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Platelet-rich plasma injections for the treatment of hamstring injuries: a randomized controlled trial

A Hamid MS, Mohamed Ali MR, Yusof A, George J, Lee LP

Am J Sports Med, 2014 Oct;42(10):2410-8.
PMID: 25073598 DOI: 10.1177/0363546514541540

BACKGROUND: A hamstring injury is one of the most common types of injury affecting athletes. Despite this, the optimal management of hamstring muscle injuries is not yet defined. The effect of autologous platelet-rich plasma (PRP) therapy on the recovery of hamstring injuries is unclear.
PURPOSE: To investigate the effect of a single PRP injection in the treatment of grade 2 hamstring muscle injuries.
STUDY DESIGN: Randomized controlled trial; Level of evidence, 2.
METHODS: Twenty-eight patients diagnosed with an acute hamstring injury were randomly allocated to autologous PRP therapy combined with a rehabilitation program or a rehabilitation program only. The primary outcome of this study was time to return to play. In addition, changes in pain severity and pain interference scores over time were examined.
RESULTS: Patients in the PRP group achieved full recovery significantly earlier than controls (P = .02). The mean time to return to play was 26.7 ± 7.0 days and 42.5 ± 20.6 days for the PRP and control groups, respectively (t(22) = 2.50, P = .02). [corrected]. Significantly lower pain severity scores were observed in the PRP group throughout the study. However, no significant difference in the pain interference score was found between the 2 groups.
CONCLUSION: A single autologous PRP injection combined with a rehabilitation program was significantly more effective in treating hamstring injuries than a rehabilitation program alone.
KEYWORDS: management; muscle injury; platelet-rich plasma (PRP); return to play

Matched MeSH terms: Lower Extremity/injuries*
Stature Estimation from Lower Limb Anthropometry using Linear Regression Analysis: A Study on the Malaysian Population

Abu Bakar SN, Aspalilah A, AbdelNasser I, Nurliza A, Hairuliza MJ, Swarhib M, et al.

Clin Ter, 2017 Mar-Apr;168(2):e84-e87.
PMID: 28383619 DOI: 10.7417/CT.2017.1988

INTRODUCTION: Stature is one of the characteristics that could be used to identify human, besides age, sex and racial affiliation. This is useful when the body found is either dismembered, mutilated or even decomposed, and helps in narrowing down the missing person's identity.

AIM: The main aim of the present study was to construct regression functions for stature estimation by using lower limb bones in the Malaysian population.

MATERIALS AND METHODS: The sample comprised 87 adult individuals (81 males, 6 females) aged between 20 to 79 years. The parameters such as thigh length, lower leg length, leg length, foot length, foot height and foot breadth were measured. They were measured by a ruler and measuring tape. Statistical analysis involved independent t-test to analyse the difference between lower limbs in male and female. The Pearson's correlation test was used to analyse correlations between lower limb parameters and stature, and the linear regressions were used to form equations. The paired t-test was used to compare between actual stature and estimated stature by using the equations formed.

RESULTS: Using independent t-test, there was a significant difference (p< 0.05) in the measurement between males and females with regard to leg length, thigh length, lower leg length, foot length and foot breadth. The thigh length, leg length and foot length were observed to have strong correlations with stature with p= 0.75, p= 0.81 and p= 0.69, respectively. Linear regressions were formulated for stature estimation. Paired t-test showed no significant difference between actual stature and estimated stature.

CONCLUSIONS: It is concluded that regression functions can be used to estimate stature to identify skeletal remains in the Malaysia population.

Matched MeSH terms: Lower Extremity; Bones of Lower Extremity
Fulltext Case review of sarcoidosis resembling Sjogren's syndrome

Ahmad Y, Shahril NS, Hussein H, Said MS

J Clin Med Res, 2010 Dec 11;2(6):284-8.
PMID: 22043264 DOI: 10.4021/jocmr482w

We would like to report a case of a 29-year-old male patient who presented with multiple lymphadenopathy and vague symptoms of low grade fever, cough, weight loss, rashes, vomiting, dry eyes and dry mouth. Physical examination revealed submandibular lymphadenopathy, vasculitic rashes over both lower limbs, and parotid gland enlargement. Blood investigations showed mild anemia with leukocytosis, predominantly eosinophilia and high erythrocyte sedimentation rate and C-reactive protein. Computed tomography of the neck, thorax and abdomen showed bilateral submandibular, submental adenopathy, mediastinal and para-aortic lymphadenopathy with generalized reticulonodular densities in both lower lobes. There were hepatomegaly and bilateral enlarged kidneys with renal cyst. Histopathological examination from the cervical lymph node later revealed non-caseating granuloma, consistent of sarcoidosis. Patient responded well to prednisolone 50 mg daily with subsequent reduction in the size of cervical lymphadenopathy and parotid swelling.

