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  1 / 21478 MEDLINE  
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Registro de Ensayos Clínicos
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PMID:29414988
Autor:Morgan SJ; McDonald CL; Halsne EG; Cheever SM; Salem R; Kramer PA; Hafner BJ
Dirección:Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States of America.
Título:Laboratory- and community-based health outcomes in people with transtibial amputation using crossover and energy-storing prosthetic feet: A randomized crossover trial.
Fuente:PLoS One; 13(2):e0189652, 2018.
ISSN:1932-6203
País de publicación:United States
Idioma:eng
Resumen:Contemporary prosthetic feet are generally optimized for either daily or high-level activities. Prosthesis users, therefore, often require multiple prostheses to participate in activities that span a range of mobility. Crossover feet (XF) are designed to increase the range of activities that can be performed with a single prosthesis. However, little evidence exists to guide clinical prescription of XF relative to traditional energy storing feet (ESF). The objective of this study was to assess the effects of XF and ESF on health outcomes in people with transtibial amputation. A randomized crossover study was conducted to assess changes in laboratory-based (endurance, perceived exertion, walking performance) and community-based (step activity and self-reported mobility, fatigue, balance confidence, activity restrictions, and satisfaction) outcomes. Twenty-seven participants were fit with XF and ESF prostheses with standardized sockets, interfaces, and suspensions. Participants were not blinded to the intervention, and wore each prosthesis for one month while their steps were counted with an activity monitor. After each accommodation period, participants returned for data collection. Endurance and perceived exertion were measured with the Six-Minute Walk Test and Borg-CR100, respectively. Walking performance was measured using an electronic walkway. Self-reported mobility, fatigue, balance confidence, activity restrictions, and satisfaction were measured with survey instruments. Participants also reported foot preferences upon conclusion of the study. Differences between feet were assessed with a crossover analysis. While using XF, users experienced improvements in most community-based outcomes, including mobility (p = .001), fatigue (p = .001), balance confidence (p = .005), activity restrictions (p = .002), and functional satisfaction (p < .001). Participants also exhibited longer sound side steps in XF compared to ESF (p < .001). Most participants (89%) reported an overall preference for XF; others (11%) reported no preference. Results indicate that XF may be a promising alternative to ESF for people with transtibial amputation who engage in a range of mobility activities. TRIAL REGISTRATION: ClinicalTrials.gov NCT02440711.
Tipo de publicación:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T


  2 / 21478 MEDLINE  
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PMID:28460018
Autor:Nieuwenhuis WP; van Steenbergen HW; Mangnus L; Newsum EC; Bloem JL; Huizinga TWJ; le Cessie S; Reijnierse M; van der Helm-van Mil AHM
Dirección:Department of Rheumatology.
Título:Evaluation of the diagnostic accuracy of hand and foot MRI for early Rheumatoid Arthritis.
Fuente:Rheumatology (Oxford); 56(8):1367-1377, 2017 Aug 01.
ISSN:1462-0332
País de publicación:England
Idioma:eng
Resumen:Objectives: To assess the diagnostic value of MRI for early RA. In some RA patients, a classifiable diagnosis cannot be made at first presentation; these patients present with unclassified arthritis (UA). The use of MRI for early diagnosis of RA is recommended, yet the evidence for its reliability is limited. Methods: MRI of hand and foot was performed in 589 early arthritis patients included in the Leiden Early Arthritis Clinic (229 presented with RA, 159 with other arthritides and 201 with UA). Symptom-free controls provided a reference for defining an abnormal MRI. In preliminary investigations, MRI of patients who presented with RA was compared with MRI of symptom-free controls and of patients with other arthritides. Thereafter, the value of MRI in early RA diagnosis was determined in UA patients using the 1-year follow-up on fulfilling the 1987 RA criteria and start of disease-modifying drugs as outcomes. Results: Preliminary investigations were promising. Of the UA patients, 14% developed RA and 37% started disease-modifying treatment. MRI-detected tenosynovitis was associated with RA development independent of other types of MRI-detected inflammation [odds ratio (OR) = 7.5, 95% CI: 2.4, 23] and also independent of age and other inflammatory measures (swollen joints, CRP) (OR = 4.2, 95% CI: 1.4, 12.9). Within UA patients, the negative predictive value of abnormal tenosynovitis was 95% (95% CI: 89%, 98%) and the positive predictive value 25% (95% CI: 17%, 35%). The performance was best in the subgroup of UA patients presenting with oligoarthritis (18% developed RA): the positive predictive value was 36% (95% CI: 23%, 52%), the negative predictive value was 98% (95% CI: 88%, 100%), the sensitivity was 93% (95% CI: 70%, 99%) and the specificity was 63% (95% CI: 51%, 74%). Conclusion: MRI contributes to the identification of UA patients who will develop RA, mostly in UA patients presenting with oligoarthritis.
Tipo de publicación:EVALUATION STUDIES; JOURNAL ARTICLE
Nombre de substancia:0 (Antirheumatic Agents)


