scholarly journals Electroneuromyography for early diagnosis of diabetic distal polyneuropathy

2019 ◽  
Vol 22 (2) ◽  
pp. 141-150
Author(s):  
Elena S. Mazurenko ◽  
Lyudmila A. Ruyatkina ◽  
Igor A. Pakhomov ◽  
Elena V. Chesheva ◽  
Larisa O. Gavrilova
Keyword(s):  
Early Diagnosis ◽  
Lower Limb ◽  
Clinical Signs ◽  
Sensory Neuropathy ◽  
Limb Amputation ◽  
Control Group ◽  
Ulcer Formation ◽  
Neurological Assessment ◽  
Motor Nerves ◽  
Neuropathy Symptom Score

BACKGROUND: Diabetic distal polyneuropathy (DDPN) is a predictor of diabetic foot syndrome development, ulcer formation and lower limb amputation. An early DDPN diagnosis is therefore relevant. AIM: To investigate the effectiveness and suitability of electroneuromyography (ENMG) for early DDPN diagnosis. MATERIALS AND METHODS: This study was performed in the Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya. L. Tsivyan. A total of 80 participants were examined, including 30 DM2 patients, 30 patents without carbohydrate metabolism disorders, and 20 healthy volunteers aged 2030 years. None of the participants showed clinical signs of distal polyneuropathy (DPN). All participants underwent evaluation of neuropathy symptoms by the Neuropathy Symptom Score scale, neurological assessment using on the scale of Neuropathic Dysfunctional Score and stimulating ENMG. RESULTS: ENMG revealed the presence of neuropathy in 86.7% of DM2 patients. Moreover, among DM2 patients, 12 (40%) presented sensory DDPN, 13 (43.3%) presented sensorimotor neuropathy and 1 (3.3%) presented motor DDPN. The medial and lateral plantar nerves were the most commonly affected (p = 0.018 and p = 0.002, respectively). Among the 30 control individuals, 9 (30%) showed signs of DPN in combination with radiculopathy. ENMG - indicators of DDPN: latency and amplitude and speed for 3 sensory (n. Plantaris lateralis, n. Plantaris medialis, n. Suralis) and 2 motor nerves (n. Peroneus, n. Tibialis) were significantly worse in individuals with DM2 than in the control group, both for those with and without radiculopathy. Among participants with DM2, those sensorimotor DDPN tended to have a longer diabetes duration (p = 0.503), higher levels of HbA1c (p = 0.077) and higher BMI (p = 0.050) than those with sensory neuropathy, although the differences were not significant. CONCLUSION: This study confirms the effectiveness and suitability of ENMG for the early diagnosis of DDPN. Moreover, the optimal ENMG indices necessary for this diagnosis were identified.

scholarly journals Dysfunction in the hip joints in children with Charcot-Marie-Tooth syndrome (literature review)

2015 ◽  
Vol 3 (3) ◽  
pp. 52-56
Author(s):  
Ivan Yurievich Pozdnikin
Keyword(s):  
Early Diagnosis ◽  
Hip Joint ◽  
Clinical Signs ◽  
Sensory Neuropathy ◽  
Disease Diagnosis ◽  
Lower Limbs ◽  
Foot Deformities ◽  
Hip Joints ◽  
Charcot Marie Tooth ◽  
Reconstructive Operations

A review of the literature on the treatment of children with dysfunction in the hip joints in motor-sensory neuropathy Charcot-Marie-Tooth is presented. Peculiarities of disease diagnosis and the approach used in the treatment of patients are described. The Charcot-Marie-Tooth syndrome is a hereditary neuromuscular disease characterized by progressive atrophy of the distal muscle group of the lower limbs. According to international authors, the incidence of hip joint dysfunction in this condition is at least 10%, ranking second only to foot deformities. In the Russian literature, the problem has not been adequately interpreted. Early diagnosis of dysfunction in the hip joints during Charcot-Marie-Tooth syndrome is complicated by the child's age and is characterized by progression. Conflicting clinical signs and trivial symptoms of the disease also confuse diagnosis, until it becomes clearer in adolescence or the second or third decade of life. Surgical reconstructive operations on the hip joint often occur too late, and they are accompanied by a greater frequency of neurological complications. Practitioner awareness coupled with an early diagnosis of hip subluxation and decentration and complex orthopedic and neurological examinations of children with the disease of Charcot-Marie-Tooth should result in more favorable outcomes.

