Effect of residual lower-extremity function on strategies and execution time for raising and lowering trousers in patients with hemiparetic stroke: a cross-sectional study

2021 ◽  
pp. 1-7
Author(s):  
Kenji Iwata ◽  
Soichiro Koyama ◽  
Toshihiro Yamazaki ◽  
Keisuke Kimura ◽  
Hiroaki Sakurai ◽  
...  
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Lower Limb ◽  
Execution Time ◽  
Standing Position ◽  
Cross Sectional Study ◽  
Lower Extremity Function ◽  
Cross Sectional ◽  
Paretic Side ◽  
Hemiparetic Stroke

Background/aims There are no established methods for patients with hemiparetic stroke to practice the raising and lowering of trousers. The aim of this study was to investigate the use of different strategies by patients with hemiparetic stroke for lowering and raising trousers by using the non-paretic upper limb in the standing position, based on residual motor function in the paretic lower limb. Methods A total of 28 patients with hemiparetic stroke were included in the study (n=10, 12, and 6 with lower-limb Brunnstrom stages III, IV and V respectively). Endpoints were execution time and frequency of changing the manipulation region. Results Lower-limb Brunnstrom stages III, IV and V were associated with execution times of 24.1 ± 11.1, 18.1 ± 6.5 and 16.9 ± 9.6 seconds respectively, and the mean frequency of manipulation of trousers on the posterior paretic side was significantly lower than those of the anterior paretic, anterior non-paretic, and posterior non-paretic sides in all patients (P<0.05). Conclusions Motor function of the paretic lower limb did not affect the strategies used for lowering and raising trousers with the non-paretic upper limb. Manipulation of trousers on the posterior paretic side was especially difficult.

The relationship between upper limb function and activities of daily living without the effects of lower limb function: A cross-sectional study

2021 ◽  
pp. 030802262110300
Author(s):  
Haruka Yamamoto ◽  
Kazuya Takeda ◽  
Soichiro Koyama ◽  
Keisuke Morishima ◽  
Yuichi Hirakawa ◽  
...  
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Lower Limb ◽  
Daily Living ◽  
Partial Correlation ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Partial Correlation Analysis ◽  
Cross Sectional ◽  
The Relationship

Introduction Upper limb motor function and activities of daily living (ADL) are related in chronic stroke patients. This study investigated this relationship after removal of the influence of motor function of the affected lower limb, which until now has remained unclear. Methods This retrospective cross-sectional study included 53 patients with chronic stroke. Upper and lower limb motor function and ADL were assessed using the Fugl-Meyer assessment of the upper (FMA-UL) and lower limbs (FMA-LL) and functional independence measure motor score (FIM-M). To clarify the relationship between FMA-UL and total FIM-M before and after removal of the influence of FMA-LL, Spearman’s rank correlation coefficient and partial correlation analysis were used. The relationship between FMA-UL and each item of FIM-M after removal of the influence of FMA-LL was assessed using partial correlation analysis. Results Before the influence of FMA-LL was removed, FMA-UL was moderately to well correlated with total FIM-M. This became weak after the influence was removed. Regarding each item of FIM-M, FMA-UL was correlated with dressing (upper body), toileting, and walking or wheelchair after removal of the influence. Conclusion The relationship between upper limb motor function and ADL is strongly influenced by lower limb motor function.

scholarly journals Relationship between upper limb motor function and activities of daily living after removing the influence of lower limb motor function in subacute patients with stroke: A cross-sectional study

2020 ◽  
pp. 156918612092660
Author(s):  
Haruka Yamamoto ◽  
Kazuya Takeda ◽  
Soichiro Koyama ◽  
Keisuke Morishima ◽  
Yuichi Hirakawa ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Motor Function ◽  
Upper Limb ◽  
Lower Limb ◽  
Daily Living ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Motor Score ◽  
Cross Sectional ◽  
The Relationship

