significantly affects the SIF at the ASTB toe. A proper method to reduce stress concentration is setting a slope edge arc size equal to the ASTB arm length.

Modified toe pulp fillet flap coverage: Better wound healing and satisfactory length preservation.

PubMed

Baek, Sang Oon; Suh, Hyo Wan; Lee, Jun Yong

2018-01-01

Amputation is commonly performed for toe necrosis secondary to peripheral vascular diseases, such as diabetes mellitus. When amputating a necrotic toe, preservation of the bony structure is important for preventing the collapse of adjacent digits into the amputated space. However, in the popular terminal Syme's amputation technique, partial amputation of the distal phalanx could cause increased tension on the wound margin. Herein, we introduce a new way to resect sufficient bony structure while maintaining the normal length, based on a morphological analysis of the toes. Unlike the pulp of the finger in the distal phalanx, the toe has abundant teardrop-shaped pulp tissue. The ratio of the vertical length to the longitudinal length in the distal phalanx was compared between the toes and fingers. Amputation was performed at the proximal interphalangeal joint level. Then, a mobilizable pulp flap was rotated 90° cephalad to replace the distal soft tissue defect. This modified toe fillet flap was performed in 5 patients. The toe pulp was found to have a vertically oriented morphology compared to that of the fingers, enabling length preservation through cephalad rotation. All defects were successfully covered without marginal ischemia. While conventional toe fillet flap coverage focuses on the principle of length preservation as the first priority, our modified method takes both wound healing and length into account. The fattiest part of the pulp is advanced to the toe tip, providing a cushioning effect and enough length to substitute for phalangeal bone loss. Our modified method led to satisfactory functional and aesthetic outcomes.

Measurement of Toe-Brachial Indices in People with Subnormal Toe Pressures Complexities and Revelations.

PubMed

McAra, Sylvia; Trevethan, Robert

2018-03-01

Insufficient information exists about the nature of toe-brachial indices (TBIs) and how best to obtain them, yet their validity may be particularly important for the identification and management of peripheral artery disease and cardiovascular disease risk. We explore ways in which valid TBI measurements might be obtained. The TBI data were recorded from 97 people with subnormal toe pressures. Most people provided three TBI readings from each foot on six different occasions over a 6-month period. The foot with the lower baseline TBI was noted. For most people, only small inconsistencies existed among the three readings taken from each foot on a single occasion, and there were no consistent differences based on sequence. However, for some people there were noticeable and unsystematic differences among the measures. Selecting any specific one of the three readings based on its sequential position, or averaging specific readings, did not yield TBIs that were unequivocally typical for a person, and taking the lowest reading of each set seemed to offer the most expedient solution in this context. That permitted baseline descriptive statistics to be produced for both the higher and lower pressure feet, between which there was a statistically significant TBI difference. Accurate and consistent TBI readings cannot be assumed for people with subnormal toe pressures, and taking only a single reading or indiscriminately averaging readings seems inadvisable. Two readings and, if they are discrepant, additional readings, are recommended for each foot, ideally on several occasions, and careful consideration should be given to determine the most representative reading for each foot. Cuff sizes and other sources of inaccuracy or distortion should not be ignored, and standardized protocols for obtaining TBIs are recommended.

A mechanical protocol to replicate impact in walking footwear.

PubMed

Price, Carina; Cooper, Glen; Graham-Smith, Philip; Jones, Richard

2014-01-01

Impact testing is undertaken to quantify the shock absorption characteristics of footwear. The current widely reported mechanical testing method mimics the heel impact in running and therefore applies excessive energy to walking footwear. The purpose of this study was to modify the ASTM protocol F1614 (Procedure A) to better represent walking gait. This was achieved by collecting kinematic and kinetic data while participants walked in four different styles of walking footwear (trainer, oxford shoe, flip-flop and triple-density sandal). The quantified heel-velocity and effective mass at ground-impact were then replicated in a mechanical protocol. The kinematic data identified different impact characteristics in the footwear styles. Significantly faster heel velocity towards the floor was recorded walking in the toe-post sandals (flip-flop and triple-density sandal) compared with other conditions (e.g. flip-flop: 0.36±0.05 ms(-1) versus trainer: 0.18±0.06 ms(-1)). The mechanical protocol was adapted by altering the mass and drop height specific to the data captured for each shoe (e.g. flip-flop: drop height 7 mm, mass 16.2 kg). As expected, the adapted mechanical protocol produced significantly lower peak force and accelerometer values than the ASTM protocol (p<.001). The mean difference between the human and adapted protocol was 12.7±17.5% (p<.001) for peak acceleration and 25.2±17.7% (p=.786) for peak force. This paper demonstrates that altered mechanical test protocols can more closely replicate loading on the lower limb in walking. This therefore suggests that testing of material properties of footbeds not only needs to be gait style specific (e.g. running versus walking), but also footwear style specific. Copyright © 2014 Elsevier B.V. All rights reserved.

Idiopathic ophthalmodynia and idiopathic rhinalgia: two topographic facial pain syndromes.

PubMed

Pareja, Juan A; Cuadrado, María L; Porta-Etessam, Jesús; Fernández-de-las-Peñas, César; Gili, Pablo; Caminero, Ana B; Cebrián, José L

2010-09-01

To describe 2 topographic facial pain conditions with the pain clearly localized in the eye (idiopathic ophthalmodynia) or in the nose (idiopathic rhinalgia), and to propose their distinction from persistent idiopathic facial pain. Persistent idiopathic facial pain, burning mouth syndrome, atypical odontalgia, and facial arthromyalgia are idiopathic facial pain syndromes that have been separated according to topographical criteria. Still, some other facial pain syndromes might have been veiled under the broad term of persistent idiopathic facial pain. Through a 10-year period we have studied all patients referred to our neurological clinic because of facial pain of unknown etiology that might deviate from all well-characterized facial pain syndromes. In a group of patients we have identified 2 consistent clinical pictures with pain precisely located either in the eye (n=11) or in the nose (n=7). Clinical features resembled those of other localized idiopathic facial syndromes, the key differences relying on the topographic distribution of the pain. Both idiopathic ophthalmodynia and idiopathic rhinalgia seem specific pain syndromes with a distinctive location, and may deserve a nosologic status just as other focal pain syndromes of the face. Whether all such focal syndromes are topographic variants of persistent idiopathic facial pain or independent disorders remains a controversial issue.

GUTs and TOEs

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

Lincoln, Don

2015-01-20

Albert Einstein said that what he wanted to know was “God’s thoughts,” which is a metaphor for the ultimate and most basic rules of the universe. Once known, all other phenomena would then be a consequence of these simple rules. While modern science is far from that goal, we have some thoughts on how this inquiry might unfold. In this video, Fermilab’s Dr. Don Lincoln tells what we know about GUTs (grand unified theories) and TOEs (theories of everything).

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

Gait and energy consumption in adolescent idiopathic scoliosis: A literature review.

PubMed

Daryabor, Aliyeh; Arazpour, Mokhtar; Sharifi, Guive; Bani, Monireh Ahmadi; Aboutorabi, Atefeh; Golchin, Navid

2017-04-01

Adolescent idiopathic scoliosis (AIS) is a progressive growth disease that affects spinal anatomy, mobility, and left-right trunk symmetry. The disease can modify human gait. We aimed to review articles describing the measurement of gait parameters and energy consumption in AIS during walking without any intervention. Literature review. The search strategy was based on the Population Intervention Comparison Outcome method and included all relevant articles published from 1996 to 2015. Articles were searched in MEDLINE via PubMed, Science Direct, Google Scholar, and ISI Web of Knowledge databases. We selected 33 studies investigating the effect of scoliosis deformity on gait parameters and energy expenditure during walking. Most of the studies concluded no significant differences in walking speed, cadence and step width in scoliosis patients and normal participants. However, patients showed decreased hip and pelvic motion, excessive energy cost of walking, stepping pattern asymmetry and ground reaction force asymmetry. We lack consistent evidence of the effect of scoliosis on temporal spatial and kinematic parameters in AIS patients as compared with normal people. However, further research is needed to assess the effect of scoliosis on gait and energy consumption. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

An Integrated Theory of Everything (TOE)

NASA Astrophysics Data System (ADS)

Colella, Antonio

2014-03-01

An Integrated TOE unifies all known physical phenomena from the Planck cube to the Super Universe (multiverse). Each matter/force particle is represented by a Planck cube string. Any Super Universe object is a volume of contiguous Planck cubes. Super force Planck cube string singularities existed at the start of all universes. An Integrated TOE foundations are twenty independent existing theories and without sacrificing their integrities, are replaced by twenty interrelated amplified theories. Amplifications of Higgs force theory are key to an Integrated TOE and include: 64 supersymmetric Higgs particles; super force condensations to 17 matter particles/associated Higgs forces; spontaneous symmetry breaking is bidirectional; and the sum of 8 permanent Higgs force energies is dark energy. Stellar black hole theory was amplified to include a quark star (matter) with mass, volume, near zero temperature, and maximum entropy. A black hole (energy) has energy, minimal volume (singularity), near infinite temperature, and minimum entropy. Our precursor universe's super supermassive quark star (matter) evaporated to a super supermassive black hole (energy). This transferred total conserved energy/mass and transformed entropy from maximum to minimum. Integrated Theory of Everything Book Video: https://www.youtube.com/watch?v=4a1c9IvdoGY Research Article Video: http://www.youtube.com/watch?v=CD-QoLeVbSY Research Article: http://toncolella.files.wordpress.com/2012/07/m080112.pdf.

Operative Outcomes of Grade 3 Turf Toe Injuries in Competitive Football Players.

PubMed

Smith, Kenneth; Waldrop, Norman

2018-06-01

Turf toe is a term used to describe a hyperextension injury to the first metatarsophalangeal joint. Although the vast majority of turf toe injuries can be treated successfully without operative intervention, there are instances where surgery is required to allow the athlete to return to play. Although there is a plethora of literature on turf toe injuries and nonoperative management, there are currently few reports on operative outcomes in athletes. We obtained all cases of turf toe repair according to the ICD-10 procedural code. The inclusion criteria included: age greater than 16, turf toe injury requiring operative management and at least a varsity level high school football player. The charts were reviewed for age, BMI, level of competition, injury mechanism, football position, setting of injury and playing surface. In addition, we recorded the specifics of the operative procedure, a listing of all injured structures, the implants used and the great toe range of motion at final follow-up visit. The AOFAS Hallux score and VAS was used postoperatively as our outcome measures. Our patient population included 15 patients. The average follow-up time was 27.5 months. The average patient was 19.3 years old with a body mass index of 32.3. The average playing time missed was 16.5 weeks. The average dorsiflexion range of motion at the final follow-up was 42.3 degrees. At final follow-up, the average AOFAS Hallux score was 91.3. The average VAS pain score was 0.7 at rest and 0.8 with physical activity. Complete turf toe injuries are often debilitating and may require operative management to restore a pain-free, stable, and functional forefoot. This study represents the largest cohort of operatively treated grade 3 turf toe injuries in the literature and demonstrates that good clinical outcomes were achieved with operative repair. Level IV, case series.

Effect of toe extension on EMG of triceps surae muscles during isometric dorsiflexion.

PubMed

Siddiqi, Ariba; Arjunan, Sridhar P; Kumar, Dinesh

2016-12-01

The protocol for estimating force of contraction by triceps surae (TS) muscles requires the immobilization of the ankle during dorsiflexion and plantar flexion. However, large variability in the results has been observed. To identify the cause of this variability, experiments were conducted where ankle dorsiflexion force and electromyogram (EMG) of the TS were recorded under two conditions: (i) toes were strapped and (ii) toes were unstrapped, with all other conditions such as immobilization of the ankle remaining unchanged. The root mean square (RMS) of the EMG and the force were analyzed and one-tail Student's t-test was performed for significance between the two conditions. The RMS of the EMG from TS muscles was found to be significantly higher (~55%) during dorsiflexion with toes unstrapped compared with when the toes were strapped. The torque corresponding to dorsiflexion was also higher with toes unstrapped. Our study has shown that it is important to strap the toes when measuring the torque at the ankle and EMG of the TS muscles.

Loss of balance during balance beam walking elicits a multifocal theta band electrocortical response

PubMed Central

Gwin, Joseph T.; Makeig, Scott; Ferris, Daniel P.

2013-01-01

Determining the neural correlates of loss of balance during walking could lead to improved clinical assessment and treatment for individuals predisposed to falls. We used high-density electroencephalography (EEG) combined with independent component analysis (ICA) to study loss of balance during human walking. We examined 26 healthy young subjects performing heel-to-toe walking on a treadmill-mounted balance beam as well as walking on the treadmill belt (both at 0.22 m/s). ICA identified clusters of electrocortical EEG sources located in or near anterior cingulate, anterior parietal, superior dorsolateral-prefrontal, and medial sensorimotor cortex that exhibited significantly larger mean spectral power in the theta band (4–7 Hz) during walking on the balance beam compared with treadmill walking. Left and right sensorimotor cortex clusters produced significantly less power in the beta band (12–30 Hz) during walking on the balance beam compared with treadmill walking. For each source cluster, we also computed a normalized mean time/frequency spectrogram time locked to the gait cycle during loss of balance (i.e., when subjects stepped off the balance beam). All clusters except the medial sensorimotor cluster exhibited a transient increase in theta band power during loss of balance. Cluster spectrograms demonstrated that the first electrocortical indication of impending loss of balance occurred in the left sensorimotor cortex at the transition from single support to double support prior to stepping off the beam. These findings provide new insight into the neural correlates of walking balance control and could aid future studies on elderly individuals and others with balance impairments. PMID:23926037

Loss of balance during balance beam walking elicits a multifocal theta band electrocortical response.

PubMed

Sipp, Amy R; Gwin, Joseph T; Makeig, Scott; Ferris, Daniel P

2013-11-01

Determining the neural correlates of loss of balance during walking could lead to improved clinical assessment and treatment for individuals predisposed to falls. We used high-density electroencephalography (EEG) combined with independent component analysis (ICA) to study loss of balance during human walking. We examined 26 healthy young subjects performing heel-to-toe walking on a treadmill-mounted balance beam as well as walking on the treadmill belt (both at 0.22 m/s). ICA identified clusters of electrocortical EEG sources located in or near anterior cingulate, anterior parietal, superior dorsolateral-prefrontal, and medial sensorimotor cortex that exhibited significantly larger mean spectral power in the theta band (4-7 Hz) during walking on the balance beam compared with treadmill walking. Left and right sensorimotor cortex clusters produced significantly less power in the beta band (12-30 Hz) during walking on the balance beam compared with treadmill walking. For each source cluster, we also computed a normalized mean time/frequency spectrogram time locked to the gait cycle during loss of balance (i.e., when subjects stepped off the balance beam). All clusters except the medial sensorimotor cluster exhibited a transient increase in theta band power during loss of balance. Cluster spectrograms demonstrated that the first electrocortical indication of impending loss of balance occurred in the left sensorimotor cortex at the transition from single support to double support prior to stepping off the beam. These findings provide new insight into the neural correlates of walking balance control and could aid future studies on elderly individuals and others with balance impairments.

Improvisation in wrap-around toe-to-thumb transfer.

PubMed

Govila, A

1993-01-01

Wrap-around partial great toe transfer, a one time dream, is now a well established and universally accepted method of thumb reconstruction. In this technique, part of the soft tissue of the great toe are wrapped around and shaped to the size of the graft from iliac bone in such a manner that a thumb of normal dimensions and shape is produced. Instead of the iliac bone graft, we found great merit in using the second metacarpal from the traumatised hand to be reconstructed. In this paper its use and merits are elaborated.

Double second toe transfer in congenital hand anomalies.

PubMed

Van Holder, C; Giele, H; Gilbert, A

1999-08-01

A series of 14 patients with congenital hand anomalies who received staged double second toe transfers to the same hand for restoration of function or form were reviewed retrospectively. There were three children with constriction ring syndrome, two with symbrachydactyly and nine with transverse absence (failure of formation). There were different indications, technical difficulties and results with the various anomalies. All transferred toes were mobile and sensate, and were reported to be of benefit in both function and appearance. However, secondary surgical procedures were required in all patients.

Differences in foot kinematics between young and older adults during walking.

PubMed

Arnold, John B; Mackintosh, Shylie; Jones, Sara; Thewlis, Dominic

2014-02-01

Our understanding of age-related changes to foot function during walking has mainly been based on plantar pressure measurements, with little information on differences in foot kinematics between young and older adults. The purpose of this study was to investigate the differences in foot kinematics between young and older adults during walking using a multi-segment foot model. Joint kinematics of the foot and ankle for 20 young (mean age 23.2 years, standard deviation (SD) 3.0) and 20 older adults (mean age 73.2 years, SD 5.1) were quantified during walking with a 12 camera Vicon motion analysis system using a five segment kinematic model. Differences in kinematics were compared between older adults and young adults (preferred and slow walking speeds) using Student's t-tests or if indicated, Mann-Whitney U tests. Effect sizes (Cohen's d) for the differences were also computed. The older adults had a less plantarflexed calcaneus at toe-off (-9.6° vs. -16.1°, d = 1.0, p = <0.001), a smaller sagittal plane range of motion (ROM) of the midfoot (11.9° vs. 14.8°, d = 1.3, p = <0.001) and smaller coronal plane ROM of the metatarsus (3.2° vs. 4.3°, d = 1.1, p = 0.006) compared to the young adults. Walking speed did not influence these differences, as they remained present when groups walked at comparable speeds. The findings of this study indicate that independent of walking speed, older adults exhibit significant differences in foot kinematics compared to younger adults, characterised by less propulsion and reduced mobility of multiple foot segments. Copyright © 2013 Elsevier B.V. All rights reserved.

GUTs and TOEs

ScienceCinema

Lincoln, Don

2018-01-16

Albert Einstein said that what he wanted to know was “God’s thoughts,” which is a metaphor for the ultimate and most basic rules of the universe. Once known, all other phenomena would then be a consequence of these simple rules. While modern science is far from that goal, we have some thoughts on how this inquiry might unfold. In this video, Fermilab’s Dr. Don Lincoln tells what we know about GUTs (grand unified theories) and TOEs (theories of everything).

Correlation between toe flexor strength and ankle dorsiflexion ROM during the countermovement jump.

PubMed

Yun, Sung Joon; Kim, Moon-Hwan; Weon, Jong-Hyuck; Kim, Young; Jung, Sung-Hoon; Kwon, Oh-Yun

2016-08-01

[Purpose] This study assessed the relationships between peak toe flexor muscle strength, ankle dorsiflexion range of motion, and countermovement jump height. [Subjects and Methods] Eighteen healthy volunteers participated in the study. Each participant completed tests for peak toe flexor muscle strength, ankle dorsiflexion range of motion, and countermovement jump height. [Results] The results showed (1) a moderate correlation between ankle dorsiflexion range of motion and countermovement jump height and (2) a high correlation between peak first toe flexor muscle strength and countermovement jump height. Peak first toe flexor muscle strength and ankle dorsiflexion range of motion are the main contributors to countermovement jump performance. [Conclusion] These findings indicate that the measurement of peak first toe flexor muscle strength and ankle dorsiflexion range of motion may be useful in clinical practice for improving jump performance in athletes training for sports such as volleyball and basketball.

The effects of Taraxacum officinale extracts (TOE) supplementation on physical fatigue in mice.

PubMed

Jinchun, Zhang; Jie, Chen

2011-01-01

The study is to investigate the effect of Taraxacum officinale extracts (TOE) supplementation on physical fatigue based on the forced swimming capacity in mice. Forty Kunming male mice were randomly divided into 4 groups, i.e., normal control (NC) and three doses of TOE treated group (High-dose, Middle-dose and Low-dose). Three TOE treated groups were treated by oral TOE with 10, 30 and 100mg/kg b.w respectively for a period of 42 days. The normal control group was given a corresponding volume of sterile distilled water. After 6 weeks, the forced swimming capacity and blood biochemical parameters in mice were measured, and the result showed that TOE had an anti- physical fatigue effect. It enhanced the maximum swimming capacity of mice, effectively delayed the lowering of glucose in the blood, and prevented the increase in lactate and triglyceride concentrations.

Characteristics of Plantar Loads During Walking in Patients with Knee Osteoarthritis.

PubMed

Zhang, Zhiwang; Wang, Lin; Hu, Kaijun; Liu, Yu

2017-12-01

BACKGROUND Knee osteoarthritis (KOA) is a common disease that can change the load on lower limbs during walking. Plantar loads in patients with KOA may provide a basis for clinical decisions regarding footwear and foot orthoses. This study aimed to compare plantar loads in females with and without KOA during gait. MATERIAL AND METHODS Plantar pressure during walking was recorded in 23 females with KOA and 23 females without KOA. Maximum force (MF), contact area (CA), and peak pressure (PP) were measured at 7 different regions underneath the foot, named heel (M1), midfoot (M2), first metatarsophalangeal joint (MPJ) (M3), second MPJ (M4), third to fifth MPJ (M5), hallux (M6), and lesser toes (M7). RESULTS PPs for M2 and (M3) in females with KOA were higher than those in females without KOA. High PPs were also found in females with KOA for M2, M3, and M4. CONCLUSIONS Increased plantar loading in females with KOA may lead to foot pronation and gait changes during walking. Plantar loading may be offered to patients with KOA when considering footwear and foot orthoses.

[Toe transplantation in congenital malformations of the hand].

PubMed

Foucher, G

1997-11-01

Toe transfer is a well established procedure for thumb and finger reconstruction after mutilation. The indications in congenital malformations are a mater of controversy. Out of a personal series of 209 patients, 42 were children presenting a congenital malformation. Thirty six, with 46 transfers were available for review. There is only one failure at the beginning of our experience. The main indication was absence of pinch either due to absence of thumb (like in congenital band syndrome or some extreme cases of ulnar club hand or cleft hand) or absence of long finger (like in symbrachydactyly monodactylous type) or lack of both thumb and finger (like in peromelic type of symbrachydactyly). In this last type, we have been disappointed by the functional result of the distal implantation of two second toes taken from both feet; we have proposed a "stub" operation consisting in a second toe transfer on the anterior aspect of the radial epiphysis to take advantage of the mobility of the wrist and the availability of plenty tendon transfer (in this proximal situation). When planing to "built" an absent pincer, an early age is mandatory for operation (mean 12 months), to ensure a good cortical integration. A less frequent indication is a partial toe transfer with a vascularized epiphysis to provide growth and mobility in some cases of thumb hypoplasia (like in symbrachydactyly or Blauth and Manske type III b). Results are difficult to assess due to the early operation but if the mobility has been disappointing (mean 32 degrees), sensibility (mean 2PD 5 mm) and growth were excellent.

Effect of turf toe on foot contact pressures in professional American football players.

PubMed

Brophy, Robert H; Gamradt, Seth C; Ellis, Scott J; Barnes, Ronnie P; Rodeo, Scott A; Warren, Russell F; Hillstrom, Howard

2009-05-01

The relationship between turf toe and plantar foot pressures has not been extensively studied. Two hypotheses were tested in a cohort of professional American football players: first, that a history of turf toe is associated with increased peak hallucal and first metatarsophalangeal (MTP) plantar pressures; second, that decreased range of motion (ROM) of the first MTP correlates with increased peak hallucal and first MTP plantar pressures. Forty-four athletes from one National Football League (NFL) team were screened for a history of turf toe during preseason training. Dorsal passive MTP ROM and dynamic plantar pressures were measured in both feet of each player. Anatomical masking was used to assess peak pressure at the first MTP and hallux. First MTP dorsiflexion was significantly lower in halluces with a history of turf toe (40.6 +/- 15.1 degrees versus 48.4 +/- 12.8 degrees, p = 0.04). Peak hallucal pressures were higher in athletes with turf toe (535 +/- 288 kPa versus 414 +/- 202 kPa, p = 0.05) even after normalizing for athlete body mass index (p = 0.0003). Peak MTP pressure was not significantly different between the two groups tested. First MTP dorsiflexion did not correlate with peak hallucal or first MTP pressures. This study showed that turf toe is associated with decreased MTP motion. In addition, increased peak hallucal pressures were found. Further study is warranted to determine whether these pressures correlate with the severity of symptoms or progression of turf toe to first MTP arthritis.

Assessment of leg muscle activity using toe tapping in patients with Parkinson's disease: comparison of two types of toe tapping.

PubMed

Taniguchi, Seira; Peper, Ferdinand; Shimokawa, Tetsuya

2018-05-01

[Purpose] This study investigates two types of toe tapping, i.e., "closed," with both feet on the floor, and "open," in which the foot does not touch the ground, and evaluates their usefulness in combination with monitoring of muscle activity during toe tapping. [Subjects and Methods] The study enrolled 11 patients with Parkinson's disease (PD) and 9 controls (Controls). The tibialis anterior (TA) and gastrocnemius (GS) muscle activity during toe tapping was measured using surface electromyography. [Results] In closed tapping, the minima in GS activation with the first tap was significantly higher in patients with PD than in Controls. In open tapping, the coefficient of variation (CV) of local maxima in TA activation was significantly higher in patients with PD than in Controls. In both types of tapping, the CV of extrema in GS activities increased with disease duration, but this may be due to the long-term administration of Levodopa, which itself tends to cause excessive GS activities. [Conclusion] Closed tapping is suitable for the assessment of GS activity and can detect excessive activities, which is observed as visible movement. Open tapping, on the other hand, is suitable for assessment of TA activity.

Swing limb mechanics and minimum toe clearance in people with knee osteoarthritis.

PubMed

Levinger, Pazit; Lai, Daniel T H; Menz, Hylton B; Morrow, Adam D; Feller, Julian A; Bartlett, John R; Bergman, Neil R; Begg, Rezaul

2012-02-01

Knee osteoarthritis (OA) has been shown to be a risk factor for falls. Reductions in foot clearance during the swing phase of walking can cause a trip and potentially lead to a fall. This study examined the swing phase mechanics of people with and without knee OA during walking. Minimum toe clearance (MTC) height, joint angles at the time of MTC and the influence of the angular changes of the hip, knee and ankle of the swing leg on foot clearance using sensitivity analysis were investigated in 50 knee OA participants and 28 age-matched asymptomatic controls. Although both groups had a similar MTC height (controls: 12.8±6.7 mm, knee OA: 13.4±7.0 mm), the knee OA group used a different strategy to achieve the same foot clearance, as evidenced by greater knee flexion (52.5±5.3° vs 49.4±4.8°, p=0.007), greater hip abduction (-3.6±3.3° vs -1.8±3.3°, p=0.03) and less ankle adduction (2.8±1.9° vs 4.2±2.1°, p=0.01). MTC height was comparable between the groups, however a different swing phase mechanism was used by the knee OA. Although adequate MTC is an important component of safe locomotion, it does not appear to be impaired in people with knee OA. Other factors, such as inadequate responses to postural perturbation, may be responsible for falls in this group. Copyright © 2011 Elsevier B.V. All rights reserved.

Effect of concurrent walking and interlocutor distance on conversational speech intensity and rate in Parkinson's disease.

PubMed

McCaig, Cassandra M; Adams, Scott G; Dykstra, Allyson D; Jog, Mandar

2016-01-01

Previous studies have demonstrated a negative effect of concurrent walking and talking on gait in Parkinson's disease (PD) but there is limited information about the effect of concurrent walking on speech production. The present study examined the effect of sitting, standing, and three concurrent walking tasks (slow, normal, fast) on conversational speech intensity and speech rate in fifteen individuals with hypophonia related to idiopathic Parkinson's disease (PD) and fourteen age-equivalent controls. Interlocuter (talker-to-talker) distance effects and walking speed were also examined. Concurrent walking was found to produce a significant increase in speech intensity, relative to standing and sitting, in both the control and PD groups. Faster walking produced significantly greater speech intensity than slower walking. Concurrent walking had no effect on speech rate. Concurrent walking and talking produced significant reductions in walking speed in both the control and PD groups. In general, the results of the present study indicate that concurrent walking tasks and the speed of concurrent walking can have a significant positive effect on conversational speech intensity. These positive, "energizing" effects need to be given consideration in future attempts to develop a comprehensive model of speech intensity regulation and they may have important implications for the development of new evaluation and treatment procedures for individuals with hypophonia related to PD. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.

Idiopathic anaphylaxis.

PubMed

Fenny, Nana; Grammer, Leslie C

2015-05-01

Idiopathic anaphylaxis is a diagnosis of exclusion after other causes have been thoroughly evaluated and excluded. The pathogenesis of idiopathic anaphylaxis remains uncertain, although increased numbers of activated lymphocytes and circulating histamine-releasing factors have been implicated. Signs and symptoms of patients diagnosed with idiopathic anaphylaxis are indistinguishable from the manifestations of other forms of anaphylaxis. Treatment regimens are implemented based on the frequency and severity of patient symptoms and generally include the use of epinephrine autoinjectors, antihistamines, and steroids. The prognosis of idiopathic anaphylaxis is generally favorable with well-established treatment regimens and effective patient education. Copyright © 2015 Elsevier Inc. All rights reserved.

The miR172 target TOE3 represses AGAMOUS expression during Arabidopsis floral patterning.

PubMed

Jung, Jae-Hoon; Lee, Sangmin; Yun, Ju; Lee, Minyoung; Park, Chung-Mo

2014-02-01

microRNA172 (miR172) regulates phase transition and floral patterning in Arabidopsis by repressing targets that encode the APETALA2 (AP2) and AP2-like transcription factors. The miR172-mediated repression of the AP2 gene restricts AGAMOUS (AG) expression. In addition, most miR172 targets, including AP2, redundantly act as floral repressors, and the overexpression of the target genes causes delayed flowering. However, how miR172 targets other than AP2 regulate both of the developmental processes remains unclear. Here, we demonstrate that miR172-mediated repression of the TARGET OF EAT 3 (TOE3) gene is critical for floral patterning in Arabidopsis. Transgenic plants that overexpress a miR172-resistant TOE3 gene (rTOE3-ox) exhibit indeterminate flowers with numerous stamens and carpelloid organs, which is consistent with previous observations in transgenic plants that overexpress a miR172-resistant AP2 gene. TOE3 binds to the second intron of the AG gene. Accordingly, AG expression is significantly reduced in rTOE3-ox plants. TOE3 also interacts with AP2 in the nucleus. Given the major role of AP2 in floral patterning, miR172 likely regulates TOE3 in floral patterning, at least in part via AP2. In addition, a miR156 target SQUAMOSA PROMOTER BINDING PROTEIN-LIKE 3 directly activates TOE3 expression, revealing a novel signaling interaction between miR156 and miR172 in floral patterning. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

In-Toeing and Out-Toeing in Toddlers

MedlinePlus

... life. Often this is most noticeable when a child learns to walk because if the tibia or femur ... a neuromuscular condition in rare cases. Have your child evaluated by a doctor if ... such as not learning to talk as expected gait abnormalities that worsen ...

Increased healing in diabetic toe ulcers in a multidisciplinary foot clinic-An observational cohort study.

PubMed

Almdal, T; Nielsen, A Anker; Nielsen, K E; Jørgensen, M E; Rasmussen, A; Hangaard, S; Siersma, V; Holstein, P E

2015-12-01

To study toe ulcer healing in patients with diabetic foot ulcers attending a multidisciplinary foot clinic over a 10 years period. The study was retrospective, consecutive and observational during 2001 through 2011. The patients were treated according to the International Consensus on the Diabetic Foot. During the period the chiropodist staffing in the foot clinic was doubled; new offloading material and orthopedic foot corrections for recalcitrant ulcers were introduced. Healing was investigated in toe ulcers in Cox regression models. 2634 patients developed foot ulcers, of which 1461 developed toe ulcers; in 790 patients these were neuropathic, in 551 they were neuro-ischemic and in 120 they were critically ischemic. One-year healing rates increased in the period 2001-2011 from 75% to 91% for neuropathic toe ulcers and from 72% to 80% for neuro-ischemic toe ulcers, while no changes was observed for ischemic toe ulcers. Adjusted for changes in the patient population, the overall rate of healing for neuropathic and neuro-ischemic toe ulcers almost doubled (HR=1.95 [95% CI: 1.36-2.80]). The results show that the healing of toe ulcers improved. This outcome could not be explained by changes in the patient characteristics, but coincided with a number of improvements in organization and therapy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A Two-Step Integrated Theory of Everything (TOE)

NASA Astrophysics Data System (ADS)

Colella, Antonio

2017-01-01

Two opposing TOE visions are my Two-Step (physics/math) and Hawking's single math step. My Two-Step should replace the single step because of the latter's near zero results after a century of attempts. My physics step had 3 goals. First ``Everything'' was defined as 20 interrelated amplified theories (e.g. string, Higgs forces, spontaneous symmetry breaking, particle decays, dark matter, dark energy, stellar black holes) and their intimate physical interrelationships. Amplifications of Higgs forces theory (e.g. matter particles and their associated Higgs forces were one and inseparable, spontaneous symmetry breaking was bidirectional and caused by high temperatures not Higgs forces, and sum of 8 Higgs forces of 8 permanent matter particles was dark energy) were key to my Two-Step TOE. The second goal answered all outstanding physics questions: what were Higgs forces, dark energy, dark matter, stellar black holes, our universe's creation, etc.? The third goal provided correct inputs for the two part second math step, an E8 Lie algebra for particles and an N-body cosmology simulation (work in progress). Scientific advancement occurs only if the two opposing TOEs are openly discussed/debated.

Five- and 10-Year Follow-Up of Nonvascularized Toe Phalanx Transfers.

PubMed

Kawabata, Hidehiko; Tamura, Daisuke

2018-05-01

The purpose of this study was to evaluate long-term outcomes of nonvascularized toe phalanx transfer. We retrospectively reviewed 54 nonvascularized toe phalanx transfers in 29 children with symbrachydactyly. Forty-seven transfers in 24 children were evaluated at 5-year follow-up and 27 transfers in 14 children were evaluated at 10-year follow-up. We recorded the incidence of the early physeal closure and the length of the transferred toe phalanx on plain radiographs at 5- and 10-year follow-up. Growth rate in the first 5 years and the following 5 years were calculated. Function of the metacarpophalangeal joint (motion, stability, and alignment) was also evaluated. The mean age at surgery was 1.5 years. Seven toe phalanges were trimmed because the skin pocket was tight. Five transfers required revision surgery for partial necrosis of the skin pocket. At 5-year follow-up, the physis was closed in 23%, and at 10 years, 78% of physes were closed. The phalanx length was 87% of expected at 5-year follow-up and 71% at 10-year follow-up. Growth rate was 0.83 mm/y in the first 5 years and 0.22 mm/y in the following 5 years. Active motion was rated as good in 24, fair in 7, and poor in 16. Stability and alignment were rated as good in 37 and 33, fair in 8 and 5, and poor in 2 and 9, respectively. Nonvascularized toe phalanx transfer offered a relatively simple method to lengthen short digits and to provide satisfactory function. The transferred toe phalanges grew at a near-normal rate in the first 5 years, but the growth rate decreased between 5 and 10 years. Therapeutic IV. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Acute Effects of Walking Exercise on Stair Negotiation in Sedentary and Physically Active Older Adults.

PubMed

Kunzler, Marcos R; da Rocha, Emmanuel S; Bobbert, Maarten F; Duysens, Jacques; Carpes, Felipe P

2017-07-01

In negotiating stairs, low foot clearance increases the risk of tripping and a fall. Foot clearance may be related to physical fitness, which differs between active and sedentary participants, and be acutely affected by exercise. Impaired stair negotiation could be an acute response to exercise. Here we determined acute changes in foot clearances during stair walking in sedentary (n = 15) and physically active older adults (n = 15) after prolonged exercise. Kinematic data were acquired during negotiation with a 3-steps staircase while participants walked at preferred speed, before and after 30 min walking at preferred speed and using a treadmill. Foot clearances were compared before and after exercise and between the groups. Sedentary older adults presented larger (0.5 cm for lead and 2 cm for trail leg) toe clearances in ascent, smaller (0.7 cm) heel clearance in the leading foot in descent, and larger (1 cm) heel clearance in the trailing foot in descent than physically active. Sedentary older adults negotiate stairs in a slightly different way than active older adults, and 30 min walking at preferred speed does not affect clearance in stair negotiation.

The impact of footwear and walking distance on gait stability in diabetic patients with peripheral neuropathy.

PubMed

Najafi, Bijan; Khan, Tahir; Fleischer, Adam; Wrobel, James

2013-01-01

We explored gait differences in patients with diabetes and peripheral neuropathy (DPN) and aged-matched controls over short and long walking distances. The potential benefit of footwear for improving gait in patients with DPN was also explored. Twelve patients with DPN and eight controls walked at their habitual speed over short (7 m) and long (20 m) distances under two conditions: barefoot and regular shoes. A validated system of body-worn sensors was used to extract spatiotemporal gait parameters. Neuropathy severity was quantified using vibratory perception threshold measured at the great toe. Gait deterioration in the DPN group was observed during all of the walking trials. However, the difference between patients with DPN and participants in the control group achieved statistical significance only during long walking distance trials. Shod and barefoot double support times were longer in the DPN group during long walking distances (>20%, P = .03). Gait unsteadiness, defined as coefficient of variation of gait velocity, was also significantly higher in the DPN group when barefoot walking over long distances (83%, P = .008). Furthermore, there was a high correlation between neuropathy severity and gait unsteadiness best demonstrated during the barefoot walking/long walking distance condition (r = 0.77, P < .001). The addition of footwear improved gait steadiness in the DPN group by 46% (P = .02). All differences were independent of age, sex, and body mass index (P > .05). This study suggests that gait alteration in patients with DPN is most pronounced while walking barefoot over longer distances and that footwear may improve gait steadiness in patients with DPN.

Rupture of the extensor hood of the fifth toe: a rare injury.

PubMed

Venturini, Sara; Gaba, Suchi; Mangwani, Jitendra

2017-02-27

Closed injuries of the extensor hood of the lesser toes are rare and seldom reported in the literature. We present the case of a woman aged 25 years who presented to the orthopaedic fracture clinic with a 2-week history of pain in the left fifth toe and inability to extend following a ballet dancing session. Investigations showed no fracture on plain radiographs, but an ultrasound scan demonstrated rupture to the extensor hood of the little toe. Successful surgical repair of the extensor hood was performed, and the patient made a good recovery with return to dancing activities. 2017 BMJ Publishing Group Ltd.

Repair of webbed fingers or toes

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Finger Injuries and Disorders Read more Toe Injuries ...

Flexor digitorum brevis transfer for floating toe prevention after Weil osteotomy: a cadaveric study.

PubMed

Lee, Lydia C; Charlton, Timothy P; Thordarson, David B

2013-12-01

A floating toe deformity occurs in many patients who undergo Weil osteotomies. It is likely caused by the failure of the windlass mechanism in shortening the metatarsal. For patients who require a proximal interphalangeal (PIP) joint arthroplasty or fusion in addition to a Weil osteotomy, the transfer of the flexor digitorum brevis (FDB) tendon to the PIP joint might restore the windlass mechanism and decrease the incidence of floating toes. Fourteen cadaveric foot specimens were examined to determine the effects of changing metatarsal length as well as tensioning the FDB tendon on the angle of the metatarsophalangeal (MTP) joint as a measure of a floating toe. Shortening and lengthening the second metatarsal resulted in a significant change in MTP angle (P = .03 and .02, respectively), though there was no clear relationship found between the amount of change in metatarsal length and the change in MTP angle. Transferring the FDB to a PIP arthroplasty site plantarflexed the MTP joint and corrected floating toes; the change in angle was significant compared with the control and shortening groups (P = .0001 and .002, respectively). This study supports the theory that change in length of the metatarsal, possibly via the windlass mechanism, plays a role in the pathophysiology of the floating toe deformity. Tensioning and transferring the FDB tendon into the PIP joint helped prevent the floating toe deformity in this cadaveric model. Continued research in this subject will help to refine methods of prevention and correction of the floating toe deformity.

Efficacy of N-Acetylcysteine in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis.

PubMed

Sun, Tong; Liu, Jing; Zhao, De Wei

2016-05-01

There are a number of conflicting reports describing the clinical outcomes of using N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis. We have, therefore, performed a meta-analysis to evaluate the efficacy of N-acetylcysteine, compared with control, for the treatment of idiopathic pulmonary fibrosis.Original controlled clinical trials evaluating the efficacy of N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis were included in the analysis. Searches for relevant articles were carried out in July 2014 by 2 independent researchers using PubMed, Embase, Cochrane Central, and Google Scholar. Change in forced vital capacity, change in percentage of predicted vital capacity, change in percentage of predicted carbon monoxide diffusing capacity, changes in 6 minutes walking test distance, rate of adverse events, and rate of death were expressed as outcomes using RevMan 5.0.1.Five trials, with a total of 564 patients, were included in this meta-analysis. The meta-analysis showed that the control group had significant decreases in percentage of predicted vital capacity (standardized mean difference [SMD] = 0.37; 95% confidence interval [CI]: 0.13 to -0.62; P = 0.003) and 6 minutes walking test distance (SMD = 0.25; 95% CI: 0.02-0.48; P = 0.04). There were no statistically significant differences in forced vital capacity (SMD = 0.07; 95% CI: -0.13-0.27; P = 0.52), percentage of predicted carbon monoxide diffusing capacity (SMD = 0.12; 95% CI: -0.06-0.30; P = 0.18), rates of adverse events (odd ratio = 4.50; 95% CI: 0.19-106.41; P = 0.35), or death rates (odd ratio = 1.79; 95% CI: 0.3-5.12; P = 0.28) between the N-acetylcysteine group and the control group.N-Acetylcysteine was found to have a significant effect only on decreases in percentage of predicted vital capacity and 6 minutes walking test distance. N-acetylcysteine showed no beneficial effect on changes in forced vital capacity

Stooped postures are modified by pretask walking in a simulated weed-pulling task.

PubMed

Hudson, D S; Copeland, J L; Hepburn, C G; Doan, J B

2014-01-01

Seasonal agricultural workers are hired in some sectors for intermittent manual weed removal, a stoop and grasp harvesting task likely similar to those associated with the high prevalence of musculoskeletal disorders in agriculture. Evaluation of this task in an experimental situation would be useful for identifying and controlling musculoskeletal injury risks, presuming a valid experimental model of the task can be created. The purpose of the present study was to examine how a relevant work-related task, namely prolonged walking, altered the biomechanics of manual weed removal in a laboratory setting. Preliminary field assessments informed the development and analysis of a simulated manual weed removal with two separate conditions: not primed, where 11 participants (4 female, mean age 21.6 years) manually removed a simulated weed six times, and primed, where 23 participants (13 female, mean age 22.1 years) walked 1600 m prior to manually removing the same simulated weed six successive times. Segment end point markers and experimental motion capture were used to determine hip, knee, and ankle angles, as well as toe-target proximity, during weed removal. Significant differences between primed and not primed participants were found for angular displacement at the ankle (t(32) = 5.08, P < .001) and toe-target proximity (t(32) = 2.78, P = .008), where primed participants had increased ankle flexion and a greater distance to the weed, leading to decreased trunk flexion during the harvesting task. These findings suggest that priming can positively influence whole-body postures for manual weed removal.

Idiopathic Ophthalmodynia and Idiopathic Rhinalgia: A Prospective Series of 16 New Cases.

PubMed

Pareja, Juan A; Montojo, Teresa; Guerrero, Ángel L; Álvarez, Mónica; Porta-Etessam, Jesús; Cuadrado, María L

2015-01-01

Idiopathic ophthalmodynia and idiopathic rhinalgia were described a few years ago. These conditions seem specific pain syndromes with a distinctive location in the eye or in the nose. We aimed to present a new prospective series in order to verify the consistency of these syndromes. We performed a descriptive study of all patients referred to our regional neurologic clinics from 2010 to 2014 because of facial pain exclusively felt in the eye or in the nose fulfilling the proposed diagnostic criteria for idiopathic ophthalmodynia and idiopathic rhinalgia. There were 9 patients with idiopathic ophthalmodynia and 7 patients with idiopathic rhinalgia, with a clear female preponderance, and a mean age at onset in the fifth decade. The pain was usually moderate and the temporal pattern was generally chronic. Only one patient reported accompaniments (hypersensitivity to the light and to the flow of air in the symptomatic eye). Preventive treatment with amitriptyline, pregabalin, or gabapentin was partially or totally effective. The clinical features of this new series parallels those of the original description, thus indicating that both idiopathic ophthalmodynia and idiopathic rhinalgia have clear-cut clinical pictures with excellent consistency both inter- and intra-individually. © 2015 American Headache Society.

Toe spatiotemporal differences between transition steps when ascending shorter flight stairways of different heights.

PubMed

Ajisafe, Toyin; Wu, Jianhua; Geil, Mark

2017-03-01

Studies have typically treated the first and second floor-to-stair transition steps (TS1 and TS2) as one stride. However, because the foot is devoid of plantar cutaneous input from the stair surface at TS1, these steps may have different toe spatiotemporal profiles, and resultantly, different susceptibilities to a trip and/or a fall. This study compared vertical toe clearance, forward velocity, and their respective variability magnitudes between TS1 and TS2 when ascending stairs of different heights. Twenty young adults (seven males and 13 females) (21.68 ± 2.49 years; 169.70 ± 9.56 cm; 63.91 ± 9.62 kg) negotiated an intervening three-step staircase placed midpoint on a 10 m walkway. There were three stair heights: low stairs (LS), medium stairs (MS), and high stairs (HS). Vertical toe clearance, forward velocity, and their variability magnitudes were calculated. Vertical toe clearance was only higher (P < 0.05) at TS1 than TS2 in the medium and high stairs. Vertical toe clearance was more variable (P < 0.05) in the low compared to medium stairs. Also, forward toe velocity was greater at TS1 than TS2, but was lower in the medium and high stairs. The locomotor system appeared cautious by exaggerating vertical toe clearance at both TS1 and TS2 only in low stairs, possibly due to higher forward toe velocity. If the exaggeration strategy consistently persists, this finding may suggest decreased trip or fall risk at both TS1 and TS2 only when transitioning onto low stairs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Impact of sildenafil on survival of patients with idiopathic pulmonary arterial hypertension.

PubMed

Zeng, Wei-Jie; Sun, Yun-Juan; Gu, Qing; Xiong, Chang-Ming; Li, Jian-Jun; He, Jian-Guo

2012-09-01

It has been reported that short-term sildenafil therapy is safe and effective for patients with pulmonary arterial hypertension. However, data regarding the impact of sildenafil on the survival of patients with idiopathic pulmonary arterial hypertension remain limited. The study was conducted on 77 patients with newly diagnosed idiopathic pulmonary arterial hypertension at Fu Wai Hospital between September 2005 and September 2009. Patients were divided into 2 groups: the sildenafil group and the conventional group. Nine patients treated with sildenafil were re-evaluated by right heart catheterization after 3 months. Our data demonstrated that the 6-minute walk distance, World Health Organization functional class, mixed venous oxygen saturation, and hemodynamics significantly improved after 3 months of sildenafil therapy (P < .05). The baseline characteristics of the sildenafil group were similar to those of the conventional group. The 1-, 2-, and 3-year survival rates in the sildenafil group were 88%, 72%, and 68% compared with 61%, 36%, and 27% in the conventional group (P < .001). The absence of sildenafil therapy, lower body mass index, and lower mixed venous oxygen saturation were found to be independent predictors of mortality. In conclusion, sildenafil therapy was found to be associated with improved survival in patients with idiopathic pulmonary arterial hypertension.

[Therapy of the peromelic form of symbrachydactyly by double second-toe transplantation].

PubMed

Hülsemann, W; Preisser, P; Habenicht, R; Partecke, B-D

2002-09-01

From 1989 to 2001 eleven children with the peromelic type of symbrachydactyly underwent a staged double second toes transplantation for restoration of two finger rays. The second toe of the feet were transplanted first to the small finger position and in the second step to the thumb position. One failure occurred in the first toe transplantation and another developed a venous thrombosis with partial necrosis and eventually a useless ray. Eight children were reviewed retrospectively in a mean follow-up of 5.3 years. The ability to pinch was restored in four children. In all patients without complications the function of the hand improved and the sensitivity was good.

Plantar-plate disruptions: "the severe turf-toe injury." three cases in contact athletes.