  3 / 21478 MEDLINE  
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PMID:29326105
Autor:Barraclough K; Bradbury A
Dirección:Hoyland House, Painswick, UK k.barraclough@btinternet.com.
Título:Chronic limb threatening ischaemia.
Fuente:BMJ; 360:j5460, 2018 01 11.
ISSN:1756-1833
País de publicación:England
Idioma:eng
Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE


  4 / 21478 MEDLINE  
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PMID:28417667
Autor:Au IPH; Lau FOY; An WW; Zhang JH; Chen TL; Cheung RTH
Dirección:a Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences , The Hong Kong Polytechnic University , Hong Kong, China.
Título:Immediate and short-term biomechanical adaptation of habitual barefoot runners who start shod running.
Fuente:J Sports Sci; 36(4):451-455, 2018 Feb.
ISSN:1466-447X
País de publicación:England
Idioma:eng
Resumen:This study investigated the immediate and short-term effects of minimalist shoes (MS) and traditional running shoes (TRS) on vertical loading rates, foot strike pattern and lower limb kinematics in a group of habitual barefoot runners. Twelve habitual barefoot runners were randomly given a pair of MS or TRS and were asked to run with the prescribed shoes for 1 month. Outcome variables were obtained before, immediate after and 1 month after shoe prescription. Average and instantaneous vertical loading rates at the 1-month follow-up were significantly higher than that at the pre-shod session (P < 0.034, η > 0.474). Foot strike angle in the TRS group was significantly lower than that in the MS group (P = 0.045, η = 0.585). However, there was no significant time nor shoe effect on overstride, knee and ankle excursion (P > 0.061). Habitual barefoot runners appeared to land with a greater impact during shod running and they tended to have a more rearfoot strike pattern while wearing TRS. Lower limb kinematics were comparable before and after shoe prescription. Longer period of follow-up is suggested to further investigate the footwear effect on the running biomechanics in habitual barefoot runners.
Tipo de publicación:JOURNAL ARTICLE


