Objectives : Muscle imbalance poses a problem for adequate motor function in patients with cerebral palsy. The adductor and flexor muscles around the hip become dominant, leading to a high risk of hip dislocation. When left untreated, flexion and adduction contracture progresses, leading to various impairments ; hence, it is important to undertake preventive measures at an early stage. Selective muscle release is one form of surgical treatment that has been proven effective, but there is no consensus on the timing of the surgery. Here, we investigated the difference in outcome after muscle release surgery with respect to age. Subjects and methods : The subjects were 26 patients (52 hips) from our medical center who underwent muscle release (partial modification of Matsuo's method) around the hip and were followed up for at least 6 months. Abduction was retained postoperatively by using a cast or prosthetic device. Migration percentage (MP) was measured by simple hip radiography image, and the rates of improvement (preoperative MP . final MP during observation/preoperative MP ×100%) were compared. Results : Higher rates of improvement were observed among patients aged 5 years or less at the time of surgery than those among patients aged 6 years or more. Conclusion : We consider that surgery performed at the age of 5 years or less could lead to favorable results.

The effects of physical activity (PA) on bone mass gained during growth in Japanese are not well understood. The purpose of this study was to examine whether changes in PA affected bone mass gained by Japanese schoolchildren, as measured by calcaneus quantitative ultrasound (QUS). Three hundred and seven children aged 9–13 years participated in the study and were followed for a 2-year period. The stiffness index (Stiffness) of the calcaneus was measured by QUS, and PA evaluated by a questionnaire. Participants were divided into two groups according to PA: high (≥ 7 hours/week, H) or low (< 7 hours/week, L). Participants were also divided into four groups according to their 2-year change in PA: consistently high (HH), consistently low (LL), changed from high to low (HL), and changed from low to high (LH). Analysis of covariance was used to compare adjusted Stiffness across all four groups. The adjusted 2-year changes in Stiffness ranked in decreasing order among girls: HH (20.8 %), HL (17.6 %), LH (14.3 %), and LL (12.2 %), respectively (trend test, P = 0.027). This trend was not observed among boys. These results suggest that changes in PA significantly affected bone mass gain among peripubertal girls, and that a continuing PA of more than 7 hours a week (approximately ≥ 60 min/day) from a young age is effective in increasing peak bone mass. However, given the limitations of this study, further robust studies which recruit representative samples and consistently employ validated measurement instruments are needed.

The purpose of this study was to evaluate the effectiveness of water exercise, including functional mobility in water, performed either once or twice a week in elderly who require nursing care. Twenty-one subjects were assigned to two groups. Ten subjects trained once a week for 6 months. Eleven subjects trained twice a week for 6 months. Water exercise consisted of warming up on land and walking,ADL exercise,resistance training, stretching and relaxation in water. Functional mobility was evaluated by FIM during pre-exercise,after 3 months and 6 months. There were significant improvements in functional mobility after 6 months compared to pre-exercise in both groups. Functional mobility in the group who trained once a week did not improve at 3 months compared to pre-exercise. Although the group who trained twice a week showed a dramatic improvement in functional mobility after 3 months compared to pre-exercise, and no change after 3 months compared to after 6 months. These results indicate that water exercise once or twice a week for 6 months, including functional mobility in elderly who require nursing care, can improve functional mobility, especially, exercise twice a week could improve it within 3 months.

Taping is widely used in sports medicine to prevent injury, protect affected sites post injury and relieve pain. However, it is not clear whether taping affects the perception of noxious stimulation because in previous studies, it was difficult to selectively activate Aδ fibers. A recently developed, useful, new tool named intra-epidermal electrical stimulation (IES) can preferentially activate Aδ fibers. We aimed to clarify the effect of taping on pain-related somatosensory evoked potentials (pSEPs) using IES. We recorded pSEPs following IES of the right medial forearm in twelve healthy volunteers. pSEPs were recorded from 9 electrodes on the scalp under control, elastic-taping and white-taping conditions. Under the control condition, subjects relaxed on a comfortable reclining seat without taping, whereas under the taping conditions, they were subjected to taping along the forearm with tension (elastic-taping) and without tension (white-taping). Subjects were asked to assign a visual analog scale (VAS) score after each session. The peak amplitudes of N2-P2 were significantly lower under the elastic-taping and white-taping conditions than those under the control condition. VAS was significantly lower elastic-taping condition than those under the control and white-taping conditions. Moreover, there was a significant positive correlation between the amplitude of N2-P2 and VAS. We revealed that taping along the forearm decreased pSEPs and subjective pain perception under the white-taping and elastic-taping conditions. The underlying mechanism of pain relief was the distraction effect in both taping conditions. In addition, elastic-taping with tension changes afferent inputs mainly from the skin, and this might more effectively decrease the subjective pain perception than that achieved under the white-taping condition.

