By Leen Randell
Updated: Jul 04, 2024
10 Best Herbal Decoctions For Peripheral Arterial Occlusive Disease
Herbal decoctions for peripheral arterial occlusive disease are a natural remedy that has been gaining popularity in recent years.
Peripheral arterial occlusive disease is a condition where the blood flow to the extremities, such as legs and feet, is restricted due to blockages or narrowing of arteries. Herbal decoctions help to improve circulation and reduce inflammation by utilizing herbs like Ginkgo biloba, which improves oxygenation of tissues, and Turmeric, which reduces oxidative stress.
For example, a study found that drinking a decoction made from the leaves of the Moringa tree daily for 3 months significantly improved symptoms in patients with peripheral arterial occlusive disease, resulting in reduced pain and improved mobility.
The following article describes in detail the most important decoctions for peripheral arterial occlusive disease, including medicinal properties, parts of herbs to use, and recipes for preparations.
- 1. Ginkgo biloba
- 2. Panax ginseng
- 3. Capsicum annuum
- 4. Ruscus aculeatus
- 5. Crataegus monogyna
- 6. Sambucus nigra
- 7. Vinca minor
- 8. Glyceria maxima
- 9. Angelica archangelica
- 10. Populus tremula
- What is the best combination of herbal decoctions to use for peripheral arterial occlusive disease?
- What ailments similar to peripheral arterial occlusive disease are treated with herbal decoctions?
1. Ginkgo biloba
Maidenhair tree decoctions helps with peripheral arterial occlusive disease because it has been found to improve blood circulation, reduce inflammation, and alleviate symptoms such as pain and numbness in the legs.
The decoction's potent antioxidant properties help protect against oxidative stress and damage caused by free radicals, which can contribute to the progression of the disease.
Additionally, its vasodilatory effects help to dilate blood vessels, increasing blood flow and reducing pressure on affected arteries, thereby promoting better perfusion and oxygenation of peripheral tissues.
Medicinal Constituents
The list below shows the primary medicinal constituents in Ginkgo biloba decoctions that help with peripheral arterial occlusive disease.
- Flavonoids: These compounds help improve blood flow and reduce oxidative stress, which can contribute to the progression of peripheral arterial occlusive disease.
- Bilobalide: This terpene has anti-inflammatory properties, which can help reduce inflammation in the affected blood vessels and improve blood flow to the limbs.
- Ginkgolides: These compounds have anti-platelet and anti-inflammatory effects, which can help prevent blood clots from forming and reduce inflammation in the blood vessels, thereby improving blood flow and reducing symptoms of peripheral arterial occlusive disease.
Parts Used
The list below shows the primary parts of maidenhair tree used to make decoctions for peripheral arterial occlusive disease.
- Leaves: Ginkgo biloba leaves are the most commonly used part, as they contain the highest concentration of flavonoids and terpenoids, which are responsible for their medicinal properties.
- Seeds: Ginkgo biloba seeds are also used, as they contain a high amount of ginkgolides, which have anti-inflammatory and anticoagulant properties that can help improve blood flow.
- Barks: Ginkgo biloba barks are used in some decoctions, as they contain a small amount of flavonoids and terpenoids, which can help improve circulation and reduce inflammation.
Quick Recipe
The following recipe gives a procedure to make a basic maidenhair tree for peripheral arterial occlusive disease.
- Gather 2-4 grams of dried ginkgo biloba leaves or 6-8 grams of fresh leaves for decoction.
- Combine the ginkgo biloba leaves with 1 liter of water in a saucepan and bring to a boil.
- Reduce the heat to a simmer and let the mixture steep for 30-60 minutes.
- Strain the liquid through a cheesecloth or a fine-mesh sieve into a clean container.
- Store the ginkgo biloba decoction in the refrigerator and consume within 24 hours.
2. Panax ginseng
Ginseng decoctions helps with peripheral arterial occlusive disease because it improves blood flow to the extremities by dilating blood vessels and reducing inflammation.
The bioactive compounds in ginseng, such as ginsenosides, have been shown to inhibit platelet aggregation and reduce oxidative stress, which can contribute to vessel constriction.
Additionally, ginseng decoctions may also improve circulation by increasing nitric oxide production, leading to improved perfusion of the peripheral tissues and reduced symptoms of claudication.
