This study aimed to assess the preventive role of rehabilitation nursing in the formation of deep vein thrombosis (DVT) in the lower limbs after fracture and its effect on the patient's quality of ...life. Ninety patients with lower limb fractures were randomly divided into a study group (n = 45) and a control group (n = 45). Patients in the control group received routine care postoperatively, whereas patients in the study group received rehabilitation nursing intervention on the same postoperative day. A follow-up examination was conducted after 3 months. The occurrence rate of lower limb DVT (LDVT) complications, hemorheology, quality of life (SF-36) scores, coagulation profile, and nursing satisfaction were compared between the groups. After the intervention, the study group presented with lower extremity DVT and higher hemorheology indices than those of the control group ( P < .05). The SF-36 scores of both groups increased, but the increase in SF-36 scores in the study group was more significant ( P < .001). The satisfaction level of the patients in the study group with nursing services was higher than that of the control group ( P = .004). Coagulation indicators can be effectively adjusted and the occurrence of postoperative complications can be reduced in patients undergoing spine fracture surgery such as DVT via standardized rehabilitation care, thereby improving patients’ quality of life and nursing conditions.
The aim of this study was to compare the long term efficacy of lower limb bypass with that of endovascular treatment (EVT) in patients with chronic limb threatening ischaemia (CLTI).
This ...retrospective, multicentre study evaluated the outcomes of patients with CLTI who underwent first time infra-inguinal bypass or EVT. The primary outcome was to compare amputation free survival (AFS) rates between the two propensity score matched groups. The secondary outcome was to compare wound healing within the first six months. Major adverse events were compared according to the type of revascularisation.
Overall, 793 patients fulfilled the eligibility criteria, from whom 236 propensity score matched pairs were analysed. The mean follow up was 52 months. The 236 bypass procedures included 190 autogenous bypass grafts (80.5%), 151 (64.0%) of which were infrapopliteal. Among the 236 EVT procedures, the target lesion was the femoropopliteal segment in 81 patients (34.3%), the femoropopliteal and infrapopliteal segments in 101 patients (42.8%), and the infrapopliteal segment in 54 patients (22.9%). AFS was significantly better in the bypass group at five years (60.5 ± 3.6%) compared with the EVT group (35.3 ± 3.6%) (p < .001). Major amputation occurred in 61 patients (25.8%) in the bypass group and 85 patients (36.0%) in the EVT group (HR 0.66, 95% CI 0.47 – 0.92; p = .014). The probability of healing was significantly better in the bypass group at six months compared with the EVT group (p = .003). The median length of stay was shorter for the EVT group (4 days) than for the bypass group (8 days) (p = .001). Urgent re-intervention and re-admission rates were high and did not differ significantly between the groups.
This study has shown that lower limb bypass surgery offered a significantly higher probability of AFS and wound healing compared with EVT in patients with CLTI.
Objective: A severe and long-term alcohol use can have adverse effects on lower limb function. Over time, some individuals may develop gait ataxia, which refers to the impairment of controlled lower ...body movements that are important for walking and maintaining proper gait. Gait ataxia is well-documented in patients who have been diagnosed with alcohol-related Wernicke-Korsakoff syndrome (WKS); however, less is known on how common ataxia is among patients with alcohol use disorder (AUD) without WKS. To date, no study has systematically reviewed the evidence focusing on patients suffering only from AUD. Our aim was to perform a qualitative synthesis of the existing literature examining behavioral signs of gait ataxia among abstinent patients with AUD. Method: Two facets were created encompassing keywords for "alcohol use disorder" and "measures of gait ataxia." Databases, including EMBASE, APA PsycInfo, Medline, and Cochrane Library, were searched for studies, and a quality assessment was performed. Results: Ten studies were identified (37 ≥ ns ≤ 247), which were all rated as being of moderate (N = 7) to good quality (N = 3). The age range was 31.4-53.4 years (weighted mean age: 53.6 years), and 78.3% of the participants were male. Eight studies found that patients with AUD and without WKS exhibited behavioral signs of gait ataxia. Conclusions: Although there is evidence of gait ataxia among patients with AUD, heterogeneous results and methodological shortcomings such as lack of screening for neurocognitive deficits deem these findings preliminary and highlight the need for more research in the future.