  5 / 21478 MEDLINE  
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PMID:29385996
Autor:Bae KH; Go HY; Park KH; Ahn I; Yoon Y; Lee S
Dirección:Mibyeong Research Center, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, 34054, Republic of Korea.
Título:The association between cold hypersensitivity in the hands and feet and chronic disease: results of a multicentre study.
Fuente:BMC Complement Altern Med; 18(1):40, 2018 Jan 31.
ISSN:1472-6882
País de publicación:England
Idioma:eng
Resumen:BACKGROUND: Cold hypersensitivity in the hands and feet (CHHF) is a common symptom in Korea and patients with CHHF complain of coldness in the hands and feet in an environment that is not considered cold by unaffected people. In traditional East Asian medicine, CHHF is believed to be accompanied by various diseases and symptoms, and is considered a symptom that needs active treatment. CHHF is used for pattern identification in the cold pattern, yang deficiency, and constitution. This study aimed to examine the differences in frequencies of chronic diseases with respect to the presence of CHHF. METHODS: Disease history, CHHF, body measurements, and blood test survey data from 6149 patients collected by 25 medical institutes in Korea were obtained from the Korean Medicine Data Center. The participants were divided into CHHF (n = 1909) and non-CHHF groups (n = 3017) according to the CHHF survey. The differences in frequencies of 18 diseases were analysed using chi-square tests, and the odds ratios (ORs) for each disease according to CHHF status were examined via logistic regression with adjustment for age, sex, and body mass index (BMI). RESULTS: Based on chi-square test results, the CHHF group showed a higher frequency of the following diseases: anaemia, hypotension, chronic gastritis, reflux oesophagitis, chronic rhinitis, dysmenorrhoea, and gastroduodenal ulcer. Diseases found in lower frequencies were as follows: hypertension, diabetes mellitus, impaired fasting glucose, dyslipidaemia, stroke, fatty liver, and angina pectoris. In addition, from the logistic regression with adjustment for age, sex, and BMI, the CHHF group showed a lower OR in diabetes mellitus and dyslipidaemia than the non-CHHF group, but a higher OR in degenerative arthritis, chronic gastritis, gastroduodenal ulcer, reflux oesophagitis, and chronic rhinitis. CONCLUSIONS: This study showed that CHHF is associated with chronic disease. Further large-scale prospective studies are needed to validate these associations.
Tipo de publicación:JOURNAL ARTICLE; MULTICENTER STUDY


  6 / 21478 MEDLINE  
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PMID:29370202
Autor:Rumble DD; Hurt CP; Brown DA
Dirección:PhD in Rehabilitation Science Program, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
Título:Step-by-step variability of swing phase trajectory area during steady state walking at a range of speeds.
Fuente:PLoS One; 13(1):e0191247, 2018.
ISSN:1932-6203
País de publicación:United States
Idioma:eng
Resumen:BACKGROUND: Step kinematic variability has been characterized during gait using spatial and temporal kinematic characteristics. However, people can adopt different trajectory paths both between individuals and even within individuals at different speeds. Single point measures such as minimum toe clearance (MTC) and step length (SL) do not necessarily account for the multiple paths that the foot may take during the swing phase to reach the same foot fall endpoint. The purpose of this study was to test a step-by-step foot trajectory area (SBS-FTA) variability measure that is able to characterize sagittal plane foot trajectories of varying areas, and compare this measure against MTC and SL variability at different speeds. We hypothesize that the SBS-FTA variability would demonstrate increased variability with speed. Second, we hypothesize that SBS-FTA would have a stronger curvilinear fit compared with the CV and SD of SL and MTC. Third, we hypothesize SBS-FTA would be more responsive to change in the foot trajectory at a given speed compared to SL and MTC. Fourth, SBS-FTA variability would not strongly co-vary with SL and MTC variability measures since it represents a different construct related to foot trajectory area variability. METHODS: We studied 15 nonimpaired individuals during walking at progressively faster speeds. We calculated SL, MTC, and SBS-FTA area. RESULTS: SBS-FTA variability increased with speed, had a stronger curvilinear fit compared with the CV and SD of SL and MTC, was more responsive at a given speed, and did not strongly co-vary with SL and MTC variability measures. CONCLUSION: SBS foot trajectory area variability was sensitive to change with faster speeds, captured a relationship that the majority of the other measures did not demonstrate, and did not co-vary strongly with other measures that are also components of the trajectory.
Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T