KEYWORDS: Lymphadenopathy; Granuloma; Sjogren; Sarcoidosis.

Matched MeSH terms: Lower Extremity
Fulltext Paravertebral Abscess Caused By Bukholderia Pseudomallei In

Ahmad, S., Azura, L., Duski, S., Aziz, M.Y.

Malays Orthop J, 2009;3(1):88-90.
MyJurnal

A 53-year-old Malay man was admitted with intestinal obstruction, fever and lower limb weakness. Initial clinical impression was myelitis causing paralytic ilues and paraperesis. Blood culture showed Burkholderia pseudomallei infection and subsequent MRI showed paravertebral abscess. This case highlights a rare manifestation of melioidosis involving the spine and difficulties in establishing the diagnosis.

Matched MeSH terms: Lower Extremity
Fulltext A preliminary evaluation of linear control schemes for FES-assisted movements

Ahmed, M., Huq, M.S., Ibrahim, B.S.K.K., Ahmed, A.

Movement Health & Exercise, 2018;7(1):211-223.
MyJurnal

Functional Electrical Stimulation (FES) can be used to revive movement
functions of the human body to a certain degree which was lost due to
occurrences of the nervous system disorders resulting from accidents or
diseases. It can also be employed for gait rehabilitation as well as therapy.
Control systems could be employed to improve on the FES-induced motion,
and the closed-loop was targeted due to its advantages. Based on the papers
reviewed, studies have shown that the linear control schemes are popular for
movement restoration in the lower limb, but mostly for continuous standing
contributing to mainly the stance phase. Therefore, a myriad of limitations
was observed which include: the need for using improved sensors, re-tuning
for every subject, tests conducted using patient with more straightforward
ailments, complexity in implementation and most importantly is the issue of
stability. The swing phase of gait movement and the full walking motion have
more complex dynamics and coupled with the nature of the plant (human with
nervous system disorder and the neuromuscular structure) could render the
linear control method obsolete or unsuitable. Hence, there is a need to
investigate other techniques such as the nonlinear and intelligent control
methods.

Matched MeSH terms: Lower Extremity
Fulltext Negative pressure wound therapy: Has it made a revolution in wound management?

Al-Shaham, Ali Abbas Hadi, Al-Shaham, Serene Ali, Jerjess, Mustafa

Medical Health Reviews, 2009;2009(1):3-13.
MyJurnal

Negative pressure if applied in topical manner to a wound surface has been reported to enhance wound healing due to increase in local blood flow, reduction of tissue oedema, and by stimulating angiogenesis. An air-tight film covering the wound is connected by suction tube to a control unit by which negative pressure is applied to the surface of the wound in the range of 80-125 mm Hg. This method has been called negative pressure wound therapy (NPWT) or vacuum assisted closure (VAC). It has been recommended for virtually all kinds of complex wounds. The duration of the therapy varies from several days to several months. This technology promotes formation of granulation tissue, enhances healing of diabetic foot, and significantly reduces the size of the acute and chronic wounds and ulcers. It lowers the morbidity of Fournier’s gangrene, ensures better healing of lower limb wounds and ulcer of ischemic origin, and can serve as temporary wound cover when no closure technique is available. The limitations to using NPWT are presence of dead tissue, exposed vital structures, untreated osteomyelitis, unexplored fistulae and malignant wounds. The cost of the equipment may constitute another factor in limiting the use of this new technology. In conclusion the NPWT under certain circumstances is more effective than other available local wound treatments.

Matched MeSH terms: Lower Extremity
Fulltext Does fear of re-injury affect the self-perceived level of lower limb functionality among soccer players with ACL reconstruction?: A cross-sectional study

Almansour A, Madkhali M, Alzhrani M, Alanazi A, Aldaihan MM, Alamri YH, et al.