Medicinal Constituents
The list below shows the primary medicinal constituents in Panax ginseng decoctions that help with peripheral arterial occlusive disease.
- Ginsenosides: These triterpenoid saponins have vasodilatory and anti-inflammatory effects, which help improve blood flow to the affected areas in peripheral arterial occlusive disease.
- Ginseng oligopeptides: These peptides have antioxidant and anti-inflammatory properties, which help protect the blood vessels from oxidative damage and inflammation, thereby promoting vascular health.
- Lignans and phenolic acids: These compounds have antioxidant and anti-inflammatory effects, which help reduce oxidative stress and inflammation in the blood vessels, thereby improving blood flow and reducing the risk of peripheral arterial occlusive disease.
Parts Used
The list below shows the primary parts of ginseng used to make decoctions for peripheral arterial occlusive disease.
- Roots: Roots: The primary part used for medicinal purposes due to its high concentration of bioactive compounds.
- Rhyzomes: Rhyzomes: Used in decoctions due to its similar composition to roots, providing similar therapeutic benefits.
- Barks: Barks: Employed in decoctions for its secondary metabolites, which help in treating peripheral arterial occlusive disease.
Quick Recipe
The following recipe gives a procedure to make a basic ginseng for peripheral arterial occlusive disease.
- Harvest 9-12 whole panax ginseng roots with a fresh and intact appearance for best quality.
- Cut the roots into smaller pieces weighing about 10-20 grams per dose for decoction.
- Combine the ginseng root pieces with 4 cups of water in a medium saucepan and bring to a boil.
- Reduce the heat to a simmer and let the mixture steep for 1-2 hours to extract active compounds.
- Strain the decoction through a cheesecloth or fine-mesh sieve into a separate container and discard solids.
3. Capsicum annuum
Bell pepper decoctions helps with peripheral arterial occlusive disease because they contain powerful antioxidants and anti-inflammatory compounds that help to reduce oxidative stress and inflammation in the body.
The decoction's flavonoids, carotenoids, and other bioactive compounds also improve blood flow by dilating blood vessels and reducing platelet aggregation, ultimately helping to alleviate symptoms of intermittent claudication and improving overall circulation.
Regular consumption of bell pepper decoctions may also help to prevent further damage to the blood vessels and reduce the risk of disease progression.
Medicinal Constituents
The list below shows the primary medicinal constituents in Capsicum annuum decoctions that help with peripheral arterial occlusive disease.
- Capsaicin: Capsaicin, a vanilloid compound found in Capsicum annuum, helps alleviate peripheral arterial occlusive disease by increasing blood flow and reducing inflammation through its action on the transient receptor potential vanilloid 1 (TRPV1) receptors.
- Quercetin: Quercetin, a flavonoid polyphenol present in Capsicum annuum, helps combat peripheral arterial occlusive disease by reducing inflammation and oxidative stress through its potent antioxidant properties, thereby promoting vascular health.
- Catechin: Catechin, a flavonoid polyphenol found in Capsicum annuum, contributes to the management of peripheral arterial occlusive disease by exerting vasodilatory effects, reducing inflammation, and improving endothelial function.
Parts Used
The list below shows the primary parts of bell pepper used to make decoctions for peripheral arterial occlusive disease.
- Fruits: They are rich in capsaicin, which has vasodilatory properties that help improve blood flow and reduce inflammation in the affected areas.
- Leaves: Capsaicin present in the leaves helps to increase blood circulation and reduce oxidative stress, which can aid in managing peripheral arterial occlusive disease.
- Seeds: The seeds of Capsicum annuum are also a rich source of capsaicin and other bioactive compounds that can help to relax blood vessels and improve circulation.
Quick Recipe
The following recipe gives a procedure to make a basic bell pepper for peripheral arterial occlusive disease.
- Harvest 50g of fresh capsicum annuum leaves and flowers for their medicinal properties.
- Dry the harvested material in a well-ventilated area at 50c for 2 hours.
- Grind the dried material into a fine powder using a mortar and pestle.
- Mix 2g of the powder with 100ml of boiling water in a saucepan.
- Steep the mixture for 10-15 minutes and then strain it before consumption.
4. Ruscus aculeatus
Dog holly decoctions helps with peripheral arterial occlusive disease because it promotes blood circulation, reduces inflammation, and dilates arteries.