Background Previous studies have reported a relationship between upper limb motor function and activities of daily living. However, their relationship after removing the influence of lower limb motor function has not been clarified. Objective This study aimed to investigate the relationship between Fugl-Meyer assessment upper limb and total Functional Independence Measure motor score and between Fugl-Meyer assessment upper limb and each item contained in Functional Independence Measure motor score after eliminating the influence of the motor function of the affected lower limb. Methods This retrospective cross-sectional study included 58 subacute stroke patients. To investigate the relationship between the Fugl-Meyer assessment upper limb and total Functional Independence Measure motor score before and after removing the influence of Fugl-Meyer assessment lower limb, Spearman’s rank correlation coefficient and partial correlation analysis were used. Additionally, the relationship between Fugl-Meyer assessment upper limb and each item of Functional Independence Measure motor score after removing the influence was assessed. Results Before removing the influence of Fugl-Meyer assessment lower limb, Fugl-Meyer assessment upper limb was strongly correlated with total Functional Independence Measure motor score (r = 0.74, p < 0.001). However, it became weak after removing the influence (r = 0.27, p = 0.04). Regarding each item of Functional Independence Measure motor score, Fugl-Meyer assessment upper limb was correlated with grooming (r = 0.27, p = 0.04), bathing (r = 0.28, p = 0.03), dressing upper body (r = 0.33, p = 0.01), dressing lower body (r = 0.31, p = 0.02), and stair-climbing (r = 0.31, p = 0.02) after removing the influence. Conclusion These findings suggest that the relationship between the upper limb motor function and activities of daily living is strongly influenced by lower limb motor function.

scholarly journals Kinematic Analysis of Lower Limb Joint Asymmetry during Gait in People with Multiple Sclerosis

Symmetry ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 598
Author(s):  
Massimiliano Pau ◽  
Bruno Leban ◽  
Michela Deidda ◽  
Federica Putzolu ◽  
Micaela Porta ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Lower Limb ◽  
Sagittal Plane ◽  
Cross Sectional Study ◽  
Camera Motion ◽  
Cross Sectional ◽  
Temporal Parameters ◽  
Wide Range ◽  
Edss Score ◽  
Spatio Temporal

The majority of people with Multiple Sclerosis (pwMS), report lower limb motor dysfunctions, which may relevantly affect postural control, gait and a wide range of activities of daily living. While it is quite common to observe a different impact of the disease on the two limbs (i.e., one of them is more affected), less clear are the effects of such asymmetry on gait performance. The present retrospective cross-sectional study aimed to characterize the magnitude of interlimb asymmetry in pwMS, particularly as regards the joint kinematics, using parameters derived from angle-angle diagrams. To this end, we analyzed gait patterns of 101 pwMS (55 women, 46 men, mean age 46.3, average Expanded Disability Status Scale (EDSS) score 3.5, range 1–6.5) and 81 unaffected individuals age- and sex-matched who underwent 3D computerized gait analysis carried out using an eight-camera motion capture system. Spatio-temporal parameters and kinematics in the sagittal plane at hip, knee and ankle joints were considered for the analysis. The angular trends of left and right sides were processed to build synchronized angle–angle diagrams (cyclograms) for each joint, and symmetry was assessed by computing several geometrical features such as area, orientation and Trend Symmetry. Based on cyclogram orientation and Trend Symmetry, the results show that pwMS exhibit significantly greater asymmetry in all three joints with respect to unaffected individuals. In particular, orientation values were as follows: 5.1 of pwMS vs. 1.6 of unaffected individuals at hip joint, 7.0 vs. 1.5 at knee and 6.4 vs. 3.0 at ankle (p < 0.001 in all cases), while for Trend Symmetry we obtained at hip 1.7 of pwMS vs. 0.3 of unaffected individuals, 4.2 vs. 0.5 at knee and 8.5 vs. 1.5 at ankle (p < 0.001 in all cases). Moreover, the same parameters were sensitive enough to discriminate individuals of different disability levels. With few exceptions, all the calculated symmetry parameters were found significantly correlated with the main spatio-temporal parameters of gait and the EDSS score. In particular, large correlations were detected between Trend Symmetry and gait speed (with rho values in the range of –0.58 to –0.63 depending on the considered joint, p < 0.001) and between Trend Symmetry and EDSS score (rho = 0.62 to 0.69, p < 0.001). Such results suggest not only that MS is associated with significantly marked interlimb asymmetry during gait but also that such asymmetry worsens as the disease progresses and that it has a relevant impact on gait performances.

