Margarida Florindo, Sérgio Loureiro Nuno, Luis Monteiro Rodrigues
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引用次数: 3
Abstract
Introduction: The human lower limb is widely used as a model to study in vivo microcirculatory physiology and pathophysiology. It is a preferential target for critical comorbidities (overweight, diabetes, and peripheral vascular disease). Movement and activity are consistently regarded as beneficial, but the related adaptive physiology is still poorly understood. Our goal was to better identify the foot microcirculatory changes after a regular walking gait activity in healthy subjects of different ages.
Methods: Twelve healthy participants of both sexes, with normal BMI and Ankle-Brachial Index, were selected and grouped according to age - group I (21.0 ± 1 y.o.) and group II (55.8 ± 3 y.o.). The protocol involved 2 phases of 5-min duration each - phase 1, a static standing position, and phase 2, 5-min walking with a comfortable pace on a pre-established circuit. Perfusion changes were assessed in the dorsal region of both feet before (baseline, phase 1) and after (phase 2) the gait period by noninvasive optical technologies - laser Doppler flowmetry (LDF), photoplethysmography, and polarized spectroscopy (PSp). Comparative statistics were performed with a 95% confidence level.
Results: All instruments detected an asymmetric nonsignificant perfusion between right and left feet during rest in all participants with values in females consistently lower than men. Older participants exhibited lower baseline values than the younger group. Gait evoked a perfusion reduction in all participants relative to phase 1 detected with all technologies, with statistically significant changes recorded with LDF (group I, p = 0.033, and group II, p = 0.028) and PSp (group II, p = 0.041). Furthermore, LDF revealed that gait significantly reduced perfusion velocity in the older group (p = 0.003). Corresponding changes in the younger group were present but discrete. Recovery to baseline levels was also slower in the older group.
Discussion/conclusions: Our results confirm that perfusion is age dependent and demonstrate the clinical relevance of simple dynamic activities such as gait. This reduction of the dorsal foot perfusion occurs in depth, being more pronounced with the movement intensity, suggesting a wide application potential in early diagnostics as for rehabilitation.
人体下肢被广泛用作研究体内微循环生理和病理生理的模型。它是治疗严重合并症(超重、糖尿病和周围血管疾病)的首选靶点。运动和活动一直被认为是有益的，但相关的适应性生理学仍然知之甚少。我们的目的是更好地识别不同年龄的健康受试者在常规步行步态活动后的足部微循环变化。方法:选取身体质量指数(BMI)、踝肱指数(Ankle-Brachial Index)正常的男女健康受试者12例，按年龄分为I组(21.0±1 y.o)和II组(55.8±3 y.o)。该方案包括2个阶段，每个阶段持续5分钟，第1阶段，静止站立，第2阶段，在预先建立的环路上以舒适的速度步行5分钟。通过非侵入性光学技术——激光多普勒血流仪(LDF)、光容积脉搏描记仪和偏振光谱(PSp)，评估步态期前(基线，第1阶段)和后(第2阶段)双脚背区灌注变化。比较统计以95%的置信水平进行。结果:所有仪器在所有参与者休息期间检测到左右脚之间不对称的无显著灌注，女性的值始终低于男性。年龄较大的参与者表现出比年轻组更低的基线值。步态诱发了所有参与者相对于第一阶段的灌注减少，LDF(组I, p = 0.033，组II, p = 0.028)和PSp(组II, p = 0.041)记录了具有统计学意义的变化。此外，LDF显示步态显著降低了老年组的灌注速度(p = 0.003)。在年轻的一组中，相应的变化是存在的，但是离散的。老年人恢复到基线水平的速度也较慢。讨论/结论:我们的研究结果证实灌注是年龄依赖性的，并证明了简单的动态活动(如步态)的临床相关性。这种足背灌注的减少发生在深度，随着运动强度的增加而更加明显，这表明在早期诊断和康复方面具有广泛的应用潜力。
期刊介绍：
In the past decade research into skin pharmacology has rapidly developed with new and promising drugs and therapeutic concepts being introduced regularly. Recently, the use of nanoparticles for drug delivery in dermatology and cosmetology has become a topic of intensive research, yielding remarkable and in part surprising results. Another topic of current research is the use of tissue tolerable plasma in wound treatment. Stimulating not only wound healing processes but also the penetration of topically applied substances into the skin, this novel technique is expected to deliver very interesting results.
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