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Purpose: To determine the acute cardiovascular and perceptual responses of low-load exercise with or without blood flow restriction and compare those responses to that of moderately heavy exercise., Methods: Twenty-two participants completed unilateral elbow flexion exercise with a moderately heavy-load- [70% one-repetition maximum (1RM); 70/0] and with three low-load conditions (15% 1RM) in combination with 0% (15/0), 40%, (15/40) and 80% (15/80) arterial occlusion pressure. Participants exercised until failure (or until 90 repetitions per set). The cardiovascular response (arterial occlusion) was measured pre and post exercise and the perceptual responses [ratings of perceived exertion (RPE) and discomfort] were determined before and after each set of exercise., Results: For arterial occlusion pressure, the lower-load conditions had greater change from pre to post compared to 70/00 (e.g., 15/80: 44 vs. 70/0: 34 mmHg). RPE was highest across the sets for the 15/80 condition with the other conditions having similar RPE (e.g., set 4: median rating of 17.2 for 15/80 vs. ~ 15.5 for other conditions). Ratings of discomfort were also greatest for the 15/80 condition (15/80 > 15/40 > 15/0 > 70/0). Exercise volume within the 15/0 and 15/40 conditions were similar but were significantly greater than that observed with the 15/80 and 70/0 conditions., Conclusion: Low-load exercise to volitional failure results in a greater cardiovascular response to that of moderately heavy-load exercise. When high pressure is applied to low load exercise, there is a reduction in exercise volume but an elevated perceptual response that may be an important consideration when applying this stimulus in practice.

Arterial vasculopathy is a well-recognized but uncommon manifestation of neurofibromatosis type 1 (NF-1). It can manifest as stenoses, aneurysms or arteriovenous malformations. NF-1 vasculopathy typically involves the aorta, visceral arteries or carotid-vertebral circulation. Aortic and visceral vasculopathy typically presents as stenotic lesions, while aneurysms have been reported primarily in the subclavian/vertebral arteries. Aneurysms of the peripheral/extremity arteries are an extremely rare complication of NF-1 that may present as a mass or spontaneous rupture. We present the case of a teenage boy with an arm mass secondary to an aneurysm. We hope this case will increase recognition of the variable clinical manifestations of NF-1 vasculopathy among radiologists.

This study compared cardiovascular responses to static extension and flexion exercises at four upper and lower limb joints. Eight males performed a 2 min static contraction at 30% of maximal voluntary torque followed immediately by 2 min post-exercise muscle ischaemia (PEMI) using each of four joints: the wrist, elbow, ankle, and knee. In the PEMI, an occlusion cuff placed around the proximal portion of the exercising muscle was inflated to 250 mmHg immediately before the cessation of exercise. Mean arterial pressure (MAP), heart rate (HR), calf blood flow, and calf vascular conductance (CVC) in the non-exercised calf were measured. There was a significant interaction for direction of movement (extension vs. flexion) and limb (upper vs. lower) in HR and CVC during both exercise and PEMI; extension in the wrist and elbow evoked a greater increase in HR and a greater decrease in CVC than flexion, whereas flexion in the ankle and knee elicited a greater increase in HR and a greater decrease in CVC than extension. These results suggest that the cardiovascular responses to extension and flexion differ between arms and legs, partly arising from the activation of the muscle metaboreflex.

The complex injury is characterized by a fracture and/or dislocation of the elbow in association with a serial injury of the upper extremity, or a severe soft tissue trauma, or a prolonged ischemia caused by vascular injury or compartment syndrome. They are defined as complex injuries because their treatment differs from that of a simple fracture implying that standardized concepts usually cannot be employed. The results of primary treatment show a high rate of complications. They are accompanied by functional deficits including pseudarthrosis and ankylosis. As a consequence, ulnar neuropathy may occur. Inadequate treatment leads to delayed rehabilitation and several secondary operations. The main goal points at the reconstruction of the elbow joint to restore function. Therefore, the logistical pathway of individual therapy is the key for success. The operation has to include fracture stabilisation of all injuries of the upper extremity. Only stable osteosynthesis makes early mobilisation possible. Transfixation of the elbow joint should be reserved for exceptional cases. The principals of AO have proven to be practical both for the distal humerus and the proximal forearm. Successful reconstruction of the elbow joint often demands extended approaches. ORIF of the proximal ulna can be achieved by indirect reposition techniques. Dynamic stabilisation should be established by conservation of the radial head and coronoid process. For treatment of soft tissue injury it is necessary to undertake local reconstructive measures. Operative treatment is widely indicated for forearm compartment syndrome. Diagnosis and therapy of possible accompanying vascular injury should be made early to avoid prolonged ischemia. Operative treatment of nerve injury is only indicated in case of sharp dissection of the nerve. Otherwise the reconstruction should be performed, but not earlier than three months. Rehabilitation outcome depends on primary therapy. Sufficient functional results are only achieved after early mobilisation and intensive physiotherapy. If necessary, arthrolysis is planned early and combined with removal of implants at 6 months post injury.