A lower-extremity exoskeleton can facilitate the lower limbs' rehabilitation by providing additional structural support and strength. This article discusses the design and implementation of a functional prototype of lower extremity brace actuation and its wireless communication control system. The design provides supportive torque and increases the range of motion after complications reducing muscular strength. The control system prototype facilitates elevating a leg, gradually followed by standing and slow walking. The main control modalities are based on an Artificial Neural Network (ANN). The prototype's functionality was tested by time-angle graphs. The final prototype demonstrates the potential application of the ANN in the control system of exoskeletons for joint impairment therapy.

• Klíčová slova
• Keras, Lower-extremity, control system, exoskeleton, neural network, walking,
• MeSH
• chůze MeSH
• dolní končetina MeSH
• exoskeleton * MeSH
• neuronové sítě MeSH
• točivý moment MeSH
• Publikační typ
• časopisecké články MeSH

The authors present a case of a 40-year-old male with devastating amputation trauma of both lower extremities. Reconstruction of the right lower extremity was solved by the unusual use of inserted vascularized bone-skin graft from the left crus with a simultaneous replantation of the right foot. The result after 3.5 years is preservation of one extremity with full knee mobility. The other lower extremity was fitted for thigh prosthesis.

• MeSH
• dolní končetina krevní zásobení   zranění   inervace   chirurgie   MeSH
• dospělí MeSH
• lidé MeSH
• replantace metody   MeSH
• traumatická amputace chirurgie   MeSH
• záchrana končetiny metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

The correct and precise nomenclature of the veins of the lower extremity is a necessary tool for communication. Three important changes have been done over the last 13 years. Terminologia Anatomica, the latest version of the Latin anatomical nomenclature, was published in 1998, extended in the area of the lower extremity veins with two consensus documents, in 2001, during the 14th World Congress of the International Union of Phlebology and in 2004 during the 21st World Congress of the International Union of Angiology. This article is a free continuation of two previous articles, reviewing the detailed anatomy and correct nomenclature of the superficial veins of the lower extremities and veins of pelvis. Now, it is concentrated on the deep venous system, in which 15 new terms have been added in both Latin and English languages.

• MeSH
• dolní končetina krevní zásobení   MeSH
• kongresy jako téma MeSH
• lidé MeSH
• terminologie jako téma MeSH
• vény * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Intramedullary nailing is a worldwide accepted technique for stabilization of fractures of long bones. Technique, instruments and implants primarily have been developed for the fixation of short (transverse and oblique) diaphyseal fractures. First generation nails were hollow and slotted, which gave them some elasticity. When the tip of the nail passed the fracture gap, picked up the opposite fracture fragment and was driven further down, the longitudinal axis of the bone was restored and the extremity realigned. Bone length was restored by closure of the fracture gap. The tight connection between the deformable hollow nail and the inner cortex at the isthmus realized a press-fit, which achieved a very stable bone-implant construct. The nail had the function of a weight-shearing implant. Interlocked nails represent the second-generation nails. They changed the spectrum of indications for nailing considerably. Not only short middle-third shaft fractures, but shaft fractures of all types (from transverse to comminuted) and all localizations can be stabilized with an interlocked nail. Due to interlocking, length and rotation are controlled. The nail bridges the area of instability, being a weight-bearing implant. Small diameter, solid nails formed the next generation of nail implants. They were conceived for the provisional treatment of fractures with an enhanced risk of postoperative infection such as open fractures or closed fractures with severe soft tissue damage. They were increasingly used for minimal invasive treatment of closed fractures without soft tissue damage as well, as reaming was not necessary and endosteal blood supply less damaged. Nevertheless, it became clear that they were connected with a higher incidence of implant failure and revision surgery. Another development was the creation of nails with multiple and angular stable interlocking options. Major advantage is that high stability is obtained in the fracture fragment, in which multiple interlocking is used. This property gives the possibility of nailing fractures close to a joint with a short fracture segment (24). Nevertheless, intramedullary nailing of metaphyseal fractures remains controversial. Major complications to be avoided are malalignment, delayed union, nonunion and implant failure due to suboptimal fracture reduction (23).