Medicine (Baltimore), 2023 Nov 03;102(44):e35645.
PMID: 37933019 DOI: 10.1097/MD.0000000000035645

The fear of re-injury may persist after anterior cruciate ligament (ACL) reconstruction (ACLR) in professional soccer players (PSPs) even after a successful return to sport (RTS). This study aimed to determine the extent of this fear of re-injury and the impact of demographic variables and this fear of re-injury on the lower extremity functional scale (LEFS) scores in PSPs who had completed a successful RTS following ACLR. A cross-sectional survey design was used. Sixty-seven PSPs who had successfully RTS after ACLR, completed a demographic information sheet, the Athlete Fear-Avoidance Questionnaire (AFAQ), and the LEFS. The average AFAQ scores indicated low fear (M = 10.2, SD = 6.7), while high LEFS scores were observed (M = 67.1, SD = 12.4). There were significant strong negative correlations between LEFS and body mass index (BMI; rs [65] = -0.501, P = .001) and AFAQ and BMI (rs [65] = -0.378, P = .001). A hierarchical linear regression analysis found AFAQ to be a significant predictor of LEFS (b = -0.92, s.e. = 0.19, P = .001), with a total variance (adjusted R2) of 32.9%. PSPs' fear of re-injury post-ACLR significantly reduced their perceived levels of lower limb functionality. This study highlights the need to further explore and develop strategies to manage PSP fear of re-injury to improve sports-related performance post-ACLR.

Matched MeSH terms: Lower Extremity
Fulltext Stature approximation of Malays, Chinese and Indian in Malaysia using radiographs of femur, tibia and fibula

Amal Hayati Zainal Abidin, Khairul Osman, Sri Pawita Albakri Amir Hamzah, Noor Hazfalinda Hamzah, Ab Halim Mansar, Normaizatul Afizah Ismail

Jurnal Sains Kesihatan Malaysia, 2011;9(1):45-50.
MyJurnal

The study was conducted to create specific formulae for stature estimation of adult male population in Malaysia based on measurements of femur, tibia and fibula lengths using radiographic method. A number of thirty two Malaysians from hospitals involved as subjects in this study. The subjects were Malays (14), Chinese (8) and Indians (10) from 25-45 years old. The standing height of the subject was recorded before femur, tibia and fibula were scanned with an x-ray
machine. The bones length was measured on the x-ray film in centimetres (cm) and analysed using Statistical Package for Social Sciences (SPSS) version 19.0 for Windows. The results showed a significant relationship (p < 0.05) between stature and measurements of length of femur, tibia and fibula. Stature of Malays and Indians were significant (p < 0.05) with measurements of length of femur, tibia and fibula but insignificant in Chinese. Simple Linear Regression Analysis was used to derive regression equation for single bone and Multiple Linear Regression Analysis was used to derive regression equation for combination of femur, tibia and fibula. Six formulae for stature estimation of adult male population in Malaysia were derived. The formulae consist of three formulae for single bone, a formulae for combination bones with unknown race, a formulae for combination bones of Malays population and a formulae for combination bones of Indians population. Formulae for combination bones had the highest correlation coefficient compared to the formula using a single bone. Standard error was found to be high in all the formulae due to small sample size. Extension for this study is essential to provide Malaysia with accurate formulae.

Matched MeSH terms: Bones of Lower Extremity
Fulltext Effect of tocotrienol rich fraction (TRF) on muscles reinnervation after sciatic nerve crush injury in rats

Amalia Lailanor, Nurul Alaina Hj Yahya, Junedah Sanusi, Huzwah Khaza’ai, Muhammad Danial Che Ramli

Malaysian Journal of Medicine and Health Sciences, 2020;16(101):118-124.
MyJurnal

Introduction: Muscle denervation is a process where muscles lose nerve supply due to neural damage and this may lead to paralysis in human. Muscle denervation is mainly caused by peripheral nerve injuries especially in the lower extremities that resulted in devastating effect on human daily functions and routines. Tocotrienol Rich Fraction (TRF) consist of 75% of tocotrienols have shown potential neuroprotective properties. The objective of this study is to ob- serve motor coordination and histological characteristics on muscles that underwent sciatic nerve crush injury and supplemented with TRF. Methods: A total of 104 Sprague-Dawley rats were divided into four groups; normal group (n=8) with no sciatic nerve crush injury, negative control (n=32) with sciatic nerve crush injury at hindlimb without treatment, positive control (n=32) sciatic nerve crush injury treated with 500 µg/kg/day of methylcobalamin, and experimental group (n=32) of rats that underwent sciatic nerve crush injury and treated with 200 mg/kg/day of TRF. Result: Skeletal muscles which located at hind limb; Soleus Muscle and Extenstor Digitorum Longus Muscle (EDL) muscle have shown an increasing in weight when it is supplemented with TRF 200 mg/kg/day and improved myelin layer of nerve. Conclusion: This study showed that TRF has the potency to improve reinnervation rate and neuron supply in hind muscle.

