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Mitral valve velocity time integral and passive leg raise as a measure of volume responsiveness

Mitral valve velocity time integral and passive leg raise as a measure of volume responsiveness

passive leg raise was 69% sensitive and 89% specific for response to 500 mL of crystalloid administration. To the best of our knowledge, our study is the first study looking at the role of non-invasive cardiac echocardiography in the emergency department for the evaluation of volume responsiveness. A study by Dinh et  al. in 2012 showed that emergency physicians can accurately measure LVOT VTI and cardiac output [30]. Our study remains the only study that looked at the role of MV VTI as a predictor of volume responsiveness. MV VTI was found to be highly specific for fluid responsiveness as well as having a high positive predictive value for detecting a volume-respon- sive state. This technique can be an alternative for physi- cians to evaluate volume responsiveness in cases where patients’ body habitus prevents them from getting an adequate apical five-chamber view. It is important to note that there were four patients that had a MV VTI < 12% while having an LVOT VTI > 12%. Possible explanations for the discrepancy could be that the patients had dias- tolic dysfunction or mitral regurgitation, two conditions that could affect mitral valve VTI. We did not, however, check for diastolic dysfunction on our patients. Fur- thermore, one patient had a MV > 12% and an LVOT VTI < 12%. This particular patient had an aortic valve replacement and his low LVOT VTI could be due to the metallic valve.
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Passive leg raise (PLR) during cardiopulmonary (CPR) – a method article on a randomised study of survival in out-of-hospital cardiac arrest (OHCA)

Passive leg raise (PLR) during cardiopulmonary (CPR) – a method article on a randomised study of survival in out-of-hospital cardiac arrest (OHCA)

Background: It is estimated that about 275,000 inhabitants experience an out-of-hospital cardiac arrest (OHCA) every year in Europe. Survival in out-of-hospital cardiac arrest is relatively low, generally between five per cent and 10%. Being able to explore new methods to improve the relatively low survival rate is vital for people with these conditions. Passive leg raise (PLR) during cardiopulmonary resuscitation (CPR) has been found to improve cardiac preload and blood flow during chest compressions. The aim of our study is to evaluate whether early PLR during CPR also has an impact on one-month survival in sudden and unexpected out-of-hospital cardiac arrest (OHCA). Method/Design: A prospective, randomized, controlled trial in which all patients ( ≥ 18 years) receiving out-of hospital CPR are randomized by envelope to be treated with either PLR or in the flat position. The ambulance crew use a special folding stool which allows the legs to be elevated about 20 degrees. Primary end-point: survival to one month. Secondary end-point: survival to hospital admission to one month and to one year with acceptable cerebral performance classification (CPC) 1 – 2.
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Comparison of active knee extension test and straight leg raise angle in visual display terminal operators with or without low back pain

Comparison of active knee extension test and straight leg raise angle in visual display terminal operators with or without low back pain

There is no sensitivity between both the tests. Gajdosik and Lusin (1986) stated the active knee extension test have good interrater reliability and found to be effective when used with the stabilizing apparatus for measuring hamstring muscle length. Tiago Neto, Lia Jacobsohn, Ana I. Carita, and Raul oliveria stated that the straight leg raise test were found to have excellent intrarater reliability. The standard error measurements and minimal detectable differences recorded are also very encouraging for the use of these tests in subjects with flexibility deficits. Hence this study concludes that either active knee extension test or straight leg raise test can be used to assess low back pain. This study has some limitations like low back pain population included in the study were smaller in size and thorough history of low back pain has not been taken due to insufficient study duration. Future studies should look for more number of population with low back pain.
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Inter-rater agreement, sensitivity, and specificity of the prone hip extension test and active straight leg raise test

