The Effect of Induced Weight Bearing Method Using a Cane on Weight Bearing Distribution in Children with Spastic Hemiplegic Cerebral Palsy
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- The Journal of Korean Physical Therapy
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- v.35 no.2
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- pp.48-52
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- 2023
Purpose: This study was undertaken to determine whether the position of cane use affects the distribution of weight-bearing on both feet of children with hemiplegic cerebral palsy in a standing posture. Methods: Twenty participants with cerebral palsy were recruited as volunteers for this study. Using the Zebris FDM-System, weight-bearing distribution according to the method of using a cane was measured under three conditions in randomized order: (1) standing unaided (no cane); (2) standing with the affected side using the cane; and (3) standing with the non-affected side using the cane. The cane was matched by measuring length-from-floor to the greater trochanter of the subject, and was placed 15 cm outward from the little toe on the supporting side. Results: Evaluating the method of using a cane under the three conditions, we determined that pressure of the foot on the affected side was higher in the order: standing with affected side using cane > standing unaided (no cane) > standing with non-affected side using cane (p<0.05). In the post-hoc analysis, a significant difference was observed between (i) standing unaided (no cane) and standing with the affected side using cane, and (ii) standing with affected side using cane and standing with non-affected side using cane (p<0.05). Conclusion: This study suggests that induced weight-bearing methods using a cane on the affected side could increase the weight-bearing capacity on the affected side in children with spastic hemiplegic cerebral palsy, which will have a positive effect on reducing asymmetry weight support.
Introduction: Pressure ulcers, often found in patients with mobility issues, particularly elderly patients, are increasing in prevalence. Their treatment is complex, with recovery more challenging in advanced stages, and certain factors can delay healing. Case Presentation: An 87-year-old male developed a grade IV pressure ulcer on his left greater trochanter following lumbar fractures and subsequent percutaneous vertebroplasty in 2021. Despite potential surgical recommendations, his treatment consisted of daily wet dressings, acupuncture from July 2021 to February 2022, and Gami-sipjeondaebo-tang beginning August 2021. The ulcer, initially measuring 6 cm×6 cm and showing a red wound without necrosis, healed completely and showed no signs of recurrence as of August 2023. Conclusion: A grade IV pressure ulcer was effectively treated using wet dressing, acupuncture, and Gami-sipjeondaebo-tang, demonstrating no recurrence over a 1.5-year period.
Purpose: The aim of this study was to compare short-term results from use of the direct anterior approach (DAA) and the conventional posterolateral approach (PLA) in performance of bipolar hemiarthroplasty for treatment of femoral intertrochanteric fractures in elderly patients. Materials and Methods: A retrospective review of 100 patients with intertrochanteric fractures who underwent bipolar hemiarthroplasty was conducted. The PLA was used in 50 cases from 2016 to 2019; since that time we have used the DAA in 50 cases from 2019 to 2021. Measurements of mean operative time, blood loss, hospitalization period, and ambulation status, greater trochanter (GT) migration and stem subsidence were performed. And the incidence of complications was examined. Results: Operative time was 73.60±14.56 minutes in the PLA group and 79.80±8.89 minutes in the DAA group (P<0.05). However, after experiencing 20 cases using DAA, there was no statistically difference in operative time between two groups (P=0.331). Blood loss was 380.76±180.67 mL in the PLA group and 318.14± 138.51 mL in the DAA group (P<0.05). The hospitalization was 23.76±11.89 days in the PLA group and 21.45 ±4.18 days in the DAA group (P=0.207). In both groups, there were no progressive GT migration, intraoperative fractures or dislocations, although there was one case of infection in the PLA group. Conclusion: Although use of the DAA in performance of bipolar hemiarthroplasty required slightly more time in the beginning compared with the PLA, the DAA may well be an alternative, safe surgical technique as a muscle preserving procedure in elderly patients with intertrochanteric fractures.