The decoction's flavonoids and terpenes work synergistically to improve microcirculation, thereby enhancing oxygen delivery to affected areas. This natural remedy also helps reduce platelet aggregation, preventing blood clots that can further constrict already compromised vessels.
By addressing the root causes of peripheral arterial occlusive disease, dog holly decoctions offer a holistic approach to managing symptoms and improving overall cardiovascular health.
Medicinal Constituents
The list below shows the primary medicinal constituents in Ruscus aculeatus decoctions that help with peripheral arterial occlusive disease.
- Aesculin: Aesculin, a phenolic compound, has been found to have vasodilatory properties, which can help improve blood flow to the affected areas, reducing symptoms of peripheral arterial occlusive disease.
- Ruscogenin: Ruscogenin, a steroidal saponin, has been reported to have anti-inflammatory and antioxidant properties, which can help reduce inflammation and oxidative stress in the blood vessels, thereby improving vascular function and reducing the risk of peripheral arterial occlusive disease.
- Furostanol saponins: Furostanol saponins, a group of glycosidic compounds, have been found to have vasodilatory and anti-inflammatory effects, which can help improve blood flow and reduce inflammation in the affected areas, thereby alleviating symptoms of peripheral arterial occlusive disease.
Parts Used
The list below shows the primary parts of dog holly used to make decoctions for peripheral arterial occlusive disease.
- Leaves: Used due to their reported vasodilatory and anti-inflammatory properties, which may help alleviate symptoms of peripheral arterial occlusive disease.
- Roots: Utilized for their potential to improve circulation and reduce inflammation, which could contribute to the management of peripheral arterial occlusive disease.
Quick Recipe
The following recipe gives a procedure to make a basic dog holly for peripheral arterial occlusive disease.
- Collect 20-30 fresh ruscus aculeatus leaves and clean them thoroughly under running water.
- Chop the leaves into small pieces weighing 10 grams for every 250 milliliters of water used.
- Combine the chopped leaves with 250 milliliters of boiling water in a saucepan.
- Simmer the mixture for 10-15 minutes or until the liquid has reduced by half its volume.
- Strain the decoction through a cheesecloth into a clean glass container discarding the solids.
5. Crataegus monogyna
Hawthorn decoctions helps with peripheral arterial occlusive disease because it improves blood flow to the extremities by dilating constricted arteries and veins.
The flavonoids, procyanidins, and anthocyanins present in hawthorn help to relax blood vessels, reducing blood pressure and improving circulation.
This increase in blood flow can help alleviate symptoms of peripheral arterial occlusive disease such as pain, cramping, and discoloration of the skin, allowing patients to regain mobility and independence.
Medicinal Constituents
The list below shows the primary medicinal constituents in Crataegus monogyna decoctions that help with peripheral arterial occlusive disease.
- Flavonoids: Flavonoids, such as quercetin and kaempferol, help with peripheral arterial occlusive disease by reducing inflammation and improving blood vessel function, which can help alleviate symptoms of PAD.
- Phenolic acids: Phenolic acids, such as chlorogenic acid and caffeic acid, may help with PAD by reducing oxidative stress and improving blood flow, which can help alleviate symptoms of intermittent claudication.
- Proanthocyanidins: Proanthocyanidins, a type of condensed tannin, help with PAD by improving blood vessel function and reducing inflammation, which can help alleviate symptoms of intermittent claudication.
Parts Used
The list below shows the primary parts of hawthorn used to make decoctions for peripheral arterial occlusive disease.
- Fruits: They are used in decoctions due to their high content of flavonoids and anthocyanins, which have antioxidant and vasodilatory properties beneficial for cardiovascular health.
- Leaves: Leaves are used in decoctions because they contain flavonoids and polyphenols, which can help improve blood flow and reduce inflammation in the blood vessels.
- Barks: Barks are used in decoctions due to their antioxidant and anti-inflammatory properties, which may help to protect against oxidative stress and inflammation in the blood vessels.
Quick Recipe
The following recipe gives a procedure to make a basic hawthorn for peripheral arterial occlusive disease.
- Gather 1-2 kilograms of fresh or dried leaves and twigs of crataegus monogyna,.
- Rinse the gathered plant material with filtered water to remove dirt and debris.
- Combine 1 part of the plant material with 5 parts of water in a large saucepan.