scholarly journals Sensory Neuropathy in Hypothyroidism: Electrophysiological and Clinical Findings

1970 ◽  
Vol 2 ◽  
pp. 1-6 ◽  
Author(s):  
Sabina Yeasmin ◽  
Noorzahan Begum ◽  
Shelina Begum ◽  
Shah M Hafizur Rahman
Keyword(s):  
Healthy Subjects ◽  
Hormone Replacement ◽  
Clinical Signs ◽  
Sensory Neuropathy ◽  
Clinical Findings ◽  
Ultra Sound ◽  
Personal Contact ◽  
Control Group ◽  
Group B ◽  
Hypothyroid Patients

Peripheral neuropathy may be a manifestation of hypothyroidism which usually develops insidiously over a long period of time due to irregular taking of drugs or lack of thyroid hormone replacement. The present study was designed to observe the clinical and electro-physiological findings in hypothyroid patients in order to evaluate the neuromuscular dysfunction as well as sensory neuropathy. For this purpose, 70 subjects with the age range of 20 to 50 years of both sexes were included in the study. Among them, 40 hypothyroid patients were taken in study group (Group B) and 30 aparently healthy subjects were taken as control (Group A). On the basis of their TSH levels, group B was further divided into group B1 with TSH <60 MIU /L or (less severe) and group B2 with TSH >60 MIU /L (severe group). The duration of the disease ranged from 6 months to 5 years. All the hypothyroid patients were selected from Thyroid Clinic, Center of Nuclear Medicine and Ultra sound, Dhaka Medical College and Hospital, Dhaka, during the period from January 2005 to December 2005. Healthy subjects were selected from personal contact. Most of the hypothyroid patients were under hormone replacement therapy. Diagnosis of hypothyroidism was done by serum levels of TT3, TT4 and the TSH. In this study, both TT3, TT4 levels were significantly (P<0.01) lower in hypothyroids in comparison to those of control. The patients were searched for the clinical signs of sensory neuropathy. Clinical findings revealed diminished or absence of most of the deep tendon reflexes. The nerve conduction studies for sensory nerve function were done in all the subjects by electrophysiological technique. All the tests were done in median and ulnar nerve for upper limb and in sural nerve for lower limb and these parameters were measured on the day 1 (one) of their first visit. Data were compared among the different groups. Most of the patients had higher sensory distal latencies (SDL) with lower conduction velocities (SNCV) which were more marked in severe cases. About 67.5% of hypothyroid patients had shown abnormal sensory NCV when compared to that of euthyroids. Therefore, this study concludes that sensory neuropathy may be a consequence of hypothyroidism. Key Words: Hypothyroidism; Neuropathy; ElectrophysiologyDOI:10.3329/jbsp.v2i0.975  J Bangladesh Soc Physiol. 2007 Dec;(2): 1-6.

Epidural block and phantom limb pain

2018 ◽  
Author(s):  
Stephan Schug
Keyword(s):  
Epidural Analgesia ◽  
Lower Limb ◽  
Phantom Limb Pain ◽  
Epidural Block ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Control Group ◽  
Limb Pain ◽  
Epidural Group ◽  
Number Of Patients

The landmark paper discussed in this chapter, published by Bach et al. in 1988 is a Danish paper that describes a study where patients who were to undergo lower-limb amputation received either preventive, preoperative epidural analgesia for 72 hours before the amputation, or systemic analgesia. At 6 and 12 months post-operatively, all patients in the epidural group were pain free, while 38% and 27%, respectively, in the control group had phantom limb pain. The study has been criticized for a number of points including the pseudorandomization by year of birth, the lack of any blinding, and the small number of patients used in the study (only 25 patients overall).

scholarly journals Quality of life, body image and self-esteem in patients with unilateral transtibial amputations

