Search

To investigate the immediate effects of thoracic spine self-mobilization in patients with mechanical neck pain.Randomized, controlled trial.Thoracic spine self-mobilization is performed after thoracic spine thrust manipulation to augment and maintain its effects. To the best of our knowledge, no study has investigated the effects of thoracic spine self-mobilization alone in individuals with mechanical neck pain. The purpose of this randomized, controlled trial was to evaluate the immediate effects of thoracic spine self-mobilization alone without any other intervention on disability, pain, and cervical range of motion in patients with mechanical neck pain.Fifty-two patients (39 females and 13 males) with mechanical neck pain were randomly allocated to either a thoracic spine self-mobilization group that was performing a thoracic spine active flexion and extension activity using two tennis balls fixed by athletic tape or a placebo thoracic spine self-mobilization group. Outcome measures were collected at pre-intervention and immediately after intervention, including the Neck Disability Index, visual analogue scale, and active cervical range of motion (ROM). The immediate effect of the intervention was analyzed using two-way repeated measures analysis of variance (ANOVA). If interactions were found, a simple main effect test was performed to compare the pre-post intra-group results.The results of two-way repeated measures ANOVA indicated that the main effect of time was significant (p 0.05) for all measurement outcomes. The main effect of group was not significant for all measurement outcomes (p 0.05). The group × time interactions for cervical flexion active ROM (p = 0.005) and cervical extension active ROM (p = 0.036) were significant. The tests of simple main effect in cervical flexion active ROM (p 0.0001) and cervical extension active ROM (p 0.0001) showed a significant difference before and after intervention in the thoracic spine self-mobilization group.Patients with mechanical neck pain who carried out thoracic spine self-mobilization showed increases in active cervical flexion and extension ROM.

The aims of this study were to translate and culturally adapt the Patient-Specific Functional Scale (PSFS) and validate the Japanese version of the PSFS (PSFS-J) in outpatients with neck pain.The PSFS was translated and adapted into Japanese in accordance with the published guidelines. A total of 103 outpatients with neck pain were recruited for this study. Psychometric evaluation included test-retest reliability, convergent validity by comparing the PSFS-J to the Neck Disability Index (NDI), patient's global impression of change (PGIC), and responsiveness (unpaired t test, minimal detectable change).The intraclass correlation coefficient for test-retest reliability was 0.98 (95% confidence interval = 0.95-0.99). The Pearson correlation coefficient with the NDI was -0.35. The Spearman correlation coefficient showed a strong relationship between the change score in the PSFS-J and PGIC (-0.70). The analysis of responsiveness was calculated with the unpaired t test showing a significant difference between the stable and improved patients (P0.01). The minimal detectable change was calculated as 0.64.The Japanese version of the PSFS is a valid, reliable, and responsive instrument to assess Japanese outpatients with neck pain.

[Purpose] This study investigated lumbar muscle fatigue before and after maintaining a seated position for one hour, lumbar and pelvic inclination angle change, in subjects with and without active lumber support. [Subjects and Methods] Fourteen healthy subjects randomized into two groups sat on a floor chair, placed on an office chair, that cyclically changed its lumbar supporting shape to provide active lumbar support (ALS) or no ALS for one hour. Before and after, we measured the frequency of muscle waveforms of the trunk extensor muscles when the subjects lifted an object weighing 10% of their body weight, using both hands while seated. In addition, ROMt (Range of motion test) of trunk rotation, degree of fatigue and muscle stiffness were analyzed. [Results] Muscle frequency while lifting the weight decreased significantly without ALS compared to with ALS. Mean muscle stiffness increased, ROMt decreased in desk work task significantly without ALS compared to with ALS. [Conclusion] These results suggest that the lumbar muscles became fatigued, because low frequencies, increased muscle stiffness, and decreased ROMt without ALS. We suggest lumbar muscle fatigue was maintained low for subjects seated in a chair with ALS.

The aim of this study was to show highly reliable normal values and three-dimensional characteristics for final range of motion during active movements of the upper extremity joints, and to develop a database from healthy participants, with the advantage of this database lying in the methods of defining shoulder axial rotation angle and of compensating for soft tissue artifacts.We used an electromagnetic tracking system (FASTRAK) to measure three-dimensional motions of the shoulder (thoracohumeral), elbow/forearm, and wrist in 20 healthy adults (age range: 18-34 years) during active joint motion tasks of the upper extremity.Joint angles of the upper extremity at the final position of joint motion tasks were determined. Highly reliable data for shoulder axial rotation angle were obtained, using a new definition of joint angle and regression analysis to compensate for estimation errors.These results should be useful in setting goals for the treatment of upper extremity joint functions in the fields of rehabilitation, orthopedics, and sports medicine.

