Comparative study of osteoarthritis of the contralateral knee joint of male amputees who do and do not play volleyball.

OBJECTIVE: To assess the prevalence of osteoarthritis (OA) of the contralateral knee of men with traumatic amputation who do and do not participate in regular, vigorous physical activity. METHODS: Three groups of patients were assessed. Group 1 consisted of 8 male amputee volleyball players. Group 2 consisted of 24 male amputees who do not play volleyball, and Group 3 was made up of 24 healthy controls matched by age and weight to Group 2. The prevalence of contralateral knee OA in Groups 1 and 2 was assessed by questionnaire, physical examination, and radiographs, and was compared with findings for Group 3. RESULTS: The rate of OA in all amputees (Groups 1 and 2 together) was 65.6%, which was significantly higher than among the controls (p < 0.05). The most common findings among the amputees were patellar and medial osteophytosis of the tibiofemoral joint, with a tendency to medial narrowing of the tibiofemoral joint space. CONCLUSION: Traumatic amputees have a higher prevalence of OA in the knee of the nonamputated leg than matched healthy controls.

Sensory deficit in the hands of children with cerebral palsy: a new look at assessment and prevalence.

The sensory function of the hand was assessed in 55 children with cerebral palsy (CP) and 15 control children with lower-limb involvement after poliomyelitis by testing stereognosis and two-point discrimination. A 0 to 10 per cent error in the post-polio group defined normal limits, according to which 51 per cent of the CP group showed impairment on one or both of the tests. These results confirm those of studies carried out 30 to 40 years ago, and draw attention to a neglected aspect of CP in which the possibility of therapeutic intervention has yet to be adequately explored.

Patients' fall records as an aid in designing and assessing therapy in Parkinsonism.

Performance of Parkinson patients in a laboratory setting often gives little indication of their real-life behaviour. This is particularly the case for patients who fall. Two such patients were asked to record the time and location of every fall on maps of their apartments before and during their participation in a trial of physiotherapy designed to improve mobility. These fall diaries provided both valuable insight for understanding and addressing their problems and documentation of decreased falling following therapy.

A controlled trial of the retraining of the sensory function of the hand in stroke patients.

A controlled trial of retraining of the sensory function of the hand was undertaken in hemiplegic patients after the period of spontaneous recovery. Twenty hemiplegic patients with sensory deficit in the hand, two or more years after stroke, received systematic retraining three times a week for six weeks. Sensation in the plegic hand was tested before and after this period in these patients and in 19 untreated control patients. The treated group showed large and significant gains on all sensory tests (P < 0.001), while no change occurred in the control group. It is concluded that somatosensory deficit can be alleviated even years after stroke and that rehabilitation for stroke patients should include sensory retraining for those with sensory deficit.

The prevalence of hypertension, ischaemic heart disease and diabetes in traumatic spinal cord injured patients and amputees.

The clinical impression that spinal cord injured and traumatic lower limb amputees are more prone to develop degenerative diseases was investigated by comparing the prevalence of hypertension, ischaemic heart disease, and diabetes mellitus in these two patient groups with the prevalence of these diseases among a group of healthy age-matched controls. Seventy seven spinal cord injured patients and 53 amputees fulfilled the criteria for inclusion in this study. Our results show a significant increased incidence of hypertension and ischaemic heart disease among those with spinal cord injuries compared with their controls; and among the amputees, a significant increased incidence of ischaemic heart disease and of diabetes mellitus.

Proprioceptive function in children with adolescent idiopathic scoliosis.

Recent studies in Japan and in Sweden have suggested that a disturbance of postural equilibrium exists in idiopathic scoliosis. Proprioceptive function is one of the factors involved, and therefore a study of proprioception in patients with adolescent idiopathic scoliosis (AIS) was carried out. No difference was noted in joint position sense and in fine motor control between 24 scoliotics and matched controls taken from a group of 70 normal children of the same age group. Blindfold weight discrimination, a test of muscle spindle and tendon stretch receptor function, also showed no abnormality in scoliotic children. The Charpentier test, thought to be a test of control of muscle spindle function, showed a tendency to an infantile response in patients with adolescent idiopathic scoliosis, while the control subjects showed a normal size-weight response.l This suggests that the muscle spindle system may be at fault in AIS and supports the suggestion that postural equilibrium reactions may be abnormal in this disease.