PubMed

Drakos, Mark C; Fiore, Russell; Murphy, Conor; DiGiovanni, Christopher W

2015-05-01

To present 3 cases of plantar-plate rupture and turf-toe injury in contact athletes at 1 university and to discuss appropriate diagnosis and treatment algorithms for each case. Turf toe is a common injury in athletes participating in outdoor cutting sports. However, it has been used as an umbrella term to describe many different injuries of the great toe. In some cases, the injury can be so severe that the plantar plate and sesamoid apparatus may be ruptured. These patients may be better managed with surgery than with traditional nonoperative interventions. Turf toe, plantar-plate disruption, sesamoid fracture. For stable injuries in which the plantar plate is not completely disrupted, nonoperative treatment with casting or a stiff-soled shoe, gradual weight bearing, and rehabilitation is the best practice. Unstable injuries require surgical intervention and plantar-plate repair. Turf toe and injury to the first metatarsophalangeal joint are relatively common injuries in athletes, but few researchers have detailed the operative and nonoperative treatments of plantar-plate disruption in these patients. We examine 3 cases that occurred over 4 seasons on a collegiate football team. Turf toe represents a wide array of pathologic conditions involving the first metatarsophalangeal joint. Stress and instability testing are key components to assess in determining whether surgical intervention is warranted to restore optimal function. Stiffer-soled shoes or shoes with steel-plate insertions may help to prevent these injuries and are useful tools for protection during the rehabilitation period.

Kinematic adaptations of the hindfoot, forefoot, and hallux during cross-slope walking.

PubMed

Damavandi, Mohsen; Dixon, Philippe C; Pearsall, David J

2010-07-01

Despite cross-slope surfaces being a regular feature of our environment, little is known about segmental adaptations required to maintain both balance and forward locomotion. The purpose of this study was to determine kinematic adaptations of the foot segments in relation to transverse (cross-sloped) walking surfaces. Ten young adult males walked barefoot along an inclinable walkway (level, 0° and cross-slope, 10°). Kinematic adaptations of hindfoot with respect to tibia (HF/TB), forefoot with respect to hindfoot (FF/HF), and hallux with respect to forefoot (HX/FF) in level walking (LW), inclined walking up-slope (IWU), i.e., the foot at the higher elevation, and inclined walking down-slope (IWD), i.e., the foot at the lower elevation, were measured. Multivariate analysis of variance (MANOVA) for repeated measures was used to analyze the data. In the sagittal plane, the relative FF/HF and HX/FF plantar/dorsiflexion angles differed across conditions (p=0.024 and p=0.026, respectively). More importantly, numerous frontal plane alterations occurred. For the HF/TB angle, inversion of IWU and eversion of IWD was seen at heel-strike (p<0.001). This pattern reversed with IWU showing eversion and IWD inversion in early stance (p=0.024). For the FF/HF angle, significant differences were observed in mid-stance with IWD revealing inversion while IWU was everted (p<0.004). At toe-off, the pattern switched to eversion of IWD and inversion of IWU (p=0.032). The information obtained from this study enhances our understanding of the kinematics of the human foot in stance during level and cross-slope walking. Copyright © 2010 Elsevier B.V. All rights reserved.

The use of antigravity suits in the treatment of idiopathic orthostatic hypotension

NASA Technical Reports Server (NTRS)

Landmark, K.; Kravik, S.

1980-01-01

Idiopathic orthostatic hypotension is an uncommon disease characterized by a drop in blood pressure when going from a recumbent to a standing position. Treatment by medication generally produces poor results. Three patients at the Royal Hospital in Oslo were treated with antigravity suits and all were able to maintain adequate blood pressures in the standing position. One patient improved dramatically and was able to take short walks while wearing the suit. The two other patients, however, felt that wearing the suits eventually became uncomfortable. This treatment represents a useful treatment alternative for intractable cases.

Molded foot orthosis after great toe or medial ray amputations in diabetic feet.

PubMed

Due, T M; Jacobs, R L

1985-12-01

Necrosis of the tip of the next lateral remaining toe has been found to be a late complication of great toe and medial ray amputations in diabetic feet. The use of custom-molded insert foot orthoses helps avoid this complication.

[Normal lung volumes in patients with idiopathic pulmonary fibrosis and emphysema].

PubMed

Casas, Juan Pablo; Abbona, Horacio; Robles, Adriana; López, Ana María

2008-01-01

Pulmonary function tests in idiopathic pulmonary fibrosis characteristically show a restrictive pattern, resulting from reduction of pulmonary compliance due to diffuse fibrosis. Conversely, an obstructive pattern with hyperinflation results in emphysema by loss of elastic recoil, expiratory collapse of the peripheral airways and air trapping. Previous reports suggest that when both diseases coexist, pulmonary volumes are compensated and a smaller than expected reduction or even normal lung volumes can be found. We report 4 male patients of 64, 60, 73 and 70 years, all with heavy cigarette smoking history and progressive breathlessness. Three of them had severe limitation in their quality of life. All four showed advanced lung interstitial involvement, at high resolution CT scan, fibrotic changes predominantly in the subpleural areas of lower lung fields and concomitant emphysema in the upper lobes. Emphysema and pulmonary fibrosis was confirmed by open lung biopsy in one patient. The four patients showed normal spirometry and lung volumes with severe compromise of gas exchange and poor exercise tolerance evaluated by 6 minute walk test. Severe pulmonary arterial hypertension was also confirmed in three patients. Normal lung volumes does not exclude diagnosis of idiopathic pulmonary fibrosis in patients with concomitant emphysema. The relatively preserved lung volumes may underestimate the severity of idiopathic pulmonary fibrosis and attenuate its effects on lung function parameters.

Tic Tac Toe Math. Instructional Guide.

ERIC Educational Resources Information Center

Cooper, Richard

This instructional guide and set of three companion workbooks are intended for use in an arithmetic course based on the Tic Tac Toe method of addition and multiplication, which is an alternative means of learning to add and multiply that was developed for students whose learning disabilities (including difficulty in distinguishing left from right…

Heel and toe driving on fuel cell vehicle

DOEpatents

Choi, Tayoung; Chen, Dongmei

2012-12-11

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

In vivo fascicle behavior of the flexor hallucis longus muscle at different walking speeds.

PubMed

Péter, A; Hegyi, A; Finni, T; Cronin, N J

2017-12-01

Ankle plantar flexor muscles support and propel the body in the stance phase of locomotion. Besides the triceps surae, flexor hallucis longus muscle (FHL) may also contribute to this role, but very few in vivo studies have examined FHL function during walking. Here, we investigated FHL fascicle behavior at different walking speeds. Ten healthy males walked overground at three different speeds while FHL fascicle length changes were recorded with ultrasound and muscle activity was recorded with surface electromyography (EMG). Fascicle length at heel strike at toe off and at peak EMG activity did not change with speed. Range of FHL fascicle length change (3.5-4.5 and 1.9-2.9 mm on average in stance and push-off phase, respectively), as well as minimum (53.5-54.9 and 53.8-55.7 mm) and maximum (58-58.4 and 56.8-57.7 mm) fascicle length did not change with speed in the stance or push-off phase. Mean fascicle velocity did not change in the stance phase, but increased significantly in the push-off phase between slow and fast walking speeds (P=.021). EMG activity increased significantly in both phases from slow to preferred and preferred to fast speed (P<.02 in all cases). FHL muscle fascicles worked near-isometrically during the whole stance phase (at least during slow walking) and operated at approximately the same length at different walking speeds. FHL and medial gastrocnemius (MG) have similar fiber length to muscle belly length ratios and, according to our results, also exhibit similar fascicle behavior at different walking speeds. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Material and biofilm load of K wires in toe surgery: titanium versus stainless steel.

PubMed

Clauss, Martin; Graf, Susanne; Gersbach, Silke; Hintermann, Beat; Ilchmann, Thomas; Knupp, Markus

2013-07-01

Recurrence rates for toe deformity correction are high and primarily are attributable to scar contractures. These contractures may result from subclinical infection. We hypothesized that (1) recurrence of toe deformities and residual pain are related to low-grade infections from biofilm formation on percutaneous K wires, (2) biofilm formation is lower on titanium (Ti) K wires compared with stainless steel (SS) K wires, and (3) clinical outcome is superior with the use of Ti K wires compared with SS K wires. In this prospective nonrandomized, comparative study, we investigated 135 lesser toe deformities (61 patients; 49 women; mean ± SD age, 60 ± 15 years) temporarily fixed with K wires between August 2010 and March 2011 (81 SS, 54 Ti). K wires were removed after 6 weeks. The presence of biofilm-related infections was analyzed by sonication. High bacterial loads (> 500 colony-forming units [CFU]/mL) were detected on all six toes requiring revision before 6 months. Increased bacterial load was associated with pain and swelling but not recurrence of the deformity. More SS K wires had greater than 100 CFU/mL bacteria than Ti K wires. For K wires with a bacterial count greater than 100 CFU/mL, toes with Ti K wires had a lower recurrence rate, less pain, and less swelling than toes with SS K wires. Ti K wires showed superior clinical outcomes to SS K wires. This appears to be attributable to reduced infection rates. Although additional study is needed, we currently recommend the use of Ti K wires for the transfixation of toe deformities. Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Repair, Evaluation, Maintenance, and Rehabilitation Research Program. Stability of Toe Berm Armor Stone and Toe Buttressing Stone on Rubble-Mound Breakwaters and Jetties. Physical Model Investigation

DTIC Science & Technology

1989-09-01

Rehabilitation of Rubble-Mound Structure Toes. The first objective of this work unit was to gain an iinderstanding of the toe stability problems experi- enced ...6.75-FT WAVE FLUMES 12.0- 11.0 - Be10.0- z 0 8.0 0 n- 7.0- _U Z 0 0 6.0 --- (0cc 5.0- h 0 0 LADo cc 4.0 0 . 0 -3 -P - -2 - - 01.0-0.0- - 0_0 co 2.0

3D Printing Technology in Planning Thumb Reconstructions with Second Toe Transplant.

PubMed

Zang, Cheng-Wu; Zhang, Jian-Lei; Meng, Ze-Zu; Liu, Lin-Feng; Zhang, Wen-Zhi; Chen, Yong-Xiang; Cong, Rui

2017-05-01

To report preoperative planning using 3D printing to plan thumb reconstructions with second toe transplant. Between December 2013 and October 2015, the thumbs of five patients with grade 3 thumb defects were reconstructed using a wrap-around flap and second toe transplant aided by 3D printing technology. CT scans of hands and feet were analyzed using Boholo surgical simulator software (www.boholo.com). This allowed for the creation of a mirror image of the healthy thumb using the uninjured thumb. Using 3D images of the reconstructed thumb, a model of the big toe and the second toe was created to understand the dimensions of the donor site. This model was also used to repair the donor site defect by designing appropriate iliac bone and superficial circumflex iliac artery flaps. The polylactic acid model of the donor toes and reconstructed thumb was produced using 3D printing. Surgically, the wrap-around flap of the first dorsal metatarsal artery and vein combined with the joint and bone of the second toe was based upon the model donor site. Sensation was reconstructed by anastomosing the dorsal nerve of the foot and the plantar digital nerve of the great toe. Patients commenced exercises 2 weeks after surgery. All reconstructed thumbs survived, although partial flap necrosis occurred in one case. This was managed with regular dressing changes. Patients were followed up for 3-15 months. The lengths of the reconstructed thumbs are 34-49 mm. The widths of the thumb nail beds are 16-19 mm, and the thickness of the digital pulp is 16-20 mm. The thumb opposition function was 0-1.5 cm; the extension angle was 5°-20° (mean, 16°), and the angle of flexion was 38°-55° (mean, 47°). Two-point discrimination was 9-11 mm (mean, 9.6 mm). The reconstructed thumbs had good appearance, function and sensation. Based on the criteria set forth by the Standard on Approval of Reconstructed Thumb and Finger Functional Assessment of the Chinese Medical Association, the results were

Benefits of pulmonary rehabilitation in idiopathic pulmonary fibrosis.

PubMed

Swigris, Jeffrey J; Fairclough, Diane L; Morrison, Marianne; Make, Barry; Kozora, Elizabeth; Brown, Kevin K; Wamboldt, Frederick S

2011-06-01

Information on the benefits of pulmonary rehabilitation (PR) in patients with idiopathic pulmonary fibrosis (IPF) is growing, but PR's effects on certain important outcomes is lacking. We conducted a pilot study of PR in IPF and analyzed changes in functional capacity, fatigue, anxiety, depression, sleep, and health status from baseline to after completion of a standard, 6-week PR program. Six-min walk distance improved a mean ± standard error 202 ± 135 feet (P = .01) from baseline. Fatigue Severity Scale score also improved significantly, declining an average 1.5 ± 0.5 points from baseline. There were trends toward improvement in anxiety, depression, and health status. PR improves functional capacity and fatigue in patients with IPF. (Clinical Trials.gov registration NCT00692796.)

SPECT (HMPAO) support for activation of the medial prefrontal cortices during toe graphaesthesia.

PubMed

Persinger, M A; Webster, D; Tiller, S G

1998-08-01

This experiment was designed to test the construct validity of psychometric analyses that suggested a strong functional association between the accuracy for toe graphaesthesia and selective activation of neurons within the medial prefrontal regions. Single Photon Emission Computerized Tomography (SPECT) profiles were obtained for three volunteers (2 men, 1 woman) after they had been exposed to a toe graphaesthesia task or had been exposed to the control setting. The two measurements for each participant were separated by at least one week. Qualitative evaluation, using criteria employed for clinical diagnoses, of serial coronal, sagittal, and horizontal sections clearly indicated a specific increase in uptake of tracer within the rostral one-third to one-half of the medial prefrontal cortices of all three subjects during the toe graphaesthesia task compared to that during baseline conditions. The results are consistent with our neuropsychological research which indicates that toe graphaesthesia may be an accurate and useful indicator of the functional integrity of the medial surfaces of the anterior cerebral hemispheres.

[Lesser toe deformities. Definition, pathogenesis, and options for surgical correction].

PubMed

Arnold, H

2005-08-01

Whereas in the past resection arthroplasty was - in analogy to hallux valgus surgery - the preferred therapy to correct lesser toe deformities, the point of view has undergone a change. Much interest is directed toward functional aspects that require reconstructive management. Whenever possible the integrity of joint play should be saved. Above all the metatarsophalangeal joint of the lesser toes is worth being preserved to prevent a severe disturbance of the biomechanics of the foot. Tendon transfers and subtle corrective osteotomies such as the Weil procedure allow restricting resection procedures to contraction deformities.

A new treatment for parrot beak deformity of the toe.

PubMed

Kurokawa, M; Isshiki, N; Inoue, K

1994-03-01

Two cases of congenital parrot beak deformity of the toe were treated by pushing back the nail plate, nailbed, matrix, and proximal skin fold in one piece as a flap. The proximal skin portion of this flap was deepithelialized to facilitate this shift, and thus no dog-ear deformity was produced. The distal skin defect of the pulp was covered by a palmar advancement flap. This method does not require augmentation of the fingertip or toetip and is very useful for correcting parrot beak deformities of the toes.

Heart Rate Recovery After 6-Min Walk Test Predicts Survival in Patients With Idiopathic Pulmonary Fibrosis

PubMed Central

Swigris, Jeffrey J.; Swick, Jeff; Wamboldt, Frederick S.; Sprunger, David; du Bois, Roland; Fischer, Aryeh; Cosgrove, Gregory P.; Frankel, Stephen K.; Fernandez-Perez, Evans R.; Kervitsky, Dolly; Brown, Kevin K.

2009-01-01

Background: In patients with idiopathic pulmonary fibrosis (IPF), our objectives were to identify predictors of abnormal heart rate recovery (HRR) at 1 min after completion of a 6-min walk test (6MWT) [HRR1] and 2 min after completion of a 6MWT (HRR2), and to determine whether abnormal HRR predicts mortality. Methods: From 2003 to 2008, we identified IPF patients who had been evaluated at our center (n = 76) with a pulmonary physiologic examination and the 6MWT. We used logistic regression to identify predictors of abnormal HRR, the product-limit method to compare survival in the sample stratified on HRR, and Cox proportional hazards analysis to estimate the prognostic capability of abnormal HRR. Results: Cutoff values were 13 beats for abnormal HRR1 and 22 beats for HRR2. In a multivariable model, predictors of abnormal HRR1 were diffusing capacity of the lung for carbon monoxide (odds ratio [OR], 0.4 per 10% predicted; 95% confidence interval [CI], 0.2 to 0.7; p = 0.003), change in heart rate from baseline to maximum (OR, 0.9; 95% CI, 0.8 to 0.97; p = 0.01), and having a right ventricular systolic pressure > 35 mm Hg as determined by transthoracic echocardiogram (OR, 12.7; 95% CI, 2.0 to 79.7; p = 0.01). Subjects with an abnormal HRR had significantly worse survival than subjects with a normal HRR (for HRR1, p = 0.0007 [log-rank test]; for HRR2, p = 0.03 [log-rank test]); these results held for the subgroup of 30 subjects without resting pulmonary hypertension (HRR1, p = 0.04 [log-rank test]). Among several candidate variables, abnormal HRR1 appeared to be the most potent predictor of mortality (hazard ratio, 5.2; 95% CI, 1.8 to 15.2; p = 0.004). Conclusion: Abnormal HRR after 6MWT predicts mortality in IPF patients. Research is needed to confirm these findings prospectively and to examine the mechanisms of HRR in IPF patients. PMID:19395579

The effect of pretest rest time on automated measures of toe systolic blood pressure and the toe brachial index.

PubMed

Sadler, Sean G; Hawke, Fiona E; Chuter, Vivienne H

2015-10-01

Evaluation of peripheral blood supply is fundamental to risk categorization and subsequent ongoing monitoring of patients with lower extremity peripheral arterial disease. Toe systolic blood pressure (TSBP) and the toe brachial index (TBI) are both valid and reliable vascular screening techniques that are commonly used in clinical practice. However, the effect of pretest rest duration on the magnitude of these measurements is unclear. Eighty individuals meeting current guidelines for lower extremity peripheral arterial disease screening volunteered to participate. The Systoe and MicroLife automated devices were used to measure toe and brachial systolic blood pressures, respectively, following 5, 10 and 15 min of rest in a horizontal supine position. A ratio of TSBP to brachial pressure was used to calculate the TBI and change in TBI at each time interval was investigated. A significant increase in TSBP [3.66 mmHg; 95% confidence interval (CI): 1.44-5.89; P≤0.001] and the TBI (0.03; 95% CI: 0.01-0.05; P≤0.001) occurred between 5 and 10 min. Between 10 and 15 min, there was a nonsignificant decrease in TSBP (-0.73 mmHg; 95% CI: -1.48 to 2.93; P=1.000) and the TBI (0.00; 95% CI: -0.02 to 0.02; P=1.000). Ten minutes of pretest rest is recommended for measurement of TSBP and for both pressure measurements used in the calculation of a TBI to ensure that stable pressures are measured.

Immediate toe-to-hand transfer in acute hand injuries: overall results, compared with results for elective cases.

PubMed

Woo, Sang-Hyun; Kim, Joo-Sung; Seul, Jung-Hyun

2004-03-01

In the past 5 years, 25 mutilated digits were reconstructed with immediate toe-to-hand transfers after acute hand injuries, for 21 patients. The overall results of the immediate toe-to-hand transfers were evaluated and compared with the results of 65 elective procedures performed during the same period by the same surgeon. There were 15 cases of great toe-to-hand transfer for thumb reconstruction, two cases of second toe transfer for index finger reconstruction, and four cases of simultaneous two-toe transfer for reconstruction of multiple-digit amputations. Two cases (two of 25 cases, 8 percent) were successfully salvaged with emergency reexploration. The incidences of emergency reexploration and postoperative infection were not significantly different from those for elective toe-to-hand transfer cases. The duration of industrial insurance coverage was much shorter than for elective cases, averaging 225 days (p < 0.001). Approximately 44 percent of the patients maintained their original jobs after immediate toe-to-hand transfer. The subjective satisfaction self-assessment scores of aesthetic appearance and function for the newly reconstructed thumb averaged 80 and 88 (of a total score of 100), respectively. Although satisfaction was lower than for elective reconstruction (p < 0.001), it was higher than for reconstruction of other digits. The donor-site appearance after great toe harvesting was mostly unsatisfactory. Immediate toe-to-hand transfer provides many advantages over the elective procedure in acute hand injuries, including single-stage reconstruction, shortened convalescence, early return to work, and socioeconomic efficiency. Because there were no significant differences in the success rates, frequencies of complications, or ultimate functional results, immediate toe-to-hand transfer is a safe and reliable procedure that is indicated for specific cases of acute digital amputation.

The effects of military body armour on the lower back and knee mechanics during toe-touch and two-legged squat tasks.

PubMed

Phillips, Megan; Bazrgari, Babak; Shapiro, Robert

2015-01-01

While effective in the prevention of otherwise lethal injuries, military body armour (BA) has been suggested to reduce warfighter's performance and increase injury-related musculoskeletal conditions. Providing the significant role of joint biomechanics in both performance and risk of injury, the immediate and prolonged effects of wearing BA on biomechanics of the lower back and knee during toe-touch (TT) and two-legged squat (TLS) tasks were investigated. The immediate effects of BA were an increase of >40 ms (p ≤ 0.02) in flexion duration of the dominant joint and an ∼1 s (p ≤ 0.02) increase in overall task duration as well as an ∼18% (p = 0.03) decrease in the lumbopelvic rhythm ratio near the mid-range of trunk flexion. In general the prolonged duration of wearing BA (i.e. 45 min of walking) was not found to cause more changes in our measures than walking without BA. The effects of wearing military BA on biomechanics of the lower back and knee during TT and TLS tasks were investigated. The immediate effects of BA were increased flexion duration, increased overall trial duration and decreased lumbopelvic rhythm near the mid-range of trunk flexion.

From tails to toes: developing nonlethal tissue indicators of mercury exposure in five amphibian species.

PubMed

Pfleeger, Adam Z; Eagles-Smith, Collin A; Kowalski, Brandon M; Herring, Garth; Willacker, James J; Jackson, Allyson K; Pierce, John R

2016-04-01

Exposure to environmental contaminants has been implicated as a factor in global amphibian decline. Mercury (Hg) is a particularly widespread contaminant that biomagnifies in amphibians and can cause a suite of deleterious effects. However, monitoring contaminant exposure in amphibian tissues may conflict with conservation goals if lethal take is required. Thus, there is a need to develop non-lethal tissue sampling techniques to quantify contaminant exposure in amphibians. Some minimally invasive sampling techniques, such as toe-clipping, are common in population-genetic research, but it is unclear if these methods can adequately characterize contaminant exposure. We examined the relationships between mercury (Hg) concentrations in non-lethally sampled tissues and paired whole-bodies in five amphibian species. Specifically, we examined the utility of three different tail-clip sections from four salamander species and toe-clips from one anuran species. Both tail and toe-clips accurately predicted whole-body THg concentrations, but the relationships differed among species and the specific tail-clip section or toe that was used. Tail-clips comprised of the distal 0-2 cm segment performed the best across all salamander species, explaining between 82 and 92% of the variation in paired whole-body THg concentrations. Toe-clips were less effective predictors of frog THg concentrations, but THg concentrations in outer rear toes accounted for up to 79% of the variability in frog whole-body THg concentrations. These findings suggest non-lethal sampling of tails and toes has potential applications for monitoring contaminant exposure and risk in amphibians, but care must be taken to ensure consistent collection and interpretation of samples.

In-toeing in children with type I osteogenesis imperfecta: an observational descriptive study.

PubMed

Losa Iglesias, Marta Elena; Becerro de Bengoa Vallejo, Ricardo; Salvadores Fuentes, Paloma

2009-01-01

Osteogenesis imperfecta is an autosomal-dominant disorder of the connective tissue. Also known as brittle bone disease, it renders those affected susceptible to fractures after minimal trauma. Therefore, it is important to minimize the risk of falls and subsequent fractures in patients with this disease. In-toeing is a common condition in children that can result from various pathologic entities, including anteversion, internal tibial torsion, and metatarsus adductus. These conditions can result in frequent tripping and other functional problems. A descriptive study was undertaken to determine the prevalence of in-toeing gait attributable to tibial or femoral torsion or metatarsus adductus in children with type I osteogenesis imperfecta. The study involved orthopedic and biomechanical examination of 15 children (9 girls and 6 boys) aged 4 to 9 years with confirmed type I osteogenesis imperfecta. Patients who used assistive ambulatory devices, such as canes, crutches, and wheelchairs, were excluded from the study. Of the 15 children studied, 12 (80%) demonstrated previously undiagnosed in-toeing gait attributable to torsional deformity or metatarsus adductus in all but one child. Many children with confirmed type I osteogenesis imperfecta have in-toeing gait caused by torsional deformity or metatarsus adductus. Detection and control of in-toeing gait in children with osteogenesis imperfecta is important to prevent fractures resulting from trauma directly related to these conditions.

Science 101: Why Are Hippos Unguligrades?

ERIC Educational Resources Information Center

Robertson, Bill

2014-01-01

In this article, Bill Robinson describes the three main classifications of gait for animals: (1) Plantigrade--animals that walk on their entire foot; (2) Digitigrade--animals that walk on their "toes"; and (3) Unguligrade--animals that walk on the tips of their toes or hooves. Robinson explains each gait in great detail, but leaves his…

Musical motor feedback (MMF) in walking hemiparetic stroke patients: randomized trials of gait improvement.

PubMed

Schauer, Michael; Mauritz, Karl-Heinz

2003-11-01

To demonstrate the effect of rhythmical auditory stimulation in a musical context for gait therapy in hemiparetic stroke patients, when the stimulation is played back measure by measure initiated by the patient's heel-strikes (musical motor feedback). Does this type of musical feedback improve walking more than a less specific gait therapy? The randomized controlled trial considered 23 registered stroke patients. Two groups were created by randomization: the control group received 15 sessions of conventional gait therapy and the test group received 15 therapy sessions with musical motor feedback. Inpatient rehabilitation hospital. Median post-stroke interval was 44 days and the patients were able to walk without technical aids with a speed of approximately 0.71 m/s. Gait velocity, step duration, gait symmetry, stride length and foot rollover path length (heel-on-toe-off distance). The test group showed more mean improvement than the control group: stride length increased by 18% versus 0%, symmetry deviation decreased by 58% versus 20%, walking speed increased by 27% versus 4% and rollover path length increased by 28% versus 11%. Musical motor feedback improves the stroke patient's walk in selected parameters more than conventional gait therapy. A fixed memory in the patient's mind about the song and its timing may stimulate the improvement of gait even without the presence of an external pacemaker.

Lower limb muscle co-contraction and joint loading of flip-flops walking in male wearers

PubMed Central

Chen, Tony Lin-Wei; Wong, Duo Wai-Chi; Xu, Zhi; Tan, Qitao; Wang, Yan; Luximon, Ameersing

2018-01-01

Flip-flops may change walking gait pattern, increase muscle activity and joint loading, and predispose wearers to foot problems, despite that quantitative evidence is scarce. The purpose of this study was to examine the lower limb muscle co-contraction and joint contact force in flip-flops gait, and compare with those of barefoot and sports shoes walking. Ten healthy males were instructed to perform over-ground walking at self-selected speed under three footwear conditions: 1) barefoot, 2) sports shoes, and 3) thong-type flip-flops. Kinematic, kinetic and EMG data were collected and input to a musculoskeletal model to estimate muscle force and joint force. One-way repeated measures ANOVA was conducted to compare footwear conditions. It was hypothesized that flip-flops would induce muscle co-contraction and produce different gait kinematics and kinetics. Our results demonstrated that the musculoskeletal model estimation had a good temporal consistency with the measured EMG. Flip-flops produced significantly lower walking speed, higher ankle and subtalar joint range of motion, and higher shear ankle joint contact force than sports shoes (p < 0.05). There were no significant differences between flip-flops and barefoot conditions in terms of muscle co-contraction index, joint kinematics, and joint loading of the knee and ankle complex (p > 0.05). The variance in walking speed and footwear design may be the two major factors that resulted in the comparable joint biomechanics in flip-flops and barefoot walking. From this point of view, whether flip-flops gait is potentially harmful to foot health remains unclear. Given that shod walking is more common than barefoot walking on a daily basis, sports shoes with close-toe design may be a better footwear option than flip-flops for injury prevention due to its constraint on joint motion and loading. PMID:29561862

Lower limb muscle co-contraction and joint loading of flip-flops walking in male wearers.

PubMed

Chen, Tony Lin-Wei; Wong, Duo Wai-Chi; Xu, Zhi; Tan, Qitao; Wang, Yan; Luximon, Ameersing; Zhang, Ming

2018-01-01

Flip-flops may change walking gait pattern, increase muscle activity and joint loading, and predispose wearers to foot problems, despite that quantitative evidence is scarce. The purpose of this study was to examine the lower limb muscle co-contraction and joint contact force in flip-flops gait, and compare with those of barefoot and sports shoes walking. Ten healthy males were instructed to perform over-ground walking at self-selected speed under three footwear conditions: 1) barefoot, 2) sports shoes, and 3) thong-type flip-flops. Kinematic, kinetic and EMG data were collected and input to a musculoskeletal model to estimate muscle force and joint force. One-way repeated measures ANOVA was conducted to compare footwear conditions. It was hypothesized that flip-flops would induce muscle co-contraction and produce different gait kinematics and kinetics. Our results demonstrated that the musculoskeletal model estimation had a good temporal consistency with the measured EMG. Flip-flops produced significantly lower walking speed, higher ankle and subtalar joint range of motion, and higher shear ankle joint contact force than sports shoes (p < 0.05). There were no significant differences between flip-flops and barefoot conditions in terms of muscle co-contraction index, joint kinematics, and joint loading of the knee and ankle complex (p > 0.05). The variance in walking speed and footwear design may be the two major factors that resulted in the comparable joint biomechanics in flip-flops and barefoot walking. From this point of view, whether flip-flops gait is potentially harmful to foot health remains unclear. Given that shod walking is more common than barefoot walking on a daily basis, sports shoes with close-toe design may be a better footwear option than flip-flops for injury prevention due to its constraint on joint motion and loading.

Design and analysis of an original powered foot clearance creator mechanism for walking in patients with spinal cord injury.

PubMed

Maleki, Maryam; Badri, Samaneh; Shayestehepour, Hamed; Arazpour, Mokhtar; Farahmand, Farzam; Mousavi, Mohamad Ebrahim; Abdolahi, Ehsan; Farkhondeh, Hasan; Head, John S; Golchin, Navid; Mardani, Mohammad Ali

2018-03-12

The aim of this study was to assess the performance of an original powered foot clearance creator (PFCC) mechanism worn in conjunction with an isocentric reciprocal gait orthosis (IRGO) and evaluate its effect on trunk compensatory movements and spatiotemporal parameters in nine healthy subjects. A PFCC motorized mechanism was designed that incorporated twin sole plates, the movements of which enabled increased toe to floor clearance during swing phase. A prototype was constructed in combination with an IRGO, and hence was re-named as an IRGO-PFCC orthosis. The effects of IRGO-PFCC usage on the spatiotemporal parameters and trunk compensatory movements during walking were then analyzed under two conditions, firstly with the PFCC 'active' i.e., with the motorized device functioning, and secondly inactive, where floor clearance was standard. Ambulating with IRGO-PFCC orthosis resulted in reduction in the spatiotemporal parameters of gait (speed of walking, cadence and stride length) in nine healthy subjects. Walking with IRGO-PFCC orthosis led to significant differences in lateral (p = .007) and vertical (p = .008) trunk compensatory movements. In other words, through using IRGO-PFCC orthosis, the lateral and vertical trunk compensatory movements decreased by 51.32% and 42.7%, respectively. An adapted PFCC mechanism, with a relatively small motor and power supply could effectively increase toe to floor clearance during swing phase and thereby decrease trunk compensatory motions and potentially improve energy consumption. Implications for rehabilitations •The High rejection rates of reciprocal gait orthoses are related to the increasing in energy expenditure and burden loads on the upper limb joints during walking following trunk compensatory movements.•An original powered foot clearance creator mechanism was designed and constructed to assisting floor clearance capability and reduce trunk compensatory movements in subjects with spinal cord injury during

[Microsurgical 2nd toe transfer for catastrophic hand reconstruction].

PubMed

Placer, A; Lozano, Ja

2007-01-01

The correct reconstruction of the catastrophic hand requires complex surgical techniques. The microsurgical transference of a toe is indicated when all other reconstructive options are shown to be useless for the reconstruction of the required clamp function. In this clinical note we set out the case of a 32 year old man, who came to our accident and emergency department after suffering a traffic accident. After exploration the diagnosis was that of catastrophic left hand, among other policontusions. Urgent surgery was carried out, saving the maximum possible viable structures. The immediate result of this surgery was a hand with 1st, 4th and 5th functional fingers. As the essential clamp function between the 1st and 4th or 5th fingers was not totally satisfactory, we decided to reconstruct the 3rd finger of his hand with his ipsilateral 2nd toe. All pertinent studies to determine vascularisation of the flap were carried out in planning the surgery, and the microsurgical transfer was then realized, which was successful. Today, after a suitable rehabilitation, the patient has recovered a satisfactory function of heavy and fine clamp in the operated hand. Toe to hand transfer is a good option for finger reconstruction and its function. Rehabilitation is the key to functional recovery.

Tic Tac Toe Math. Train the Trainer.

ERIC Educational Resources Information Center

Center for Alternative Learning, Bryn Mawr, PA.

This report describes a project that developed a "Train the Trainer" program that would enable individuals to learn and teach the alternative instructional technique, Tic Tac Toe Math, developed by Richard Cooper for adult basic education students. The pilot workshop conducted as part of the project identified problems that traditional…

From tails to toes: developing nonlethal tissue indicators of mercury exposure in five amphibian species

USGS Publications Warehouse

Pfleeger, Adam Z.; Eagles-Smith, Collin A.; Kowalski, Brandon M.; Herring, Garth; Willacker, James J.; Jackson, Allyson K.; Pierce, John

2016-01-01

Exposure to environmental contaminants has been implicated as a factor in global amphibian decline. Mercury (Hg) is a particularly widespread contaminant that biomagnifies in amphibians and can cause a suite of deleterious effects. However, monitoring contaminant exposure in amphibian tissues may conflict with conservation goals if lethal take is required. Thus, there is a need to develop non-lethal tissue sampling techniques to quantify contaminant exposure in amphibians. Some minimally invasive sampling techniques, such as toe-clipping, are common in population-genetic research, but it is unclear if these methods can adequately characterize contaminant exposure. We examined the relationships between mercury (Hg) concentrations in non-lethally sampled tissues and paired whole-bodies in five amphibian species. Specifically, we examined the utility of three different tail-clip sections from four salamander species and toe-clips from one anuran species. Both tail and toe-clips accurately predicted whole-body THg concentrations, but the relationships differed among species and the specific tail-clip section or toe that was used. Tail-clips comprised of the distal 0–2 cm segment performed the best across all salamander species, explaining between 82 and 92 % of the variation in paired whole-body THg concentrations. Toe-clips were less effective predictors of frog THg concentrations, but THg concentrations in outer rear toes accounted for up to 79 % of the variability in frog whole-body THg concentrations. These findings suggest non-lethal sampling of tails and toes has potential applications for monitoring contaminant exposure and risk in amphibians, but care must be taken to ensure consistent collection and interpretation of samples.

Benefits of Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis

PubMed Central

Swigris, Jeffrey J.; Fairclough, Diane L.; Morrison, Marianne; Make, Barry; Kozora, Elizabeth; Brown, Kevin K.; Wamboldt, Frederick S.

2013-01-01

BACKGROUND Information on the benefits of pulmonary rehabilitation (PR) in patients with idiopathic pulmonary fibrosis (IPF) is growing, but PR’s effects on certain important outcomes is lacking. METHODS We conducted a pilot study of PR in IPF and analyzed changes in functional capacity, fatigue, anxiety, depression, sleep, and health status from baseline to after completion of a standard, 6-week PR program. RESULTS Six-min walk distance improved a mean ± standard error 202 ± 135 feet (P = .01) from baseline. Fatigue Severity Scale score also improved significantly, declining an average 1.5 ± 0.5 points from baseline. There were trends toward improvement in anxiety, depression, and health status. CONCLUSIONS PR improves functional capacity and fatigue in patients with IPF. (ClinicalTrials.gov registration NCT00692796.) PMID:21333082

Juvenile Idiopathic Arthritis

MedlinePlus

... Is Juvenile Idiopathic Arthritis the same as Juvenile Rheumatoid Arthritis? Yes, Juvenile Idiopathic Arthritis (JIA) is a new ... of chronic inflammatory diseases that affect children. Juvenile Rheumatoid Arthritis (JRA) is the older term that was used ...

Idiopathic Intracranial Hypertension (Pseudotumor Cerebri)

MedlinePlus

... Asked Questions Español Condiciones Chinese Conditions Idiopathic Intracranial Hypertension (Pseudotumor Cerebri) En Español Read in Chinese What is idiopathic intracranial hypertension? Idiopathic intracranial hypertension (IIH) is a disorder that ...

Effect of flip-flops on lower limb kinematics during walking: a cross-sectional study using three-dimensional gait analysis.

PubMed

Sharpe, T; Malone, A; French, H; Kiernan, D; O'Brien, T

2016-05-01

Flip-flops are a popular footwear choice in warm weather however their minimalist design offers little support to the foot. To investigate the effect of flip-flops on lower limb gait kinematics in healthy adults, to measure adherence between the flip-flop and foot, and to assess the effect on toe clearance in swing. Fifteen healthy adults (8 male, mean age 27 years) completed a three-dimensional gait analysis assessment using Codamotion. Kinematic and lower limb temporal-spatial data were captured using the Modified Helen Hayes marker set with additional markers on the hallux and flip-flop sole. Compared to barefoot walking, there were no differences in temporal-spatial parameters walking with flip-flops. There was an increase in peak knee flexion in swing (mean difference 4.6°, 95 % confidence interval (CI) [-5.8°, -3.4°], p < 0.001) and peak ankle dorsiflexion at terminal swing (mean difference 2°, 95 % CI [-3°, -1°], p = 0.001). Other kinematic parameters were unchanged. Peak separation between foot and flip-flop was 8.8 cm (SD 1.48), occurring at pre-swing. Minimum toe clearance of the hallux in barefoot walking measured 4.2 cm (SD 0.8). Minimum clearance of the flip-flop was 1.6 cm (SD 0.56). Healthy adults adapted well to flip-flops. However, separation of the flip-flop from the foot led to increased knee flexion and ankle dorsiflexion in swing, probably to ensure that the flip-flop did not contact the ground and to maximise adherence to the foot. Minimum clearance of the flip-flop was low compared to barefoot clearance. This may increase the risk of tripping over uneven ground.

Effects of jumping skill training on walking balance for children with mental retardation and Down's syndrome.

PubMed

Wang, W Y; Chang, J J

1997-08-01

In the present study, we hypothesized that the enhancements obtained from the practice of jumping activity could be transferred to improve the walking balance in children with mental retardation (MR) and Down's syndrome (DS). Fourteen children with the diagnosis of MR or DS, aged 3 to 6 years, were recruited from a day care institution. They were ambulant but without jumping ability. Sixty-one non-handicapped children was used to serve as a normative comparison group. Before the training program, the performances of walking balance, jump skills and jumping distances were assessed individually by one physical therapist. The balance sub-test in the Bruininks Oseretsky Test of Motor Proficiency (BOTMP) was administered to assess the walking balance. Motor Skill Inventory (MSI) was used to assess the qualitative levels of jumping skills. A jumping skill training lesson that included horizontal jumps and vertical jumps was designed and integrated into the educational program. The recruited children received 3 sessions of training per-week for 6 weeks. A post-training test and a follow-up test were administered to the handicapped children. In BOTMP scores, statistical differences exited between the pre-training and post-training tests in the tested items of floor walk and beam walk. However, no significant difference was found in the items of floor stand, beam stand and floor heel-toe walk. MSI scales revealed there were significant differences between pre-training and post-training tests. There was no significant difference between the scores of post-training test and the follow-up test. The results implicated that the jumping activity might effectively evoke the automatic and dynamic postural control. Moreover, the significant improvements of the floor walk and beam walk performances might be due to the transferred effects via the practice of dynamic jumping activity. Furthermore, implications and suggestions are discussed.

Intercalary non-vascularised toe phalanx transplantation for short finger-type symbrachydactyly.

PubMed

Kanauchi, Yumiko; Takahara, Masatoshi; Ogino, Toshihiko; Kashiwa, Hideo; Ishigaki, Daisuke

2003-12-01

A two-year-old boy with short finger-type symbrachydactyly involving the index, middle, and ring fingers was treated with intercalary nonvascularised toe phalanx transplantation into the middle finger to obtain stability of the middle finger before syndactyly release. He underwent syndactyly release one year after the transplantation. Two years after the transplantation, the clinical result was satisfactory, although X-ray showed fibrous union between the transplanted phalanx and the host phalanx. Intercalary nonvascularised toe phalanx transplantation is one of the way of stabilising a finger after syndactyly release.

Juvenile idiopathic arthritis.

PubMed

Boros, Christina; Whitehead, Ben

2010-09-01

Juvenile idiopathic arthritis is the most common rheumatic disease in childhood, occurring in approximately 1:500 children. Despite a recent expansion in treatment options and improvement of outcomes, significant morbidity still occurs. This article outlines the clinical manifestations, assessment, detection of complications, treatment options and monitoring requirements, with the aid of guidelines recently published by The Royal Australian College of General Practitioners, which provide practical support for general practitioners to ensure best practice care and to prevent lifelong disability in patients with juvenile idiopathic arthritis. General practice plays an important role in the early detection, initial management and ongoing monitoring of children with juvenile idiopathic arthritis. Early detection involves understanding the classification framework for subtypes of juvenile idiopathic arthritis, and being aware of the clinical manifestations and how to look for them, through history, examination and appropriate investigation. The major extra-articular manifestations of juvenile idiopathic arthritis are uveitis and growth disturbance. Treatment options include nonsteroidal anti-inflammatory drugs, methotrexate, biologic agents, and corticosteroids. Management using a multidisciplinary approach can prevent long term sequelae. Unfortunately, approximately 50% of children will have active disease as adults.

Neuroleptic-induced "painful legs and moving toes" syndrome: successful treatment with clonazepam and baclofen.

PubMed

Sandyk, R

1990-12-01

The syndrome of "painful legs and moving toes" is characterised by spontaneous causalgic pain in the lower extremities associated with peculiar involuntary movements of the toes and feet. It has been observed after a variety of lesions affecting the posterior nerve roots, the spinal ganglia and the peripheral nerves. The pathophysiology of the syndrome is unknown. I report a patient who developed the syndrome during treatment for schizophrenia with the antipsychotic agent molindone hydrochloride. The patient's response to the combination of clonazepam and baclofen suggests that the pathophysiology of the "painful legs and moving toes" may be linked to impairment of spinal serotonergic and GABA functions.

A systematic review of discomfort due to toe or ear clipping in laboratory rodents

PubMed Central

Geessink, Florentine J.; Brouwer, Michelle A. E.; Tillema, Alice; Ritskes-Hoitinga, Merel

2017-01-01

Toe clipping and ear clipping (also ear notching or ear punching) are frequently used methods for individual identification of laboratory rodents. These procedures potentially cause severe discomfort, which can reduce animal welfare and distort experimental results. However, no systematic summary of the evidence on this topic currently exists. We conducted a systematic review of the evidence for discomfort due to toe or ear clipping in rodents. The review methodology was pre-specified in a registered review protocol. The population, intervention, control, outcome (PICO) question was: In rodents, what is the effect of toe clipping or ear clipping, compared with no clipping or sham clipping, on welfare-related outcomes? Through a systematic search in PubMed, Embase, Web of Science and grey literature, we identified seven studies on the effect of ear clipping on animal welfare, and five such studies on toe clipping. Studies were included in the review if they contained original data from an in vivo experiment in rodents, assessing the effect of toe clipping or ear clipping on a welfare-related outcome. Case studies and studies applying unsuitable co-interventions were excluded. Study quality was appraised using an extended version of SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE)’s risk of bias tool for animal studies. Study characteristics and outcome measures were highly heterogeneous, and there was an unclear or high risk of bias in all studies. We therefore present a narrative synthesis of the evidence identified. None of the studies reported a sample size calculation. Out of over 60 different outcomes, we found evidence of discomfort due to ear clipping in the form of increased respiratory volume, vocalization and blood pressure. For toe clipping, increased vocalization and decreased motor activity in pups were found, as well as long-term effects in the form of reduced grip strength and swimming ability in adults. In conclusion, there

Developmental and Behavioral Effects of Toe Clipping on Neonatal and Preweanling Mice with and without Vapocoolant Anesthesia

PubMed Central

Paluch, Lee-Ronn; Lieggi, Christine C; Dumont, Magali; Monette, Sebastien; Riedel, Elyn R; Lipman, Neil S

2014-01-01

Toe clipping is used to identify and genotype preweanling mice, but the procedure generates concerns relevant to pain and distress. The few pertinent studies available evaluated mice between postnatal days (PND) 3 and 7, advocate the use of toe clipping in mice PND 7 or younger, and identify handling as the most distressing aspect of the procedure. Because both toe and tail clipping may be necessary in older mice to obtain sufficient DNA for genotyping, we surmised that performing these procedures concurrently to minimize handling would be beneficial. We also examined reflex development until PND 21 and adult behavior at 8 to 10 wk of age in mice toe clipped at PND 7 or 17 and the benefits of using topical vapocoolant anesthesia. C57BL/6J pups at PND 7 and 17 were assigned to 1 of 4 groups: 1) clipping of digit 3 of contralateral fore- and hindpaws; 2) toe clipping after topical vapocoolant anesthesia; 3) unclipped, unsprayed controls; and, 4) unclipped and vapocoolant-sprayed. Compared with unanesthetized pups, those sprayed with vapocoolant vocalized and struggled more when handled and had more bleeding, erythema, and swelling, which persisted for as long as 12 h after toe clipping. Reflex development, anxiety, locomotion, and motor coordination were not different among groups or with regard to the age of toe clipping. No tissue reaction was noted microscopically in paws collected at 10 wk of age. We conclude that the use of vapocoolant cannot be recommended due to its harmful effects and that toe clipping at PND 7 or 17 does not significantly affect the long-term welfare of mice. PMID:24602538

Vocal cord paralysis: What matters between idiopathic and non-idiopathic cases?

PubMed

Özbal Koç, Ayça Eltaf; Türkoğlu, Seda Babakurban; Erol, Ozan; Erbek, Selim

2016-01-01

This study aims to evaluate the demographic and clinical characteristics of patients with idiopathic and non-idiopathic vocal cord paralysis (VCP). This retrospective cohort was performed on data extracted from medical files of 92 consecutive patients (43 males, 49 females; median age 52.1±23.1 years; min. 1 - max. 87) with VCP diagnosed in the otorhinolaryngology department between April 2012 and December 2015. Diagnoses associated with VCP, side of involvement (right, left or bilateral) and previous medical histories were noted and compared between patients with idiopathic and non-idiopathic VCP. Vocal cord paralysis occurred on the left side (n=56, 60.9%), right side (n=28, 30.4%) or bilaterally (n=8, 8.7%). A clinical entity related with VCP was identified in 63 patients (68.5%), while 29 (31.5%) patients had idiopathic VCP. Most common etiologies for VCP were thyroid surgery (n=32, 34.8%), cardiovascular surgery (n=9, 9.8%), lung cancer (n=6, 6.5%) and cardiac anomalies (n=4, 4.3%), respectively. Patients with idiopathic VCP were significantly older (p<0.001), while gender distribution (p=0.121) and side of involvement (p=0.340) did not differ between two groups. Vocal cord paralysis is a relatively common clinical entity with substantial rate of morbidity. Identification of the underlying etiology and awareness on the clinical characteristics are keystones for foreseeing complications and determining the appropriate therapeutic modality.

The effect of toe marker placement error on joint kinematics and muscle forces using OpenSim gait simulation.

PubMed

Xu, Hang; Merryweather, Andrew; Bloswick, Donald; Mao, Qi; Wang, Tong

2015-01-01

Marker placement can be a significant source of error in biomechanical studies of human movement. The toe marker placement error is amplified by footwear since the toe marker placement on the shoe only relies on an approximation of underlying anatomical landmarks. Three total knee replacement subjects were recruited and three self-speed gait trials per subject were collected. The height variation between toe and heel markers of four types of footwear was evaluated from the results of joint kinematics and muscle forces using OpenSim. The reference condition was considered as the same vertical height of toe and heel markers. The results showed that the residual variances for joint kinematics had an approximately linear relationship with toe marker placement error for lower limb joints. Ankle dorsiflexion/plantarflexion is most sensitive to toe marker placement error. The influence of toe marker placement error is generally larger for hip flexion/extension and rotation than hip abduction/adduction and knee flexion/extension. The muscle forces responded to the residual variance of joint kinematics to various degrees based on the muscle function for specific joint kinematics. This study demonstrates the importance of evaluating marker error for joint kinematics and muscle forces when explaining relative clinical gait analysis and treatment intervention.

