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Bone & Joint Research
Vol. 2, Issue 9 | Pages 179 - 185
1 Sep 2013
Warwick DJ Shaikh A Gadola S Stokes M Worsley P Bain D Tucker AT Gadola SD

Objectives

We aimed to examine the characteristics of deep venous flow in the leg in a cast and the effects of a wearable neuromuscular stimulator (geko; FirstKind Ltd) and also to explore the participants’ tolerance of the stimulator.

Methods

This is an open-label physiological study on ten healthy volunteers. Duplex ultrasonography of the superficial femoral vein measured normal flow and cross-sectional area in the standing and supine positions (with the lower limb initially horizontal and then elevated). Flow measurements were repeated during activation of the geko stimulator placed over the peroneal nerve. The process was repeated after the application of a below-knee cast. Participants evaluated discomfort using a questionnaire (verbal rating score) and a scoring index (visual analogue scale).


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_II | Pages 305 - 305
1 May 2006
Khakha R Bloomer Z Bain D Nicholson G Gall A Ferguson-Pell M
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Introduction: Studies have shown Near Infrared Spectroscopy (NIRS) as being an effective tool in measuring oxygenation non-invasively in tissues. More recently it has been used in clinical settings to assess circulatory and metabolic abnormalities, however, clinical studies in bone are lacking.

Materials and Methods: Ten able-bodied (AB) (5 men and 5 women; age, 23-40 years) and ten spinal cord injured (SCI) (complete cord transection above T10, 5 men and 5 women; age 19–38) participants were matched by age, gender, skin pigmentation and studied.

A spectrometer measured between 498-1000nm, at 0.2Hz , using glass optodes (2mm diameter). Five minutes of resting readings, followed by 3 minutes of below knee arterial occlusion and then 6 minutes post-occlusion were made. The second study, started with 5 minutes of resting readings, vibration loading for 3 minutes at 30 Hz with acceleration of 3g and 6 minutes post-vibration was then conducted.

Results: NIRS showed changes in blood parameters during the hyperemic response (avg. 97% increase in Hb from baseline, p< 0.0001). Able-bodied subjects had significantly quicker (p=0.01) capacity for Hb to return to baseline. There was a significant difference (p=0.001) in the time to peak for Hb following arterial occlusion in the SCI group, 16.6 seconds (sd 4.3), and 10.1 seconds (sd 1.7) in the able bodied.

Conclusion: Our findings suggest that there is a reduction in the bone’s ability to restore oxygenated blood in SCI participants compared to the AB participants. Future studies looking at changes in bone following a range of vibration amplitudes and frequencies in the SCI group should be considered using NIRS in order to optimize potential clinical benefits.