• MeSH
• dolní končetina zranění   chirurgie   MeSH
• fraktury kostí chirurgie   MeSH
• hojení fraktur MeSH
• intramedulární fixace fraktury škodlivé účinky   přístrojové vybavení   metody   MeSH
• kostní hřeby * MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

OBJECTIVES: To compare lower extremity mechanics and energy absorption during two types of landing after a successful or unsuccessful block in volleyball and assess the risks of anterior cruciate ligament (ACL) injury. DESIGN: Cohort study. SUBJECTS: Fourteen elite male volleyball players (aged 24.5 ± 4.6 years; height 1.94 ± 0.06 m; mass 86.6 ± 7.6 kg). INTERVENTIONS: Subjects were required to land on force platforms using stick landing or step-back landing (with the right lower extremity stepping back away from the net) techniques after performing a standing block jump movement. MAIN OUTCOME MEASURES: Vertical ground reaction force (body weight); knee flexion (degrees); knee moments (Nm/kg); and hip, knee and ankle energy absorption (J/kg). RESULTS: The right lower extremity showed a greater first peak of vertical ground reaction force, a greater valgus moment, lower energy absorption by the knee, and higher energy absorption by the hip and ankle joints during step-back landing. CONCLUSIONS: The lower extremity may be exposed to a greater risk of ACL injury when stepping back from the net during the initial impact phase after a step-back landing.

• Klíčová slova
• Injury prevention, Knee, Landing, Lower extremity,
• MeSH
• biomechanika MeSH
• dolní končetina * MeSH
• dospělí MeSH
• kohortové studie MeSH
• lidé MeSH
• mladý dospělý MeSH
• poranění předního zkříženého vazu * MeSH
• postura těla * MeSH
• rány a poranění etiologie   MeSH
• rizikové faktory MeSH
• volejbal * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

PURPOSE: The loss of muscle functions is a significant health issue among dialysis patients. Poor muscle strength negatively affects a patient's mobility, independence and quality of life. The aim of the study was to assess the effects of an intradialytic resistance training (IRT) on lower extremity muscle functions among dialysed patients. MATERIALS AND METHODS: Ninety patients were allocated into an experimental group (n = 57) or control group (CNG) (n = 33) according to the location of the dialysis service center. Fifty-eight patients completed the study follow-up. The intervention regarded 12-week IRT, while the controls remained physically inactive during hemodialysis. In both groups of patients, we assessed lower extremity muscle functions by a diagnostics of maximal isometric force generated during hip flexion (HF), hip extension (HE), and knee extension (KE) contractions at baseline, after the 12-weeks intervention and after a further 12-weeks follow up. RESULTS: We found that improvements in HE between baseline and post-intervention were significantly larger for the experimental than the CNG (difference 32.0, 95% CI = 12.3-51.8, p = 0.002). For the other primary outcomes, we found no differences between the groups, and neither for the two other indices of muscle strength (HF and KE). At 12-weeks follow-up, we found no statistically significant differences between the two groups. CONCLUSIONS: Our findings indicate that exercise during dialysis not just suppresses adverse effects in muscle strength and functioning, but effectively and safely increases lower extremities muscle function in a relatively short time.Implications for RehabilitationRegular, progressive, resistance training realized during dialysis is well tolerated and safe for exercise interventions in hemodialysis patients.A 12-weeks intradialytic resistance training is effective in the prevention and clinical management of muscle function loss among hemodialysis patients.The range of improvements in muscle functions, demonstrated by the assessment of maximal isometric force, varied severely during different lower extremity movements of hemodialysis patients.