Emplacement of Pahoehoe Toe Networks: Observations of May, 2010 Tube-fed Flows at Kilauea Volcano, Hawai'i

NASA Astrophysics Data System (ADS)

Crown, D. A.; Ramsey, M.; Hon, K.

2010-12-01

Pahoehoe lava flows are compound features that consist of multiple overlapping and interfingering lobes and exhibit morphologically diverse surfaces characterized by channelized zones, smooth-surfaced sheets, and numerous, small toe networks. Previous work compiled detailed planform maps of solidified pahoehoe toe networks to document their morphology, morphometry and connective relationships in order to provide constraints on lava transport models. In order to expand this research to active flow emplacement, we observed slow-moving, tube-fed pahoehoe flows on the coastal plain near Kalapana, Hawaii in May, 2010. The evolution of pahoehoe toe and toe network characteristics over their emplacement history was examined and the role of small-scale flow inflation on the advance of pahoehoe lobes evaluated. We collected both visible video footage and high-speed, high-precision thermal infrared (TIR) data using a FLIR S-40 camera. The TIR data provide surface temperature maps that can be easily used to identify formation of new toes and track their growth and surface cooling. From these maps, lobe development, connective relationships, and frontal and lateral spreading rates can be analyzed. Preliminary results suggest that regular cycles of activity characterize the development of these pahoehoe lobes: 1) emplacement of new toes in local topographic lows at the front, margin, and within the interior of an active lobe forming small interconnected networks, 2) decline and sometimes temporary cessation in the production of new pahoehoe toes, 3) inflation of the recently emplaced flow surface, either partially or en masse depending on the rate of influx of new lava, the degree of irregularity of the pre-flow surface, and/or the slope across the recently emplaced lava surface, and 4) fracturing of the recently emplaced surface crust that feeds emplacement of new toes. Inflation fractures typically cut across several previously emplaced toes and can occur at the front, along

Idiopathic hypersomnia.

PubMed

Billiard, Michel; Sonka, Karel

2016-10-01

Idiopathic hypersomnia continues to evolve from the concept of "sleep drunkenness" introduced by Bedrich Roth in Prague in 1956 and the description of idiopathic hypersomnia with two forms, polysymptomatic and monosymptomatic, by the same Bedrich Roth in 1976. The diagnostic criteria of idiopathic hypersomnia have varied with the successive revisions of the International classifications of sleep disorders, including the recent 3rd edition. No epidemiological studies have been conducted so far. Disease onset occurs most often during adolescence or young adulthood. A familial background is often present but rigorous studies are still lacking. The key manifestation is hypersomnolence. It is often accompanied by sleep of long duration and debilitating sleep inertia. Polysomnography (PSG) followed by a multiple sleep latency test (MSLT) is mandatory, as well as a 24 h PSG or a 2-wk actigraphy in association with a sleep log to ensure a total 24-h sleep time longer than or equal to 66O minutes, when the mean sleep latency on the MSLT is longer than 8 min. Yet, MSLT is neither sensitive nor specific and the polysomnographic diagnostic criteria require continuous readjustment and biologic markers are still lacking. Idiopathic hypersomnia is most often a chronic condition though spontaneous remission may occur. The condition is disabling, sometimes even more so than narcolepsy type 1 or 2. Based on neurochemical, genetic and immunological analyses as well as on exploration of the homeostatic and circadian processes of sleep, various pathophysiological hypotheses have been proposed. Differential diagnosis involves a number of diseases and it is not yet clear whether idiopathic hypersomnia and narcolepsy type 2 are not the same condition. Until now, the treatment of idiopathic hypersomnia has mirrored that of the sleepiness of narcolepsy type 1 or 2. The first randomized, double-blind, placebo-controlled trials of modafinil have just been published, as well as a double

Plantar-Plate Disruptions: “The Severe Turf-Toe Injury.” Three Cases in Contact Athletes

PubMed Central

Drakos, Mark C.; Fiore, Russell; Murphy, Conor; DiGiovanni, Christopher W.

2015-01-01

Objective: To present 3 cases of plantar-plate rupture and turf-toe injury in contact athletes at 1 university and to discuss appropriate diagnosis and treatment algorithms for each case. Background: Turf toe is a common injury in athletes participating in outdoor cutting sports. However, it has been used as an umbrella term to describe many different injuries of the great toe. In some cases, the injury can be so severe that the plantar plate and sesamoid apparatus may be ruptured. These patients may be better managed with surgery than with traditional nonoperative interventions. Differential Diagnosis: Turf toe, plantar-plate disruption, sesamoid fracture. Treatment: For stable injuries in which the plantar plate is not completely disrupted, nonoperative treatment with casting or a stiff-soled shoe, gradual weight bearing, and rehabilitation is the best practice. Unstable injuries require surgical intervention and plantar-plate repair. Uniqueness: Turf toe and injury to the first metatarsophalangeal joint are relatively common injuries in athletes, but few researchers have detailed the operative and nonoperative treatments of plantar-plate disruption in these patients. We examine 3 cases that occurred over 4 seasons on a collegiate football team. Conclusions: Turf toe represents a wide array of pathologic conditions involving the first metatarsophalangeal joint. Stress and instability testing are key components to assess in determining whether surgical intervention is warranted to restore optimal function. Stiffer-soled shoes or shoes with steel-plate insertions may help to prevent these injuries and are useful tools for protection during the rehabilitation period. PMID:25695855

Walking variations in healthy women wearing high-heeled shoes: Shoe size and heel height effects.

PubMed

Di Sipio, Enrica; Piccinini, Giulia; Pecchioli, Cristiano; Germanotta, Marco; Iacovelli, Chiara; Simbolotti, Chiara; Cruciani, Arianna; Padua, Luca

2018-05-03

The use of high heels is widespread in modern society in professional and social contests. Literature showed that wearing high heels can produce injurious effects on several structures from the toes to the pelvis. No studies considered shoe length as an impacting factor on walking with high heels. The aim of this study is to evaluate walking parameters in young healthy women wearing high heels, considering not only the heel height but also the foot/shoe size. We evaluate spatio-temporal, kinematic and kinetic data, collected using a 8-camera motion capture system, in a sample of 21 healthy women in three different walking conditions: 1) barefoot, 2) wearing 12 cm high heel shoes independently from shoe size, and 3) wearing shoes with heel height based on shoe size, keeping the ankles' plantar flexion angle constant. The main outcome measures were: spatio-temporal parameters, gait harmony measurement, range of motion, flexion and extension maximal values, power and moment of lower limb joints. Comparing the three walking conditions, the Mixed Anova test, showed significant differences between both high heeled conditions (variable and constant height) and barefoot in spatio-temporal, kinematic and kinetic parameters. Regardless of the shoe size, both heeled conditions presented a similar gait pattern and were responsible for negative effects on walking parameters. Considering our results and the relevance of the heel height, further studies are needed to identify a threshold, over which it is possible to observe that wearing high heels could cause harmful effects, independently from the foot/shoe size. Copyright © 2018 Elsevier B.V. All rights reserved.

Development of a Subject-Specific Foot-Ground Contact Model for Walking.

PubMed

Jackson, Jennifer N; Hass, Chris J; Fregly, Benjamin J

2016-09-01

Computational walking simulations could facilitate the development of improved treatments for clinical conditions affecting walking ability. Since an effective treatment is likely to change a patient's foot-ground contact pattern and timing, such simulations should ideally utilize deformable foot-ground contact models tailored to the patient's foot anatomy and footwear. However, no study has reported a deformable modeling approach that can reproduce all six ground reaction quantities (expressed as three reaction force components, two center of pressure (CoP) coordinates, and a free reaction moment) for an individual subject during walking. This study proposes such an approach for use in predictive optimizations of walking. To minimize complexity, we modeled each foot as two rigid segments-a hindfoot (HF) segment and a forefoot (FF) segment-connected by a pin joint representing the toes flexion-extension axis. Ground reaction forces (GRFs) and moments acting on each segment were generated by a grid of linear springs with nonlinear damping and Coulomb friction spread across the bottom of each segment. The stiffness and damping of each spring and common friction parameter values for all springs were calibrated for both feet simultaneously via a novel three-stage optimization process that used motion capture and ground reaction data collected from a single walking trial. The sequential three-stage process involved matching (1) the vertical force component, (2) all three force components, and finally (3) all six ground reaction quantities. The calibrated model was tested using four additional walking trials excluded from calibration. With only small changes in input kinematics, the calibrated model reproduced all six ground reaction quantities closely (root mean square (RMS) errors less than 13 N for all three forces, 25 mm for anterior-posterior (AP) CoP, 8 mm for medial-lateral (ML) CoP, and 2 N·m for the free moment) for both feet in all walking trials. The

Development of a Subject-Specific Foot-Ground Contact Model for Walking

PubMed Central

Jackson, Jennifer N.; Hass, Chris J.; Fregly, Benjamin J.

2016-01-01

Computational walking simulations could facilitate the development of improved treatments for clinical conditions affecting walking ability. Since an effective treatment is likely to change a patient's foot-ground contact pattern and timing, such simulations should ideally utilize deformable foot-ground contact models tailored to the patient's foot anatomy and footwear. However, no study has reported a deformable modeling approach that can reproduce all six ground reaction quantities (expressed as three reaction force components, two center of pressure (CoP) coordinates, and a free reaction moment) for an individual subject during walking. This study proposes such an approach for use in predictive optimizations of walking. To minimize complexity, we modeled each foot as two rigid segments—a hindfoot (HF) segment and a forefoot (FF) segment—connected by a pin joint representing the toes flexion–extension axis. Ground reaction forces (GRFs) and moments acting on each segment were generated by a grid of linear springs with nonlinear damping and Coulomb friction spread across the bottom of each segment. The stiffness and damping of each spring and common friction parameter values for all springs were calibrated for both feet simultaneously via a novel three-stage optimization process that used motion capture and ground reaction data collected from a single walking trial. The sequential three-stage process involved matching (1) the vertical force component, (2) all three force components, and finally (3) all six ground reaction quantities. The calibrated model was tested using four additional walking trials excluded from calibration. With only small changes in input kinematics, the calibrated model reproduced all six ground reaction quantities closely (root mean square (RMS) errors less than 13 N for all three forces, 25 mm for anterior–posterior (AP) CoP, 8 mm for medial–lateral (ML) CoP, and 2 N·m for the free moment) for both feet in all walking

Microsurgical transfer of the second toe for congenital deficiency of the thumb.

PubMed

Lister, G

1988-10-01

Twelve second-toe transfers have been performed to substitute for thumbs congenitally deficient through constriction ring syndrome, symbrachydactyly, and true transverse arrest. The children were on average 3 years of age, and the youngest was undertaken at 10 months. Anatomic variations were the rule in the six cases of transverse absence and the three cases of symbrachydactyly, requiring nerves, tendons, and vessels in the toe be connected to whatever appropriate structure could be located. All transfers survived, and only one required exploration. Sensation appeared good in the 11 seen in later review, but interphalangeal motion was achieved in only 3. However, good use was made of the digit by all except one patient, an early patient in whom there was not an adequate skeleton on which to base the transfer. This small series suggests that in appropriate cases toe transfer can be undertaken early for congenital deficiency with little fear of encountering microsurgical problems unique to the infant.

Relationship Between Muscle Strength Asymmetry and Body Sway in Older Adults.

PubMed

Koda, Hitoshi; Kai, Yoshihiro; Murata, Shin; Osugi, Hironori; Anami, Kunihiko; Fukumoto, Takahiko; Imagita, Hidetaka

2018-05-31

The purpose of this study was to investigate the relationship between muscle strength asymmetry and body sway while walking. We studied 63 older adult women. Strong side and weak side of knee extension strength, toe grip strength, hand grip strength, and body sway while walking were measured. The relationship between muscle strength asymmetry for each muscle and body sway while walking was evaluated using Pearson's correlation coefficient. Regarding the muscles recognized to have significant correlation with body sway, the asymmetry cutoff value causing an increased sway was calculated. Toe grip strength asymmetry was significantly correlated with body sway. Toe grip strength asymmetry causing an increased body sway had a cutoff value of 23.5%. Our findings suggest toe grip strength asymmetry may be a target for improving gait stability.

Effect of Guci powder on toe swelling induced by egg white in rats

NASA Astrophysics Data System (ADS)

Xie, Guoqi; Hao, Shaojun; Shen, Huiling; Ma, Zhenzhen; Zhang, Xuehui; Zhang, Zhengchen

2018-04-01

To observe the effect of Guci Powder on foot swelling induced by egg white in rats. 50 male rats were randomly divided into normal saline group (n=10), white vinegar group (n=10) and Guning lotion group (n=10). There were 10 rats in the high-dose group and 10 in the low-dose group. The rats in each group were treated with the drug on the left and right feet of the rats. 0.5 hours after the last administration, the rats in each group were inflamed. The left hindsole plantar volume was measured respectively, so that the difference of the posterior toe volume before inflammation was taken as the swelling degree, and the swelling degree of each group was calculated. Compared with physiological saline group, the rats' egg white toe swelling (P<0.01) was significantly inhibited at 0.5˜6h after administration. The swelling of egg white toe in rats was inhibited at 0.5˜2h (P<0.05). Bone spur powder has a good intervention effect on the model of toe swelling induced by egg white in rats, and the external application of bone spur powder has anti-inflammatory and swelling effect.

The Role of Surface Chemistry in Adhesion and Wetting of Gecko Toe Pads

PubMed Central

Badge, Ila; Stark, Alyssa Y.; Paoloni, Eva L.; Niewiarowski, Peter H.; Dhinojwala, Ali

2014-01-01

An array of micron-sized setal hairs offers geckos a unique ability to walk on vertical surfaces using van der Waals interactions. Although many studies have focused on the role of surface morphology of the hairs, very little is known about the role of surface chemistry on wetting and adhesion. We expect that both surface chemistry and morphology are important, not only to achieve optimum dry adhesion but also for increased efficiency in self-cleaning of water and adhesion under wet conditions. Here, we used a plasma-based vapor deposition process to coat the hairy patterns on gecko toe pad sheds with polar and non-polar coatings without significantly perturbing the setal morphology. By a comparison of wetting across treatments, we show that the intrinsic surface of gecko setae has a water contact angle between 70–90°. As expected, under wet conditions, adhesion on a hydrophilic surface (glass) was lower than that on a hydrophobic surface (alkyl-silane monolayer on glass). Surprisingly under wet and dry conditions the adhesion was comparable on the hydrophobic surface, independent of the surface chemistry of the setal hairs. This work highlights the need to utilize morphology and surface chemistry in developing successful synthetic adhesives with desirable adhesion and self-cleaning properties. PMID:25323067

The Role of Surface Chemistry in Adhesion and Wetting of Gecko Toe Pads

NASA Astrophysics Data System (ADS)

Badge, Ila; Stark, Alyssa Y.; Paoloni, Eva L.; Niewiarowski, Peter H.; Dhinojwala, Ali

2014-10-01

An array of micron-sized setal hairs offers geckos a unique ability to walk on vertical surfaces using van der Waals interactions. Although many studies have focused on the role of surface morphology of the hairs, very little is known about the role of surface chemistry on wetting and adhesion. We expect that both surface chemistry and morphology are important, not only to achieve optimum dry adhesion but also for increased efficiency in self-cleaning of water and adhesion under wet conditions. Here, we used a plasma-based vapor deposition process to coat the hairy patterns on gecko toe pad sheds with polar and non-polar coatings without significantly perturbing the setal morphology. By a comparison of wetting across treatments, we show that the intrinsic surface of gecko setae has a water contact angle between 70-90°. As expected, under wet conditions, adhesion on a hydrophilic surface (glass) was lower than that on a hydrophobic surface (alkyl-silane monolayer on glass). Surprisingly under wet and dry conditions the adhesion was comparable on the hydrophobic surface, independent of the surface chemistry of the setal hairs. This work highlights the need to utilize morphology and surface chemistry in developing successful synthetic adhesives with desirable adhesion and self-cleaning properties.

Idiopathic Inflammatory Myopathies

PubMed Central

Dimachkie, Mazen M.; Barohn, Richard J.

2012-01-01

The idiopathic inflammatory myopathies are a group of rare disorders including polymyositis (PM), dermatomyositis (DM), and autoimmune necrotizing myopathies (NMs). The idiopathic inflammatory myopathies share many similarities. They present acutely, subacutely, or chronically with marked proximal and symmetric muscle weakness, except for associated distal and asymmetric weakness in inclusion body myositis. The idiopathic inflammatory myopathies also share a variable degree of creatine kinase (CK) elevation and a nonspecifically abnormal electromyogram demonstrating an irritative myopathy. The muscle pathology demonstrates inflammatory exudates of variable distribution within the muscle fascicle. Despite these similarities, the idiopathic inflammatory myopathies are a heterogeneous group. The overlap syndrome (OS) refers to the association of PM, DM, or NM with connective tissue disease, such as scleroderma or systemic lupus erythematosus. In addition to elevated antinuclear antibodies (ANA), patients with OS may be weaker in the proximal arms than the legs mimicking the pattern seen in some muscular dystrophies. In this review, we focus on DM, PM, and NM and examine current and promising therapies. PMID:23117947

16 CFR Figures 6 and 7 to Part 1512 - Toe Clearance and Chain Guard Requirements

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Toe Clearance and Chain Guard Requirements 6 Figures 6 and 7 to Part 1512 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS SUBSTANCES ACT REGULATIONS REQUIREMENTS FOR BICYCLES Pt. 1512, Figs. 6 and 7 Figures 6 and 7 to Part 1512—Toe...

16 CFR Figures 6 and 7 to Part 1512 - Toe Clearance and Chain Guard Requirements

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Toe Clearance and Chain Guard Requirements 6 Figures 6 and 7 to Part 1512 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS SUBSTANCES ACT REGULATIONS REQUIREMENTS FOR BICYCLES Pt. 1512, Figs. 6 and 7 Figures 6 and 7 to Part 1512—Toe...

Non-vascularized free toe phalanx transfers in congenital hand deformities--the Great Ormond Street experience.

PubMed

Cavallo, A V; Smith, P J; Morley, S; Morsi, A W

2003-12-01

Many options of varying complexity are available for the management of congenital short digits resulting from aphalangia in symbrachydactyly and constriction ring syndrome. We have used non-vascularized free toe phalanx transfers for these children when a vascularized toe transfer has been contraindicated. We describe our technique and experience with 22 children who underwent a total of 64 transfers of the proximal (35) or middle (29) toe phalanges (average 3 per child). The mean age at initial surgery was 15 months, and the mean follow-up was 5 years. Duration of time until epiphyseal closure could not be determined accurately, but total digital elongation averaged 6mm. Complications of this technique include joint instability, premature epiphyseal closure and, in one patient, infection and graft loss. Donor site deformity was determined according to measured growth deficit and toe function. This technique is a simple option for digital elongation and, if performed in the appropriate age group in short fingered and monodactylous subtypes of symbrachydactyly, has the potential to allow growth and function with minimal donor site deficit.

Quantum Tic-Tac-Toe as Metaphor for Quantum Physics

NASA Astrophysics Data System (ADS)

Goff, Allan; Lehmann, Dale; Siegel, Joel

2004-02-01

Quantum Tic-Tac-Toe is presented as an abstract quantum system derived from the rules of Classical Tic-Tac-Toe. Abstract quantum systems can be constructed from classical systems by the addition of three types of rules; rules of Superposition, rules of Entanglement, and rules of Collapse. This is formally done for Quantum Tic-Tac-Toe. As a part of this construction it is shown that abstract quantum systems can be viewed as an ensemble of classical systems. That is, the state of a quantum game implies a set of simultaneous classical games. The number and evolution of the ensemble of classical games is driven by the superposition, entanglement, and collapse rules. Various aspects and play situations provide excellent metaphors for standard features of quantum mechanics. Several of the more significant metaphors are discussed, including a measurement mechanism, the correspondence principle, Everett's Many Worlds Hypothesis, an ascertainity principle, and spooky action at a distance. Abstract quantum systems also show the consistency of backwards-in-time causality, and the influence on the present of both pasts and futures that never happened. The strongest logical argument against faster-than-light (FTL) phenomena is that since FTL implies backwards-in-time causality, temporal paradox is an unavoidable consequence of FTL; hence FTL is impossible. Since abstract quantum systems support backwards-in-time causality but avoid temporal paradox through pruning of the classical ensemble, it may be that quantum based FTL schemes are possible allowing backwards-in-time causality, but prohibiting temporal paradox.

Adhesion and friction in gecko toe attachment and detachment

PubMed Central

Tian, Yu; Pesika, Noshir; Zeng, Hongbo; Rosenberg, Kenny; Zhao, Boxin; McGuiggan, Patricia; Autumn, Kellar; Israelachvili, Jacob

2006-01-01

Geckos can run rapidly on walls and ceilings, requiring high friction forces (on walls) and adhesion forces (on ceilings), with typical step intervals of ≈20 ms. The rapid switching between gecko foot attachment and detachment is analyzed theoretically based on a tape model that incorporates the adhesion and friction forces originating from the van der Waals forces between the submicron-sized spatulae and the substrate, which are controlled by the (macroscopic) actions of the gecko toes. The pulling force of a spatula along its shaft with an angle θ between 0 and 90° to the substrate, has a “normal adhesion force” contribution, produced at the spatula-substrate bifurcation zone, and a “lateral friction force” contribution from the part of spatula still in contact with the substrate. High net friction and adhesion forces on the whole gecko are obtained by rolling down and gripping the toes inward to realize small pulling angles θ between the large number of spatulae in contact with the substrate. To detach, the high adhesion/friction is rapidly reduced to a very low value by rolling the toes upward and backward, which, mediated by the lever function of the setal shaft, peels the spatulae off perpendicularly from the substrates. By these mechanisms, both the adhesion and friction forces of geckos can be changed over three orders of magnitude, allowing for the swift attachment and detachment during gecko motion. The results have obvious implications for the fabrication of dry adhesives and robotic systems inspired by the gecko's locomotion mechanism. PMID:17148600

Kinetic analysis of the function of the upper body for elite race walkers during official men 20 km walking race.

PubMed

Hoga-Miura, Koji; Ae, Michiyoshi; Fujii, Norihisa; Yokozawa, Toshiharu

2016-10-01

This study investigated the function of the upper extremities of elite race walkers during official 20 km races, focusing on the angular momentum about the vertical axis and other parameters of the upper extremities. Sixteen walkers were analysed using the three-dimensional direct linear transformation method during three official men's 20 km walking races. The subjects, included participants at the Olympics and World Championships, who finished without disqualification and had not been disqualified during the two years prior to or following the races analysed in the present study. The angular momenta of the upper and lower body were counterbalanced as in running and normal walking. The momentum of the upper body was mainly generated by the upper extremities. The joint force moment of the right shoulder and the joint torque at the left shoulder just before right toe-off were significantly correlated with the walking speed. These were counterbalanced by other moments and torques to the torso torque, which worked to obtain a large mechanical energy flow from the recovery leg to the support leg in the final phase of the support phase. Therefore, a function of the shoulder torque was to counterbalance the torso torque to gain a fast walking speed with substantial mechanical energy flow.

Phalangeal joints kinematics during ostrich (Struthio camelus) locomotion

PubMed Central

Ji, Qiaoli; Luo, Gang; Xue, Shuliang; Ma, Songsong; Li, Jianqiao

2017-01-01

The ostrich is a highly cursorial bipedal land animal with a permanently elevated metatarsophalangeal joint supported by only two toes. Although locomotor kinematics in walking and running ostriches have been examined, these studies have been largely limited to above the metatarsophalangeal joint. In this study, kinematic data of all major toe joints were collected from gaits with double support (slow walking) to running during stance period in a semi-natural setup with two selected cooperative ostriches. Statistical analyses were conducted to investigate the effect of locomotor gait on toe joint kinematics. The MTP3 and MTP4 joints exhibit the largest range of motion whereas the first phalangeal joint of the 4th toe shows the largest motion variability. The interphalangeal joints of the 3rd and 4th toes present very similar motion patterns over stance phases of slow walking and running. However, the motion patterns of the MTP3 and MTP4 joints and the vertical displacement of the metatarsophalangeal joint are significantly different during running and slow walking. Because of the biomechanical requirements, osctriches are likely to select the inverted pendulum gait at low speeds and the bouncing gait at high speeds to improve movement performance and energy economy. Interestingly, the motions of the MTP3 and MTP4 joints are highly synchronized from slow to fast locomotion. This strongly suggests that the 3rd and 4th toes really work as an “integrated system” with the 3rd toe as the main load bearing element whilst the 4th toe as the complementary load sharing element with a primary role to ensure the lateral stability of the permanently elevated metatarsophalangeal joint. PMID:28097064

[Breast cancer metastasis in distal phalanx of the big toe. Case report].

PubMed

Carlesimo, B; Tempesta, M; Fioramonti, P; Bistoni, G; Ruggiero, M; Marchetti, F

2009-01-01

Breast cancer represents the most prevalent malignancies in women and bone is the first site of metastasis in 26-50% of cases. Usually metastasis involve limbs in 16%. We present a rare case of 47-year-old woman, who underwent to monolateral mastectomy for lobular cancer. After 8 years from surgery, she presented pain, swelling and functional limitations, gradually increasing, to the left big toe. X-rays and MRI showed a lucent area of bone destruction on the shaft of the distal phalanx of the left big toe. Surgical biopsy on the excised bone assessed for breast cancer metastasis.

Free toe pulp transfer for digital reconstruction after high-pressure injection injury.

PubMed

Chan, B K; Tham, S K; Leung, M

1999-10-01

We report two cases of high-pressure injection injuries to the fingertip in which free toe pulp flaps were used to resurface the palmar surface of the finger following extensive wound debridement. There was good return of sensibility and, because of the high durability of the donor skin, both patients regained good functional use of the injured digits and returned to heavy manual work. There was minimal associated morbidity of the donor sites. The free toe pulp flap represents an excellent alternative for resurfacing the digit with a large residual skin defect after high-pressure injection injury.

Agility, gnosis, and graphaesthesia for the toes and fingers in children: normative data (ages 7-14 years).

PubMed

Richards, P M; Persinger, M A

2004-01-01

The differential representation of the toes/feet and fingers/hands along the medial and lateral surfaces of the cerebral cortices, respectively, may have diagnostic utility. Normative data for errors for toe and finger graphaesthesia and gnosis, as well as foot and finger agility, were collected for 86 children (ages 7 to 14). The fingers were more agile than the feet, and the right side of the body was more agile than the left side, regardless of age. A marked improvement in toe gnosis, but not in finger gnosis occurred in children after 11-12 years of age. A statistically significant interaction between laterality and gender was due to the greater numbers of errors for both toe and finger gnosis, displayed by girls for the left sides of their bodies compared to their right sides. This discrepancy was not significant for boys.

Gross motor development in babies with treated idiopathic clubfoot.

PubMed

Garcia, Nancy L; McMulkin, Mark L; Tompkins, Bryan J; Caskey, Paul M; Mader, Shelley L; Baird, Glen O

2011-01-01

To investigate the effect of treated clubfoot disorder on gross motor skill level measured by the Alberta Infant Motor Scale (AIMS). Fifty-two babies participated: 26 were treated for idiopathic clubfoot (12 with the Ponseti treatment method, 9 with the French physical therapy technique, and 5 with a combination of both methods); 26 were babies who were typically developing and without medical diagnoses. The AIMS was administered at 3-month intervals. No significant differences in AIMS scores were found between the clubfoot and control groups at 3 and 6 months, but at 9 and 12 months the clubfoot group scored significantly lower. Babies who were typically developing were significantly more likely to be walking at 12 months than babies with clubfoot. Treated clubfoot was associated with a mild delay in attainment of gross motor skills at 9 and 12 months of age.

5. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, LOOKING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, LOOKING SOUTHWEST - High Mountain Dams in Upalco Unit, Kidney Lake Dam, Ashley National Forest, 4.7 miles North of Miners Gulch Campground, Mountain Home, Duchesne County, UT

6. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, LOOKING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, LOOKING SOUTHWEST - High Mountain Dams in Upalco Unit, Kidney Lake Dam, Ashley National Forest, 4.7 miles North of Miners Gulch Campground, Mountain Home, Duchesne County, UT

5. DETAIL VIEW OF TOE SPILLWAY SECTION OF LOWWATER DAM, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. DETAIL VIEW OF TOE SPILLWAY SECTION OF LOW-WATER DAM, LOOKING NORTHWEST (UPSTREAM). ST. LOUIS WATER DEPARTMENT INTAKE IN BACKGROUND - Upper Mississippi River 9-Foot Channel Project, Lock & Dam 27, Granite City, Madison County, IL

Development of an ankle torque measurement device for measuring ankle torque during walking.

PubMed

Tanino, Genichi; Tomita, Yutaka; Mizuno, Shiho; Maeda, Hirofumi; Miyasaka, Hiroyuki; Orand, Abbas; Takeda, Kotaro; Sonoda, Shigeru

2015-05-01

[Purpose] To develop a device for measuring the torque of an ankle joint during walking in order to quantify the characteristics of spasticity of the ankle and to verify the functionality of the device by testing it on the gait of an able-bodied individual and an equinovarus patient. [Subjects and Methods] An adjustable posterior strut (APS) ankle-foot orthosis (AFO) was used in which two torque sensors were mounted on the aluminum strut for measuring the anterior-posterior (AP) and medial-lateral (ML) directions. Two switches were also mounted at the heel and toe in order to detect the gait phase. An able-bodied individual and a left hemiplegic patient with equinovarus participated. They wore the device and walked on a treadmill to investigate the device's functionality. [Results] Linear relationships between the torques and the corresponding output of the torque sensors were observed. Upon the analyses of gait of an able-body subject and a hemiplegic patient, we observed toque matrices in both AP and ML directions during the gait of the both subjects. [Conclusion] We developed a device capable of measuring the torque in the AP and ML directions of ankle joints during gait.

Comparison of monocyte gene expression among patients with neurocysticercosis-associated epilepsy, Idiopathic Epilepsy and idiopathic headaches in India.

PubMed

Prabhakaran, Vasudevan; Drevets, Douglas A; Ramajayam, Govindan; Manoj, Josephine J; Anderson, Michael P; Hanas, Jay S; Rajshekhar, Vedantam; Oommen, Anna; Carabin, Hélène

2017-06-01

Neurocysticercosis (NCC), a neglected tropical disease, inflicts substantial health and economic costs on people living in endemic areas such as India. Nevertheless, accurate diagnosis using brain imaging remains poorly accessible and too costly in endemic countries. The goal of this study was to test if blood monocyte gene expression could distinguish patients with NCC-associated epilepsy, from NCC-negative imaging lesion-free patients presenting with idiopathic epilepsy or idiopathic headaches. Patients aged 18 to 51 were recruited from the Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, India, between January 2013 and October 2014. mRNA from CD14+ blood monocytes was isolated from 76 patients with NCC, 10 Recovered NCC (RNCC), 29 idiopathic epilepsy and 17 idiopathic headaches patients. A preliminary microarray analysis was performed on six NCC, six idiopathic epilepsy and four idiopathic headaches patients to identify genes differentially expressed in NCC-associated epilepsy compared with other groups. This analysis identified 1411 upregulated and 733 downregulated genes in patients with NCC compared to Idiopathic Epilepsy. Fifteen genes up-regulated in NCC patients compared with other groups were selected based on possible relevance to NCC, and analyzed by qPCR in all patients' samples. Differential gene expression among patients was assessed using linear regression models. qPCR analysis of 15 selected genes showed generally higher gene expression among NCC patients, followed by RNCC, idiopathic headaches and Idiopathic Epilepsy. Gene expression was also generally higher among NCC patients with single cyst granulomas, followed by mixed lesions and single calcifications. Expression of certain genes in blood monocytes can distinguish patients with NCC-related epilepsy from patients with active Idiopathic Epilepsy and idiopathic headaches. These findings are significant because they may lead to the development of new tools to

The DEP domain-containing protein TOE-2 promotes apoptosis in the Q lineage of C. elegans through two distinct mechanisms

PubMed Central

Gurling, Mark; Talavera, Karla; Garriga, Gian

2014-01-01

Neuroblast divisions in the nematode Caenorhabditis elegans often give rise to a larger neuron and a smaller cell that dies. We have previously identified genes that, when mutated, result in neuroblast divisions that generate daughter cells that are more equivalent in size. This effect correlates with the survival of daughter cells that would normally die. We now describe a role for the DEP domain-containing protein TOE-2 in promoting the apoptotic fate in the Q lineage. TOE-2 localized at the plasma membrane and accumulated in the cleavage furrow of the Q.a and Q.p neuroblasts, suggesting that TOE-2 might position the cleavage furrow asymmetrically to generate daughter cells of different sizes. This appears to be the case for Q.a divisions where loss of TOE-2 led to a more symmetric division and to survival of the smaller Q.a daughter. Localization of TOE-2 to the membrane is required for this asymmetry, but, surprisingly, the DEP domain is dispensable. By contrast, loss of TOE-2 led to loss of the apoptotic fate in the smaller Q.p daughter but did not affect the size asymmetry of the Q.p daughters. This function of TOE-2 required the DEP domain but not localization to the membrane. We propose that TOE-2 ensures an apoptotic fate for the small Q.a daughter by promoting asymmetry in the daughter cell sizes of the Q.a neuroblast division but by a mechanism that is independent of cell size in the Q.p division. PMID:24961802

Associations between cognitive and gait performance during single- and dual-task walking in people with Parkinson disease.

PubMed

Stegemöller, Elizabeth L; Wilson, Jonathan P; Hazamy, Audrey; Shelley, Mack C; Okun, Michael S; Altmann, Lori J P; Hass, Chris J

2014-06-01

Cognitive impairments in Parkinson disease (PD) manifest as deficits in speed of processing, working memory, and executive function and attention abilities. The gait impairment in PD is well documented to include reduced speed, shortened step lengths, and increased step-to-step variability. However, there is a paucity of research examining the relationship between overground walking and cognitive performance in people with PD. This study sought to examine the relationship between both the mean and variability of gait spatiotemporal parameters and cognitive performance across a broad range of cognitive domains. A cross-sectional design was used. Thirty-five participants with no dementia and diagnosed with idiopathic PD completed a battery of 12 cognitive tests that yielded 3 orthogonal factors: processing speed, working memory, and executive function and attention. Participants completed 10 trials of overground walking (single-task walking) and 5 trials of overground walking while counting backward by 3's (dual-task walking). All gait measures were impaired by the dual task. Cognitive processing speed correlated with stride length and walking speed. Executive function correlated with step width variability. There were no significant associations with working memory. Regression models relating speed of processing to gait spatiotemporal variables revealed that including dual-task costs in the model significantly improved the fit of the model. Participants with PD were tested only in the on-medication state. Different characteristics of gait are related to distinct types of cognitive processing, which may be differentially affected by dual-task walking due to the pathology of PD. © 2014 American Physical Therapy Association.

Gait Evaluation of Overground Walking and Treadmill Walking Using Compass-Type Walking Model

NASA Astrophysics Data System (ADS)

Nagata, Yousuke; Yamamoto, Masayoshi; Funabiki, Shigeyuki

A treadmill is a useful apparatus for the gait training and evaluation. However, many differences are reported between treadmill and overground walking. Experimental comparisons of the muscle activity of the leg and the heart rate have been carried out. However, the dynamic comparison has not been performed. The dynamic evaluation of the overground walking and the treadmill walking using a compass-type walking model (CTWM) which is a simple bipedal walking model, then their comparison is discussed. It is confirmed that the walking simulation using the CTWM can simulate the difference of that walk, it is clarified that there are the differences of the kick impulse on the ground and the turning impulse of the foot to the variation of the belt speed and then differences are the main factor of two walking.

Effect of thong style flip-flops on children's barefoot walking and jogging kinematics.

PubMed

Chard, Angus; Greene, Andrew; Hunt, Adrienne; Vanwanseele, Benedicte; Smith, Richard

2013-03-05

Thong style flip-flops are a popular form of footwear for children. Health professionals relate the wearing of thongs to foot pathology and deformity despite the lack of quantitative evidence to support or refute the benefits or disadvantages of children wearing thongs. The purpose of this study was to compare the effect of thong footwear on children's barefoot three dimensional foot kinematics during walking and jogging. Thirteen healthy children (age 10.3 ± 1.6 SD years) were recruited from the metropolitan area of Sydney Australia following a national press release. Kinematic data were recorded at 200 Hz using a 14 camera motion analysis system (Cortex, Motion Analysis Corporation, Santa Rosa, USA) and simultaneous ground reaction force were measured using a force platform (Model 9281B, Kistler, Winterthur, Switzerland). A three-segment foot model was used to describe three dimensional ankle, midfoot and one dimensional hallux kinematics during the stance sub-phases of contact, midstance and propulsion. Thongs resulted in increased ankle dorsiflexion during contact (by 10.9°, p; = 0.005 walk and by 8.1°, p; = 0.005 jog); increased midfoot plantarflexion during midstance (by 5.0°, p; = 0.037 jog) and propulsion (by 6.7°, p; = 0.044 walk and by 5.4°, p;= 0.020 jog); increased midfoot inversion during contact (by 3.8°, p;= 0.042 jog) and reduced hallux dorsiflexion during walking 10% prior to heel strike (by 6.5°, p; = 0.005) at heel strike (by 4.9°, p; = 0.031) and 10% post toe-off (by 10.7°, p; = 0.001). Ankle dorsiflexion during the contact phase of walking and jogging, combined with reduced hallux dorsiflexion during walking, suggests a mechanism to retain the thong during weight acceptance. Greater midfoot plantarflexion throughout midstance while walking and throughout midstance and propulsion while jogging may indicate a gripping action to sustain the thong during stance. While these compensations exist, the overall findings suggest that foot

Lethocerus americanus, the "toe biter".

PubMed

Huntley, A

1998-10-01

Lethocerus americanus is a large water bug commonly found in ponds and slowly moving fresh water. Also known as the "toe biter" for its encounters with swimmers, it has the reputation of inflicting painful bites when carelessly handled. It normally feeds on other pond life: insects, tadpoles, salamander, small fish, and snails. These large tan or brown bugs may leave their habitat at night in search of mates or another pond. It is thought that the relative nearness of bright lights for a creature that evolved using celestial navigation, results in disorientation, spiral flight paths, and eventual death from exhaustion. This would account for the occasional find of several dead giant water bugs underneath street lamps.

Human's Capability to Discriminate Spatial Forces at the Big Toe.

PubMed

Hagengruber, Annette; Höppner, Hannes; Vogel, Jörn

2018-01-01

A key factor for reliable object manipulation is the tactile information provided by the skin of our hands. As this sensory information is so essential in our daily life it should also be provided during teleoperation of robotic devices or in the control of myoelectric prostheses. It is well-known that feeding back the tactile information to the user can lead to a more natural and intuitive control of robotic devices. However, in some applications it is difficult to use the hands as natural feedback channels since they may already be overloaded with other tasks or, e.g., in case of hand prostheses not accessible at all. Many alternatives for tactile feedback to the human hand have already been investigated. In particular, one approach shows that humans can integrate uni-directional (normal) force feedback at the toe into their sensorimotor-control loop. Extending this work, we investigate the human's capability to discriminate spatial forces at the bare front side of their toe. A state-of-the-art haptic feedback device was used to apply forces with three different amplitudes-2 N, 5 N, and 8 N-to subjects' right big toes. During the experiments, different force stimuli were presented, i.e., direction of the applied force was changed, such that tangential components occured. In total the four directions up (distal), down (proximal), left (medial), and right (lateral) were tested. The proportion of the tangential force was varied corresponding to a directional change of 5° to 25° with respect to the normal force. Given these force stimuli, the subjects' task was to identify the direction of the force change. We found the amplitude of the force as well as the proportion of tangential forces to have a significant influence on the success rate. Furthermore, the direction right showed a significantly different successrate from all other directions. The stimuli with a force amplitude of 8 N achieved success rates over 89% in all directions. The results of the user study

Human's Capability to Discriminate Spatial Forces at the Big Toe

PubMed Central

Hagengruber, Annette; Höppner, Hannes; Vogel, Jörn

2018-01-01

A key factor for reliable object manipulation is the tactile information provided by the skin of our hands. As this sensory information is so essential in our daily life it should also be provided during teleoperation of robotic devices or in the control of myoelectric prostheses. It is well-known that feeding back the tactile information to the user can lead to a more natural and intuitive control of robotic devices. However, in some applications it is difficult to use the hands as natural feedback channels since they may already be overloaded with other tasks or, e.g., in case of hand prostheses not accessible at all. Many alternatives for tactile feedback to the human hand have already been investigated. In particular, one approach shows that humans can integrate uni-directional (normal) force feedback at the toe into their sensorimotor-control loop. Extending this work, we investigate the human's capability to discriminate spatial forces at the bare front side of their toe. A state-of-the-art haptic feedback device was used to apply forces with three different amplitudes—2 N, 5 N, and 8 N—to subjects' right big toes. During the experiments, different force stimuli were presented, i.e., direction of the applied force was changed, such that tangential components occured. In total the four directions up (distal), down (proximal), left (medial), and right (lateral) were tested. The proportion of the tangential force was varied corresponding to a directional change of 5° to 25° with respect to the normal force. Given these force stimuli, the subjects' task was to identify the direction of the force change. We found the amplitude of the force as well as the proportion of tangential forces to have a significant influence on the success rate. Furthermore, the direction right showed a significantly different successrate from all other directions. The stimuli with a force amplitude of 8 N achieved success rates over 89% in all directions. The results of the user

Asymmetrical trunk movement during walking improved to normal range at 3 months after corrective posterior spinal fusion in adolescent idiopathic scoliosis.

PubMed

Wong-Chung, Daniel A C F; Schimmel, Janneke J P; de Kleuver, Marinus; Keijsers, Noël L W

2018-02-01

To investigate the effects of posterior spinal fusion (PSF) and curve type on upper body movements in Adolescent Idiopathic Scoliosis (AIS) patients during gait. Twenty-four girls (12-18 years) with AIS underwent PSF. 3D-Gait-analyses were performed preoperatively, at 3 months and 1 year postoperatively. Mean position (0° represents symmetry) and range of motion (ROM) of the trunk (thorax-relative-to-pelvis) in all planes were assessed. Lower body kinematics and spatiotemporal parameters were also evaluated. Mean trunk position improved from 7.0° to 2.9° in transversal plane and from 5.0° to - 0.8° in frontal plane at 3 months postoperative (p < 0.001), and was maintained at 1 year. Trunk ROM in transverse plane decreased from 9.6° to 7.5° (p < 0.001) after surgery. No effects of PSF were observed on the lower body kinematics during the gait cycle. Patients with a double curve had a more axial rotated trunk before and after surgery (p = 0.013). In AIS patients, during gait an evident asymmetrical position of the trunk improved to an almost symmetric situation already 3 months after PSF and was maintained at 1 year. Despite a reduction of trunk ROM, patients were able to maintain the same walking pattern in the lower extremities after surgery. This improvement of symmetry and maintenance of normal gait can explain the rapid recovery and well functioning in daily life of AIS patients, despite undergoing a fusion of large parts of their spine.

7. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, WITH ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, WITH OUTLET CULVERT AND WING RETAINING WALLS, LOOKING NORTH - High Mountain Dams in Upalco Unit, Twin Pots Dam, Ashley National Forest, 10.1 miles North of Mountain Home, Mountain Home, Duchesne County, UT

Color of the tarsi and toes of the black rail

USGS Publications Warehouse

Meanley, B.; Stewart, R.E.

1960-01-01

Examination of two fresh specimens of the Black Rail (Laterallus jamaicensis) has prompted us to call attention to the color of the tarsi and toes of this species, since our observations do not agree with published accounts. Audubon (Ornithological Biography, vol. IV; 361, 1838) and Friedmann (Birds of North and Middle America, U.S. Nat'l. Mus. Bull., 50: 154, 1941) state that the tarsi and toes are bright yellowish-green. Descriptions in other publications are similar. Prominent bird artists, including Fuertes, have depicted the color of these appendages as yellowish-green, yellow, or green; while Allan Brooks' illustration of this species (The Book of Birds, vol. I, National Geographic Society, p. 291, 1932) shows pink legs. An adult female specimen was collected by J. A. Hagar, C. S. Robbins, and R. E. Stewart near Elliott Island, Maryland, on 8 June 1958. A second adult Black Rail, presumed to be a female by its dull color and call, was caught alive by the authors in the same area on 17 June 1958, and is still held in captivity. The tarsi and toes of these two birds show no trace of yellow or green. They appear grayish, matching "Flint" (plate 56-1C) or "Gunmetal" (plate 48-2C) in Maerz and Paul's "A Dictionary of Color" (1930), and "blackish-brown" in the color charts provided with Palmer and Reilly's "A Concise Color Standard" (Am. Ornith. Union Handbook Fund, 1956). A grayed-off blackish-brown would seem to be an appropriate description.

A Unique Case of Classic Kaposi's sarcoma restricted to the toes.

PubMed

Renteria, Anne S; Marshall, Vickie A; Sun, Yanyu; Chockalingam, Porselvi; Cooper, Jay S; Huang, Yiwu; Whitby, Denise

2013-01-01

Kaposi's sarcoma associated-herpesvirus causes all forms of Kaposi's sarcoma, and six major subtypes have been described based on the amino acid sequences of the open reading frame K1. A 71-year-old man from China, HIV negative, presented with nodules on the dorsal aspect of his toes. Biopsy confirmed the diagnosis of Kaposi's sarcoma and virology studies of his blood and saliva confirmed the presence of Kaposi's sarcoma associated-herpesvirus infection. Viral genotyping was consistent with subtype C3. Intervention has been deferred as our patient has remained clinically asymptomatic and without evident growth of his lesions over a 2-year follow up. We herein report the first known case of Kaposi's sarcoma restricted to the toes caused by the viral subtype C3 in an HIV-negative patient from Harbin, China.

Effect of thong style flip-flops on children’s barefoot walking and jogging kinematics

PubMed Central

2013-01-01

Background Thong style flip-flops are a popular form of footwear for children. Health professionals relate the wearing of thongs to foot pathology and deformity despite the lack of quantitative evidence to support or refute the benefits or disadvantages of children wearing thongs. The purpose of this study was to compare the effect of thong footwear on children’s barefoot three dimensional foot kinematics during walking and jogging. Methods Thirteen healthy children (age 10.3 ± 1.6 SD years) were recruited from the metropolitan area of Sydney Australia following a national press release. Kinematic data were recorded at 200 Hz using a 14 camera motion analysis system (Cortex, Motion Analysis Corporation, Santa Rosa, USA) and simultaneous ground reaction force were measured using a force platform (Model 9281B, Kistler, Winterthur, Switzerland). A three-segment foot model was used to describe three dimensional ankle, midfoot and one dimensional hallux kinematics during the stance sub-phases of contact, midstance and propulsion. Results Thongs resulted in increased ankle dorsiflexion during contact (by 10.9°, p; = 0.005 walk and by 8.1°, p; = 0.005 jog); increased midfoot plantarflexion during midstance (by 5.0°, p; = 0.037 jog) and propulsion (by 6.7°, p; = 0.044 walk and by 5.4°, p;= 0.020 jog); increased midfoot inversion during contact (by 3.8°, p;= 0.042 jog) and reduced hallux dorsiflexion during walking 10% prior to heel strike (by 6.5°, p; = 0.005) at heel strike (by 4.9°, p; = 0.031) and 10% post toe-off (by 10.7°, p; = 0.001). Conclusions Ankle dorsiflexion during the contact phase of walking and jogging, combined with reduced hallux dorsiflexion during walking, suggests a mechanism to retain the thong during weight acceptance. Greater midfoot plantarflexion throughout midstance while walking and throughout midstance and propulsion while jogging may indicate a gripping action to sustain the thong during stance. While these compensations exist

Relation between random walks and quantum walks

NASA Astrophysics Data System (ADS)

Boettcher, Stefan; Falkner, Stefan; Portugal, Renato

2015-05-01

Based on studies of four specific networks, we conjecture a general relation between the walk dimensions dw of discrete-time random walks and quantum walks with the (self-inverse) Grover coin. In each case, we find that dw of the quantum walk takes on exactly half the value found for the classical random walk on the same geometry. Since walks on homogeneous lattices satisfy this relation trivially, our results for heterogeneous networks suggest that such a relation holds irrespective of whether translational invariance is maintained or not. To develop our results, we extend the renormalization-group analysis (RG) of the stochastic master equation to one with a unitary propagator. As in the classical case, the solution ρ (x ,t ) in space and time of this quantum-walk equation exhibits a scaling collapse for a variable xdw/t in the weak limit, which defines dw and illuminates fundamental aspects of the walk dynamics, e.g., its mean-square displacement. We confirm the collapse for ρ (x ,t ) in each case with extensive numerical simulation. The exact values for dw themselves demonstrate that RG is a powerful complementary approach to study the asymptotics of quantum walks that weak-limit theorems have not been able to access, such as for systems lacking translational symmetries beyond simple trees.

