著者

Hiroki Fujita Atsushi Teramoto Hiroyori Fusagawa Toshihiko Yamashita and Paulo Selber

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.8, pp.20230029, 2023 (Released:2023-09-20)

参考文献数

16

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Background: There are numerous etiologies relating to physeal arrest. The clinical manifestations of physeal arrest may include limb length discrepancy (LLD) and bone malalignment, especially in younger children with more growth ahead of them.Case: We performed three-dimensional gait analysis (3DGA) four times over a 13-year period in a boy aged from 9 to 22 years who was suffering from LLD and genu valgum. At the final follow-up, the patient’s LLD and coronal malalignment had been ameliorated on radiographic findings after multiple corrective surgeries, including the use of external fixation. In 3DGA, the patient’s Gait Profile Score (GPS) at age 12.5 years was poorest at 12.4°, improving to 8.4° at age 22.3, a change of 2.5 times the minimal clinically important difference. Assessment of kinetics showed a mean knee coronal moment during the stance phase of 0.17 (varus) and 0.20 (valgus) Nm/kg at the ages of 18.6 and 22.3 years, respectively. Importantly, this revealed significant improvement from the perspective of knee coronal moment (P <0.001).Discussion: This is the first report of long-term follow-up 3DGA using GPS in a patient undergoing multiple corrective surgeries for LLD and genu valgum. Although both LLD and genu valgum improved, gait function did not normalize. This shows that focusing on radiographic findings alone may not lead to improved patient outcomes and indicates the value of gait function assessment.

著者

Yudai Watanabe Rikiya Shirato Takuro Wada Kousuke Iba Tomoko Sonoda Toshihiko Yamashita

出版者

The Society of Physical Therapy Science

雑誌

Journal of Physical Therapy Science (ISSN:09155287)

巻号頁・発行日

vol.32, no.11, pp.748-753, 2020 (Released:2020-11-11)

参考文献数

30

被引用文献数

3

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[Purpose] Isolated finger flexion associated with function of the flexor digitorum superficialis has been qualitatively assessed using standard and modified tests. The purpose of this study was to quantify isolated finger flexion in healthy participants. [Participants and Methods] We assessed 100 volunteers (mean age: 44.6 years) without upper limb dysfunction using the standard and modified flexor digitorum superficialis tests. The sum of the isolated active flexion angles of the metacarpophalangeal and proximal interphalangeal joints of the test finger was also calculated, with the other three fingers held in an extended position with our original jig. [Results] The mean isolated flexion angles were, respectively, 152.4° and 154.8° for the right and left index fingers, 161.1° and 160.4° for the middle fingers, 160.6° and 158.2° for the ring fingers, 129.4° and 134.6° for the independent flexor digitorum superficialis function, 85.8° and 74.7° for the common flexor digitorum superficialis function, and 75.8° and 71.2° for absent flexor digitorum superficialis function in the small finger. The functional variations of the flexor digitorum superficialis of the small fingers showed symmetry in 65.0% of the fingers but asymmetry in 35.0%. [Conclusion] The data obtained in this study provide normal reference values for the examination of independent movement disorders of the fingers.

著者

Gen Inoue Takashi Kaito Yukihiro Matsuyama Toshihiko Yamashita Mamoru Kawakami Kazuhisa Takahashi Munehito Yoshida Shiro Imagama Seiji Ohtori Toshihiko Taguchi Hirotaka Haro Hiroshi Taneichi Masashi Yamazaki Kotaro Nishida Hiroshi Yamada Daijiro Kabata Ayumi Shintani Motoki Iwasaki Manabu Ito Naohisa Miyakoshi Hideki Murakami Kazuo Yonenobu Tomoyuki Takura Joji Mochida

出版者

The Japanese Society for Spine Surgery and Related Research

雑誌

Spine Surgery and Related Research (ISSN:2432261X)

巻号頁・発行日

pp.2020-0083, (Released:2020-11-20)

被引用文献数

2

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Introduction: Chronic low back pain (CLBP) is a leading cause of disability, yet there is limited high-quality evidence to identify the most suitable pharmacological therapy. The purpose of this Japanese nationwide, multicenter, prospective study was to compare the effectiveness of four representative drug therapies—acetaminophen, celecoxib, loxoprofen, and a tramadol and acetaminophen (T+A) combination drug—to establish evidence for a drug of choice for CLBP.Methods: Patients with CLBP (N = 471) received one of the four treatments and were evaluated, prospectively and comprehensively, once every month for six months using a visual analog scale (VAS) for LBP, the Japanese Orthopedic Association (JOA) score, the JOA Back Pain Evaluation Questionnaire (JOABPEQ), the Roland–Morris Disability Questionnaire (RDQ), the EuroQol five-dimensions three-levels (EQ-5D-3L), and the Short Form-8 item health survey (SF-8). We conducted multivariable linear regression analyses of the four drugs at 1 and 6 months after drug allocation. Differences with P < 0.05 were considered statistically significant.Results: Patients who received acetaminophen showed a significant improvement from baseline in the mental health subscale of the JOABPEQ at one month (P = 0.02) and the JOA score at six months (P < 0.01). None of the other outcome measures among the four drugs differed significantly. Across groups, all outcome measures, except the mental component summary (MCS) score of the SF-8, improved equivalently, although most measurements showed no obvious cumulative effect over six months. The MCS score of the SF-8 decreased gradually over six months in all groups.Conclusions: Most of the outcome measures among the treated groups were not significantly different, indicating similar treatment effects of the four drugs for CLBP. Our study indicated the limit of each outcome measure for evaluating the patient status, suggesting that a single outcome measure is insufficient to reflect treatment effectiveness.