〔目的〕股関節外転筋疲労前後の片脚立位時の重心動揺と中殿筋・脊柱起立筋の活動との関係を明らかにすることを目的とした．〔対象〕神経学・整形外科学的な疾患の既往のない健常成人男性22名（平均年齢21.4歳）とした．〔方法〕股関節外転筋疲労前後で片脚静止立位時の重心動揺と筋活動量の変化を計測した．疲労前後の重心動揺と筋活動量を対応のあるt検定，重心動揺と筋活動の関係をpearsonの相関を用いて求めた．〔結果〕疲労後にX方向の重心動揺が有意に増加し，中殿筋の活動は減少，右脊柱起立筋の活動は有意に高まった．右脊柱起立筋の活動の増加と重心動揺に正の相関がみられた．〔結語〕筋疲労により筋の作用に関連する方向の重心動揺が増大し，代償のための筋活動が増加したと考えられる．

Our report discusses a 29 year old female patient with nephrotic syndrome due to lupus nephritis, biopsy-proven World Health Organization classification Types IVb and V that was controlled with low-density lipoprotein (LDL) apheresis. She was initially treated with steroid therapy, including methylprednisolone pulse therapy, and the serological activity of her systemic lupus erythematosus was suppressed. However, her nephrotic state, accompanied by severe hyperlipidemia, persisted despite the steroid therapy. Since we could not obtain her consent to administer immunosuppressants such as cyclophosphamide, we tried to treat her using LDL apheresis (LDL-A). We found that her urine protein excretion, hyperlipidemia, hypoalbuminemia, and renal function improved following the initiation of LDL-A. This suggests that LDL-A may be an effective therapy for nephrotic syndrome due to lupus nephritis through short-term amelioration of hyperlipidemia.

Study design Translation and psychometric testing. Objective To translate and culturally adapt the Neck Disability Index (NDI) and to assess the reliability and validity of the Japanese version of the NDI (NDI-J) in Japanese outpatients with neck pain. Summary of background data To date, no previous report exists on the translation process and psychometric testing of the NDI-J. Methods The NDI was translated and culturally adapted into Japanese in accordance with published guidelines. A total of 110 outpatients with neck pain participated in the study. Psychometric testing included reliability by internal consistency (Cronbach α) and test-retest reliability (intraclass correlation coefficient), factor analysis, convergent validity by comparing the NDI-J with the short-form health survey (Pearson correlation) and responsiveness (unpaired t tests, standard error of measurement, and minimal detectable change). Results The Cronbach α of the NDI-J was 0.88 and the intraclass correlation coefficient for test-retest reliability was 0.91 (95% confidence interval, 0.82-0.95). Factor analysis demonstrated a 2-factor structure, explaining 61.8% of the total variance. The correlation between the NDI-J and the short-form health survey, version 36, subscales ranged from good to fair (-0.25 to -0.51). The analysis of responsiveness was calculated with an unpaired t test after 3 weeks of treatment demonstrating a statistically significant difference between the stable and improved patients (P ≤ 0.05). The standard error of measurement and minimal detectable change were calculated as 2.9 and 6.8, respectively. Conclusion The NDI-J is a valid, reliable, and responsive tool that can be used to assess neck pain in Japanese outpatients.

Highly reliable information on the range of motion (ROM) required to perform activities of daily living (ADL) is important to allow rehabilitation professionals to make appropriate clinical judgments of patients with limited ROM of the upper extremity joints. There are, however, no data available that take full account of corrections for gimbal-lock and soft tissue artifacts, which affect estimation errors for joint angles. We used an electromagnetic three-dimensional tracking system (FASTRAK) to measure the three-dimensional ROM of the upper extremity joints of healthy adults (N=20, age range 18-34) during 16 ADL movement tasks. The ROM required for the performance of each movement was shown in terms of the joint angle at the completion of the task, using a new definition of joint angle and regression analysis to compensate for estimation errors. The results of this study may be useful in setting goals for the treatment of upper extremity joint function.

A 60-year-old man with polycystic disease (PCD) undergoing hemodialysis was admitted to our hospital because of refractory ascites in September 2000. He had been diagnosed with probable chronic inflammatory demyelinating polyradiculopathy 6 months before admission. Though the ascites was bloody and exudative, the cytology was normal and cultures of bacteria and acid-fast bacillus were both negative. Hepatic venous outflow obstruction was excluded by several radiological examinations. Because of the presence of polyneuropathy, organomegaly, endocrine abnormality, M-protein, plasma cell dyscrasia, and skin lesions, POEMS, syndrome was diagnosed; this had caused the refractory ascites. Initial prednisolone therapy was effective for the refractory ascites, but it was not effective in preventing recurrence. He died due to cachexia in December 2000. This is a very rare case of the presence of both PCD and POEMS syndrome in a patient.