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Koyama K, Yamauchi J. Mechanical drivers of intrinsic foot muscle for maximum toe flexor strength in upright standing across different body size. Foot (Edinb) 2024; 61:102128. [PMID: 39276714 DOI: 10.1016/j.foot.2024.102128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/25/2024] [Accepted: 08/29/2024] [Indexed: 09/17/2024]
Abstract
This study aimed to evaluate maximum toe flexor strength, foot arch height, intrinsic toe flexor muscle size and foot arch stiffness among individuals with different body sizes, and to compare these variables between sitting and standing positions. Maximum toe flexor strength in sitting and standing, and intrinsic foot muscle thicknesses (flexor hallucis brevis: FHB, flexor digitorum brevis: FDB, abductor hallucis: AH and quadratus plantae: QP), were measured using a toe grip dynamometer and a B-mode ultrasound in healthy young men. FHB was thicker than AH, FDB and QP, AH was thicker than FDB and QP, and no significant difference was found between FDB and QP. Toe flexor strength was correlated with FHB and AH, and foot arch height was correlated with FHB. Toe flexor strength was greater in standing than in sitting. Stepwise multiple regression analysis identified FHB and AH as determinants of toe flexor strength in standing, and the relative muscle strength values per body weight in standing were determined by QP, foot arch index and foot arch stiffness. Overweight individuals had a decreased rate of increase in relative toe flexor strength compared to normal individuals. These results suggest that a large muscle thickness of intrinsic foot muscle a key contributor to toe flexor strength. Moreover, toe flexor muscle in upright standing could have the potential to generate force independently of intrinsic foot muscle size, but obese individuals who chronically put weight on their feet might impair the force amplification mechanism in upright standing.
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Buckley JG, Frost SS, Hartley S, Rodacki ALF, Barrett BT. Moving from stable standing to single-limb stance or an up-on-the-toes position: The importance of vision to dynamic balance control. PLoS One 2024; 19:e0307365. [PMID: 39042648 PMCID: PMC11265682 DOI: 10.1371/journal.pone.0307365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 07/03/2024] [Indexed: 07/25/2024] Open
Abstract
Understanding the contribution vision has to dynamic balance control may help in understanding where/why loss of balance occurs during everyday locomotion. The current study determined how body-centre-of-mass (BCoM) dynamics and postural stability when moving to and holding a single-limb-stance (SS) or an up-on-the-toes (UTT) position were affected by visual occlusion. From standing on a force platform, 18 adults (mean (SD) 26.7 (4.8) years; 1.73 (0.08) m; 84.0 (22.9) kg; 7 females) completed repeated trials (x3) with and without vision in which they moved to either a SS or an UTT position (order countered-balanced), and attempted to hold that position for 2 (SS) or 5 (UTT) seconds before returning to standing. UTT trials were also repeated at a fast speed, and SS trials were repeated using both the dominant and non-dominant limb. BCoM dynamics were assessed by analysing the displacement and peak velocity of the centre-of-pressure (CoP) when moving to and from the SS and UTT positions. Balance stability was the variability in the CoP displacement/velocity when holding these positions. Results indicate that under visual occlusion, the peak CoP velocity when moving to the SS or UTT position was reduced (ES, 0.67 and 0.68, respectively), suggesting greater caution. Both the variability in the CoP displacement/velocity when holding these positions and the peak CoP velocity when returning to flat-standing increased (SS: ES, 1.0 and 0.86, respectively; UTT: ES 1.26 and 0.66, respectively), suggesting, respectively, greater instability and poorer control. The poorer control in SS trials, occurred when returning to standing from the SS position held on the non-dominant limb, and correspondingly, the reduction in SS duration when vision was occluded was greater for the non-dominant limb trails (limb-vision interaction; p = 0.042). This suggests that movements initiated/controlled by the non-dominant limb are more reliant on visual feedback than those initiated/controlled by the dominant limb.
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Affiliation(s)
- John G Buckley
- School of Engineering, University of Bradford, Bradford, United Kingdom
| | | | - Shaun Hartley
- School of Engineering, University of Bradford, Bradford, United Kingdom
| | - Andre L F Rodacki
- Department of Physical Education, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Brendan T Barrett
- School of Optometry and Vision Science, University of Bradford, Bradford, United Kingdom
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Spicer S, Zanghi N, Lo D. Effects of a Single Electrical Stimulation Session on Foot Force Production, Foot Dome Stability, and Dynamic Postural Control. J Athl Train 2024; 59:680. [PMID: 38918008 PMCID: PMC11220772 DOI: 10.4085/1062-6050-1004.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Affiliation(s)
- Seth Spicer
- Department of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ
| | - Nicholas Zanghi
- Department of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ
| | - David Lo
- American Preventive Screening and Education Association, Stratford, NJ
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Azhdari N, Ebrahimi S, Abolahrari-Shirazi S, Rojhani-Shirazi Z, Bervis S, Ghahramani L. Investigating the lumbar proprioception and core muscles recruitment pattern while getting up from a chair with weight lifting in patients with chronic functional constipation: cross-sectional study. Int Urogynecol J 2024; 35:109-117. [PMID: 37991565 DOI: 10.1007/s00192-023-05673-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/01/2023] [Indexed: 11/23/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Patients with chronic functional constipation have some problems such as weakness of pelvic floor muscles, and a lack of coordination of pelvic floor and abdominal muscles has been seen. The goal of this study was to investigate the lumbar proprioception and the core muscle recruitment pattern. METHODS The study type is a cross-sectional case-control study. There were 30 participants (case, n = 15, and control, n = 15). Electromyography of the core muscles was recorded while the subjects were getting up from the chair accompanied by lifting a weight, to check the pattern of muscle recruitment. Moreover, the lumbar proprioception was evaluated by an isokinetic device in both groups. The study was analyzed using independent t test and Mann-Whitney U test, and a nonparametric Friedman test was performed followed by Bonferroni pairwise comparison. RESULTS The comparison of muscle activity delay between the two groups showed that there was a significant difference between the two groups regarding the abdominal muscles, anal sphincter, and erector spinae (p < 0.05). However, there was no significant difference in the rectus femoris and gluteal muscles between the two groups (p > 0.05). Moreover, the proprioception of the lumbar region showed a significant difference (p < 0.05) between the two groups. CONCLUSIONS The results of this study demonstrated that the lumbar proprioception sense was reduced in the case group. This result can be justified, based on the problems in constipation (lack of coordination of muscles, weakness of pelvic floor muscles). The coordination of core muscles changed in patients with chronic functional constipation during a functional task.
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Affiliation(s)
- Negar Azhdari
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, 1st, Abivardi Avenue, Chamran Blvd, Shiraz, Iran
| | - Samaneh Ebrahimi
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, 1st, Abivardi Avenue, Chamran Blvd, Shiraz, Iran.
- Rehabilitation Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Sara Abolahrari-Shirazi
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, 1st, Abivardi Avenue, Chamran Blvd, Shiraz, Iran
- Rehabilitation Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Rojhani-Shirazi
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, 1st, Abivardi Avenue, Chamran Blvd, Shiraz, Iran
- Rehabilitation Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soha Bervis
- Rehabilitation Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Ghahramani
- Department of Colorectal Surgery, School of Medicine Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Arnold T, Johnston CS. An examination of relationships between vitamin B12 status and functional measures of peripheral neuropathy in young adult vegetarians. Front Nutr 2023; 10:1304134. [PMID: 38174111 PMCID: PMC10764020 DOI: 10.3389/fnut.2023.1304134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Prevalence rates for vitamin B12 deficiency in U.S. adult vegetarians may exceed 30%, which is concerning given the role for this vitamin in numerous nervous system functions, including the synthesis of myelin sheaths. Defective myelin synthesis and repair are directly linked to peripheral neuropathy; yet, few investigations have examined how physical indicators of peripheral neuropathy (e.g., hand dexterity, vibration sensitivity and balance) are impacted in individuals adhering to vegetarian diets. This feasibility research explored the relationships between peripheral neuropathy and vitamin B12 status using a cross-sectional study design. In addition, a small pilot trial was conducted for limited-efficacy testing of vitamin B12 supplementation for reducing peripheral neuropathy. Methods Healthy, able-bodied adults (n = 38; 19-40 years of age) reported exclusive adherence to a vegetarian or vegan diet for 3 years. Peripheral neuropathy was measured using a force plate for assessing balance, and a vibration sensitivity tester and pegboard tests to assess hand dexterity. Serum vitamin B12 and folate were measured using standard radioimmunoassay techniques. Results Twenty-six percent of the sample displayed deficient or marginal vitamin B12 status (serum vitamin B12 <221 pmol/L). Participants with adequate vitamin B12 status scored 10% higher on the Purdue pegboard assembly test and 20% higher on the left hand adjusted functional dexterity test in comparison to participants with marginal-to-deficient vitamin B12 status (p < 0.05). Discussion These data provide preliminary evidence that peripheral neuropathy can be detected in individuals with marginal-to-deficient vitamin B12 status.
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Affiliation(s)
| | - Carol S. Johnston
- Nutrition Program, College of Health Solutions, Arizona State University, Phoenix, AZ, United States
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Gulley Cox LI, Dias N, Zhang C, Zhang Y, Gorniak SL. Effects of Type II Diabetes on Proprioception during a Reach to Pinch Task. J Mot Behav 2023; 56:263-274. [PMID: 37997260 PMCID: PMC10957313 DOI: 10.1080/00222895.2023.2285888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
Older adults with type II diabetes (T2D) are at risk of developing nerve disorders that result in functional impairment. Most work in proprioceptive dysfunction in older adults with T2D has focused on functional deficits of the lower limb. The purpose of this study was to examine proprioceptive effects of T2D on the upper limb in older adults. Kinematic performance of a reach-to-pinch action toward a virtual target was assessed in a T2D group (60+ years old with T2D) and a healthy age- and sex-matched control group. Tactile and vibratory thresholds did not differ between T2D and controls. Task accuracy via mean pinch location was significantly worse for persons with T2D (pwT2D) with differences in wrist extension/flexion (ex/fl), wrist abduction/adduction (ab/ad), 1st carpometacarpal (CMC) ab/ad, 2nd metacarpophalangeal (MCP2) ex/fl, MCP2 ab/ad, and digit 1 and hand transport trajectories. Group differences persisted with consideration of body mass index; sex differences in task accuracy emerged. Findings indicate that proprioception of the upper extremity is altered in pwT2D such that they exhibit a unique aperture position and aiming strategy during a reach-to-pinch action. These findings characterize functional sensorimotor impairment of the upper limb in pwT2D with respect to workspaces without visual or tactile feedback.
