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Study design:Retrospective study at a rehabilitation center.Objectives:Patients with spinal cord injury, even if they are wheelchair users, sometimes suffer from fractures of the lower limb bones. As their bones are too weak to have surgery, and because a precise reduction is not required for restoration, such patients are often indicated for conservative treatment. This case series study investigated the use of a hinged, soft-plastic brace as a conservative approach to treating fractures of the lower extremities of patients with spinal cord injury.Setting:National Rehabilitation Center, Japan.Methods:Fifteen patients (male, n=10; female, n=5; average age, 52.7 years) with 19 fractures of the femur or the tibia who were treated with a newly-developed hinged, soft-plastic brace were studied. All of them used wheelchairs. We analyzed the time taken for fracture union and for wearing orthotics, degree of malalignment, femorotibial angle and side effects.Results:The fractures in this series were caused by relatively low-energy impact. The average time taken for fracture union was 80.1 (37-189) days, and the average amount of time spent wearing orthotics was 77.9 (42-197) days. On final X-ray imaging, the average femorotibial angle was 176.9° (s.d. ±8.90), and 15° of misalignment in the sagittal plane occurred in one patient.Conclusion:A hinged, soft-plastic brace is a useful option as a conservative approach for treating fractures of the lower extremities in patients with spinal cord injury. [ABSTRACT FROM AUTHOR]

Study design:Cross-sectional and comparative investigation using quadriplegics (QP) and nondisabled subjects (ND).Objective:To evaluate cardiorespiratory responses during passive walking-like exercise (PWE) in QP.Setting:National Rehabilitation Center for Persons with Disabilities in Japan.Method:The subjects were seven male QP with complete lesion (age: 27.0±5.4, injured level: C6–C7) and six male ND (age: 26.3±4.5). Cardiorespiratory responses were measured until voluntary fatigue during PWE, the rhythmical activity of paralyzed lower limbs synchronized with arm movements.Results:There were no significant differences in oxygen consumption (\[Vdot]O2), pulmonary ventilation (\[Vdot]E), heart rate (HR) and oxygen pulse (O2 pulse) between QP and ND during PWE. ND showed increased ventilatory equivalent for oxygen (\[Vdot]E/\[Vdot]O2 ratio) during exercise, while QP showed a significantly greater respiratory rate (RR) during exercise than ND (P<0.05).Conclusion:PWE elicited an increase in \[Vdot]O2 with workload increment in QP similar to ND. However, higher RR suggested the intrinsic dysfunction of RR control during submaximal exercise in QP. From these results, it was thought that respiratory response would be the restriction factor of efficient oxygen transportation during PWE in QP.Spinal Cord (2006) 44, 480–486. doi:10.1038/sj.sc.3101875; published online 29 November 2005 [ABSTRACT FROM AUTHOR]