  7 / 21478 MEDLINE  
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PMID:28463819
Autor:Bishop C; Hillier S; Thewlis D
Dirección:Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Australia. Electronic address: Christopher.bishop@unisa.edu.au.
Título:The reliability of the Adelaide in-shoe foot model.
Fuente:Gait Posture; 56:1-7, 2017 Jul.
ISSN:1879-2219
País de publicación:England
Idioma:eng
Resumen:Understanding the biomechanics of the foot is essential for many areas of research and clinical practice such as orthotic interventions and footwear development. Despite the widespread attention paid to the biomechanics of the foot during gait, what largely remains unknown is how the foot moves inside the shoe. This study investigated the reliability of the Adelaide In-Shoe Foot Model, which was designed to quantify in-shoe foot kinematics and kinetics during walking. Intra-rater reliability was assessed in 30 participants over five walking trials whilst wearing shoes during two data collection sessions, separated by one week. Sufficient reliability for use was interpreted as a coefficient of multiple correlation and intra-class correlation coefficient of >0.61. Inter-rater reliability was investigated separately in a second sample of 10 adults by two researchers with experience in applying markers for the purpose of motion analysis. The results indicated good consistency in waveform estimation for most kinematic and kinetic data, as well as good inter-and intra-rater reliability. The exception is the peak medial ground reaction force, the minimum abduction angle and the peak abduction/adduction external hindfoot joint moments which resulted in less than acceptable repeatability. Based on our results, the Adelaide in-shoe foot model can be used with confidence for 24 commonly measured biomechanical variables during shod walking.
Tipo de publicación:JOURNAL ARTICLE


  8 / 21478 MEDLINE  
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PMID:29234466
Autor:McQueen P; Gates L; Marshall M; Doherty M; Arden N; Bowen C
Dirección:Faculty of Health Sciences, University of Southampton, Highfield Campus Building 45, Southampton, SO17 1BJ UK.
Título:The effect of variation in interpretation of the La Trobe radiographic foot atlas on the prevalence of foot osteoarthritis in older women: the Chingford general population cohort.
Fuente:J Foot Ankle Res; 10:54, 2017.
ISSN:1757-1146
País de publicación:England
Idioma:eng
Resumen:Background: The prevalence of foot osteoarthritis (OA) is much less understood than hip, knee and hand OA. The foot is anatomically complex and different researchers have investigated different joints with lack of methodological standardisation across studies. The La Trobe Foot Atlas (LFA) is the first to address these issues in providing quantitative assessment of radiographic foot OA, but has not been tested externally. The aim of this study was to evaluate three different interpretive approaches to using the LFA for grading OA when scoring is difficult due to indistinct views of interosseous space and joint contour. Methods: Foot radiographs of all remaining participants ( = 218) assessed in the Chingford Women Study 23 year visit (mean (SD) for age: 75.5 years (5.1)) were scored using the LFA defined protocol (Technique 1). Two revised scoring strategies were applied to the radiographs in addition to the standard LFA analyses. Technique 2 categorised joints that were difficult to grade as 'missing'. Technique 3 included joints that were difficult to grade as an over estimated score. Radiographic OA prevalence was defined for the foot both collectively and separately for individual joints. Results: When radiographs were scored using the LFA (Technique 1), radiographic foot OA was present in 89.9%. For Technique 2 the presence of radiographic foot OA was 83.5% and for Technique 3 it was 97.2%. At the individual joint level, using Technique 1, the presence of radiographic foot OA was higher with a wider range (18.3-74.3%) than Technique 2 (17.9-46.3%) and lower with a wider range (18.3-74.3%) than Technique 3 (39.9-79.4%). Conclusion: The three different ways of interpreting the LFA scoring system when grading of individual joints is technically difficult and result in very different estimates of foot OA prevalence at both the individual joint and global foot level. Agreement on the best strategy is required to improve comparability between studies.
Tipo de publicación:JOURNAL ARTICLE