Public Health Significance Statement
The lack of knowledge on whether gait ataxia is present among patients with alcohol use disorder can delay an early diagnosis and impede on the treatment of the motor dysfunction. This systematic review provides important insights to the nature of gait ataxia among patients with alcohol use disorder.
Objective:
The aim of this study was to evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on the post-stroke recovery of lower limb motor function.
Data sources:
We searched ...the databases of PubMed, Cochrane Library, and Embase. The randomized controlled trials were published by 25 January 2019.
Review methods:
We included randomized controlled trials that evaluated the effects of rTMS on lower limb motor recovery in patients with stroke. Two reviewers independently screened the searched records, extracted data, and assessed the risk of bias. The treatment effect sizes were pooled in a meta-analysis by using the RevMan 5.3 software. The internal validity was assessed using topics suggested by the Physiotherapy Evidence Database (PEDro).
Results:
Eight studies with 169 participants were included in the meta-analysis. Pooled estimates demonstrated that rTMS significantly improved the body function of the lower limbs (standardized mean difference (SMD) = 0.66; P < 0.01), lower limb activity (SMD = 0.66; P < 0.01), and motor-evoked potential (SMD = 1.13; P < 0.01). The subgroup analyses results also revealed that rTMS improved walking speed (SMD = 1.13) and lower limb scores on the Fugl-Meyer Assessment scale (SMD = 0.63). We found no significant differences between the groups in different mean post-stroke time or stimulation mode over lower limb motor recovery. Only one study reported mild adverse effects.
Conclusion:
rTMS may have short-term therapeutic effects on the lower limbs of patients with stroke. Furthermore, the application of rTMS is safe. However, this evidence is limited by a potential risk of bias.
Aims
This pilot study aimed to evaluate the effects of motor imagery training on lower limb motor function of stroke patients.
Background
Motor imagery training has played an important role in ...rehabilitation outcomes of stroke patients.
Methods
In this pilot randomized controlled trial 32 stroke patients were randomly divided into experimental and control groups from January to June 2017. Patients in both groups received conventional neuro‐rehabilitation five times a week in 3‐h segments for 6 weeks. Patients in the experimental group underwent an additional 20 min of motor imagery training. Measures were evaluated by motor function of the lower extremity, activities of daily living and balance ability.
Results
The outcomes significantly improved by motor imagery training were the Fugl‐Meyer Assessment of the lower extremity, the Functional Independence Measure dealing with transfers and locomotion, and the Berg Balance Scale.
Conclusion
Motor imagery training could be used as a complement to physical rehabilitation of stroke patients. Our findings may be helpful to develop nursing strategies aimed at improving functional ability of stroke patients and thus enhancing their quality of life.
Summary statement
What is already known about this topic?
Lower extremity dyskinesia is among the most common complications that significantly limit the patient's activities of daily living. Motor imagery training, a safe and cost‐efficient technique, may be used as a complement to physical rehabilitation of stroke patients.
Evidence suggests that motor imagery training is effective in upper limb recovery after stroke.
There is limited evidence of the effectiveness of motor imagery training on lower limb motor functions of patients with chronic stroke.
What this paper adds?
Motor imagery training can be incorporated into conventional therapy among individuals by rehabilitation specialist nurses with sufficient experience of motor imagery training, but substantial resources are needed.
Six‐week motor imagery training resulted in a significant improvement in the motor performance of lower limbs in patients with stroke.
Further study is needed to modify and optimize the present programme and should be focused on enabling more stroke patients to benefit from motor imagery training.
