Arthritis, Juvenile ; physiopathology ; Humans ; Joints ; physiopathology

PURPOSE: The purpose of our study was to investigate the effect of gait training with rhythmic auditory stimulation (RAS) on both kinematic and temporospatial gait patterns in patients with hemiplegia. MATERIALS AND METHODS: Eighteen hemiplegic patients diagnosed with either cerebral palsy or stroke participated in this study. All participants underwent the 4-week gait training with RAS. The treatment was performed for 30 minutes per each session, three sessions per week. RAS was provided with rhythmic beats using a chord progression on a keyboard. Kinematic and temporospatial data were collected and analyzed using a three-dimensional motion analysis system. RESULTS: Gait training with RAS significantly improved both proximal and distal joint kinematic patterns in hip adduction, knee flexion, and ankle plantar flexion, enhancing the gait deviation index (GDI) as well as ameliorating temporal asymmetry of the stance and swing phases in patients with hemiplegia. Stroke patients with previous walking experience demonstrated significant kinematic improvement in knee flexion in mid-swing and ankle dorsiflexion in terminal stance. Among stroke patients, subacute patients showed a significantly increased GDI score compared with chronic patients. In addition, household ambulators showed a significant effect on reducing anterior tilt of the pelvis with an enhanced GDI score, while community ambulators significantly increased knee flexion in mid-swing phase and ankle dorsiflexion in terminal stance phase. CONCLUSION: Gait training with RAS has beneficial effects on both kinematic and temporospatial patterns in patients with hemiplegia, providing not only clinical implications of locomotor rehabilitation with goal-oriented external feedback using RAS but also differential effects according to ambulatory function.
Acoustic Stimulation/*methods ; Aged ; Ankle Joint/physiopathology ; Biomechanical Phenomena ; Cerebral Palsy/*diagnosis/physiopathology ; Female ; Foot Joints/physiopathology ; *Gait ; Gait Disorders, Neurologic/etiology/physiopathology/*rehabilitation ; Hemiplegia ; Humans ; Knee/physiopathology ; Knee Joint/physiopathology ; Male ; Middle Aged ; Stroke/*diagnosis/physiopathology

OBJECTIVETo verify the clinical efficacy of shu-stream point acupuncture combined with fire needle therapy in the treatment of hand osteoarthritis.

METHODSEighty cases were randomized into an acupuncture group (shu-stream point acupuncture combined with fire needle therapy) and a medication group(votalin emulgel). For the 42 cases in the acupuncture group, acupuncture at shu-stream points on the three yang meridians of the hand including Sanjian (LI 3), Zhongzhu (TE 3), Houxi (SI 3) and fire needle at Ashi points were applied, the treatments were given once every other day, 15 times as a treatment course. For the 38 cases in the medication group, votalin emulgel was prescribed for local embrocation, twice a day, 30 days as a treatment course. The visual analogue scale (VAS) of arthralgia, joint function score and the duration of morning stiffness, joint tenderness, swelling were observed before and after treatment in both groups.

RESULTSAfter two courses of clinical treatment, the VAS score of arthralgia, joint function score and the duration of morning stiffness, joint tenderness, swelling were statistically significant differences as compared with before treatment (all P < 0.01 ), the efficacy in the acupuncture group was superior to that in the medication group (all P < 0.01 ). The cured-markedly effective rate and total effective rate were 61.9% (26/42) and 95.2% (40/42) in the acupuncture group, and 36.8% (14/38) and 76.3% (29/38) in the medication group respectively, with statistically significant differences between the two groups (both P < 0.05).

CONCLUSIONShu-stream point acupuncture combined with fire needle therapy achieves a significant efficacy in the treatment of hand osteoarthritis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Female ; Hand Joints ; physiopathology ; Humans ; Male ; Middle Aged ; Osteoarthritis ; physiopathology ; therapy

The scaling method of the loss degree of joint motion is very common in clinical forensic medicine. However, there is no uniform criterion until now. Therefore, this had made a negative effect to ensure the impartiality and justice in law and the identification. The advantages and disadvantages of the four methods recorded in literatures by practical case, which include major and minor methods, additional methods, directive average methods, axial directive average methods, were discussed and compared. Now three basic critics about how to choosing the applicable technique in forensic medicine were supposed according to the impartiality and justice principle, scientific and objective principle, simple and easy principle. It was hoped that we can reach a consensus in our legal-medical circumscription that all of us can choose the Axial Directive Average Methods as our standard for the loss degree of joint motion, to avoid the disadvantages of this aspect.
Adult ; Forensic Medicine/methods* ; Humans ; Joints/injuries* ; Male ; Range of Motion, Articular/physiology* ; Wrist Injuries/physiopathology*

OBJECTIVETo analyze the fenestration operation for treatment of acetabular parastyle fracture combined with articular facet compression and collapse of acetabular top involving weight-bearing dome.

