OBJECTIVE: The purpose of this study was to determine the effects of isokinetic eccentric knee extensor and flexor strengthening training on affected limbs of patients with chronic hemiplegia. METHOD: Twenty-one subjects with chronic stroke were participated in this study. All subjects were indoor ambula tors. The hemiplegic knee flexors and extensors of the experimental group (n=11) were trained eccentrically using Cybex 770 dynamometer 3 times a week for 6 weeks. Conventional rehabilitation treatment was administrated to the control group at the same duration and frequency as the experimental group. Total peak torque, total work and functional parameters were measured before and after training. RESULTS: Significantly higher mean percent changes of peak torque and total work were observed in the experimental group compared to the control group at all eccentric angular velocities tested. Functional parameters also showed significant improvements in the gait speed, a timed stair climb up and down, and sit-to-stand time compared to the control group (p<0.05). CONCLUSION: The isokinetic eccentric strengthening training of knee extensors and flexors in patients with chronic hemi plegia were useful in strengthening the affected leg and functional improvement.
Extremities ; Gait ; Hemiplegia* ; Humans ; Knee* ; Leg ; Paralysis ; Rehabilitation ; Stroke ; Torque

Foot drop from paralysis of the muscles of the anterior and lateral compartments of the leg is common in leprosy. Surgical correction of foot drop in leprosy appears to have been neglected until Brand pointed out that anterior transposition of the tibialis posterior tendon to the intermediate cuneiform bone gave encouraging results. Many methods of correcting the functional problems associated with a foot drop have been tried with the object of providing a foot that is stable and socially acceptable. Fifteen cases of foot drop admitted to the Hospital of Leprosy Mission in Taegu, Korea during past 3 years from 1965 to 1968 were reviewed.
Daegu ; Foot ; Korea ; Leg ; Leprosy ; Muscles ; Paralysis ; Tarsal Bones ; Tendons

We report various causes of acute abdominal aortic occlusion, a condition which is infrequent but usually ends catastrophically. The three cases are embolic occlusion by myxoma, thrombotic occlusion of aortic aneurysm, and thrombosis of an atherosclerotic aorta; the first two causes are very rare clinical presentations. All patients showed leg paralysis, pain, and severe ischemic symptoms. Diagnosis was done by emergent-CT (computed tomography) scan and surgery was performed urgently. Nevertheless, all patients died in the early postoperative period. As acute aortic occlusion is infrequent, its diagnosis may be delayed. The mortality rates remains high even with urgent surgical care.
Aorta ; Aorta, Abdominal* ; Aortic Aneurysm ; Diagnosis ; Humans ; Leg ; Mortality ; Myxoma ; Paralysis ; Postoperative Period ; Thrombosis

PURPOSE: Widely used fiberglass splints are made from straight-form material. These prove difficult to mold at joints and form wrinkles, causing complications such as pain, pressure sores, and peripheral nerve palsy. We compared the usefulness of wave-form splints with straight-form splints and the level of satisfaction of these designs from care providers and wearers. METHODS: Eighty-nine (n=89) emergency physicians and orthopedic surgeons participated in this study. The subjects (acting as care providers and mock patients) used wave-form and straight-form material to construct and wear short leg splints, long arm splints, and sugar tong splints. The clinicians were surveyed on their satisfaction as providers and wearers. All questions were measured on scores from 0 and 10(10=maximum score). After splints were removed, subjects were surveyed on the extent of splint wrinkling with scores from 1 to 3(3=maximum wrinkling). RESULTS: Provider satisfaction scores for wave-form splints versus straight-form splints in short leg splint applications were 7.76+/-1.30 vs 6.74+/-1.25 (p=0.000). Provider satisfaction scores for wave-form splints versus straight-form splints in long arm splint applications were 7.73+/-1.33 and 6.73+/-1.59 (p=0.004), respectively. The subjects felt more comfortable wearing wave-form splints, compared to straight-form splints (7.79+/-1.49 vs. 6.79+/-1.58, respectively; p=0.004) and more satisfied (8.03+/-1.35 vs. 7.18+/-1.33, respectively; p=0.003). The frequencies of wrinkle occurrence in wave-form and straight-form splints were 29.7% and 42.2%, respectively (p=0.02). CONCLUSION: Wave-form splints may be more practical for molding and wearing than traditional straight-form splints.
Arm ; Casts, Surgical ; Emergencies ; Fungi ; Glass ; Immobilization ; Joints ; Leg ; Orthopedics ; Paralysis ; Peripheral Nerves ; Pressure Ulcer ; Splints