The implications of this paper:
The addition of motor imagery training to the conventional neuro‐rehabilitation can significantly promote the recovery of motor performance of lower limbs in stroke patients, thus reducing long‐term disability and associated socio‐economic burden.
The findings of this pilot study may be helpful to develop nursing strategies aimed at improving functional ability and consequently the quality of life of stroke patients.
Nurses can learn the motor imagery training as a technique for practising psychomotor nursing skills.
Background and Aims This study addresses only those interventions, such as feedback and kinesio taping, that affect lower limb function in athletes with impaired lower limb movement patterns. Methods ...This research is a systematic review study that examined all published articles in English about the effect of feedback and kinesio taping on correcting defective movement patterns and reducing injury risk factors. The current study was conducted by searching foreign databases such as Google Scholar, PubMed, and ScienceDirect and domestic databases, including Magiran and Irandoc with the keywords of “videotape augmented feedback,” “taping,” “kinesio taping,” and “lower extremity” from January 2000 to January 2021. Results After reviewing the full texts of 45 articles, 24 articles were finally selected according to the purpose of the research. Of 24 articles, 20 were interventional studies, 1 was a systematic review, 1 was a meta-analysis, and 2 were meta-analysis and systematic reviews. In all studies, feedback training methods positively affected lower limb biomechanics, and tipping methods improved pain. Conclusion After comparing the effects of feedback and kinesio taping interventions in the studied studies, it can be concluded that feedback is better than kinesio taping taping in improving kinetic and kinematic variables in people with lower limb movement pattern defects.
Objective Running is known as one of the most popular sports for which there is no time and space limit. Recently, due to lifestyle changes, the use of treadmills for walking and running has ...increased. However, the biomechanical differences in coordination between running on a treadmill at different speeds have not been sufficiently addressed. The aim of this study was to investigate the effect of increasing running speed on three-dimensional changes of lower extremity joint angles in the open motor chain and swing phase. Methods 28 elite runners participated in this study. Subjects ran on an equipped treadmill while kinematic running data was recorded for 30 seconds through a three-dimensional 12-camera motion recording system at speeds of 2.5, 3.5 and 4.5 m / s. Data were normalized based on the subjects' body mass as well as 101 time points in the running cycle. The normality and homogeneity of variance of the dependent variable were tested using Bartlett and Leven’s tests. Repeated measurement test was performed to measure the angles of the pelvis, knee and ankle between the dominant and non-dominant lower limb joints in the running swing phase. Results In the range of motion of hip, knee and ankle joint, there were significant differences among all the three speed rates of 2.5, 3.5 and 4.5 on all planes. Conclusion Changes in the angle and range of motion of the hip, knee and ankle joints are significantly greater in the swing phase as the running speed increases. Due to the fact that in high-speed running, the stability of the body decreases, the central nervous system commands to increase the range of motion of the angle of the mentioned joints to regulate the structure of the body and reduce the instability in response to the applied disorders. The results also show that the ankle joint, as the closest joint in contact with the ground, helps to run faster and more efficiently by increasing changes in the angle and range of motion of the ankle joint during running, and by reducing the time of foot contact with the ground at each step. It can be concluded that this point is effective in increasing speed.
Females use various behavioural tactics in order to attract the attention of a desirable mate. Wearing high heels enhances female physical attractiveness for the opposite sex, thus their use seems to ...be a powerful sexual signal. We investigated female preferences for high heels both in everyday life as well as in a hypothetical mating scenario. Slovak females reported a low frequency of wearing high heels (45% once per month, 38% never) in everyday life. Females with a lower body height and high self-perceived attractiveness reported more frequent use of high heels than others. Sociosexuality and involvement in a romantic relationship did not predict the wearing of high heels. When females imagined an interaction with an attractive male, preferences for high heels steeply increased compared with a scenario with an unattractive male. Females with a low body height use high heels in all probability to visually elongate their leg length in order to increase their physical attractiveness. High heels seem to be a form of sexual signalling by females in intersexual interactions.
