A 3-Dimensional Gait Analysis of the Effects of Fatigue-Induced Reduced Foot Adductor Muscle Strength on the Walking of Healthy Subjects.

Dysfunction of the tibialis posterior muscle is the most common cause of adult acquired flat foot. Tibialis posterior muscle weakness has been observed in several patient populations, including those in the early stages of rheumatoid arthritis. However, the influence of tibialis posterior weakness on gait mechanics is not fully understood, although gait instability has been reported. In 24 healthy participants, 3-dimension lower limb kinematics and kinetics during walking were evaluated bilaterally, before and after, a muscle fatigue protocol aiming to decrease the right foot adductor muscles strength, including the tibialis posterior muscle. The 3-dimension gait kinematics and kinetics were analyzed with statistical parametric mapping. The stance phase duration was increased for the right side. The right ankle external rotation moment decreased, and the left hip extension moment increased with reduced muscle strength compared with normal strength conditions. These changes are similar in patients with dysfunction in the tibialis posterior muscle, indicating that compensatory strategies observed in these patients might be related to the loss of tibialis posterior muscle strength. Such strategies may involve the unaffected side.

Venous Thromboembolism and Major Bleeding in Patients With Coronavirus Disease 2019 (COVID-19): A Nationwide, Population-Based Cohort Study.

BACKGROUND: Venous thromboembolism (VTE) is a potentially fatal complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and thromboprophylaxis should be balanced against risk of bleeding. This study examined risks of VTE and major bleeding in hospitalized and community-managed SARS-CoV-2 patients compared with control populations. METHODS: Using nationwide population-based registries, 30-day risks of VTE and major bleeding in SARS-CoV-2 positive patients were compared with those of SARS-CoV-2 test-negative patients and with an external cohort of influenza patients. Medical records of all COVID-19 patients at 6 departments of infectious diseases in Denmark were reviewed in detail. RESULTS: The overall 30-day risk of VTE was 0.4% (40/9460) among SARS-CoV-2 patients (16% hospitalized), 0.3% (649/226 510) among SARS-CoV-2 negative subjects (12% hospitalized), and 1.0% (158/16 281) among influenza patients (59% hospitalized). VTE risks were higher and comparable in hospitalized SARS-CoV-2 positive (1.5%), SARS-CoV-2 negative (1.8%), and influenza patients (1.5%). Diagnosis of major bleeding was registered in 0.5% (47/9460) of all SARS-CoV-2 positive individuals and in 2.3% of those hospitalized. Medical record review of 582 hospitalized SARS-CoV-2 patients observed VTE in 4% (19/450) and major bleeding in 0.4% (2/450) of ward patients, of whom 31% received thromboprophylaxis. Among intensive care patients (100% received thromboprophylaxis), risks were 7% (9/132) for VTE and 11% (15/132) for major bleeding. CONCLUSIONS: Among people with SARS-CoV-2 infection in a population-based setting, VTE risks were low to moderate and were not substantially increased compared with SARS-CoV-2 test-negative and influenza patients. Risk of severe bleeding was low for ward patients, but mirrored VTE risk in the intensive care setting.