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Affiliation(s)
- Lauren I. Gulley Cox
- Department of Health and Human Performance, University of Houston, Houston, TX 77204
| | - Nicholas Dias
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204
| | - Chuan Zhang
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204
| | - Yingchun Zhang
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204
| | - Stacey L. Gorniak
- Department of Health and Human Performance, University of Houston, Houston, TX 77204
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Luo X, Zhang C, Huang Q, Du Z, Ni X, Zeng Q, Cheng Q. Correlation analysis between foot deformity and diabetic foot with radiographic measurement. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2023; 4:1121128. [PMID: 37333801 PMCID: PMC10275571 DOI: 10.3389/fcdhc.2023.1121128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 05/17/2023] [Indexed: 06/20/2023]
Abstract
Background Foot deformity is a risk factor for diabetic foot ulcer. This study was aimed to investigate the relationship between hallux valgus (HV) and diabetic foot through the radiographic measurement. Methods The patients with diabetic foot hospitalizing in the Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University from September 2016 to June 2020 were selected. Then the foot plain X-ray radiographs were completed, and the size of HV angle (HVA) was measured. Their clinical data were collected, and the ulcer recurrence rate, amputation rate and mortality rate of the patients were followed up. Results A total of 370 patients were included. According to HVA, patients were divided into non-HV group (HVA<15°), and mild (15°≤HVA ≤ 20°), moderate (20°40°) HV groups. The age, height, BMI, smoking history and glycosylated hemoglobin level among the non-HVA, mild, moderate, and severe HV group (P<0.05), while smoking history, HbA1c, eGFR and autonomic neuropathy were significantly lower in HV group than those in non-HV group (P<0.05). The ulcer area in patients with moderate HV was larger than that in non-HV patients, and the severity of infection in patients with severe HV was significantly higher than that the other three groups (P<0.05). Conclusion The occurrence of HV is not only related to age and BMI, but also to the creatinine and eGFR level, autonomic neuropathy, lower limb arteriosclerosis occlusion, coronary heart disease and hypertension. Therefore, more attention should be paid to renal function screening, neuropathy screening and evaluation of lower extremity vascular lesions in patients with diabetes, especially those with moderate or higher HV.
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Affiliation(s)
- Xu Luo
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chun Zhang
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Qiuhong Huang
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhipeng Du
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xia Ni
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinglian Zeng
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qingfeng Cheng
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Park JH, Benson RF, Morgan KD, Matharu R, Block HJ. Balance effects of tactile stimulation at the foot. Hum Mov Sci 2023; 87:103024. [PMID: 36370618 DOI: 10.1016/j.humov.2022.103024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/12/2022] [Accepted: 11/02/2022] [Indexed: 11/10/2022]
Abstract
Balance relies on several types of sensory information, including somatosensory senses such as touch and position sense (proprioception). As these senses decline in older adults, there is a question of whether shoes limit somatosensory feedback from the floor. Textured insoles are designed to stimulate the soles of the feet to enhance tactile feedback. Textured insoles have shown balance benefits in some populations, but it is unclear if such tactile stimulation improves a person's balance even in cushioned athletic shoes, which dampen proprioceptive signals. Here we ask whether tactile vs. proprioceptive cues contribute differently to balance control in the healthy somatosensory system. We assessed balance in 20 healthy young adults under four footwear conditions: cushioned shoes with regular insoles, cushioned shoes with textured insoles, barefoot, and minimalist shoes. Each condition was evaluated using the Y-Balance Test (YBT) and the Balance Error Scoring System (BESS), validated tests of dynamic and static balance, respectively. YBT is a dynamic reaching test performed on one leg. The BESS includes various stance conditions with eyes closed. The results showed that footwear influenced dynamic balance only, with textured insoles leading to significantly better performance than barefoot and minimalist shoes did in the YBT. These results suggest that at least for dynamic balance, balance benefits of tactile stimulation from the textured insoles offset any dampening of proprioception caused by the athletic shoes' cushioning. Future research on how these conditions compare in older adults may lead to improved footwear recommendations to reduce fall risk and injuries for that population.
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Affiliation(s)
- Jung Hyun Park
- Department of Kinesiology, School of Public Health, Indiana University Bloomington, United States of America
| | - Rhea F Benson
- Department of Kinesiology, School of Public Health, Indiana University Bloomington, United States of America
| | - Katherine D Morgan
- Department of Kinesiology, School of Public Health, Indiana University Bloomington, United States of America
| | - Roma Matharu
- Department of Kinesiology, School of Public Health, Indiana University Bloomington, United States of America
| | - Hannah J Block
- Department of Kinesiology, School of Public Health, Indiana University Bloomington, United States of America.
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Determination of light pressing pressure for improving foot skin blood flow in type 2 diabetic patients. J Bodyw Mov Ther 2023; 33:14-19. [PMID: 36775509 DOI: 10.1016/j.jbmt.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 05/07/2022] [Accepted: 09/18/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Traditional Thai massage is one of the alternative treatments for diabetic feet. However, the specific amount of pressing pressure applied to the foot during Thai foot massage is unknown. This study aimed to evaluate the effect of light pressing pressure on foot skin blood flow in type 2 diabetic patients. METHODES A single-arm repeated measures was conducted. Forty-three participants were recruited via the subjective examination and screening using the Michigan Neuropathy Screening Instrument. To obtain foot skin blood flow by laser doppler blood flowmetry, a probe was pasted on the 1st distal phalange of the big toe. Light pressure at a single point was applied on the plantar skin fold between the bases of the second and third toes by using the digital algometer. The pressure was applied gently, then increased slightly until the participant started to feel some minor discomfort. Patients were asked to rate their pain intensity using the visual analogue scale. RESULTS The average pressing pressure without discomfort was 3.55 ± 1.04 kg/cm2. The foot skin blood flow increased significantly immediately after the pressing pressure, and this increase represented about 1.9 times when compared with the baseline (p < 0.001). CONCLUSION The application of light pressing pressure could be used as a basic standard criterion for massage to improve the foot skin blood flow in type 2 diabetic patients.
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Asiri F, Reddy RS, Narapureddy BR, Raizah A. Comparisons and Associations between Hip-Joint Position Sense and Glycosylated Hemoglobin in Elderly Subjects with Type 2 Diabetes Mellitus-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15514. [PMID: 36497588 PMCID: PMC9741323 DOI: 10.3390/ijerph192315514] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/16/2022] [Accepted: 11/20/2022] [Indexed: 06/17/2023]
Abstract
Hip-joint position sense (JPS) accuracy may be impaired in individuals with type 2 diabetes mellitus (T2DM). An impaired hip JPS can alter postural control and bodily balance. The objectives of this study are to (1) compare the hip JPS between T2DM and asymptomatic and (2) assess the relationship between hip JPS and glycosylated hemoglobin (HbAlc). This comparative cross-sectional study included 117 elderly individuals with T2DM (mean age: 59.82 ± 6.80 y) and 142 who were asymptomatic (mean age: 57.52 ± 6.90 y). The hip JPS was measured using a digital inclinometer. The individuals were repositioned to a target position with their eyes closed, and the magnitudes of matching errors were estimated as reposition errors. The hip JPS was evaluated in the flexion and abduction directions. The magnitude of reposition errors was significantly larger in the T2DM group in the right flexion (p < 0.001), the right abduction (p < 0.001), the left flexion (p < 0.001), and the left abduction (p < 0.001) directions compared to the asymptomatic group. HbA1c values showed a significant positive correlation with JPS in the right-hip flexion (r = 0.43, p < 0.001), the right-hip abduction (r = 0.36, p < 0.001), the left-hip flexion (r = 0.44, p < 0.001), and the left-hip abduction (r = 0.49, p < 0.001) directions. Hip JPS testing may be considered when assessing and formulating treatment strategies for individuals with type 2 diabetes. Future research should focus on how hip JPS can impact balance and falls in individuals with T2DM.
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Affiliation(s)
- Faisal Asiri
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Bayapa Reddy Narapureddy
- Department of Public Health, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Abdullah Raizah
- Department of Orthopaedics, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
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Gille J, Körner V, Oheim R, Paech A, Mittelstädt H, Schulz AP, Schagemann J. Dynamic Postural Stability after Cartilage Repair in the Knee. Open Orthop J 2022. [DOI: 10.2174/18743250-v16-e2206300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Background:
Articular cartilage has an exceptionally poor capacity for healing, but Autologous Matrix Induced Chondrogenesis is a procedure with a substantial body of literature that demonstrates its performance in chondral and osteochondral repair. However, data concerning dynamic postural stability after cartilage repair procedures is lacking.
Objective:
Therefore, the present study was designed to assess postural stability following cartilage repair in the knee.
Methods:
20 adults had undergone Autologous Matrix Induced Chondrogenesis for the treatment of full-thickness cartilage defects, with minimum 36 months of follow-up. Clinical outcomes were evaluated by patient reported outcome measures while dynamic postural stability was assessed using the star excursion balance test. The untreated, contralateral limbs served as controls.
Results:
At a mean follow-up of 43 months, patients reported a Visual Analog Score for pain of 1.6±2.2, a mean Lysholm score of 78.5±17.9 and a mean Knee Osteoarthritis Outcome Score of 143.3±16.1. The star excursion balance test showed no significant difference between limbs.
Conclusion:
With no difference in dynamic postural stability, our results indicate that this treatment provides a positive clinical outcome, with no deficits in postural stability when compared to the contralateral, untreated leg.
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Complications of Lesser Toe Surgery: How To Avoid Them before Surgery and How To Assess and Treat Them When They Have Occurred. Foot Ankle Clin 2022; 27:233-251. [PMID: 35680286 DOI: 10.1016/j.fcl.2021.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Complications following lesser toe surgery are challenging to manage. The keys to treatment of any of these conditions are, first, to try to avoid them through identification of patient- and surgeon-related variables that contribute to their development and, second, following the occurance of a complication, to understand what can and cannot be corrected with surgical and nonsurgical management. This review provides a comprehensive assessment of current literature, demonstrates best practices and approaches to lesser toe complications, and provides an illustration of clinical examples.
