Relationship Between Lumbosacral Alignment and Lumbar Motor Control Determined by the Sahrmann Core Stability Test in Adolescents With Lumbar Spondylolysis / 日本農村医学会雑誌

Patients with lumbar spondylolysis may have poor lumbo-pelvic function and improving lumbar segmental stability may take time. It is assumed that the stronger the lordosis, the poorer the lumbo-pelvic function; however, to our knowledge, evidence of this relationship is lacking. To clarify the relationship between lumbosacral alignment and lumbo-pelvic function in lumbar spondylolysis, we assessed lumbar lordosis and sacral slope in the standing lateral view on plain X-rays and Sahrmann Core Stability Test (SCST) results in 66 adolescents with lumbar spondylolysis with bone marrow edema. Based on SCST results, the patients were divided into those with level 1 or 2 core stability (low group) and those with level 3 or higher core stability (high group). No significant difference was found in lumbosacral alignment between the two groups. In adult patients with spondylolisthesis, the lumbar lordosis angle and sacral slope increases to maintain the center of gravity, but no such increase in compensation was evident in our patients who were young and without slip. These findings suggest that lumbo-pelvic function does not affect lumbosacral alignment in adolescents with spondylolysis. It should be noted that using the SCST alone to evaluate motor control may not be precise enough to determine the relationship between lumbosacral alignment and lumbo-pelvic function because the SCST may not have high enough sensitivity to assess trunk extensor muscles.

Factors Related to Knee Swelling After Total Knee Arthroplasty / 日本農村医学会雑誌

Knee swelling after total knee arthroplasty (TKA) is common and can lead to loss of functional performance. The aim of this study was to reveal the factors related to knee swelling after TKA. In total, 86 patients who underwent unilateral TKA were enrolled. Changes in thigh circumference at 0, 5, and 10 cm proximal from upper pole of the patella were evaluated. In addition, age, body mass index, operation time, blood loss volume, C-reactive protein, albumin, and D-dimer levels, and changes in knee flexion were also assessed preoperatively and at 7 days postoperatively. Thigh circumference at all sites increased postoperatively. Changes in thigh circumference at the superior edge of the patella correlated with changes in knee flexion (r =－0.33, p < 0.01). No significant correlation was found between the other factors. In conclusion, this study revealed a correlation between swelling and flexion after TKA, but no correlation between other factors pre-, intra-, or postoperatively. It is thus necessary to consider other factors in the future.

Risk factors for shoulder injuries with or without past history in collegiate rugby players / 体力科学

To examine risk factors for shoulder injuries with or without history of the injuries using the stratification analysis for collegiate rugby players. 71 elite rugby players from one university rugby club joined in the preseason medical screening related to their shoulder joints, including basic demographics, history of injuries, and physical findings at that time. Subsequently, the occurrence of shoulder injuries was recorded during four playing seasons. Analysis was stratified with or without history of the injuries; player without the past history of injury, 47 players; player with the past history of injury, 24 players. As a result of all players with the past history, 13 players sustained the shoulder injuries. Internal rotational range of motion [IR ROM] (OR, 1.5; 95%CI, 1.13-1.96; p=0.004), external rotational range of motion [ER ROM] (OR, 1.9; 95%CI, 1.21-2.87; p=0.005), horizontal flexion range of motion [HF ROM] (OR, 1.3; 95%CI, 1.03-1.64; p=0.025), IR muscle strength (OR, 0.4; 95%CI, 0.20-0.65; p=0.001) and rugby experience (OR, 1.2; 95%CI, 1.02-1.46; p=0.032) were associated with the shoulder injuries. On the other hand, 10 players sustained injuries of the players without the past history of injury. IR muscle strength (OR, 0.3; 95%CI, 0.11-0.72; p=0.008) and rugby experience (OR, 1.4; 95%CI, 1.11-1.66; p=0.003) were associated with the shoulder injuries. This study clearly showed that IR, ER, HF ROM, IR muscle strength and rugby experience were important initial risk factors for shoulder injuries. Moreover, IR muscle strength and rugby experience were important recurrence risk factors for shoulder injuries.