We report clinical and histological features of 16 consecutive patients with hypertensive leg ulcers. The lumen/wall ratio in arterioles at the edges of these hypertensive leg ulcers was compared with that in other types of chronic leg ulcers and was found to be significantly reduced (P < 0.001). Additional conditions such as venous hypertension or main vessel arterial disease contributed. Nineteen of 22 ulcers were completely healed after a mean of 4.9 months. Recognition of this condition enables correct treatment choice, which usually involves excision and grafting, and early healing.

Study Design: Single group, post-test design using the uninvolved lower extremity as the experimental control. Objectives: To determine relationships between ankle swelling and flexor digitorum longus and peroneus longus H-reflex amplitude and latency.Backgnnmd: Primary capsuloligamentous injury, neural injury, and joint effusion and swelling may contribute to H-reflex changes following inversion ankle sprain. The relationship between ankle swelling and invertor or evertor H-reflexes has not been reported. Methods and Measures: Fifteen subjects with acute grade I or II inversion ankle sprains (mean + SD) 6.5 + 3 days after onset participated in this study. Swelling was estimated using a tape measure and the figure-of-eight girth assessment method. H-reflexes were determined using standard techniques. Paired t-tests were used to compare mean differences in ankle girth (swelling) and ankle invertor or evertor H-reflex amplitude and latency between the involved and uninvolved limbs. Pearson product moment correlations were used to assess relationships between swelling and H-reflex variables.Results: Involved limb ankle girth was increased with respect to the uninvolved limb (1.5 + 0.9 cm) and the involved ankle flexor digitorum longus latency was delayed (0.72 2 0.7 ms). There was a moderate positive association (r = 0.73) between the latency delay in the involved ankle flexor digitorum longus and swelling. There were no significant differences in H-reflex amplitude and peroneus longus latency between ankles. Conclusions: Grade I or II inversion sprains and the related swelling appear to delay involved ankle flexor digitorum longus latency to a greater extent than peroneus longus latency. Clinicians need to direct greater attention to the ankle invertors when designing and implementing ankle rehabilitation programs, particularly during the swelling management phase of treatment. ) Olthop Sports Phys Ther l999;29:33%344.

Background and Purpose. In patients with patellofemoral pain syndrome (PFPS), the authors determined which aspects of the examination could be used to identify those patients most likely to respond to off-the-shelf foot orthoses and instruction in activity modification. Participants and Methods. Fifty participants were enrolled in the study, and data for 5 individuals were excluded from analysis. Thirty-four men and 11 women completed the study. Participants were given foot orthoses and instructed in activity modification for 3 weeks. A 50% reduction in pain was considered a success. Likelihood ratios (LRs) were computed to determine which examination findings were most predictive of success. Results. The best predictors of improvement were forefoot valgus alignment of ≥2 degrees (+LR=4.0, 95% confidence interval [CI]=0.7–21.9), great toe extension of ≤78 degrees (+LR=4.0, 95% CI=0.7–21.9), and navicular drop of ≤3 mm (+LR=2.4, 95% CI=1.3–4.3). Discussion and Conclusion. The results suggest that patients with PFPS who have forefoot valgus alignment of ≥2 degrees, passive great toe extension of ≤78 degrees, or navicular drop of ≤3 mm are most likely to respond favorably to initial intervention with an off-the-shelf foot orthosis and instruction in activity modification.

Study Design: Prospecfive correlational study involving a convenience sample. Objectk To investigate the relationships among figure-ofeight girth measurements and functional level in patients with acute lateral ankle sprains to determine the appropriate use of these clinical measures. Background: Research has shown that subjective scales of perceived athletic ability and measurements of swelling are useful in assessing clinical improvement following an acute ankle sprain; however, the relationship between ankle swelling and level of function is not known. Methods and Measures: Twenty-nine subjects (20 men, 9 women) varying in age from 18-59 years of age (mean age, 30.8 + 11.37) with acute lateral ankle sprains were included in this study. Each subject was evaluated by 1 of 3 raters for ankle girth, weight-bearing status, and functional level as determined by a modified Ankle Osteoarthritis Scale (AOS) and the Foot and Ankle Ability Index (FAAI). This study also investigated the relationship between these measures and the sport subscale of the FAAl (FAA1 sport). This is an &item subscale which includes questions on running, jumping, landing, quick starts and stops, cutting or lateral movements, low impact activities, ability to perform an activity with normal technique, and ability to participate in desired sports. Results: No significant correlations were found behyeen figurwfeight girth measurements and functional level. However, we did find moderate to good correlations between the FAA1 vs. weight-bearing (rho = 0.73), FAA1 vs. AOS (rho = -0.79), FAA1 sport vs. weight-bearing (rho = 0.68), FAA1 vs. FAA1 Sport (rho = 0.73), weight-bearing vs. AOS (rho = -0.571, and FAAl Sport vs. AOS (rho = -0.50). Conclusions: The figure-ofeight method is highly reliable and is appropriate for measuring ankle swelling however, it does not correlate with functional level as determined by the modified AOS, FAAI, or observed weight-bearing status during gait. Therefore, clinicians should refrain from making assumptions about function based on ankle swelling. ) Orthop Sportr Phys 7her 2001;3 1:384-388.

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