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Emamhadi M, Haghani Dogahe M. Clinical Application of Saphenous Nerve Transfer for Sensory Reconstruction of the Sole After Sciatic Nerve Injury: A Case Series. Oper Neurosurg (Hagerstown) 2022; 22:373-379. [DOI: 10.1227/ons.0000000000000152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022] Open
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Ankle complex proprioception and plantar cutaneous sensation in older women with different physical activity levels. Exp Brain Res 2022; 240:981-989. [DOI: 10.1007/s00221-021-06273-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 11/11/2021] [Indexed: 11/04/2022]
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Barrett P, Quick TJ, Mudera V, Player DJ. Neuregulin 1 Drives Morphological and Phenotypical Changes in C2C12 Myotubes: Towards De Novo Formation of Intrafusal Fibres In Vitro. Front Cell Dev Biol 2022; 9:760260. [PMID: 35087826 PMCID: PMC8787273 DOI: 10.3389/fcell.2021.760260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Muscle spindles are sensory organs that detect and mediate both static and dynamic muscle stretch and monitor muscle position, through a specialised cell population, termed intrafusal fibres. It is these fibres that provide a key contribution to proprioception and muscle spindle dysfunction is associated with multiple neuromuscular diseases, aging and nerve injuries. To date, there are few publications focussed on de novo generation and characterisation of intrafusal muscle fibres in vitro. To this end, current models of skeletal muscle focus on extrafusal fibres and lack an appreciation for the afferent functions of the muscle spindle. The goal of this study was to produce and define intrafusal bag and chain myotubes from differentiated C2C12 myoblasts, utilising the addition of the developmentally associated protein, Neuregulin 1 (Nrg-1). Intrafusal bag myotubes have a fusiform shape and were assigned using statistical morphological parameters. The model was further validated using immunofluorescent microscopy and western blot analysis, directed against an extensive list of putative intrafusal specific markers, as identified in vivo. The addition of Nrg-1 treatment resulted in a 5-fold increase in intrafusal bag myotubes (as assessed by morphology) and increased protein and gene expression of the intrafusal specific transcription factor, Egr3. Surprisingly, Nrg-1 treated myotubes had significantly reduced gene and protein expression of many intrafusal specific markers and showed no specificity towards intrafusal bag morphology. Another novel finding highlights a proliferative effect for Nrg-1 during the serum starvation-initiated differentiation phase, leading to increased nuclei counts, paired with less myotube area per myonuclei. Therefore, despite no clear collective evidence for specific intrafusal development, Nrg-1 treated myotubes share two inherent characteristics of intrafusal fibres, which contain increased satellite cell numbers and smaller myonuclear domains compared with their extrafusal neighbours. This research represents a minimalistic, monocellular C2C12 model for progression towards de novo intrafusal skeletal muscle generation, with the most extensive characterisation to date. Integration of intrafusal myotubes, characteristic of native, in vivo intrafusal skeletal muscle into future biomimetic tissue engineered models could provide platforms for developmental or disease state studies, pre-clinical screening, or clinical applications.
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Affiliation(s)
- Philip Barrett
- Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, United Kingdom
| | - Tom J Quick
- Peripheral Nerve Injury Research Unit, Royal National Orthopaedic Hospital, London, United Kingdom.,UCL Centre for Nerve Engineering, University College London, London, United Kingdom
| | - Vivek Mudera
- Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, United Kingdom
| | - Darren J Player
- Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, United Kingdom
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16
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Abstract
When animals walk overground, mechanical stimuli activate various receptors located in muscles, joints, and skin. Afferents from these mechanoreceptors project to neuronal networks controlling locomotion in the spinal cord and brain. The dynamic interactions between the control systems at different levels of the neuraxis ensure that locomotion adjusts to its environment and meets task demands. In this article, we describe and discuss the essential contribution of somatosensory feedback to locomotion. We start with a discussion of how biomechanical properties of the body affect somatosensory feedback. We follow with the different types of mechanoreceptors and somatosensory afferents and their activity during locomotion. We then describe central projections to locomotor networks and the modulation of somatosensory feedback during locomotion and its mechanisms. We then discuss experimental approaches and animal models used to investigate the control of locomotion by somatosensory feedback before providing an overview of the different functional roles of somatosensory feedback for locomotion. Lastly, we briefly describe the role of somatosensory feedback in the recovery of locomotion after neurological injury. We highlight the fact that somatosensory feedback is an essential component of a highly integrated system for locomotor control. © 2021 American Physiological Society. Compr Physiol 11:1-71, 2021.
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Affiliation(s)
- Alain Frigon
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Quebec, Canada
| | - Turgay Akay
- Department of Medical Neuroscience, Atlantic Mobility Action Project, Brain Repair Center, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Boris I Prilutsky
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, USA
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17
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Bilello J, Jupiter DC. A Pilot Survey: Knowledge of Charcot Neuroarthropathy Among Family and Internal Medicine Practitioners. J Foot Ankle Surg 2021; 60:1204-1206. [PMID: 34148799 DOI: 10.1053/j.jfas.2020.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/03/2020] [Accepted: 11/05/2020] [Indexed: 02/03/2023]
Abstract
Charcot neuroarthropathy secondary to diabetes mellitus is a serious complication, requiring specialist management. As a relatively rare pathology bearing similarity to other, more common diseases, it may be misdiagnosed at initial presentation, potentially leading to delays in appropriate management. We conducted a 2-part online survey of primary care physicians within an academic medical institution to assess knowledge of presentation, complications, diagnosis, and treatment of Charcot neuropathy. The first section was designed to assess physician knowledge of Charcot foot, while the second section was completed only by physicians who were familiar with the condition and was designed to gauge their level of knowledge. Most clinicians were familiar with Charcot, encountering it at least annually. They identified common signs of Charcot (eg, swelling, pain) and complications due to its mismanagement (eg, ulcer, amputation). However, there was some disagreement on how to diagnose the pathology, with some relying on film, others referring to specialists, and some saying they were unsure. There was uncertainty on when to choose surgical options; fewer than half referred to specialists for help with this decision, and a quarter were unsure how to make the decision. While, in general, clinicians were aware of Charcot and its characteristics, there was confusion regarding how to diagnose or appropriate nonsurgical treatment.
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Affiliation(s)
- Joshua Bilello
- Medical Student, School of Medicine, The University of Texas Medical Branch, Galveston, TX
| | - Daniel C Jupiter
- Associate Professor, Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX; Associate Professor, Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch, Galveston, TX.
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18
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Maras O, Dulgeroglu D, Cakci A. Ankle Proprioception in Patients with Type 2 Diabetes Mellitus. J Am Podiatr Med Assoc 2021; 111:470034. [PMID: 34478528 DOI: 10.7547/18-178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Ankle position sense may be reduced before the appearance of the clinical manifestation of diabetic peripheral neuropathy. This is known to impair gait and cause falls and foot ulcers. Early detection of impaired ankle proprioception is important because it allows physicians to prescribe an exercise program to patients to prevent foot complications. METHODS Forty-six patients diagnosed as having type 2 diabetes mellitus and 22 control patients were included in the study. Presence of neuropathy was assessed using the Michigan Neuropathy Screening Instrument (MNSI). Level of foot care awareness was determined using the Nottingham Assessment of Functional Footcare (NAFF). Joint position sense was measured using a dynamometer. RESULTS Mean absolute angular error (MAAE) values were significantly higher in the neuropathy group compared with the control group (P < .05). Right plantarflexion MAAE values were significantly lower in the group without neuropathy compared with the group with neuropathy (P < .05). No correlation was found between MAAE values (indicating joint position sense) and age, educational level, disease duration, glycemic control, NAFF score, and MNSI history and examination scores in the groups with and without neuropathy (P > .05). Educational level and disease duration were found to be correlated with NAFF scores. CONCLUSIONS Increased MNSI history scores and increased deficits in ankle proprioception demonstrate that diabetic foot complications associated with reduced joint position sense may be seen at an increased rate in symptomatic patients.
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19
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Horstink KA, van der Woude LHV, Hijmans JM. Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: A systematic review. Rev Endocr Metab Disord 2021; 22:325-335. [PMID: 33452959 PMCID: PMC8087551 DOI: 10.1007/s11154-020-09619-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2020] [Indexed: 11/06/2022]
Abstract
Patients with diabetic peripheral neuropathy (DPN) usually have reduced somatosensory information and altered perception in feet and ankles. Somatosensory information acts as feedback for movement control and loss of somatosensation leads to altered plantar pressure patterns during gait and stance. Offloading devices are used to reduce peak plantar pressure and prevent diabetic foot ulcers. However, offloading devices can unfortunately have negative effects on static and dynamic balance. It is important to investigate these unwanted effects, since patient with DPN already are at high risk of falling and offloading devices could potentially increase this risk. The aim of this systematic review is to investigate the effects of plantar offloading devices used for ulcer prevention on their role in static and dynamic balance control in patients with DPN. PubMed and Embase were systematically searched using relevant search terms. After title selection, abstract selection, and full-text selection only five articles could be included for further analysis. Two articles included static balance measurements, two articles included dynamic balance measurements, and one article included both. Results suggested that static balance control is reduced when rocker bottom shoes and different insole configurations are used, however, toe-only rockers showed less evidence for reduced static balance control. There was no evidence for reduced dynamic balance control in combination with offloading devices. However, these results should be interpreted with care, since the number of studies was very small and the quality of the studies was moderate. Future research should evaluate balance in combination with different offloading devices, so that clinicians subscribing them are more aware of their potential unwanted consequences.
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Affiliation(s)
- Koen Andre Horstink
- Center for Human Movement Science, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lucas Henricus Vincentius van der Woude
- Center for Human Movement Science, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- School of Sport, Exercise & Health, Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, UK
| | - Juha Markus Hijmans
- Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
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20
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Domínguez-Muñoz FJ, Carlos-Vivas J, Villafaina S, García-Gordillo MA, Hernández-Mocholi MÁ, Collado-Mateo D, Gusi N, Adsuar JC. Association between 30-s Chair Stand-Up Test and Anthropometric Values, Vibration Perception Threshold, FHSQ, and 15-D in Patients with Type 2 Diabetes Mellitus. BIOLOGY 2021; 10:biology10030246. [PMID: 33809864 PMCID: PMC8004132 DOI: 10.3390/biology10030246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/14/2021] [Accepted: 03/18/2021] [Indexed: 12/26/2022]
Abstract
Simple Summary Type 2 diabetes mellitus is a chronic global disease with a series of complications that lead to problems in the somatosensory system, the cardiovascular system, health-related quality of life, foot health, and even balance. These balance problems arise from deficits in lower limb strength, among other causes. The 30-s chair stand-up test is a test that evaluates leg strength and is an easy, quick, inexpensive, and predictive test of different parameters. How this test relates to health-related quality of life, vibration sensitivity threshold, and foot health has not been studied. This study tests the degree of the relationships of the 30-s chair stand-up test with the 15-dimensional (15-D) questionnaire, Foot Health Status Questionnaire (FHSQ), vibration sensitivity threshold, and body composition questionnaires. Abstract Background: Type 2 diabetes mellitus (T2DM) is a chronic, worldwide disease affecting more than 400 million people. This pathology involves several associated problems, such as diabetic neuropathy complications, obesity, and foot problems, both in terms of health and sensitivity. Objective: The objective of this study was to explore the relationships of the 30-s chair stand-up test with the Foot Health Status Questionnaire (FHSQ), the vibration perception threshold (VPT), and the 15-dimensional (15-D) questionnaire in T2DM people. Methodology: Ninety participants with T2DM were assessed in terms of fat mass percentage, VPT, foot health, health-related quality of life (HRQoL), and the 30-s chair stand-up test. Results: The 30-s chair stand-up test was found to exhibit a moderate relationship with “physical activity” (rho = 0.441; p ≤ 0.001) and “vigor” (rho = 0.443; p ≤ 0.001) from FHSQ. The 30-s chair stand-up test was also found to be weakly associated with foot pain (rho = 0.358; p = 0.001), 15-D total score (rho = 0.376; p ≤ 0.001), “sleeping” (rho = 0.371; p < 0.001), and “depression” (rho = 0.352; p = 0.001). Conclusions: The 30-s chair stand-up test is associated with “physical activity”, “vigor”, and “foot pain” from the FHSQ and the 15-D questionnaire total score and its dimensions “sleeping” and “depression” in type 2 diabetes mellitus patients. Therefore, following the results obtained, qualified clinicians can use the 30-s chair stand-up test as a good tool for monitoring and managing type 2 diabetes.