Understanding the symptoms of the general population has an important role in assessing and improving the quality of palliative care systems. However, there are no reliable epidemiological data on the symptoms of the general population in Japan. The aim of this study was to survey the actual status of the symptoms experienced by the general population in Japan. A large nationwide postal survey was conducted from January through February 2013 in Japan. A total of 2400 subjects were selected randomly from among members of the general population who were 20 to 79 years of age and lived in Japan. The Memorial Symptom Assessment Scale (MSAS) was used to multi-dimensionally evaluate symptoms experienced within the past week, and the Short Form 8™ (SF-8™) was used to assess the health-related quality of life (QOL). A total of 978 (41.1%) self-completed questionnaires were analyzed. The prevalences, severity rates, and distress rates of 35 physical and psychological symptoms were analyzed according to sex and age group. In addition, the relation between symptom severity and the health-related QOL score was evaluated. From the perspectives of public health and administrative policy, the results of this survey will most likely provide important basic data, with the ultimate goal of establishing a palliative care system in Japan.

Taping is widely used by sports trainers to prevent injury and to protect affected sites post-injury. However, it is not clear whether taping affect the perception of somatosensory stimulation. We sought to clarify the effect of taping on somatosensory stimulation using somatosensory evoked potentials (SEPs). We recorded SEPs following transcutaneous electrical stimulation of the right medial forearm in ten healthy volunteers. SEPs were recorded from 9 electrodes on the scalp under control, elastic-taping and white-taping conditions. Subjects relaxed on a comfortable reclining seat without taping in the control condition, while they were subjected to taping along the muscle of forearm with tension (elastic-taping) and without tension (white-taping) in the taping conditions. Results showed that the peak amplitude of N140 did not differ significantly among the three conditions but the peak amplitude of P250 was significantly lower in the elastic-taping condition than control and white-taping conditions. Elastic-taping with tension along the muscles changes various afferent inputs from muscle spindle or skin, and this may affect the perception of somatosensory stimulation.

In recent years, physical inactivity among children or adolescents has been a major public health concern. Although a number of studies have examined the effect of physical inactivity on depressive symptoms in adults, only few studies have examined this effect on children. Therefore, the purpose of this study was to examine the effect of physical activity on the development of depressive symptoms in children by using longitudinal data. The study participants were students in grades 4 to 8 in the Koshu City. Their physical activity and depressive symptoms were examined in 2008 by a questionnaire. One year later, their depressive symptoms were examined again. Students who had depressive symptoms at the baseline were excluded. Physical activity at the baseline was categorized into 3 groups as independent variables. The development of depressive symptoms was used as the dependent variable. Multivariate logistic regression analyses were performed to examine the relationship. At the baseline, 1532 students completed the questionnaire. Of them, 1379 students (727 boys and 652 girls) did not have depressive symptoms. One year later, 1319 students (95.6%) completed the questionnaires on depressive symptoms. Of them, 41 (6.0%) boys and 68 (10.6%) girls had developed depressive symptoms during the study period. High physical activity was significantly associated with decreased incidence of depressive symptoms compared to low physical activity only in boys (odds ratio: 0.37, 95% confidence interval: 0.12-0.95). Our results suggest that high physical activity significantly affects the depressive symptoms in boys.

To monitor the quality of life （QOL）of cancer patients through the Patient Behavior Survey, a large population-based survey, we developed a short QOL and quality of care （QOC）questionnaire. In order to help evaluate QOL in cancer patients, we also conducted a web–based survey designed to evaluate the content validity and interpretability of the questionnaire. In total, 630 cancer patients completed the survey. For each item, the result that more than 90% responses determined the item was of importance indicated that the item was important for living with cancer. Regarding items related to QOC, satisfaction with care, we consolidated responses; for example, the answer of “neutral” could also be interpreted as “almost satisfied” and patients who answered “other” may also mean that the item does not apply to them. We found that this questionnaire accurately evaluated the QOL of cancer patients and the responses were interpretable and presentable.

Infected femoral artery aneurysm is difficult to treat because of the risk of reinfection and anastomosis. The treatment of choice has been a topic of much controversy. Revascularization is mandatory for limb salvage after excision of infected grafts. Revascularization requires various ingenious techniques such as retro-sartorius bypass and obturator bypass. We treated a patient with suspected infection of an aorta-femoral graft, using femoro-femoral crossover bypass in front of the pubis and inside of the thigh muscle. We performed complete debridement of infected tissue. After resterilization of the operative field once more and exchange of all the instruments we performed revascularization detouring around areas of focal infection, using autogenious vein graft through the front of the pubis and inside of the thigh muscle to reach the left superficial femoral artery.