Inter-rater agreement, sensitivity, and specificity of the prone hip extension test and active straight leg raise test

postures or tasks can be objectively quantified and used to provide estimates of spinal stability [1,16]. However, these methods involve the use of advanced technology and mathematical modeling that make them of limited use in a routine clinical setting. It would therefore be valuable to develop practical clinical tests that demonstrate sufficient reliability and validity in assessing the neuromuscular con- trol strategies of LBP patients to help facilitate treatment targeted at correcting specific neuromuscular control defi- cits. Two tests that have been suggested as having poten- tial in this regard are the prone hip extension (PHE) test [17] and active straight leg raise (ASLR) test [18,19].
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Involuntary hamstring muscle activity reduces passive hip range of motion during the straight leg raise test: a stimulation study in healthy people

Involuntary hamstring muscle activity reduces passive hip range of motion during the straight leg raise test: a stimulation study in healthy people

retained. Based on our current results, inclusion of these measures would have reduced measures of ankle mobil- ity, possibly masking a true treatment effect. The failure to consider the impact of involuntary muscle activity on measures of passive range of motion may explain in part why human studies on the mechanisms of contracture (i.e. loss of passive joint range of motion) are inconclu- sive [16–20]. Involuntary muscle activity is common during the passive straight leg raise test [7, 9, 12]. Ran- domized controlled trials have shown that stretching programs increase stretch tolerance (measured at max- imal tolerated torque), but not muscle extensibility (measured at a standardized torque) [6, 15]. However, these and other studies [21–23] used the passive straight leg raise test to examine whether stretching is effective without considering whether involuntary muscle activity limits range of motion during assessment. Because of this, it cannot be determined whether stretching pro- grams are ineffective, or whether real treatment effects are masked by the presence of involuntary muscle activ- ity during outcome assessments or interventions.
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Passive leg raise testing effectively reduces fluid administration in septic shock after correction of non-compliance to test results

Passive leg raise testing effectively reduces fluid administration in septic shock after correction of non-compliance to test results

This study shows that successful implementation of PLR testing effectively reduces fluid administration. However, introduction of a seemingly simple intervention, based on solid scientific principles, does not automatically guarantee improvement in a clinically relevant endpoint. Despite an intensive training program the fluid balance after 48 h of ICU admission did not change in patients with septic shock. Only after the ICU team became aware that non-compliance to the test results was the main rea- son for the failure of successful implementation of PLR testing, the administered amount of fluids in the first 48 h of ICU admission reduced significantly and substantially. Fig. 2 Setting passive leg raise test. a Resting condition. b Supine
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THE EFFECT OF MULLIGAN’S BENT LEG RAISE [BLR] VERSUS INSTRUMENT ASSISTED SOFT TISSUE MOBILIZATION [M2T] IN SUBJECTS WITH HAMSTRING TIGHTNESS IN NON - SPECIFIC LOW BACKACHE: A RANDOMIZED CLINICAL TRIAL

THE EFFECT OF MULLIGAN’S BENT LEG RAISE [BLR] VERSUS INSTRUMENT ASSISTED SOFT TISSUE MOBILIZATION [M2T] IN SUBJECTS WITH HAMSTRING TIGHTNESS IN NON - SPECIFIC LOW BACKACHE: A RANDOMIZED CLINICAL TRIAL

Mulligan’s bent leg raise (BLR) is a technique used for improving range of straight leg raise (SLR) in sub- jects with LBP and/or referred thigh pain (Mulligan, 1999)  and to increase the flexibility of hamstring. Its effect was studied by Hall T et al. (2006), in subjects with LBA. But it was an immediate effect after a single intervention [6].Instrument Assisted Soft Tissue Mobili- zation (IASTM) is a soft-tissue treatment technique where a tool is used to stimulate and mobilize the affected scar tissue and myofascial adhesions [7]. Nicole MacDonald et al. (2016) conducted a study to know the effects of IASTM (Tecnica Gavilan, Tracy, CA) on lower extremity muscle performance of the quadriceps muscle. But it was on quad- riceps [8].
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Effectiveness of the intermittent lumbar traction with 30% and 60% body weight on straight leg raise test of symptomatic patients with lumber spondylosis with sciatica: A comparative study