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Affiliation(s)
- Francisco Javier Domínguez-Muñoz
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (F.J.D.-M.); (S.V.); (M.Á.H.-M.); (N.G.)
| | - Jorge Carlos-Vivas
- Health Economy Motricity and Education (HEME), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (J.C.-V.); (J.C.A.)
| | - Santos Villafaina
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (F.J.D.-M.); (S.V.); (M.Á.H.-M.); (N.G.)
| | - Miguel A. García-Gordillo
- Facultad de Administración y Negocios, Universidad Autónoma de Chile, Sede Talca 3467987, Chile
- Correspondence:
| | - Miguel Ángel Hernández-Mocholi
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (F.J.D.-M.); (S.V.); (M.Á.H.-M.); (N.G.)
| | - Daniel Collado-Mateo
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, 28943 Madrid, Spain;
| | - Narcis Gusi
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (F.J.D.-M.); (S.V.); (M.Á.H.-M.); (N.G.)
| | - José C. Adsuar
- Health Economy Motricity and Education (HEME), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (J.C.-V.); (J.C.A.)
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21
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Barrett P, Quick TJ, Mudera V, Player DJ. Generating intrafusal skeletal muscle fibres in vitro: Current state of the art and future challenges. J Tissue Eng 2020; 11:2041731420985205. [PMID: 34956586 PMCID: PMC8693220 DOI: 10.1177/2041731420985205] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/12/2020] [Indexed: 01/18/2023] Open
Abstract
Intrafusal fibres are a specialised cell population in skeletal muscle, found within the muscle spindle. These fibres have a mechano-sensory capacity, forming part of the monosynaptic stretch-reflex arc, a key component responsible for proprioceptive function. Impairment of proprioception and associated dysfunction of the muscle spindle is linked with many neuromuscular diseases. Research to-date has largely been undertaken in vivo or using ex vivo preparations. These studies have provided a foundation for our understanding of muscle spindle physiology, however, the cellular and molecular mechanisms which underpin physiological changes are yet to be fully elucidated. Therefrom, the use of in vitro models has been proposed, whereby intrafusal fibres can be generated de novo. Although there has been progress, it is predominantly a developing and evolving area of research. This narrative review presents the current state of art in this area and proposes the direction of future work, with the aim of providing novel pre-clinical and clinical applications.
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Affiliation(s)
- Philip Barrett
- Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK
| | - Tom J Quick
- Peripheral Nerve Injury Research Unit, Royal National Orthopaedic Hospital, Stanmore, UK
- UCL Centre for Nerve Engineering, University College London, London, UK
| | - Vivek Mudera
- Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK
| | - Darren J Player
- Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK
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22
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Besnard P, Christensen JE, Bernard A, Simoneau-Robin I, Collet X, Verges B, Burcelin R. Identification of an oral microbiota signature associated with an impaired orosensory perception of lipids in insulin-resistant patients. Acta Diabetol 2020; 57:1445-1451. [PMID: 32676702 PMCID: PMC7591415 DOI: 10.1007/s00592-020-01567-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 06/26/2020] [Indexed: 12/16/2022]
Abstract
AIMS Type 2 diabetes leads to multiple sensory dysfunctions affecting notably the gustatory sensitivity. Although this sensory defect, by impacting food choices, might lead to unhealthy eating behavior, underlying mechanisms remains poorly studied. We have recently reported that the composition of microbiota in contact with circumvallate gustatory papillae might affect the orosensory perception of lipids in lean and normoglycemic obese subjects. This finding has prompted us to explore whether such a phenomenon also occurs in diabetic obese patients. METHODS The composition of microbiota surrounding the circumvallate papillae was analyzed in combination with the linoleic acid perception thresholds in male insulin-resistant patients and weight-matched healthy controls. Two complementary comparisons were performed: (1) controls vs diabetic and (2) diabetic low-lipid tasters versus diabetic high-lipid tasters. RESULTS Despite subtle modifications in the oral microbiota composition, comparison of orosensory lipid perception in controls and diabetic subjects did not lead to discriminating data due to the large inter-individual variability of linoleic acid perception thresholds. In contrast, specific bacterial signatures were found by comparing diabetic low- and high-lipid tasters leading to differential molecular pathways. Surprisingly, a lower fatty taste perception was mainly found in patients treated with metformin and/or statins, suggesting a possible side effect of these antidiabetic and/or hypolipidemic drugs on taste acuity. CONCLUSIONS Collectively, these data show that the diabetic patients with defective fatty taste detection are characterized by a specific microbiota metabolism at the circumvallate papillae levels, this occurrence seeming amplified by drugs commonly used to counteract the damaging metabolic effects of T2D. Trial registration for original previous studies: ClinicalTrials.gov #NCT02028975.
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Affiliation(s)
- Philippe Besnard
- UMR 1231 Lipides/Nutrition/Cancer INSERM/Univ Bourgogne-Franche Comté/AgroSup Dijon, 21000, Dijon, France.
- Physiologie de La Nutrition, AgroSup Dijon, 26 Bd Dr Petitjean, 21000, Dijon, France.
| | | | - Arnaud Bernard
- UMR 1231 Lipides/Nutrition/Cancer INSERM/Univ Bourgogne-Franche Comté/AgroSup Dijon, 21000, Dijon, France
| | - Isabelle Simoneau-Robin
- UMR 1231 Lipides/Nutrition/Cancer INSERM/Univ Bourgogne-Franche Comté/AgroSup Dijon, 21000, Dijon, France
| | - Xavier Collet
- UMR 1048 INSERM/Univ Toulouse III Paul Sabatier, 31000, Toulouse, France
| | - Bruno Verges
- UMR 1231 Lipides/Nutrition/Cancer INSERM/Univ Bourgogne-Franche Comté/AgroSup Dijon, 21000, Dijon, France
| | - Rémy Burcelin
- UMR 1048 INSERM/Univ Toulouse III Paul Sabatier, 31000, Toulouse, France
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23
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Billot M, Calvani R, Urtamo A, Sánchez-Sánchez JL, Ciccolari-Micaldi C, Chang M, Roller-Wirnsberger R, Wirnsberger G, Sinclair A, Vaquero-Pinto N, Jyväkorpi S, Öhman H, Strandberg T, Schols JMGA, Schols AMWJ, Smeets N, Topinkova E, Michalkova H, Bonfigli AR, Lattanzio F, Rodríguez-Mañas L, Coelho-Júnior H, Broccatelli M, D'Elia ME, Biscotti D, Marzetti E, Freiberger E. Preserving Mobility in Older Adults with Physical Frailty and Sarcopenia: Opportunities, Challenges, and Recommendations for Physical Activity Interventions. Clin Interv Aging 2020; 15:1675-1690. [PMID: 32982201 PMCID: PMC7508031 DOI: 10.2147/cia.s253535] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/26/2020] [Indexed: 12/13/2022] Open
Abstract
One of the most widely conserved hallmarks of aging is a decline in functional capabilities. Mobility loss is particularly burdensome due to its association with negative health outcomes, loss of independence and disability, and the heavy impact on quality of life. Recently, a new condition, physical frailty and sarcopenia, has been proposed to define a critical stage in the disabling cascade. Physical frailty and sarcopenia are characterized by weakness, slowness, and reduced muscle mass, yet with preserved ability to move independently. One of the strategies that have shown some benefits in combatting mobility loss and its consequences for older adults is physical activity. Here, we describe the opportunities and challenges for the development of physical activity interventions in people with physical frailty and sarcopenia. The aim of this article is to review age-related physio(patho)logical changes that impact mobility in old age and to provide recommendations and procedures in accordance with the available literature.
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Affiliation(s)
- Maxime Billot
- Clinical Gerontology, University Hospital of Limoges, Limoges, France.,PRISMATICS (Predictive Research in Spine/Neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Riccardo Calvani
- Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Annele Urtamo
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki University Central Hospital, Unit of Primary Health Care, Helsinki, Finland
| | | | | | - Milan Chang
- Faculty of Health Promotion, Sports and Leisure Studies, School of Education, University of Iceland, Reykjavik, Iceland.,The Icelandic Gerontological Research Center, Landspitali University Hospital and University of Iceland, Reykjavik, Iceland
| | | | - Gerhard Wirnsberger
- Medical University of Graz, Division of Nephrology, Department of Internal Medicine, Graz, Austria
| | - Alan Sinclair
- Foundation for Diabetes Research in Older People, Diabetes Frail Ltd., Luton, UK
| | | | - Satu Jyväkorpi
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki University Central Hospital, Unit of Primary Health Care, Helsinki, Finland
| | - Hanna Öhman
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki University Central Hospital, Unit of Primary Health Care, Helsinki, Finland
| | - Timo Strandberg
- University of Helsinki, Clinicum, Helsinki, Finland; Helsinki University Hospital, Medicine and Rehabilitation, Helsinki, Finland.,University of Oulu, Center for Life Course Health Research, Oulu, Finland
| | - Jos M G A Schols
- Department of Health Services Research, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Annemie M W J Schols
- Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Nick Smeets
- Department of Health & Fitness, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Eva Topinkova
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Helena Michalkova
- Faculty of Social and Health Sciences, South Bohemian University, Ceske Budejovice, Czech Republic
| | | | | | | | | | | | - Maria Elena D'Elia
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Damiano Biscotti
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Emanuele Marzetti
- Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Ellen Freiberger
- Institute for Biomedicine of Aging, FAU Erlangen-Nürnberg, Nürnberg, Germany
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24
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Nakamura S, Sato Y, Kobayashi T, Kaneko Y, Ito E, Soma T, Okada H, Miyamoto K, Oya A, Matsumoto M, Nakamura M, Kanaji A, Miyamoto T. Vitamin D protects against immobilization-induced muscle atrophy via neural crest-derived cells in mice. Sci Rep 2020; 10:12242. [PMID: 32699341 PMCID: PMC7376070 DOI: 10.1038/s41598-020-69021-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 07/06/2020] [Indexed: 12/18/2022] Open
Abstract
Vitamin D deficiency is a recognized risk factor for sarcopenia development, but mechanisms underlying this outcome are unclear. Here, we show that low vitamin D status worsens immobilization-induced muscle atrophy in mice. Mice globally lacking vitamin D receptor (VDR) exhibited more severe muscle atrophy following limb immobilization than controls. Moreover, immobilization-induced muscle atrophy was worse in neural crest-specific than in skeletal muscle-specific VDR-deficient mice. Tnfα expression was significantly higher in immobilized muscle of VDR-deficient relative to control mice, and was significantly elevated in neural crest-specific but not muscle-specific VDR-deficient mice. Furthermore, muscle atrophy induced by limb immobilization in low vitamin D mice was significantly inhibited in Tnfα-deficient mice. We conclude that vitamin D antagonizes immobilization-induced muscle atrophy via VDR expressed in neural crest-derived cells.
