Intermittent Claudication Study

An attending physician statement completed by Dr. Peter Chweyah (Internal Medicine), dated 06/16/2016, indicated that the claimant presented with complaints of lower extremity weakness, neuropathy, weight loss, acute renal failure, and gout, as well as anemia. Objective findings showed an extreme weakness of the legs and pain in the feet. He also had diabetes mellitus type 2, chronic kidney disease, and hypertension. It was noted that the claimant was totally disabled from 05/30/2017 through 06/15/2017 and 05/23/2017 - 05/26/2017 secondary to gout.

#2. What changes in Jim's muscles promote unloading of O2 from hemoglobin for use by the muscles cells?

The EMS increase also the strength ans muscular mass, and you can elevate the intensity of your training, means more and more fibres are recruited in the

The patient is a 50 year old male construction worker who sustained a work-related injury while lifting heavy boxes of metals. In an office visit dated 12/14/13, patient complaints of intermittent severe low back pain which radiates to bilateral lower extremities. The claimant had an epidural injection, which significantly alleviated right leg pain for a short period of time. Unfortunately pain has returned. It is in the right leg as well as severe pain in the lower back. The claimant wishes to consider surgical intervention due to severity of pain. Objective examination reveals weakness in the right extensor halucis longus and anterior tibialis which are 4+/5. The claimant has diminished sensation along the dorsum of right foot. The claimant has a positive straight leg raise.

There is pain with lumbar flexion and extension. There is no aberrant behavior. The patient feels that he can perform increased activities of daily living with his current medications.

Based on the progress report dated 08/23/16, the patient complains left knee pain upon walking. Discomfort was described as aching, tingling, intense, severe, continuous, pain, discomfort, increasing with movement and varying with activity. Pain is rated as 5/10 without medications and 4/10 with medications.

Based on the progress report dated 09/12/16, the patient reports more frequent pain with activity since the last

This activity is the critical driving force of muscle contraction. The stream of action potentials along the muscle fiber surface is terminated as Acetylcholine at the neuromuscular junction is broken down by acetyl cholinesterase. The release of Calcium ions is ceased. The action of the myosin molecule heads is obstructed because of the change in the configuration of troponin and tropomyosin due to the absence of calcium ions. This will eventually cause the contraction to be ceased. Together with these physical processes, an external stretching force such as gravity pulls the muscle back to its normal length.

Intermittent claudication is a symptom of Peripheral Arterial Disease (PAD). PAD is the gradual narrowing or full or partial blockage of the arteries due to plague, which is also known as atherosclerosis. This blockage deprives the lower extremities form receiving adequate blood that contain oxygen and nutrients. Smoking, obesity, hyperlipidemia, hypertension, diabetes mellitus and familial preposition puts patient at a higher risk for PAD. The elderly are also at a higher risk for PAD due to their various illness. PAD can lead to strokes, chronic angina and myocardial infraction (MI). A nurse assessing a patient with PAD will notice bruit or aneurysm during assessment. This is the first stage of PAD which is also known as the asymptomatic

jacket. This pain should not affect the patient’s ability to feed himself or use the toilet because

Able to walk without a mechanical aid for only short distances (e.g. 1 block at most) with a mild

muscles run out of oxygenated blood and the arteries cannot keep up with the demand because of

Stimulation of Red blood cells which brings a changes in muscles by increasing the level of oxygen, which further leads to carry oxygen and nutrition to every area of body including skin, hair bones and muscles.

provide the muscles with the nutrients they need for their repair. As blood and lymph flow is helped

Increase the glucose uptake by cell membrane of the skeletal muscle cells and fat cells, increased protein synthesis