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Identifying gait asymmetry using gyroscopes--a cross-correlation and Normalized Symmetry Index approach

Gouwanda D, Senanayake SM

J Biomech, 2011 Mar 15;44(5):972-8.
PMID: 21306714 DOI: 10.1016/j.jbiomech.2010.12.013

Injury to a lower limb may disrupt natural walking and cause asymmetrical gait, therefore assessing the gait asymmetry has become one of the important procedures in gait analysis. This paper proposes the use of wireless gyroscopes as a new instrument to determine gait asymmetry. It also introduces two novel approaches: normalized cross-correlations (Cc(norm)) and Normalized Symmetry Index (SI(norm)). Cc(norm) evaluates the waveform patterns generated by the lower limb in each gait cycle. SI(norm) provides indications on the timing and magnitude of the bilateral differences between the limbs while addressing the drawbacks of the conventional methods. One-way ANOVA test reveals that Cc(norm) can be considered as single value indicator that determines the gait asymmetry (p<0.01). The experiment results showed that SI(norm) in asymmetrical gait were different from normal gait. SI(norm) in asymmetrical gait were found to be approximately 20% greater than SI(norm) in normal gait during pre-swing and initial swing.

Matched MeSH terms: Lower Extremity/pathology*
Periodical gait asymmetry assessment using real-time wireless gyroscopes gait monitoring system

Gouwanda D, Senanayake SM

J Med Eng Technol, 2011 Nov;35(8):432-40.
PMID: 22074136 DOI: 10.3109/03091902.2011.627080

A real-time gait monitoring system that incorporates an immediate and periodical assessment of gait asymmetry is described. This system was designed for gait analysis and rehabilitation of patients with pathologic gait. It employs wireless gyroscopes to measure the angular rate of the thigh and shank in real time. Cross-correlation of the lower extremity (Cc(norm)), and normalized Symmetry Index (SI(norm)) are implemented as new approaches to periodically determine the gait asymmetry in each gait cycle. Cc(norm) evaluates the signal patterns measured by wireless gyroscopes in each gait cycle. SI(norm) determines the movement differences between the left and right limb. An experimental study was conducted to examine the viability of these methods. Artificial asymmetrical gait was simulated by placing a load on one side of the limbs. Results showed that there were significant differences between the normal gait and asymmetrical gait (p < 0.01). They also indicated that the system worked well in periodically assessing the gait asymmetry.

Matched MeSH terms: Lower Extremity/pathology*
The anomalous origin and branches of the obturator artery with its clinical implications

Jusoh AR, Abd Rahman N, Abd Latiff A, Othman F, Das S, Abd Ghafar N, et al.

Rom J Morphol Embryol, 2010;51(1):163-6.
PMID: 20191138

The obturator artery (OA) originates from the internal iliac artery. Variation in the origin of the OA may be asymptomatic in individuals and occasionally be detected during routine cadaveric dissections or autopsies. In the present study, we observed the origin and the branching pattern of the OA on 34 lower limbs (17 right sides and 17 left sides) irrespective of sex. The bifurcation of the common iliac artery into internal and external iliac from the sacral ala varied between 4.3-5.3 cm. The distance of the origin of the anterior division of internal iliac artery from the bifurcation of common iliac artery varied between 1-6 cm. The distance of the origin of the posterior division of the internal iliac artery from the point of bifurcation of the common iliac artery varied between 0-6 cm. Out of 34 lower limbs studied, two specimens (5.8%) showed anomalous origin of the OA originating from the posterior division of the internal iliac artery. Of these two, one limb belonged to the right side while the other was from the left side. The anomalous OA gave off an inferior vesical branch to the prostate in both the specimens. No other associated anomalies regarding the origin or branching pattern of the OA were observed. Prior knowledge of the anatomical variations may be beneficial for vascular surgeons ligating the internal iliac artery or its branches and the radiologists interpreting angiograms of the pelvic region.

Matched MeSH terms: Lower Extremity/pathology
Cellulitis: An unusual manifestation of Neisseria meningitidis infection

Muhd Yusoff NH, Zainol Rashid Z, Sulong A, Shafiee MN, Ismail Z

Malays J Pathol, 2019 Dec;41(3):351-354.
PMID: 31901921

INTRODUCTION: Neisseria meningitidis infections often cause severe meningitis as well as bacteraemia. However, cellulitis in meningococcal diseases have rarely been described. Here, we report a case of right lower limb cellulitis caused by N. meningitidis.
CASE REPORT: A 69-year-old woman presented with fever and lower limb swelling. She had diabetes mellitus, hypertension, dyslipidaemia and a history of surgical resection of vulvar carcinoma. N. meningitidis was isolated from her blood culture.
DISCUSSION: This report provides additional evidence in support of N. meningitidis as a cause of cellulitis.

Matched MeSH terms: Lower Extremity/pathology
Fulltext Elephantiasis nostras verrucosa: a rare complication of lower limb lymphoedema

Kar Keong N, Siing Ngi AT, Muniandy P, Voon Fei W

BMJ Case Rep, 2017 Aug 28;2017.
PMID: 28847994 DOI: 10.1136/bcr-2017-221492

We reported a case of a 49-year-old man who had chronic lymphoedema of bilateral lower limbs for 30 years, but he did not seek treatment. His disease was complicated with irreversible changes of elephantiasis nostras verrucosa and had recurrent admissions due to infection. He was not keen for surgical intervention. This case report illustrated a rare and non-reversible complication of a common skin disease, lymphoedema and also the importance of identifying and treating it early.

Matched MeSH terms: Lower Extremity/pathology*