Matched MeSH terms: Lower Extremity
Fulltext Comparison of lower limb kinematics during early and late phases of 2km time trial on stationary rowing ergometer among male national rowers

Amirah Zahiran, Fara Liana Zainuddin, Shazlin Shaharudin

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):3-7.
MyJurnal

Introduction: In this study, we evaluated the kinematics of lower limb during early and late phases of 2km time trial on stationary rowing ergometer among Malaysian male rowers. Methods: Seventeen national-level rowers voluntari- ly participated. Three dimensional lower limb kinematics data were collected to represent the first 400 m (i.e., early) and the last 400m (i.e., late) phases of 2km time trial on a stationary ergometer. The kinematics data at sagittal, frontal and transverse planes of dominant leg during catch and finish positions were compared across early and late phases of the time trial using paired T-test. Results: The kinematics of lower limb joints at three planes were not significantly different during early versus late phases of 2km time trial among male senior rowers except for hip flexion at finish (p=0.411), ankle rotation at catch (p=0.779) and ankle abduction at finish (p=0.677). Conclusion: Lower limb kine- matics particularly the hip flexion, ankle rotation and ankle abduction may change across early and late phases of 2km time trial due to fatigue. Coaches and rowers should monitor these motions during fatiguing rowing piece and develop necessary injury prevention measures.

Matched MeSH terms: Lower Extremity
Fulltext Improved Active Disturbance Rejection Control for Trajectory Tracking Control of Lower Limb Robotic Rehabilitation Exoskeleton

Aole S, Elamvazuthi I, Waghmare L, Patre B, Meriaudeau F

Sensors (Basel), 2020 Jun 30;20(13).
PMID: 32630115 DOI: 10.3390/s20133681

Neurological disorders such as cerebral paralysis, spinal cord injuries, and strokes, result in the impairment of motor control and induce functional difficulties to human beings like walking, standing, etc. Physical injuries due to accidents and muscular weaknesses caused by aging affect people and can cause them to lose their ability to perform daily routine functions. In order to help people recover or improve their dysfunctional activities and quality of life after accidents or strokes, assistive devices like exoskeletons and orthoses are developed. Control strategies for control of exoskeletons are developed with the desired intention of improving the quality of treatment. Amongst recent control strategies used for rehabilitation robots, active disturbance rejection control (ADRC) strategy is a systematic way out from a robust control paradox with possibilities and promises. In this modern era, we always try to find the solution in order to have minimum resources and maximum output, and in robotics-control, to approach the same condition observer-based control strategies is an added advantage where it uses a state estimation method which reduces the requirement of sensors that is used for measuring every state. This paper introduces improved active disturbance rejection control (I-ADRC) controllers as a combination of linear extended state observer (LESO), tracking differentiator (TD), and nonlinear state error feedback (NLSEF). The proposed controllers were evaluated through simulation by investigating the sagittal plane gait trajectory tracking performance of two degrees of freedom, Lower Limb Robotic Rehabilitation Exoskeleton (LLRRE). This multiple input multiple output (MIMO) LLRRE has two joints, one at the hip and other at the knee. In the simulation study, the proposed controllers show reduced trajectory tracking error, elimination of random, constant, and harmonic disturbances, robustness against parameter variations, and under the influence of noise, with improvement in performance indices, indicates its enhanced tracking performance. These promising simulation results would be validated experimentally in the next phase of research.