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nuria Sarroca ◽  
José Valero ◽  
Javier Deus ◽  
Josefa Casanova ◽  
María José Luesma ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Image ◽  
Lower Limb ◽  
Self Esteem ◽  
Lower Limb Amputation ◽  
Lower Limbs ◽  
Limb Amputation ◽  
Control Group ◽  
Life Questionnaire

AbstractAmputation represents a drastic impact on the patient’s body and perception. This cross-sectional study aims to analyse the aesthetic concern represented by body image, self-esteem and quality of life in patients with unilateral transtibial amputations of lower limbs compared to control group. People living with amputations present lower average levels than controls in all subscales of the SF-36 (Short Form 36 Health Survey) quality of life questionnaire, and in both the physical component summary and the mental component summary, although the difference is not statistically significant in the latter. These patients present a significantly lower mean score (p = 0.002) in the MBSRQ (Body-Self Relations Questionnaire) body image questionnaire: 2.64 ± 0.49 opposed to 3.16 ± 0.55 in controls. People living with amputations had a lower mean score on the Rosenberg Self-Esteem scale than controls (34.44 ± 4.61 v 36.04 ± 3.63). The results also show that amputation has a significant influence on the BI (Body image) of patients with unilateral transtibial amputations. SE (Self-Esteem) seems to be an aspect that is not significantly affected by lower limb amputation, although these patients scored a lower mean on the RSE scale compared to the control group. We consider it is highly relevant to assess QoL (Quality of life), BI and SE in patients after a lower limb amputation process.

scholarly journals USING PERFORATED LINERS TO COMBAT THE DETRIMENTAL EFFECTS OF EXCESSIVE SWEATING IN LOWER LIMB PROSTHESIS USERS

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Katherine C. Davies ◽  
Mike McGrath ◽  
Alison Stenson ◽  
Zoe Savage ◽  
David Moser ◽  
...  
Keyword(s):  
Lower Limb ◽  
The Body ◽  
Limb Amputation ◽  
Control Group ◽  
Residual Limb ◽  
Excessive Sweating ◽  
Lower Limb Prosthesis ◽  
Skin Conditions ◽  
The Impact ◽  
Limb Prosthesis

BACKGROUND: Excessive sweating of the residual limb has a substantial effect on the daily activities of people with lower limb amputation. Prosthetic liners offer protection and comfort to sensitive areas but often exacerbate perspiration. They act as insulators, trapping sweat on the skin’s surface to the detriment of skin health. Recently, liners with perforations have been developed, allowing the moisture to escape. The goal of this study was to assess the impact of such liners. METHODS: A sample group of 13 patients with unilateral transtibial amputation, who wore a perforated liner (PL) as part of their current prescription, was compared to 20 control patients who wore non-perforated liners (NPL). During their routine appointments, they completed a survey of scientifically validated outcome measures relating to their limb health, pain and the impact on daily life over a 12-month period. RESULTS: Patients using the PL had healthier residual limbs, reporting higher scores on questions relating to limb health, experiencing fewer skin issues (p<0.001) and estimating a 61.8% lower rating in perceived sweat (p=0.004). Perhaps consequentially, there was a lower incidence of residual (p=0.012) and phantom (p=0.001) limb pain when compared to the control group. The prevalence of individual issues affecting the residual limbs of PL users was also lower. Of the issues that remained, only 23% were attributed to sweating in PL users, compared to 49% for the NPL group (p=0.066). PL users missed fewer days of work in the year (2.4 vs 11.6, p=0.267) and were also limited on fewer days (1.4 vs 75.4, p=0.009). CONCLUSION: The use of perforated liners shows much promise within prosthetic care, significantly improving the health of the residual limb. The observed effects on perceived sweat reduction, residual skin health, pain levels and patient limitation suggest that perforated liners are highly beneficial to patients. Layman's Abstract Individuals with amputation often find that they sweat more as they exert more energy when walking and because the total surface area of their body is reduced. Silicone liners are used to cushion the residual limb and as a way of attaching a prosthetic leg, but they act as insulators causing the residual limb to get hot and sweaty. The material isn’t breathable, so the sweat is not able to escape, instead staying on the skin’s surface and causing discomfort or leading to the development of skin conditions. Liners that have small holes in them allow sweat to travel away from the body and preserve skin health. Patients who wore a perforated liner, as well as patients who wore a liner without holes, filled in questionnaires about their experience, the results of which were compared. Generally, patients who wore the perforated liner had healthier skin on their residual limbs and experienced fewer skin conditions than the other patient group. Out of the issues they did experience, fewer were attributed to sweating. The study group experienced less frequent pain both in their physical and phantom limbs. They also considered themselves less limited by their prosthetic device and missed fewer days of work. These observations suggest that perforated liners are highly beneficial to patients within the prosthetic field. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/34610/26579 How To Cite: Davies K.C, McGrath M, Savage Z, Stenson A, Moser D, Zahedi S. Using perforated liners to combat the detrimental effects of excessive sweating in lower limb prosthesis users. Canadian Prosthetics & Orthotics Journal. 2020;Volume 3, Issue 2, No.1. https://doi.org/10.33137/cpoj.v3i2.34610 Corresponding Author: K.C Davies, Blatchford Group, Unit D Antura, Bond Close, Basingstoke, RG24 8PZ, UK.E-mail: [email protected]: https://orcid.org/0000-0003-2933-4365