To Study the Clinical Profile and Management of Cellulitis of Lower Limb in Northern India

2021 ◽  
pp. 153473462098667
Author(s):  
Tripta S. Bhagat ◽  
Luv Kumar ◽  
Prakhar Garg ◽  
Apoorv Goel ◽  
Amit Aggarwal ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Lower Limb ◽  
Surgical Intervention ◽  
Significant Risk ◽  
Cross Sectional Study ◽  
Common Complication ◽  
Cross Sectional ◽  
Medical College ◽  
Northern India ◽  
Working Age

Cellulitis is a bacterial infection of the dermis and subcutaneous tissues occupying a large proportion of hospital beds. This study was conducted for analysis of patients with cellulitis according to their demographics and clinical presentation and to examine their comorbidities, complications, and its management. This observational cross-sectional study was conducted in the Department of Surgery at Santosh Medical College and Hospitals involving a total of 60 cases having cellulitis and other soft tissue infections of lower limb. Analysis of their demographic profile, management, and complications was done. Cellulitis is seen commonly in males, 46 (76.6%). The mean age of patients affected by cellulitis in the study was 36.4 ± 1.23 years. The most common site affected is leg involving more people in field jobs. The most common risk factor was trauma in 46.6%, and other factors were diabetes mellitus and smoking, while abscess formation was the most common complication observed in 36.6% of cases. A total of 56.6% cases were managed conservatively, while 43.3% cases required surgical intervention. Mean hospital stay in this study was 5.02 ± 0.23 days. It was concluded that cellulitis is subcutaneous, spreading bacterial infection is more common in males, and its incidence is highest in working age group population. Lower limb is commonly involved. Trauma, smoking, and diabetes are significant risk factors for development of cellulitis. Abscess is the most common complication. About 50% patients with cellulitis can be managed conservatively and the rest require surgical intervention.

Validity of Skeletal Muscle Ultrasound in Assessment of Suspected Limb Girdle Muscular Dystrophy Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rasha M Ibrahim ◽  
Haitham M Hamdy ◽  
Amr A Mohammed ◽  
Ahmed M Elsadek ◽  
Ahmed M Bassiouny ◽  
...  
Keyword(s):  
Muscular Dystrophy ◽  
Upper Limb ◽  
Lower Limb ◽  
Limb Girdle Muscular Dystrophy ◽  
Ultrasound Images ◽  
General Electric ◽  
Cross Sectional ◽  
Lower Limb Muscles ◽  
Limb Muscles ◽  
Muscle Ultrasound

Abstract Background Limb-girdle muscular dystrophies (LGMDs) are a clinically and genetically heterogeneous group of disorders characterized by progressive muscle weakness and degenerative muscle changes. Studies have shown that ultrasound can be useful both for diagnosis and follow-up of LGMDs patients. Objectives This study aims to measure the sensitivity and the specificity of muscle ultrasound in assessment of suspected limb girdle muscular dystrophy patients. Subjects and Methods This cross-sectional descriptive study was conducted on Fifty-five patients with suspected LGMD from neuromuscular unit, myology clinic, Ain Shams University hospitals and eight healthy subjects. Age was above 2 years. Both sexes were included in the study. They underwent real-time B-mode ultrasonography performed with using Logiq p9 General Electric ultrasound machine and General Electric 7-11.5 MHZ linear array ultrasound probe. All ultrasound images have been obtained and scored by a single examiner and muscle echo intensity was visually graded semiquantitative according to Heckmatt's scale. The examiner was blinded to the muscle biopsy results and clinical evaluations. Results Statistical analysis revealed that the diagnostic performance of muscle US (Heckmatt’s score) in LGMD is most sensitive when calculated in all examined upper limb and lower limb muscles, followed by lower limb muscles alone. US of upper limb was found to be the least sensitive. Conclusions Muscle ultrasound is a practical and reproducible and valid tool that can be used in assessment of suspected LGMD patients.