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

Plantar pressure of clipless and toe-clipped pedals in cyclists - A pilot study

PubMed Central

Davis, Andrea; Pemberton, Troy; Ghosh, Subhajit; Maffulli, Nicola; Padhiar, Nat

2011-01-01

Summary To determine the effect of clipless and toe-clipped pedals on plantar foot pressure while cycling. Seven bikers and 11 healthy volunteers were tested on a Giant ATX Team mountain bike, Tekscan Clinical 5.24 F-scan® system with an inner sole pressure sensor, a Tacx Cycle force One Turbo Trainer and a Cateye Mity 8 computerized speedometer were used. The subjects wore Shimano M037 shoes and used a standard clipless and toe-clipped pedal. The seat height was set at 100% of subject’s trochanteric height. Plantar pressures were recorded over 12 consecutive crank cycles at a constant speed for each of the power outputs. The videos were analysed to record the pressure exerted at 12 positions on the foot for each variable. Whether there is any dominance of any of the metatarsals, and any difference in plantar pressures between clipped and clipless pedal. There was a significant difference in the pressure at many positions of the foot, but the sites were different for each individual. General regression analysis indicated that pedal type had a statistically significant effect on plantar pressure at the sites of 1st metatarsal (p=0.042), 3rd metatarsal (p<0.001), 5th metatarsal (<0.001), 2nd (p=0.018) and 5th toe (p<0.001), lateral midfoot (p<0.001) and central heel (p<0.001) areas. Clipless pedals produce higher pressures which are more spread across the foot than toe-clipped pedals. This may have implications for their use in the prevention and/or management of overuse injuries in the knee and foot. PMID:23738240

Interaction of the body, head, and eyes during walking and turning

NASA Technical Reports Server (NTRS)

Imai, T.; Moore, S. T.; Raphan, T.; Cohen, B.

2001-01-01

Body, head, and eye movements were measured in five subjects during straight walking and while turning corners. The purpose was to determine how well the head and eyes followed the linear trajectory of the body in space and whether head orientation followed changes in the gravito-inertial acceleration vector (GIA). Head and body movements were measured with a video-based motion analysis system and horizontal, vertical, and torsional eye movements with video-oculography. During straight walking, there was lateral body motion at the stride frequency, which was at half the frequency of stepping. The GIA oscillated about the direction of heading, according to the acceleration and deceleration associated with heel strike and toe flexion, and the body yawed in concert with stepping. Despite the linear and rotatory motions of the head and body, the head pointed along the forward motion of the body during straight walking. The head pitch/roll component appeared to compensate for vertical and horizontal acceleration of the head rather than orienting to the tilt of the GIA or anticipating it. When turning corners, subjects walked on a 50-cm radius over two steps or on a 200-cm radius in five to seven steps. Maximum centripetal accelerations in sharp turns were ca.0.4 g, which tilted the GIA ca.21 degrees with regard to the heading. This was anticipated by a roll tilt of the head of up to 8 degrees. The eyes rolled 1-1.5 degrees and moved down into the direction of linear acceleration during the tilts of the GIA. Yaw head deviations moved smoothly through the turn, anticipating the shift in lateral body trajectory by as much as 25 degrees. The trunk did not anticipate the change in trajectory. Thus, in contrast to straight walking, the tilt axes of the head and the GIA tended to align during turns. Gaze was stable in space during the slow phases and jumped forward in saccades along the trajectory, leading it by larger angles when the angular velocity of turning was greater

Case Report: 35-Year Follow-up for Nonvascularized Toe Phalangeal Transfer for Multiple Digit Symbrachydactyly.

PubMed

Naran, Sanjay; Imbriglia, Joseph E

2016-12-01

Background: A case is discussed in which a young girl was born with symbrachydactyly of multiple digits in whom nonvascularized proximal toe phalanges were transferred to the aphalangic digits at the age of four. At 39 years of age, she presented incidentally to our clinic and was observed to have a very functional hand with mobile metacarpophalangeal joints in all reconstructed digits. Methods: We present a case report which is discussed in the context of long-term follow-up, and phalangeal growth in the absence of distraction, and a review of the current literature in regards to outcomes for this modality of treatment. Results: We document growth of the transplanted phalanges, despite surgery occurring after the reported optimum age of before 18 months, and the patient not undergoing distraction. The patient reported no donor site morbidity in regards to function or psychosocial impact. Furthermore, we observed active function at the metacarpophalangeal joints of all operated digits. Conclusions: We report the longest follow-up (35 years) following nonvascularized proximal toe phalangeal transfer for short finger type symbrachydactyly. We highlight the long-term functional outcome of nonvascularized toe phalangeal transfers, and present an overview of the current outcome literature for this type of procedure, advocating that nonvascularized toe phalangeal transfers remain a viable treatment option for select cases of symbrachydactyly.

Natural history of idiopathic diabetes insipidus.

PubMed

Richards, Gail E; Thomsett, Michael J; Boston, Bruce A; DiMeglio, Linda A; Shulman, Dorothy I; Draznin, Martin

2011-10-01

To determine what percentage of diabetes insipidus (DI) in childhood is idiopathic and to assess the natural history of idiopathic DI. We conducted a retrospective chart review of 105 patients with DI who were born or had DI diagnosed between 1980-1989 at 3 medical centers. A second cohort of 30 patients from 6 medical centers in whom idiopathic DI was diagnosed after 1990 was evaluated retrospectively for subsequent etiologic diagnoses and additional hypothalamic/pituitary deficiencies and prospectively for quality of life. In the first cohort, 11% of patients had idiopathic DI. In the second cohort, additional hypothalamic/pituitary hormone deficiencies developed in 33%, and 37% received an etiologic diagnosis for DI. Health-related quality of life for all the patients with idiopathic DI was comparable with the healthy reference population. Only a small percentage of patients with DI will remain idiopathic after first examination. Other hormone deficiencies will develop later in one-third of those patients, and slightly more than one-third of those patients will have an etiology for the DI diagnosed. Long-term surveillance is important because tumors have been diagnosed as long as 21 years after the onset of DI. Quality of life for these patients is as good as the reference population. Copyright © 2011 Mosby, Inc. All rights reserved.

Fire-Walking

ERIC Educational Resources Information Center

Willey, David

2010-01-01

This article gives a brief history of fire-walking and then deals with the physics behind fire-walking. The author has performed approximately 50 fire-walks, took the data for the world's hottest fire-walk and was, at one time, a world record holder for the longest fire-walk (www.dwilley.com/HDATLTW/Record_Making_Firewalks.html). He currently…

Vitamin D deficiency in chronic idiopathic urticaria.

PubMed

Movahedi, Masoud; Tavakol, Marzieh; Hirbod-Mobarakeh, Armin; Gharagozlou, Mohammad; Aghamohammadi, Asghar; Tavakol, Zahra; Momenzadeh, Kaveh; Nabavi, Mohammad; Dabbaghzade, Abbas; Mosallanejad, Asieh; Rezaei, Nima

2015-04-01

Chronic urticaria is the most common skin diseases, characterized by chronic cutaneous lesions which severely debilitates patients in several aspects of their everyday life. Vitamin D is known to exert several actions in the immune system and to influence function and differentiation of mast cells, central role players in the pathogenesis of chronic idiopathic urticaria. This study was performed to evaluate the relationship between vitamin D levels and susceptibility to chronic idiopathic urticaria. One hundred and fourteen patients with chronic idiopathic urticaria were recruited in this study along with one hundred and eighty seven sex-matched and age-matched healthy volunteers as the control group. For each patient, urticaria activity score was calculated and autologous serum skin test was done. Vitamin D metabolic statue was measured in serum as 25 hydroxyvitamin D using enzyme immunoassay method. Patients with chronic idiopathic urticaria significantly showed lower levels of vitamin D. Vitamin D deficiency was significantly associated with increased susceptibility to chronic idiopathic urticaria. There was a significant positive correlation between vitamin D levels and urticaria activity score. This study showed that patients with chronic idiopathic urticaria had reduced levels of vitamin D, while vitamin D deficiency could increase susceptibility to chronic idiopathic urticaria.

Idiopathic ventricular tachycardia and fibrillation.

PubMed

Belhassen, B; Viskin, S

1993-06-01

Important data have recently been added to our understanding of sustained ventricular tachyarrhythmias occurring in the absence of demonstrable heart disease. Idiopathic ventricular tachycardia (VT) is usually of monomorphic configuration and can be classified according to its site of origin as either right monomorphic (70% of all idiopathic VTs) or left monomorphic VT. Several physiopathological types of monomorphic VT can be presently individualized, according to their mode of presentation, their relationship to adrenergic stress, or their response to various drugs. The long-term prognosis is usually good. Idiopathic polymorphic VT is a much rarer type of arrhythmia with a less favorable prognosis. Idiopathic ventricular fibrillation may represent an underestimated cause of sudden cardiac death in ostensibly healty patients. A high incidence of inducibility of sustained polymorphic VT with programmed ventricular stimulation has been found by our group, but not by others. Long-term prognosis on Class IA antiarrhythmic medications that are highly effective at electrophysiologic study appears excellent.

Measuring systolic ankle and toe pressure using the strain gauge technique--a comparison study between mercury and indium-gallium strain gauges.

PubMed

Broholm, Rikke; Wiinberg, Niels; Simonsen, Lene

2014-09-01

Measurement of the ankle and toe pressures are often performed using a plethysmograph, compression cuffs and a strain gauge. Usually, the strain gauge contains mercury but other alternatives exist. From 2014, the mercury-containing strain gauge will no longer be available in the European Union. The aim of this study was to compare an indium-gallium strain gauge to the established mercury-containing strain gauge. Consecutive patients referred to the Department of Clinical Physiology and Nuclear Medicine at Bispebjerg and Frederiksberg Hospitals for measurements of systolic ankle and toe pressures volunteered for the study. Ankle and toe pressures were measured twice with the mercury and the indium-gallium strain gauge in random order. Comparison of the correlation between the mean pressure using the mercury and the indium-gallium device and the difference between the two devices was performed for both toe and ankle level. A total of 53 patients were included (36 male). Mean age was 69 (range, 45-92 years). Mean pressures at toe and ankle level with the mercury and the indium-gallium strain gauges were 77 (range, 0-180) mm Hg and 113 (range, 15-190) mm Hg, respectively. Comparison between the mercury and the indium-gallium strain gauge showed a difference in toe blood pressure values of - 0.7 mm Hg (SD: 7.0). At the ankle level, a difference of 2.0 mm Hg (SD: 8.6) was found. The two different devices agree sufficiently in the measurements of systolic ankle and toe pressure for the indium-gallium strain gauge to replace the mercury strain gauge.

Relation between adolescent idiopathic scoliosis and morphologic somatotypes.

PubMed

LeBlanc, R; Labelle, H; Rivard, C H; Poitras, B

1997-11-01

A prospective and controlled comparative study. To verify the difference in morphologic appearance between a group of adolescents with progressive adolescent idiopathic scoliosis and a control group of normal adolescents. In a previous retrospective study, the possibility of a relation between progressive adolescent idiopathic scoliosis and specific morphotypes was demonstrated. Fifty-two adolescent girls with progressive adolescent idiopathic scoliosis were compared with an age-matched control group of 62 unaffected girls using a classification technique based on morphologic somatotypes. Morphotypes were evaluated with standardized pre-established criteria based on Sheldon's technique. Patients with progressive adolescent idiopathic scoliosis showed significantly less mesomorphism (mean value of 0.88 +/- 0.51) than control girls (mean value of 1.72 +/- 0.52). Adolescent girls with progressive adolescent idiopathic scoliosis have a morphologic somatotype that is different from the normal adolescent population. Subjects with progressive adolescent idiopathic scoliosis are significantly less mesomorphic than control girls. This observation may be of value as a predictive factor for early identification of subjects with adolescent idiopathic scoliosis at greater risk of progression.

Perspective: Update on Idiopathic Intracranial Hypertension

PubMed Central

Bruce, Beau B.; Biousse, Valérie; Newman, Nancy J.

2011-01-01

Purpose Provide an update on various features of idiopathic intracranial hypertension. Design Perspective. Methods Selected articles on the epidemiology, clinical and imaging features, natural history, pathophysiology, and treatment of idiopathic intracranial hypertension were reviewed and interpreted in the context of the authors’ clinical and research experience. Results Idiopathic intracranial hypertension is primarily a disease of obese women of childbearing age, but it can affect patients of any weight, sex, and age. Although a relatively rare disorder, idiopathic intracranial hypertension’s associated costs in the U.S. entail hundreds of millions of dollars. Even following treatment, headaches are frequently persistent and may require the continued involvement of a neurologist. Quality of life reductions and depression are common among idiopathic intracranial hypertension patients. However, visual dysfunction, especially visual field abnormalities, represents the major morbidity of this disorder, and serial automated perimetry remains the primary mode of patient monitoring. Patients who are men, black, very obese, or anemic are at higher risk of visual loss. Vitamin A metabolism, adipose tissue as an actively secreting endocrine tissue, and cerebral venous abnormalities are areas of active study regarding idiopathic intracranial hypertension’s pathophysiology. Treatment studies show that lumbar puncture is a valuable treatment (in addition to its crucial diagnostic role) and that weight management is critical. However, open questions remain regarding the efficacy of acetazolamide, CSF diversion procedures, and cerebral venous stenting. Conclusions Many questions remain unanswered about idiopathic intracranial hypertension. Ongoing studies, especially an ongoing NIH-funded clinical trial of acetazolamide, should provide more insight into this important, yet poorly understood syndrome of isolated intracranial hypertension. PMID:21696699

Fatigue and Muscle Strength Involving Walking Speed in Parkinson's Disease: Insights for Developing Rehabilitation Strategy for PD.

PubMed

Huang, Ying-Zu; Chang, Fang-Yu; Liu, Wei-Chia; Chuang, Yu-Fen; Chuang, Li-Ling; Chang, Ya-Ju

2017-01-01

Background . Problems with gait in Parkinson's disease (PD) are a challenge in neurorehabilitation, partly because the mechanisms causing the walking disability are unclear. Weakness and fatigue, which may significantly influence gait, are commonly reported by patients with PD. Hence, the aim of this study was to investigate the association between weakness and fatigue and walking ability in patients with PD. Methods . We recruited 25 patients with idiopathic PD and 25 age-matched healthy adults. The maximum voluntary contraction (MVC), twitch force, and voluntary activation levels were measured before and after a knee fatigue exercise. General fatigue, central fatigue, and peripheral fatigue were quantified by exercise-induced changes in MVC, twitch force, and activation level. In addition, subjective fatigue was measured using the Multidimensional Fatigue Inventory (MFI) and Fatigue Severity Scale (FSS). Results . The patients with PD had lower activation levels, more central fatigue, and more subjective fatigue than the healthy controls. There were no significant differences in twitch force or peripheral fatigue index between the two groups. The reduction in walking speed was related to the loss of peripheral strength and PD itself. Conclusion . Fatigue and weakness of central origin were related to PD, while peripheral strength was important for walking ability. The results suggest that rehabilitation programs for PD should focus on improving both central and peripheral components of force.

Effect of Toe Clips During Bicycle Ergometry on VO2 max.

ERIC Educational Resources Information Center

Moffat, Roger S.; Sparling, Phillip B.

1985-01-01

Eight men participated in three randomized maximal oxygen uptake tests to investigate the hypothesis that the use of toe clips on bicycle ergometers produced a higher VO2 max. No significant difference in mean VO2 max or performance time was observed. (Author/MT)

Walk Score(TM), Perceived Neighborhood Walkability, and walking in the US.

PubMed

Tuckel, Peter; Milczarski, William

2015-03-01

To investigate both the Walk Score(TM) and a self-reported measure of neighborhood walkability ("Perceived Neighborhood Walkability") as estimators of transport and recreational walking among Americans. The study is based upon a survey of a nationally-representative sample of 1224 American adults. The survey gauged walking for both transport and recreation and included a self-reported measure of neighborhood walkability and each respondent's Walk Score(TM). Binary logistic and linear regression analyses were performed on the data. The Walk Score(TM) is associated with walking for transport, but not recreational walking nor total walking. Perceived Neighborhood Walkability is associated with transport, recreational and total walking. Perceived Neighborhood Walkability captures the experiential nature of walking more than the Walk Score(TM).

Field Test: Results of Tandem Walk Performance Following Long-Duration Spaceflight

NASA Technical Reports Server (NTRS)

Rosenberg, M. J. F.; Reschke, M. F.; Cerisano, J. M.; Kofman, I. S.; Fisher, E. A.; Gadd, N. E.; May-Phillips, T. R.; Lee, S. M. C.; Laurie, S. S.; Stenger, M. B.;

Nonlinear finite element analysis of the plantar fascia due to the windlass mechanism.

PubMed

Cheng, Hsin-Yi Kathy; Lin, Chun-Li; Chou, Shih-Wei; Wang, Hsien-Wen

2008-08-01

Tightening of plantar fascia by passively dorsiflexing the toes during walking has functional importance. The purpose of this research was to evaluate the influence of big toe dorsiflexion angles upon plantar fascia tension (the windlass effect) with a nonlinear finite element approach. A two-dimensional finite element model of the first ray was constructed for biomechanical analysis. In order to imitate the windlass effect and to evaluate the mechanical responses of the plantar fascia under various conditions, 12 model simulations--three dorsiflexion angles of the big toe (45 degrees, 30 degrees, and 15 degrees), two plantar fascia properties (linear, nonlinear), and two weightbearing conditions (with body weight, without body weight)--were designed and analyzed. Our results demonstrated that nonlinear modeling of the plantar fascia provides a more sophisticated representation of experimental data than the linear one. Nonlinear plantar fascia setting also predicted a higher stress distribution along the fiber directions especially with larger toe dorsiflexion angles (45 degrees>30 degrees>15 degrees). The plantar fascia stress was found higher near the metatarsal insertion and faded as it moved toward the calcaneal insertion. Passively dorsiflexing the big toe imposes tension onto the plantar fascia. Windlass mechanism also occurs during stance phase of walking while the toes begin to dorsiflex. From a biomechanical standpoint, the plantar fascia tension may help propel the body upon its release at the point of push off. A controlled stretch via dorsiflexing the big toe may have a positive effect on treating plantar fasciitis by providing proper guidance for collagen regeneration. The windlass mechanism is also active during the stance phase of walking when the toes begin to dorsiflex.

The Natural History of Idiopathic Scoliosis During Growth: A Meta-Analysis.

PubMed

Di Felice, Francesca; Zaina, Fabio; Donzelli, Sabrina; Negrini, Stefano

2018-05-01

The aim of the study was to provide a meta-analysis of current literature concerning the natural history of idiopathic scoliosis during growth. A comprehensive search of Medline, Embase, And Scopus databases was conducted up to November 2016. Eligible works were prospective or retrospective studies that enrolled patients with infantile idiopathic scoliosis, juvenile idiopathic scoliosis, or adolescent idiopathic scoliosis, followed up without any treatment from the time of detection. A meta-analysis for proportion was performed. The following studies were grouped per diagnosis: infantile idiopathic scoliosis, juvenile idiopathic scoliosis, and adolescent idiopathic scoliosis. Of the 1797 citations screened, we assessed 61 full-text articles and included 13 of these (2301 participants). Three studies included infantile idiopathic scoliosis patients (347 participants), five studies included a mixed population of juvenile idiopathic scoliosis and adolescent idiopathic scoliosis (1330 participants), and five studies included adolescent idiopathic scoliosis patients only (624 participants). The random pooled estimated progression rate was 49% (95% confidence interval = 1%-97%) for infantile idiopathic scoliosis, 49% in a mixed group of patients affected by juvenile idiopathic scoliosis or adolescent idiopathic scoliosis (95% confidence interval = 19%-79%), and 42% in adolescent idiopathic scoliosis (95% confidence interval = 11%-73%). During growth, idiopathic scoliosis tends to progress in a high percentage of cases. The progression rate varies according to the age at diagnosis, with infantile scoliosis being the most unpredictable. There are many confounders, such as age, Risser sign and baseline Cobb angles that were not consistent among studies, making the data very heterogeneous.

Using Student-Produced Video to Validate Head-to-Toe Assessment Performance.

PubMed

Purpora, Christina; Prion, Susan

2018-03-01

This study explored third-semester baccalaureate nursing students' perceptions of the value of using student-produced video as an approach for learning head-to-toe assessment, an essential clinical nursing skill taught in the classroom. A cognitive apprenticeship model guided the study. The researchers developed a 34-item survey. A convenience sample of 72 students enrolled in an applied assessment and nursing fundamentals course at a university in the western United States provided the data. Most students reported a videotaping process that worked, supportive faculty, valuable faculty review of their work, confidence, a sense of performance independence, the ability to identify normal assessment findings, and few barriers to learning. The results suggested that a student-produced video approach to learning head-to-toe assessment was effective. Further, the study demonstrated how to leverage available instructional technology to provide meaningful, personalized instruction and feedback to students about an essential nursing skill. [J Nurs Educ. 2018;57(3):154-158.]. Copyright 2018, SLACK Incorporated.

[Non vascularized toe phalangeal transfers for symbrachydactyly. Active range of motion without joint reconstruction].

PubMed

Leca, J-B; Auquit Auckbur, I; Bachy, B; Milliez, P-Y

2008-12-01

Symbrachydactyly is a rare congenital malformation of the hand and its treatment is controversial. Non vascularized toe phalangeal transfers have been used for management of short digits for three children. Six phalanges have been harvested complete with their periosteum. No joint reconstruction has been performed and all children have undergone surgery at a young age. Four of six digits involved have an active range of motion (range 30 to 105 degrees ). All authors who have reported active range of motion of toe phalangeal transfers have performed joint reconstruction. Here, we report obtaining active range of motion of phalangeal transfers without necessity of joint reconstruction.

[Fingers, toes and thumbs, correct digital nomenclature based on early Hebrew texts].

PubMed

Leibner, Efraim D; London, Eli; Elishoov, Ofer

2005-08-01

There is some dissonance as to the correct Hebrew terms for the digits of the extremities. Terms in common use include 'Etzba, 'Bohen' and 'Agudal'. While most agree that 'Etzba' in the singular represents the index finger, there is debate about the plural (Etzba'ot), whether it represents 'fingers' (upper extremity only) or 'digits' (upper and lower). The meaning of 'Bohen' is disputed as well, with proponents existing for it to represent: 'Toe', 'Big Toe' or 'Big Digit'. 'Agudal' is in the same predicament, with uses as 'Thumb' or 'Big Digit'. We undertook a computerized search of the Bible for these words and their derivatives in order to establish their correct use. The term 'Etzba' and its derivatives appeared numerous times in the scriptures both in singular and in plural. 'Bohen' appeared somewhat less, however, all appearances were in conjunction, viz" 'Bohen' of the hand" or " 'Bohen' of the foot". 'Agudal' was not found in our computerized search. According to the early Hebrew texts 'Etzba' in singular usually represents the index finger. However, the plural form 'Etzba'ot', corresponds to the term 'digits' and may be used both for fingers and toes. 'Bohen' is a term representing the large digit of all extremities, i.e. both 'Thumb' and 'Hallux'. Likewise, the term 'Agudal', while not appearing in the scriptures, appears in later contexts in early Hebrew texts, and also represents both the thumb and the hallux.

Customizing Extensor Reconstruction in Vascularized Toe Joint Transfers to Finger Proximal Interphalangeal Joints: A Strategic Approach for Correcting Extensor Lag.

PubMed

Loh, Charles Yuen Yung; Hsu, Chung-Chen; Lin, Cheng-Hung; Chen, Shih-Heng; Lien, Shwu-Huei; Lin, Chih-Hung; Wei, Fu-Chan; Lin, Yu-Te

2017-04-01

Vascularized toe proximal interphalangeal joint transfer allows the restoration of damaged joints. However, extensor lag and poor arc of motion have been reported. The authors present their outcomes of treatment according to a novel reconstructive algorithm that addresses extensor lag and allows for consistent results postoperatively. Vascularized toe joint transfers were performed in a consecutive series of 26 digits in 25 patients. The average age was 30.5 years, with 14 right and 12 left hands. Reconstructed digits included eight index, 10 middle, and eight ring fingers. Simultaneous extensor reconstructions were performed and eight were centralization of lateral bands, five were direct extensor digitorum longus-to-extensor digitorum communis repairs, and 13 were central slip reconstructions. The average length of follow-up was 16.7 months. The average extension lag was 17.9 degrees. The arc of motion was 57.7 degrees (81.7 percent functional use of pretransfer toe proximal interphalangeal joint arc of motion). There was no significant difference in the reconstructed proximal interphalangeal joint arc of motion for the handedness (p = 0.23), recipient digits (p = 0.37), or surgical experience in vascularized toe joint transfer (p = 0.25). The outcomes of different techniques of extensor mechanism reconstruction were similar in terms of extensor lag, arc of motion, and reconstructed finger arc of motion compared with the pretransfer toe proximal interphalangeal joint arc of motion. With this treatment algorithm, consistent outcomes can be produced with minimal extensor lag and maximum use of potential toe proximal interphalangeal joint arc of motion. Therapeutic, IV.

Who walks? Factors associated with walking behavior in disabled older women with and without self-reported walking difficulty.

PubMed

Simonsick, E M; Guralnik, J M; Fried, L P

1999-06-01

To determine how severity of walking difficulty and sociodemographic, psychosocial, and health-related factors influence walking behavior in disabled older women. Cross-sectional analyses of baseline data from the Women's Health and Aging Study (WHAS). An urban community encompassing 12 contiguous zip code areas in the eastern portion of Baltimore City and part of Baltimore County, Maryland. A total of 920 moderately to severely disabled community-resident women, aged 65 years and older, identified from an age-stratified random sample of Medicare beneficiaries. Walking behavior was defined as minutes walked for exercise and total blocks walked per week. Independent variables included self-reported walking difficulty, sociodemographic factors, psychological status (depression, mastery, anxiety, and cognition), and health-related factors (falls and fear of falling, fatigue, vision and balance problems, weight, smoking, and cane use). Walking at least 8 blocks per week was strongly negatively related to severity of walking difficulty. Independent of difficulty level, older age, black race, fatigue, obesity, and cane use were also negatively associated with walking; living alone and high mastery had a positive association with walking. Even among functionally limited women, sociocultural, psychological, and health-related factors were independently associated with walking behavior. Thus, programs aimed at improving walking ability need to address these factors in addition to walking difficulties to maximize participation and compliance.

Idiopathic Hypersomnia: A Study of 77 Cases

PubMed Central

Anderson, Kirstie N.; Pilsworth, Samantha; Sharples, Linda D.; Smith, Ian E.; Shneerson, John M.

2007-01-01

Study Objectives: To review the clinical and polysomnographic characteristics of idiopathic hypersomnia as well as the long-term response to treatment. Setting: The Respiratory Support and Sleep Centre at Papworth Hospital, Cambridge, UK. Patients and Design: A large database of more than 6000 patients with sleep disorders was reviewed. A retrospective study of the clinical and polysomnographic characteristics of 77 patients with idiopathic hypersomnia was performed. Comparison with a similar group of patients with narcolepsy was performed. The response to drug treatment was assessed in 61 patients over a mean follow-up of 3.8 years. Measurements and Results: Idiopathic hypersomnia was 60% as prevalent as narcolepsy. Comparison with a similar group of patients with narcolepsy showed that those with idiopathic hypersomnia were more likely to have prolonged unrefreshing daytime naps, a positive family history, increased slow-wave sleep, and a longer sleep latency on the Multiple Sleep Latency Test. The results of the Multiple Sleep Latency Test were not helpful in predicting disease severity or treatment response. The clinical features were heterogeneous and of variable severity. The majority of patients with idiopathic hypersomnia had symptoms that remained stable over many years, but 11% had spontaneous remission, which was never seen in narcolepsy. Two thirds of patients with idiopathic hypersomnolence had a sustained improvement in daytime somnolence with medication, although a third needed high doses or combinations of drugs. Conclusions: Idiopathic hypersomnolence has characteristic clinical and polysomnographic features but the prolonged latency on the Multiple Sleep Latency Test raises doubt about the validity of this test within the current diagnostic criteria. The disease often responds well to treatment and a substantial minority of patients appear to spontaneously improve. Citation: Anderson KN; Pilsworth S; Sharples LD; Smith IE; Shneerson JM. Idiopathic

Physical Therapy for a Child With Infantile Idiopathic Scoliosis and Motor Delay.

PubMed

Hall, Rhea K; Rapport, Mary Jane

2017-07-01

The purpose of this case report is to describe physical therapy (PT) for a child with infantile idiopathic scoliosis and motor delay. A 10-month-old boy with a 28° left thoracolumbar scoliosis was referred for PT and was seen weekly in his home over a 6-month period following a diagnosis of scoliosis and delayed gross motor milestones. Before the initiation of PT, the child was scheduled to undergo serial casting for correction of the spinal curve and was not yet rolling or transitioning in or out of sitting. By the end of the 6-month intervention period, the spinal curve had resolved to 12° without the need for serial casting and the child was walking independently. PT appeared to have a positive effect on reduction of the spinal curve and achievement of gross motor milestones.

An uncommon presentation of non-small-cell lung cancer with acrometastases to the great toe and index finger.

PubMed

Reynolds, Jamie; Skandan, Savitri P

2016-03-01

Acrometastasis as initial presentation of metastatic cancer is an extremely rare finding. We describe an unusual case of late-stage non-small-cell lung cancer with metastatic lesions to the great toe and index fnger with associated pain in those areas as the only presenting symptom. A 71-year-old white woman was referred to the emergency department by her primary care physician for necrosis and swelling of the left great toe for work-up of possible osteomyelitis (Figure 1). Before she presented to her physician, she had been complaining of severe pain, swelling, and erythema of the left great toe that had lasted for 1-2 months. Infection was initially suspected. She completed 2 courses of oral antibiotics with no improvement. She was also complaining of similar symptoms on the left index finger and attributed her symptoms to an injury a month earlier (Figure 2). The pain was so severe that she was not able to bear weight on her left foot. An outpatient X-ray of her left great toe raised her physician's concerns that it might be osteomyelitis so she was referred to the emergency department. ©2016 Frontline Medical Communications.

Aetiology of idiopathic granulomatous mastitis.

PubMed

Altintoprak, Fatih; Kivilcim, Taner; Ozkan, Orhan Veli

2014-12-16

Idiopathic granulomatous mastitis is a rare chronic inflammatory lesion of the breast that can clinically and radiographically mimic breast carcinoma. The most common clinical presentation is an unilateral, discrete breast mass, nipple retraction and even a sinus formation often associated with an inflammation of the overlying skin. The etiology of idiopathic granulomatous mastitis is still obscure. Its treatment remains controversial. The cause may be the autoimmune process, infection, a chemical reaction associated with oral contraceptive pills, or even lactation. Various factors, including hormonal imbalance, autoimmunity, unknown microbiological agents, smoking and α 1-antitrypsin deficiency have been suggested to play a role in disease aetiology. In this review, causing factors in the aetiology of idiopathic granulomatous mastitis are reviewed in detail.

Aetiology of idiopathic granulomatous mastitis

PubMed Central

Altintoprak, Fatih; Kivilcim, Taner; Ozkan, Orhan Veli

2014-01-01

Idiopathic granulomatous mastitis is a rare chronic inflammatory lesion of the breast that can clinically and radiographically mimic breast carcinoma. The most common clinical presentation is an unilateral, discrete breast mass, nipple retraction and even a sinus formation often associated with an inflammation of the overlying skin. The etiology of idiopathic granulomatous mastitis is still obscure. Its treatment remains controversial. The cause may be the autoimmune process, infection, a chemical reaction associated with oral contraceptive pills, or even lactation. Various factors, including hormonal imbalance, autoimmunity, unknown microbiological agents, smoking and α 1-antitrypsin deficiency have been suggested to play a role in disease aetiology. In this review, causing factors in the aetiology of idiopathic granulomatous mastitis are reviewed in detail. PMID:25516860

Gradual digital lengthening with autologous bone graft and external fixation for correction of flail toe in a patient with Raynaud's disease.

PubMed

Lamm, Bradley M; Ades, Joe K

2009-01-01

Iatrogenic flail toe is a complication of hammertoe surgery that occurs when an overaggressive resection of the proximal phalanx occurs. This can cause both functional and cosmetic concerns for the patient. We present a case report of the correction of a flail second toe in a patient with Raynaud's disease. The correction was achieved by means of gradual soft tissue lengthening with external fixation and an interposition autologous bone graft digital arthrodesis. After 5 months, this 2-stage procedure lengthened, stabilized, and restored the function of the toe. 4.

Relationship between early motor milestones and severity of restricted and repetitive behaviors in children and adolescents with autism spectrum disorder.

PubMed

Uljarević, Mirko; Hedley, Darren; Alvares, Gail A; Varcin, Kandice J; Whitehouse, Andrew J O

2017-06-01

This study explored the relationships between the later age of achievement of early motor milestones, current motor atypicalities (toe walking), and the severity of restricted and repetitive behaviors (RRBs) in individuals with autism spectrum disorder (ASD). Parents of 147 children and adolescents with ASD (M age  = 8.09 years, SD = 4.28; 119 males) completed an early developmental milestones questionnaire and the Social Responsiveness Scale as a measure of Insistence on Sameness (IS) and Repetitive Mannerisms (RM). Two hierarchical regression analyses were conducted to test whether RM and IS behaviors were predicted by early motor milestones, or current toe walking. The final model predicting RM accounted for 15% of the variance (F = 3.02, p = .009), with toe walking as a unique and independent predictor of RM scores (t = 3.568, p = .001). The final model predicting IS accounted for 19.1% of variance in IS scores (F = 4.045, p = .001), with chronological age (CA) (t = 2.92, p = .004), age when first standing (t = 2.09, p = .038), and toe walking (t = 2.53, p = .013) as unique independent predictors. Toe walking (t = 2.4, p = .018) and age when first sitting (t = 2.08, p = .04) predicted the severity of RRBs on the Autism Diagnostic Observation Schedule (F = 2.334, p = .036). Our study replicates previous findings on the relationship between concurrent motor impairments and RRBs, and provides the first evidence for the association between RRBs and age of attainment of early motor milestones. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1163-1168. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Walking Perception by Walking Observers

ERIC Educational Resources Information Center

Jacobs, Alissa; Shiffrar, Maggie

2005-01-01

People frequently analyze the actions of other people for the purpose of action coordination. To understand whether such self-relative action perception differs from other-relative action perception, the authors had observers either compare their own walking speed with that of a point-light walker or compare the walking speeds of 2 point-light…

Walk Score®

PubMed Central

Brown, Scott C.; Pantin, Hilda; Lombard, Joanna; Toro, Matthew; Huang, Shi; Plater-Zyberk, Elizabeth; Perrino, Tatiana; Perez-Gomez, Gianna; Barrera-Allen, Lloyd; Szapocznik, José

2013-01-01

Background Walk Score® is a nationally and publicly available metric of neighborhood walkability based on proximity to amenities (e.g., retail, food, schools). However, few studies have examined the relationship of Walk Score to walking behavior. Purpose To examine the relationship of Walk Score to walking behavior in a sample of recent Cuban immigrants, who overwhelmingly report little choice in their selection of neighborhood built environments when they arrive in the U.S. Methods Participants were 391 recent healthy Cuban immigrants (M age=37.1 years) recruited within 90 days of arrival in the U.S., and assessed within 4 months of arrival (M=41.0 days in the U.S.), who resided throughout Miami-Dade County FL. Data on participants’ addresses, walking and sociodemographics were collected prospectively from 2008 to 2010. Analyses conducted in 2011 examined the relationship of Walk Score for each participant’s residential address in the U.S. to purposive walking, controlling for age, gender, education, BMI, days in the U.S., and habitual physical activity level in Cuba. Results For each 10-point increase in Walk Score, adjusting for covariates, there was a significant 19% increase in the likelihood of purposive walking, a 26% increase in the likelihood of meeting physical activity recommendations by walking, and 27% more minutes walked in the previous week. Conclusions Results suggest that Walk Score is associated with walking in a sample of recent immigrants who initially had little choice in where they lived in the U.S. These results support existing guidelines indicating that mixed land use (such as parks and restaurants near homes) should be included when designing walkable communities. PMID:23867028

Impaired diversity of the lung microbiome predicts progression of idiopathic pulmonary fibrosis.

PubMed

Takahashi, Youhei; Saito, Atsushi; Chiba, Hirofumi; Kuronuma, Koji; Ikeda, Kimiyuki; Kobayashi, Tomofumi; Ariki, Shigeru; Takahashi, Motoko; Sasaki, Yasushi; Takahashi, Hiroki

2018-02-27

Idiopathic pulmonary fibrosis (IPF) is the most frequent and severe form of idiopathic interstitial pneumonias. Although IPF has not been thought to be associated with bacterial communities, recent papers reported the possible role of microbiome composition in IPF. The roles of microbiomes in respiratory functions and as clinical biomarkers for IPF remain unknown. In this study, we aim to identify the relationship between the microbial environment in the lung and clinical findings. Thirty-four subjects diagnosed with IPF were included in this analysis. The 16S rDNA was purified from bronchoalveolar lavage fluid obtained at the time of diagnosis and analyzed using next-generation sequencing techniques to characterize the bacterial communities. Furthermore, microbiomes from mice with bleomycin-induced lung fibrosis were analyzed. The most prevalent lung phyla were Firmicutes, Proteobacteria and Bacteroidetes. Decreased microbial diversity was found in patients with low forced vital capacity (FVC) and early mortality. Additionally, the diversity and relative abundance of Firmicutes, Streptococcaceae, and Veillonellaceae were significantly associated with FVC, 6-min walk distance, and serum surfactant protein D. Bleomycin-induced lung fibrosis resulted in decrease of diversity and alteration of microbiota in PCoA analysis. These results support the observations in human specimens. This study identified relationships between specific taxa in BALF and clinical findings, which were also supported by experiments in a mouse model. Our data suggest the possibility that loss of microbial diversity is associated with disease activities of IPF.

Shared and task-specific muscle synergies of Nordic walking and conventional walking.

PubMed

Boccia, G; Zoppirolli, C; Bortolan, L; Schena, F; Pellegrini, B

2018-03-01

Nordic walking is a form of walking that includes a poling action, and therefore an additional subtask, with respect to conventional walking. The aim of this study was to assess whether Nordic walking required a task-specific muscle coordination with respect to conventional walking. We compared the electromyographic (EMG) activity of 15 upper- and lower-limb muscles of 9 Nordic walking instructors, while executing Nordic walking and conventional walking at 1.3 ms -1 on a treadmill. Non-negative matrix factorization method was applied to identify muscle synergies, representing the spatial and temporal organization of muscle coordination. The number of muscle synergies was not different between Nordic walking (5.2 ± 0.4) and conventional walking (5.0 ± 0.7, P = .423). Five muscle synergies accounted for 91.2 ± 1.1% and 92.9 ± 1.2% of total EMG variance in Nordic walking and conventional walking, respectively. Similarity and cross-reconstruction analyses showed that 4 muscle synergies, mainly involving lower-limb and trunk muscles, are shared between Nordic walking and conventional walking. One synergy acting during upper limb propulsion is specific to Nordic walking, modifying the spatial organization and the magnitude of activation of upper limb muscles compared to conventional walking. The inclusion of the poling action in Nordic walking does not increase the complexity of movement control and does not change the coordination of lower limb muscles. This makes Nordic walking a physical activity suitable also for people with low motor skill. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Acute Idiopathic Scrotal Edema: Systematic Literature Review.

PubMed

Santi, Maristella; Lava, Sebastiano A G; Simonetti, Giacomo D; Bianchetti, Mario G; Milani, Gregorio P

2018-06-01

 Existing information on acute idiopathic scrotal edema relies on small case series and textbooks.  We searched reports with no date limits on acute idiopathic scrotal edema.  Thirty-seven studies were included. Sixteen case series addressed the prevalence of acute idiopathic scrotal edema among males with acute scrotum: among 3,403 cases, the diagnosis of acute idiopathic scrotal edema was made in 413 cases (12%). Twenty-four reports addressed history, findings, management, and course of acute idiopathic scrotal edema in 311 patients. The patients mostly ranged in age from 5 to 8 years, presented with acute scrotal redness and swelling, associated or not with mild pain. Ninety percent or more of the cases developed in patients without atopic diathesis and were not preceded by inguinoscrotal surgery, acute febrile illnesses, or trauma. They were afebrile; in good general condition; and presented without pruritus, nausea or vomiting, or abdominal pain. The lesions were bilateral in two-thirds and unilateral in one-third of the cases. The condition resolved spontaneously within 2 to 3 days without sequelae. Approximately 10% of the cases experienced a recurrence.  Acute idiopathic scrotal edema is a self-limiting condition that accounts for ≥ 10% of cases of acute scrotum in children and adolescents. Georg Thieme Verlag KG Stuttgart · New York.

Quantum Ultra-Walks: Walks on a Line with Spatial Disorder

NASA Astrophysics Data System (ADS)

Boettcher, Stefan; Falkner, Stefan

We discuss the model of a heterogeneous discrete-time walk on a line with spatial disorder in the form of a set of ultrametric barriers. Simulations show that such an quantum ultra-walk spreads with a walk exponent dw that ranges from ballistic (dw = 1) to complete confinement (dw = ∞) for increasing separation 1 <= 1 / ɛ < ∞ in barrier heights. We develop a formalism by which the classical random walk as well as the quantum walk can be treated in parallel using a coined walk with internal degrees of freedom. For the random walk, this amounts to a 2nd -order Markov process with a stochastic coin, better know as an (anti-)persistent walk. The exact analysis, based on the real-space renormalization group (RG), reproduces the results of the well-known model of ``ultradiffusion,'' dw = 1 -log2 ɛ for 0 < ɛ <= 1 / 2 . However, while the evaluation of the RG fixed-points proceeds virtually identical, for the corresponding quantum walk with a unitary coin it fails to reproduce the numerical results. A new way to analyze the RG is indicated. Supported by NSF-DMR 1207431.

Timing of intermittent torque control with wire-driven gait training robot lifting toe trajectory for trip avoidance.

PubMed

Miyake, Tamon; Kobayashi, Yo; Fujie, Masakatsu G; Sugano, Shigeki

2017-07-01

Gait training robots are useful for changing gait patterns and decreasing risk of trip. Previous research has reported that decreasing duration of the assistance or guidance of the robot is beneficial for efficient gait training. Although robotic intermittent control method for assisting joint motion has been established, the effect of the robot intervention timing on change of toe clearance is unclear. In this paper, we tested different timings of applying torque to the knee, employing the intermittent control of a gait training robot to increase toe clearance throughout the swing phase. We focused on knee flexion motion and designed a gait training robot that can apply flexion torque to the knee with a wire-driven system. We used a method of timing detecting for the robot conducting torque control based on information from the hip, knee, and ankle angles to establish a non-time dependent parameter that can be used to adapt to gait change, such as gait speed. We carried out an experiment in which the conditions were four time points: starting the swing phase, lifting the foot, maintaining knee flexion, and finishing knee flexion. The results show that applying flexion torque to the knee at the time point when people start lifting their toe is effective for increasing toe clearance in the whole swing phase.

Idiopathic hypersomnia: a study of 77 cases.

PubMed

Anderson, Kirstie N; Pilsworth, Samantha; Sharples, Linda D; Smith, Ian E; Shneerson, John M

2007-10-01

To review the clinical and polysomnographic characteristics of idiopathic hypersomnia as well as the long-term response to treatment. The Respiratory Support and Sleep Centre at Papworth Hospital, Cambridge, UK. A large database of more than 6000 patients with sleep disorders was reviewed. A retrospective study of the clinical and polysomnographic characteristics of 77 patients with idiopathic hypersomnia was performed. Comparison with a similar group of patients with narcolepsy was performed. The response to drug treatment was assessed in 61 patients over a mean follow-up of 3.8 years. Idiopathic hypersomnia was 60% as prevalent as narcolepsy. Comparison with a similar group of patients with narcolepsy showed that those with idiopathic hypersomnia were more likely to have prolonged unrefreshing daytime naps, a positive family history, increased slow-wave sleep, and a longer sleep latency on the Multiple Sleep Latency Test. The results of the Multiple Sleep Latency Test were not helpful in predicting disease severity or treatment response. The clinical features were heterogeneous and of variable severity. The majority of patients with idiopathic hypersomnia had symptoms that remained stable over many years, but 11% had spontaneous remission, which was never seen in narcolepsy. Two thirds of patients with idiopathic hypersomnolence had a sustained improvement in daytime somnolence with medication, although a third needed high doses or combinations of drugs. Idiopathic hypersomnolence has characteristic clinical and polysomnographic features but the prolonged latency on the Multiple Sleep Latency Test raises doubt about the validity of this test within the current diagnostic criteria. The disease often responds well to treatment and a substantial minority of patients appear to spontaneously improve.

Rare case of Isolated Aspergillus Osteomyelitis of Toe: Presentation and Management

PubMed Central

Pattanashetty, O.B.; B.B., Dayanand; Bhavi, Shushrut B; Bami, Monish

2013-01-01

Introduction: Fungal osteomyelitis is an uncommon diseases and generally present in an indolent fashion. Isolated bone affection due to fungi are rare and we present one such case with fungal osteomyelitis of terminal phalanx of second toe. Case Report: We present a rare case of fungal osteomyelitis of right second toe in a 30 year old Indian female who presented with swelling of 8 months duration. Diagnosis was based on the histo-pathological report and culture showing Aspergillus growth. The patient was treated with surgical debridement and amphotericin-B was given for 6 weeks after debridement. There was no recurrence one year post surgery. Conclusion: Isolated Aspergillus osteomyelitis of the bone are very rare and mostly seen in immunocompromised patients and larger bones like spine, femur and tibia. Treatment with wound debridement and subsequently followed up with a course of Amphotericin-B for 6 weeks provided good results. There was no recurrence noted at 1 year follow up. Fungi should be kept in mind for differential diagnosis of osteomyelitis and culture should be appropriately ordered. PMID:27298903

Rare case of Isolated Aspergillus Osteomyelitis of Toe: Presentation and Management.

PubMed

Pattanashetty, O B; B B, Dayanand; Bhavi, Shushrut B; Bami, Monish

2013-01-01

Fungal osteomyelitis is an uncommon diseases and generally present in an indolent fashion. Isolated bone affection due to fungi are rare and we present one such case with fungal osteomyelitis of terminal phalanx of second toe. We present a rare case of fungal osteomyelitis of right second toe in a 30 year old Indian female who presented with swelling of 8 months duration. Diagnosis was based on the histo-pathological report and culture showing Aspergillus growth. The patient was treated with surgical debridement and amphotericin-B was given for 6 weeks after debridement. There was no recurrence one year post surgery. Isolated Aspergillus osteomyelitis of the bone are very rare and mostly seen in immunocompromised patients and larger bones like spine, femur and tibia. Treatment with wound debridement and subsequently followed up with a course of Amphotericin-B for 6 weeks provided good results. There was no recurrence noted at 1 year follow up. Fungi should be kept in mind for differential diagnosis of osteomyelitis and culture should be appropriately ordered.

Implications of low great toe pressures in clinical practice.