scholarly journals Dynamic and Static Postural Control in Volleyball Players with Transfemoral Amputation

2019 ◽  
Vol 25 (1) ◽  
pp. 58-62 ◽  
Author(s):  
Helmorany Nunes de Araújo ◽  
Felipe Augusto dos Santos Mendes ◽  
Caroline Echavarria Fortes ◽  
Gabriela Borin ◽  
Patrícia Azevedo Garcia ◽  
...  
Keyword(s):  
Postural Control ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Controlled Study ◽  
Control Group ◽  
Transfemoral Amputation ◽  
Physically Active ◽  
Sit To Stand ◽  
Volleyball Players

ABSTRACT Introduction: A decrease in postural control and proprioception is a common result of lower limb amputation. However, postural control adaptation in Paralympic sitting volleyball players with lower limb amputation is not yet understood. Objective: The purpose of this cross-sectional controlled study was to investigate static and dynamic postural control in sitting volleyball players with unilateral transfemoral amputation. Methods: Sixteen subjects participated in the study, eight of whom were amputees with unilateral transfemoral amputation (amputee group: age: 33.5 ± 5.6 years, weight: 77.7 ± 5.3 kg, height: 179.4 ± 5.3 cm) and eight physically active non-amputees (control group age: 27.2 ± 8.4 years, weight: 82.7 ± 6.6 kg, height: 178.7 ± 6.1 cm). Static and dynamic postural control was evaluated using the Neurocom® Balance Master System platform (Modified Clinical Test of Sensory Interaction on Balance, Limits of Stability, Rhythmic Weight Shift, Sit-to-Stand, Walk Across, and Step and Quick Turn). Statistical analyses were performed with the Shapiro-Wilk test, Levene's test, and Student's t-test for paired samples (p <0.05). Results: The amputee group demonstrated impaired postural control in all tests when compared to the control group (p <.05) for all postural tests except for the rhythmic change and sit-to-stand tests (p >.05). Conclusion: Despite training in sitting volleyball, our results demonstrated that amputees have poorer postural control in both static and dynamic tasks when compared to physically active non-amputees. Level of Evidence II; Prognostic Studies—Investigating the Effect of a Patient Characteristic on Disease Outcome / Retrospectivef Study.

scholarly journals Maximal Walking Distance in Persons with a Lower Limb Amputation

Sensors ◽  
2020 ◽  
Vol 20 (23) ◽  
pp. 6770
Author(s):  
Cheriel J. Hofstad ◽  
Kim T.J. Bongers ◽  
Mark Didden ◽  
René F. van Ee ◽  
Noël L.W. Keijsers
Keyword(s):  
Lower Limb ◽  
Daily Life ◽  
Objective Assessment ◽  
Lower Limb Amputation ◽  
Self Report ◽  
Walking Distance ◽  
Limb Amputation ◽  
Control Group ◽  
Accelerometer Sensor ◽  
Walking Test