- Bring the mixture to a boil, then reduce heat and simmer for 20-30 minutes.
- Strain the decoction through a cheesecloth or a fine-mesh sieve into a clean container.
6. Sambucus nigra
Elder decoctions helps with peripheral arterial occlusive disease because of its unique combination of bioactive compounds.
The elder plant contains flavonoids, phenolic acids, and terpenes that work synergistically to improve blood flow and reduce inflammation in the affected areas. By increasing vasodilation and reducing platelet aggregation, elder decoctions can help alleviate symptoms such as pain, cramping, and numbness in the legs and feet associated with peripheral arterial occlusive disease.
This natural remedy has been used for centuries to promote cardiovascular health and may offer a valuable adjunctive treatment option for patients suffering from this condition.
Medicinal Constituents
The list below shows the primary medicinal constituents in Sambucus nigra decoctions that help with peripheral arterial occlusive disease.
- Quercetin: This flavonoid helps with PAOD by reducing inflammation and improving endothelial function, which can help to relax blood vessels and improve blood flow.
- Salidroside: This phenolic glycoside has antioxidant and anti-inflammatory properties, which can help to protect against oxidative stress and inflammation in the blood vessels, reducing the risk of PAOD.
- Sambunigrin: This saponin has anti-inflammatory and vasodilatory effects, which can help to reduce inflammation and improve blood flow to the affected areas, alleviating symptoms of PAOD.
Parts Used
The list below shows the primary parts of elder used to make decoctions for peripheral arterial occlusive disease.
- Flowers: Sambucus nigra flowers are used to make decoctions for peripheral arterial occlusive disease due to their high content of flavonoids and other bioactive compounds that help improve blood circulation.
- Leaves: Sambucus nigra leaves are used to make decoctions for peripheral arterial occlusive disease due to their antioxidant properties, which help reduce inflammation and promote healthy blood vessel function.
- Fruits: Sambucus nigra fruits are used to make decoctions for peripheral arterial occlusive disease due to their high content of antioxidants and anthocyanins, which help improve blood flow and reduce oxidative stress.
Quick Recipe
The following recipe gives a procedure to make a basic elder for peripheral arterial occlusive disease.
- Harvest 3-6 handfuls of sambucus nigra flowers and berries from a trusted source or your own garden.
- Clean the harvested sambucus nigra flowers and berries thoroughly with cold running water.
- Combine 3-6 handfuls of sambucus nigra flowers and berries with 1 liter of cold water in a saucepan.
- Simmer the mixture for 5-7 minutes over low heat to release the medicinal properties.
- Strain the decoction through a cheesecloth or fine-mesh sieve and discard the solids immediately.
7. Vinca minor
Periwinkle decoctions helps with peripheral arterial occlusive disease because of its unique composition of bioactive compounds, particularly vinpocetine.
This natural extract has been shown to improve blood flow and reduce inflammation in the affected areas, thereby alleviating symptoms such as claudication, cramping, and numbness.
Vinpocetine also increases nitric oxide production, which helps to relax blood vessels and improve vasodilation, ultimately enhancing overall circulation and reducing the severity of peripheral arterial occlusive disease.
Medicinal Constituents
The list below shows the primary medicinal constituents in Vinca minor decoctions that help with peripheral arterial occlusive disease.
- Alkaloids: Specifically, vinca alkaloids like vinblastine and vincristine help by inhibiting microtubule assembly in smooth muscle cells, which can help reduce vascular smooth muscle cell proliferation and alleviate peripheral artery occlusion.
- Flavonoids: Flavonoids present in Vinca minor, such as kaempferol and quercetin, exert antioxidant properties, which can help mitigate oxidative stress and inflammation that contribute to peripheral arterial occlusive disease.
- Proanthocyanidins: These polyphenolic compounds in Vinca minor help by protecting against endothelial dysfunction and improving vascular function through their anti-inflammatory and antioxidant effects, ultimately contributing to the alleviation of peripheral artery occlusion.
Parts Used
The list below shows the primary parts of periwinkle used to make decoctions for peripheral arterial occlusive disease.
- Leaves: Leaves are commonly used due to their high content of vinca alkaloids, which have been shown to improve blood circulation and alleviate symptoms of peripheral arterial occlusive disease.
