The purpose of this study was to assess the effects of different daily lengths of physical training on postoperative walking ability and functional performance among elderly inpatients following hip fracture. Fifty-eight eligible elderly patients (mean age 81 years, SD 8) undergoing inpatient rehabilitation after fall-related hip fracture were randomized to receive either 2 units (40 minutes in 29 patients) or 6 units (120 minutes in 29 patients) of daily physical training postoperatively. There were no significant differences in patients' age, preoperative walking ability, type of femoral neck fracture and preoperative QOL functional score (FIM, BI and EQ-5D). All patients commenced the same postoperative rehabilitation program immediately after surgery consisting of bed-side sitting, wheelchair mobilization and progressive muscle strengthening exercises on the second day, followed by weight-bearing exercises and walking between the second and the 14th day. All patients walked with a stick or a rollator at the time of discharge from the hospital after 4 weeks of inhospital rehabilitation. There was no significant difference in the BI, FIM and EQ-5D scores and walking ability between the two groups during 12 weeks postoperatively, however, medical expenses in the 2 units group were decreased by US$ 2,000. Postoperative rehabilitation of elderly patients with femoral neck fracture aims to return the patients to pre-injury conditions as early as possible. This can be achieved with the help of a 2 unit (40 minutes) a day training program.

The pitching motion requires neck, trunk and hip rotations. The purpose of this study was to investigate the relationship between pitching injuries and dominant versus non-dominant differences of the ranges of these motions. The subjects were 66 high school baseball pitchers who received medical checkup during baseball classes in Kyoto prefecture. During medical checkup, physical therapists measured the ranges of neck/trunk rotations, and internal rotation of the bilateral hips. Then orthopaedic doctors did special tests such as shoulder internal impingement test, subacromial impingement test, elbow valgus stress test and elbow hyper extension test. Fourteen pitchers (21.2%) who were positive in one or more special tests were judged to require second screening (injured group). In normal group, average neck/trunk rotations toward the non-dominant side were significantly wider than rotations toward the dominant side. Average hip internal rotation was significantly wider on the non-dominant side than on the dominant side. In injured group, a larger number of pitchers had wider neck and trunk rotation ranges toward the dominant side than toward the non-dominant side, and had wide hip internal rotation range on the dominant side compared to the non-dominant side. Comparing the ranges of the neck/trunk rotations and hip internal rotation between dominant and non-dominant sides might be useful for the prediction of pitching injuries of the shoulder and the elbow.

Pitching motion is made up by three-dimensional whole body movement. Pelvic and trunk rotation movement is important for the prevention of throwing injuries. Throwing is not a simple rotation movement. Evaluation should reflect muscle strength, coordination, and pitching motion characteristics. We have devised throwing rotational assessment (TRA) similar to throwing as the new evaluation of total rotation angle required for throwing. The purpose of this study was to introduce the new method and to examine the characteristics of players with throwing disorders. The subjects were 76 high school baseball pitchers who participated in the medical check. Pain-induced tests were elbow hyperextension test and intra-articular shoulder impingement test. Pitchers who felt pain in either test were classified as disorder group. TRA evaluation was performed as follows. In the positions similar to the foot contact phase, rotation angles of the pelvis and trunk were measured. In the position similar to follow through phase, the distance between the middle finger and the second toe was measured. All tests were performed in the throwing and opposite direction. Twenty five pitchers were classified as disorder group. All TRA tests in healthy group were significantly higher in the throwing direction than in the opposite direction, but there was no significant difference in the disorder group. Disorder group had significantly lower average rotation angles of the pelvis and trunk in the throwing direction and rotation angle of trunk in the opposite direction than the healthy group. Restrictions on TRA reflecting the complex whole body rotation movement may be related to the throwing disorder. This evaluation is a simple method. It would be useful early detection of throwing disorder and systematic evaluation in medical check, as well as self-check in the sports field.

Background : The surgical repair of acute aortic dissection type A [AAD (A)] by reconstructing the left subclavian artery (LSCA) is sometimes difficult because of the deep surgical field and the occurrence of left recurrent nerve palsy or bleeding. In Japan, since 2014, a commercially available open stent graft (J-graft OPEN STENT) has been used for promoting thrombosis of the false lumen in the descending aorta. This report presents an efficacy evaluation of the surgeon-made in situ Fenestrated Open Stent (FeneOS) for LSCA reconstruction in a patient with AAD (A). Method : We performed surgery with FeneOS using the open stent graft by first deploying it from the entry of the LSCA into the descending aorta and manually making a hole on the LSCA side of the stenting portion ; then, the four-branched J graft was anastomosed between the left common carotid (lt. CCA) and SCA (ZONE 2). At our institution, 47 patients with AAD (A) underwent this surgery with FeneOS from 2014 to 2019 (FeneOS group) and 97 patients with AAD (A) underwent a normal open-stenting procedure from 2008 to 2014 (non-FeneOS group). We analyzed the postoperative results of patients in the FeneOS and non-FeneOS groups. Results : Preoperative characteristics of patients in both groups were similar. Patients in the FeneOS group had an acceptable postoperative course, with no 30-day or in-hospital deaths. The mean operation time, cardiopulmonary bypass time, selective cerebral perfusion time, and open distal anastomosis time were significantly shorter in patients in the FeneOS group (p＜0.01). None of the patients had left recurrent nerve palsy, and postoperative computed tomography or arterial echo showed that the blood flow through the LSCA was intact and revealed no endoleakage. Conclusion : FeneOS is simple, fast, and less invasive for the reconstruction of the LSCA without the risk of left recurrent nerve palsy and can be effective for treating patients with AAD (A).

Abdominal draw-in is a functional transversus abdominal muscle exercise to acquire the contraction. However, it is difficult for even healthy subjects to selectively contract the deep transversus abdominal and internal oblique muscles without over-contraction of the superficial rectus abdominis and the external oblique muscles. This study examined whether the transversus abdominal muscle is selectively contracted by our taping method. The subjects were 20 healthy males. Using ultrasound, we compared the thickness of external oblique, internal oblique, and transversus abdominal muscle among no taping, kinesio taping and abdominal muscle activation taping in the standing position. The thickness of transversus abdominal muscle significantly increased in the activation taping more than the other methods. This study showed that abdominal musculature activation taping made it possible to contract the transversus abdominal muscle selectively.