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Affiliation(s)
- Satoshi Nakamura
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuiko Sato
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Advanced Therapy for Musculoskeletal Disorders II, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Musculoskeletal Reconstruction and Regeneration Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tami Kobayashi
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Musculoskeletal Reconstruction and Regeneration Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yosuke Kaneko
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Eri Ito
- Institute for Integrated Sports Medicine, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tomoya Soma
- Division of Oral and Maxillofacial Surgery, Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hiroyuki Okada
- Department of Orthopedic Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kana Miyamoto
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Akihito Oya
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Morio Matsumoto
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masaya Nakamura
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Arihiko Kanaji
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Takeshi Miyamoto
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan. .,Department of Advanced Therapy for Musculoskeletal Disorders II, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan. .,Department of Musculoskeletal Reconstruction and Regeneration Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan. .,Department of Orthopedic Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
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25
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Asai H. Functional Role of the Somatosensory Information to Perceive the Standing Position in the Anteroposterior Direction. Somatosens Mot Res 2020. [DOI: 10.5772/intechopen.91737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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26
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Acute Effects of a Whole Body Vibration Session on the Vibration Perception Threshold in Patients with Type 2 Diabetes Mellitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124356. [PMID: 32570700 PMCID: PMC7345478 DOI: 10.3390/ijerph17124356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/07/2020] [Accepted: 06/15/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Type 2 Diabetes Mellitus (T2DM) is a chronic disease that affects millions of people, and according to the International Diabetes Federation, 46.5% of people have undiagnosed diabetes. One of the most common complications of diabetes mellitus is loss of peripheral sensation. Whole Body Vibration (WBV) is a therapy, and it would be interesting to know if it can be considered as a training method to improve the Vibration Perception Threshold (VPT). The aim of the study is to verify whether there are really acute effects on the VPT after a WBV training session in people with T2DM. METHODS Ninety people with T2DM (56 men and 34 women) were randomly allocated to two groups: the WBV group and the placebo group. The ninety subjects went through a VPT training test before receiving the assigned intervention, and they performed the VPT test using the Vibratron II device. RESULTS After one session of WBV, an increase of the VPT in the WBV group was found, with respect to the placebo group. CONCLUSIONS Vibration perception threshold is increased after a WBV training session in people with T2DM, compared to a placebo group.
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Younesian H, Farahpour N, Mazde M, Simoneau M, Turcot K. Standing Balance Performance and Knee Extensors' Strength in Diabetic Patients with Neuropathy. J Appl Biomech 2020; 36:171-177. [PMID: 32335529 DOI: 10.1123/jab.2019-0365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/11/2020] [Accepted: 02/27/2020] [Indexed: 11/18/2022]
Abstract
Diabetes peripheral neuropathy (DPN) leads to balance impairment among diabetes mellitus (DM). The aims of this study were to (1) distinguish between DM patients who have/do not have DPN and to (2) compare quadriceps' strength and balance performance of DM, DPN, and healthy groups. Fifteen healthy females and 33 females with type 2 diabetic patients participated. The electrodiagnostic method was used to classify diabetic patients into DM and DPN. A dynamometer was used to measure quadriceps' strength. Single-leg standing on a force plate was also used to quantify participants' balance. Smaller conduction velocity and amplitude and greater distal latency of all nerves were observed in the DPN compared with the DM in particular for sensory nerve. In DPN, conduction velocity was asymmetrical. The quadriceps' strength of both legs in DPN and the right leg in DM was smaller than in the control group. The root mean square of the center of pressure was similar between DM and DPN. But it was larger in DPN than in the control group. DPN is associated with asymmetrical conduction velocity, smaller quadriceps' strength, and weaker balance performance that is suggestive of higher risk of falling. Balance training is recommended for the DPN group during their rehabilitation to reduce their falling risk.
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Affiliation(s)
- Hananeh Younesian
- Laval University
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS)
- Bu-Ali Sina University
| | | | | | - Martin Simoneau
- Laval University
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS)
| | - Katia Turcot
- Laval University
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS)
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Chatchawan U, Jarasrungsichol K, Yamauchi J. Immediate Effects of Self-Thai Foot Massage on Skin Blood Flow, Skin Temperature, and Range of Motion of the Foot and Ankle in Type 2 Diabetic Patients. J Altern Complement Med 2020; 26:491-500. [PMID: 32349513 DOI: 10.1089/acm.2019.0328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: The purpose of this study was to investigate the immediate effects of self-Thai foot massages (STFMs) on the foot skin blood flow, the foot skin temperature, and range of motion (ROM) of the foot and ankle in type 2 diabetic patients with peripheral neuropathy. Design: A randomized crossover study. Subjects: Twenty five diabetic patients with peripheral neuropathy were recruited. Interventions: Participants were randomly assigned to either STFM or Thai foot massage (TFM) performed by a massage therapist; then, they were switched to the other group after a 1-week washout period. In both groups, the foot massage was performed in a seated position on the dominant lower leg and foot for 25 min. Outcome measures: Before and immediately after treatment, foot skin blood flow, foot skin temperature, and ROM of the foot and ankle were evaluated. Heart rate was measured throughout the treatment. Results: After a single treatment of the massage, foot skin blood flow and ROM of the foot and ankle significantly improved in both groups (p < 0.05). Foot skin temperature did not change in STFM, whereas it significantly increased in TFM. Heart rate significantly increased in STFM, whereas it tended to decrease in TFM. Conclusions: Both STFM and TFM by a massage therapist could improve foot skin blood flow and ROM of the foot and ankle in diabetic patients with peripheral neuropathy. An STFM could be a promising alternative treatment that patients can perform at home.
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Affiliation(s)
- Uraiwan Chatchawan
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.,Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand
| | - Kawita Jarasrungsichol
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.,Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand.,Rehabilitation Department, Warinchamrab Hospital, Ubonratchathani, Thailand
| | - Junichiro Yamauchi
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand.,Tokyo Metropolitan University, Tokyo, Japan
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Charkhkar H, Christie BP, Triolo RJ. Sensory neuroprosthesis improves postural stability during Sensory Organization Test in lower-limb amputees. Sci Rep 2020; 10:6984. [PMID: 32332861 PMCID: PMC7181811 DOI: 10.1038/s41598-020-63936-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/08/2020] [Indexed: 12/26/2022] Open
Abstract
To maintain postural stability, unilateral lower-limb amputees (LLAs) heavily rely on visual and vestibular inputs, and somatosensory cues from their intact leg to compensate for missing somatosensory information from the amputated limb. When any of these resources are compromised, LLAs exhibit poor balance control compared to able-bodied individuals. We hypothesized that restoring somatosensation related to the missing limb via direct activation of the sensory nerves in the residuum would improve the standing stability of LLAs. We developed a closed-loop sensory neuroprosthesis utilizing non-penetrating multi-contact cuff electrodes implanted around the residual nerves to elicit perceptions of the location and intensity of plantar pressures under the prosthetic feet of two transtibial amputees. Effects of the sensory neuroprosthesis on balance were quantified with the Sensory Organization Test and other posturographic measures of sway. In both participants, the sensory neuroprosthesis improved equilibrium and sway when somatosensation from the intact leg and visual inputs were perturbed simultaneously. One participant also showed improvement with the sensory neuroprosthesis whenever somatosensation in the intact leg was compromised via perturbations of the platform. These observations suggest the sensory feedback elicited by neural stimulation can significantly improve the standing stability of LLAs, particularly when other sensory inputs are depleted or otherwise compromised.
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Affiliation(s)
- Hamid Charkhkar
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106, USA. .,Louis Stokes Cleveland Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA.
| | - Breanne P Christie
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106, USA.,Louis Stokes Cleveland Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA
| | - Ronald J Triolo
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106, USA.,Louis Stokes Cleveland Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA
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Domínguez-Muñoz FJ, Adsuar JC, Carlos-Vivas J, Villafaina S, Garcia-Gordillo MA, Hernández-Mocholi MÁ, Collado-Mateo D, Gusi N. Association between TUG and Anthropometric Values, Vibration Perception Threshold, FHSQ and 15-D in Type 2 Diabetes Mellitus Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062018. [PMID: 32204303 PMCID: PMC7143289 DOI: 10.3390/ijerph17062018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 02/04/2023]
Abstract
Background: Diabetes Mellitus (DM) is a chronic disease and it is characterized by reduced insulin sensitivity and/or impaired insulin production. It affects approximately 415 million people worldwide and involves a variety of complications. DM has a number of complications, including diabetic neuropathy. All of these complications can have effects on body composition, vibration perception threshold (VPT), foot health and health-related quality of life (HRQoL). Objective: The aim of this study is to determine the correlation between the Timed Up and Go (TUG), VPT, Foot Health Status Questionnaire and 15-D Questionnaire in type 2 diabetes mellitus (T2DM) patients. Methodology: A total of 90 T2DM patients (56 men and 34 women) were evaluated on their body composition, VPT, the foot health status through the FHSQ, the HRQoL was evaluated through the 15-D Questionnaire and the TUG test was performed. Results: Statistically significant associations were found between TUG and lean and fat mass, VPT, the sections "General Foot Health" and "Physical Activity" in the FHSQ questionnaire, and the 15D total score and its sections "Mobility" and "Depression". Conclusions: There is a moderate direct correlation between the Timed Up and Go and the fat mass percentage and the vibration perception threshold. Moreover, there is a moderate inverse correlation between Timed Up and Go and fat-free mass, foot health and health-related quality of life in T2DM patients. Therefore, Timed Up and Go can be a tool to assist clinicians in monitoring and managing T2DM patients.
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Affiliation(s)
- Francisco Javier Domínguez-Muñoz
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (F.J.D.-M.); (S.V.); (M.Á.H.-M.); (N.G.)
| | - José Carmelo Adsuar
- Health Economy Motricity and Education (HEME), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (J.C.A.); (J.C.-V.)
| | - Jorge Carlos-Vivas
- Health Economy Motricity and Education (HEME), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (J.C.A.); (J.C.-V.)
| | - Santos Villafaina
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (F.J.D.-M.); (S.V.); (M.Á.H.-M.); (N.G.)
| | | | - Miguel Ángel Hernández-Mocholi
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (F.J.D.-M.); (S.V.); (M.Á.H.-M.); (N.G.)
| | - Daniel Collado-Mateo
- Centre for Sport Studies, Rey Juan Carlos University, 28943 Fuenlabrada, Madrid, Spain;
| | - Narcis Gusi
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (F.J.D.-M.); (S.V.); (M.Á.H.-M.); (N.G.)
