Effects of plantar intrinsic foot muscle strengthening exercise on static and dynamic foot kinematics: A pilot randomized controlled single-blind trial in individuals with pes planus.
- 作者列表："Okamura K","Fukuda K","Oki S","Ono T","Tanaka S","Kanai S
BACKGROUND:No reliable evidence has confirmed whether plantar intrinsic foot muscle strengthening exercises improve static and dynamic foot kinematics in individuals with pes planus. RESEARCH QUESTION:Does the short-foot exercise affect static foot alignment and foot kinematics during gait in individuals with pes planus? METHODS:This was a randomized controlled single-blind trial involving 20 participants with pes planus who were randomly allocated to a short-foot exercise group (exercise) or a control group (controls). Exercise patients performed a progressive short-foot exercise three times per week for 8 weeks; controls received no intervention. Before and after the 8-week intervention, foot kinematics during gait, including dynamic navicular drop-the difference between navicular height at heel strike and the minimum value-and the time at which navicular height reached its minimum value were assessed, using three-dimensional motion analysis. We assessed static foot alignment by foot posture index and navicular drop test, and the thickness of the intrinsic and extrinsic foot muscles using ultrasound. All measurements were performed by one investigator (KO) blinded to the participants' allocation. RESULTS:After the 8-week intervention in the exercise group, foot posture index scores with regard to calcaneal inversion/eversion improved significantly (p < 0.05). Moreover, the time required for navicular height to reach the minimum value decreased significantly (p < 0.01). SIGNIFICANCE:For individuals with pes planus, the short-foot exercise effectively corrected static foot alignment and temporal parameters of foot kinematics during gait. This temporal change, which shortens the time for navicular height to reach its minimum value, indicates an improved windlass mechanism. Therefore, short-foot exercise might effectively prevent or treat injuries related to the pes planus alignment.
背景: 没有可靠的证据证实足底内在足部肌肉强化练习是否能改善pes扁平足个体的静态和动态足部运动学。 研究问题: 短脚运动是否影响pes扁平足个体步态中的静态足部对线和足部运动学？ 方法: 这是一项随机对照单盲试验，涉及 20 名pes扁平足参与者，随机分配到短脚运动组 (运动) 或对照组 (对照)。运动患者进行渐进性短脚运动，每周 3 次，持续 8 周; 对照组未接受干预。8 周干预前后，步态过程中的足部运动学，包括动态舟形落差-足跟打击时舟形高度与最小值之间的差异-以及舟形高度达到其最小值的时间进行评估，使用三维运动分析。我们通过足部姿势指数和舟状骨下垂test评估静态足部对线，以及使用超声评估足部内、外肌的厚度。所有测量均由一名研究者 (KO) 进行，对参与者的分配不敏感。 结果: 运动组干预 8 周后，跟骨内翻/外翻足部姿势指数评分明显改善 (p <0.05)。且舟形高度达到最小值所需时间显著下降 (p <0.01)。 意义: 对于患有pes扁平足的个体，短足运动有效地纠正了静态足部对线和步态过程中足部运动学的时间参数。这种时间变化，缩短了舟形高度达到最小值的时间，表明了一种改进的锚机机制。因此，短脚运动可能有效预防或治疗与pes扁平肌排列相关的损伤。
METHODS::Impairments in social cognition have been frequently described in 22q11.2 deletion syndrome (22q11.2DS) and are thought to be a hallmark of difficulties in social interactions. The present study addresses aspects that are critical for everyday social cognitive functioning but have received little attention so far. Sixteen children with 22q11.2DS and 22 controls completed 1 task of facial expression recognition, 1 task of attribution of facial expressions to faceless characters involved in visually presented social interactions, and 1 task of attribution of facial expressions to characters involved in aurally presented dialogues. All three tasks have in common to involve processing of emotions. All participants also completed two tasks of attention and two tasks of visual spatial perception, and their parents completed some scales regarding behavioural problems of their children. Patients performed worse than controls in all three tasks of emotion processing, and even worse in the second and third tasks. However, they performed above chance level in all three tasks, and the results were independent of IQ, age and gender. The analysis of error patterns suggests that patients tend to coarsely categorize situations as either attractive or repulsive and also that they have difficulties in differentiating emotions that are associated with threats. An isolated association between the tasks of emotion and behaviour was found, showing that the more frequently patients with 22q11.2DS perceive happiness where there is not, the less they exhibit aggressive behaviour.
METHODS:BACKGROUND:We describe the first radiographic clinic in the literature for DDH and how this novel clinic can significantly improve the efficiency and cost-effectiveness of service in a tertiary referral centre. AIMS:A radiographic clinic for the management of developmental dysplasia of the hip was introduced in 2017 in our institution. We performed a detailed cost analysis to assess the economic savings made with the introduction of this new clinic. We assessed the efficiency of the service by identifying how many unnecessary outpatient visits were prevented. We also assessed the difference in times from referral to review between the two clinics. METHODS:Analysis of the clinic activity in 2017 was possible as all data was collected prospectively by the DDH CNS and stored in our database. Cost analysis was performed, and the savings made per patient along with the financial benefit to our institution was recorded. RESULTS:The new radiographic clinic reduced the cost of reviewing one patient by €162.51 per patient. There was a 73% discharge rate from the clinic which prevented 251 unnecessary patient visits to the outpatient department over the course of the year. There was a significant 11-day reduction in waiting times between referral and review when comparing the radiographic to the conventional clinic (p < 0.05). CONCLUSIONS:A radiographic clinic for the management of developmental dysplasia of the hip has a significant effect on the efficiency and overall cost-effectiveness of service provision in a tertiary referral centre.
METHODS:INTRODUCTION:Triple pelvic osteotomy (TPO) involves periacetabular osteotomies of the ilium, ischium, and pubis to reorient the acetabulum. This operation is indicated in certain situations for the treatment of developmental dysplasia of the hip, dysplastic neuromuscular hips, and for containment of the femoral head in cases of Legg-Calvé-Perthes disease. METHODS:This retrospective cohort study compares radiographic outcomes of patients who underwent TPO using two different techniques and describes a novel single-incision direct lateral approach. TPO was performed on 22 patients by the senior author. The first 10 patients underwent TPO through a single-incision anterolateral approach. The last 12 patients underwent TPO using the direct lateral approach. Preoperative and postoperative pelvic radiographs were reviewed for each patient, and the migration index and center-edge angle were recorded. RESULTS:The migration index and center-edge angle were evaluated and were not found to be significantly different between the anterolateral and direct lateral groups. The direct lateral approach is described. CONCLUSION:The direct lateral approach for TPO is equivalent to the anterolateral approach on radiographic evaluation. Advantages of the direct lateral approach include direct visualization of the ischial osteotomy, effective mobilization of the acetabulum, and safety of the sciatic nerve.