PubMed

Varatharajan, Nandanan; Pillay, Sugendran; Hitos, Kerry; Fletcher, John P

2006-04-01

The aim of this study was to observe the outcome of patients with a great toe pressure (GTP) reading of less than 40 mmHg. Between 2002 and 2004, of 4,714 patients assessed in the Westmead Vascular Laboratory, 365 (7.7%) had GTP measurements for assessment of possible critical limb ischaemia. There were 56 limbs in 40 patients with a GTP measurement of less than 40 mmHg, and this group was studied to assess outcome factors of death, requirement for major or minor amputation, arterial reconstructive surgery, clinical stability, or documented improvement from the initial assessment. Patients requiring a major amputation had an average GTP of 13 mmHg and a toe brachial index (TBI) of 0.08, whereas those not undergoing a major amputation had an average GTP of 23.6 mmHg and TBI of 0.15. This association was weaker when an initial single evaluation was used as opposed to two or more serial assessments. Patients with and without a major amputation had an average ankle brachial index of 0.16 and 0.53, respectively. Diabetes mellitus requiring insulin and cerebrovascular disease were risk factors for major amputations. Low GTP was associated with a greater risk of major amputations. Two or more serial assessments were found to be of greater value than an initial single assessment.

[Idiopathic facial paralysis in children].

PubMed

Achour, I; Chakroun, A; Ayedi, S; Ben Rhaiem, Z; Mnejja, M; Charfeddine, I; Hammami, B; Ghorbel, A

2015-05-01

Idiopathic facial palsy is the most common cause of facial nerve palsy in children. Controversy exists regarding treatment options. The objectives of this study were to review the epidemiological and clinical characteristics as well as the outcome of idiopathic facial palsy in children to suggest appropriate treatment. A retrospective study was conducted on children with a diagnosis of idiopathic facial palsy from 2007 to 2012. A total of 37 cases (13 males, 24 females) with a mean age of 13.9 years were included in this analysis. The mean duration between onset of Bell's palsy and consultation was 3 days. Of these patients, 78.3% had moderately severe (grade IV) or severe paralysis (grade V on the House and Brackmann grading). Twenty-seven patients were treated in an outpatient context, three patients were hospitalized, and seven patients were treated as outpatients and subsequently hospitalized. All patients received corticosteroids. Eight of them also received antiviral treatment. The complete recovery rate was 94.6% (35/37). The duration of complete recovery was 7.4 weeks. Children with idiopathic facial palsy have a very good prognosis. The complete recovery rate exceeds 90%. However, controversy exists regarding treatment options. High-quality studies have been conducted on adult populations. Medical treatment based on corticosteroids alone or combined with antiviral treatment is certainly effective in improving facial function outcomes in adults. In children, the recommendation for prescription of steroids and antiviral drugs based on adult treatment appears to be justified. Randomized controlled trials in the pediatric population are recommended to define a strategy for management of idiopathic facial paralysis. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

[Necrosis in fingers and toes following local anaesthesia with adrenaline--an urban legend?].

PubMed

Finsen, Vilhjalmur

2013-09-17

It is often maintained that a local anaesthetic (usually lidocaine) with adrenaline must not be used in fingers and toes because it may cause necrosis due to vascular spasm in end arteries. This review article is an attempt to find evidence to support this warning. Relevant literature was found by means of searches in PubMed limited downwards to 1946 and in EMBASE from 1980 to 2012, and in reference lists. Five review articles on finger necrosis following local anaesthesia concluded that lidocaine with adrenaline does not entail a risk of ischaemic injury. One article found 48 reported cases of finger necrosis in the period 1880 to 2000. Most were from the first half of the 1900s, and none involved lidocaine. Gangrene of part of the finger tip has subsequently been described in one patient with Raynaud's syndrome. No cases of necrosis have been described in a large number of reported accidents in which EpiPen injections contained the same quantity of adrenaline as is found in 60 ml lidocaine with adrenaline. Over a quarter of a million reports have been made of operations on feet, hands, fingers and toes anaesthetised with lidocaine with adrenaline without resulting necrosis. There are no grounds for the warning against using lidocaine with adrenaline in fingers and toes. This anaesthetic offers considerable practical advantages. Care should be taken with infected fingers or fingers with poor circulation.

Friction in Total Hip Joint Prosthesis Measured In Vivo during Walking

PubMed Central

Damm, Philipp; Dymke, Joern; Ackermann, Robert; Bender, Alwina; Graichen, Friedmar; Halder, Andreas; Beier, Alexander; Bergmann, Georg

2013-01-01

Friction-induced moments and subsequent cup loosening can be the reason for total hip joint replacement failure. The aim of this study was to measure the in vivo contact forces and friction moments during walking. Instrumented hip implants with Al2O3 ceramic head and an XPE inlay were used. In vivo measurements were taken 3 months post operatively in 8 subjects. The coefficient of friction was calculated in 3D throughout the whole gait cycle, and average values of the friction-induced power dissipation in the joint were determined. On average, peak contact forces of 248% of the bodyweight and peak friction moments of 0.26% bodyweight times meter were determined. However, contact forces and friction moments varied greatly between individuals. The friction moment increased during the extension phase of the joint. The average coefficient of friction also increased during this period, from 0.04 (0.03 to 0.06) at contralateral toe off to 0.06 (0.04 to 0.08) at contralateral heel strike. During the flexion phase, the coefficient of friction increased further to 0.14 (0.09 to 0.23) at toe off. The average friction-induced power throughout the whole gait cycle was 2.3 W (1.4 W to 3.8 W). Although more parameters than only the synovia determine the friction, the wide ranges of friction coefficients and power dissipation indicate that the lubricating properties of synovia are individually very different. However, such differences may also exist in natural joints and may influence the progression of arthrosis. Furthermore, subjects with very high power dissipation may be at risk of thermally induced implant loosening. The large increase of the friction coefficient during each step could be caused by the synovia being squeezed out under load. PMID:24260114

Friction in total hip joint prosthesis measured in vivo during walking.

PubMed

Damm, Philipp; Dymke, Joern; Ackermann, Robert; Bender, Alwina; Graichen, Friedmar; Halder, Andreas; Beier, Alexander; Bergmann, Georg

2013-01-01

Friction-induced moments and subsequent cup loosening can be the reason for total hip joint replacement failure. The aim of this study was to measure the in vivo contact forces and friction moments during walking. Instrumented hip implants with Al2O3 ceramic head and an XPE inlay were used. In vivo measurements were taken 3 months post operatively in 8 subjects. The coefficient of friction was calculated in 3D throughout the whole gait cycle, and average values of the friction-induced power dissipation in the joint were determined. On average, peak contact forces of 248% of the bodyweight and peak friction moments of 0.26% bodyweight times meter were determined. However, contact forces and friction moments varied greatly between individuals. The friction moment increased during the extension phase of the joint. The average coefficient of friction also increased during this period, from 0.04 (0.03 to 0.06) at contralateral toe off to 0.06 (0.04 to 0.08) at contralateral heel strike. During the flexion phase, the coefficient of friction increased further to 0.14 (0.09 to 0.23) at toe off. The average friction-induced power throughout the whole gait cycle was 2.3 W (1.4 W to 3.8 W). Although more parameters than only the synovia determine the friction, the wide ranges of friction coefficients and power dissipation indicate that the lubricating properties of synovia are individually very different. However, such differences may also exist in natural joints and may influence the progression of arthrosis. Furthermore, subjects with very high power dissipation may be at risk of thermally induced implant loosening. The large increase of the friction coefficient during each step could be caused by the synovia being squeezed out under load.

Ankle-Brachial Index, Toe-Brachial Index, and Pulse Volume Recording in Healthy Young Adults

PubMed Central

Masaki, Hisao; Yunoki, Yasuhiro; Tabuchi, Atushi; Morita, Ichiro; Mohri, Satoshi; Tanemoto, Kazuo

2015-01-01

Objective: To clarify the characteristics of ankle-brachial index (ABI), toe-brachial index (TBI), and pulse volume recording (PVR) of the ankle with brachial-ankle pulse wave velocity (baPWV) in healthy young adults. Material and Methods: We analyzed ABI, TBI, baPWV, and PVR in the ankle of healthy adults aged 20 to 25 years (median, 20 years) using an automatic oscillometric device between 2002 and 2013. The ABI, baPWV, and PVR in 1282 legs of 641 subjects (301 men and 340 women) and the TBI in 474 toes of 237 subjects (117 men and 120 women) were evaluated. Results: The measured values showed no bilateral differences. ABI and baPWV were higher in men than in women, but TBI was similar in both sexes. ABI <1.0 was observed in 18.1% of the legs in men and in 25.6% in women. TBI <0.7 was observed in 16.2% of the toes in men and 19.1% in women. For ankle PVR, the % mean arterial pressure was higher in women than in men. The upstroke time was <180 ms in most subjects. Conclusions: For young people, ABI <1.0 or TBI <0.7 may not always indicate vascular abnormalities. When evaluating circulatory indexes, age and sex should be considered. PMID:26421072

Spinal fusion limits upper body range of motion during gait without inducing compensatory mechanisms in adolescent idiopathic scoliosis patients.

PubMed

Holewijn, R M; Kingma, I; de Kleuver, M; Schimmel, J J P; Keijsers, N L W

2017-09-01

Previous studies show a limited alteration of gait at normal walking speed after spinal fusion surgery for adolescent idiopathic scoliosis (AIS), despite the presumed essential role of spinal mobility during gait. This study analyses how spinal fusion affects gait at more challenging walking speeds. More specifically, we investigated whether thoracic-pelvic rotations are reduced to a larger extent at higher gait speeds and whether compensatory mechanisms above and below the stiffened spine are present. 18 AIS patients underwent gait analysis at increasing walking speeds (0.45 to 2.22m/s) before and after spinal fusion. The range of motion (ROM) of the upper (thorax, thoracic-pelvic and pelvis) and lower body (hip, knee and ankle) was determined in all three planes. Spatiotemporal parameters of interest were stride length and cadence. Spinal fusion diminished transverse plane thoracic-pelvic ROM and this difference was more explicit at higher walking speeds. Transversal pelvis ROM was also decreased but this effect was not affected by speed. Lower body ROM, step length and cadence remained unaffected. Despite the reduction of upper body ROM after spine surgery during high speed gait, no altered spatiotemporal parameters or increased compensatory ROM above or below the fusion (i.e. in the shoulder girdle or lower extremities) was identified. Thus, it remains unclear how patients can cope so well with such major surgery. Future studies should focus on analyzing the kinematics of individual spinal levels above and below the fusion during gait to investigate possible compensatory mechanisms within the spine. Copyright © 2017 Elsevier B.V. All rights reserved.

The Hemimelic extra toes mouse mutant: Historical perspective on unraveling mechanisms of dysmorphogenesis

EPA Science Inventory

Hemimelic extra toes (Hx) arose spontaneously as a dominant mutation in B10.D2/nSnJ mice in 1967. It specifically affects the appendicular skeleton, causing variable foreshortening of the tibia (radius) and preaxial polydactylism. Early anatomical studies revealed anterior overgr...

Drop foot corrective device

NASA Technical Reports Server (NTRS)

Deis, B. C. (Inventor)

1986-01-01

A light weight, economical device to alleviate a plurality of difficulties encountered in walking by a victim suffering from a drop foot condition is discussed. A legband girdles the leg below the knee and above the calf providing an anchor point for the upper end of a ligament having its lower end attached to a toe of a shoe or a toe on the foot. The ligament is of such length that the foot is supported thereby and retained in a normal position during walking.

A systematic review of the effect of pre-test rest duration on toe and ankle systolic blood pressure measurements

PubMed Central

2014-01-01

Background Measurement of toe and ankle blood pressure is commonly used to evaluate peripheral vascular status, yet the pre-test rest period is inconsistent in published studies and among practitioners, and could affect results. The aim of this systematic review is to evaluate all research that has investigated the effect of different periods of pre-test rest on toe and ankle systolic blood pressure. Methods The following databases were searched up to April 2012: Medline (from 1946), EMBASE (from 1947), CINAHL (from 1937), and Cochrane Central Register of Controlled Trials (CENTRAL) (from 1800). No language or publication restrictions were applied. Eighty-eight content experts and researchers in the field were contacted by email to assist in the identification of published, unpublished, and ongoing studies. Studies evaluating the effect of two or more pre-test rest durations on toe or ankle systolic blood pressure were eligible for inclusion. No restrictions were placed on participant characteristics or the method of blood pressure measurement. Outcomes included toe or ankle systolic blood pressure and adverse effects. Abstracts identified from the search terms were independently assessed by two reviewers for potential inclusion. Results 1658 abstracts were identified by electronic searching. Of the 88 content experts and researchers in the field contacted by email a total of 33 replied and identified five potentially relevant studies. No studies were eligible for inclusion. Conclusions There is no evidence of the effect of different periods of pre-test rest duration on toe and ankle systolic blood pressure measurements. Rigorous trials evaluating the effect of different durations of pre-test rest are required to direct clinical practice and research. PMID:24708870

Foot agility and toe gnosis/graphaesthesia as potential indicators of integrity of the medial cerebral surface: normative data and comparison with clinical populations.

PubMed

Persinger, M A; Richards, P M

1995-06-01

A protocol was designed to identify quantitative indicators of the function of the medial surfaces of the cerebral hemispheres. Normative data were collected from 40 volunteers for foot agility, toe gnosis, and toe graphaesthesia. A total of 100 patients (most of whom had been referred for possible closed-head injuries) completed thorough neuropsychological and cognitive assessments. Deficits for toe graphaesthesia were most consistently correlated with general brain impairment and with scores for tasks whose normal performance requires the integrity of structures within the dorsal half of the medial cerebral hemispheres.

Phase-dependent organization of postural adjustments associated with arm movements while walking.

PubMed

Nashner, L M; Forssberg, H

1986-06-01

This study examines the interactions between anteroposterior postural responses and the control of walking in human subjects. In the experimental paradigm, subjects walked upon a treadmill, gripping a rigid handle with one hand. Postural responses at different phases of stepping were elicited by rapid arm pulls or pushes against the handle. During arm movements, EMG's recorded the activity of representative arm, ankle, and thigh segment muscles. Strain gauges in the handle measured the force of the arm movement. A Selspot II system measured kinematics of the stepping movements. The duration of support and swing phases were marked by heel and toe switches in the soles of the subjects' shoes. In the first experiment, subjects were instructed to pull on the handle at their own pace. In these trials all subjects preferred to initiate pulls near heel strikes. Next, when instructed to pull as rapidly as possible in response to tone stimuli, reaction times were similar for all phases of the step cycle. Leg muscle responses associated with arm pulls and pushes, referred to as "postural activations," were directionally specific and preceded arm muscle activity. The temporal order and spatial distribution of postural activations in the muscles of the support leg were similar when arm pull movements occurred while the subject was standing in place and after heel strike while walking. Activations began in the ankle and radiated proximally to the thigh and then the arm. Activations of swing leg muscles were also directionally specific and involved flexion and forward or backward thrust of the limb. When arm movements were initiated during transitions from support by one leg to the other, patterns of postural activations were altered. Alterations usually occurred 10-20 ms before hell strikes and involved changes in the timing and sometimes the spatial structure of postural activations. Postural activation patterns are similar during in-place standing and during the support phase

KidsWalk-to-School: A Guide To Promote Walking to School.

ERIC Educational Resources Information Center

Center for Chronic Disease Prevention and Health Promotion (DHHS/CDC), Atlanta, GA.

This guide encourages people to create safe walking and biking routes to school, promoting four issues: physically active travel, safe and walkable routes to school, crime prevention, and health environments. The chapters include: "KidsWalk-to-School: A Guide to Promote Walking to School" (Is there a solution? Why is walking to school important?…

Comparison of Varying Heel to Toe Differences and Cushion to Barefoot Running in Novice Minimalist Runners

PubMed Central

MOODY, DANNY; HUNTER, IAIN; RIDGE, SARAH; MYRER, J. WILLIAM

2018-01-01

There are many different types of footwear available for runners in today’s market. Many of these shoes claim to help runners run more efficiently by altering an individual’s stride mechanics. Minimalist footwear claims to aid runners run more on their forefeet whereas more traditional footwear provides more cushioning specifically for a heel first landing. The purpose of this paper was to determine if runners, who were accustomed to running in traditional footwear would alter their running mechanics while running acutely in various types of minimalist footwear. Twelve subjects, accustomed to running in traditional 12 mm heel/toe differential footwear, ran in five footwear conditions on a treadmill at a controlled pace for two minutes after warming up in each condition for 5 minutes. While running in 12 mm heel/toe differential footwear compared to barefoot, subjects ran with a significantly longer ground time, a lower stride rate and greater vertical oscillation. There were not any differences in variables when running in the shod conditions despite the varying heel/toe differentials. Running barefoot proved to be different than running in traditional 12 mm drop cushioned footwear. PMID:29795721

Comparison of Varying Heel to Toe Differences and Cushion to Barefoot Running in Novice Minimalist Runners.

PubMed

Moody, Danny; Hunter, Iain; Ridge, Sarah; Myrer, J William

2018-01-01

There are many different types of footwear available for runners in today's market. Many of these shoes claim to help runners run more efficiently by altering an individual's stride mechanics. Minimalist footwear claims to aid runners run more on their forefeet whereas more traditional footwear provides more cushioning specifically for a heel first landing. The purpose of this paper was to determine if runners, who were accustomed to running in traditional footwear would alter their running mechanics while running acutely in various types of minimalist footwear. Twelve subjects, accustomed to running in traditional 12 mm heel/toe differential footwear, ran in five footwear conditions on a treadmill at a controlled pace for two minutes after warming up in each condition for 5 minutes. While running in 12 mm heel/toe differential footwear compared to barefoot, subjects ran with a significantly longer ground time, a lower stride rate and greater vertical oscillation. There were not any differences in variables when running in the shod conditions despite the varying heel/toe differentials. Running barefoot proved to be different than running in traditional 12 mm drop cushioned footwear.

Juvenile idiopathic arthritis

MedlinePlus

... www.ncbi.nlm.nih.gov/pubmed/21452260 . Long AR, Rouster-Stevens KA. The role of exercise therapy ... nlm.nih.gov/pubmed/21131338 . Wu EY, Bryan AR, Rabinovich CE. Juvenile idiopathic arthritis. In: Kliegman RM, ...

Walking Beliefs in Women With Fibromyalgia: Clinical Profile and Impact on Walking Behavior.

PubMed

Peñacoba, Cecilia; Pastor, María-Ángeles; López-Roig, Sofía; Velasco, Lilian; Lledo, Ana

2017-10-01

Although exercise is essential for the treatment of fibromyalgia, adherence is low. Walking, as a form of physical exercise, has significant advantages. The aim of this article is to describe, in 920 women with fibromyalgia, the prevalence of certain walking beliefs and analyze their effects both on the walking behavior itself and on the associated symptoms when patients walk according to a clinically recommended way. The results highlight the high prevalence of beliefs related to pain and fatigue as walking-inhibitors. In the whole sample, beliefs are associated with an increased perception that comorbidity prevents walking, and with higher levels of pain and fatigue. In patients who walk regularly, beliefs are only associated with the perception that comorbidity prevents them from walking. It is necessary to promote walking according to the established way (including breaks to prevent fatigue) and to implement interventions on the most prevalent beliefs that inhibit walking.

Sagittal distal limb kinematics inside the hoof capsule captured using high-speed fluoroscopy in walking and trotting horses.

PubMed

Roach, J M; Pfau, T; Bryars, J; Unt, V; Channon, S B; Weller, R

2014-10-01

Kinematic evaluation of the distal limb of the horse using standard methods is challenging, mainly due to the hoof capsule restricting visualisation, but the recent development of a high-speed fluoroscopy (HSF) system has allowed in vivo cineradiographic assessment of moving skeletal structures at high speeds. The application of this non-invasive method to the equine distal limb is used to describe 'internal' distal limb kinematics including intra-horse and inter-horse variability, and variability between walk and trot. Distal limb kinematic data were collected at walk and trot from six non-lame horses using HSF set over a force plate. The dorsal proximal interphalangeal joint (PIPJ) angle and the dorsal distal interphalangeal joint (DIPJ) angle were measured at toe-on and at 25%, 50% and 75% of stance. The PIPJ and DIPJ showed overall extension through stance. The mean ± SD range of motion (ROM) during stance of the PIPJ was 9.7 ± 2.7° (walk) and 8.7 ± 3.0° (trot) and of the DIPJ was 28.6 ± 4.6° (walk) and 26.5 ± 6.3° (trot) showing significant differences between gaits and changes through stance (P < 0.001). Inter- and intra- horse variations were also significant for both joint angles (P < 0.001). HSF allowed for kinematic assessment of the distal limb within the hoof capsule. The ROM of the PIPJ observed was similar to results published in the literature whilst the ROM for the DIPJ was less than values previously reported. Future studies will use HSF to estimate strain in the tendons and ligaments within the hoof capsule, which are a common site of lameness in the horse. Copyright © 2014. Published by Elsevier Ltd.

Effects of Nordic walking and walking on spatiotemporal gait parameters and ground reaction force.

PubMed

Park, Seung Kyu; Yang, Dae Jung; Kang, Yang Hun; Kim, Je Ho; Uhm, Yo Han; Lee, Yong Seon

2015-09-01

[Purpose] The purpose of this study was to investigate the effects of Nordic walking and walking on spatiotemporal gait parameters and ground reaction force. [Subjects] The subjects of this study were 30 young adult males, who were divided into a Nordic walking group of 15 subjects and a walking group of 15 subjects. [Methods] To analyze the spatiotemporal parameters and ground reaction force during walking in the two groups, the six-camera Vicon MX motion analysis system was used. The subjects were asked to walk 12 meters using the more comfortable walking method for them between Nordic walking and walking. After they walked 12 meters more than 10 times, their most natural walking patterns were chosen three times and analyzed. To determine the pole for Nordic walking, each subject's height was multiplied by 0.68. We then measured the spatiotemporal gait parameters and ground reaction force. [Results] Compared with the walking group, the Nordic walking group showed an increase in cadence, stride length, and step length, and a decrease in stride time, step time, and vertical ground reaction force. [Conclusion] The results of this study indicate that Nordic walking increases the stride and can be considered as helping patients with diseases affecting their gait. This demonstrates that Nordic walking is more effective in improving functional capabilities by promoting effective energy use and reducing the lower limb load, because the weight of the upper and lower limbs is dispersed during Nordic walking.

[New varieties of lateral metatarsophalangeal dislocations of the great toe].

PubMed

Bousselmame, N; Rachid, K; Lazrak, K; Galuia, F; Taobane, H; Moulay, I

2001-04-01

We report seven cases of traumatic dislocation of the great toe, detailing the anatomy, the mechanism of injury and the radiographic diagnosis. We propose an additional classification based on three hereto unreported cases. Between october 1994 and october 1997, we treated seven patients with traumatic dislocation of the first metatarso-phalangeal joint of the great toe. There were six men and one woman, mean age 35 years (range 24 - 44 years). Dislocation was caused by motor vehicle accidents in four cases and by falls in three. Diagnosis was made on anteroposterior, lateral and medial oblique radiographs. According to Jahss' classification, there was one type I and three type IIB dislocations. There was also one open lateral dislocation and two dorsomedial dislocations. Only these dorsomedial dislocations required open reduction, done via a dorsal approach. Mean follow-up was 17.5 months (range 9 - 24 months) in six cases. One patient was lost to follow-up. The outcome was good in six cases and poor in one (dorsomedial dislocation). Dislocation of the first metatarso-phalangeal joint of the great toe is an uncommon injury. In 1980, Jahss reported two cases and reviewed three others described in the literature. He proposed three types of dislocation based on the feasibility of closed reduction (type I, II and IIB). In 1991, Copeland and Kanat reported a unique case in which there was an association of IIA and IIB lesions. They proposed an addition to the classification (type IIC). In 1994, Garcia Mata et al. reported another case which had not been described by Jahss and proposed another addition. All dislocations reported to date have been sagittal dislocations. Pathological alteration of the collateral ligaments has not been previously reported. In our experience, we have seen one case of open lateral dislocation due, at surgical exploration, to medial ligament rupture and two cases of dorsomedial dislocation due, at surgical exploration, to lateral ligament

Walking drawings and walking ability in children with cerebral palsy.

PubMed

Chong, Jimmy; Mackey, Anna H; Stott, N Susan; Broadbent, Elizabeth

2013-06-01

To investigate whether drawings of the self walking by children with cerebral palsy (CP) were associated with walking ability and illness perceptions. This was an exploratory study in 52 children with CP (M:F = 28:24), mean age 11.1 years (range 5-18), who were attending tertiary level outpatient clinics. Children were asked to draw a picture of themselves walking. Drawing size and content was used to investigate associations with clinical walk tests and children's own perceptions of their CP assessed using a CP version of the Brief Illness Perception Questionnaire. Larger drawings of the self were associated with less distance traveled, higher emotional responses to CP, and lower perceptions of pain or discomfort, independent of age. A larger self-to-overall drawing height ratio was related to walking less distance. Drawings of the self confined within buildings and the absence of other figures were also associated with reduced walking ability. Drawing size and content can reflect walking ability, as well as symptom perceptions and distress. Drawings may be useful for clinicians to use with children with cerebral palsy to aid discussion about their condition. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Application of Finite Element Method of Numerical Modelling to Understand Toe Buckling Deformation in the Southern Alps of New Zealand.

NASA Astrophysics Data System (ADS)

Ridl, Romy; Bell, David; Villeneuve, Marlene

2017-04-01

Toe buckling deformation is a temporal product of induced stresses concentrated at the base of a slope. Prolonged induced stresses may lead to yielding of an anisotropic rock mass, either through rheological creep deformation (flexural toe buckling) or brittle failure (hinge buckling). Progressive deformation can lead to the breakout at the buckled toe and ultimately result in deep seated displacements on a mountain range scale, referred to as deep seated gravitational slope deformation (DSGSD). DSGSD can have a considerable impact on civil infrastructure and should be well understood for hazard identification, to inform civil engineering design and for resource management purposes. Toe buckling deformation was identified beneath the basal sliding zone of three large (≥50 Mm3) landslides in the Cromwell Gorge, New Zealand. This area was subjected to extensive geotechnical investigations for the Clyde Hydropower Scheme. During these investigations seventeen major landslides were identified in the Cromwell Gorge and subsequently stabilised. The data from the landslide stabilisation project, including 26.7 km of boreholes and 9 km of tunnels, for the three landslides exhibiting toe buckling was made available for this study. This comprehensive database has enabled comparison and validation of numerical simulations carried out for the Cromwell Gorge. The application of numerical modelling has demonstrated that toe buckling within the Cromwell Gorge is a result of the combination of induced stresses acting on an anisotropic schistose rock mass. The induced stresses comprise: i) topographically-induced gravitational stresses parallel to the slope, associated with the evolution of the Cromwell Gorge from a relatively low relief surface to present day topography (1400 m deep valley), and ii) active far-field tectonic stresses associated with the obliquely convergent stress regime of the Australian-Pacific continent plate boundary. Finite Element Method (FEM) numerical

Correlations between the equine metacarpophalangeal joint angulation and toe conformation in statics

PubMed Central

Hagen, Jenny; Kojah, Kaid; Geiger, Michael

2018-01-01

The angulation of the equine fetlock determines the load of associated tendons and probably their predisposition for injuries. However, it is questionable how the individual toe conformation and tendon properties interact with the dorsal metacarpophalangeal joint angle (DMPJ). Data are needed for a tangible evaluation of the equine limb conformation for more specific orthopaedic treatment. The aim was to evaluate the correlation between the DMPJ, toe conformation and cross-sectional area (CSA) of both flexor tendons; the superficial digital flexor tendon (SDFT) and deep digital flexor tendon (DDFT). Thirty Warmblood horses were available for the study. Lateromedial radiographs of the toe and fetlock and transverse ultrasound images of both flexor tendons were obtained from three zones. The DMPJ, length and angle of the phalanges and CSA SDFT/DDFT were measured. In addition, hoof angle, wither height, age, and sex were documented. Correlations were calculated using Pearson’s test. A paired t-test was used to evaluate left–right differences. Length and angle of the proximal and middle phalanx were significantly associated with the DMPJ (r = -0.28 – -0.45, p<0.001-0.04). Neither the angle of the hoof and distal phalanx nor the CSA SDFT/DDFT, showed a noticeable correlation with the DMPJ. Significant left–right differences occurred for the DMPJ (p<0.002) and the angle of the proximal and middle phalanx (p<0.01 – 0.002). A moderate negative correlation was shown between the DMPJ and wither height (r = - 0.31, p=0.04). Results represent only a specific population. The study provides only a static evaluation of a dynamic situation. In a clinical context, it might be useful to focus on the angulation and length of the pastern to evaluate the individual load affecting the DMPJ and its associated structures. These findings might be relevant for orthopaedic treatments and shoeing recommendations. PMID:29721438

Reliability of doming and toe flexion testing to quantify foot muscle strength.

PubMed

Ridge, Sarah Trager; Myrer, J William; Olsen, Mark T; Jurgensmeier, Kevin; Johnson, A Wayne

2017-01-01

Quantifying the strength of the intrinsic foot muscles has been a challenge for clinicians and researchers. The reliable measurement of this strength is important in order to assess weakness, which may contribute to a variety of functional issues in the foot and lower leg, including plantar fasciitis and hallux valgus. This study reports 3 novel methods for measuring foot strength - doming (previously unmeasured), hallux flexion, and flexion of the lesser toes. Twenty-one healthy volunteers performed the strength tests during two testing sessions which occurred one to five days apart. Each participant performed each series of strength tests (doming, hallux flexion, and lesser toe flexion) four times during the first testing session (twice with each of two raters) and two times during the second testing session (once with each rater). Intra-class correlation coefficients were calculated to test for reliability for the following comparisons: between raters during the same testing session on the same day (inter-rater, intra-day, intra-session), between raters on different days (inter-rater, inter-day, inter-session), between days for the same rater (intra-rater, inter-day, inter-session), and between sessions on the same day by the same rater (intra-rater, intra-day, inter-session). ICCs showed good to excellent reliability for all tests between days, raters, and sessions. Average doming strength was 99.96 ± 47.04 N. Average hallux flexion strength was 65.66 ± 24.5 N. Average lateral toe flexion was 50.96 ± 22.54 N. These simple tests using relatively low cost equipment can be used for research or clinical purposes. If repeated testing will be conducted on the same participant, it is suggested that the same researcher or clinician perform the testing each time for optimal reliability.

Walking Performance: Correlation between Energy Cost of Walking and Walking Participation. New Statistical Approach Concerning Outcome Measurement

PubMed Central

Franceschini, Marco; Rampello, Anais; Agosti, Maurizio; Massucci, Maurizio; Bovolenta, Federica; Sale, Patrizio

2013-01-01

Walking ability, though important for quality of life and participation in social and economic activities, can be adversely affected by neurological disorders, such as Spinal Cord Injury, Stroke, Multiple Sclerosis or Traumatic Brain Injury. The aim of this study is to evaluate if the energy cost of walking (CW), in a mixed group of chronic patients with neurological diseases almost 6 months after discharge from rehabilitation wards, can predict the walking performance and any walking restriction on community activities, as indicated by Walking Handicap Scale categories (WHS). One hundred and seven subjects were included in the study, 31 suffering from Stroke, 26 from Spinal Cord Injury and 50 from Multiple Sclerosis. The multivariable binary logistical regression analysis has produced a statistical model with good characteristics of fit and good predictability. This model generated a cut-off value of.40, which enabled us to classify correctly the cases with a percentage of 85.0%. Our research reveal that, in our subjects, CW is the only predictor of the walking performance of in the community, to be compared with the score of WHS. We have been also identifying a cut-off value of CW cost, which makes a distinction between those who can walk in the community and those who cannot do it. In particular, these values could be used to predict the ability to walk in the community when discharged from the rehabilitation units, and to adjust the rehabilitative treatment to improve the performance. PMID:23468871

Playing Tic-Tac-Toe with a Sugar-Based Molecular Computer.

PubMed

Elstner, M; Schiller, A

2015-08-24

Today, molecules can perform Boolean operations and circuits at a level of higher complexity. However, concatenation of logic gates and inhomogeneous inputs and outputs are still challenging tasks. Novel approaches for logic gate integration are possible when chemical programming and software programming are combined. Here it is shown that a molecular finite automaton based on the concatenated implication function (IMP) of a fluorescent two-component sugar probe via a wiring algorithm is able to play tic-tac-toe.

Predictors of Early Growth in Academic Achievement: The Head-Toes-Knees-Shoulders Task

ERIC Educational Resources Information Center

McClelland, Megan M.; Cameron, Claire E.; Duncan, Robert; Bowles, Ryan P.; Acock, Alan C.; Miao, Alicia; Pratt, Megan E.

2014-01-01

Children's behavioral self-regulation and executive function (EF; including attentional or cognitive flexibility, working memory, and inhibitory control) are strong predictors of academic achievement. The present study examined the psychometric properties of a measure of behavioral self-regulation called the Head-Toes-Knees-Shoulders (HTKS) by…

Subungual Ewing sarcoma/PNET tumor family of the great toe: a case report

PubMed Central

Binesh, Fariba; Sobhanardekani, Mohammad; Zare, Saeedeh; Behniafard, Nasim

2016-01-01

Ewing’s sarcoma is seen mainly in patients less than 18. This aggressive tumor generally affects the axial skeleton and only rarely involves the acral regions. Ewing’s sarcoma in the foot is inordinately scarce. Clinical features are uncertain and can imitate other common diseases. This paper presents a case of 62-year-old malewith complaints of pain and swelling of the subungual area of his right great toe. The lesion was excised, and histopathological diagnosis of Ewing’s sarcoma was made. Histopathological examination, supported by immunochemical methods, remains the mainstay of diagnosis. Surgical ablation along with chemotherapy is the therapy of choice. To our knowledge, this is the first report of Ewing’s sarcoma involving the nail bed of the great toe without bone erosion. The key messages of this case report is “Subungual Ewing sarcoma is a rare case, and Ewing’s sarcoma must be kept in mind for acral lesions, especially in the adult population.” PMID:27279998

Alzheimer random walk

NASA Astrophysics Data System (ADS)

Odagaki, Takashi; Kasuya, Keisuke

2017-09-01

Using the Monte Carlo simulation, we investigate a memory-impaired self-avoiding walk on a square lattice in which a random walker marks each of sites visited with a given probability p and makes a random walk avoiding the marked sites. Namely, p = 0 and p = 1 correspond to the simple random walk and the self-avoiding walk, respectively. When p> 0, there is a finite probability that the walker is trapped. We show that the trap time distribution can well be fitted by Stacy's Weibull distribution b(a/b){a+1}/{b}[Γ({a+1}/{b})]-1x^a\\exp(-a/bx^b)} where a and b are fitting parameters depending on p. We also find that the mean trap time diverges at p = 0 as p- α with α = 1.89. In order to produce sufficient number of long walks, we exploit the pivot algorithm and obtain the mean square displacement and its Flory exponent ν(p) as functions of p. We find that the exponent determined for 1000 step walks interpolates both limits ν(0) for the simple random walk and ν(1) for the self-avoiding walk as [ ν(p) - ν(0) ] / [ ν(1) - ν(0) ] = pβ with β = 0.388 when p ≪ 0.1 and β = 0.0822 when p ≫ 0.1. Contribution to the Topical Issue "Continuous Time Random Walk Still Trendy: Fifty-year History, Current State and Outlook", edited by Ryszard Kutner and Jaume Masoliver.

Intraspinal anomalies in early-onset idiopathic scoliosis.

PubMed

Pereira, E A C; Oxenham, M; Lam, K S

2017-06-01

In the United Kingdom, lower incidences of intraspinal abnormalities in patients with early onset idiopathic scoliosis have been observed than in studies in other countries. We aimed to determine the rates of these abnormalities in United Kingdom patients diagnosed with idiopathic scoliosis before the age of 11 years. This retrospective study of patients attending an urban scoliosis clinic identified 71 patients satisfying a criteria of: clinical diagnosis of idiopathic scoliosis; age of onset ten years and 11 months or less; MRI screening for intraspinal abnormalities. United Kingdom census data combined with patient referral data was used to calculate incidence. Mean age at diagnosis was six years with 39 right-sided and 32 left-sided curves. Four patients (5.6%) were found to have intraspinal abnormalities on MRI. These consisted of: two combined Arnold-Chiari type 1 malformations with syrinx; one syrinx with a low lying conus; and one isolated syrinx. Overall annual incidence of early onset idiopathic scoliosis was one out of 182 000 (0.0006%). This study reports the lowest rates to date of intraspinal anomalies in patients with early onset idiopathic scoliosis, adding to knowledge regarding current incidences of these abnormalities as well as any geographical variation in the nature of the disease. Cite this article: Bone Joint J 2017;99-B:829-33. ©2017 The British Editorial Society of Bone & Joint Surgery.

Nordic walking versus walking without poles for rehabilitation with cardiovascular disease: Randomized controlled trial.

PubMed

Girold, Sébastien; Rousseau, Jérome; Le Gal, Magalie; Coudeyre, Emmanuel; Le Henaff, Jacqueline

2017-07-01

With Nordic walking, or walking with poles, one can travel a greater distance and at a higher rate than with walking without poles, but whether the activity is beneficial for patients with cardiovascular disease is unknown. This randomized controlled trial was undertaken to determine whether Nordic walking was more effective than walking without poles on walk distance to support rehabilitation training for patients with acute coronary syndrome (ACS) and peripheral arterial occlusive disease (PAOD). Patients were recruited in a private specialized rehabilitation centre for cardiovascular diseases. The entire protocol, including patient recruitment, took place over 2 months, from September to October 2013. We divided patients into 2 groups: Nordic Walking Group (NWG, n=21) and Walking Group without poles (WG, n=21). All patients followed the same program over 4 weeks, except for the walk performed with or without poles. The main outcome was walk distance on the 6-min walk test. Secondary outcomes were maximum heart rate during exercise and walk distance and power output on a treadmill stress test. We included 42 patients (35 men; mean age 57.2±11 years and BMI 26.5±4.5kg/m 2 ). At the end of the training period, both groups showed improved walk distance on the 6-min walk test and treatment stress test as well as power on the treadmill stress test (P<0.05). The NWG showed significantly greater walk distance than the WG (P<0.05). Both ACS and PAOD groups showed improvement, but improvement was significant for only PAOD patients. After a 4-week training period, Nordic walking training appeared more efficient than training without poles for increasing walk distance on the 6-min walk test for patients with ACS and PAOD. Copyright © 2017. Published by Elsevier Masson SAS.

Angiopoietin-2 polymorphism in women with idiopathic recurrent miscarriage.

PubMed

Pietrowski, Detlef; Tempfer, Clemens; Bettendorf, Hertha; Bürkle, Bernd; Nagele, Fritz; Unfried, Gertrud; Keck, Christoph

2003-10-01

To investigate the relationship between idiopathic recurrent miscarriage and a polymorphism of the gene encoding for angiopoietin-2 (ANGPT2), an autochthonous modulator of angiogenesis during pregnancy. Prospective case control study. Academic research institution. One hundred thirty-one women with a history of three or more consecutive pregnancy losses before 20 weeks' gestation, and 125 healthy, postmenopausal controls with at least two live births and no history of pregnancy loss. Peripheral venous puncture. Polymerase chain reaction and restriction fragment length polymorphism analysis were performed to identify the different ANGPT2 alleles. No association between mutant (mt) allele and the occurrence of idiopathic recurrent miscarriage was found. Between women with primary and secondary idiopathic recurrent miscarriage, no statistically significant differences with respect to allele frequencies were observed. This is the first report on the ANGPT2 gene polymorphism in women with idiopathic recurrent miscarriage, demonstrating that the investigated polymorphism is not associated with idiopathic recurrent miscarriage in a white population.

D.U.C.K. Walking.

ERIC Educational Resources Information Center

Steller, Jenifer J.

This manual presents a schoolwide walking program that includes aerobic fitness information, curriculum integration, and walking tours. "Discover and Understand Carolina Kids by Walking" is D.U.C.K. Walking. An aerobic walking activity, D.U.C.K. Walking has two major goals: (1) to promote regular walking as a way to exercise at any age;…

Mat-Rix-Toe: Improving Writing through a Game-Based Project in Linear Algebra

ERIC Educational Resources Information Center

Graham-Squire, Adam; Farnell, Elin; Stockton, Julianna Connelly

2014-01-01

The Mat-Rix-Toe project utilizes a matrix-based game to deepen students' understanding of linear algebra concepts and strengthen students' ability to express themselves mathematically. The project was administered in three classes using slightly different approaches, each of which included some editing component to encourage the…

Frequency-velocity mismatch: a fundamental abnormality in parkinsonian gait.

PubMed

Cho, Catherine; Kunin, Mikhail; Kudo, Koji; Osaki, Yasuhiro; Olanow, C Warren; Cohen, Bernard; Raphan, Theodore

2010-03-01

Gait dysfunction and falling are major sources of disability for patients with advanced Parkinson's disease (PD). It is presently thought that the fundamental defect is an inability to generate normal stride length. Our data suggest, however, that the basic problem in PD gait is an impaired ability to match step frequency to walking velocity. In this study, foot movements of PD and normal subjects were monitored with an OPTOTRAK motion-detection system while they walked on a treadmill at different velocities. PD subjects were also paced with auditory stimuli at different frequencies. PD gait was characterized by step frequencies that were faster and stride lengths that were shorter than those of normal controls. At low walking velocities, PD stepping had a reduced or absent terminal toe lift, which truncated swing phases, producing shortened steps. Auditory pacing was not able to normalize step frequency at these lower velocities. Peak forward toe velocities increased with walking velocity and PD subjects could initiate appropriate foot dynamics during initial phases of the swing. They could not control the foot appropriately in terminal phases, however. Increased treadmill velocity, which matched the natural PD step frequency, generated a second toe lift, normalizing step size. Levodopa increased the bandwidth of step frequencies, but was not as effective as increases in walking velocity in normalizing gait. We postulate that the inability to control step frequency and adjust swing phase dynamics to slower walking velocities are major causes for the gait impairment in PD.

Frequency-Velocity Mismatch: A Fundamental Abnormality in Parkinsonian Gait

PubMed Central

Kunin, Mikhail; Kudo, Koji; Osaki, Yasuhiro; Olanow, C. Warren; Cohen, Bernard; Raphan, Theodore

2010-01-01

Gait dysfunction and falling are major sources of disability for patients with advanced Parkinson's disease (PD). It is presently thought that the fundamental defect is an inability to generate normal stride length. Our data suggest, however, that the basic problem in PD gait is an impaired ability to match step frequency to walking velocity. In this study, foot movements of PD and normal subjects were monitored with an OPTOTRAK motion-detection system while they walked on a treadmill at different velocities. PD subjects were also paced with auditory stimuli at different frequencies. PD gait was characterized by step frequencies that were faster and stride lengths that were shorter than those of normal controls. At low walking velocities, PD stepping had a reduced or absent terminal toe lift, which truncated swing phases, producing shortened steps. Auditory pacing was not able to normalize step frequency at these lower velocities. Peak forward toe velocities increased with walking velocity and PD subjects could initiate appropriate foot dynamics during initial phases of the swing. They could not control the foot appropriately in terminal phases, however. Increased treadmill velocity, which matched the natural PD step frequency, generated a second toe lift, normalizing step size. Levodopa increased the bandwidth of step frequencies, but was not as effective as increases in walking velocity in normalizing gait. We postulate that the inability to control step frequency and adjust swing phase dynamics to slower walking velocities are major causes for the gait impairment in PD. PMID:20042701

Sidewalks promote walking

DOT National Transportation Integrated Search

2004-12-01

Of Americas 205 million adults, 86% took walks during the summer months of 2002, and 40% of those walkers walked more than 15 days per month. Fourteen percent of adult Americans state they never take walks. The presence of sidewalks has a ...

Siblicide, splayed-toes-flight display, and grappling in the Saker Falcon

USGS Publications Warehouse

Ellis, D.H.; Whitlock, P.L.; Tsengeg, Pu; Nelson, R.W.

1999-01-01

We observed two incidents of novel social behavior in the saker falcon (Falco cherrug) in Mongolia. First, we provide an account of a two-week-old saker falcon chick killing its nest mate, the first direct observation of siblicide in the genus Falco. We also report aerial combat between three adult saker falcons including observations of talon grappling, whirling, and Splayed-toes-flight, a previously undescribed social display.

Gait in adolescent idiopathic scoliosis: kinematics and electromyographic analysis

PubMed Central

Banse, X.; Mousny, M.; Detrembleur, C.

2009-01-01

Adolescent idiopathic scoliosis (AIS) is a progressive growth disease that affects spinal anatomy, mobility, and left-right trunk symmetry. Consequently, AIS can modify human locomotion. Very few studies have investigated a simple activity like walking in a cohort of well-defined untreated patients with scoliosis. The first goal of this study is to evaluate the effects of scoliosis and scoliosis severity on kinematic and electromyographic (EMG) gait variables compared to an able-bodied population. The second goal is to look for any asymmetry in these parameters during walking. Thirteen healthy girls and 41 females with untreated AIS, with left thoracolumbar or lumbar primary structural curves were assessed. AIS patients were divided into three clinical subgroups (group 1 < 20°, group 2 between 20 and 40°, and group 3 > 40°). Gait analysis included synchronous bilateral kinematic and EMG measurements. The subjects walked on a treadmill at 4 km/h (comfortable speed). The tridimensional (3D) shoulder, pelvis, and lower limb motions were measured using 22 reflective markers tracked by four infrared cameras. The EMG timing activity was measured using bipolar surface electrodes on quadratus lumborum, erector spinae, gluteus medius, rectus femoris, semitendinosus, tibialis anterior, and gastrocnemius muscles. Statistical comparisons (ANOVA) were performed across groups and sides for kinematic and EMG parameters. The step length was reduced in AIS compared to normal subjects (7% less). Frontal shoulder, pelvis, and hip motion and transversal hip motion were reduced in scoliosis patients (respectively, 21, 27, 28, and 22% less). The EMG recording during walking showed that the quadratus lumborum, erector spinae, gluteus medius, and semitendinosus muscles contracted during a longer part of the stride in scoliotic patients (46% of the stride) compared with normal subjects (35% of the stride). There was no significant difference between scoliosis groups 1, 2, and 3 for

Gait in adolescent idiopathic scoliosis: kinematics and electromyographic analysis.

PubMed

Mahaudens, P; Banse, X; Mousny, M; Detrembleur, C

2009-04-01

Adolescent idiopathic scoliosis (AIS) is a progressive growth disease that affects spinal anatomy, mobility, and left-right trunk symmetry. Consequently, AIS can modify human locomotion. Very few studies have investigated a simple activity like walking in a cohort of well-defined untreated patients with scoliosis. The first goal of this study is to evaluate the effects of scoliosis and scoliosis severity on kinematic and electromyographic (EMG) gait variables compared to an able-bodied population. The second goal is to look for any asymmetry in these parameters during walking. Thirteen healthy girls and 41 females with untreated AIS, with left thoracolumbar or lumbar primary structural curves were assessed. AIS patients were divided into three clinical subgroups (group 1 < 20 degrees, group 2 between 20 and 40 degrees, and group 3 > 40 degrees). Gait analysis included synchronous bilateral kinematic and EMG measurements. The subjects walked on a treadmill at 4 km/h (comfortable speed). The tridimensional (3D) shoulder, pelvis, and lower limb motions were measured using 22 reflective markers tracked by four infrared cameras. The EMG timing activity was measured using bipolar surface electrodes on quadratus lumborum, erector spinae, gluteus medius, rectus femoris, semitendinosus, tibialis anterior, and gastrocnemius muscles. Statistical comparisons (ANOVA) were performed across groups and sides for kinematic and EMG parameters. The step length was reduced in AIS compared to normal subjects (7% less). Frontal shoulder, pelvis, and hip motion and transversal hip motion were reduced in scoliosis patients (respectively, 21, 27, 28, and 22% less). The EMG recording during walking showed that the quadratus lumborum, erector spinae, gluteus medius, and semitendinosus muscles contracted during a longer part of the stride in scoliotic patients (46% of the stride) compared with normal subjects (35% of the stride). There was no significant difference between scoliosis groups 1

The UCSD Shortness of Breath Questionnaire has Longitudinal Construct Validity in Idiopathic Pulmonary Fibrosis

PubMed Central

Swigris, Jeffrey J.; Han, Meilan; Vij, Rekha; Noth, Imre; Eisenstein, Eric L.; Anstrom, Kevin J.; Brown, Kevin K.; Fairclough, Diane

2012-01-01

Background Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease that often causes disabling dyspnea. In IPF and other lung diseases, patient-reported outcomes (PROs)—questionnaires designed to gather information from the patient's perspective—can determine whether therapies affect dyspnea or other outcomes meaningful to patients. Before a PRO can be used confidently as an outcome measure in a longitudinal trial, studies must demonstrate the PRO's ability to capture change over time in the target population. Our goal in this study was to examine whether the UCSD Shortness of Breath Questionnaire does so in patients with IPF. Methods We used data from the Sildenafil Trial of Exercise Performance in Idiopathic Pulmonary Fibrosis (STEP-IPF) to perform analyses that examined associations between UCSD scores and five external measures (anchors) at baseline and over time. Anchors included the Activity domain from St. George's Respiratory Questionnaire (SGRQ-A), the Physical Functioning domain from the SF-36 (SF36-PF), forced vital capacity (FVC), diffusing capacity of the lung for carbon monoxide (DLCO), and distance walked during a timed walk test (6MWD). Linear regression models were used to examine relationships between UCSD scores and anchors over time. Results At baseline, UCSD scores were weakly correlated with percent predicted FVC (−0.21, p=0.005) and percent predicted DLCO (−0.20, p=0.008), moderately correlated with 6MWD (−0.39, p<0.0001) and strongly correlated with SGRQ-A (0.79, p<0.0001) and SF36-PF (−0.72, p<0.0001). Change over time in UCSD scores was associated with change in FVC (estimate=2.54, standard error [SE]=1.23, p=0.04), SGRQ-A (estimate=7.94, SE=1.11, p<0.0001), SF36-PF (estimate=6.00, SE=1.13, p<0.0001), and 6MWD (estimate=4.23, SE=1.18, p=0.0004) but not DLCO (estimate=0.33, SE=1.33, p=0.80). Conclusions These results support the validity of the UCSD to assess change in dyspnea over time in patients with

Comparison of CSF Distribution between Idiopathic Normal Pressure Hydrocephalus and Alzheimer Disease.