• Klíčová slova
• Intradialytic exercise *, hemodialysis *, muscle functions *, patients *, resistance training *,
• MeSH
• dialýza ledvin škodlivé účinky   MeSH
• dolní končetina MeSH
• kvalita života MeSH
• lidé MeSH
• odporový trénink * MeSH
• svalová síla fyziologie   MeSH
• svaly MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• Klíčová slova
• DISLOCATIONS *, EXTREMITIES *,
• MeSH
• dislokace kloubu * MeSH
• dolní končetina * MeSH
• končetiny * MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

AIM: A diabetes-related foot ulcer (DFU) is a major risk factor for lower-extremity amputation (LEA). To help clinicians predict the risk of LEA in people with DFU, the Diabetic Foot Risk Assessment (DIAFORA) system was developed but has never been externally validated. METHODS: In this study, 317 people presenting with a new DFU were included. At baseline, participants were grouped into three groups based on their DIAFORA score: low-risk (<15), medium-risk (15-25), and high-risk (>25). Participants were followed until healing, LEA, death, or at least 3 months. Discriminative accuracy was evaluated using sensitivity, specificity, likelihood ratios (LRs) and the area under the curve (AUC). RESULTS: All 317 participants completed at least 3 months of follow-up for a median duration of 146 days, during which 12.6% underwent minor amputation and 2.5% major amputation. People in the low- and medium-risk categories had major amputation rates of 0.9% and 2.1%, respectively, and negative LR of major LEA of 0.10 and 0.38, respectively, while the people in the high-risk category had an amputation rate of 25.0% and a positive LR of 12.9. The DIAFORA risk groups had a sensitivity of 75.0% and a specificity of 65.7%, with a corresponding AUC of 0.78 (95% CI 0.68-0.87) for the prediction of major LEA. CONCLUSION: The DIAFORA score is a useful tool for risk stratification of people presenting with a newly occurred DFU, with the external validation presenting results similar to those presented in the original study. The DIAFORA score may guide clinicians towards more individualized DFU treatment regimens.

• Klíčová slova
• diabetic foot, diabetic foot ulcer, lower‐extremity amputations, scoring systems,
• MeSH
• amputace * statistika a číselné údaje   MeSH
• diabetická noha * chirurgie   epidemiologie   MeSH
• dolní končetina chirurgie   MeSH
• hodnocení rizik metody   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• prediktivní hodnota testů MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• senzitivita a specificita MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• validační studie MeSH
• Geografické názvy
• Dánsko epidemiologie   MeSH

• Klíčová slova
• LEG/wounds and injuries *, ORTHOPEDICS/equipment and supplies *,
• MeSH
• bérec * MeSH
• dolní končetina * MeSH
• lidé MeSH
• ortopedické výkony * MeSH
• ortopedie zásobování a distribuce   MeSH
• poranění dolní končetiny * MeSH
• rotace * MeSH
• zdravotnické prostředky * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

The purpose of this study was to examine the effects of rowing stroke rates on lower extremity intra-joint coordination variability in professional rowers. Fifteen experienced young rowers volunteered to participate in this study. Kinematic data were recorded at different rowing speeds with seven Vicon cameras. The continuous relative phase (CRP) and CRP variability (CRPV) were used to calculate joint coordination and coordination variability, respectively, for the hip, knee, and ankle in the sagittal and horizontal planes, and a comparison was made among different rowing stroke rates. A vector analysis repeated measure ANOVA using statistical parametric mapping revealed that there were statistically significant differences in the hip-ankle, hip-knee, and knee-ankle CRPs for rowing at different stroke rates. Moreover, there was higher CRPV in the mid-drive and mid-recovery phases and less variability in the transition from the drive phase to the recovery phase. The results demonstrate the importance of knee joint in rowing tasks in experienced rowers during submaximal rowing stroke rate and the shift of movement to the hip at higher rowing stroke rate. Moreover, there was a smaller variability during drive-to-recovery transition, which may suggests an increased risk for overuse injuries.

• MeSH
• biomechanika MeSH
• dolní končetina MeSH
• koleno MeSH
• kotník MeSH
• lidé MeSH
• sporty * MeSH
• vodní sporty * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH