Masayuki Tazawa

Alternation of trunk movement after arthroplasty in patients with osteoarthritis of the knee

ObjectiveTrunk movement is important but still little understood after total knee arthroplasty. The alternation of trunk movement was analyzed for use in a postoperative rehabilitation program in the short-term after arthroplasty.Materials and methodsThe subjects were 25 patients with knee osteoarthritis (4 males, 21 females). The femorotibial angle was evaluated on standing anteriorposterior radiographs and recorded at pre- and post-arthroplasty. Using three-dimensional motion capture, the gait parameters (cadence, walking speed, stride length, step length, step width), range of motion of lower extremity joints (hip, knee, and ankle), and trunk movement parameters (angle, speed, and displacement) were measured and compared between the pre- and 4th post-arthroplasty week.ResultsThe femorotibial angles of the arthroplasty side were improved from an average of 189° to 175° after arthroplasty. At the 4th post-arthroplasty week, the range of motion of the hip and knee flexion, hip adduction on the arthroplasty side, and ankle dorsiflexion on the non-arthroplasty side were significantly increased compared to pre-arthroplasty. Among gait parameters, only the stride length increased significantly. Regarding the trunk movement in the coronal plane, the maximal trunk speed to the non-arthroplasty side and maximal trunk displacement to the arthroplasty side were both reduced in a medio-lateral direction; the upward maximal trunk speed on the arthroplasty side increased and the maximal trunk displacement on the non-arthroplasty side decreased significantly in an up-down direction.ConclusionThe recovery of hip adduction during the standing phase caused by improvement of knee alignment contributed the reduction of trunk movement to the operated side. In the early post-arthroplasty period, the reduction of trunk movement in the coronal plane is beneficial to maintain trunk balance and prevent falls. Functional recovery of the lower extremities is a long-term process, and sustained functional training is necessary.

Immediate effects of physical therapy on gait disturbance and frontal assessment battery in Parkinson's disease

Aim:  To examine whether the Frontal Assessment Battery is associated with the immediate effects of physical therapy on gait disturbance in patients with Parkinsons disease.

A clinical study of the efficacy of a single session of individual exercise for depressive patients, assessed by the change in saliva free cortisol level

BackgroundThe efficacy of physical exercise as an augmentation to pharmacotherapy with antidepressants for depressive patients has been documented. However, to clarify the effectiveness of exercise in the treatment of depression, it is necessary to distinguish the effect of the exercise itself from the effect of group dynamics. Furthermore, an objective measurement for estimation of the effect is needed. Previous reports adopted a series of group exercises as the exercise intervention and mainly psychometric instruments for the measurement of effectiveness. Therefore, this clinical study was done to examine the effectiveness of a single session of individual exercise on depressive symptoms by assessing the change in saliva free cortisol level, which reflects hypothalamic-pituitary-adrenocortical axis function that is disturbed in depressive patients.MethodEighteen medicated patients, who met the DSM-IV-TR criteria for major depressive disorder, were examined for the change in saliva free cortisol levels and the change in subjective depressive symptoms before and after pedaling a bicycle ergometer for fifteen minutes. Within a month after the exercise session, participants conducted a non-exercise control session, which was sitting quietly at the same time of day as the exercise session.ResultsDepressed patients who participated in this study were in remission or in mild depressive state. However, they suffered chronic depression and had disturbed quality of life. The saliva free cortisol level and subjective depressive symptoms significantly decreased after the exercise session. Moreover, the changes in these variables were significantly, positively correlated. On the other hand, although the subjective depressive symptoms improved in the control session, the saliva free cortisol level did not change.ConclusionFor the first time in depressive patients, we were able to show a decrease in the saliva free cortisol level due to physical exercise, accompanied by the improvement of subjective depressive symptoms. This identified a possible influence of exercise on the hypothalamic-pituitary-adrenal axis in depression.These results suggest the utility of assessing the effect of physical exercise by saliva free cortisol level in depressive patients who suffer from bio-psycho-social disability.

Injuries and disorders among young ice skaters: relationship with generalized joint laxity and tightness

This study retrospectively investigated 192 teenage speed and figure skaters with prior injuries documented by an athletes’ questionnaire, who underwent a physical examination to assess their muscle tightness and generalized joint laxity. In all athletes, the degree of muscle tightness and joint laxity were measured by a standardized physical examination. A descriptive report of the types of injuries showed a predominance of fractures, ligament injuries, enthesitis, and lower back pain. Approximately 5% of all skaters tested positive for tightness, while 25.8% of figure skaters and 15.2% of speed skaters had generalized ligamentous laxity. Statistical testing showed an association between ankle sprains and muscle tightness, and an association between knee enthesitis and muscle tightness in skating athletes. There was also an association between lower back pain and generalized joint laxity, which held true only for the male skaters.

Impact of a Multidisciplinary Round Visit for the Management of Dysphagia Utilizing a Wi-Fi-Based Wireless Flexible Endoscopic Evaluation of Swallowing.

Objectives: The management of dysphagia requires a multidisciplinary approach, especially in large-scale hospitals. We introduce a novel protocol using a Wi-Fi–based flexible endoscopic evaluation of swallowing (FEES) system and aim to verify its effectiveness in evaluation and rehabilitation of inpatients with dysphagia. Method: We conducted novel Wi-Fi–based FEES at the bedside using 3 iPads as monitors and recorders. Functional outcomes of swallowing in 2 different hospitals for acute care with conventional wired or wireless FEES were compared retrospectively. Results: Using the wireless system, we could visit more patients in a short period of time. Furthermore, a large multidisciplinary team was able to be present at the bedside, which made it easy to hold discussions and rapidly devise appropriate rehabilitation strategies. Aspiration pneumonia recurred in a few cases following our intervention with wireless FEES. Functional oral intake score was significantly increased following the intervention. Moreover, the number of deaths during hospitalization using wireless FEES evaluation was lower than those observed using the conventional system. Conclusion: Wi-Fi–based wireless FEES system, the first of its kind, allowed our multidisciplinary team to easily and effectively assess inpatients with dysphagia by facilitating simple examinations and intensive transprofessional discussions for patient rehabilitation.

Immediate positive effects of physical therapy on gait disturbance in patients with parkinson's disease

Abstract Background: Gait disturbance is major disturbance of Parkinsons disease (PD). Although continuous physical therapy (PT) has been demonstrated to improve gait disturbance and prevent falls among PD patients,