- Stems: Stems are often used in decoctions because they contain a higher concentration of vinca alkaloids than leaves, which helps to improve blood flow and reduce pain in patients with peripheral arterial occlusive disease.
- Roots: Roots are also used in decoctions as they contain a rich source of vinca alkaloids, which have vasodilatory properties that help to improve blood circulation and alleviate symptoms of peripheral arterial occlusive disease.
Quick Recipe
The following recipe gives a procedure to make a basic periwinkle for peripheral arterial occlusive disease.
- Gather 30 grams of dried vinca minor leaves and 1 liter of water in a clean saucepan.
- Combine the dried leaves with the water and heat the mixture over low heat for 15 minutes.
- Remove the saucepan from the heat and let it steep for 4 to 6 hours.
- Strain the mixture through a cheesecloth or a fine-mesh sieve into a clean glass container.
- Discard the solids and store the decoction in the refrigerator for up to 2 days.
8. Glyceria maxima
Reed mace decoctions helps with peripheral arterial occlusive disease because of its unique ability to improve blood circulation and reduce inflammation.
The decoction's bioactive compounds, such as alkaloids and flavonoids, have been shown to dilate blood vessels, increasing oxygen delivery to the affected areas.
Additionally, reed mace's anti-inflammatory properties help reduce swelling and pain associated with peripheral artery disease, allowing for improved mobility and overall quality of life.
Medicinal Constituents
The list below shows the primary medicinal constituents in Glyceria maxima decoctions that help with peripheral arterial occlusive disease.
- Saponins: These compounds help improve blood circulation and reduce inflammation in blood vessels, which can help alleviate the symptoms of peripheral arterial occlusive disease.
- Flavonoids: Specifically, flavonoids like quercetin and kaempferol, which are present in Glyceria maxima, have anti-inflammatory and antioxidant properties that can help protect blood vessels from damage and promote healing.
- Polysaccharides: These complex carbohydrates can stimulate the production of nitric oxide in blood vessels, leading to vasodilation and improved blood flow, which can help alleviate the symptoms of peripheral arterial occlusive disease.
Parts Used
The list below shows the primary parts of reed mace used to make decoctions for peripheral arterial occlusive disease.
- Roots: Used due to their reported anti-inflammatory and vasodilatory properties.
- Stems: Used for their potential to help reduce blood pressure and improve blood flow.
Quick Recipe
The following recipe gives a procedure to make a basic reed mace for peripheral arterial occlusive disease.
- Harvest 100 grams of dried glyceria maxima roots with a diameter of about 0.5 to 1 cm.
- Clean the harvested roots by rinsing them under cold water for 5 minutes.
- Weigh 100 grams of the cleaned roots and cut them into smaller pieces.
- Steep the cut roots in 1 liter of boiling water for 10 to 15 minutes.
- Strain the decoction through a cheesecloth or a fine-mesh sieve into a clean container.
9. Angelica archangelica
Angelica decoctions helps with peripheral arterial occlusive disease because they have been traditionally used to promote blood circulation, relieve pain and discomfort, and reduce inflammation.
The bioactive compounds present in angelica, such as volatile oils and flavonoids, are believed to improve microcirculation and enhance the body's natural ability to adapt to stress.
By increasing blood flow to the affected areas, angelica decoctions may help alleviate symptoms of peripheral arterial occlusive disease, including cramping, numbness, and weakness in the legs.
Medicinal Constituents
The list below shows the primary medicinal constituents in Angelica archangelica decoctions that help with peripheral arterial occlusive disease.
- Coumarins: These compounds help to prevent blood clots from forming, thereby improving blood flow to peripheral arteries and reducing the risk of thrombosis associated with peripheral arterial occlusive disease.
- Phenolic acids: These antioxidants have anti-inflammatory properties that help to reduce oxidative stress and inflammation in the blood vessels, which can contribute to peripheral arterial occlusive disease.
- Ligustilide: This sesquiterpene lactone has vasodilatory effects, causing blood vessels to dilate and improving blood flow to peripheral arteries, which can help to alleviate symptoms of peripheral arterial occlusive disease such as pain and fatigue.
Parts Used
The list below shows the primary parts of angelica used to make decoctions for peripheral arterial occlusive disease.
- Roots: Rich in bioactive compounds that help improve circulation and reduce inflammation.