Effectiveness of the intermittent lumbar traction with 30% and 60% body weight on straight leg raise test of symptomatic patients with lumber spondylosis with sciatica: A comparative study

I hereby declare and present my dissertation entitled entitled “EFFECTIVENESS OF THE INTERMITTENT LUMBAR TRACTION WITH 30% AND 60% BODY WEIGHT ON STRAIGHT LEG RAISE TEST OF SYMPTOMATIC PATIENTS WITH LUMBER SPONDYLOSIS WITH SCIATICA – A COMPARATIVE STUDY” the outcome of the original research work undertaken and carried out be me , under the guidance of Mr. K. KUMAR, M.P.T. , MIAP., Associate Professor , Padmavathi College of Physiotherapy, Periyanahalli, Dharmapuri , Tamilnadu.

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Normal inter limb differences during the straight leg raise neurodynamic test: a cross sectional study

Normal inter limb differences during the straight leg raise neurodynamic test: a cross sectional study

The straight leg raise (SLR) is a common neurodynamic test used to examine the mechanosensitivity of the lower extremity nervous system in individuals with low back or lower extremity pain [1-4]. Structural differentiation is necessary to determine if symptom provocation and range of motion restrictions are related to neural tissue [5]. Pre-positioning in ankle dorsiflexion compared to plantar flexion is commonly utilized for purposes of structural differentiation during SLR testing [1,2,6,7] and distinguishes the SLR neurodynamic test from a ham- string muscle length test [8]. From here forward SLR will refer to neurodynamic testing. It has been proposed that identification of a “positive,” clinically relevant test should include consideration of three components [5]. These components include 1) reproduction of the patient’s symptoms in whole or in part, 2) distant move- ments away from that region altering the symptoms (structural differentiation), and 3) identification of differ- ences in sensory, range of motion or resistance to move- ment noted between limbs or known norms [5]. Limb elevation angle at the point of a sensory response pro- vides a mobility measurement for the third component. Ideally, normative SLR range of motion in healthy, asymptomatic individuals could be used for comparisons to testing in clinical populations. Unfortunately, when used as a neurodynamic test, normal SLR range of mo- tion is highly variable, averaging from 40° to 85° [1,3,6,9]. The large degree of variability in range of mo- tion makes valid identification of mobility impairments difficult.
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IMMEDIATE EFFECT OF NEURODYNAMIC SLIDING TECHNIQUE VERSUS MULLIGAN BENT LEG RAISE TECHNIQUE ON HAMSTRING FLEXIBILITY IN ASYMPTOMATIC INDIVIDUALS

IMMEDIATE EFFECT OF NEURODYNAMIC SLIDING TECHNIQUE VERSUS MULLIGAN BENT LEG RAISE TECHNIQUE ON HAMSTRING FLEXIBILITY IN ASYMPTOMATIC INDIVIDUALS

the immediate effect of a suboccipital muscle inhibition (SMI) technique on hamstring flexibility that measured by the forward flexion distance test; straight leg raise test; and popliteal angle test and pressure pain threshold (PPT) over myofascial trigger points (MTrPs) in the hamstring musculature. Results in their study demonstrated that the SMI technique modified the flexibility of the hamstring muscles on all outcome measures, and furthermore, there was a significant difference in pressure algometry (PPT) for MTrPs in the right semimembranosus following the SMI (p ¼ .021) but not the left semimembranosus (p ¼ .079). 21 The
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Fluid responsiveness prediction using Vigileo FloTrac measured cardiac output changes during passive leg raise test

Fluid responsiveness prediction using Vigileo FloTrac measured cardiac output changes during passive leg raise test

The aim of this study was to assess the accuracy of the Vigileo ™ monitor (Vigileo ™ ; FloTrac; Edwards ™ ; Lifesciences, Irvine, CA, USA) using third-generation software (version 3.02),[r]