Matched MeSH terms: Lower Extremity*
Fulltext Provision of Prosthetic Services Following Lower Limb Amputation in Malaysia

Arifin N, Hasbollah HR, Hanafi MH, Ibrahim AH, Rahman WAWA, Aziz RC

Malays J Med Sci, 2017 Oct;24(5):106-111.
PMID: 29386978 MyJurnal DOI: 10.21315/mjms2017.24.5.12

The incidence of lower limb amputation is high across the globe and continues to be a major threat to morbidity and mortality. Consequently, the provision of high quality and effective prosthetics services have been known as an essential component for a successful rehabilitation outcome. In Malaysia, amputation prevalence has been increasing in which several main components of service delivering aspects (such as service intervention, prosthetic personnel) should be anticipated to accommodate for the increasing demand. This article highlights the hurdles experienced in providing prosthetic services in Malaysia from multiple aspects such as financial burden to acquire the prosthesis and lack of expertise to produce quality prosthesis. This paramount issues consequently justify for the urgency to carry out national level survey on the current statistics of lower limb amputation and to ascertain the available workforce to provide a quality prosthetics services. Only with accurate and current information from the national survey, strategies and policies aimed at enhancing the outcome from prosthetics services can be achieved.

Matched MeSH terms: Lower Extremity
Fulltext A community based study on tropical phagedenic ulcers in Shah Alam, Malaysia: knowledge, attitude and practice

Asdren Zajmi, Nur Atikah Adam, Mohammed Abdelfatah Alhoot

Malaysian Journal of Medicine and Health Sciences, 2020;16(101):112-117.
MyJurnal

Introduction: Tropical phagedenic ulcer is a skin disease caused by a cocktail of bacteria. This painful ulcer forms over the lower limbs. It is also associated with necrotic slough and foul-smelling discharge that eventually lead to amputation and permanent disabilities. Tropical phagedenic ulcer in Malaysia has not been given much attention. In light of this situation, this research was conducted to assess the knowledge, attitude and practice regarding tropical phagedenic ulcer among the public in Shah Alam, Selangor. Methods: The total respondents were 384, consisting of 164 males and 220 females who were randomly selected. Data were obtained qualitatively through structured questionnaires and analysed using the chi-square test to study the association between the dependent variables and demographic factors. Results: The collected data showed that the respondents (67.2%) had poor knowledge of trop- ical phagedenic ulcer; merely 65.4% considered it to be a health problem, whereas 29.7% believed it is contagious. Also, the data revealed an association between age (χ2=13.587, p =0.004), marital status (χ2=15.435, p=0.001), time spent in community (χ2=6.438, p=0.04) and knowledge of the local name of tropical phagedenic ulcer. About 74.7% of the respondents did not know the cause of tropical phagedenic ulcer. Only 22.1% of the respondents had encoun- tered tropical phagedenic ulcer patients and an association was found between the variable with gender (χ2=4.672, p =0.031), age (χ2=24.134, p =0.000) and marital status (χ2=17.143, p =0.001). Conclusion: This study reveals mis- conceptions about the aetiology and transmission of tropical phagedenic ulcer which greatly influence the attitude of community members towards tropical phagedenic ulcer patients.

Matched MeSH terms: Lower Extremity
Fulltext Predicting Employment Status of Injured Workers Following a Case Management Intervention

Awang H, Mansor N

Saf Health Work, 2018 Sep;9(3):347-351.
PMID: 30370168 DOI: 10.1016/j.shaw.2017.11.001

Background: The success of an injury intervention program can be measured by the proportion of successful return to work (RTW). This study examined factors of successful return to employment among workers suffering from work-related injuries.
Methods: Data were obtained from the Social Security Organization, Malaysia database consisting of 10,049 RTW program participants in 2010-2014. The dependent variable was the RTW outcome which consisted of RTW with same employer, RTW with new employer or unsuccessful return. Multinomial logistic regression was performed to test the likelihood of successful return with same employer and new employer against unsuccessful return.
Results: Overall, 65.3% of injured workers were successfully returned to employment, 52.8% to the same employer and 12.5% to new employer. Employer interest; motivation; age 30-49 years; intervention less than 9 months; occupational disease; injuries in the lower limbs, upper limbs, and general injuries; and working in the manufacturing, services, and electrical/electronics were associated with returning to work with the same employer against unsuccessful return. Male, employer interest, motivation, age 49 years or younger, intervention less than 6 months, occupational disease, injuries in the upper limbs and services sector of employment were associated with returning to new employer against unsuccessful return.
Conclusion: There is a need to strengthen employer commitment for early and intensified intervention that will lead to improvement in the RTW outcome.