PubMed

Yamada, S; Ishikawa, M; Yamamoto, K

2016-07-01

CSF volumes in the basal cistern and Sylvian fissure are increased in both idiopathic normal pressure hydrocephalus and Alzheimer disease, though the differences in these volumes in idiopathic normal pressure hydrocephalus and Alzheimer disease have not been well-described. Using CSF segmentation and volume quantification, we compared the distribution of CSF in idiopathic normal pressure hydrocephalus and Alzheimer disease. CSF volumes were extracted from T2-weighted 3D spin-echo sequences on 3T MR imaging and quantified semi-automatically. We compared the volumes and ratios of the ventricles and subarachnoid spaces after classification in 30 patients diagnosed with idiopathic normal pressure hydrocephalus, 10 with concurrent idiopathic normal pressure hydrocephalus and Alzheimer disease, 18 with Alzheimer disease, and 26 control subjects 60 years of age or older. Brain to ventricle ratios at the anterior and posterior commissure levels and 3D volumetric convexity cistern to ventricle ratios were useful indices for the differential diagnosis of idiopathic normal pressure hydrocephalus or idiopathic normal pressure hydrocephalus with Alzheimer disease from Alzheimer disease, similar to the z-Evans index and callosal angle. The most distinctive characteristics of the CSF distribution in idiopathic normal pressure hydrocephalus were small convexity subarachnoid spaces and the large volume of the basal cistern and Sylvian fissure. The distribution of the subarachnoid spaces in the idiopathic normal pressure hydrocephalus with Alzheimer disease group was the most deformed among these 3 groups, though the mean ventricular volume of the idiopathic normal pressure hydrocephalus with Alzheimer disease group was intermediate between that of the idiopathic normal pressure hydrocephalus and Alzheimer disease groups. The z-axial expansion of the lateral ventricle and compression of the brain just above the ventricle were the common findings in the parameters for differentiating

Intestinal Volvulus in Idiopathic Steatorrhea

PubMed Central

Warner, H. A.; Kinnear, D. G.; Cameron, D. G.

1963-01-01

Volvulus of the intestine has recently been observed in three patients with idiopathic steatorrhea in relapse. Two patients gave a history of intermittent abdominal pain, distension and obstipation. Radiographic studies during these attacks revealed obstruction at the level of the sigmoid colon. Reduction under proctoscopic control was achieved in one instance, spontaneous resolution occurring in the other. The third patient presented as a surgical emergency and underwent operative reduction of a small intestinal volvulus. Persistence of diarrhea and weight loss postoperatively led to further investigation and a diagnosis of idiopathic steatorrhea. In all cases, treatment resulted in clinical remission with a coincident disappearance of obstructive intestinal symptoms. The pathogenesis of volvulus in sprue is poorly understood. Atonicity and dilatation of the bowel and stretching of the mesentery likely represent important factors. The symptoms of recurrent abdominal pain and distension in idiopathic steatorrhea necessitate an increased awareness of intestinal volvulus as a complication of this disease. ImagesFig. 1Fig. 2Fig. 3Figs. 4 and 5Fig. 6 PMID:13998948

A survey of foot problems in juvenile idiopathic arthritis.

PubMed

Hendry, G; Gardner-Medwin, J; Watt, G F; Woodburn, J

2008-12-01

Evidence suggests that foot problems are common in juvenile idiopathic arthritis (JIA), with prevalence estimates over 90%. The aim of this survey was to describe foot-related impairment and disability associated with JIA and foot-care provision in patients managed under modern treatment paradigms, including disease-modifying anti-rheumatic drugs (DMARDs) and biologic therapies. The Juvenile Arthritis Foot Disability Index (JAFI), Child Health Assessment Questionnaire (CHAQ), and pain visual analogue scale (VAS) were recorded in 30 consecutive established JIA patients attending routine outpatient clinics. Foot deformity score, active/limited joint counts, walking speed, double-support time (s) (DS) and step length symmetry index % (SI) were also measured. Foot-care provision in the preceding 12 months was determined from medical records. Sixty-three per cent of children reported some foot impairment, with a median (range) JAFI subscale score of 1 (0-3); 53% reported foot-related activity limitation, with a JAFI subscale score of 1 (0-4); and 60% reported participation restriction, with a JAFI subscale score of 1 (0-3). Other reported variables were CHAQ 0.38 (0-2), VAS pain 22 (0-79), foot deformity 6 (0-20), active joints 0 (0-7), limited joints 0 (0-31), walking speed 1.09 m/s (0.84-1.38 m/s), DS 0.22 s (0.08-0.26 s) and SI +/-4.0% (+/-0.2-+/-31.0%). A total of 23/30 medical records were reviewed and 15/23 children had received DMARDS, 8/23 biologic agents and 20/23 multiple intra-articular corticosteroid injections. Ten children received specialist podiatry care comprising footwear advice, orthotic therapy and silicone digital splints together with intrinsic muscle strengthening exercises. Despite frequent use of DMARD/biologic therapy and specialist podiatry-led foot care, foot-related impairment and disability persists in some children with JIA.

Lévy walks

NASA Astrophysics Data System (ADS)

Zaburdaev, V.; Denisov, S.; Klafter, J.

2015-04-01

Random walk is a fundamental concept with applications ranging from quantum physics to econometrics. Remarkably, one specific model of random walks appears to be ubiquitous across many fields as a tool to analyze transport phenomena in which the dispersal process is faster than dictated by Brownian diffusion. The Lévy-walk model combines two key features, the ability to generate anomalously fast diffusion and a finite velocity of a random walker. Recent results in optics, Hamiltonian chaos, cold atom dynamics, biophysics, and behavioral science demonstrate that this particular type of random walk provides significant insight into complex transport phenomena. This review gives a self-consistent introduction to Lévy walks, surveys their existing applications, including latest advances, and outlines further perspectives.

Effect of walking speed on lower extremity joint loading in graded ramp walking.

PubMed

Schwameder, Hermann; Lindenhofer, Elke; Müller, Erich

2005-07-01

Lower extremity joint loading during walking is strongly affected by the steepness of the slope and might cause pain and injuries in lower extremity joint structures. One feasible measure to reduce joint loading is the reduction of walking speed. Positive effects have been shown for level walking, but not for graded walking or hiking conditions. The aim of the study was to quantify the effect of walking speed (separated into the two components, step length and cadence) on the joint power of the hip, knee and ankle and to determine the knee joint forces in uphill and downhill walking. Ten participants walked up and down a ramp with step lengths of 0.46, 0.575 and 0.69 m and cadences of 80, 100 and 120 steps per minute. The ramp was equipped with a force platform and the locomotion was filmed with a 60 Hz video camera. Loading of the lower extremity joints was determined using inverse dynamics. A two-dimensional knee model was used to calculate forces in the knee structures during the stance phase. Walking speed affected lower extremity joint loading substantially and significantly. Change of step length caused much greater loading changes for all joints compared with change of cadence; the effects were more distinct in downhill than in uphill walking. The results indicate that lower extremity joint loading can be effectively controlled by varying step length and cadence during graded uphill and downhill walking. Hikers can avoid or reduce pain and injuries by reducing walking speed, particularly in downhill walking.

From Toes to Top-of-the-Atmosphere: Fowler Sneaker Index

NASA Technical Reports Server (NTRS)

Crooke, Ben A.; McKinna, Lachlan I W.; Cetinic, Ivona

2016-01-01

Fowler Sneaker Index (FSI), developed by a NASA summer intern, is a new Ocean Color application that facilitates continuous monitoring of environmental conditions in the Chesapeake Bay. It builds on three decades of citizen science data collected by former Maryland State Senator Bernie Fowler, during his yearly "Wade-ins in the Patuxent River". FSI demonstrates how NASA's Earth-observing tools, in combination with a concerned and engaged public, can take science from the tips of our toes-to-top-of the atmosphere and back.

Effects of long-term wearing of high-heeled shoes on the control of the body's center of mass motion in relation to the center of pressure during walking.

PubMed

Chien, Hui-Lien; Lu, Tung-Wu; Liu, Ming-Wei

2014-04-01

High-heeled shoes are associated with instability and falling, leading to injuries such as fracture and ankle sprain. This study investigated the effects of habitual wearing of high-heeled shoes on the body's center of mass (COM) motion relative to the center of pressure (COP) during gait. Fifteen female experienced wearers and 15 matched controls walked with high-heeled shoes (7.3cm) while kinematic and ground reaction force data were measured and used to calculate temporal-distance parameters, joint moments, COM-COP inclination angles (IA) and the rate of IA changes (RCIA). Compared with inexperienced wearers, experienced subjects showed significantly reduced frontal IA with increased ankle pronator moments during single-limb support (p<0.05). During double-limb support (DLS), they showed significantly increased magnitudes of the frontal RCIA at toe-off and contralateral heel-strike, and reduced DLS time (p<0.05) but unaltered mean RCIA over DLS. In the sagittal plane experienced wearers showed significantly increased mean RCIA (p<0.05) and significant differences in the RCIA at toe-off and contralateral heel-strike (p<0.05). Significantly increased hip flexor moments and knee extensor moments at toe-off (p<0.05) were needed for forward motion of the trailing limb. The current results identified the change in the balance control in females after long-term use of high-heeled shoes, providing a basis for future design of strategies to minimize the risk of falling during high-heeled gait. Copyright © 2014 Elsevier B.V. All rights reserved.

Nonsurgical Management of Adolescent Idiopathic Scoliosis.

PubMed

Gomez, Jaime A; Hresko, M Timothy; Glotzbecker, Michael P

2016-08-01

Pediatric patient visits for spinal deformity are common. Most of these visits are for nonsurgical management of scoliosis, with approximately 600,000 visits for adolescent idiopathic scoliosis (AIS) annually. Appropriate management of scoliotic curves that do not meet surgical indication parameters is essential. Renewed enthusiasm for nonsurgical management of AIS (eg, bracing, physical therapy) exists in part because of the results of the Bracing in Adolescent Idiopathic Scoliosis Trial, which is the only randomized controlled trial available on the use of bracing for AIS. Bracing is appropriate for idiopathic curves between 20° and 40°, with successful control of these curves reported in >70% of patients. Patient adherence to the prescribed duration of wear is essential to maximize the effectiveness of the brace. The choice of brace type must be individualized according to the deformity and the patient's personality as well as the practice setting and brace availability.

Adults' Daily Walking for Travel and Leisure: Interaction Between Attitude Toward Walking and the Neighborhood Environment.

PubMed

Yang, Yong; Diez-Roux, Ana V

2017-09-01

Studies on how the interaction of psychological and environmental characteristics influences walking are limited, and the results are inconsistent. Our aim is to examine how the attitude toward walking and neighborhood environments interacts to influence walking. Cross-sectional phone and mail survey. Participants randomly sampled from 6 study sites including Los Angeles, Chicago, Baltimore, Minneapolis, Manhattan, and Bronx Counties in New York City, and Forsyth and Davidson Counties in North Carolina. The final sample consisted of 2621 persons from 2011 to 2012. Total minutes of walking for travel or leisure, attitude toward walking, and perceptions of the neighborhood environments were self-reported. Street Smart (SS) Walk Score (a measure of walkability derived from a variety of geographic data) was obtained for each residential location. Linear regression models adjusting for age, gender, race/ethnicity, education, and income. Attitude toward walking was positively associated with walking for both purposes. Walking for travel was significantly associated with SS Walk Score, whereas walking for leisure was not. The SS Walk Score and selected perceived environment characteristics were associated with walking in people with a very positive attitude toward walking but were not associated with walking in people with a less positive attitude. Attitudes toward walking and neighborhood environments interact to affect walking behavior.

Towards evidence based emergency medicine: Best BETs from the Manchester Royal Infirmary. BET 3: Toe fractures in adults.

PubMed

Paradise, David

2012-11-01

A short cut review was carried out to establish whether intervention and follow up of patients with toe phalanx fractures is better than no treatment at reducing time to return to normal activity and need for surgical intervention. 40 papers were found using the reported searches, of which 1 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper is tabulated. It is concluded that there is no evidence to determine whether intervention of any type improves outcome in toe phalanx fractures.

Occurrence of idiopathic pulmonary fibrosis during immunosuppressive treatment: a case report.

PubMed

Cerri, Stefania; Sgalla, Giacomo; Richeldi, Luca; Luppi, Fabrizio

2016-05-25

Immunosuppressive therapy has been-until the recent release of new guidelines on diagnosis and management-the recommended treatment for idiopathic pulmonary fibrosis. However, its efficacy in patients with idiopathic pulmonary fibrosis has always been a matter of debate. We report the occurrence of idiopathic pulmonary fibrosis in a white man receiving chronic immunosuppressive treatment following a heart transplant. This case report suggests that the immune mechanisms targeted by azathioprine and cyclosporine do not play a role in the pathogenesis of idiopathic pulmonary fibrosis.

Effects of a Flexibility and Relaxation Programme, Walking, and Nordic Walking on Parkinson's Disease

PubMed Central

Reuter, I.; Mehnert, S.; Leone, P.; Kaps, M.; Oechsner, M.; Engelhardt, M.

2011-01-01

Symptoms of Parkinson's disease (PD) progress despite optimized medical treatment. The present study investigated the effects of a flexibility and relaxation programme, walking, and Nordic walking (NW) on walking speed, stride length, stride length variability, Parkinson-specific disability (UPDRS), and health-related quality of life (PDQ 39). 90 PD patients were randomly allocated to the 3 treatment groups. Patients participated in a 6-month study with 3 exercise sessions per week, each lasting 70 min. Assessment after completion of the training showed that pain was reduced in all groups, and balance and health-related quality of life were improved. Furthermore, walking, and Nordic walking improved stride length, gait variability, maximal walking speed, exercise capacity at submaximal level, and PD disease-specific disability on the UPDRS in addition. Nordic walking was superior to the flexibility and relaxation programme and walking in improving postural stability, stride length, gait pattern and gait variability. No significant injuries occurred during the training. All patients of the Nordic walking group continued Nordic walking after completing the study. PMID:21603199

Gait training reduces ankle joint stiffness and facilitates heel strike in children with Cerebral Palsy.

PubMed

Willerslev-Olsen, Maria; Lorentzen, Jakob; Nielsen, Jens Bo

2014-01-01

Foot drop and toe walking are frequent concerns in children with cerebral palsy (CP). Increased stiffness of the ankle joint muscles may contribute to these problems. Does four weeks of daily home based treadmill training with incline reduce ankle joint stiffness and facilitate heel strike in children with CP? Seventeen children with CP (4-14 years) were recruited. Muscle stiffness and gait ability were measured twice before and twice after training with an interval of one month. Passive and reflex-mediated stiffness were measured by a dynamometer which applied stretches below and above reflex threshold. Gait kinematics were recorded by 3-D video-analysis during treadmill walking. Foot pressure was measured by force-sensitive foot soles during treadmill and over-ground walking. Children with increased passive stiffness showed a significant reduction in stiffness following training (P = 0.01). Toe lift in the swing phase (P = 0.014) and heel impact (P = 0.003) increased significantly following the training during both treadmill and over-ground walking. Daily intensive gait training may influence the elastic properties of ankle joint muscles and facilitate toe lift and heel strike in children with CP. Intensive gait training may be beneficial in preventing contractures and maintain gait ability in children with CP.

IgG abnormality in narcolepsy and idiopathic hypersomnia.

PubMed

Tanaka, Susumu; Honda, Makoto

2010-03-05

A close association between narcolepsy and the Human Leukocyte Antigen (HLA)-DQB1*0602 allele suggests the involvement of the immune system, or possibly an autoimmune process. We investigated serum IgG levels in narcolepsy. We measured the serum total IgG levels in 159 Japanese narcolepsy-cataplexy patients positive for the HLA-DQB1*0602 allele, 28 idiopathic hypersomnia patients with long sleep time, and 123 healthy controls (the HLA-DQB1*0602 allele present in 45 subjects). The serum levels of each IgG subclass were subsequently measured. The distribution of serum IgG was significantly different among healthy controls negative for the HLA-DQB1*0602 allele (11.66+/-3.55 mg/ml), healthy controls positive for the HLA-DQB1*0602 allele (11.45+/-3.43), narcolepsy patients (9.67+/-3.38), and idiopathic hypersomnia patients (13.81+/-3.80). None of the following clinical variables, age, disease duration, Epworth Sleepiness Scale, smoking habit and BMI at the time of blood sampling, were associated with IgG levels in narcolepsy or idiopathic hypersomnia. Furthermore we found the decrease in IgG1 and IgG2 levels, stable expression of IgG3, and the increase in the proportion of IgG4 in narcolepsy patients with abnormally low IgG levels. The increase in the proportion of IgG4 levels was also found in narcolepsy patients with normal serum total IgG levels. Idiopathic hypersomnia patients showed a different pattern of IgG subclass distribution with high IgG3 and IgG4 level, low IgG2 level, and IgG1/IgG2 imbalance. Our study is the first to determine IgG abnormalities in narcolepsy and idiopathic hypersomnia by measuring the serum IgG levels in a large number of hypersomnia patients. The observed IgG abnormalities indicate humoral immune alterations in narcolepsy and idiopathic hypersomnia. Different IgG profiles suggest immunological differences between narcolepsy and idiopathic hypersomnia.

Pathology of idiopathic non-cirrhotic portal hypertension.

PubMed

Guido, Maria; Sarcognato, Samantha; Sacchi, Diana; Colloredo, Guido

2018-04-12

Idiopathic non-cirrhotic portal hypertension is an under-recognized vascular liver disease of unknown etiology, characterized by clinical signs of portal hypertension in the absence of cirrhosis. By definition, any disorder known to cause portal hypertension in the absence of cirrhosis and any cause of chronic liver disease must be excluded to make a diagnosis of idiopathic non-cirrhotic portal hypertension. However, the diagnosis is often difficult because the disease resembles cirrhosis and there is no gold standard test. Liver biopsy is an essential tool: it is able to exclude cirrhosis and other causes of portal hypertension and it allows the identification of the characteristic lesions. Nonetheless, the histological diagnosis of idiopathic non-cirrhotic portal hypertension is not always straightforward, in particular by needle biopsy samples, because there is no pathognomonic lesion, but rather a variety of vascular changes which are unevenly distributed, very subtle, and not all necessarily identified in a single specimen. Pathologists should be able to recognize several patterns of injury, involving portal/periportal areas as well as parenchymal structures.The histological features of idiopathic non-cirrhotic portal hypertension are described in this review, focusing on their interpretation in needle biopsy specimens.

Quantum walk computation

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

Kendon, Viv

2014-12-04

Quantum versions of random walks have diverse applications that are motivating experimental implementations as well as theoretical studies. Recent results showing quantum walks are “universal for quantum computation” relate to algorithms, to be run on quantum computers. We consider whether an experimental implementation of a quantum walk could provide useful computation before we have a universal quantum computer.

Longitudinal bracketed epiphysis of proximal phalanx of the great toe with congenital hallux varus managed simultaneously with monorail external fixator: a case report.

PubMed

Verma, Vineet; Batra, Amit; Singla, Rohit; Gogna, Paritosh; Magu, Narender; Gupta, Rakesh

2014-02-01

Longitudinal bracketed epiphysis (delta phalanx) is a rare congenital anomaly that affects phalanges in the hand more commonly than toes. We present a rare case of congenital hallux varus with longitudinal bracketed epiphysis of proximal phalanx with bifid distal phalanx of the great toe, which was managed with monorail type of external fixator. To the best of our knowledge, this is the first report of its successful implementation in simultaneous treatment of longitudinal bracketed epiphysis of the proximal phalanx of the great toe and hallux varus. Apart from adding to the literature a case of rare subtype of delta phalanx with hallux varus, the present study highlights the role of a reliable alternative in its management.

The generation of centripetal force when walking in a circle: insight from the distribution of ground reaction forces recorded by plantar insoles.

PubMed

Turcato, Anna Maria; Godi, Marco; Giordano, Andrea; Schieppati, Marco; Nardone, Antonio

2015-01-09

Turning involves complex reorientation of the body and is accompanied by asymmetric motion of the lower limbs. We investigated the distribution of the forces under the two feet, and its relation to the trajectory features and body medio-lateral displacement during curved walking. Twenty-six healthy young participants walked under three different randomized conditions: in a straight line (LIN), in a circular clockwise path and in a circular counter-clockwise path. Both feet were instrumented with Pedar-X insoles. An accelerometer was fixed to the trunk to measure the medio-lateral inclination of the body. We analyzed walking speed, stance duration as a percent of gait cycle (%GC), the vertical component of the ground reaction force (vGRF) of both feet during the entire stance, and trunk inclination. Gait speed was faster during LIN than curved walking, but not affected by the direction of the curved trajectory. Trunk inclination was negligible during LIN, while the trunk was inclined toward the center of the path during curved trajectories. Stance duration of LIN foot and foot inside the curved trajectory (Foot-In) was longer than for foot outside the trajectory (Foot-Out). vGRF at heel strike was larger in LIN than in curved walking. At mid-stance, vGRF for both Foot-In and Foot-Out was higher than for LIN foot. At toe off, vGRF for both Foot-In and Foot-Out was lower than for LIN foot; in addition, Foot-In had lower vGRF than Foot-Out. During curved walking, a greater loading of the lateral heel occurred for Foot-Out than Foot-In and LIN foot. On the contrary, a smaller lateral loading of the heel was found for Foot-In than LIN foot. At the metatarsal heads, an opposite behaviour was seen, since lateral loading decreased for Foot-Out and increased for Foot-In. The lower gait speed during curved walking is shaped by the control of trunk inclination and the production of asymmetric loading of heel and metatarsal heads, hence by the different contribution of the feet

Walking to health.

PubMed

Morris, J N; Hardman, A E

1997-05-01

Walking is a rhythmic, dynamic, aerobic activity of large skeletal muscles that confers the multifarious benefits of this with minimal adverse effects. Walking, faster than customary, and regularly in sufficient quantity into the 'training zone' of over 70% of maximal heart rate, develops and sustains physical fitness: the cardiovascular capacity and endurance (stamina) for bodily work and movement in everyday life that also provides reserves for meeting exceptional demands. Muscles of the legs, limb girdle and lower trunk are strengthened and the flexibility of their cardinal joints preserved; posture and carriage may improve. Any amount of walking, and at any pace, expends energy. Hence the potential, long term, of walking for weight control. Dynamic aerobic exercise, as in walking, enhances a multitude of bodily processes that are inherent in skeletal muscle activity, including the metabolism of high density lipoproteins and insulin/glucose dynamics. Walking is also the most common weight-bearing activity, and there are indications at all ages of an increase in related bone strength. The pleasurable and therapeutic, psychological and social dimensions of walking, whilst evident, have been surprisingly little studied. Nor has an economic assessment of the benefits and costs of walking been attempted. Walking is beneficial through engendering improved fitness and/or greater physiological activity and energy turnover. Two main modes of such action are distinguished as: (i) acute, short term effects of the exercise; and (ii) chronic, cumulative adaptations depending on habitual activity over weeks and months. Walking is often included in studies of exercise in relation to disease but it has seldom been specifically tested. There is, nevertheless, growing evidence of gains in the prevention of heart attack and reduction of total death rates, in the treatment of hypertension, intermittent claudication and musculoskeletal disorders, and in rehabilitation after heart

Smartphone App–Based Assessment of Gait During Normal and Dual-Task Walking: Demonstration of Validity and Reliability

PubMed Central

Yu, Wanting; Zhu, Hao; Harrison, Rachel; Lo, On-Yee; Lipsitz, Lewis; Travison, Thomas; Pascual-Leone, Alvaro; Zhou, Junhong

2018-01-01

Background Walking is a complex cognitive motor task that is commonly completed while performing another task such as talking or making decisions. Gait assessments performed under normal and “dual-task” walking conditions thus provide important insights into health. Such assessments, however, are limited primarily to laboratory-based settings. Objective The objective of our study was to create and test a smartphone-based assessment of normal and dual-task walking for use in nonlaboratory settings. Methods We created an iPhone app that used the phone’s motion sensors to record movements during walking under normal conditions and while performing a serial-subtraction dual task, with the phone placed in the user’s pants pocket. The app provided the user with multimedia instructions before and during the assessment. Acquired data were automatically uploaded to a cloud-based server for offline analyses. A total of 14 healthy adults completed 2 laboratory visits separated by 1 week. On each visit, they used the app to complete three 45-second trials each of normal and dual-task walking. Kinematic data were collected with the app and a gold-standard–instrumented GAITRite mat. Participants also used the app to complete normal and dual-task walking trials within their homes on 3 separate days. Within laboratory-based trials, GAITRite-derived heel strikes and toe-offs of the phone-side leg aligned with smartphone acceleration extrema, following filtering and rotation to the earth coordinate system. We derived stride times—a clinically meaningful metric of locomotor control—from GAITRite and app data, for all strides occurring over the GAITRite mat. We calculated stride times and the dual-task cost to the average stride time (ie, percentage change from normal to dual-task conditions) from both measurement devices. We calculated similar metrics from home-based app data. For these trials, periods of potential turning were identified via custom-developed algorithms

[Adolescent idiopathic scoliosis].

PubMed

2016-12-01

Adolescent idiopathic scoliosis is a 3D spinal deformity in frontal, sagittal and axial planes, with high relevance in the pediatric population especially in adolescents and females between 10 years of age and the end of growth spurt and skeletal maturity. The radiographic manifestation is a curve greater than 10° measured by Cobb method associated with vertebral rotation. "Idiopathic" diagnosis has to be done after neuroanatomical anomalies of the posterior cerebral fosa and spinal canal have been ruled out. The physical finding of a thoracic or lumbar hump is the clinical manifestation of vertebral rotation seen in a forward bending test (Adam's Test). It is recommended that all curves with a magnitude greater than 20° have to be controlled and treated by a spinal surgeon being observation, bracing and surgery the different treatment options based on the extent, progression of deformity and basically the clinical condition of the patient. Sociedad Argentina de Pediatría.

Idiopathic pulmonary fibrosis.

PubMed

Xaubet, Antoni; Ancochea, Julio; Molina-Molina, María

2017-02-23

Idiopathic pulmonary fibrosis is a fibrosing interstitial pneumonia associated with the radiological and/or histological pattern of usual interstitial pneumonia. Its aetiology is unknown, but probably comprises the action of endogenous and exogenous micro-environmental factors in subjects with genetic predisposition. Its diagnosis is based on the presence of characteristic findings of high-resolution computed tomography scans and pulmonary biopsies in absence of interstitial lung diseases of other aetiologies. Its clinical evolution is variable, although the mean survival rate is 2-5 years as of its clinical presentation. Patients with idiopathic pulmonary fibrosis may present complications and comorbidities which modify the disease's clinical course and prognosis. In the mild-moderate disease, the treatment consists of the administration of anti-fibrotic drugs. In severe disease, the best therapeutic option is pulmonary transplantation. In this paper we review the diagnostic and therapeutic aspects of the disease. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Increasing Walking in the Hartsfield-Jackson Atlanta International Airport: The Walk to Fly Study.

PubMed

Fulton, Janet E; Frederick, Ginny M; Paul, Prabasaj; Omura, John D; Carlson, Susan A; Dorn, Joan M

2017-07-01

To test the effectiveness of a point-of-decision intervention to prompt walking, versus motorized transport, in a large metropolitan airport. We installed point-of-decision prompt signage at 4 locations in the airport transportation mall at Hartsfield-Jackson Atlanta International Airport (Atlanta, GA) at the connecting corridor between airport concourses. Six ceiling-mounted infrared sensors counted travelers entering and exiting the study location. We collected traveler counts from June 2013 to May 2016 when construction was present and absent (preintervention period: June 2013-September 2014; postintervention period: September 2014-May 2016). We used a model that incorporated weekly walking variation to estimate the intervention effect on walking. There was an 11.0% to 16.7% relative increase in walking in the absence of airport construction where 580 to 810 more travelers per day chose to walk. Through May 2016, travelers completed 390 000 additional walking trips. The Walk to Fly study demonstrated a significant and sustained increase in the number of airport travelers choosing to walk. Providing signage about options to walk in busy locations where reasonable walking options are available may improve population levels of physical activity and therefore improve public health.

Swan-neck sign of the big toe - association with hypocalcaemia.

PubMed

Agarwal, Kishore S; Baijal, Noopur; Tiwari, Lokesh; Verma, Neeraj; Sahni, Mohit; Puliyel, Jacob M

2007-10-01

The sensitivity and specificity of a new clinical sign of hypocalcaemia were evaluated. The Swan-neck sign, wherein infants with symptomatic hypocalcaemia keep their big toe hyperextended at the metatarsophalangeal joint and flexed at the interphalangeal joint, was looked for in 25 infants presenting with non-febrile seizures, alongside their serum calcium levels. The study showed that the sign had a sensitivity of 63.6% and specificity of 66.6%. (Predictive values of positive and negative tests were 93.3% and 20%, respectively.) This is compared with the standard Trousseau and Chvostek signs.

CLINICAL CHARACTERISTICS OF IDIOPATHIC FOVEOMACULAR RETINOSCHISIS.

PubMed

Maruko, Ichiro; Morizane, Yuki; Kimura, Shuhei; Shiode, Yusuke; Hosokawa, Mio; Sekiryu, Tetsuju; Iida, Tomohiro; Shiraga, Fumio

2016-08-01

To describe the clinical features of idiopathic foveomacular retinoschisis not in association with myopia, glaucoma, optic disk pit, or juvenile retinoschisis. Retrospective observational case series. Five eyes of five patients with idiopathic foveomacular retinoschisis were included. The patients were 2 men and 3 women (average age, 75.2 years; range, 71-78 years). The average spherical equivalent was +2.40 diopters (range, +0.88 to +5.75 diopters), and the average axial length was 22.0 mm (range, 21.1-23.1 mm). All patients had retinoschisis from the macula to the optic disk in the affected eye. No patients had retinoschisis in the fellow eye. The average best-corrected visual acuity was 20/44 (68 Early Treatment Diabetic Retinopathy Study letter score). Idiopathic foveomacular retinoschisis is not inherited or associated with myopia, vitreomacular traction syndrome, optic pit, or glaucoma but is associated with older age, unilaterality, hyperopia with short axial length, complete posterior vitreous detachment, and weak leakage from the optic disk on fluorescein angiography.

Heightening Walking Above its Pedestrian Status : Walking and Travel Behavior in California

DOT National Transportation Integrated Search

2016-06-30

People walk a lotto walk pets, to exercise and recreate, and to access public transit and local shops. Walk trips begin and end almost every journey, even trips made by automobile. Data from the current California Household Travel Survey (CHTS) sh...

Walk Score® and Transit Score® and Walking in the Multi-Ethnic Study of Atherosclerosis

PubMed Central

Hirsch, Jana A.; Moore, Kari A.; Evenson, Kelly R.; Rodriguez, Daniel A; Diez Roux, Ana V.

2013-01-01

Background Walk Score® and Transit Score® are open-source measures of the neighborhood built environment to support walking (“walkability”) and access to transportation. Purpose To investigate associations of Street Smart Walk Score and Transit Score with self-reported transport and leisure walking using data from a large multi-city and diverse population-based sample of adults. Methods Data from a sample of 4552 residents of Baltimore MD; Chicago IL; Forsyth County NC; Los Angeles CA; New York NY; and St. Paul MN from the Multi-Ethnic Study of Atherosclerosis (2010–2012) were linked to Walk Score and Transit Score (collected in 2012). Logistic and linear regression models estimated ORs of not walking and mean differences in minutes walked, respectively, associated with continuous and categoric Walk Score and Transit Score. All analyses were conducted in 2012. Results After adjustment for site, key sociodemographic, and health variables, a higher Walk Score was associated with lower odds of not walking for transport and more minutes/week of transport walking. Compared to those in a “walker’s paradise,” lower categories of Walk Score were associated with a linear increase in odds of not transport walking and a decline in minutes of leisure walking. An increase in Transit Score was associated with lower odds of not transport walking or leisure walking, and additional minutes/week of leisure walking. Conclusions Walk Score and Transit Score appear to be useful as measures of walkability in analyses of neighborhood effects. PMID:23867022

Optimal management of idiopathic scoliosis in adolescence

PubMed Central

Kotwicki, Tomasz; Chowanska, Joanna; Kinel, Edyta; Czaprowski, Dariusz; Tomaszewski, Marek; Janusz, Piotr

2013-01-01

Idiopathic scoliosis is a three-dimensional deformity of the growing spine, affecting 2%–3% of adolescents. Although benign in the majority of patients, the natural course of the disease may result in significant disturbance of body morphology, reduced thoracic volume, impaired respiration, increased rates of back pain, and serious esthetic concerns. Risk of deterioration is highest during the pubertal growth spurt and increases the risk of pathologic spinal curvature, increasing angular value, trunk imbalance, and thoracic deformity. Early clinical detection of scoliosis relies on careful examination of trunk shape and is subject to screening programs in some regions. Treatment options are physiotherapy, corrective bracing, or surgery for mild, moderate, or severe scoliosis, respectively, with both the actual degree of deformity and prognosis being taken into account. Physiotherapy used in mild idiopathic scoliosis comprises general training of the trunk musculature and physical capacity, while specific physiotherapeutic techniques aim to address the spinal curvature itself, attempting to achieve self-correction with active trunk movements developed in a three-dimensional space by an instructed adolescent under visual and proprioceptive control. Moderate but progressive idiopathic scoliosis in skeletally immature adolescents can be successfully halted using a corrective brace which has to be worn full time for several months or until skeletal maturity, and is able to prevent more severe deformity and avoid the need for surgical treatment. Surgery is the treatment of choice for severe idiopathic scoliosis which is rapidly progressive, with early onset, late diagnosis, and neglected or failed conservative treatment. The psychologic impact of idiopathic scoliosis, a chronic disease occurring in the psychologically fragile period of adolescence, is important because of its body distorting character and the onerous treatment required, either conservative or surgical

Foot deformation during walking: differences between static and dynamic 3D foot morphology in developing feet.

PubMed

Barisch-Fritz, Bettina; Schmeltzpfenning, Timo; Plank, Clemens; Grau, Stefan

2014-01-01

The complex functions of feet require a specific composition, which is progressively achieved by developmental processes. This development should take place without being affected by footwear. The aim of this study is to evaluate differences between static and dynamic foot morphology in developing feet. Feet of 2554 participants (6-16 years) were recorded using a new scanner system (DynaScan4D). Each foot was recorded in static half and full weight-bearing and during walking. Several foot measures corresponding to those used in last construction were calculated. The differences were identified by one-way ANOVA and paired Student's t-test. Static and dynamic values of each foot measure must be considered to improve the fit of footwear. In particular, footwear must account for the increase of forefoot width and the decrease of midfoot girth. Furthermore, the toe box should have a more rounded shape. The findings are important for the construction of footwear for developing feet.

Generalized teleportation by quantum walks

NASA Astrophysics Data System (ADS)

Wang, Yu; Shang, Yun; Xue, Peng

2017-09-01

We develop a generalized teleportation scheme based on quantum walks with two coins. For an unknown qubit state, we use two-step quantum walks on the line and quantum walks on the cycle with four vertices for teleportation. For any d-dimensional states, quantum walks on complete graphs and quantum walks on d-regular graphs can be used for implementing teleportation. Compared with existing d-dimensional states teleportation, prior entangled state is not required and the necessary maximal entanglement resource is generated by the first step of quantum walk. Moreover, two projective measurements with d elements are needed by quantum walks on the complete graph, rather than one joint measurement with d^2 basis states. Quantum walks have many applications in quantum computation and quantum simulations. This is the first scheme of realizing communicating protocol with quantum walks, thus opening wider applications.

Walking economy during cued versus non-cued self-selected treadmill walking in persons with Parkinson's disease.

PubMed

Gallo, Paul M; McIsaac, Tara L; Garber, Carol Ewing

2014-01-01

Gait impairments related to Parkinson's disease (PD) include variable step length and decreased walking velocity, which may result in poorer walking economy. Auditory cueing is a common method used to improve gait mechanics in PD that has been shown to worsen walking economy at set treadmill walking speeds. It is unknown if auditory cueing has the same effects on walking economy at self-selected treadmill walking speeds. To determine if auditory cueing will affect walking economy at self-selected treadmill walking speeds and at speeds slightly faster and slower than self-selected. Twenty-two participants with moderate PD performed three, 6-minute bouts of treadmill walking at three speeds (self-selected and ± 0.22 m·sec-1). One session used cueing and the other without cueing. Energy expenditure was measured and walking economy was calculated (energy expenditure/power). Poorer walking economy and higher energy expenditure occurred during cued walking at a self-selected and a slightly faster walking speed, but there was no apparent difference at the slightly slower speed. These results suggest that potential gait benefits of auditory cueing may come at an energy cost and poorer walking economy for persons with PD at least at some treadmill walking speeds.

Comparison of two 6-minute walk tests to assess walking capacity in polio survivors.

PubMed

Brehm, Merel-Anne; Verduijn, Suzan; Bon, Jurgen; Bredt, Nicoline; Nollet, Frans

2017-11-21

To compare walking dynamics and test-retest reliability for 2 frequently applied walk tests in polio survivors: the 6-minute walk test (6MWT) to walk as far as possible; and the 6-minute walking energy cost test (WECT) at comfortable speed. Observational study. Thirty-three polio survivors, able to walk ≥ 150 m. On the same day participants performed a 6MWT and a WECT, which were repeated 1-3 weeks later. For each test, distance walked, heart rate and reduction in speed were assessed. The mean distance walked and mean heart rate were significantly higher in the 6MWT (441 m (standard deviation) (SD 79.7); 118 bpm (SD 19.2)) compared with the WECT (366 m (SD 67.3); 103 bpm (SD 14.3)); p< 0.001. Furthermore, during the 6MWT, patients continuously slowed down (-6%), while during the WECT speed dropped only slightly during the first 2 min, by -1.8% in total. Test-retest reliability of both tests was excellent (intraclass correlation coefficient (ICC) ≥ 0.95; lower bound 95% confidence interval (95% CI) ≥ 0.87). The smallest detectable change for the walked distance was 42 m (9.7% change from the mean) and 50 m (13.7%) on the 6MWT and WECT, respectively. Both the 6MWT and the WECT are reliable to assess walking capacity in polio survivors, with slightly superior sensitivity to detect change for the 6MWT. Differences in walking dynamics confirm that the tests cannot be used interchangeably. The 6MWT is recommended for measuring maximal walking capacity and the WECT for measuring submaximal walking capacity.

Walking straight into circles.

PubMed

Souman, Jan L; Frissen, Ilja; Sreenivasa, Manish N; Ernst, Marc O

2009-09-29

Common belief has it that people who get lost in unfamiliar terrain often end up walking in circles. Although uncorroborated by empirical data, this belief has widely permeated popular culture. Here, we tested the ability of humans to walk on a straight course through unfamiliar terrain in two different environments: a large forest area and the Sahara desert. Walking trajectories of several hours were captured via global positioning system, showing that participants repeatedly walked in circles when they could not see the sun. Conversely, when the sun was visible, participants sometimes veered from a straight course but did not walk in circles. We tested various explanations for this walking behavior by assessing the ability of people to maintain a fixed course while blindfolded. Under these conditions, participants walked in often surprisingly small circles (diameter < 20 m), though rarely in a systematic direction. These results rule out a general explanation in terms of biomechanical asymmetries or other general biases [1-6]. Instead, they suggest that veering from a straight course is the result of accumulating noise in the sensorimotor system, which, without an external directional reference to recalibrate the subjective straight ahead, may cause people to walk in circles.

The Relationship Between Walking Capacity, Biopsychosocial Factors, Self-Efficacy and Walking Activity in Individuals Post Stroke

PubMed Central

Danks, Kelly A.; Pohlig, Ryan T.; Roos, Margie; Wright, Tamara R.; Reisman, Darcy S.

2016-01-01

Background/Purpose Many factors appear to be related to physical activity after stroke, yet it is unclear how these factors interact and which ones might be the best predictors. Therefore, the purpose of this study was twofold: 1) to examine the relationship between walking capacity and walking activity, and 2) to investigate how biopsychosocial factors and self-efficacy relate to walking activity, above and beyond walking capacity impairment post-stroke. Methods Individuals greater than 3 months post-stroke (n=55) completed the Yesavage Geriatric Depression Scale (GDS), Fatigue Severity Scale (FSS), Modified Cumulative Illness Rating (MCIR) Scale, Walk 12, Activities Specific Balance Confidence (ABC) Scale, Functional Gait Assessment (FGA), and oxygen consumption testing. Walking activity data was collected via a StepWatch Activity Monitor (SAM). Predictors were grouped into 3 constructs: (1) Walking Capacity: oxygen consumption and FGA; (2) Biopsychosocial: GDS, FSS, and MCIR; (3) Self-Efficacy: Walk 12 and ABC. Moderated sequential regression models were used to examine what factors best predicted walking activity. Results Walking capacity explained 35.9% (p<0.001) of the variance in walking activity. Self-efficacy (ΔR2 = 0.15, p<0.001) and the interaction between the FGA*ABC (ΔR2 = 0.047, p<0.001) significantly increased the variability explained. FGA (β=0.37, p=0.01), MCIR (β=−0.26, p=0.01), and Walk 12 (β=−0.45, p=0.00) were each individually significantly associated with walking activity. Discussion/Conclusion While measures of walking capacity and self-efficacy significantly contributed to "real-world" walking activity, balance self-efficacy moderated the relationship between walking capacity and walking activity. Improving low balance self-efficacy may augment walking capacity and translate to improved walking activity post-stroke. PMID:27548750

Treatment of the idiopathic scoliosis with brace and physiotherapy.

PubMed

Hundozi-Hysenaj, Hajrije; Dallku, Iliriana Boshnjaku; Murtezani, Ardiana; Rrecaj, Shkurte

2009-01-01

Scoliosis is a three-dimensional deformation of the spine with a lateral curvature or deviation greater than 10 degrees and associated with vertebral rotation. Many conservative treatments are available for adolescents with idiopathic scoliosis, but the evidence for their effectiveness is still questioned. The objective of this study was to define the effectiveness of braces and individual physiotherapy for the comprehensive treatment of idiopathic scoliosis in adolescents. A retrospective study of 57 children with idiopathic thoracic dextroscoliosis with the magnitude of the thoracic curve between 20 degrees-35 degrees, treated in Orthopedic and Physiatrist Clinic as well as National Ortho-prosthetic Center within University Clinical Center of Kosova in Prishtina, during the period of 2003-2006. Inclusion of kinesitherapy in the comprehensive management of idiopathic scoliosis varied in the improvement of the muscle strength (satisfied and moderate) in almost 80% of the children while the correction of the curve was small in approximately 42.1% of cases. For children with idiopathic scoliosis, who require braces, an exercise program helps chest mobility, muscle strength, proper breathing flexibility in the spine, correct posture and keeps muscles in tone so that the transition period after brace removal is easier.

Acute exacerbation of idiopathic pulmonary fibrosis triggered by Aspergillus empyema.

PubMed

Suzuki, Atsushi; Kimura, Tomoki; Kataoka, Kensuke; Matsuda, Toshiaki; Yokoyama, Toshiki; Mori, Yuta; Kondoh, Yasuhiro

2018-01-01

Acute exacerbation (AE) is a severe and life-threatening complication of idiopathic pulmonary fibrosis (IPF). In 2016, the definition and diagnostic criteria for AE-IPF were updated by an international working group. The new definition includes any acute, clinically significant respiratory deterioration (both idiopathic and triggered events) characterized by evidence of new widespread alveolar abnormality in patients with IPF. There are no currently proven beneficial management strategies for idiopathic and triggered AE-IPF. This is the first report describing AE-IPF triggered by Aspergillus empyema, which was improved by a combination of corticosteroid, systemic antifungal therapy, local antifungal therapy, and additional pharmacological therapies. Future research may reveal optimal strategies for both idiopathic and triggered AE-IPF.

Idiopathic intracranial hypertension and sickle cell disease: two case reports.

PubMed

Segal, Laura; Discepola, Marino

2005-12-01

Two patients with sickle cell disease presented with headaches and visual disturbances, typical complaints of this disorder. However, prompt diagnosis of idiopathic intracranial hypertension and initiation of medical therapy lead to improved symptoms and restored vision. Ophthalmologists should consider sickle cell disease to be an independent risk factor for idiopathic intracranial hypertension when a patient is being assessed for visual disturbances. Although a rare condition, idiopathic intracranial hypertension has several key signs useful in establishing a diagnosis. It is critical to recognize the warning signs and symptoms to prevent devastating ophthalmologic complications. We report the first cases of idiopathic intracranial hypertension in patients with the novel Quebec-Chori beta-chain variant of sickle cell disease.

Guidelines for the medical treatment of idiopathic pulmonary fibrosis.

PubMed

Xaubet, Antoni; Molina-Molina, María; Acosta, Orlando; Bollo, Elena; Castillo, Diego; Fernández-Fabrellas, Estrella; Rodríguez-Portal, José Antonio; Valenzuela, Claudia; Ancochea, Julio

2017-05-01

Idiopathic pulmonary fibrosis is defined as chronic fibrosing interstitial pneumonia limited to the lung, with poor prognosis. The incidence has been rising in recent years probably due to improved diagnostic methods and increased life expectancy. In 2013, the SEPAR guidelines for the diagnosis and treatment for idiopathic pulmonary fibrosis were published. Since then, clinical trials and meta-analyses have shown strong scientific evidence for the use of pirfenidone and nintedanib in the treatment of idiopathic pulmonary fibrosis. In 2015, the international consensus of 2011 was updated and new therapeutic recommendations were established, prompting us to update our recommendation for the medical treatment of idiopathic pulmonary fibrosis accordingly. Diagnostic aspects and non-pharmacological treatment will not be discussed as no relevant developments have emerged since the 2013 guidelines. Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Relationship between oxygen cost of walking and level of walking disability after stroke: An experimental study.

PubMed

Polese, Janaine C; Ada, Louise; Teixeira-Salmela, Luci F

2018-01-01

Since physical inactivity is the major risk factor for recurrent stroke, it is important to understand how level of disability impacts oxygen uptake by people after stroke. This study investigated the nature of the relationship between level of disability and oxygen cost in people with chronic stroke. Level of walking disability was measured as comfortable walking speed using the 10-m Walk Test reported in m/s with 55 ambulatory people 2 years after stroke. Oxygen cost was measured during 3 walking tasks: overground walking at comfortable speed, overground walking at fast speed, and stair walking at comfortable speed. Oxygen cost was calculated from oxygen uptake divided by distance covered during walking and reported in ml∙kg -1 ∙m -1 . The relationship between level of walking disability and oxygen cost was curvilinear for all 3 walking tasks. One quadratic model accounted for 81% (95% CI [74, 88]) of the variance in oxygen cost during the 3 walking tasks: [Formula: see text] DISCUSSION: The oxygen cost of walking was related the level of walking disability in people with chronic stroke, such that the more disabled the individual, the higher the oxygen cost of walking; with oxygen cost rising sharply as disability became severe. An equation that relates oxygen cost during different walking tasks according to the level of walking disability allows clinicians to determine oxygen cost indirectly without the difficulty of measuring oxygen uptake directly. Copyright © 2017 John Wiley & Sons, Ltd.