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Volume 5, Issue 12, 2019

Volume 5, Issue 12, 2019

The FMS test battery including 7 stations as the deep squat, the hurdle step, the in-line lunge, shoulder mobility, active straight-leg raise, trunk stability push-up, and the rotary trunk was applied. The total scores of the people were obtained by having them perform totally 7 individual movement patterns. Each movement was scored between 0-3. Therefore, the participants had a score between 0-21 points. The scores obtained in each movement were added and the FMS total score of a participant was calculated. For each movement pattern, scoring was performed based on the criteria from the norm table. The functional movement screens of the students were assessed with the help of FMS test kit including hurdle and test strip (Cook et al., 2010).
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Tight Hamstring Syndrome Related Lumbar Disc Herniation and Its Rehabilitation Program to Two Case Reports

Tight Hamstring Syndrome Related Lumbar Disc Herniation and Its Rehabilitation Program to Two Case Reports Emine Eda Kurt 1* , Öznur Büyükturan 2, Figen Tuncay1 and Hatice Rana Erdem 1

Case Report 1: 17 year old male was complaining of low back and right leg pain which spread to the back right leg for last two month. He walking with limited forward flexion and right knee flexion. Stright leg raising test (SLRT) was leading to elevation of whole body like a board with painful and patient was suffering from pain when his legs was elevated to 30 degree. Popliteal angle of effected sign was 87 degrees. There was no weakness of lower extremity. MRI of lumbar spine showed L5-S1 right far lateral disc herniation. It was decided that patient’s diagnosis was THS depending on lumbar discopathy. Medical treatment, conventional physical therapy (15 session) and Mulligan traction straight leg raise technique (TSLR) were applied (9 session). After the
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A Comparative Study on Effectiveness of Mulligan’s Rotation Mobilization with Movement Versus Deep Heating Modality along with Quadriceps Exercises in the Management of Osteoarthrosis Knee Subjects.

A Comparative Study on Effectiveness of Mulligan’s Rotation Mobilization with Movement Versus Deep Heating Modality along with Quadriceps Exercises in the Management of Osteoarthrosis Knee Subjects.

1 Research Design Flow Chart 21 2 Mulligan’s Rotation Mobilization with Movement 24 3 Shortwave diathermy treatment 25 4 a Static Quadriceps Exercise 26 4 b Straight Leg Raise 27 4 c Kne[r]

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Pregnancy related pelvic girdle pain in nulliparous women in Ireland : a longitudinal mixed methods study

Pregnancy related pelvic girdle pain in nulliparous women in Ireland : a longitudinal mixed methods study

and decreased diaphragmatic excursion during an active straight leg raise in a supine position in 13 people with pelvic girdle pain compared to age, gender and body mass index matched controls. This discrepancy was improved through a motor control learning intervention (O'Sullivan & Beales 2007). Although it has been questioned whether intra-abdominal pressure has a function in lumbopelvic stabilisation or is just a result of the contraction of stabilising muscles (Marras & Mirka 1996), Hodges et al. (2005) showed that intra-abdominal pressure does increase spinal stiffness regardless of abdominal muscles contraction. However, intra-abdominal pressure also increases the load on the pelvis. This can potentially have a harmful effect and may lead to pain if loads exceed 100N, which is the amount of force that provides relief when wearing a pelvic belt by reducing vertical shear force and increasing sacroiliac joint compression (Mens et al. 2006, Pel et al. 2008a). Intra-abdominal pressure increases with the size of the abdomen during pregnancy. Nevertheless, Mens et al. (2006) found that transversus abdominis and pelvic floor muscle contraction, exercises commonly used in treatment of PPGP, do not significantly increase intra- abdominal pressure and therefore are not contraindicated. Bearing this in mind, the observed descend of the pelvic floor during an active straight leg raise (O'Sullivan & Beales 2007) could be a reaction to relieve the intra- abdominal pressure putting excessive load on the pelvis, rather than a failure of the pelvic floor muscles to contract appropriately.
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A Comparison of the Effect of Muscle Energy Technique (Chaitow Method) and Passive Stretching on Hamstring Extensibility

A Comparison of the Effect of Muscle Energy Technique (Chaitow Method) and Passive Stretching on Hamstring Extensibility

