Balance Control and Knee Osteoarthritis Severity

OBJECTIVE: To investigate balance control according to the severity of knee osteoarthritis (OA) using clinical tests and Tetra-ataxiometric posturography (Tetrax(R)). METHOD: A total 80 patients with primary knee OA classified according to American College of Rheumatology criteria, and 40 age-matched controls were enrolled in this study. Of those with OA, 39 patients had mild OA (Kellgren-Lawrence [KL] grade 1, 2) and the other 41 had moderate to severe OA (KL grade 3, 4). The postural control capabilities of the subjects were assessed using the timed up and go test (TUG), Berg balance scale (BBS), and Tetrax(R), which utilizes two paired force plates to measure vertical pressure fluctuations over both heels and forefeet. The subjects were checked for their stability index (ST), Fourier index, weight distribution index (WDI), and synchronization index (SI) in eight positions using Tetrax(R). RESULTS: Patients with moderate to severe OA exhibited significantly higher stability indices in all positions than patients with mild OA. The Fourier index was also higher in patients with moderate to severe OA than in patients with mild OA. However, the weight distribution index and synchronization of both heels and forefeet were not significantly different in the three groups. CONCLUSION: These findings suggest that patients with moderate to severe OA have more deficits in balance control than those with mild disease. Therefore, evaluation of balance control and education aimed at preventing falls would be useful to patients with knee OA.

The Shoulder Gradient in Patients with Unilateral Shoulder Impingement Syndrome

OBJECTIVE: To investigate the relationship between the shoulder gradient and acromiohumeral interval of both shoulders in patients with unilateral shoulder impingement syndrome. METHOD: Using the angulometer, we measured the shoulder gradient in patients with unilateral shoulder impingement syndrome in a standing position. Using the radiography, we measured the acromiohumeral interval and the angle between a vertical line and a line connecting a superior angle with an inferior angle of the scapula. RESULTS: In patients with unilateral shoulder impingement syndrome, the frequency of shoulder impingement syndrome was 76.2% (16 of 21) on the side of the relatively lower shoulder. The mean acromiohumeral interval on the side of the lower shoulder was 10.03+/-1.28 mm, compared with 10.46+/-1.50 mm for the higher shoulder. The angle between a vertical line and a line connecting a superior angle with an inferior angle of the scapular of the side of the lower shoulder was -0.31+/-3.73 degrees, compared with 3.85+/-4.42 degrees for the higher shoulder. CONCLUSION: The frequency of shoulder impingement syndrome was significantly higher on the side of the relatively lower shoulder, and there is no significant difference in the acromiohumeral interval between the side of the lower shoulder and that of the higher shoulder. In patients with unilateral shoulder impingement syndrome, the scapular on the side of lower shoulder was more rotated downward than on the side of the higher shoulder.

Quantitative Correlations of Trunk Muscles in Young and Middle-aged Men with Chronic Low Back Pain by Magnetic Resonance Imaging

OBJECTIVE: To evaluate the correlation of the cross-sectional areas (CSA) of paraspinal (multifidus and erector spinae) and psoas muscles and chronic low back pain by MRI (magnetic resonance image) in young and middle-aged patients. METHOD: Medical records of eighty subjects (50 young-aged and 30 middle-aged men) with low back pain were retrospectively reviewed. Their MR images were scanned and analysed by means of pixel to find the lumbar paraspinal and psoas muscle CSA and evaluated the correlation of the types of disc and age. RESULTS: There were significant increases of body mass index (BMI) in middle-aged patients compared with young- aged, and no difference in the disc types. Paraspinal muscle atrophy was increased in young patients with HIVD (herniated intervertebral disc), but not in middle-aged patients although they had HIVD. CONCLUSION: The paraspinal and psoas muscle atrophy could be assessed by MRI of lumbar spine in young patient with chronic low back pain. It may helpful for further evaluation and planning the treatment of low back pain.