METHODSFrom July 2005 to February 2007, 52 cases of acetabular parastyle fracture combined with articular facet compression and collapse of acetabular top involving weight-bearing dome were treated by two methods. Among them, 24 cases were treated by fenestration operation for articular facet reduction, bone grafing, anatomical reconstruction of the acetabular parastyle with internal fixation, included 17 males and 7 females with an average age of (35.2 +/- 6.4) years old; the other 28 cases were treated only anatomical reconstruction of the acetabular parastyle with internal fixation, included 19 males and 9 females with an average age of (36.4 +/- 4.8) years old. All the patients were evaluated with modified d'Aubigne-Postel clinical evaluation standard.

RESULTSAll patients gained bone healing. There were only 1 patient occurenced femoral nerve injury and recovered 2 months later. There were no other complications. All patients were followed up from 12 to 51 months (averaged in 31.5 months). According to modified d'Aubigne-Postel clinical evaluation standard, there were statistic difference between the two groups of patients in pain, walking, range of motion and total score. In fenestration operation group, the results were excellent in 13 patients, good in 9, fair in 1, poor in 1; in parastyle reduction group,the results were excellent in 9 patients, good in 11, fair in 6, poor in 2 (u=0.613, P<0.05).

CONCLUSIONFenestration operation for treatment of acetabular parastyle fracture combined with articular facet compression and collapse of acetabular top involving weight-bearing dome is a feasible method for the recovery of hip joint function.

Acetabulum ; injuries ; physiopathology ; surgery ; Adult ; Aged ; Female ; Fractures, Compression ; physiopathology ; surgery ; Humans ; Joints ; injuries ; physiopathology ; surgery ; Male ; Middle Aged ; Treatment Outcome ; Weight-Bearing ; Young Adult

OBJECTIVETo evaluate the therapy and the key points of the tarsometatarsal joint injury combined with metatarsal fracture.

METHODSFrom Jan. 2006 to Jul. 2008,19 patients with tarsometatarsal joint injury combined with metatarsal fracture were treated with opened reduction and internal fixation of Kirschner wire or screws, included 13 males and 6 females with an average age of 38.1 years ranging from 21 to 56 years. The classification of tarsometatarsal joint injury showed that there were 2 cases of inner column injury, 5 cases of inner and medial column injury, 3 cases of lateral and medial column injury, 9 cases of tri-column injury. There were 8 cases of shaft fracture, 7 of neck fracture, 19 of foundation fracture.

RESULTSAll the incisions were first stage healed without skin necrosis. The healing time of fracture was 11.2 weeks on average. All the patients were followed-up for 6 to 17 months with an average of 12.8 months. According to the standard of AOFAS, the average score was (84.500 +/- 8.553), the results were excellent in 4 cases, good in 9 cases, fair in 3, and poor in 3. The regular daily life was recovered after 6.4 months, 3 patients suffer from mild osteoarthritis.

CONCLUSIONNo matter which fixed mode was used, the anatomical reduction was the most important to rebuild arches of the foot and recover medial longitudinal and lateral arch. Rebuilding arches of the foot guaranteed the integrity of the stress point scaffold and avoided the pain and limp. The anatomical reduction of tarsometatarsal joint and metatarsal was also important to rebuild the function of foot.

Adult ; Female ; Foot Joints ; injuries ; physiopathology ; surgery ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; physiopathology ; surgery ; Humans ; Male ; Metatarsal Bones ; injuries ; physiopathology ; surgery ; Middle Aged ; Recovery of Function ; Young Adult

OBJECTIVE: To analyze and compare different methods for assessment of the limbs joints function and to discuss the rationality of the methods. METHODS: Eight hundred and six cases were collected from the Fujian Minzhong Forensic Appraisal Center from 2007 to 2010. These cases included injuries of large limbs joints with or without peripheral nerve injury. The loss of joint function was calculated according to the simple joint mobility method or the table method introduced in the book "Forensic Clinical Judicial Authentication Practice". The results of disability evaluation with different methods were analyzed and compared between different joints and injury patterns. RESULTS: In 642 cases of simple joint injuries without peripheral nerve injury, the results of disability evaluation based on simple joint mobility were the same as that based on the table. In 118 cases of joint injuries with peripheral nerve injury, all of them could be classified as disability, 33 cases (28.00%) had higher degree based on the table method than based on the simple joint mobility method. While 21 cases (17.80%) did not be evaluated as disabled based on the simple joint mobility method. CONCLUSION The evaluation for loss of limb function would be easier, more scientific and reasonable by the direct table method than the simple joint mobility method.
Accidents, Traffic ; Adult ; Arm Injuries/physiopathology* ; Disability Evaluation ; Extremities ; Female ; Forensic Medicine/methods* ; Humans ; Joints/physiopathology* ; Leg Injuries/physiopathology* ; Male ; Peripheral Nerve Injuries/physiopathology* ; Range of Motion, Articular/physiology* ; Trauma Severity Indices

OBJECTIVETo evaluate the quality of life of arthritis patients in China.