Walking economy during cued versus non-cued treadmill walking in persons with Parkinson's disease.

PubMed

Gallo, Paul M; McIsaac, Tara L; Garber, Carol Ewing

2013-01-01

Gait impairment is common in Parkinson's disease (PD) and may result in greater energy expenditure, poorer walking economy, and fatigue during activities of daily living. Auditory cueing is an effective technique to improve gait; but the effects on energy expenditure are unknown. To determine whether energy expenditure differs in individuals with PD compared with healthy controls and if auditory cueing improves walking economy in PD. Twenty participants (10 PD and 10 controls) came to the laboratory for three sessions. Participants performed two, 6-minute bouts of treadmill walking at two speeds (1.12 m·sec-1 and 0.67 m·sec-1). One session used cueing and the other without cueing. A metabolic cart measured energy expenditure and walking economy was calculated (energy expenditure/power). PD had worse walking economy and higher energy expenditure than control participants during cued and non-cued walking at the 0.67 m·sec-1 speed and during non-cued walking at the 1.12 m·sec-1. With auditory cueing, energy expenditure and walking economy worsened in both participant groups. People with PD use more energy and have worse walking economy than adults without PD. Walking economy declines further with auditory cuing in persons with PD.

Walk This Way

ERIC Educational Resources Information Center

Mason, Nick

2007-01-01

A generation ago, it was part of growing up for all kids when they biked or walked to school. But in the last 30 years, heavier traffic, wider roads and more dangerous intersections have made it riskier for students walking or pedaling. Today, fewer than 15 percent of kids bike or walk to school compared with more than 50 percent in 1969. In the…

Maternal asthma and idiopathic preterm labor.

PubMed

Kramer, M S; Coates, A L; Michoud, M C; Dagenais, S; Moshonas, D; Davis, G M; Hamilton, E F; Nuwayhid, B; Joshi, A K; Papageorgiou, A

1995-11-15

Previous studies suggest that women with asthma are at increased risk of preterm birth. Moreover, drugs (especially beta-agonists) used to treat asthma are also used to treat preterm labor. The authors carried out a case-control study of 555 women from three hospital centers with idiopathic preterm labor (< 37 weeks), including two overlapping (i.e., non-mutually exclusive) subsamples: cases with early idiopathic preterm labor (< 34 weeks) and cases with idiopathic recurrent preterm labor (< 37 weeks plus a previous history of preterm delivery or second-trimester miscarriage). Controls were matched to cases according to race and smoking history prior to and during pregnancy. All subjects responded in person to questions about atopic, respiratory, obstetric, and sociodemographic histories. Subjects in the early and recurrent preterm labor subsamples were also asked to undergo spirometric testing with methacholine challenge 6-12 weeks after delivery. Cases were significantly more likely to report histories of asthma symptoms and physician-diagnosed asthma (matched odds ratios of 2-3) than controls, particularly those cases with recurrent preterm labor. No significant associations were observed, however, with methacholine responsiveness. These results could not be explained by residual confounding by smoking or other variables, nor by selective recall of asthma symptoms and histories by cases. Women with asthma are at increased risk of idiopathic preterm labor. The fact that no such association was seen with methacholine responsiveness suggests that nonatopic, noncholinergic mechanisms may link bronchial and uterine smooth muscle lability.

Cellular telephone use during free-living walking significantly reduces average walking speed.

PubMed

Barkley, Jacob E; Lepp, Andrew

2016-03-31

Cellular telephone (cell phone) use decreases walking speed in controlled laboratory experiments and there is an inverse relationship between free-living walking speed and heart failure risk. The purpose of this study was to examine the impact of cell phone use on walking speed in a free-living environment. Subjects (n = 1142) were randomly observed walking on a 50 m University campus walkway. The time it took each subject to walk 50 m was recorded and subjects were coded into categories: cell phone held to the ear (talking, n = 95), holding and looking at the cell phone (texting, n = 118), not visibly using the cell phone (no use, n = 929). Subjects took significantly (p < 0.001) longer traversing the walkway when talking (39.3 s) and texting (37.9 s) versus no use (35.3 s). As was the case with the previous laboratory experiments, cell phone use significantly reduces average speed during free-living walking.

Altered Regional Cerebral Blood Flow in Idiopathic Hypersomnia.

PubMed

Boucetta, Soufiane; Montplaisir, Jacques; Zadra, Antonio; Lachapelle, Francis; Soucy, Jean-Paul; Gravel, Paul; Dang-Vu, Thien Thanh

2017-10-01

Idiopathic hypersomnia is characterized by excessive daytime sleepiness, despite normal or long sleep time. Its pathophysiological mechanisms remain unclear. This pilot study aims at characterizing the neural correlates of idiopathic hypersomnia using single photon emission computed tomography. Thirteen participants with idiopathic hypersomnia and 16 healthy controls were scanned during resting wakefulness using a high-resolution single photon emission computed tomography scanner with 99mTc-ethyl cysteinate dimer to assess cerebral blood flow. The main analysis compared regional cerebral blood flow distribution between the two groups. Exploratory correlations between regional cerebral blood flow and clinical characteristics evaluated the functional correlates of those brain perfusion patterns. Significance was set at p < .05 after correction for multiple comparisons. Participants with idiopathic hypersomnia showed regional cerebral blood flow decreases in medial prefrontal cortex and posterior cingulate cortex and putamen, as well as increases in amygdala and temporo-occipital cortices. Lower regional cerebral blood flow in the medial prefrontal cortex was associated with higher daytime sleepiness. These preliminary findings suggest that idiopathic hypersomnia is characterized by functional alterations in brain areas involved in the modulation of vigilance states, which may contribute to the daytime symptoms of this condition. The distribution of regional cerebral blood flow changes was reminiscent of the patterns associated with normal non-rapid-eye-movement sleep, suggesting the possible presence of incomplete sleep-wake transitions. These abnormalities were strikingly distinct from those induced by acute sleep deprivation, suggesting that the patterns seen here might reflect a trait associated with idiopathic hypersomnia rather than a non-specific state of sleepiness. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep

Idiopathic Hypersomnia: Clinical Features and Response to Treatment

PubMed Central

Ali, Mohsin; Auger, R. Robert; Slocumb, Nancy L.; Morgenthaler, Timothy I.

2009-01-01

Objective: A recent American Academy of Sleep Medicine publication identified a need for research regarding idiopathic hypersomnia. We describe various clinical and polysomnographic features of patients with idiopathic hypersomnia, with an emphasis on response to pharmacotherapy. Methods: A retrospective review of our database initially identified 997 patients, utilizing “idiopathic hypersomnia,” “hypersomnia NOS,” and “primary hypersomnia” as keywords. The charts of eligible patients were examined in detail, and data were abstracted and analyzed. Response to treatment was graded utilizing an internally developed scale. Results: Eighty-five patients were ultimately identified (65% female). Median (interquartile range) ages of onset and diagnosis were 19.6 (15.5) and 33.7 (15.5), respectively. During a median follow-up duration of 2.4 (4.7) years, 65% of patients demonstrated a “complete response” to pharmacotherapy as assessed by the authors' grading schema. Methylphenidate was most commonly used as a first-line agent prior to December 1998, but subsequently, modafinil became the most common first drug. At the last recorded follow-up visit, 92% of patients were on monotherapy, with greater representation of methylphenidate versus modafinil (51% vs. 32%). Among these patients, methylphenidate produced a higher percentage of “complete” or “partial” responses than modafinil, although statistical significance was not reached (38/40 [ 95%] vs 22/25 [88%], respectively, p = 0.291). Conclusions: The majority of patients with idiopathic hypersomnia respond well to treatment. Methylphenidate is chosen more often than modafinil as final monotherapy in the treatment of idiopathic hypersomnia, despite the fact that it is less commonly used initially. Further prospective comparisons of medications should be explored. Citation: Ali M; Auger RR; Slocumb NL; Morgenthaler TI. Idiopathic hypersomnia: clinical features and response to treatment. J Clin Sleep

Talk the Walk: Does Socio-Cognitive Resource Reallocation Facilitate the Development of Walking?

PubMed

Geva, Ronny; Orr, Edna

2016-01-01

Walking is of interest to psychology, robotics, zoology, neuroscience and medicine. Human's ability to walk on two feet is considered to be one of the defining characteristics of hominoid evolution. Evolutionary science propses that it emerged in response to limited environmental resources; yet the processes supporting its emergence are not fully understood. Developmental psychology research suggests that walking elicits cognitive advancements. We postulate that the relationship between cognitive development and walking is a bi-directional one; and further suggest that the initiation of novel capacities, such as walking, is related to internal socio-cognitive resource reallocation. We shed light on these notions by exploring infants' cognitive and socio-communicative outputs prospectively from 6-18 months of age. Structured bi/tri weekly evaluations of symbolic and verbal development were employed in an urban cohort (N = 9) for 12 months, during the transition from crawling to walking. Results show links between preemptive cognitive changes in socio-communicative output, symbolic-cognitive tool-use processes, and the age of emergence of walking. Plots of use rates of lower symbolic play levels before and after emergence of new skills illustrate reductions in use of previously attained key behaviors prior to emergence of higher symbolic play, language and walking. Further, individual differences in age of walking initiation were strongly related to the degree of reductions in complexity of object-use (r = .832, p < .005), along with increases, counter to the general reduction trend, in skills that serve recruitment of external resources [socio-communication bids before speech (r = -.696, p < .01), and speech bids before walking; r = .729, p < .01)]. Integration of these proactive changes using a computational approach yielded an even stronger link, underscoring internal resource reallocation as a facilitator of walking initiation (r = .901, p<0.001). These

Talk the Walk: Does Socio-Cognitive Resource Reallocation Facilitate the Development of Walking?

PubMed Central

Orr, Edna

2016-01-01

Walking is of interest to psychology, robotics, zoology, neuroscience and medicine. Human’s ability to walk on two feet is considered to be one of the defining characteristics of hominoid evolution. Evolutionary science propses that it emerged in response to limited environmental resources; yet the processes supporting its emergence are not fully understood. Developmental psychology research suggests that walking elicits cognitive advancements. We postulate that the relationship between cognitive development and walking is a bi-directional one; and further suggest that the initiation of novel capacities, such as walking, is related to internal socio-cognitive resource reallocation. We shed light on these notions by exploring infants’ cognitive and socio-communicative outputs prospectively from 6–18 months of age. Structured bi/tri weekly evaluations of symbolic and verbal development were employed in an urban cohort (N = 9) for 12 months, during the transition from crawling to walking. Results show links between preemptive cognitive changes in socio-communicative output, symbolic-cognitive tool-use processes, and the age of emergence of walking. Plots of use rates of lower symbolic play levels before and after emergence of new skills illustrate reductions in use of previously attained key behaviors prior to emergence of higher symbolic play, language and walking. Further, individual differences in age of walking initiation were strongly related to the degree of reductions in complexity of object-use (r = .832, p < .005), along with increases, counter to the general reduction trend, in skills that serve recruitment of external resources [socio-communication bids before speech (r = -.696, p < .01), and speech bids before walking; r = .729, p < .01)]. Integration of these proactive changes using a computational approach yielded an even stronger link, underscoring internal resource reallocation as a facilitator of walking initiation (r = .901, p<0.001). These

Tic Tac TOE: Effects of Predictability and Importance on Acoustic Prominence in Language Production

ERIC Educational Resources Information Center

Watson, Duane G.; Arnold, Jennifer E.; Tanenhaus, Michael K.

2008-01-01

Importance and predictability each have been argued to contribute to acoustic prominence. To investigate whether these factors are independent or two aspects of the same phenomenon, naive participants played a verbal variant of Tic Tac Toe. Both importance and predictability contributed independently to the acoustic prominence of a word, but in…

Brain MRI findings in patients with idiopathic hypersomnia.

PubMed

Trotti, Lynn Marie; Bliwise, Donald L

2017-06-01

Proper diagnosis of idiopathic hypersomnia necessitates the exclusion of neurologic or medical causes of sleepiness that better explain the clinical syndrome. However, there are no formal guidelines regarding the use of neuroimaging to identify such secondary causes of symptoms. We sought to characterize brain MRI findings in a series of patients with idiopathic hypersomnia. We reviewed medical records on a consecutive series of 61 patients diagnosed with idiopathic hypersomnia to determine the frequency and results of brain magnetic resonance imaging (MRI). One-third of patients had undergone brain MRI, with focal neurologic signs or symptoms being the most common indication for neuroimaging. Although seven patients had an identifiable finding on neuroimaging (e.g., chronic microvascular ischemic changes), clinical management was changed as a result of imaging in only three cases. In all three, the imaging finding was predated by clear clinical abnormalities. Neuroimaging may be a complementary part of an idiopathic hypersomnia evaluation, but the decision to pursue imaging should be made on a case-by-case basis. Copyright © 2017 Elsevier B.V. All rights reserved.

Non-vascularized free toe phalanx transplantation in the treatment of symbrachydactyly and constriction ring syndrome.

PubMed

Gohla, T; Metz, Ch; Lanz, U

2005-10-01

Forty-eight patients underwent a total number of 113 non-vascularized free toe phalanx transplantations for congenital short digits between 1975 and 2003, a mean number of 2.3 transplanted phalanges per patient. The mean age at the time of initial surgery was 3.6 years (range 6 months to 21 years). The follow-up time ranged from 4 months to 14 years with a mean of 6 years. Sixty-four phalanges showed radiographically measured growth, 22 phalanges showed signs of resorption, while 27 phalanges showed neither growth nor resorption. Resorption increased with patient age. Three patients developed donor site problems. The optimum timing for initial surgery is as early as possible because of the safer and greater growth potential and less resorption of the transplanted phalanges. Non-vascularized free toe phalanx transplantations offer a simple and safe method of lengthening with a significant improvement of hand function.

Foot pressure distributions during walking in African elephants (Loxodonta africana)

PubMed Central

Pataky, Todd C.; Day, Madeleine; Hensman, Michael C.; Hensman, Sean; Hutchinson, John R.; Clemente, Christofer J.

2016-01-01

Elephants, the largest living land mammals, have evolved a specialized foot morphology to help reduce locomotor pressures while supporting their large body mass. Peak pressures that could cause tissue damage are mitigated passively by the anatomy of elephants' feet, yet this mechanism does not seem to work well for some captive animals. This study tests how foot pressures vary among African and Asian elephants from habitats where natural substrates predominate but where foot care protocols differ. Variations in pressure patterns might be related to differences in husbandry, including but not limited to trimming and the substrates that elephants typically stand and move on. Both species' samples exhibited the highest concentration of peak pressures on the lateral digits of their feet (which tend to develop more disease in elephants) and lower pressures around the heel. The trajectories of the foot's centre of pressure were also similar, confirming that when walking at similar speeds, both species load their feet laterally at impact and then shift their weight medially throughout the step until toe-off. Overall, we found evidence of variations in foot pressure patterns that might be attributable to husbandry and other causes, deserving further examination using broader, more comparable samples. PMID:27853539

Vestibular ataxia and its measurement in man

NASA Technical Reports Server (NTRS)

Fregly, A. R.

1974-01-01

Methods involved in and results obtained with a new comprehensive ataxia test battery are described, and definitions of spontaneous and induced vestibular ataxia in man are given in terms of these findings. In addition, the topic of alcohol-induced ataxia in relation to labyrinth function is investigated. Items in the test battery comprise a sharpened Romberg test, in which the subject stands on the floor with eyes closed and arms folded against his chest, feet heel-to-toe, for 60 seconds; an eyes-open walking test; an eyes-open standing test; an eyes-closed standing test; an eyes-closed on-leg standing test; an eyes-closed walk a line test; an eyes-closed heel-to-toe walking test; and supplementary ataxia tests such as the classical Romberg test.

Late Holocene earthquakes on the Toe Jam Hill fault, Seattle fault zone, Bainbridge Island, Washington

USGS Publications Warehouse

Nelson, A.R.; Johnson, S.Y.; Kelsey, H.M.; Wells, R.E.; Sherrod, B.L.; Pezzopane, S.K.; Bradley, L.A.; Koehler, R. D.; Bucknam, R.C.

2003-01-01

Five trenches across a Holocene fault scarp yield the first radiocarbon-measured earthquake recurrence intervals for a crustal fault in western Washington. The scarp, the first to be revealed by laser imagery, marks the Toe Jam Hill fault, a north-dipping backthrust to the Seattle fault. Folded and faulted strata, liquefaction features, and forest soil A horizons buried by hanging-wall-collapse colluvium record three, or possibly four, earthquakes between 2500 and 1000 yr ago. The most recent earthquake is probably the 1050-1020 cal. (calibrated) yr B.P. (A.D. 900-930) earthquake that raised marine terraces and triggered a tsunami in Puget Sound. Vertical deformation estimated from stratigraphic and surface offsets at trench sites suggests late Holocene earthquake magnitudes near M7, corresponding to surface ruptures >36 km long. Deformation features recording poorly understood latest Pleistocene earthquakes suggest that they were smaller than late Holocene earthquakes. Postglacial earthquake recurrence intervals based on 97 radiocarbon ages, most on detrital charcoal, range from ???12,000 yr to as little as a century or less; corresponding fault-slip rates are 0.2 mm/yr for the past 16,000 yr and 2 mm/yr for the past 2500 yr. Because the Toe Jam Hill fault is a backthrust to the Seattle fault, it may not have ruptured during every earthquake on the Seattle fault. But the earthquake history of the Toe Jam Hill fault is at least a partial proxy for the history of the rest of the Seattle fault zone.

Idiopathic granulomatous mastitis: an institutional experience

PubMed Central

Prasad, Seetharam; Jaiprakash, Padmapriya; Dave, Aniket; Pai, Deepti

2017-01-01

Objective To study idiopathic granulomatous mastitis with respect to its various clinical features, etiologic factors, treatment modalities and complications. Material and methods Retrospective study of all patients who were diagnosed with idiopathic granulomatous mastitis from 1st January 2006 to 31st December 2014 at Kasturba Hospital, Manipal, India (a tertiary care referral centre). The research was performed according to the World Medical Association Declaration of Helsinki. Informed consent was taken from the patient before invasive procedures including surgery. Data was analysed using the Statistical Package for Social Sciences version 16.0 wherever appropriate. Results 73 patients diagnosed with idiopathic granulomatous mastitis during the time period were included. One patient was a male (1.37%), rest were all females (98.63%). The mean age of presentation was 32.67 years (range 23 to 66 years). 70 patients (95.89%) were parous females. Average duration since last childbirth was 4.6 years (range: 3 months to 33 years). 8 patients (10.95%) were lactating. History of oral contraceptive pill use was present in 40 patients (54.79%). The right breast was affected in 44 patients (60.27%), and the left breast in 29 patients (39.73%). None of the patients had bilateral disease. The most common symptom was a painless lump (61.64%). Rest of the patients (38.36%) presented with features of a breast abscess. 19 out of 39 FNACs done (48.72%) were positive for granulomatous mastitis. 59 were primarily managed surgically (lumpectomy/wide excision-33, incision & drainage-26). One patient was treated primarily with prednisolone. 13 patients did not receive specific treatment, and were only kept on regular follow-up. Patients managed with lumpectomy/wide excision had the least rate of complications & recurrence (18.18%). Conclusion Patients with idiopathic granulomatous mastitis can present with a wide variety of symptoms which mimic other more common conditions. Surgical

On Heels and Toes: How Ants Climb with Adhesive Pads and Tarsal Friction Hair Arrays.

PubMed

Endlein, Thomas; Federle, Walter

2015-01-01

Ants are able to climb effortlessly on vertical and inverted smooth surfaces. When climbing, their feet touch the substrate not only with their pretarsal adhesive pads but also with dense arrays of fine hairs on the ventral side of the 3rd and 4th tarsal segments. To understand what role these different attachment structures play during locomotion, we analysed leg kinematics and recorded single-leg ground reaction forces in Weaver ants (Oecophylla smaragdina) climbing vertically on a smooth glass substrate. We found that the ants engaged different attachment structures depending on whether their feet were above or below their Centre of Mass (CoM). Legs above the CoM pulled and engaged the arolia ('toes'), whereas legs below the CoM pushed with the 3rd and 4th tarsomeres ('heels') in surface contact. Legs above the CoM carried a significantly larger proportion of the body weight than legs below the CoM. Force measurements on individual ant tarsi showed that friction increased with normal load as a result of the bending and increasing side contact of the tarsal hairs. On a rough sandpaper substrate, the tarsal hairs generated higher friction forces in the pushing than in the pulling direction, whereas the reverse effect was found on the smooth substrate. When the tarsal hairs were pushed, buckling was observed for forces exceeding the shear forces found in climbing ants. Adhesion forces were small but not negligible, and higher on the smooth substrate. Our results indicate that the dense tarsal hair arrays produce friction forces when pressed against the substrate, and help the ants to push outwards during horizontal and vertical walking.

Idiopathic granulomatous mastitis: a diagnostic dilemma for the breast radiologist.

PubMed

Sripathi, Smiti; Ayachit, Anurag; Bala, Archana; Kadavigere, Rajagopal; Kumar, Sandeep

2016-08-01

Idiopathic granulomatous mastitis is a chronic inflammatory disease of the breast, which is often difficult to differentiate both clinically and radiologically from infectious aetiologies such as tuberculosis, fungal infections, and also from malignancy, thus posing a diagnostic dilemma. We present a pictorial review of the commonly encountered imaging findings in idiopathic granulomatous mastitis on mammography and ultrasound. Mammographic and ultrasound findings of histopathologically proven cases of granulomatous mastitis are discussed. Idiopathic granulomatous mastitis has varied and non-specific appearances on ultrasound and mammography. Histopathology is essential to establish diagnosis. • Idiopathic granulomatous mastitis often poses a diagnostic dilemma for the radiologist by mimicking malignancy. • It has varied and non-specific appearances on mammography and ultrasound. • Histopathology is mandatory to establish the diagnosis and decide management.

Idiopathic scrotal elephantiasis.

PubMed

Hornberger, Brad J; Elmore, James M; Roehrborn, Claus G

2005-02-01

Scrotal lymphedema (scrotal elephantiasis) is a condition that has historically been described in areas endemic to filariasis. We present a unique case of a 22-year-old man with idiopathic lymphedema isolated to the scrotum. After acquired causes of lymphedema were ruled out, the patient was treated with scrotectomy and scrotal reconstruction.

A marching-walking hybrid induces step length adaptation and transfers to natural walking.

PubMed

Long, Andrew W; Finley, James M; Bastian, Amy J

2015-06-01

Walking is highly adaptable to new demands and environments. We have previously studied adaptation of locomotor patterns via a split-belt treadmill, where subjects learn to walk with one foot moving faster than the other. Subjects learn to adapt their walking pattern by changing the location (spatial) and time (temporal) of foot placement. Here we asked whether we can induce adaptation of a specific walking pattern when one limb does not "walk" but instead marches in place (i.e., marching-walking hybrid). The marching leg's movement is limited during the stance phase, and thus certain sensory signals important for walking may be reduced. We hypothesized that this would produce a spatial-temporal strategy different from that of normal split-belt adaptation. Healthy subjects performed two experiments to determine whether they could adapt their spatial-temporal pattern of step lengths during the marching-walking hybrid and whether the learning transfers to over ground walking. Results showed that the hybrid group did adapt their step lengths, but the time course of adaptation and deadaption was slower than that for the split-belt group. We also observed that the hybrid group utilized a mostly spatial strategy whereas the split-belt group utilized both spatial and temporal strategies. Surprisingly, we found no significant difference between the hybrid and split-belt groups in over ground transfer. Moreover, the hybrid group retained more of the learned pattern when they returned to the treadmill. These findings suggest that physical rehabilitation with this marching-walking paradigm on conventional treadmills may produce changes in symmetry comparable to what is observed during split-belt training. Copyright © 2015 the American Physiological Society.

Idiopathic diaphragmatic paralysis: Bell's palsy of the diaphragm?

PubMed

Crausman, Robert S; Summerhill, Eleanor M; McCool, F Dennis

2009-01-01

Idiopathic diaphragm paralysis is probably more common and responsible for more morbidity than generally appreciated. Bell's palsy, or idiopathic paralysis of the seventh cranial nerve, may be seen as an analogous condition. The roles of zoster sine herpete and herpes simplex have increasingly been recognized in Bell's palsy, and there are some data to suggest that antiviral therapy is a useful adjunct to steroid therapy. Thus, we postulated that antiviral therapy might have a positive impact on the course of acute idiopathic diaphragm paralysis which is likely related to viral infection. Three consecutive patients with subacute onset of symptomatic idiopathic hemidiaphragm paralysis were empirically treated with valacyclovir, 1,000 mg twice daily for 1 week. Prior to therapy, diaphragmatic function was assessed via pulmonary function testing and two-dimensional B-mode ultrasound, with testing repeated 1 month later. Diaphragmatic function pre- and post-treatment was compared to that of a historical control group of 16 untreated patients. All three subjects demonstrated ultrasound recovery of diaphragm function 4-6 weeks following treatment with valacyclovir. This recovery was accompanied by improvements in maximum inspiratory pressure (PI(max)) and vital capacity (VC). In contrast, in the untreated cohort, diaphragm recovery occurred in only 11 subjects, taking an average of 14.9 +/- 6.1 months (mean +/- SD). The results of this small, preliminary study suggest that antiviral therapy with valacyclovir may be helpful in the treatment of idiopathic diaphragm paralysis induced by a viral infection.

[Physical therapy for idiopathic scoliosis].

PubMed

Steffan, K

2015-11-01

The objective is the description and summary of the current state of idiopathic scoliosis treatment with physical therapy based on new scientific knowledge and concluded from more than 15 years of experience as a leading physician in two well-known clinics specializing in the conservative treatment of scoliosis. Based on current scientific publications on physical therapy in scoliosis treatment and resulting from the considerable personal experience gained working with conservative treatment and consulting scoliosis patients (as inpatients and outpatients), the current methods of physical therapy have been compared and evaluated. Physical therapy according to Schroth and Vojta therapy are at present the most common and effective methods in the physical treatment of idiopathic scoliosis. These methods can be applied during inpatient or outpatient treatment or intensified in the practice of specialized therapists. As there are only a few scientific studies on this subject, the author's findings are based mainly on his own experiences of the conservative treatment of idiopathic scoliosis. Athough these experiences are the results of over 15 years of working in the field of therapy, and the Schroth method in combination with corrective bracing presents highly promising results, it would nevertheless be desirable to conduct detailed scientific studies to verify the effectiveness of conservative treatment.

Walking for Well-Being: Are Group Walks in Certain Types of Natural Environments Better for Well-Being than Group Walks in Urban Environments?

PubMed Central

Marselle, Melissa R.; Irvine, Katherine N.; Warber, Sara L.

2013-01-01

The benefits of walking in natural environments for well-being are increasingly understood. However, less well known are the impacts different types of natural environments have on psychological and emotional well-being. This cross-sectional study investigated whether group walks in specific types of natural environments were associated with greater psychological and emotional well-being compared to group walks in urban environments. Individuals who frequently attended a walking group once a week or more (n = 708) were surveyed on mental well-being (Warwick Edinburgh Mental Well-being Scale), depression (Major Depressive Inventory), perceived stress (Perceived Stress Scale) and emotional well-being (Positive and Negative Affect Schedule). Compared to group walks in urban environments, group walks in farmland were significantly associated with less perceived stress and negative affect, and greater mental well-being. Group walks in green corridors were significantly associated with less perceived stress and negative affect. There were no significant differences between the effect of any environment types on depression or positive affect. Outdoor walking group programs could be endorsed through “green prescriptions” to improve psychological and emotional well-being, as well as physical activity. PMID:24173142

"I'm Just a'-Walking the Dog" correlates of regular dog walking.

PubMed

Christian nee Cutt, Hayley; Giles-Corti, Billie; Knuiman, Matthew

2010-01-01

Intrapersonal and environmental factors associated with dog walking (N = 483) were examined. A greater proportion of regular (80%) than irregular (59%) dog walkers met the recommended 150 minutes of physical activity per week. Owners who perceived greater social support and motivation from their dogs to walk, and who had access to a dog-supportive park within their neighborhood, were more likely to regularly walk with their dogs, even after adjustment for other well-known correlates of physical activity. The higher level of physical activity of regular dog walkers can be attributed to the additional walking these owners perform with their dogs.

The Tic-Tac-Toe Theory of Gravity

NASA Astrophysics Data System (ADS)

Greenberger, Daniel M.

2012-01-01

The Tic-Tac-Toe theory is a qualitative, phenomenological theory that automatically explains many of the features of the universe that we see, such as dark matter and dark energy. In that sense it is a Copernican theory that gives an alternate approach, which immediately and intuitively explains phenomena,independently of any detailed dynamics, for which the explanations in accepted standard theories are usually somewhat ad-hoc. The basic concept is to take the possibility of negative masses seriously, and generalize this to counter the unconvincing treatment of negative masses by the equivalence principle. Surprisingly, this automatically solves all sorts of other problems at the same time. Since the theory comes without a detailed dynamics, one can hardly expect people to embrace it with open arms, but it is presented to help convince students that there are many plausible new ideas available to them, and they should not let themselves be intimidated into believing that we are close to understanding nature.

Macrodystrophia lipomatosa of foot involving great toe.

PubMed

Gaur, A K; Mhambre, A S; Popalwar, H; Sharma, R

2014-06-01

Macrodystrophia lipomatosa is a rare form of congenital disorder in which there is localized gigantism characterized by progressive overgrowth of all mesenchymal elements with a disproportionate increase in the fibroadipose tissues. The adipose tissue infiltration involves subcutaneous tissue, periosteum, nerves and bone marrow. Most of the cases reported have hand or foot involvement. Patient seeks medical help for improving cosmesis or to get the size of the involved part reduced in order to reduce mechanical problems. We report a case of macrodystrophia lipomatosa involving medial side of foot with significant enlargement of great toe causing concern for cosmesis and inconvenience due to mechanical problems. The X-rays showed increased soft tissue with more of adipose tissue and increased size of involved digits with widening of ends. Since the patient's mother did not want any surgical intervention he was educated about foot care and proper footwear design was suggested. Copyright © 2014 Elsevier Ltd. All rights reserved.

Beam walking can detect differences in walking balance proficiency across a range of sensorimotor abilities.

PubMed

Sawers, Andrew; Ting, Lena H

2015-02-01

The ability to quantify differences in walking balance proficiency is critical to curbing the rising health and financial costs of falls. Current laboratory-based approaches typically focus on successful recovery of balance while clinical instruments often pose little difficulty for all but the most impaired patients. Rarely do they test motor behaviors of sufficient difficulty to evoke failures in balance control limiting their ability to quantify balance proficiency. Our objective was to test whether a simple beam-walking task could quantify differences in walking balance proficiency across a range of sensorimotor abilities. Ten experts, ten novices, and five individuals with transtibial limb loss performed six walking trials across three different width beams. Walking balance proficiency was quantified as the ratio of distance walked to total possible distance. Balance proficiency was not significantly different between cohorts on the wide-beam, but clear differences between cohorts on the mid and narrow-beams were identified. Experts walked a greater distance than novices on the mid-beam (average of 3.63±0.04m verus 2.70±0.21m out of 3.66m; p=0.009), and novices walked further than amputees (1.52±0.20m; p=0.03). Amputees were unable to walk on the narrow-beam, while experts walked further (3.07±0.14m) than novices (1.55±0.26m; p=0.0005). A simple beam-walking task and an easily collected measure of distance traveled detected differences in walking balance proficiency across sensorimotor abilities. This approach provides a means to safely study and evaluate successes and failures in walking balance in the clinic or lab. It may prove useful in identifying mechanisms underlying falls versus fall recoveries. Copyright © 2015 Elsevier B.V. All rights reserved.

Evaluation of the effectiveness of toe board energy-absorbing material for foot, ankle, and lower leg injury reduction.

PubMed

Patalak, John P; Stitzel, Joel D

2018-02-17

Since 2000, numerous improvements have been made to the National Association for Stock Car Auto Racing, Incorporated (NASCAR®) driver restraint system, resulting in improved crash protection for motorsports drivers. Advancements have included seats, head and neck restraints (HNRs), seat belt restraint systems, driver helmets, and others. These enhancements have increased protection for drivers from severe crash loading. Extending protection to the driver's extremities remains challenging. Though the drivers' legs are well contained for lateral and vertical crashes, they remain largely unrestrained in frontal and frontal oblique crashes. Sled testing was conducted for the evaluation of an energy-absorbing (EA) toe board material to be used as a countermeasure for leg and foot injuries. Testing included baseline rigid toe boards, tests with EA material-covered toe boards, and pretest positioning of the 50th percentile male frontal Hybrid III anthropomorphic test device (ATD) lower extremities. ATD leg and foot instrumentation included foot acceleration and tibia forces and moments. The sled test data were evaluated using established injury criteria for tibial plateau fractures, leg shaft fractures, and calcaneus, talus, ankle, and midfoot fractures. A polyurethane EA foam was found to be effective in limiting axial tibia force and foot accelerations when subjected to frontal impacts using the NASCAR motorsport restraint system.

Smartphone App-Based Assessment of Gait During Normal and Dual-Task Walking: Demonstration of Validity and Reliability.

PubMed

Manor, Brad; Yu, Wanting; Zhu, Hao; Harrison, Rachel; Lo, On-Yee; Lipsitz, Lewis; Travison, Thomas; Pascual-Leone, Alvaro; Zhou, Junhong

2018-01-30

Walking is a complex cognitive motor task that is commonly completed while performing another task such as talking or making decisions. Gait assessments performed under normal and "dual-task" walking conditions thus provide important insights into health. Such assessments, however, are limited primarily to laboratory-based settings. The objective of our study was to create and test a smartphone-based assessment of normal and dual-task walking for use in nonlaboratory settings. We created an iPhone app that used the phone's motion sensors to record movements during walking under normal conditions and while performing a serial-subtraction dual task, with the phone placed in the user's pants pocket. The app provided the user with multimedia instructions before and during the assessment. Acquired data were automatically uploaded to a cloud-based server for offline analyses. A total of 14 healthy adults completed 2 laboratory visits separated by 1 week. On each visit, they used the app to complete three 45-second trials each of normal and dual-task walking. Kinematic data were collected with the app and a gold-standard-instrumented GAITRite mat. Participants also used the app to complete normal and dual-task walking trials within their homes on 3 separate days. Within laboratory-based trials, GAITRite-derived heel strikes and toe-offs of the phone-side leg aligned with smartphone acceleration extrema, following filtering and rotation to the earth coordinate system. We derived stride times-a clinically meaningful metric of locomotor control-from GAITRite and app data, for all strides occurring over the GAITRite mat. We calculated stride times and the dual-task cost to the average stride time (ie, percentage change from normal to dual-task conditions) from both measurement devices. We calculated similar metrics from home-based app data. For these trials, periods of potential turning were identified via custom-developed algorithms and omitted from stride-time analyses

Walking Wellness. Student Workbook.

ERIC Educational Resources Information Center

Sweetgall, Robert; Neeves, Robert

This comprehensive student text and workbook, for grades four through eight, contains 16 workshop units focusing on walking field trips, aerobic pacing concepts, walking techniques, nutrition, weight control and healthy life-style planning. Co-ordinated homework assignments are included. The appendixes include 10 tips for walking, a calorie chart,…

[Vitrectomy for idiopathic and secondary preretinal macular membrane].

PubMed

Oficjalska-Młyńczak, Jolanta; Jamrozy-Witkowska, Agnieszka

2004-01-01

To evaluate the results of pars plana vitrectomy and membrane stripping for idiopathic and secondary preretinal macular membrane (PMM). Twenty one consecutive subjects (21 eyes) ranging in age from 40 to 78 (mean 66.9) with PMM underwent vitrectomy and membrane peeling. 17 cases had membranes that were considered idiopathic, and 4 cases were associated with other disorders: 3 occurred after successful retinal reattachment surgery, 1--after laserotherapy in the course of diabetic retinopathy. Visual acuity (VA), Amsler grid, and postoperative complications were assessed. The follow-up was 1 to 22 months, mean 5.7. Visual acuity improved postoperatively in 15 eyes (71.4%), at least two lines on the Snellen chart in 8 eyes (38.1%), entirely in patients with idiopathic PMM. It remained unchanged in 3 eyes (14.3%) and deteriorated in 3 eyes (14.3%). Eyes with transparent membrane showed greater visual improvement than opaque ones. The preoperative Amsler test was positive in 15 patients (71.4%), postoperatively--in 4 cases (19%). 2 idiopathic cases with VA of 0.7 showed postoperatively VA of 1.0. Complications included retinal detachment in 2 eyes (1 in idiopathic and 1 in secondary PMM), and development of nuclear sclerotic cataract in 2 eyes. At 6 months of follow-up, a residual membrane formation in 1 cases appeared. Macular pseudohole was observed in 1 eye with no impact on visual results. 1. Vitrectomy with membrane peeling for preretinal macular membrane provides improvement in visual acuity and reduces metamorphopsia 2. Thin, cellophane-like appearance of the membrane gives a better prognosis of visual function improvement.

Idiopathic hypersomnia: clinical features and response to treatment.

PubMed

Ali, Mohsin; Auger, R Robert; Slocumb, Nancy L; Morgenthaler, Timothy I

2009-12-15

A recent American Academy of Sleep Medicine publication identified a need for research regarding idiopathic hypersomnia. We describe various clinical and polysomnographic features of patients with idiopathic hypersomnia, with an emphasis on response to pharmacotherapy. A retrospective review of our database initially identified 997 patients, utilizing "idiopathic hypersomnia", "hypersomnia NOS", and "primary hypersomnia" as keywords. The charts of eligible patients were examined in detail, and data were abstracted and analyzed. Response to treatment was graded utilizing an internally developed scale. Eighty-five patients were ultimately identified (65% female). Median (interquartile range) ages of onset and diagnosis were 19.6 (15.5) and 33.7 (15.5), respectively. During a median follow-up duration of 2.4 (4.7) years, 65% of patients demonstrated a "complete response" to pharmacotherapy as assessed by the authors' grading schema. Methylphenidate was most commonly used as a first-line agent prior to December 1998, but subsequently, modafinil became the most common first drug. At the last recorded follow-up visit, 92% of patients were on monotherapy, with greater representation of methylphenidate versus modafinil (51% vs. 32%). Among these patients, methylphenidate produced a higher percentage of "complete" or "partial" responses than modafinil, although statistical significance was not reached (38/40 [95%] vs. 22/25 [88%], respectively, p = 0.291). The majority of patients with idiopathic hypersomnia respond well to treatment. Methylphenidate is chosen more often than modafinil as final monotherapy in the treatment of idiopathic hypersomnia, despite the fact that it is less commonly used initially. Further prospective comparisons of medications should be explored.

Idiopathic inflammatory myopathies overlapping with systemic diseases

PubMed Central

Lepreux, Sébastien; Hainfellner, Johannes A.; Vital, Anne

2018-01-01

A muscle biopsy is currently requested to assess the diagnosis of an idiopathic inflammatory myopathy overlapping with a systemic disease. During the past few years, the classification of inflammatory myopathy subtypes has been revisited progressively on the basis of correlations between clinical phenotypes, autoantibodies and histological data. Several syndromic entities are now more clearly defined, and the aim of the present review is to clarify the contribution of muscle biopsy in a setting of idiopathic inflammatory myopathies overlapping with systemic diseases. PMID:29154752

Obesity is a significant susceptibility factor for idiopathic AA amyloidosis.

PubMed

Blank, Norbert; Hegenbart, Ute; Dietrich, Sascha; Brune, Maik; Beimler, Jörg; Röcken, Christoph; Müller-Tidow, Carsten; Lorenz, Hanns-Martin; Schönland, Stefan O

2018-03-01

To investigate obesity as susceptibility factor in patients with idiopathic AA amyloidosis. Clinical, biochemical and genetic data were obtained from 146 patients with AA amyloidosis. Control groups comprised 40 patients with long-standing inflammatory diseases without AA amyloidosis and 56 controls without any inflammatory disease. Patients with AA amyloidosis had either familial Mediterranean fever (FMF) or long-standing rheumatic diseases as underlying inflammatory disease (n = 111, median age 46 years). However, in a significant proportion of patients with AA amyloidosis no primary disease was identified (idiopathic AA; n = 37, median age 60 years). Patients with idiopathic AA amyloidosis were more obese and older than patients with AA amyloidosis secondary to FMF or rheumatic diseases. Serum leptin levels correlated with the body mass index (BMI) in all types of AA amyloidosis. Elevated leptin levels of more than 30 µg/l were detected in 18% of FMF/rheumatic + AA amyloidosis and in 40% of patients with idiopathic AA amyloidosis (p = .018). Finally, the SAA1 polymorphism was confirmed as a susceptibility factor for AA amyloidosis irrespective of the type of the disease. Obesity, age and the SAA1 polymorphism are susceptibility factors for idiopathic AA amyloidosis. Recent advances in treatment of FMF and rheumatic disorders will decrease the incidence of AA amyloidosis due to these diseases. Idiopathic AA, however, might be an emerging problem in the ageing and increasingly obese population.

A marching-walking hybrid induces step length adaptation and transfers to natural walking

PubMed Central

Long, Andrew W.; Finley, James M.

2015-01-01

Walking is highly adaptable to new demands and environments. We have previously studied adaptation of locomotor patterns via a split-belt treadmill, where subjects learn to walk with one foot moving faster than the other. Subjects learn to adapt their walking pattern by changing the location (spatial) and time (temporal) of foot placement. Here we asked whether we can induce adaptation of a specific walking pattern when one limb does not “walk” but instead marches in place (i.e., marching-walking hybrid). The marching leg's movement is limited during the stance phase, and thus certain sensory signals important for walking may be reduced. We hypothesized that this would produce a spatial-temporal strategy different from that of normal split-belt adaptation. Healthy subjects performed two experiments to determine whether they could adapt their spatial-temporal pattern of step lengths during the marching-walking hybrid and whether the learning transfers to over ground walking. Results showed that the hybrid group did adapt their step lengths, but the time course of adaptation and deadaption was slower than that for the split-belt group. We also observed that the hybrid group utilized a mostly spatial strategy whereas the split-belt group utilized both spatial and temporal strategies. Surprisingly, we found no significant difference between the hybrid and split-belt groups in over ground transfer. Moreover, the hybrid group retained more of the learned pattern when they returned to the treadmill. These findings suggest that physical rehabilitation with this marching-walking paradigm on conventional treadmills may produce changes in symmetry comparable to what is observed during split-belt training. PMID:25867742

Retrograde tracing and toe spreading after experimental autologous nerve transplantation and crush injury of the sciatic nerve: a descriptive methodological study.

PubMed

van Neerven, Sabien Ga; Bozkurt, Ahmet; O'Dey, Dan Mon; Scheffel, Juliane; Boecker, Arne H; Stromps, Jan-Philipp; Dunda, Sebastian; Brook, Gary A; Pallua, Norbert

2012-04-30

Evaluation of functional and structural recovery after peripheral nerve injury is crucial to determine the therapeutic effect of a nerve repair strategy. In the present study, we examined the relationship between the structural evaluation of regeneration by means of retrograde tracing and the functional analysis of toe spreading. Two standardized rat sciatic nerve injury models were used to address this relationship. As such, animals received either a 2 cm sciatic nerve defect (neurotmesis) followed by autologous nerve transplantation (ANT animals) or a crush injury with spontaneous recovery (axonotmesis; CI animals). Functional recovery of toe spreading was observed over an observation period of 84 days. In contrast to CI animals, ANT animals did not reach pre-surgical levels of toe spreading. After the observation period, the lipophilic dye DiI was applied to label sensory and motor neurons in dorsal root ganglia (DRG; sensory neurons) and spinal cord (motor neurons), respectively. No statistical difference in motor or sensory neuron counts could be detected between ANT and CI animals.In the present study we could indicate that there was no direct relationship between functional recovery (toe spreading) measured by SSI and the number of labelled (motor and sensory) neurons evaluated by retrograde tracing. The present findings demonstrate that a multimodal approach with a variety of independent evaluation tools is essential to understand and estimate the therapeutic benefit of a nerve repair strategy.

Placental villous hypermaturation is associated with idiopathic preterm birth

PubMed Central

Morgan, Terry K.; Tolosa, Jorge E.; Mele, Lisa; Wapner, Ronald J.; Spong, Catherine Y.; Sorokin, Yoram; Dudley, Donald J.; Peaceman, Alan M.; Mercer, Brian M.; Thorp, John M.; O’Sullivan, Mary Jo; Ramin, Susan M.; Rouse, Dwight J.; Sibai, Baha

2014-01-01

Objective Pregnancy complications such as intra-amniotic infection, preeclampsia, and fetal intrauterine growth restriction (IUGR) account for most cases of preterm birth (PTB), but many spontaneous PTB cases do not have a clear etiology. We hypothesize that placental insufficiency may be a potential cause of idiopathic PTB. Methods Secondary analysis of 82 placental samples from women with PTB obtained from a multicenter trial of repeat versus single antenatal corticosteroids. Samples were centrally reviewed by a single placental pathologist masked to clinical outcomes. The histopathologic criterion for infection was the presence of acute chorioamnionitis defined as neutrophils marginating into the chorionic plate. Placental villous hypermaturation (PVH) was defined as a predominance of terminal villi (similar to term placenta) with extensive syncytial knotting. Idiopathic PTB comprised a group without another known etiology such as preeclampsia, IUGR or infection. Results Acute chorioamnionitis was observed in 33/82 (40%) cases. Other known causes of PTB were reported in 18/82 (22%). The remaining 31/82 (38%) were idiopathic. The frequency of PVH in idiopathic PTB (26/31=84%) was similar to cases with IUGR or preeclampsia (16/ 18=89%), but significantly more common than PVH in the group with acute chorioamnionitis (10/33=30%) (p<0.001). Conclusions PVH, which is a histologic marker of relative placental insufficiency, is a common finding in idiopathic PTB. PMID:23130816

Allelic variation of the FRMD7 gene in congenital idiopathic nystagmus.

PubMed

Self, James E; Shawkat, Fatima; Malpas, Crispin T; Thomas, N Simon; Harris, Christopher M; Hodgkins, Peter R; Chen, Xiaoli; Trump, Dorothy; Lotery, Andrew J

2007-09-01

To perform a genotype-phenotype correlation study in an X-linked congenital idiopathic nystagmus pedigree (pedigree 1) and to assess the allelic variance of the FRMD7 gene in congenital idiopathic nystagmus. Subjects from pedigree 1 underwent detailed clinical examination including nystagmology. Screening of FRMD7 was undertaken in pedigree 1 and in 37 other congenital idiopathic nystagmus probands and controls. Direct sequencing confirmed sequence changes. X-inactivation studies were performed in pedigree 1. The nystagmus phenotype was extremely variable in pedigree 1. We identified 2 FRMD7 mutations. However, 80% of X-linked families and 96% of simplex cases showed no mutations. X-inactivation studies demonstrated no clear causal link between skewing and variable penetrance. We confirm profound phenotypic variation in X-linked congenital idiopathic nystagmus pedigrees. We demonstrate that other congenital nystagmus genes exist besides FRMD7. We show that the role of X inactivation in variable penetrance is unclear in congenital idiopathic nystagmus. Clinical Relevance We demonstrate that phenotypic variation of nystagmus occurs in families with FRMD7 mutations. While FRMD7 mutations may be found in some cases of X-linked congenital idiopathic nystagmus, the diagnostic yield is low. X-inactivation assays are unhelpful as a test for carrier status for this disease.

When Human Walking is a Random Walk

NASA Astrophysics Data System (ADS)

Hausdorff, J. M.