•Preference for high heels correlated with female self-perceived attractiveness.•Shorter body height correlated with preferences for high heels.•High heels were most preferred in interaction with an attractive male.•High heels were least preferred in interaction with an unattractive male.•High heels are female sexual signals.
•Three positions are needed to get 90 % of maximal activation for 90 % of the individuals.•Unipodal standing is the more efficient position to obtain a maximal activation.•Five maximal contractions ...are recommended to obtain a valid maximal activation.•A compromise between maximal activation and reproducibility has to be found.
Even though most studies normalize the surface EMG signal of the gastrocnemius muscle using a single position of maximum voluntary isometric contraction (MVIC), several studies tend to indicate that several positions are in fact needed to obtain a maximal voluntary activation (MVA) for most of the subjects. However, no combination of positions has already been described.
A combination of MVIC positions to normalize the EMG signal of the gastrocnemius muscle is investigated. the influence of using several positions on the reproducibility of the normalization process is evaluated.
Twenty healthy volunteers (45 % female – 55 % male, 25.4 years (SD 4.3), 72.6 kg (SD 13.9), 1.78 m (SD 0.12)) were recruited. Six positions for MVIC were compared and the effect of several normalization combinations on a functional task (gait) was evaluated.
Several positions are needed to obtain at least 90 % of the MVA for 90 % of the volunteers even though the use of a single well-chosen position (unipodal standing position with knee fully extended and ankle fully plantar-flexed) will lead to no statistically significant differences of the gait evaluation during stance phase. For each position, five repetitions of the MVIC are recommended to obtain a valid MVA.
This study confirms that using several MVIC positions is recommended when possible to normalize the gastrocnemius muscle EMG signal. However, in the situation of a patient where limited MVIC attempts are possible, using a single well-chosen position should not significantly influence the amplitude and the reproducibility of the measures.
Aims
To explore the beneficial effects of virtual reality (VR) interventions on upper‐ and lower‐limb motor function, balance, gait, cognition and daily function outcomes in stroke patients.
Design
A ...systematic review and meta‐analysis of randomized controlled trials.
Data Sources
English databases (PubMed, EMBASE, the Cochrane Library, CINAHL, Web of Science, Physiotherapy Evidence Database, ProQuest Dissertations and Theses) and Chinese databases (Chinese BioMedical Literature Service System, WANFANG, CNKI) and the Clinical Trial Registry Platform were systematically searched from inception until December 2019. Additionally, reference lists of the included studies were manually searched.
Review Methods
The methodological quality of studies was scored with the Cochrane ‘risk‐of‐bias tool’ and PEDro scale from the Physiotherapy Evidence Database by two independent evaluators.
Results
In total, 87 studies with 3540 participants were included. Stroke patients receiving VR interventions showed significant improvements in Fugl‐Meyer assessment of Upper Extremity, Action Research Arm Test, Wolf Motor Function Test, Fugl‐Meyer Assessment of Lower Extremity, Functional Ambulation Classification, Berg Balance Scale, Time Up and Go, Velocity, Cadence, Modified Barthel Index and Functional Independence Measure. However, differences between VR intervention and traditional rehabilitation groups were not significant for Box‐Block Test, 10 m Walk Test, Auditory Continuous Performance Test, Mini‐Mental State Examination and Visual Continuous Performance Test.
Conclusion
This review suggests that VR interventions effectively improve upper‐ and lower‐limb motor function, balance, gait and daily function of stroke patients, but have no benefits on cognition.
Impact
This review identified the positive effects of VR‐assisted rehabilitation on upper‐ and lower‐limb motor function, balance, gait and daily function of stroke patients. And, we verified the duration of VR intervention affects some health benefits. The benefit of VR on cognitive function requires further investigation through large‐scale multicentre RCTs.