scholarly journals Education and work participation among adults with congenital unilateral upper limb deficiency in Norway: A cross-sectional study

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0207846
Author(s):  
Heidi Johansen ◽  
Trine Bathen ◽  
Liv Øinæs Andersen ◽  
Svend Rand-Hendriksen ◽  
Kristin Østlie
Keyword(s):  
Upper Limb ◽  
Cross Sectional Study ◽  
Work Participation ◽  
Sectional Study ◽  
Cross Sectional ◽  
Limb Deficiency

scholarly journals Chronic pain and fatigue in adults with congenital unilateral upper limb deficiency in Norway. A cross-sectional study

PLoS ONE ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. e0190567 ◽  
Author(s):  
Heidi Johansen ◽  
Trine Bathen ◽  
Liv Øinæs Andersen ◽  
Svend Rand-Hendriksen ◽  
Kristin Østlie
Keyword(s):  
Chronic Pain ◽  
Upper Limb ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Limb Deficiency

IS DISTRIBUTION OF PAIN RELATED WITH CENTRAL SENSITIZATION IN PATIENTS WITH LOWER LIMB OSTEOARTHRITIS?

2021 ◽  
pp. 2150019
Author(s):  
Andriana Koufogianni ◽  
Asimakis K. Kanellopoulos ◽  
Konstantinos Vassis ◽  
Ioannis A. Poulis
Keyword(s):  
Lower Limb ◽  
Central Sensitization ◽  
Rating Scale ◽  
Cross Sectional Study ◽  
The Body ◽  
Cross Sectional ◽  
Numeric Pain Rating Scale ◽  
The Relationship ◽  
Pain Distribution

Design: Cross-sectional study. Background: Osteoarthritis is one of the most common conditions in our society. A growing number of studies suggest the existence of central sensitization (CS) in a subgroup of osteoarthritic patients. One of the criteria included for the classification of CS pain is the expanded distribution of pain. As this criterion is a well-recognized sign of CS, a digital pain drawing (DPD) analysis would be useful to easily identify possible extended areas of pain distribution (PD) in patients with OA. Objective: To study the relationship between the percentage of distribution of pain in the lower limb for both knee and hip, in patients before hip or knee arthroplasty, and the Central Sensitization Inventory Questionnaire. Methods: Twenty women (mean [Formula: see text] years) with diagnosed chronic (over 3 months) knee ([Formula: see text]) and hip ([Formula: see text]) OA participated in the study, with intensity of pain from mild to severe, meaning pain [Formula: see text]/10 using the Numeric Pain Rating Scale (NPRS). The PD was analyzed via software created for this research, called “Pain Distribution Application”. Results: A statistically significant positive correlation between CSI and PD to the lower extremity OA (hip and knee) ([Formula: see text], [Formula: see text]) was found. The distribution of pain has a linear correlation with the results in CSI, of patients who tested positive for CS, i.e. with a score of [Formula: see text]. Conclusions: As the distribution of pain on the surface of the body (diffusion) increases, so does the score of people who test positive for CSI. Our results showed that calculating the distribution of pain with our application may have a utility as a CS screening tool. The PD threshold of 10% of the body area is an index for CS for chronic pain lower limb OA patients.

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