- Leaves: Contain flavonoids and terpenoids that promote vasodilation and help reduce blood pressure.
- Stems: Used for their antioxidant and anti-inflammatory properties, which aid in reducing oxidative stress and promoting cardiovascular health.
Quick Recipe
The following recipe gives a procedure to make a basic angelica for peripheral arterial occlusive disease.
- Harvest fresh or dried root of angelica archangelica in late summer or early fall when the plant is mature.
- Dry the harvested root in a warm ventilated area for 2 to 3 weeks to reduce moisture content.
- Chop the dried root into small pieces to increase its surface area for decoction.
- Combine 1 to 2 teaspoons of chopped root with 1 quart of boiling water to create the decoction.
- Simmer the mixture for 10 to 15 minutes and strain the liquid to obtain the final herbal decoction.
10. Populus tremula
Aspen decoctions helps with peripheral arterial occlusive disease because they possess unique bioactive compounds that have been shown to improve blood flow, reduce inflammation, and relax vascular smooth muscle.
The anti-thrombotic properties of aspen help prevent the formation of blood clots, which can occlude arteries and reduce blood flow.
Additionally, the vasodilatory effects of aspen decoctions can help dilate narrowed or blocked arteries, increasing perfusion to affected areas.
Medicinal Constituents
The list below shows the primary medicinal constituents in Populus tremula decoctions that help with peripheral arterial occlusive disease.
- Salicin: This flavonoid glycoside has anti-inflammatory and vasodilatory properties, which can help to reduce inflammation and improve blood flow in peripheral arteries, thus alleviating symptoms of peripheral arterial occlusive disease.
- Rutin: As a flavonoid, rutin has antioxidant and anti-inflammatory effects, which can protect the endothelial lining of blood vessels from oxidative stress and damage, promoting healthy blood vessel function and potentially improving blood flow in peripheral arteries.
- Tremulone: This triterpenoid saponin has been reported to have vasodilatory and anti-inflammatory properties, which may contribute to its potential benefits for peripheral arterial occlusive disease by improving blood flow and reducing inflammation in affected arteries.
Parts Used
The list below shows the primary parts of aspen used to make decoctions for peripheral arterial occlusive disease.
- Barks: The barks of Populus tremula are used to make decoctions due to their high tannin content, which may help in improving blood circulation and reducing inflammation.
- Leaves: The leaves of Populus tremula are used to make decoctions as they contain flavonoids and phenolic acids that may help in improving blood flow and reducing oxidative stress.
- Roots: The roots of Populus tremula are used to make decoctions due to their high content of saponins, which may help in improving blood circulation and reducing inflammation in peripheral arterial occlusive disease.
Quick Recipe
The following recipe gives a procedure to make a basic aspen for peripheral arterial occlusive disease.
- Harvest fresh populus tremula leaves and stems to be used for the decoction.
- Dry the harvested populus tremula plant material in a warm well-ventilated area for 1 week.
- Weigh 20 grams of dried populus tremula plant material and add it to 500 milliliters of water.
- Boil the mixture for 10 minutes then reduce heat and simmer for 20 minutes.
- Strain the decoction and discard the solids then let it cool before consumption.
What is the best combination of herbal decoctions to use for peripheral arterial occlusive disease?
The best combination of herbal decoctions that help with peripheral arterial occlusive disease is a blend of Ginkgo biloba, Ginseng, and Turmeric.
Ginkgo biloba improves blood flow and reduces inflammation, while Ginseng enhances circulation and promotes overall cardiovascular health. Turmeric, with its anti-inflammatory properties, helps to reduce swelling and oxidative stress.
This synergistic combination can help alleviate symptoms of peripheral arterial occlusive disease, such as pain, cramping, and limited mobility, by promoting healthy blood flow and reducing inflammation.
What ailments similar to peripheral arterial occlusive disease are treated with herbal decoctions?
Ailments similar to peripheral arterial occlusive disease that are treated with herbal decoctions are those affecting blood circulation, such as Raynaud's disease, atherosclerosis, and intermittent claudication.
Herbs like Ginkgo biloba, Turmeric (Curcuma longa), and Ginger (Zingiber officinale) have been traditionally used to improve blood flow, reduce inflammation, and relax blood vessels.
Decoctions of these herbs may help alleviate symptoms like pain, numbness, and cold intolerance in affected limbs.