Effectiveness of simple tracing test as an objective evaluation of hand dexterity.

This study aimed to demonstrate that the simple tracing test (STT) is useful for assessing the hand dexterity in patients with cervical spondylotic myelopathy (CSM) by comparing STT scores between healthy volunteers and CSM patients. This study included 25 CSM patients and 38 healthy volunteers. In the STT, the participants traced a sine wave displayed on a tablet device at a comfortable pace, and the tracing accuracy, changes in the total sum of pen pressures, and tracing duration were assessed. Data were analyzed using an artificial neural networks (ANN) model to obtain STT scores. All participants were evaluated using the subsection for the upper extremity function of the Japanese Orthopaedic Association (JOA) scoring system for cervical myelopathy (JOA subscore for upper extremity function) and the grip and release test (GRT). The results were compared with the STT scores. The mean STT scores were 24.4 ± 32.8 in the CSM patients and 84.9 ± 31.3 in the healthy volunteers, showing a significant difference. The STT scores showed highly positive correlations with both the JOA subscore for upper extremity function (r = 0.66; P < 0.001) and GRT values (r = 0.74; P < 0.001). Furthermore, receiver operating characteristic analysis showed an area under the curve of 0.89 (95% confidence interval, 0.76-1.00), demonstrating that STT has excellent discriminative ability. This study revealed that STT enables accurate assessment of the hand dexterity in CSM patients.

Effect of Foot Progression Angle and Lateral Wedge Insole on a Reduction in Knee Adduction Moment.

This study evaluated the effect of foot progression angle on the reduction in knee adduction moment caused by a lateral wedged insole during walking. Twenty healthy, young volunteers walked 10 m at their comfortable velocity wearing a lateral wedged insole or control flat insole in 3 foot progression angle conditions: natural, toe-out, and toe-in. A 3-dimensional rigid link model was used to calculate the external knee adduction moment, the moment arm of ground reaction force to knee joint center, and the reduction ratio of knee adduction moment and moment arm. The result indicated that the toe-out condition and lateral wedged insole decreased the knee adduction moment in the whole stance phase. The reduction ratio of the knee adduction moment and the moment arm exhibited a close relationship. Lateral wedged insoles decreased the knee adduction moment in various foot progression angle conditions due to decrease of the moment arm of the ground reaction force. Moreover, the knee adduction moment during the toe-out gait with lateral wedged insole was the smallest due to the synergistic effect of the lateral wedged insole and foot progression angle. Lateral wedged insoles may be a valid intervention for patients with knee osteoarthritis regardless of the foot progression angle.

The Effects of a Lateral Wedge Insole on Knee and Ankle Joints During Slope Walking.

The purpose of this study was to determine whether a lateral wedge insole reduces the external knee adduction moment during slope walking. Twenty young, healthy subjects participated in this study. Subjects walked up and down a slope using 2 different insoles: a control flat insole and a 7° lateral wedge insole. A three-dimensional motion analysis system and force plate were used to examine the knee adduction moment, the ankle valgus moment, and the moment arm of the ground reaction force to the knee joint center in the frontal plane. The lateral wedge insole significantly decreased the moment arm of the ground reaction force, resulting in a reduction of the knee adduction moment during slope walking, similar to level walking. The reduction ratio of knee adduction moment by the lateral wedge insole during the early stance of up-slope walking was larger than that of level walking. Conversely, the lateral wedge insole increased the ankle valgus moment during slope walking, especially during the early stance phase of up-slope walking. Clinicians should examine the utilization of a lateral wedge insole for knee osteoarthritis patients who perform inclined walking during daily activity, in consideration of the load on the ankle joint.

Temperature changes caused by the difference in the distance between the ultrasound transducer and bone during 1†mhz and 3†mhz continuous ultrasound: a phantom study.

[Purpose] This study aimed to use a thermograph to observe temperature changes caused by different distances between an ultrasound transducer and bone during 1 MHz and 3 MHz continuous ultrasound emission on a phantom. [Materials and Methods] We observed the distribution of temperature elevations on a phantom consisting of pig ribs and tissue-mimicking material. One megahertz and 3 MHz ultrasound were delivered at 2.0 W/cm(2) for 5 minutes. To record the temperature changes on the phantom, we took a screenshot of the thermograph with a digital camera every 20 seconds. [Results] With 1 MHz ultrasound at the distances of 2 and 3 cm, the temperature elevation near the bone was higher than that near the transducer. However, with 3 MHz ultrasound, the temperature elevation was higher near the transducer rather than near the bone. At this point, we consider that there is a possibility of heat injury to internal organs in spite of there being no elevation of skin temperature. [Conclusion] When performing ultrasonic therapy, not only should the frequency be taken into consideration, but also the influence of the absorption coefficient and the reflection of the tissue. We visually confirmed the thermal ultrasound effect by thermography. Special attention to the temperature elevation of the internal organs is necessary to avoid injuries.

The loss of dexterity in the bilateral lower extremities in patients with stroke.

The aim of this study was to examine the dexterity of both lower extremities in patients with stroke. Twenty patients with stroke and 20 age-matched control subjects participated in this study. To determine the dexterity of the lower extremities, we examined the ability to control muscle force during submaximal contractions in the knee extensor muscles using a force tracking task. The root mean square errors were calculated from the difference between the target and response force. The root mean square error was significantly greater in the affected limb of patients with stroke compared with those of the unaffected limb and the control subjects, and in the unaffected limb compared with that of the control subjects. Furthermore, the root mean square error of the affected limb was related significantly to motor function as determined by Fugl-Myer assessment. These results demonstrate impairment of the dexterity of both the affected and the unaffected lower extremities in patients with stroke.