BACKGROUND AND PURPOSE: Hyperkalemic periodic paralysis (hyperKPP) is a muscle sodium-ion channelopathy characterized by recurrent paralytic attacks. A proportion of affected individuals develop fixed or chronic progressive weakness that results in significant disability. However, little is known about the pathology of hyperKPP-induced fixed weakness, including the pattern of muscle involvement. The aim of this study was to characterize the patterns of muscle involvement in hyperKPP by whole-body magnetic resonance imaging (MRI). METHODS: We performed whole-body muscle MRI in seven hyperKPP patients carrying the T704M mutation in the SCN4A skeletal sodium-channel gene. Muscle fat infiltration, suggestive of chronic progressive myopathy, was analyzed qualitatively using a grading system and was quantified by the two-point Dixon technique. RESULTS: Whole-body muscle MRI analysis revealed muscle atrophy and fatty infiltration in hyperKPP patients, especially in older individuals. Muscle involvement followed a selective pattern, primarily affecting the posterior compartment of the lower leg and anterior thigh muscles. The muscle fat fraction increased with patient age in the anterior thigh (r=0.669, p=0.009), in the deep posterior compartment of the lower leg (r=0.617, p=0.019), and in the superficial posterior compartment of the lower leg (r=0.777, p=0.001). CONCLUSIONS: Our whole-body muscle MRI findings provide evidence for chronic progressive myopathy in hyperKPP patients. The reported data suggest that a selective pattern of muscle involvement-affecting the posterior compartment of the lower leg and the anterior thigh-is characteristic of chronic progressive myopathy in hyperKPP.
Channelopathies ; Humans ; Leg ; Magnetic Resonance Imaging* ; Muscles ; Muscular Atrophy ; Muscular Diseases* ; Paralysis, Hyperkalemic Periodic* ; Pathology ; Thigh

PURPOSE: The purpose of this study was to evaluate the prevalence of leg length discrepancy (LLD) in hemiplegic cerebral palsy and to assess the gait pattern of hemiplegic patients with LLD. MATERIALS AND METHODS: 189 patients with hemiplegic cerebral palsy were included in this study. We evaluated the prevalence of LLD of more than 1.5 cm and compared the results of 3-dimensional gait analysis of a group with LLD (Group I) and a group without LLD (Group II). RESULTS: A leg length discrepancy exceeding 1.5 cm was noted in 25 patients (13.2%). In spastic type, the prevalence of LLD was highest in Winter type IV patients (30.8%) than any other type (6.7-13.0%), and the prevalence in patients older than 12 years of age (27.5%) was higher than that in younger patients (8.0%). According to 3-dimensional gait analysis, there were significant decreases in the range of motion of the hip and ankle in the sagittal plane of Group I compared with Group II, and the muscles of the Group I were affected more severely than those of Group II. CONCLUSION: Prevalence of LLD in hemiplegic tcerebral palsy was higher than that in the normal population, and the discrepancy increased with skeletal maturity. When muscles were affected more severely, the prevalence of LLD increased.
Ankle ; Cerebral Palsy* ; Gait* ; Hemiplegia ; Hip ; Humans ; Leg* ; Muscle Spasticity ; Muscles ; Paralysis ; Prevalence* ; Range of Motion, Articular