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Sparto PJ, Rosso AL, Divecha AA, Metti AL, Rosano C. Shared neural substrates of cognitive function and postural control in older adults. Alzheimers Dement 2020; 16:621-629. [PMID: 32147950 DOI: 10.1002/alz.12053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 10/04/2019] [Accepted: 12/05/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Poor cognitive function and postural control co-occur in older adults. It is unclear whether they share neural substrates. METHODS Postural sway error during a novel visual tracking (VT) condition and gray matter volume (GMV) were compared between participants with normal cognition (NC), mild cognitive impairment (MCI), or dementia (n = 179, mean age 82, 56% females, 56% white). Associations between VT error, cognitive function, and GMV were examined. RESULTS Greater VT error was associated with having dementia compared to NC or MCI (odds ratio [95% CI] = 2.15 [1.38, 3.36] and 1.58 [1.05, 2.38]). Regions with lower GMV related to greater VT error and worse cognition were: bilateral hippocampi, parahippocampi, entorhinal, and parietal cortices (all P ≤0.05). GMV of bilateral hippocampi and left parahippocampus explained >20% of VT error between dementia and NC. DISCUSSION Postural control during visuospatial tasks and dementia may share neural substrates, specifically memory-related regions.
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Affiliation(s)
- Patrick J Sparto
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrea L Rosso
- Department of Epidemiology, Graduate School, of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ayushi A Divecha
- Department of Epidemiology, Graduate School, of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrea L Metti
- Department of Epidemiology, Graduate School, of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Caterina Rosano
- Department of Epidemiology, Graduate School, of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Test-Retest Reliability of Vibration Perception Threshold Test in People with Type 2 Diabetes Mellitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051773. [PMID: 32182888 PMCID: PMC7084471 DOI: 10.3390/ijerph17051773] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/21/2020] [Accepted: 03/05/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Diabetes mellitus is a chronic disease characterized by fasting hyperglycemia. It affects approximately 415 million people worldwide and involves a variety of complications. One of them is the loss of sensitivity to peripheral vibration. OBJECTIVE Our study aims to discover the test-retest reliability of a procedure for assessing vibration sensitivity in people with type 2 diabetes mellitus. METHODOLOGY 90 people with type 2 diabetes mellitus (56 men and 34 women) performed the vibration perception threshold (VPT) test using the Vibratron II device. A re-test was completed seven days after the first reading. RESULTS The relative reliability of the VPT test result is excellent (intraclass correlation coefficient = 0.96). The same applies to gender and obesity subgroups. Regarding absolute reliability, the standard error of measurement is 8.99%, and the small real difference is 24.94%. CONCLUSIONS The relative and absolute reliability results of the vibration perception threshold in people with type 2 diabetes mellitus offer excellent results.
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Perazzolo M, Reeves ND, Bowling FL, Boulton AJM, Raffi M, Marple‐Horvat DE. Altered accelerator pedal control in a driving simulator in people with diabetic peripheral neuropathy. Diabet Med 2020; 37:335-342. [PMID: 30924960 PMCID: PMC7004113 DOI: 10.1111/dme.13957] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/27/2019] [Indexed: 11/29/2022]
Abstract
AIM To investigate whether the sensory-motor impairment attributable to diabetic peripheral neuropathy would affect control of the accelerator pedal during a driving simulator task. METHODS A total of 32 active drivers, 11 with diabetic peripheral neuropathy (mean ± sd age 67±5.0 years), 10 with diabetes but no neuropathy (diabetes group; mean ± sd age 62±10 years), and 11 healthy individuals without diabetes (healthy group; mean ± sd age 60±11 years), undertook a test on a dynamometer to assess ankle plantar flexor muscle strength and ankle joint proprioception function of the right leg, in addition to a driving simulator task. The following variables were measured: maximal ankle plantar flexor muscle strength; speed of strength generation (Nm/s); and ankle joint proprioception (ankle repositioning error, degrees). In the driving simulator task, driving speed (mph), accelerator pedal signal (degrees) and the duration of specific 'loss-of-control events' (s) were measured during two drives (Drive 1, Drive 2). RESULTS Participants with diabetic peripheral neuropathy had a lower speed of strength generation (P<0.001), lower maximal ankle plantar flexor muscle strength (P<0.001) and impaired ankle proprioception (P=0.034) compared to healthy participants. The diabetic peripheral neuropathy group drove more slowly compared with the healthy group (Drive 1 P=0.048; Drive 2 P=0.042) and showed marked differences in the use of the accelerator pedal compared to both the diabetes group (P=0.010) and the healthy group (P=0.002). Participants with diabetic peripheral neuropathy had the longest duration of loss-of-control events, but after one drive, this was greatly reduced (P=0.023). CONCLUSIONS Muscle function, ankle proprioception and accelerator pedal control are all affected in people with diabetic peripheral neuropathy, adversely influencing driving performance, but potential for improvement with targeted practice remains possible.
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Affiliation(s)
- M. Perazzolo
- Research Centre for Musculoskeletal Science and Sports MedicineSchool of Healthcare ScienceFaculty of Science and EngineeringManchester Metropolitan UniversityManchesterUK
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - N. D. Reeves
- Research Centre for Musculoskeletal Science and Sports MedicineSchool of Healthcare ScienceFaculty of Science and EngineeringManchester Metropolitan UniversityManchesterUK
| | - F. L. Bowling
- Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - A. J. M. Boulton
- Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Diabetes Research InstituteUniversity of MiamiMiamiFLUSA
| | - M. Raffi
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - D. E. Marple‐Horvat
- Research Centre for Musculoskeletal Science and Sports MedicineSchool of Healthcare ScienceFaculty of Science and EngineeringManchester Metropolitan UniversityManchesterUK
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Evans ES, Ketcham CJ, Hibberd JC, Cullen ME, Basiliere JG, Murphy DL. Examination of clinical and laboratory measures of static and dynamic balance in breast cancer survivors. Physiother Theory Pract 2019; 37:1199-1209. [DOI: 10.1080/09593985.2019.1692391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Elizabeth S. Evans
- Department of Physical Therapy Education, Elon University, Elon, NC, USA
| | | | - Julie C. Hibberd
- Department of Physical Therapy Education, Elon University, Elon, NC, USA
- Department of Exercise Science, Elon University, Elon, NC, USA
| | | | | | - Dorriea L. Murphy
- Department of Physical Therapy Education, Elon University, Elon, NC, USA
- Department of Rehabilitation Services, Alamance Regional Medical Center, Burlington, NC, USA
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Test-Retest Reliability of Kinematic Parameters of Timed Up and Go in People with Type 2 Diabetes. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9214709] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Diabetes mellitus is a chronic disease defined as a state of hyperglycaemia in fasting or postprandial states. Patients with type 2 diabetes mellitus (T2DM) often show reduced physical function, including low levels of strength, balance or mobility. In this regard, the timed up and go (TUG) is a widely used physical fitness test in people with T2DM. However, there is a lack of studies evaluating the properties TUG in this population. The present study aimed to evaluate the test-retest reliability of kinetic and kinematic parameters obtained from TUG in the diabetic population with different levels of diabetic neuropathy. A total of 56 patients with T2DM participated in the study. They were divided into three groups according to the vibration threshold: (a) severe neuropathy, (b) moderate neuropathy and (c) normal perception. The TUG was performed using two force platforms to assess kinematic measurements. The results show that both kinetic and kinematic variables had good to excellent reliability. The reliability of TUG was excellent for the whole sample and the groups with non-severe neuropathy. However, it was just good for the group with severe neuropathy.
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Kul A, Bilen A, Bilge N, Sarıhan K, Uzkeser H, Dayanan R, Baygutalp F. Balance disorders and hypothyroidism: A rare cause worth remembering. ENT UPDATES 2019. [DOI: 10.32448/entupdates.633311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Yahya A, Kluding P, Pasnoor M, Wick J, Liu W, Dos Santos M. The impact of diabetic peripheral neuropathy on pinch proprioception. Exp Brain Res 2019; 237:3165-3174. [PMID: 31586215 DOI: 10.1007/s00221-019-05663-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 09/28/2019] [Indexed: 12/01/2022]
Abstract
This study aims to investigate the impact of type 2 diabetes (T2D) and diabetic peripheral neuropathy (DPN) on pinch proprioception and to establish the correlations with sensory impairments. We collected data from a total of 36 participants (healthy, n = 12; T2D without DPN, n = 11; and T2D + DPN, n = 13), all matched for age, 60 ± 6 years. Pinch proprioception was determined through 3 trials of attempts to actively reproduce 15° of pinch position without visual feedback. Target accuracy and precision was compared between groups using Kruskal-Wallis test. Sensation was tested through the two-point discrimination and Semmes-Weinstein monofilaments applied on the fingers. Sensory measures were correlated with pinch proprioception measures via Spearman's rank test. The T2D + DPN group showed significant decrements in accuracy and precision as compared to the T2D-only (p = 0.003 and p = 0.006, respectively) and the healthy groups (both p = 0.002); no significant differences were found between T2D-only and healthy. Spearman's rank showed moderate (r = 0.45-0.66, p < 0.001) correlations between pinch proprioception and sensory measures. Our results showed pinch proprioception disruption in people with T2D + DPN, but not in people with T2D-only. The awareness of pinch proprioceptive deficits is paramount for the safety of individuals with T2D and DPN. Moderate correlations between sensory impairments and pinch proprioceptive deficits suggest that not only superficial/discriminative sensation is implicated in proprioceptive decrements. Other mechanisms such as damage to muscle spindles or central nervous system associated with T2D + DPN warrant further investigations.
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Affiliation(s)
- Abdalghani Yahya
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA.
| | - Patricia Kluding
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Mamatha Pasnoor
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jo Wick
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Wen Liu
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Marcio Dos Santos
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
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Handsaker JC, Brown SJ, Petrovic M, Bowling FL, Rajbhandari S, Marple-Horvat DE, Boulton AJM, Reeves ND. Combined exercise and visual gaze training improves stepping accuracy in people with diabetic peripheral neuropathy. J Diabetes Complications 2019; 33:107404. [PMID: 31371130 DOI: 10.1016/j.jdiacomp.2019.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/20/2019] [Accepted: 07/02/2019] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Patients with diabetes and diabetic peripheral neuropathy (DPN) place their feet with less accuracy whilst walking, which may contribute to the increased falls-risk. This study examines the effects of a multi-faceted intervention on stepping accuracy, in patients with diabetes and DPN. METHODS Forty participants began the study, of which 29 completed both the pre and post-intervention tests, 8 patients with DPN, 11 patients with diabetes but no neuropathy (D) and 10 healthy controls (C). Accuracy of stepping was measured pre- and post-intervention as participants walked along an irregularly arranged stepping walkway. Participants attended a one-hour session, once a week, for sixteen weeks, involving high-load resistance exercise and visual-motor training. RESULTS Patients who took part in the intervention improved stepping accuracy (DPN: +45%; D: +36%) (p < 0.05). The diabetic non-intervention (D-NI) group did not display any significant differences in stepping accuracy pre- to post- the intervention period (-7%). DISCUSSION The improved stepping accuracy observed in patients with diabetes and DPN as a result of this novel intervention, may contribute towards reducing falls-risk. This multi-faceted intervention presents promise for improving the general mobility and safety of patients during walking and could be considered for inclusion as part of clinical treatment programmes.