The purpose of this study was to analyze the effects of ballet program training at the Royal Academy of dance (RAD) on body composition (BC), physical fitness (PF) and bone mineral density (BMD) in college women. The subjects for this study were 14 females aged 19 to 22, who were divided into the Experimental group (n=7, EG) and the Control group (n=7, CG). The RAD ballet program training was done by 7 subjects (EG), 60 minutes per day, three times a week for 12 weeks. The TBF and %fat significantly decreased and LBM increased in the Experimental group, but all the variables of Body composition in the Control group did not significantly changed. The AMS, Sit ups, STF, SLJ CFB and 1,200 m R & W in the EG significantly increased, but 1,200 m R & W in the CG decreased. The lumbar vertebra (LV), femoral neck (FN), greater trochanter (GT) and ward's triangle (WT) did not significantly change in the EG, but LV, GT and WT in the CG decreased. There was no significant difference in osteopenia for EG, but there were increases in GT and WT for the CG. There was significant correlation between BMDs and body weight, TBF, LBM, %fat, BMI, AMS. There was significant correlation between LV and FN and LV and whole body. In conclusion, regular and continuous RAD training was effective in improving the body composition, physical fitness and bone mineral density. Consequently, RAD training will be effective for preventing osteopenia and osteoporosis, and for improving the health-related fitness for college and middle-aged women.
Purpose: Chondroblastoma is a rare benign bone tumor which occurs most frequently at epiphysis of long bones. This study analyzed the difference between patients with chondroblastoma either on their epiphysis or apophysis. Materials and Methods: We reviewed 19 patients with chondroblastoma who visited our hospital from August 1987 to August 2005. The mean follow up period was five years. Fifteen patients were male and 4 patients were female. The mean age of the patients was 17.6 years. The treatment consisted of either curettage alone, curettage with bone graft or curettage with cementation. We retrospectively compared the difference between one chondroblastoma originating from the epiphysis and the other chondroblastoma originating from the apophysis in terms of age predilection, duration of symptoms, size of tumor, status of the physis, presence of pathologic fracture, recurrence rate and accompanying aneurismal bone cyst. Results: Among the 19 patients, 11 patients had chondroblastoma at the epiphysis, and 8 at the apophysis. Distal femur was the most common site for epiphysis lesions while the greater trochanter was the most common site for lesions arising at the apophysis. The mean age was 14.2 years in the epiphysis group and 22.3 years in the apophysis group. Chondroblastoma occurred after closure of the physis in 3 out of 11 cases in the epiphysis group and in all 8 cases in the apophysis group showing a statistical significance between the groups in terms of status of the physis at onset. Size of the lesion was bigger in the apophysis group with statistical significance. Conclusion: Chondroblastoma is known to occur frequently at the epiphysis of long bones, but our study shows that in patients over 20 years old it occurs more frequently at the apophysis which needs to be considered when making the proper diagnosis. There was a significant difference between the two groups in terms of the age of occurrence, status of physis and size of tumor while there was none in terms of the duration of symptoms, presence of pathologic fracture, recurrence rate and presence of accompanying aneurismal bone cyst.
The purpose of this study was to investigate whether 12-weeks of movement training would increase the psoas major cross-sectional area (CSA) in senior men and women. Fifty eight men and women aged 65 to 80 years old (
Purpose: Total hip arthroplasty was performed using a direct anterior approach (DAA) on an ordinary operation table and a short femoral stem. The clinical radiographic results were evaluated by a comparison with those performed using the modified hardinge (anterolateral approach, ALA) method. Materials and Methods: From January 2013 to November 2015, 102 patients who underwent total hip arthroplasty using DAA (DAA group) and the same number of patients using ALA (ALA group), both performed by a single surgeon, were compared and analyzed retrospectively. The operation time and amounts of bleeding were compared, and the improvement in post-operative pain, ambulatory capacity and functional recovery of the hip joint were checked. The location of insertion of the acetabular cup and femoral stem were evaluated radiologically, and the complications that occurred in the two groups were investigated. Results: The amount of bleeding was significantly smaller in the DAA group (p=0.018). Up to 3 weeks postoperatively, recovery of hip muscle strength was significantly higher in the DAA group (flexion/extension strength p=0.023, abduction strength p=0.031). The Harris hip score was significantly better in the DAA group for up to 3 months (p<0.001) and the Koval score showed significantly better results in the DAA group up to 6 weeks (p≤0.001). The visual analogue scale score improvement was significantly higher in the DAA group by day 7 (p=0.035). The inclination angle (p<0.001) and anteversion angle (p<0.001) of the acetabular cup were located in the safe zone of the DAA group more than in the ALA group, and there was no statistically significant difference in the position of the femur stem and leg length difference. During surgery, two cases of greater trochanter fracture occurred in the DAA group (p=0.155). Conclusion: The DAA performed in the ordinary operation table using a short femoral stem showed post-operative early functional recovery. Because a simple to use fluoroscope was used during surgery with an anatomical position familiar to the surgeon, it is considered to be useful for the insertion of implants into the desired position and for an approach that is useful for the prevention of leg length differences.
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70