Matched MeSH terms: Lower Extremity
Fulltext The Effects of Leg Length Discrepancy on Stability and Kinematics-Kinetics Deviations: A Systematic Review

Azizan NA, Basaruddin KS, Salleh AF

Appl Bionics Biomech, 2018;2018:5156348.
PMID: 30116295 DOI: 10.1155/2018/5156348

Various studies have examined body posture stability, including postural sway and associated biomechanical parameters, to assess the severity effects of leg length discrepancy (LLD). However, various viewpoints have been articulated on the results of these studies because of certain drawbacks in the comprehensive analysis of the effect of variations in LLD magnitude. Therefore, this systematic review was performed to help focus on the current findings to help identify which biomechanical parameters are most relevant, commonly used, and able to distinguish and/or have specific clinical relevance to the effect of variations in LLD magnitude during static (standing) and dynamic (walking) conditions. Several electronic databases containing studies from the year 1983 to 2016 (Scopus, ScienceDirect, PubMed, PMC, and ProQuest) were obtained in our literature search. The search process yielded 22 published articles that fulfilled our criteria. We found most of the published data that we analyzed to be inconsistent, and very little data was obtained on the correlation between LLD severity and changes in body posture stability during standing and walking. However, the results of the present review study are in line with previous observational studies, which describe asymmetry in the lower limbs corresponding to biomechanical parameters such as gait kinematics, kinetics, and other parameters described during static (standing) postural balance. In future investigations, we believe that it might be useful to use and exploit other balance-related factors that may potentially influence body posture stability.

Matched MeSH terms: Lower Extremity
Fulltext Brodie's Abscess of Posterior Ilium with Gluteal Syndrome, an Unusual Cause of Paediatric Low Back Pain: A Case Report

Behera G, Poduval M, Patro DK, Sahoo S

Malays Orthop J, 2017 Jul;11(2):68-71.
PMID: 29021883 DOI: 10.5704/MOJ.1707.009

Brodie's abscess is a variety of subacute osteomyelitis with a long duration of presentation and intermittent pain. It usually involves the metaphyseal region of long bones of the lower limbs. Brodie's abscess of pelvic bone is very rare. Involvement of posterior ilium with gluteal syndrome is extremely unusual and can be easily missed or misdiagnosed. We present a 9-year old boy who reported to us with intermittent low back pain of three months duration without any other constitutional symptoms. Clinically, there was mild tenderness over the posterior ilium. Computed tomography showed a lytic lesion in the posterior ilium with a breach in the outer cortex. MRI and bone scan were suggestive of inflammatory pathology. Keeping infective, tubercular and benign bone tumors as differential diagnoses, open biopsy and curettage were done. Staphylococcus aureus was cultured and histopathology was suggestive of osteomyelitis. The patient received appropriate antibiotics for six weeks. He was asymptomatic till 18 months of follow up without any recurrence. We present this case because of its rarity and unusual presentation as gluteal syndrome and low back pain, and its resemblance to other pelvic and sacroiliac joint pathologies which are often missed or misdiagnosed in paediatric patients.

Study done in India

Matched MeSH terms: Lower Extremity
Fulltext "Bring Your Own Device"-A New Approach to Wearable Outcome Assessment in Trauma

Braun BJ, Histing T, Menger MM, Platte J, Grimm B, Hanflik AM, et al.

Medicina (Kaunas), 2023 Feb 19;59(2).
PMID: 36837604 DOI: 10.3390/medicina59020403

Background and Objectives: Outcome data from wearable devices are increasingly used in both research and clinics. Traditionally, a dedicated device is chosen for a given study or clinical application to collect outcome data as soon as the patient is included in a study or undergoes a procedure. The current study introduces a new measurement strategy, whereby patients' own devices are utilized, allowing for both a pre-injury baseline measure and ability to show achievable results. Materials and Methods: Patients with a pre-existing musculoskeletal injury of the upper and lower extremity were included in this exploratory, proof-of-concept study. They were followed up for a minimum of 6 weeks after injury, and their wearable outcome data (from a smartphone and/or a body-worn sensor) were continuously acquired during this period. A descriptive analysis of the screening characteristics and the observed and achievable outcome patterns was performed. Results: A total of 432 patients was continuously screened for the study, and their screening was analyzed. The highest success rate for successful inclusion was in younger patients. Forty-eight patients were included in the analysis. The most prevalent outcome was step count. Three distinctive activity data patterns were observed: patients recovering, patients with slow or no recovery, and patients needing additional measures to determine treatment outcomes. Conclusions: Measuring outcomes in trauma patients with the Bring Your Own Device (BYOD) strategy is feasible. With this approach, patients were able to provide continuous activity data without any dedicated equipment given to them. The measurement technique is especially suited to particular patient groups. Our study's screening log and inclusion characteristics can help inform future studies wishing to employ the BYOD design.

