Between-day reliability and minimum detectable change of the Conventional Gait Model 2 and Plug-in Gait Model during running.

BACKGROUND: The Plug-in Gait model (PiG) is commonly used in 3D motion analysis but has limited reliability. Although an improved version of PiG has been developed, called the Conventional Gait Model 2 (CGM2), there is limited evidence on its between-day reliability for running. RESEARCH QUESTION: What is the between-day intraclass correlation coefficient (ICC3,k) and minimum detectable change (MDC) of lower limb kinematics and kinetics for CGM2 during running and does reliability differ between CGM2 and PiG. METHODS: Twenty-three healthy participants performed running at a comfortable speed in two identical test sessions at least 5 days apart. Lower limb kinematic and kinetic data in the three planes of motion were calculated using CGM2 and PiG. The ICC and MDC were calculated for the kinematic and kinetic parameters at initial contact and peak during the stance phase of running. RESULTS: CGM2 kinematics showed good-to-excellent reliability (ICC: 0.75-0.93), except for hip extension and ankle internal rotation, and less than 5° MDC (1.8°-4.9°) of the coronal and sagittal planes, except for hip extension. PiG showed poor-to-moderate reliability (ICC: -0.15 to 0.72) in the coronal and transverse planes and greater than 5° MDC (5.0°-21.8°), except for knee extension, adduction, and ankle dorsiflexion. CGM2 showed good-to-excellent reliability for peak kinetics (ICC: 0.75-0.97), except for hip internal rotation and knee extension. The ICC and MDC were higher for CGM2 than PiG, with significant differences in the coronal plane of the hip and knee joints and transverse plane of the hip joint in kinematics and in the sagittal and coronal plane of the hip and knee joints in kinetics. SIGNIFICANCE: The between-day reliability of CGM2 was mostly good to excellent for lower limb kinematics and kinetics during running. We believe that CGM2 can more accurately assess kinematic differences between the coronal and transverse planes than the PiG.

Ethanol injection therapy of an isolated bile duct associated with a biliary-cutaneous fistula.

Bile leakage after hepatic resection often results in the formation of a biliary-cutaneous fistula. Such a fistula, when caused by an isolated bile duct in the remnant liver, can be intractable. We report a successful case of ethanol injection therapy of an isolated bile duct. A 73-year-old man underwent right hepatic resection for hepatocellular carcinoma. Bile leakage occurred after surgery, and the patient developed a biliary-cutaneous fistula. Fistulography revealed an isolated bile duct in the remnant portion of the caudate lobe without communication to the main biliary system. As conservative management with simple drainage was ineffective, injection therapy with ethanol was performed with a balloon occlusion catheter. After 11 therapy sessions, the bile duct was eradicated, and the biliary- cutaneous fistula was completely healed. The post-treatment course was uneventful. Ethanol injection therapy can be a choice for management of patients with a biliary fistula caused by an isolated bile duct.