The distance one can walk at a time could be considered an important functional outcome in people with a lower limb amputation. In clinical practice, walking distance in daily life is based on self-report (SIGAM mobility grade (Special Interest Group in Amputee Medicine)), which is known to overestimate physical activity. The aim of this study was to assess the number of consecutive steps and walking bouts in persons with a lower limb amputation, using an accelerometer sensor. The number of consecutive steps was related to their SIGAM mobility grade and to the consecutive steps of age-matched controls in daily life. Twenty subjects with a lower limb amputation and ten age-matched controls participated in the experiment for two consecutive days, in their own environment. Maximal number of consecutive steps and walking bouts were obtained by two accelerometers in the left and right trouser pocket, and one accelerometer on the sternum. In addition, the SIGAM mobility grade was determined and the 10 m walking test (10 MWT) was performed. The maximal number of consecutive steps and walking bouts were significantly smaller in persons with a lower limb amputation, compared to the control group (p < 0.001). Only 4 of the 20 persons with a lower limb amputation had a maximal number of consecutive steps in the range of the control group. Although the maximal covered distance was moderately correlated with the SIGAM mobility grade in participants with an amputation (r = 0.61), for 6 of them, the SIGAM mobility grade did not match with the maximal covered distance. The current study indicated that mobility was highly affected in most persons with an amputation and that the SIGAM mobility grade did not reflect what persons with a lower limb amputation actually do in daily life. Therefore, objective assessment of the maximal number of consecutive steps of maximal covered distance is recommended for clinical treatment.

scholarly journals A low-cost easily implementable physiotherapy intervention clinically improves gait implying better adaptation to lower limb prosthesis: a randomized clinical trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Leticia Vargas Almeida ◽  
Claudiane Arakaki Fukuchi ◽  
Tania Emi Sakanaka ◽  
Alberto Cliquet
Keyword(s):  
Lower Limb ◽  
Low Cost ◽  
Intervention Group ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Control Group ◽  
Post Intervention ◽  
Physiotherapy Intervention ◽  
Lower Limb Prosthesis ◽  
Limb Prosthesis

AbstractLower limb amputation highly impacts the lives of individuals. The inability to walk due to difficulties in adapting to wearing prosthesis can potentially result in physical degeneration and comorbidity in this population. In this randomized clinical trial study, we investigated if a low-cost and easily implementable physiotherapy intervention was effective in improving gait performance and adaptation to lower limb prosthesis in individuals with an amputation. A total of 26 individuals participated in the study, 16 with lower limb amputation and 10 without amputation. Participants with amputation were further divided in intervention and control groups. The intervention group underwent a rehabilitation protocol aimed at strengthening muscles and improving prosthesis adaptation. Muscle strengthening targeted the hip segment, prioritizing the abdominal muscles, hip flexors, extensors, adductors and abductors, followed by cicatricial mobilization and weight-bearing on the stump for desensitization. Assessment and measures were performed across the kinetic and kinematic parameters of gait. In the comparison between pre-and post-intervention, a significant increase in gait speed (0.68—2.98, 95% CI, 1.83, effect size ES) and cadence (0.56—2.69, 95% CI, 1.63, ES) was found between groups and time points. Step (0.73—3.11, 95% CI, 1.92, ES) and stride length (0.62—2.84, 95% CI, 1.73) increased between pre- and post-intervention, while in the control group both variables remained smaller. The intervention group decreased stance phase as a percentage of gait cycle between pre- and post-intervention (− 1.33—0.62, 95% CI, − 36, ES), while it increased in the control group. Improvement in a combination of important gait parameters indicates that the intervention protocol promoted the adaptation to prosthesis and the functional independence of individuals with lower limb amputation. It is recommended that the participants continue receiving follow-up assessments and rehabilitation interventions.