Matched MeSH terms: Lower Extremity
Clinical efficacy and safety of a new 1000-mg suspension versus twice-daily 500-mg tablets of MPFF in patients with symptomatic chronic venous disorders: a randomized controlled trial

Carpentier P, van Bellen B, Karetova D, Hanafiah H, Enriquez-Vega E, Kirienko A, et al.

Int Angiol, 2017 Oct;36(5):402-409.
PMID: 28206732 DOI: 10.23736/S0392-9590.17.03801-9

BACKGROUND: Chronic venous disorders (CVD) is estimated to affect 30% to 50% of women and 10% to 30% of men. The most widely prescribed treatment for CVD worldwide is micronized purified flavonoid fraction 500 mg (MPFF). The aim of this clinical trial was to develop a new once daily 1000-mg oral suspension of MPFF.
METHODS: In an international, randomized, double-blind, parallel-group study, symptomatic individuals classified CEAP C0s to C4s were randomized in either treatment arm and treated for 8 weeks. Lower limb symptoms (discomfort, pain and heaviness) were assessed using Visual Analog Scales (VAS), and quality of life (QoL) was measured with the CIVIQ-20 Questionnaire.
RESULTS: A total of 1139 patients were included in the study. Both MPFF treatment regimens were well tolerated and associated with a significant reduction in lower limb symptoms. A non-inferiority of MPFF 1000-mg oral suspension once daily compared to MPFF 500-mg tablet twice daily (P<0.0001) was found for lower limb discomfort (-3.33 cm for MPFF 1000 mg and -3.37 cm for MPFF 500 mg), leg pain (-3.27 cm for MPFF 1000 mg and -3.31 cm for MPFF 500 mg) and leg heaviness (-3.41 cm for MPFF 1000 mg and -3.46 cm for MPFF 500 mg). The patients' QoL was improved by about 20 points on the CIVIQ scale in both groups (19.33 points for MPFF 1000 mg and 20.28 points for MPFF 500 mg).
CONCLUSIONS: MPFF 1000-mg oral suspension and MPFF 500-mg tablets treatments were associated with similar reductions in lower limb symptoms and QoL improvement. The new once daily MPFF1000-mg oral suspension has a similar safety profile to two tablets of MPFF 500 mg, with the advantage of one daily intake, potentially associated with improved patient adherence and easier CVD management.

Matched MeSH terms: Lower Extremity/blood supply*; Lower Extremity/physiopathology
Clinical characteristics of patients with lower limb cellulitis and antibiotic usage in Hospital Kuala Lumpur: a 7-year retrospective study

Ch'ng CC, Johar A

Int J Dermatol, 2016 Jan;55(1):30-5.
PMID: 26275796 DOI: 10.1111/ijd.12850

Cellulitis commonly involved lower limbs. This study was carried out to determine the demography, clinical characteristics, risk factors, microbiological aspects, and antibiotics usage in this group of patients in Hospital Kuala Lumpur.

Matched MeSH terms: Lower Extremity
Fulltext Necrotizing Fasciitis of the Lower Limb: A Prospective Study of Prognostic Factors Affecting Mortality

Chee, E.K., Kwan, M.K., Khoo, E.H.

Malays Orthop J, 2009;3(1):32-35.
MyJurnal

Necrotizing fasciitis is a life and limb threatening soft tissue infection with a high mortality rate. This study tries to identify the possible risk factors that contribute to mortality in patients with necrotizing fasciitis involving a lower limb. We prospectively reviewed 41 patients that presented with necrotizing fasciitis of the lower limb over a period of one year. Results show that the mortality rate for necrotizing fasciitis of the lower limb is quite high at 19.5%. Comparison among necrotizing fasciitis patients reveals that higher mortality rate is seen among those patients with advanced age and those presented with initial high pre-operative creatinine levels. Sex, pre-morbid diabetes mellitus, duration from initial symptoms to presentation for treatment and presence of streptococcus group A were not associated with an increased mortality rate. Neither were admission vital signs, subcutaneous gas on radiograph, prior antibiotic treatment on admission or clinical note of bullae formation.

Matched MeSH terms: Lower Extremity

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