A common peroneal nerve palsy caused by a ganglion has been rarely reported. A Ganglion may arise from joint, tendon sheath or sheath of peripheral nerve. They may also be intraosseous and intraneural but relatively rare entities. Although intraneural ganglion is a well recognized entity, few reports in the literature describe motor weakness and sensory change as a primary clinical manifestation. The pathogenesis of intraneural ganglion cyst remains controversial. We describe the case of 42-year-old male manual worker with a 2 month history of weakness of the right ankle and foot drop and paresthesia of the anterolateral aspect of the lower leg, as a result of compression of the common peroneal nerve by a ganglion, in both intraneural and intramuscular forms.
Adult ; Ankle ; Foot ; Ganglion Cysts* ; Humans ; Joints ; Leg ; Male ; Paralysis* ; Paresthesia ; Peripheral Nerves ; Peroneal Nerve* ; Tendons

The authors carriod out lumbodorsal fasciotomy on six cases of paralytic scoliosis with pelvic obliquity. In our experience, in those older children and adolescents with paralysis in whom scoliotic curve is not severe and is more or less static, correction and maintenance of the correction can be achieved by lumbodorsal fasciotomy without resorting to spine fusion. While it is a common practice to leave a mild and static curve uncorrected, even a mild degree of scoliosis, when associated with pelvic obliquity, abduction contracture of the hip, instability of the other hip and leg length discrepancy, is a major problem in paralytic patients. Initial results indicate that lumbodorsal fasciotomy, combined with contralateral Soutters or Campbells fasciotomy if necessary, is a simple and effective method in correcting these deformities and restoring balance and function.
Adolescent ; Child ; Congenital Abnormalities ; Contracture ; Health Resorts ; Hip ; Humans ; Leg ; Methods ; Paralysis ; Scoliosis ; Spine

Bowing of one or both bones of the forearm in children following acute trauma was first recognized by Borden in 1974. Since then, a total of 30 cases have been reported in the English literature. The injury is a result of an acute plastic deformation of the tubular bones due to mainly a longitudinal compression force, and is charactcrized by: 1) a broad fixed curvature of the entire bone, 2) absence of periosteal new bone formation on later roentgenograms, and 3) partial correction of the curvature through cortical remodeling in young children. In this paper, three cases of traumatic bowing of the tubular bone in children are presented: one traumatic bowing of both forearm bones in 15 years old girl and two traumatic bowing of fibulae in combination with fractures of diaphysis of the tibiae of the same legs in 6 years old girl and 6 years old boy respectively. Manipulative reduction for the bowing of the both forearm bones corrected remarkably the plastic curvature, whereas manipulation for the bent fibulae with fractures of the tibiae failed to reduce the curvature, causing no delay in fracturt healing. These three cases are of special interest from two points of view. The first case was caused by tangential force instead of a longitudinal one and was associated with ulnar nerve paralysis which has eventually been recovered. The other two cases occurred in the lower leg in which plastic deformation, according to previous report, would not develop because of the lack of intrinsic curvature of the tibia and fibula.
Child ; Diaphyses ; Female ; Fibula ; Forearm ; Humans ; Leg ; Male ; Osteogenesis ; Paralysis ; Plastics ; Tibia ; Ulnar Nerve

Two hundred and thirty-seven patients who had paresis or paralysis of the quadriceps muscles underwent a transfer of the biceps femoris by Caldwell's method or medial hamstring to the patella. Seventy-six legs of seventy-two patients who had followed-up more than one year were reviewed and analysed. The results showed there was an overall improvement measured by decreased extension lag in all age groups and relatively uniform good results in young age group. Again we reviewed the forty-six patients chronologically to eliminate the outer factors who were transfered normal biceps femoris or medial hamstring power to absent quadriceps. By that we found the extension power of the knee joint after muscle transfer had been decreased by age.
Clothing ; Humans ; Knee Joint ; Leg ; Methods ; Paralysis ; Paresis ; Patella ; Poliomyelitis ; Quadriceps Muscle