1998-03-01

The complex, hierarchical locomotor system normally does a remarkable job of controlling an inherently unstable, multi-joint system. Nevertheless, the stride interval --- the duration of a gait cycle --- fluctuates from one stride to the next, even under stationary conditions. We used random walk analysis to study the dynamical properties of these fluctuations under normal conditions and how they change with disease and aging. Random walk analysis of the stride-to-stride fluctuations of healthy, young adult men surprisingly reveals a self-similar pattern: fluctuations at one time scale are statistically similar to those at multiple other time scales (Hausdorff et al, J Appl Phsyiol, 1995). To study the stability of this fractal property, we analyzed data obtained from healthy subjects who walked for 1 hour at their usual pace, as well as at slower and faster speeds. The stride interval fluctuations exhibited long-range correlations with power-law decay for up to a thousand strides at all three walking rates. In contrast, during metronomically-paced walking, these long-range correlations disappeared; variations in the stride interval were uncorrelated and non-fractal (Hausdorff et al, J Appl Phsyiol, 1996). To gain insight into the mechanism(s) responsible for this fractal property, we examined the effects of aging and neurological impairment. Using detrended fluctuation analysis (DFA), we computed α, a measure of the degree to which one stride interval is correlated with previous and subsequent intervals over different time scales. α was significantly lower in healthy elderly subjects compared to young adults (p < .003) and in subjects with Huntington's disease, a neuro-degenerative disorder of the central nervous system, compared to disease-free controls (p < 0.005) (Hausdorff et al, J Appl Phsyiol, 1997). α was also significantly related to degree of functional impairment in subjects with Huntington's disease (r=0.78). Recently, we have observed that just as

Study on Treatment with Respect to Idiopathic Scoliosis

NASA Astrophysics Data System (ADS)

Takeuchi, Kenzen; Azegami, Hideyuki; Murachi, Shunji; Kitoh, Junzoh; Ishida, Yoshito; Kawakami, Noriaki; Makino, Mitsunori

A hypothesis that the thoracic idiopathic scoliosis is buckling phenomenon of the fourth mode induced by the growth of thoracic vertebral bodies was presented in the previous work by the authors using numerical simulations with finite element model of the spine. If the hypothesis is acceptable, sensitivity function with respect to the critical growth of thoracic vertebrae on the maximization problem of buckling load with the fourth buckling mode gives us useful information to improve and develop treatments for the idiopathic scoliosis. The numerical results analyzed by the finite element method demonstrated that the sensitivity function is high at the articular capsules of the intervertebral joints, the intervertebral disks, the costotransverse joints and the constovertebral joints around the apex of the curvature in the case of the thoracic idiopathic scoliosis.

Diagnosis and Management of Common Foot Fractures.

PubMed

Bica, David; Sprouse, Ryan A; Armen, Joseph

2016-02-01

Foot fractures are among the most common foot injuries evaluated by primary care physicians. They most often involve the metatarsals and toes. Patients typically present with varying signs and symptoms, the most common being pain and trouble with ambulation. Diagnosis requires radiographic evaluation, although emerging evidence demonstrates that ultrasonography may be just as accurate. Management is determined by the location of the fracture and its effect on balance and weight bearing. Metatarsal shaft fractures are initially treated with a posterior splint and avoidance of weight-bearing activities; subsequent treatment consists of a short leg walking cast or boot for four to six weeks. Proximal fifth metatarsal fractures have different treatments depending on the location of the fracture. A fifth metatarsal tuberosity avulsion fracture can be treated acutely with a compressive dressing, then the patient can be transitioned to a short leg walking boot for two weeks, with progressive mobility as tolerated after initial immobilization. A Jones fracture has a higher risk of nonunion and requires at least six to eight weeks in a short leg non-weight-bearing cast; healing time can be as long as 10 to 12 weeks. Great toe fractures are treated with a short leg walking boot or cast with toe plate for two to three weeks, then a rigid-sole shoe for an additional three to four weeks. Lesser toe fractures can be treated with buddy taping and a rigid-sole shoe for four to six weeks.

Walking groups for women with breast cancer: Mobilising therapeutic assemblages of walk, talk and place.

PubMed

Ireland, Aileen V; Finnegan-John, Jennifer; Hubbard, Gill; Scanlon, Karen; Kyle, Richard G

2018-03-08

Walking is widely accepted as a safe and effective method of promoting rehabilitation and a return to physical activity after a cancer diagnosis. Little research has considered the therapeutic qualities of landscape in relation to understanding women's recovery from breast cancer, and no study has considered the supportive and therapeutic benefits that walking groups might contribute to their wellbeing. Through a study of a volunteer-led walking group intervention for women living with and beyond breast cancer (Best Foot Forward) we address this gap. A mixed-methods design was used including questionnaires with walkers (n = 35) and walk leaders (n = 13); telephone interviews with walkers (n = 4) and walk leaders (n = 9); and walking interviews conducted outdoors and on the move with walkers (n = 15) and walk leaders (n = 4). Questionnaires were analysed descriptively. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Our study found that the combination of walking and talking enabled conversations to roam freely between topics and individuals, encouraging everyday and cancer-related conversation that created a form of 'shoulder-to-shoulder support' that might not occur in sedentary supportive care settings. Walking interviews pointed to three facets of the outdoor landscape - as un/natural, dis/placed and im/mobile - that walkers felt imbued it with therapeutic qualities. 'Shoulder-to-shoulder support' was therefore found to be contingent on the therapeutic assemblage of place, walk and talk. Thus, beyond the physical benefits that walking brings, it is the complex assemblage of walking and talking in combination with the fluid navigation between multiple spaces that mobilises a therapeutic assemblage that promotes wellbeing in people living with and beyond breast cancer. Copyright © 2018 Elsevier Ltd. All rights reserved.

Aerobic treadmill plus Bobath walking training improves walking in subacute stroke: a randomized controlled trial.

PubMed

Eich, H-J; Mach, H; Werner, C; Hesse, S

2004-09-01

To evaluate the immediate and long-term effects of aerobic treadmill plus Bobath walking training in subacute stroke survivors compared with Bobath walking training alone. Randomized controlled trial. Rehabilitation unit. Fifty patients, first-time supratentorial stroke, stroke interval less than six weeks, Barthel Index (0-100) from 50 to 80, able to walk a minimum distance of 12 m with either intermittent help or stand-by while walking, cardiovascular stable, minimum 50 W in the bicycle ergometry, randomly allocated to two groups, A and B. Group A 30 min of treadmill training, harness secured and minimally supported according to patients' needs, and 30 min of physiotherapy, every workday for six weeks, speed and inclination of the treadmill were adjusted to achieve a heart rate of HR: (Hrmax-HRrest)*0.6+HRrest; in group B 60 min of daily physiotherapy for six weeks. Primary outcome variables were the absolute improvement of walking velocity (m/s) and capacity (m), secondary were gross motor function including walking ability (score out of 13) and walking quality (score out of 41), blindly assessed before and after the intervention, and at follow-up three months later. Patients tolerated the aerobic training well with no side-effects, significantly greater improvement of walking velocity and capacity both at study end (p =0.001 versus p =0.002) and at follow-up (p <0.001 versus p <0.001) in the experimental group. Between weeks 0 and 6, the experimental group improved walking speed and capacity by a mean of.31 m/s and 91 m, the control group by a mean of 0.16 m/s and 56 m. Between weeks 0 and 18, the experimental group improved walking speed and capacity by a mean of 0.36 m/s and 111 m, the control group by a mean of 0.15 m/s and 57 m. Gross motor function and walking quality did not differ at any time. Aerobic treadmill plus Bobath walking training in moderately affected stroke patients was better than Bobath walking training alone with respect to the improvement

Idiopathic orbital inflammatory disease successfully treated with rituximab.

PubMed

Schafranski, Marcelo Derbli

2009-02-01

We report a case of a 66-year-old Caucasian female with a diagnosis of idiopathic orbital inflammatory disease (OID) refractory to azathioprine therapy. The coexistence of diabetes mellitus represented a relative contraindication to chronic prednisone use. After two infusions of rituximab, a chimeric anti-CD20+ antibody, ophthalmic signs and symptoms remarkably improved. To our knowledge, this is the first case of idiopathic OID successfully treated with rituximab.

Dog ownership, dog walking, and leisure-time walking among Taiwanese metropolitan and nonmetropolitan older adults.

PubMed

Liao, Yung; Huang, Pin-Hsuan; Chen, Yi-Ling; Hsueh, Ming-Chun; Chang, Shao-Hsi

2018-04-04

This study examined the prevalence of dog ownership and dog walking and its association with leisure-time walking among metropolitan and nonmetropolitan older adults. A telephone-based cross-sectional survey targeting Taiwanese older adults was conducted in November 2016. Data related to dog ownership, time spent dog walking (categorized as non-dog owner, non-dog walkers, and dog walkers), and sociodemographic variables were obtained from 1074 older adults. Adjusted binary logistic regression was then performed. In this sample, 12% of Taiwanese older adults owned a dog and 31% of them walked their dogs for an average of 232.13 min over 5.9 days/week (standard deviation = 2.03). Older adults living in nonmetropolitan areas were more likely to own a dog (14.7% vs. 9.1%) but less likely to walk their dog (25.9% vs. 39.6%) than were those living in metropolitan areas. Compared with non-dog owners, only older adults living in nonmetropolitan areas who were dog walkers achieved 150 min of leisure-time walking (odds ratio: 3.03, 95% confidence interval: 1.05-8.77), after adjustment for potential confounders. Older Taiwanese adults living in nonmetropolitan areas who owned and walked their dogs were more likely to achieve health-enhancing levels of leisure-time walking. Tailored physical activity interventions for promoting dog walking should be developed for older adults who are dog owners living in nonmetropolitan areas and who do not engage in dog walking.

Walk on Floor Eyes Closed Test as a Measure of Postflight Ataxia

NASA Technical Reports Server (NTRS)

Reschke, M. F.; Fisher, E. A.; Kofman, I. S.; Cerisano, J. M.; Harm, D.L.; Peters, B. T.; Bloomberg, J. J.

2010-01-01

INTRODUCTION: Astronauts returning from space flight universally exhibit impaired posture and locomotion. Measurement of this impairment is an evolving process. The walk on the floor line test with the eyes closed (WOFEC) provides a unique procedure for quantifying postflight ataxia. Data from a modified WOFEC were obtained as part of an ongoing NASA interdisciplinary pre- and postflight study (Functional Task Test, FTT) designed to evaluate astronaut postflight functional performance. METHODS: Seven astronauts (5 short duration with flights of 12-16 days; 2 long duration crewmembers with flights of 6 months) were tested twice before flight, on landing day (short duration only), and 1, 6, and 30 days after flight. The WOFEC consisted of walking for 10 steps (repeated twice) with the feet heel to toe in tandem, arms folded across the chest and the eyes closed. The performance metric (scored by three examiners from video) was the percentage of correct steps completed over the three trials. A step was not counted as correct if the crewmember sidestepped, opened their eyes, or paused for more than three seconds between steps. RESULTS/ CONCLUSIONS: There was a significant decrease in percentage of correct steps on landing day (short duration crew) and on first day following landing (long duration) with partial recovery the following day, and full recovery beginning on day sixth after flight. Both short and long duration fliers appeared to be unaware of foot position relative to their bodies or the floor. Postflight, deviation from a straight path was common, and the test for two crewmembers elicited motion sickness symptoms. These data clearly demonstrate the sensorimotor challenges facing crewmembers after returning from spaceflight. The WOFEC test has value providing the investigator or crew surgeon with a simple method to quantify vestibular ataxia, as well as providing instant feedback of postural ataxia without the use of complex test equipment.

Turf toe and sesamoiditis: what the radiologist needs to know.

PubMed

Schein, Aaron J; Skalski, Matthew R; Patel, Dakshesh B; White, Eric A; Lundquist, Ryan; Gottsegen, Christopher J; Forrester, Deborah M; Matcuk, George R

2015-01-01

The first metatarsophalangeal (MTP) joint complex is a critical weight-bearing structure important to biomechanics. An acute dorsiflexion injury, named "turf toe," is common among American football and soccer players. "Sesamoiditis" is a name often given for pain arising from the hallux sesamoids in the absence of acute trauma, and may result from a variety of causes. The first MTP joint complex can also be affected by degenerative or inflammatory arthritis, infarct, and infection. This review article will cover the anatomy and biomechanics of the first MTP joint complex, its patterns of injury and pathology, imaging techniques, and management. Copyright © 2015 Elsevier Inc. All rights reserved.

Look who's walking: social and environmental correlates of children's walking in London.

PubMed

Steinbach, Rebecca; Green, Judith; Edwards, Phil

2012-07-01

A substantial literature examines the social and environmental correlates of walking to school but less addresses walking outside the school commute. Using travel diary data from London, we examined social and environmental correlates of walking: to school; outside the school commute during term time; and during the summer and weekends. Living in a household without a car was associated with all journey types; 'Asian' ethnicity was negatively associated with walking for non-school travel; environmental factors were associated with non-school journeys, but not the school commute. Interventions aiming to increase children's active travel need to take account of the range of journeys they make. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effect of type of cognitive task and walking speed on cognitive-motor interference during dual-task walking.

PubMed

Patel, P; Lamar, M; Bhatt, T

2014-02-28

We aimed to determine the effect of distinctly different cognitive tasks and walking speed on cognitive-motor interference of dual-task walking. Fifteen healthy adults performed four cognitive tasks: visuomotor reaction time (VMRT) task, word list generation (WLG) task, serial subtraction (SS) task, and the Stroop (STR) task while sitting and during walking at preferred-speed (dual-task normal walking) and slow-speed (dual-task slow-speed walking). Gait speed was recorded to determine effect on walking. Motor and cognitive costs were measured. Dual-task walking had a significant effect on motor and cognitive parameters. At preferred-speed, the motor cost was lowest for the VMRT task and highest for the STR task. In contrast, the cognitive cost was highest for the VMRT task and lowest for the STR task. Dual-task slow walking resulted in increased motor cost and decreased cognitive cost only for the STR task. Results show that the motor and cognitive cost of dual-task walking depends heavily on the type and perceived complexity of the cognitive task being performed. Cognitive cost for the STR task was low irrespective of walking speed, suggesting that at preferred-speed individuals prioritize complex cognitive tasks requiring higher attentional and processing resources over walking. While performing VMRT task, individuals preferred to prioritize more complex walking task over VMRT task resulting in lesser motor cost and increased cognitive cost for VMRT task. Furthermore, slow walking can assist in diverting greater attention towards complex cognitive tasks, improving its performance while walking. Copyright © 2013 IBRO. Published by Elsevier Ltd. All rights reserved.

Usefulness of Irradiated Polyglactin 910 (Vicryl Rapide) for Skin Suturing during Surgery for Lateral Ray Polydactyly of the Toes in Children

PubMed Central

Takeuchi, Masaki

2013-01-01

Background: This study describes the use of a bioabsorbable suture for skin suturing during surgery for lateral ray polydactyly followed by favorable postoperative outcome without the need for postoperative suture removal. Methods: A 5-0 Vicryl Rapide suture was used for skin suturing during surgery for lateral ray polydactyly in 9 children (mean age, 12.4 mo). Children were allowed to walk and bathe 2 weeks after surgery when over-the-suture taping therapy was started. Results: In all cases, the Vicryl Rapide suture disappeared completely within 3 weeks of surgery, and no removal of residual suture was required. No postoperative complications, such as suture abscess, wound dehiscence, or ulcer, were observed. During a mean 24-month postoperative follow-up, no elevation of the interdigital space due to hypertrophic scarring or scar contracture was observed, and no revision surgery was required. Conclusions: Although the breaking strength of Vicryl Rapide declines within the first 10 days after surgery, this property will unlikely lead to postoperative wound dehiscence due to a relatively light load being applied to the lateral toes. The use of a bioabsorbable suture for skin suturing during surgery for lateral lay polydactyly is highly beneficial as it eliminates pain caused by suture removal and the risk of tissue damage while reducing the burden on medical staff. PMID:25289236

Predicting ground contact events for a continuum of gait types: An application of targeted machine learning using principal component analysis.

PubMed

Osis, Sean T; Hettinga, Blayne A; Ferber, Reed

2016-05-01

An ongoing challenge in the application of gait analysis to clinical settings is the standardized detection of temporal events, with unobtrusive and cost-effective equipment, for a wide range of gait types. The purpose of the current study was to investigate a targeted machine learning approach for the prediction of timing for foot strike (or initial contact) and toe-off, using only kinematics for walking, forefoot running, and heel-toe running. Data were categorized by gait type and split into a training set (∼30%) and a validation set (∼70%). A principal component analysis was performed, and separate linear models were trained and validated for foot strike and toe-off, using ground reaction force data as a gold-standard for event timing. Results indicate the model predicted both foot strike and toe-off timing to within 20ms of the gold-standard for more than 95% of cases in walking and running gaits. The machine learning approach continues to provide robust timing predictions for clinical use, and may offer a flexible methodology to handle new events and gait types. Copyright © 2016 Elsevier B.V. All rights reserved.

Reliability of laser Doppler flowmetry curve reading for measurement of toe and ankle pressures: intra- and inter-observer variation.

PubMed

Høyer, C; Paludan, J P D; Pavar, S; Biurrun Manresa, J A; Petersen, L J

2014-03-01

To assess the intra- and inter-observer variation in laser Doppler flowmetry curve reading for measurement of toe and ankle pressures. A prospective single blinded diagnostic accuracy study was conducted on 200 patients with known or suspected peripheral arterial disease (PAD), with a total of 760 curve sets produced. The first curve reading for this study was performed by laboratory technologists blinded to clinical clues and previous readings at least 3 months after the primary data sampling. The pressure curves were later reassessed following another period of at least 3 months. Observer agreement in diagnostic classification according to TASC-II criteria was quantified using Cohen's kappa. Reliability was quantified using intra-class correlation coefficients, coefficients of variance, and Bland-Altman analysis. The overall agreement in diagnostic classification (PAD/not PAD) was 173/200 (87%) for intra-observer (κ = .858) and 175/200 (88%) for inter-observer data (κ = .787). Reliability analysis confirmed excellent correlation for both intra- and inter-observer data (ICC all ≥.931). The coefficients of variance ranged from 2.27% to 6.44% for intra-observer and 2.39% to 8.42% for inter-observer data. Subgroup analysis showed lower observer-variation for reading of toe pressures in patients with diabetes and/or chronic kidney disease than patients not diagnosed with these conditions. Bland-Altman plots showed higher variation in toe pressure readings than ankle pressure readings. This study shows substantial intra- and inter-observer agreement in diagnostic classification and reading of absolute pressures when using laboratory technologists as observers. The study emphasises that observer variation for curve reading is an important factor concerning the overall reproducibility of the method. Our data suggest diabetes and chronic kidney disease have an influence on toe pressure reproducibility. Copyright © 2013 European Society for Vascular Surgery. Published

Pathogenesis, Newly Recognized Etiologies, and Management of Idiopathic Anaphylaxis

PubMed Central

Kuhlen, James L.; Virkud, Yamini V.

2018-01-01

Idiopathic anaphylaxis (IA) is a life-threatening allergic disease and the most common diagnosis given to patients following an anaphylactic event. The inability of the healthcare provider and the patient to identify the trigger for anaphylaxis makes standard allergen avoidance measures ineffectual. IA is diagnosed after other causes of anaphylaxis have been excluded. Mast cell activation syndromes (MCAS), mastocytosis, IgE to galactose-alpha-1,3-galactose (α-gal), and certain medications have recently been recognized as causes of anaphylaxis that were previously labeled idiopathic. This review will describe the epidemiology and proposed theories of pathogenesis for IA, its diagnostic approach, its clinical management, and examine newly recognized disorders that were previously labeled as idiopathic anaphylaxis. PMID:25725228

Walking with a Slower Friend

ERIC Educational Resources Information Center

Bailey, Herb; Kalman, Dan

2011-01-01

Fay and Sam go for a walk. Sam walks along the left side of the street while Fay, who walks faster, starts with Sam but walks to a point on the right side of the street and then returns to meet Sam to complete one segment of their journey. We determine Fay's optimal path minimizing segment length, and thus maximizing the number of times they meet…

Walk Score, Transportation Mode Choice, and Walking Among French Adults: A GPS, Accelerometer, and Mobility Survey Study.

PubMed

Duncan, Dustin T; Méline, Julie; Kestens, Yan; Day, Kristen; Elbel, Brian; Trasande, Leonardo; Chaix, Basile

2016-06-20

Few studies have used GPS data to analyze the relationship between Walk Score, transportation choice and walking. Additionally, the influence of Walk Score is understudied using trips rather than individuals as statistical units. The purpose of this study is to examine associations at the trip level between Walk Score, transportation mode choice, and walking among Paris adults who were tracked with GPS receivers and accelerometers in the RECORD GPS Study. In the RECORD GPS Study, 227 participants were tracked during seven days with GPS receivers and accelerometers. Participants were also surveyed with a GPS-based web mapping application on their activities and transportation modes for all trips (6969 trips). Walk Score, which calculates neighborhood walkability, was assessed for each origin and destination of every trip. Multilevel logistic and linear regression analyses were conducted to estimate associations between Walk Score and walking in the trip or accelerometry-assessed number of steps for each trip, after adjustment for individual/neighborhood characteristics. The mean overall Walk Scores for trip origins were 87.1 (SD = 14.4) and for trip destinations 87.1 (SD = 14.5). In adjusted trip-level associations between Walk Score and walking only in the trip, we found that a walkable neighborhood in the trip origin and trip destination was associated with increased odds of walking in the trip assessed in the survey. The odds of only walking in the trip were 3.48 (95% CI: 2.73 to 4.44) times higher when the Walk Score for the trip origin was "Walker's Paradise" compared to less walkable neighborhoods (Very/Car-Dependent or Somewhat Walkable), with an identical independent effect of trip destination Walk Score on walking. The number of steps per 10 min (as assessed with accelerometry) was cumulatively higher for trips both originating and ending in walkable neighborhoods (i.e., "Very Walkable"). Walkable neighborhoods were associated with increases in walking

Walk Score, Transportation Mode Choice, and Walking Among French Adults: A GPS, Accelerometer, and Mobility Survey Study

PubMed Central

Duncan, Dustin T.; Méline, Julie; Kestens, Yan; Day, Kristen; Elbel, Brian; Trasande, Leonardo; Chaix, Basile

2016-01-01

Background: Few studies have used GPS data to analyze the relationship between Walk Score, transportation choice and walking. Additionally, the influence of Walk Score is understudied using trips rather than individuals as statistical units. The purpose of this study is to examine associations at the trip level between Walk Score, transportation mode choice, and walking among Paris adults who were tracked with GPS receivers and accelerometers in the RECORD GPS Study. Methods: In the RECORD GPS Study, 227 participants were tracked during seven days with GPS receivers and accelerometers. Participants were also surveyed with a GPS-based web mapping application on their activities and transportation modes for all trips (6969 trips). Walk Score, which calculates neighborhood walkability, was assessed for each origin and destination of every trip. Multilevel logistic and linear regression analyses were conducted to estimate associations between Walk Score and walking in the trip or accelerometry-assessed number of steps for each trip, after adjustment for individual/neighborhood characteristics. Results: The mean overall Walk Scores for trip origins were 87.1 (SD = 14.4) and for trip destinations 87.1 (SD = 14.5). In adjusted trip-level associations between Walk Score and walking only in the trip, we found that a walkable neighborhood in the trip origin and trip destination was associated with increased odds of walking in the trip assessed in the survey. The odds of only walking in the trip were 3.48 (95% CI: 2.73 to 4.44) times higher when the Walk Score for the trip origin was “Walker’s Paradise” compared to less walkable neighborhoods (Very/Car-Dependent or Somewhat Walkable), with an identical independent effect of trip destination Walk Score on walking. The number of steps per 10 min (as assessed with accelerometry) was cumulatively higher for trips both originating and ending in walkable neighborhoods (i.e., “Very Walkable”). Conclusions: Walkable

Walking-age analyzer for healthcare applications.

PubMed

Jin, Bo; Thu, Tran Hoai; Baek, Eunhye; Sakong, SungHwan; Xiao, Jin; Mondal, Tapas; Deen, M Jamal

2014-05-01

This paper describes a walking-age pattern analysis and identification system using a 3-D accelerometer and a gyroscope. First, a walking pattern database from 79 volunteers of ages ranging from 10 to 83 years is constructed. Second, using feature extraction and clustering, three distinct walking-age groups, children of ages 10 and below, adults in 20-60s, and elders in 70s and 80s, were identified. For this study, low-pass filtering, empirical mode decomposition, and K-means were used to process and analyze the experimental results. Analysis shows that volunteers' walking-ages can be categorized into distinct groups based on simple walking pattern signals. This grouping can then be used to detect persons with walking patterns outside their age groups. If the walking pattern puts an individual in a higher "walking age" grouping, then this could be an indicator of potential health/walking problems, such as weak joints, poor musculoskeletal support system or a tendency to fall.

Effect of uphill and downhill walking on walking performance in geriatric patients using a wheeled walker.

PubMed

Lindemann, Ulrich; Schwenk, Michael; Schmitt, Syn; Weyrich, Michael; Schlicht, Wolfgang; Becker, Clemens

2017-08-01

Wheeled walkers are recommended to improve walking performance in older persons and to encourage and assist participation in daily life. Nevertheless, using a wheeled walker can cause serious problems in the natural environment. This study aimed to compare uphill and downhill walking with walking level in geriatric patients using a wheeled walker. Furthermore, we investigated the effect of using a wheeled walker with respect to dual tasking when walking level. A total of 20 geriatric patients (median age 84.5 years) walked 10 m at their habitual pace along a level surface, uphill and downhill, with and without a standard wheeled walker. Gait speed, stride length and cadence were assessed by wearable sensors and the walk ratio was calculated. When using a wheeled walker while walking level the walk ratio improved (0.58 m/[steps/min] versus 0.57 m/[steps/min], p = 0.023) but gait speed decreased (1.07 m/s versus 1.12 m/s, p = 0.020) when compared to not using a wheeled walker. With respect to the walk ratio, uphill and downhill walking with a wheeled walker decreased walking performance when compared to level walking (0.54 m/[steps/min] versus 0.58 m/[steps/min], p = 0.023 and 0.55 m/[steps/min] versus 0.58 m/[steps/min], p = 0.001, respectively). At the same time, gait speed decreased (0.079 m/s versus 1.07 m/s, p < 0.0001) or was unaffected. The use of a wheeled walker improved the quality of level walking but the performance of uphill and downhill walking was worse compared to walking level when using a wheeled walker.

[Objective evaluation of arterial intermittent claudication by the walking tolerance test. Comparative study of physiological walking and walking on a conveyor belt (author's transl)].

PubMed

Bouchet, J Y; Franco, A; Morzol, B; Beani, J C

1980-01-01

Two methods are used to evaluate the walking distance: physiological walking along a standard path (0% - 6 mk/h) and walking on a tread mill (10% - 3 km/h). In both tests, four data are checked: -- initial trouble distance, -- cramp or walking-distance, -- localisation of pain, -- recovery time. These tests are dependable for the diagnosis of arterial claudication, reproducible and well tolerated. Their results have been compared: there is no correlation between the initial trouble distance and the cramp distance. However there is a correlation between the cramp distance by physiological walking and on treadmill. Recovery time, if long, is a criteria of gravity. Interests of both methods are discussed.

Investigating Patients' Perception of Microvascular Free Toe Flap for Reconstruction of Amputated Thumbs: A Guide for Surgeons during Informed Consent.

PubMed

Efanov, Johnny Ionut; Wong, Christopher; Guilbault, Clarence; Bou-Merhi, Joseph; Harris, Patrick G; Izadpanah, Ali; Danino, Michel Alain

2018-04-24

 After thumb amputations, restoration of function and aesthetic can be accomplished with microvascular free toe flaps. However, many patients in clinical practice do not choose this reconstruction despite positive reported outcomes. This study aims to determine patients' perceptions with respect to free toe flaps to improve areas of informed consent.  A retrospective survey was administered to patients with thumb amputations. Participants were required to complete a questionnaire about patient demographics, the Brief Michigan Hand Questionnaire (bMHQ), the standard gamble/time trade-off questionnaires for utility scores, and a questionnaire investigating potential reasons for electing not to undergo a free toe transfer.  Thirty patients were enrolled in the study wherein 53% underwent a replantation procedure, 27% a revision amputation, and 20% a delayed reconstruction. Mean normalized score on the bMHQ was recorded as 63.54. Utility questionnaires yielded mean measures of 0.8967 and 0.86 on the standard gamble and time trade-off, respectively. From 14 elements, a majority (87%) stated flap failure as a major source of concern, followed by lack of understanding of risks and benefits (80%) and prolonged hospital stay (53%). Cultural/religious beliefs, aesthetic appearance of the foot, and concerns about footwear were not reported as important reasons in 90, 80, and 79% of patients, respectively.  A better understanding of patients' attitudes and beliefs with respect to free toe flaps will allow surgeons to better address their concerns during informed consent. This study emphasizes the importance to discuss about failure rates, risks, and benefits of the operation and prolonged hospital stay. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

MR venography in idiopathic intracranial hypertension: unappreciated and misunderstood

PubMed Central

Higgins, J; Gillard, J; Owler, B; Harkness, K; Pickard, J

2004-01-01

Background: Venous sinus disease must be excluded before diagnosing idiopathic intracranial hypertension but is found only rarely in typical cases. Magnetic resonance venography (MRV) is the technique of choice for investigating this, and provides images that are diagnostic and easy to interpret. However, recent work using more invasive techniques has documented pressure gradients and stenoses in the lateral venous sinuses in many cases of idiopathic intracranial hypertension. Objective: To examine the reason for this discrepancy and to establish whether there are characteristic appearances on MRV in idiopathic intracranial hypertension that are routinely overlooked in clinical practice. Methods: MRVs from 20 patients with idiopathic intracranial hypertension were reviewed, unblinded, by two neuroradiologists, and their appearances rated for focal narrowings and signal gaps. A control group of 40 asymptomatic volunteers, matched for age and sex with the patient group, was recruited prospectively for MRV, and their scans rated in the same way. Results: The lateral sinuses presented a range of appearances with quite different distributions in the two groups (p<0.001). Bilateral lateral sinus flow gaps were seen in 13 of 20 patients with idiopathic intracranial hypertension and in none of 40 controls. Conclusions: A historical failure to use normal healthy controls to establish the boundaries between imaging artefact, normal anatomical variant, and disease means that the pathological significance of the different appearances of the lateral sinuses on MRV has not so far been appreciated. PMID:15026510

Random walks and diffusion on networks

NASA Astrophysics Data System (ADS)

Masuda, Naoki; Porter, Mason A.; Lambiotte, Renaud

2017-11-01

Random walks are ubiquitous in the sciences, and they are interesting from both theoretical and practical perspectives. They are one of the most fundamental types of stochastic processes; can be used to model numerous phenomena, including diffusion, interactions, and opinions among humans and animals; and can be used to extract information about important entities or dense groups of entities in a network. Random walks have been studied for many decades on both regular lattices and (especially in the last couple of decades) on networks with a variety of structures. In the present article, we survey the theory and applications of random walks on networks, restricting ourselves to simple cases of single and non-adaptive random walkers. We distinguish three main types of random walks: discrete-time random walks, node-centric continuous-time random walks, and edge-centric continuous-time random walks. We first briefly survey random walks on a line, and then we consider random walks on various types of networks. We extensively discuss applications of random walks, including ranking of nodes (e.g., PageRank), community detection, respondent-driven sampling, and opinion models such as voter models.

Idiopathic scrotal calcinosis.

PubMed

Celik, Orcun; Ipekci, Tumay; Kazimoglu, Hatem

2013-12-01

Idiopathic scrotal calcinosis is a rare scrotal benign disease. Its distinct features are painless, non-pruritic, semi-soft palpable calcific transdermal nodules. We report a 42-year-old-man with asymptomatic multiple calcified scrotal skin nodules for 10 years. Under spinal anesthesia, the affected scrotal skin was excised and the nodules removed. We aim to explain the etiology, pathophysiology, diagnosis, and treatment modalities of this rare disease.

Posture alteration as a measure to accommodate uneven ground in able-bodied gait

PubMed Central

Blickhan, Reinhard; Muller, Roy; Rode, Christian

2017-01-01

Though the effects of imposed trunk posture on human walking have been studied, less is known about such locomotion while accommodating changes in ground level. For twelve able participants, we analyzed kinematic parameters mainly at touchdown and toe-off in walking across a 10-cm visible drop in ground level (level step, pre-perturbation step, step-down, step-up) with three postures (regular erect, ~30° and ~50° of trunk flexion from the vertical). Two-way repeated measures ANOVAs revealed step-specific effects of posture on the kinematic behavior of gait mostly at toe-off of the pre-perturbation step and the step-down as well as at touchdown of the step-up. In preparation to step-down, with increasing trunk flexion the discrepancy in hip−center of pressure distance, i.e. effective leg length, (shorter at toe-off versus touchdown), compared with level steps increased largely due to a greater knee flexion at toe-off. Participants rotated their trunk backwards during step-down (2- to 3-fold backwards rotation compared with level steps regardless of trunk posture) likely to control the angular momentum of their whole body. The more pronounced trunk backwards rotation in trunk-flexed walking contributed to the observed elevated center of mass (CoM) trajectories during the step-down which may have facilitated drop negotiation. Able-bodied individuals were found to recover almost all assessed kinematic parameters comprising the vertical position of the CoM, effective leg length and angle as well as hip, knee and ankle joint angles at the end of the step-up, suggesting an adaptive capacity and hence a robustness of human walking with respect to imposed trunk orientations. Our findings may provide clinicians with insight into a kinematic interaction between posture and locomotion in uneven ground. Moreover, a backward rotation of the trunk for negotiating step-down may be incorporated into exercise-based interventions to enhance gait stability in individuals who

Environmental factors influencing older adults' walking for transportation: a study using walk-along interviews.

PubMed

Van Cauwenberg, Jelle; Van Holle, Veerle; Simons, Dorien; Deridder, Riet; Clarys, Peter; Goubert, Liesbet; Nasar, Jack; Salmon, Jo; De Bourdeaudhuij, Ilse; Deforche, Benedicte

2012-07-10

Current knowledge on the relationship between the physical environment and walking for transportation among older adults (≥ 65 years) is limited. Qualitative research can provide valuable information and inform further research. However, qualitative studies are scarce and fail to include neighborhood outings necessary to study participants' experiences and perceptions while interacting with and interpreting the local social and physical environment. The current study sought to uncover the perceived environmental influences on Flemish older adults' walking for transportation. To get detailed and context-sensitive environmental information, it used walk-along interviews. Purposeful convenience sampling was used to recruit 57 older adults residing in urban or semi-urban areas. Walk-along interviews to and from a destination (e.g. a shop) located within a 15 minutes' walk from the participants' home were conducted. Content analysis was performed using NVivo 9 software (QSR International). An inductive approach was used to derive categories and subcategories from the data. Data were categorized in the following categories and subcategories: access to facilities (shops & services, public transit, connectivity), walking facilities (sidewalk quality, crossings, legibility, benches), traffic safety (busy traffic, behavior of other road users), familiarity, safety from crime (physical factors, other persons), social contacts, aesthetics (buildings, natural elements, noise & smell, openness, decay) and weather. The findings indicate that to promote walking for transportation a neighborhood should provide good access to shops and services, well-maintained walking facilities, aesthetically appealing places, streets with little traffic and places for social interaction. In addition, the neighborhood environment should evoke feelings of familiarity and safety from crime. Future quantitative studies should investigate if (changes in) these environmental factors relate to

A procedure to detect abnormal sensorimotor control in adolescents with idiopathic scoliosis.

PubMed

Pialasse, Jean-Philippe; Mercier, Pierre; Descarreaux, Martin; Simoneau, Martin

2017-09-01

This work identifies, among adolescents with idiopathic scoliosis, those demonstrating impaired sensorimotor control through a classification procedure comparing the amplitude of their vestibular-evoked postural responses. The sensorimotor control of healthy adolescents (n=17) and adolescents with idiopathic scoliosis (n=52) with either mild (Cobb angle≥15° and ≤30°) or severe (Cobb angle >30°) spine deformation was assessed through galvanic vestibular stimulation. A classification procedure sorted out adolescents with idiopathic scoliosis whether the amplitude of their vestibular-evoked postural response was dissimilar or similar to controls. Compared to controls, galvanic vestibular stimulation evoked larger postural response in adolescents with idiopathic scoliosis. Nonetheless, the classification procedure revealed that only 42.5% of all patients showed impaired sensorimotor control. Consequently, identifying patients with sensorimotor control impairment would allow to apply personalized treatments, help clinicians to establish prognosis and hopefully improve the condition of patients with adolescent idiopathic scoliosis. Copyright © 2017 Elsevier B.V. All rights reserved.

Idiopathic hemifacial spasm responsive to zonisamide: a case report.

PubMed

Siniscalchi, Antonio; Gallelli, Luca; Palleria, Caterina; De Sarro, Giovambattista

2009-01-01

We describe a patient with idiopathic hemifacial spasm (HFS) that was responsive to zonisamide treatment. A 65-year-old woman presented with a 4-year history of left-sided HFS developing gradually, starting from the upper facial muscles. After several analyses, the diagnosis of idiopathic HFS was made, and the clonazepam treatment (0.5 mg every 8 hours) was started, without a complete remission of symptoms. Therefore, zonisamide (150 mg twice a day for a 6-week period) was added, with a complete resolution. The rechallenge with zonisamide after its dechallenge confirmed its effectiveness. During follow-up, the patient remained symptom-free, with no adverse drug reactions. We suggest that zonisamide could represent a useful therapeutic option in the treatment of idiopathic HFS.

Neuromorphic walking gait control.

PubMed

Still, Susanne; Hepp, Klaus; Douglas, Rodney J

2006-03-01

We present a neuromorphic pattern generator for controlling the walking gaits of four-legged robots which is inspired by central pattern generators found in the nervous system and which is implemented as a very large scale integrated (VLSI) chip. The chip contains oscillator circuits that mimic the output of motor neurons in a strongly simplified way. We show that four coupled oscillators can produce rhythmic patterns with phase relationships that are appropriate to generate all four-legged animal walking gaits. These phase relationships together with frequency and duty cycle of the oscillators determine the walking behavior of a robot driven by the chip, and they depend on a small set of stationary bias voltages. We give analytic expressions for these dependencies. This chip reduces the complex, dynamic inter-leg control problem associated with walking gait generation to the problem of setting a few stationary parameters. It provides a compact and low power solution for walking gait control in robots.

Human H-reflexes are smaller in difficult beam walking than in normal treadmill walking.

PubMed

Llewellyn, M; Yang, J F; Prochazka, A

1990-01-01

Hoffman (H) reflexes were elicited from the soleus (SOL) muscle while subjects walked on a treadmill and on a narrow beam (3.5 cm wide, raised 34 cm from the floor). The speed of walking on the treadmill was selected for each subject to match the background activation level of their SOL muscle during beam walking. The normal reciprocal activation pattern of the tibialis anterior and SOL muscles in treadmill walking was replaced by a pattern dominated by co-contraction on the beam. In addition, the step cycle duration was more variable and the time spent in the swing phase was reduced on the beam. The H-reflexes were highly modulated in both tasks, the amplitude being high in the stance phase and low in the swing phase. The H-reflex amplitude was on average 40% lower during beam walking than treadmill walking. The relationship between the H-reflex amplitude and the SOL EMG level was quantified by a regression line relating the two variables. The slope of this line was on average 41% lower in beam walking than treadmill walking. The lower H-reflex gain observed in this study and the high level of fusimotor drive observed in cats performing similar tasks suggest that the two mechanisms which control the excitability of this reflex pathway (i.e. fusimotor action and control of transmission at the muscle spindle to moto-neuron synapse) may be controlled independently.

How might we increase physical activity through dog walking?: A comprehensive review of dog walking correlates.

PubMed

Westgarth, Carri; Christley, Robert M; Christian, Hayley E

2014-08-20

Physical inactivity and sedentary behaviour are major threats to population health. A considerable proportion of people own dogs, and there is good evidence that dog ownership is associated with higher levels of physical activity. However not all owners walk their dogs regularly. This paper comprehensively reviews the evidence for correlates of dog walking so that effective interventions may be designed to increase the physical activity of dog owners. Published findings from 1990-2012 in both the human and veterinary literature were collated and reviewed for evidence of factors associated with objective and self-reported measures of dog walking behaviour, or reported perceptions about dog walking. Study designs included cross-sectional observational, trials and qualitative interviews. There is good evidence that the strength of the dog-owner relationship, through a sense of obligation to walk the dog, and the perceived support and motivation a dog provides for walking, is strongly associated with increased walking. The perceived exercise requirements of the dog may also be a modifiable point for intervention. In addition, access to suitable walking areas with dog supportive features that fulfil dog needs such as off-leash exercise, and that also encourage human social interaction, may be incentivising. Current evidence suggests that dog walking may be most effectively encouraged through targeting the dog-owner relationship and by providing dog-supportive physical environments. More research is required to investigate the influence of individual owner and dog factors on 'intention' to walk the dog as well as the influence of human social interaction whilst walking a dog. The effects of policy and cultural practices relating to dog ownership and walking should also be investigated. Future studies must be of a higher quality methodological design, including accounting for the effects of confounding between variables, and longitudinal designs and testing of

[DORSALIS PEDIS FLAP SERIES-PARALLEL BIG TOE NAIL COMPOSITE TISSUE FLAP TO REPAIR HAND SKIN OF DEGLOVING INJURY WITH THUMB DEFECT].

PubMed

Shi, Pengju; Zhang, Wenlong; Zhao, Gang; Li, Zhigang; Zhao, Shaoping; Zhang, Tieshan

2015-07-01

To investigate the effectiveness of dorsalis pedis flap series-parallel big toe nail composite tissue flap in the repairment of hand skin of degloving injury with tumb defect. Between March 2009 and June 2013, 8 cases of hand degloving injury with thumb defect caused by machine twisting were treated. There were 7 males and 1 female with the mean age of 36 years (range, 26-48 years). Injury located at the left hand in 3 cases and at the right hand in 5 cases. The time from injury to hospitalization was 1.5-4.0 hours (mean, 2.5 hours). The defect area was 8 cm x 6 cm to 15 cm x 1 cm. The thumb defect was rated as degree I in 5 cases and as degree II in 3 cases. The contralateral dorsal skin flap (9 cm x 7 cm to 10 cm x 8 cm) combined with ipsilateral big toe nail composite tissue flap (2.5 cm x 1.8 cm to 3.0 cm x 2.0 cm) was used, including 3 parallel anastomosis flaps and 5 series anastomosis flaps. The donor site of the dorsal flap was repaired with thick skin grafts, the stumps wound was covered with tongue flap at the shank side of big toe. Vascular crisis occurred in 1 big toe nail composite tissue flap, margin necrosis occurred in 2 dorsalis pedis flap; the other flaps survived, and primary healing of wound was obtained. The grafted skin at dorsal donor site all survived, skin of hallux toe stump had no necrosis. Eight cases were followed up 4-20 months (mean, 15.5 months). All flaps had soft texture and satisfactory appearance; the cutaneous sensory recovery time was 4-7 months (mean, 5 months). At 4 months after operation, the two-point discrimination of the thumb pulp was 8-10 mm (mean, 9 mm), and the two-point discrimination of dorsal skin flap was 7-9 mm (mean, 8.5 mm). According to Society of Hand Surgery standard for the evaluation of upper part of the function, the results were excellent in 4 cases, good in 3 cases, and fair in 1 case. The donor foot had normal function. Dorsalis pedis flap series-parallel big toe nail composite tissue flap is an ideal

Optimal muscle fascicle length and tendon stiffness for maximising gastrocnemius efficiency during human walking and running.

PubMed

Lichtwark, G A; Wilson, A M

2008-06-21

Muscles generate force to resist gravitational and inertial forces and/or to undertake work, e.g. on the centre of mass. A trade-off in muscle architecture exists in muscles that do both; the fibres should be as short as possible to minimise activation cost but long enough to maintain an appropriate shortening velocity. Energetic cost is also influenced by tendon compliance which modulates the timecourse of muscle mechanical work. Here we use a Hill-type muscle model of the human medial gastrocnemius to determine the muscle fascicle length and Achilles tendon compliance that maximise efficiency during the stance phase of walking (1.2m/s) and running (3.2 and 3.9 m/s). A broad range of muscle fascicle lengths (ranging from 45 to 70 mm) and tendon stiffness values (150-500 N/mm) can achieve close to optimal efficiency at each speed of locomotion; however, efficient walking requires shorter muscle fascicles and a more compliant tendon than running. The values that maximise efficiency are within the range measured in normal populations. A non-linear toe-region region of the tendon force-length properties may further influence the optimal values, requiring a stiffer tendon with slightly longer muscle fascicles; however, it does not alter the main results. We conclude that muscle fibre length and tendon compliance combinations may be tuned to maximise efficiency under a given gait condition. Efficiency is maximised when the required volume of muscle is minimised, which may also help reduce limb inertia and basal metabolic costs.

Swing- and support-related muscle actions differentially trigger human walk-run and run-walk transitions.

PubMed

Prilutsky, B I; Gregor, R J

2001-07-01

There has been no consistent explanation as to why humans prefer changing their gait from walking to running and from running to walking at increasing and decreasing speeds, respectively. This study examined muscle activation as a possible determinant of these gait transitions. Seven subjects walked and ran on a motor-driven treadmill for 40s at speeds of 55, 70, 85, 100, 115, 130 and 145% of the preferred transition speed. The movements of subjects were videotaped, and surface electromyographic activity was recorded from seven major leg muscles. Resultant moments at the leg joints during the swing phase were calculated. During the swing phase of locomotion at preferred running speeds (115, 130, 145%), swing-related activation of the ankle, knee and hip flexors and peaks of flexion moments were typically lower (P<0.05) during running than during walking. At preferred walking speeds (55, 70, 85%), support-related activation of the ankle and knee extensors was typically lower during stance of walking than during stance of running (P<0.05). These results support the hypothesis that the preferred walk-run transition might be triggered by the increased sense of effort due to the exaggerated swing-related activation of the tibialis anterior, rectus femoris and hamstrings; this increased activation is necessary to meet the higher joint moment demands to move the swing leg during fast walking. The preferred run-walk transition might be similarly triggered by the sense of effort due to the higher support-related activation of the soleus, gastrocnemius and vastii that must generate higher forces during slow running than during walking at the same speed.

Race walking gait and its influence on race walking economy in world-class race walkers.

PubMed

Gomez-Ezeiza, Josu; Torres-Unda, Jon; Tam, Nicholas; Irazusta, Jon; Granados, Cristina; Santos-Concejero, Jordan

2018-03-06

The aim of this study was to determine the relationships between biomechanical parameters of the gait cycle and race walking economy in world-class Olympic race walkers. Twenty-One world-class race walkers possessing the Olympic qualifying standard participated in this study. Participants completed an incremental race walking test starting at 10 km·h -1 , where race walking economy (ml·kg -1 ·km -1 ) and spatiotemporal gait variables were analysed at different speeds. 20-km race walking performance was related to race walking economy, being the fastest race walkers those displaying reduced oxygen cost at a given speed (R = 0.760, p < 0.001). Longer ground contact times, shorter flight times, longer midstance sub-phase and shorter propulsive sub-phase during stance were related to a better race walking economy (moderate effect, p < 0.05). According to the results of this study, the fastest race walkers were more economi cal than the lesser performers. Similarly, shorter flight times are associated with a more efficient race walking economy. Coaches and race walkers should avoid modifying their race walking style by increasing flight times, as it may not only impair economy, but also lead to disqualification.

Walking and child pedestrian injury: a systematic review of built environment correlates of safe walking.

PubMed

Rothman, Linda; Buliung, Ron; Macarthur, Colin; To, Teresa; Howard, Andrew

2014-02-01

The child active transportation literature has focused on walking, with little attention to risk associated with increased traffic exposure. This paper reviews the literature related to built environment correlates of walking and pedestrian injury in children together, to broaden the current conceptualization of walkability to include injury prevention. Two independent searches were conducted focused on walking in children and child pedestrian injury within nine electronic databases until March, 2012. Studies were included which: 1) were quantitative 2) set in motorized countries 3) were either urban or suburban 4) investigated specific built environment risk factors 5) had outcomes of either walking in children and/or child pedestrian roadway collisions (ages 0-12). Built environment features were categorized according to those related to density, land use diversity or roadway design. Results were cross-tabulated to identify how built environment features associate with walking and injury. Fifty walking and 35 child pedestrian injury studies were identified. Only traffic calming and presence of playgrounds/recreation areas were consistently associated with more walking and less pedestrian injury. Several built environment features were associated with more walking, but with increased injury. Many features had inconsistent results or had not been investigated for either outcome. The findings emphasise the importance of incorporating safety into the conversation about creating more walkable cities.

Developing Point-of-Decision Prompts to Encourage Airport Walking: The Walk to Fly Study.

PubMed