  9 / 21478 MEDLINE  
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PMID:29234467
Autor:Ridge ST; Myrer JW; Olsen MT; Jurgensmeier K; Johnson AW
Dirección:Department of Exercise Sciences, Brigham Young University, Provo, UT 84602 USA.
Título:Reliability of doming and toe flexion testing to quantify foot muscle strength.
Fuente:J Foot Ankle Res; 10:55, 2017.
ISSN:1757-1146
País de publicación:England
Idioma:eng
Resumen:Background: Quantifying the strength of the intrinsic foot muscles has been a challenge for clinicians and researchers. The reliable measurement of this strength is important in order to assess weakness, which may contribute to a variety of functional issues in the foot and lower leg, including plantar fasciitis and hallux valgus. This study reports 3 novel methods for measuring foot strength - doming (previously unmeasured), hallux flexion, and flexion of the lesser toes. Methods: Twenty-one healthy volunteers performed the strength tests during two testing sessions which occurred one to five days apart. Each participant performed each series of strength tests (doming, hallux flexion, and lesser toe flexion) four times during the first testing session (twice with each of two raters) and two times during the second testing session (once with each rater). Intra-class correlation coefficients were calculated to test for reliability for the following comparisons: between raters during the same testing session on the same day (inter-rater, intra-day, intra-session), between raters on different days (inter-rater, inter-day, inter-session), between days for the same rater (intra-rater, inter-day, inter-session), and between sessions on the same day by the same rater (intra-rater, intra-day, inter-session). Results: ICCs showed good to excellent reliability for all tests between days, raters, and sessions. Average doming strength was 99.96 ± 47.04 N. Average hallux flexion strength was 65.66 ± 24.5 N. Average lateral toe flexion was 50.96 ± 22.54 N. Conclusions: These simple tests using relatively low cost equipment can be used for research or clinical purposes. If repeated testing will be conducted on the same participant, it is suggested that the same researcher or clinician perform the testing each time for optimal reliability.
Tipo de publicación:JOURNAL ARTICLE


  10 / 21478 MEDLINE  
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PMID:29209416
Autor:Pritchard NS; Smoliga JM; Nguyen AD; Branscomb MC; Sinacore DR; Taylor JB; Ford KR
Dirección:Department of Physical Therapy, High Point University, High Point, NC USA.
Título:Reliability of analysis of the bone mineral density of the second and fifth metatarsals using dual-energy x-ray absorptiometry (DXA).
Fuente:J Foot Ankle Res; 10:52, 2017.
ISSN:1757-1146
País de publicación:England
Idioma:eng
Resumen:Background: Metatarsal fractures, especially of the fifth metatarsal, are common injuries of the foot in a young athletic population, but the risk factors for this injury are not well understood. Dual-energy x-ray absorptiometry (DXA) provides reliable measures of regional bone mineral density to predict fracture risk in the hip and lumbar spine. Recently, sub-regional metatarsal reliability was established in fresh cadaveric specimens and associated with ultimate fracture force. The purpose of this study was to assess the reliability of DXA bone mineral density measurements of sub-regions of the second and fifth metatarsals in a young, active population. Methods: Thirty two recreationally active individuals participated in the study, and the bone density of the second (2MT) and fifth (5MT) metatarsals of each subject was measured using a Hologic QDR x-ray bone densitometer. Scans were analyzed separately by two raters, and regional bone mineral density, bone mineral content, and area measurements were calculated for the proximal, shaft, and distal regions of the bone. Intra-rater, inter-rater, and scan-rescan reliability were then determined for each region. Results: Proximal and shaft bone mineral density measurements of the second and fifth metatarsal were reliable. ICC's were variable across regions and metatarsals, with the distal region being the poorest. Conclusions: Bone mineral density measurements of the metatarsals may be a better indicator of fracture risk of the metatarsals than whole body measurements. A reliable method for measuring the regional bone mineral densities of the metatarsals was found. However, inter-rater reliability and scan-rescan reliability for the distal regions were poor. Future research should examine the relationship between DXA bone mineral density measurements and fracture risk at the metatarsals.
Tipo de publicación:JOURNAL ARTICLE



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