METHODSPatients (n = 1 344) were selected by stratified random sampling according to the economic conditions and the ranking of hospitals, and asked to complete the arthritic self-reported questionnaire of quality of life.

RESULTSThe scores of quality of life were not different between male arthritis and female arthritis in different age groups (P > 0.05). The lower scores of quality of life were reported more often among the women older than 65 years. Those of lower educational level and lower income got fewer scores. Compared to the married and unmarried patients, the divorcees and those who were bereft of their spouses gained low scores (t = 9.310, P = 0.001). Among different occupation groups, the labors and farmers also got lower scores than others (P < 0.05). On the other hand, if the arthritis with better physical conditions, it was more possible that the scores were higher, but to pressed pain index, there were no different scores shown between the second and third grade (mean difference = 4.910, P = 0.765), and to joint swell index, there are no different scores between either the 0 and 1 grade (mean difference = 16.308, P = 0.079) or the 2 and 3 grade (mean difference = 6.643, P = 0.533).

CONCLUSIONTo improve the quality of life of all arthritis patients, enhancing the quality of medical technology and enriching the medical knowledge are evidently necessary. However, it is also important to prefect social security system, to improve the country education and pay attention to life of elderly in order to improve the quality of life of all arthritis patients.

Adult ; Age Factors ; Aged ; Arthritis ; physiopathology ; psychology ; Female ; Humans ; Insurance, Health ; Joints ; physiopathology ; Male ; Marriage ; Middle Aged ; Quality of Life ; Random Allocation ; Sex Factors ; Socioeconomic Factors ; Surveys and Questionnaires

The purpose of this study was to evaluate how soft tissue surgery for correcting equinus deformity affects the kinematic and kinetic parameters of the ankle and proximal joints. Sixteen children with spastic hemiplegic cerebral palsy and equinus deformities (age range 3-16 years) were included. Soft tissue surgeries were performed exclusively on the ankle joint area in all subjects. Using computerized gait analysis (Vicon 370 Motion Analysis System), the kinematic and kinetic parameters during barefoot ambulation were collected preoperatively and postoperatively. In all 16 children, the abnormally increased ankle plantar flexion and pelvis anterior tilting on the sagittal plane were significantly improved without a weakening of push-off (p < 0.05). In a group of 8 subjects with a recurvatum knee gait pattern before operation, the postoperative kinematic and kinetic parameters of the knee joint were significantly improved (p < 0.05). In a group of 8 subjects with ipsilateral pelvic external rotation before operation, the postoperative pelvic deviations on the transverse plane were significantly decreased (p < 0.05). These findings suggest that the soft tissue surgery for correcting equinus deformity improves not only the abnormal gait pattern of the ankle, but also that of the knee and pelvis.
Male ; Kinetics ; Joints/physiopathology/surgery ; Humans ; Hemiplegia/*surgery ; Gait/physiology ; Female ; Equinus Deformity/*surgery ; Child, Preschool ; Child ; Cerebral Palsy/*surgery ; Biomechanics ; Ankle Joint/physiopathology/surgery ; Adolescent

The objective of this study was to investigate clinical and radiographic features and gender differences in Korean patients with adult-onset ankylosing spondylitis. Multicenter cross-sectional studies were conducted in the rheumatology clinics of 13 Korean tertiary referral hospitals. All patients had a confirmed diagnosis of ankylosing spondylitis according to the modified New York criteria. Clinical, laboratory, and radiographic features were evaluated and disease activities were assessed using the Bath ankylosing spondylitis disease activity index. Five hundred and five patients were recruited. The male to female ratio was 6.1:1. Average age at symptom onset was 25.4+/-8.9 yr and average disease duration was 9.6+/-6.8 yr. Males manifested symptoms at a significantly earlier age. HLA-B27 was more frequently positive in males. Hips were more commonly affected in males, and knees in females. When spinal mobility was measured using tragus-to-wall distance and the modified Schober's test, females had significantly better results. Radiographic spinal changes, including bamboo spine and syndesmophytes, were more common in males after adjustment of confounding factors. In conclusion, we observed significant gender differences in radiographic spinal involvement as well as other clinical manifestations among Korea patients with adult-onset ankylosing spondylitis. These findings may influence the timing of the diagnosis and the choice of treatment.
Adult ; Age of Onset ; *Asian Continental Ancestry Group ; Female ; HLA-B27 Antigen/diagnostic use ; Humans ; Joints/pathology ; Male ; Severity of Illness Index ; Spondylitis, Ankylosing/diagnosis/*pathology/*physiopathology/*radiography