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Affiliation(s)
- Joseph C Handsaker
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Life Sciences, Faculty of Science & Engineering, Manchester Metropolitan University, Oxford Road, Manchester, United Kingdom
| | - Steven J Brown
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Life Sciences, Faculty of Science & Engineering, Manchester Metropolitan University, Oxford Road, Manchester, United Kingdom
| | - Milos Petrovic
- Research Centre for Movement Sciences, Department of Physiotherapy, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
| | - Frank L Bowling
- Faculty of Medical and Human Sciences, University of Manchester, Manchester, United Kingdom
| | - Satyan Rajbhandari
- Lancashire Teaching Hospitals, Chorley and South Ribble Hospital, United Kingdom
| | - Dilwyn E Marple-Horvat
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Life Sciences, Faculty of Science & Engineering, Manchester Metropolitan University, Oxford Road, Manchester, United Kingdom
| | - Andrew J M Boulton
- Faculty of Medical and Human Sciences, University of Manchester, Manchester, United Kingdom; Diabetes Research Institute, University of Miami, Miami, FL, USA
| | - Neil D Reeves
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Life Sciences, Faculty of Science & Engineering, Manchester Metropolitan University, Oxford Road, Manchester, United Kingdom
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Ma S, Wu C, Zhang J, Zeng X, Zhao G, Sun X. Looking for an optimal pedal layout to improve the driving performance of patients with diabetic peripheral neuropathy. APPLIED ERGONOMICS 2019; 80:43-49. [PMID: 31280809 DOI: 10.1016/j.apergo.2019.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/29/2019] [Accepted: 04/30/2019] [Indexed: 06/09/2023]
Abstract
Diabetes can undermine people's ability to drive safely, but most previous studies have focused on its deterioration of the central nervous system. This study sought to investigate how diabetic peripheral neuropathy (DPN), a common complication of diabetes characterized by reduced sensitivity of the limbs, can influence people's braking behavior and other safety-related measures of driving. In addition, it also tested how such a deteriorating effect can be reduced by using certain pedal layout designs. In total, 29 healthy drivers and 31 drivers of type 2 diabetes matched in demographic variables were invited to participate in this study. The participants with type 2 diabetes (they are from here on out referred to as "patients")were then split into two subgroups based on the severity of DPN using the median of the Semmes-Weinstein monofilaments Examination (SWME) scores. All three groups of participants finished a series of vehicle-pedestrian conflict tasks in a driving simulator using nine different types of pedal layouts. These layouts varied in the lateral distance between the accelerator and the brake (45 mm, 60 mm, and 75 mm) and the width of brake pedals (50 mm, 70 mm, 90 mm). The results showed that patients with serious DPN had longer brake reaction times (BRT) and shorter minimum distance-to-collision (DTC) as compared to the other two groups. However, the effects of such a disadvantage varied across different pedal layouts. When the accelerator-brake distance was 45 mm, patients with serious DPN showed no compromised driving performance as compared to other two groups. In conclusion, we found the DPN could undermine driving performance of participants with type 2 diabetes, and a closer accelerator-brake lateral distance (45 mm) may be an optimal choice for them to counteract such a negative influence.
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Affiliation(s)
- Shu Ma
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, 16 Lincui Road, Chaoyang District, Beijing, 100101, China; Department of Psychology, University of the Chinese Academy of Sciences, 19 Yuquan Road, Shijingshan District, Beijing, 100049, China; Department of Psychology, Zhejiang Sci-Tech University, 928 2nd Street, Xiasha Higher Education Park, Hangzhou, 310016, China
| | - Changxu Wu
- Department of Systems and Industrial Engineering, University of Arizona, United States
| | - Jingyu Zhang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, 16 Lincui Road, Chaoyang District, Beijing, 100101, China; Department of Psychology, University of the Chinese Academy of Sciences, 19 Yuquan Road, Shijingshan District, Beijing, 100049, China.
| | - Xianzhong Zeng
- Department of Endocrinology, Ganzhou People's Hospital, Ganzhou, China
| | - Guozhen Zhao
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, 16 Lincui Road, Chaoyang District, Beijing, 100101, China; Department of Psychology, University of the Chinese Academy of Sciences, 19 Yuquan Road, Shijingshan District, Beijing, 100049, China
| | - Xianghong Sun
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, 16 Lincui Road, Chaoyang District, Beijing, 100101, China; Department of Psychology, University of the Chinese Academy of Sciences, 19 Yuquan Road, Shijingshan District, Beijing, 100049, China
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A study protocol on nerve mobilization induced diffusion tensor imaging values in posterior tibial nerve in healthy controls and in patients with diabetic neuropathy-multigroup pretest posttest design. Contemp Clin Trials Commun 2019; 16:100451. [PMID: 31650071 PMCID: PMC6804550 DOI: 10.1016/j.conctc.2019.100451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/27/2019] [Accepted: 09/14/2019] [Indexed: 12/15/2022] Open
Abstract
Background Diabetic neuropathy is the commonest chronic disabling complication of diabetes which may lead to amputation and compromising patient’s quality of life. It is characterized by pain, sensation loss associated with neural edema. Diffusion tensor imaging parameter i.e. fraction anisotropy determines the free water proton diffusion in the healthy nerve. Since the diabetes leads to altered mechanosensitivity of the posterior tibial nerve thereby, might interferes with the water molecules movement. Therefore the present clinical trial will provide the evidence of improving the diffusion tensor imaging in the diabetic neuropathy directly by targeting the nerve through nerve mobilization treatment. Methods Participants with Type II Diabetes Mellitus induced peripheral neuropathy will be selected randomly on the basis of eligibility criteria and informed consent will be taken. Participants will be recruited into three groups. Group A (experimental group A) will receive neural mobilization technique, Group B (experimental group B) will receive conventional therapy and Group C (control group) will receive sham treatment for 3 weeks. MRI technique, Visual analogue scale and neuropathy specific quality of life questionnaire will be used as assessment tools. Assessment will be taken at baseline and post intervention. Conclusion this clinical trial will provide the evidence of efficacy of nerve mobilization in determining the diffusion tensor imaging (DTI) changes in the posterior tibial nerve in patients with diabetic neuropathy. This trial will also be the first one in itself to look at the treatment induced DTI changes in the peripheral nerve. Trial Registration Clinical Trial Registry of India (CTRI/2019/06/019552).
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Charkhkar H, Shell CE, Marasco PD, Pinault GJ, Tyler DJ, Triolo RJ. High-density peripheral nerve cuffs restore natural sensation to
individuals with lower-limb amputations. J Neural Eng 2018; 15:056002. [DOI: 10.1088/1741-2552/aac964] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Yahya A, von Behren T, Levine S, Dos Santos M. Pinch aperture proprioception: reliability and feasibility study. J Phys Ther Sci 2018; 30:734-740. [PMID: 29765192 PMCID: PMC5940484 DOI: 10.1589/jpts.30.734] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 01/09/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To establish the reliability and feasibility of a novel pinch aperture device to measure proprioceptive joint position sense. [Subjects and Methods] Reliability of the pinch aperture device was assessed in 21 healthy subjects. Following familiarization with a 15° target position of the index finger and thumb, subjects performed 5 trials in which they attempted to actively reproduce the target position without visual feedback. This procedure was repeated at a testing session on a separate date, and the between-session intraclass correlation coefficient (ICC) was calculated. In addition, extensor tendon vibration was applied to 19 healthy subjects, and paired t-tests were conducted to compare performance under vibration and no-vibration conditions. Pinch aperture proprioception was also assessed in two individuals with known diabetic neuropathy. [Results] The pinch aperture device demonstrated excellent reliability in healthy subjects (ICC 0.88, 95% confidence interval 0.70-0.95). Tendon vibration disrupted pinch aperture proprioception, causing subjects to undershoot the target position (18.1 ± 2.6° vs. 14.8° ± 0.76, p<0.001). This tendency to undershoot the target position was also noted in individuals with diabetic neuropathy. [Conclusion] This study describes a reliable, feasible, and functional means of measuring finger proprioception. Further research should investigate the assessment and implications of pinch aperture proprioception in neurological and orthopedic populations.
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Affiliation(s)
- Abdalghani Yahya
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center: Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
| | - Timothy von Behren
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center: Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
| | - Shira Levine
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center: Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
| | - Marcio Dos Santos
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center: Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
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Optimization of Efficacy of Core Strengthening Exercise Protocols on Patients Suffering from Diabetes Mellitus. ROMANIAN JOURNAL OF DIABETES NUTRITION AND METABOLIC DISEASES 2018. [DOI: 10.2478/rjdnmd-2018-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background and Aims: Lack of physical activity, obesity, eating habits contributes to an increase in metabolic disorders. Patients with diabetes have balance, gait, and proprioceptive impairments which hinder the activity of daily living. Therefore, the main objective of present research was to optimize and to find efficacy of the exercise protocols on gait, balance, proprioception and glycated haemoglobin (HbA1c) levels in patients suffering from Type 2 Diabetes mellitus (T2DM).
Material and Methods: Forty individuals with T2DM age between 35 to 60 were recruited and randomly allocated to four groups with 10 subjects per group. Core strengthening exercises were given with duration of twenty or thirty minutes per session and frequency of twice or thrice weekly for six weeks.
Results: Design Expert Software version 10.0.6 was used to analyse data Design Expert software. Further duration and frequency of exercises were compares using ful factorial design. Paired sample t test was used at significance level p<0.05 to find efficacy of core strengthening exercises. The results showed the roe of duration and frequency along with significant effect of exercises on balance, gait, proprioception and HbA1c.
Conclusion: Pilates based core strengthening exercises (PBCS) significantly improved all the parameter selected if exercise protocol was given for 30 minutes and thrice weekly for six weeks. Study has also shown impact of duration and frequency of exercises separately on these parameters.
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Effects of White Noise Achilles Tendon Vibration on Quiet Standing and Active Postural Positioning. J Appl Biomech 2018; 34:151-158. [PMID: 29139321 DOI: 10.1123/jab.2016-0359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Applying white noise vibration to the ankle tendons has previously been used to improve passive movement detection and alter postural control, likely by enhancing proprioceptive feedback. The aim of the present study was to determine if similar methods focused on the ankle plantarflexors affect the performance of both quiet standing and an active postural positioning task, in which participants may be more reliant on proprioceptive feedback from actively contracting muscles. Twenty young, healthy participants performed quiet standing trials and active postural positioning trials designed to encourage reliance on plantarflexor proprioception. Performance under normal conditions with no vibration was compared to performance with 8 levels of vibration amplitude applied to the bilateral Achilles tendons. Vibration amplitude was set either as a percentage of sensory threshold (n = 10) or by root-mean-square (RMS) amplitude (n = 10). No vibration amplitude had a significant effect on quiet standing. In contrast, accuracy of the active postural positioning task was significantly (P = .001) improved by vibration with an RMS amplitude of 30 μm. Setting vibration amplitude based on sensory threshold did not significantly affect postural positioning accuracy. The present results demonstrate that appropriate amplitude tendon vibration may hold promise for enhancing the use of proprioceptive feedback during functional active movement.