Controlled Trial of the Sequential Use of Streptokinase and Ancrod in the Treatment of Deep Vein Thrombosis of Lower Limb

1977 ◽  
Vol 37 (02) ◽  
pp. 222-232 ◽  
Author(s):  
D. A Tibbutt ◽  
C. N Chesterman ◽  
E. W Williams ◽  
T Faulkner ◽  
A. A Sharp
Keyword(s):  
Deep Vein Thrombosis ◽  
Clinical Improvement ◽  
Anticoagulant Therapy ◽  
Lower Limb ◽  
Oral Anticoagulant ◽  
Controlled Trial ◽  
Oral Anticoagulant Therapy ◽  
Control Group ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryTreatment with streptokinase (‘Kabikinase’) was given to 26 patients with venographically confirmed deep vein thrombosis extending into the popliteal vein or above. Treatment was continued for 4 days and the patients were allocated randomly to oral anticoagulant therapy or a course of treatment with ancrod (‘Arvin’) for 6 days followed by oral anticoagulant therapy. The degree of thrombolysis as judged by further venographic examination at 10 days was not significantly different between the 2 groups. The majority of patients showed clinical improvement but there was no appreciable difference between the groups at 3 and 6 months. Haemorrhagic complications were a more serious problem during the period of treatment with ancrod than during the equivalent period in the control group.

Modern approaches to the treatment of mastitis in women of reproductive age

2016 ◽  
pp. 191-108
Author(s):  
A.A. Sukhanova ◽  
◽  
Yu.M. Melnik ◽  
O.O. Karlova ◽  
◽  
...  
Keyword(s):  
Ultrasound Examination ◽  
Clinical Signs ◽  
Reproductive Age ◽  
Herbal Remedies ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Clinical Method ◽  
Gynecological Examination ◽  
Study Results ◽  
Observation Period

The aim of the study: to study the efficacy and safety of use Mastofemin in the treatment of various forms of mastitis in women of reproductive age. Materials and methods. The study included 62 women of reproductive age (mean age of 33.5±2.3 years) who were screened in the Kiev city center reproductive and perinatal medicine. Women were divided into 2 groups. The first (main) group consisted of 32 patients who received the proposed treatment using herbal remedies Mastofemin 1 capsule 2 times per day for 3 months; 30 patients of the second (control) group were under observation and received no treatment. These groups were representative and homogeneous on age, clinical symptoms and sonographic characteristics. The clinical method included evaluation of complaints of patients, anamnesis, presence of concomitant gynecologic pathology, inspection, palpation of the lymph nodes and the breast and obtaining a discharge from the nipples to conduct cytological examination, which allowed excluding from the study women with suspected malignancy of the process. All the patients were performed ultrasound examination of the breast. The review was supplemented with vaginal gynecological examination and ultrasound examination of small pelvis organs to assess the condition of the uterus and its appendages, the diagnosis of gynecological diseases. Results. Summarizing obtained in this study results one should stress the positive long-term effect of applying Mastofemin for the treatment of proliferative changes of the breast in women of reproductive age. This is manifested by a decrease in the intensity of clinical signs of mastitis, consistent with the results of sonographic control. Established positive dynamics in the treatment of cystic mastitis, dectective and when combined cystic mastopathy with dectective. In the control group of patients for a given observation period (6 months) no significant changes in clinical signs of mastitis and sonographic characteristics. Regression of disease has not occurred in any of the patients, in 2 patients increased sensitivity of the breast after 6 months moved to the soreness. Sonographic characteristics of mastitis during the observation period did not change. Thus, the use of Mastofemin aimed at pathogenetic treatment of mastitis and prevention of breast cancer. Conclusion. Application of Mastofemin during the treatment of mastitis in women of reproductive age significantly improves the clinical condition of patients; reduce the subjective and objective symptoms of the disease. The positive effect of the treatment with Mastofemin proved in the case of the treatment of sonographic following forms of mastitis: cystic mastopathy, cystic mastopathy with dectectasy. Mastofemin may be the drug of choice for complex conservative monotherapy in women of reproductive age with proliferative changes in the breast, and can also be used as part of complex treatment in patients with diffuse changes of the breast when combined with hyperplastic processes of the myometrium and endometrium. Keywords: mastopathy, breast gland, herbal medicine, herbal remedies, Mastofemin.

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