Some researchers have found no difference between the effectiveness of isometric stretching techniques and passive stretching on hamstring muscle extensibility. Gribble et al (1999) compared the effects of static stretching with hold relax stretching on the hamstring muscles flexibility measured using Straight Leg Raise (SLR), and active knee extension (AKE). Gribble et al concluded that both of these techniques improved flexibility, however, no significant differences between the effectiveness of these techniques were found (Gribble et al 1999). Similarly Feland et al (2001) measured the effects of contract relax (CR) stretching, static stretch and no stretching on hamstring flexibility and found that all groups increased in flexibility from pre-test to post-test, however the increase was greater for the two treatment groups. The median difference in flexibility was one degree in the control group, five degrees in the CR stretching group and four degrees in the static group. Therefore the benefits in flexibility between CR stretching and static stretch were similar.
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Stress and stability comparison between different systems for high tibial osteotomies

Stress and stability comparison between different systems for high tibial osteotomies

Two plate-leg factors enhanced the biomechanical per- formance of the HTO construct: more screws to support the knee loads and the wider supporting base below the opening. The two-leg system provides more screws to stabilize the medial opening, thus significantly decreas- ing the plate and bone stresses and suppressing the wedge micromotion (Figures 5 and 6). For the T+I and π systems, there are two nearly parallel legs to transmit the knee loads through the opening (Figure 1). The current authors hypothesized that the plate serves as a fulcrum to transmit the knee loads from the proximal to the distal bones. With respect to the sagittal plane, the nonuniform distribution of the knee loads potentially in- duced a counterclockwise moment to the tibial plateau (Figures 3b and 8). The original loads and induced mo- ment were balanced by the plate and remaining cortex at the wedge tip (i.e. edge cc). The two plate legs can reconstruct a wider supporting base to behave as an effective force-couple mechanism. The anterior leg is
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Effects of erythropoietin on muscle O2 transport during exercise in patients with chronic renal failure

Effects of erythropoietin on muscle O2 transport during exercise in patients with chronic renal failure

Possible exercise training during rHuEPO therapy. In the current study, to preclude training occurring as a result of feel- ing better after rHuEPO therapy, all CRF patients were re- peatedly instructed to maintain the same level of daily physical activity throughout the protocol. However, if any spontaneous training effect had developed as a result of the improvement of both quality of life and exercise tolerance, the end result would have presumably been an increase in leg and muscle O 2 con-

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Letters to the Editor

Letters to the Editor

the superior ilium anteriorly to elongate that lower limb and a hypothenar ischial tuberosity push on the long leg side, or 2) no manipulation. Bilateral SI joint CMT was chosen over unilateral short leg PSIS manipulation based on preliminary data by our lab on the lack of effectiveness of unilateral corrective CMT to improve gait symmetry of our student participants (unpublished data). All CMT con- sisted of a high-velocity low-amplitude force delivered three times in a row using a drop table (Ergostyle 2000, Chattanooga Group Inc., Hixson, TX, USA). The intent of the drop table was to try to keep the amount of force reasonably standardized. This prone form of CMT was selected to decrease the likelihood of making researchers remove more reflective surface markers than the five that were absolutely necessary to remove. One minute after receiving SI joint CMT or no CMT the study participant engaged in their walking post-kinematic analysis.
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The double contact phase in walking children

The double contact phase in walking children

Recently, Donelan et al. (2002a) measured the work done by one leg pushing against the other during DC in walking adults. This mechanism had been discussed by Alexander and Jayes as early as 1978 (Alexander and Jayes, 1978), but the mechanical work had never before been measured. During DC, both legs are on the ground simultaneously and exert horizontal forces in opposite directions; the back leg is pushing forwards while the front leg is pushing backwards. The work performed during DC by the muscles of the back leg can be considered in two parts: the first is to accelerate and raise the COM, and the second is to compensate for the work simultaneously absorbed by the muscles of the front leg to redirect the trajectory of the COM. The first part is measured as W ext but
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