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Findling O, van der Logt R, Nedeltchev K, Achtnichts L, Allum JHJ. A comparison of balance control during stance and gait in patients with inflammatory and non-inflammatory polyneuropathy. PLoS One 2018; 13:e0191957. [PMID: 29474369 PMCID: PMC5824992 DOI: 10.1371/journal.pone.0191957] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 01/15/2018] [Indexed: 01/30/2023] Open
Abstract
Introduction We compared changes in balance control due to chronic inflammatory demyelinating polyneuropathy (CIDP) and non-inflammatory (non-inf) polyneuropathy (PNP) to each other and with respect to healthy controls (HCs). Differences in patients’ subjective impressions of balance capabilities were also compared. Methods Balance control of 11 CIDP patients (mean age 61.1±(sd) 11, 8 male) and 10 non-inf PNP patients (mean age 68.5±11.7, all male) was examined and compared to that of 18 age- and gender-matched healthy controls. Balance control during stance and gait tasks was measured as trunk sway angles and angular velocities with body-worn gyroscopes. Patients’ subjective impressions of balance were obtained using the Dizziness Handicap Inventory (DHI). The Neuropathy Impairment Score in the Lower Limbs (NIS-LL) was used to measure clinical disease status. Results Non-inf PNP patients had slightly lower NIS-LL (13.5±7.2 vs. 17.9±15.1) and DHI scores (22.6±17.1 vs 27.6±16.3). Gait tasks showed a significant decrease in gait speed with respect to HCs for both patient groups but reduced trunk sway for non-inf PNP patients. Trunk sway during tandem walking and walking on the heels was greater for both groups than that of HCs. Sway during 2-legged stance tasks with eyes closed on a firm or foam surface was also greater than for HCs. Discussion Compared to HCs both groups of patients have significantly greater sway for most stance and gait tasks accompanied by reduced gait speed. As for HCs, non-inf PNP patients reduced trunk sway with slower gait speed. In CIDP patients this compensatory strategy was absent, possibly due to a greater deficit of efferent and motor nerve fibers. An interpretation of these findings is that CIDP patients have reduced ability to decrease trunk sway with slower gait speed and is possibly associated with an increased risk of falls.
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Affiliation(s)
- Oliver Findling
- Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland
- Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland
- * E-mail:
| | | | - Krassen Nedeltchev
- Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland
- Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland
| | - Lutz Achtnichts
- Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - John H. J. Allum
- Division of Audiology and Neurootology, Department of ORL, University Hospital Basel, Basel, Switzerland
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Ng TKW, Kwan RLC, Lo SK, Cheing GLY. A Tailor-Made Exercise Program for Improving Balance and Mobility in Older Adults With Type 2 Diabetes. J Gerontol Nurs 2018; 44:41-48. [PMID: 28990633 DOI: 10.3928/00989134-20171002-04] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 08/25/2017] [Indexed: 11/20/2022]
Abstract
Effectiveness of an exercise program designed for improving postural control and mobility in older adults with type 2 diabetes was investigated. Ninety-three adults 65 or older diagnosed with type 2 diabetes and able to walk unaided were recruited. The intervention group received exercise training focused on ankle strengthening and mobility twice per week for 10 weeks. The control group did not participate in any exercise program. After 10 weeks, the intervention group showed significantly greater improvement in the mean Sensory Organization Test composite score (4.4 vs. 0.3; p = 0.01) as well as visual ratio (0.1 vs. 0.002; p = 0.01) and vestibular ratio (0.1 vs. 0.003; p < 0.001) than the control group after adjusting for covariates. A greater trend of improvement in the Timed Up and Go and Single-Leg Stance Test was also found in the intervention group. Exercise training focusing on the ankle is effective in enhancing the postural stability of older adults with type 2 diabetes and can potentially be effective in improving single-leg standing balance and mobility. [Journal of Gerontological Nursing, 44(2), 41-48.].
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Dixon CJ, Knight T, Binns E, Ihaka B, O'Brien D. Clinical measures of balance in people with type two diabetes: A systematic literature review. Gait Posture 2017; 58:325-332. [PMID: 28865394 DOI: 10.1016/j.gaitpost.2017.08.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 08/17/2017] [Accepted: 08/18/2017] [Indexed: 02/02/2023]
Abstract
Approximately 422 million people have diabetes mellitus worldwide, with the majority diagnosed with type 2 diabetes mellitus (T2DM). The complications of diabetes mellitus include diabetic peripheral neuropathy (DPN) and retinopathy, both of which can lead to balance impairments. Balance assessment is therefore an integral component of the clinical assessment of a person with T2DM. Although there are a variety of balance measures available, it is uncertain which measures are the most appropriate for this population. Therefore, the aim of this study was to conduct a systematic review on clinical balance measures used with people with T2DM and DPN. Databases searched included: CINAHL plus, MEDLINE, SPORTDiscus, Dentistry and Oral Sciences source, and SCOPUS. Key terms, inclusion and exclusion criteria were used to identify appropriate studies. Identified studies were critiqued using the Downs and Black appraisal tool. Eight studies were included, these studies incorporated a total of ten different clinical balance measures. The balance measures identified included the Dynamic Balance Test, balance walk, tandem and unipedal stance, Functional Reach Test, Clinical Test of Sensory Interaction and Balance, Berg Balance Scale, Tinetti Performance-Oriented Mobility Assessment, Activity-Specific Balance Confidence Scale, Timed Up and Go test, and the Dynamic Gait Index. Numerous clinical balance measures were used for people with T2DM. However, the identified balance measures did not assess all of the systems of balance, and most had not been validated in a T2DM population. Therefore, future research is needed to identify the validity of a balance measure that assesses these systems in people with T2DM.
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Affiliation(s)
- C J Dixon
- Torbay Physiotherapy and Hand Therapy, 1042 Beach Road, Torbay, Auckland, New Zealand.
| | - T Knight
- Taranaki Base Hospital, David Street, New Plymouth 4310, New Zealand.
| | - E Binns
- Physiotherapy Department, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
| | - B Ihaka
- Podiatry Department, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
| | - D O'Brien
- Physiotherapy Department, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
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Furmanek MP, Solnik S, Piscitelli D, Rasouli O, Falaki A, Latash ML. Synergies and Motor Equivalence in Voluntary Sway Tasks: The Effects of Visual and Mechanical Constraints. J Mot Behav 2017; 50:492-509. [PMID: 28915097 DOI: 10.1080/00222895.2017.1367642] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The authors used two analyses developed within the framework of the uncontrolled manifold hypothesis to quantify multimuscle synergies during voluntary body sway: analysis of intertrial variance and analysis of motor equivalence with respect to the center of pressure (COP) trajectory. Participants performed voluntary sway tasks in the anteroposterior direction at 0.33 and 0.66 Hz. Muscle groups were identified in the space of muscle activations and used as elemental variables in the synergy analyses. Changing mechanical and vision feedback-based constraints led to significant changes in indices of sway performance such as COP deviations in the uninstructed, mediolateral direction and indices of spontaneous postural sway. In contrast, there were no significant effects on synergy indices. These findings show that the neural control of performance and of its stability may involve different control variables and neurophysiological structures. There were strong correlations between the indices of motor equivalence and those computed using the intercycle variance analysis. This result is potentially important for studies of patients with movement disorders who may be unable to perform multiple trials (cycles) at any given task, making analysis of motor equivalence of single trials a viable alternative to explore changes in stability of actions.
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Affiliation(s)
- Mariusz P Furmanek
- a Department of Human Motor Behavior , The Jerzy Kukuczka Academy of Physical Education , Katowice , Poland.,b Department of Kinesiology , Pennsylvania State University , University Park
| | - Stanisław Solnik
- c Department of Physical Therapy, University of North Georgia , Dahlonega.,d University School of Physical Education , Wroclaw , Poland
| | - Daniele Piscitelli
- b Department of Kinesiology , Pennsylvania State University , University Park.,e School of Medicine and Surgery , University of Milano-Bicocca , Milan , Italy
| | - Omid Rasouli
- f Faculty of Health and Social Sciences , Norwegian University of Science and Technology , Trondheim
| | - Ali Falaki
- b Department of Kinesiology , Pennsylvania State University , University Park
| | - Mark L Latash
- b Department of Kinesiology , Pennsylvania State University , University Park
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Seth M, Lamberg E. Standing balance in people with trans-tibial amputation due to vascular causes: A literature review. Prosthet Orthot Int 2017; 41:345-355. [PMID: 28067120 DOI: 10.1177/0309364616683819] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Balance is an important variable to consider during the rehabilitation process of individuals with trans-tibial amputation. Limited evidence exists on the balance abilities of people with trans-tibial amputation due to vascular causes. OBJECTIVE The purpose of this article is to review literature and determine if standing balance is diminished in people with trans-tibial amputation due to vascular causes. STUDY DESIGN Literature review. METHODS Data were obtained from PubMed, Google Scholar, OandP.org , CINHAL, and Science Direct. Studies were selected only if they included standing balance assessment of people with unilateral trans-tibial amputation due to vascular causes. RESULTS The review yielded seven articles that met the inclusion criteria. The general test methodology required participants to stand still on force platforms, with feet together, while center of pressure or postural sway was recorded. CONCLUSION According to the findings of this review, individuals with trans-tibial amputees due to vascular causes have diminished balance abilities. Limited evidence suggests their balance might be further diminished as compared to individuals with trans-tibial amputation due to trauma. Although the evidence is limited, because of the underlying pathology and presence of comorbidities in individuals with trans-tibial amputation due to vascular causes, one cannot ignore these findings, as even a minor injury from a fall may develop into a non-healing ulcer and affect their health and well-being more severely than individuals with trans-tibial amputation due to trauma. Clinical relevance Individuals with trans-tibial amputation due to vascular causes have diminished balance abilities compared to healthy individuals and individuals with trans-tibial amputation due to trauma. This difference should be considered when designing and fabricating prostheses. Prosthetists and rehabilitation clinicians should consider designing amputation cause-specific rehabilitation interventions, focussing on balance and other functional limitations related to comorbidities of amputation.
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Affiliation(s)
- Mayank Seth
- Stony Brook University, Stony Brook, NY, USA
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van Deursen RW, Bouwman EF. Diabetic foot care within the context of rehabilitation: keeping people with diabetic neuropathy on their feet. A narrative review. PHYSICAL THERAPY REVIEWS 2017. [DOI: 10.1080/10833196.2017.1353750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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