As a method of agility measurement under wide current use, the repeated side step is well-known. At present in Japan, a duration of 20 seconds is employed to test agility ; but it is often reported that the factor of endurance is included in this. When a diagnosis involving agility is made based on the performance of exercise, the duration of the time of measurement was controlled in order to avoid the mixing of other factors and to ensure measurement of as few factors as possible. The distance of step was made flexible according to the age. Since a constant distance makes the longitudinal tracing easier, the distance of step was also studied.
Side steps were tested and duration of measurement was examined based on determinations in 1857 subjects, Junior and Senior school boys and girls and male university students. During the 20 seconds of measurement, scores were recorded every 5 seconds to study the time course of the fluctuations of scores. Taking into consideration factors of endurance such as the endurance of the lower extremity system, the knee test was conducted to see the relationship between scores of the repeated side step and knee test values. As to the distance of the step, 200 high school girls were tested over a distance of 100cm ×2 and 120cm ×2, for 10 seconds each.
As to the time of measurement, the average score during the first 10-15 seconds after start tended to decrease. In the time course of fluctuations of the scores in each subject, a decrease in the fall of scorse was seen about 10 seconds after the start in approximately 55% of the test subjects.
Based on the assumption that the endurance of the lower extremity system participates in this, high and low groups with a significant difference in the endurance of the lower extremity at the level of P<0.001 were compared. While no difference was seen in the slope of the score increase over a 10-second period from the start, changes of scores were distinctly different between 10 and 20 seconds, the lower values in the low group being obvious. The endurance of the lower extremity system was then studied in the two groups with high and low scores in the side step between 10 and 20 seconds. In the group with high scores, the endurance of the lower extremity was high : and a significant difference at P<0.01 was noted in this index.
These results would definitely indicate that mixing of other factors is unavoidable under the current measurement duration of 20 seconds
As to the distance of the step, scores are apparently different even in the same test subject, depending upon the distance of the step. The scores are also different depending upon the body length.
In both of the two groups, however, the scores for each different distance of the step showed a high correlation between each other, giving a correlation coefficient of γ= 0.88 in the group with high body length and γ= 0.82 in the group with low body length, indicating a high correlation.
Based on the diagnosis of agility and performance of exercise, in order to obtain the results of measurement of as simple a factor as possible, the agility time measurement is corrected to 10 seconds ; and the distance of the step is made constant at 100cm×2 regardless of the age, to a distance without unnatural effort even by a primary school pupil, in order to obtain a better diagnosis and tolerance for exercise for the desirable development and maintenance of agility.
The influence of body height on the score should be studied in the future.

Myxoma of the left ventricle is exceedingly rare and to the best of our knowledge not a single case of its recurrence has been reported in Japan. We have recently experienced a case in which a myxomatous tumor of the left ventricle recurred at the same site as the primary lesion 2.5 years after operation and was treated by surgical excision. The patient was a 28-year-old female who, under the diagnosis of myxoma of the left ventricle, underwent surgical removal of the tumor and mitral valve replacement at her age of 25 years. Although her postoperative course was uneventful, she was noticed, at her age of 28 years, of her inaudible prosthetic valve clicks on auscultation at the outpatient service. Echocardiography revealed a tumor mass in the left ventricle, which tended to grow with the elapse of time. Echocardiography on rehospitalization disclosed a mobile cystic tumor on the posterior wall of the left ventricle, while pulmonary arteriography also revealed a movable tumor in the left ventricle. Intraoperatively, there was noted a solid tumor, composed partly of cystic structure, on the posterior wall of the left ventricle and quick pathology led to a suspected diagnosis of myxoma. Since the tumor was found to have involved the ventricular septum and myocardial tissue of the posterior wall of the left ventricle, its complete surgical excision was impossible. The tumor, with its growth pattern and morphology, was diagnosed as a malignant clinical behavior one, although histopathological evidence indicates its benignancy.

A simple method of evaluation and measurement of endurance of the whole body for exercise prescription for sportsmen was previously reported. In the present study, a method of loading for general population was deviced and is the subject of the present communication.
The site of loading was divided into relatively localized portions of the lower extremity, upper extremity and trunk.
By substituting the kneeling exercise with step test, individual difference in body height was corrected.

Hip dysplasia is the most common cause of secondary osteoarthritis (OA). To prevent the early onset of secondary OA, Nishio's transposition osteotomy, Steel's triple osteotomy, Eppright's dial osteotomy, Wagner's spherical acetabular osteotomy, Tagawa's rotational acetabular osteotomy (RAO), and Ganz' periacetabular osteotomy (PAO) have been proposed. PAO and RAO are now commonly used in surgical treatment of symptomatic acetabular dysplasia in Europe, North America, and Asia. The aim of this paper is to present the followings: the patient selection criteria for RAO; the surgical technique of RAO; the long-term outcome of RAO; and the future perspectives.
Acetabulum* ; Asia ; Europe ; Hip Dislocation ; North America ; Osteoarthritis ; Osteotomy* ; Patient Selection

Methods: Adolescent athletes with spondylolysis, including those with symptoms of low back pain, were enrolled. The sporting activity of the patients was restricted, and a hard brace was attached to the spine. The BME range of interest was taken on T2-weighed fat-saturated MRI, and the signal intensity (SI) of the BME (SIedema) was measured. The contrast ratio (CR) between the SI of the BME and SI of the spinal cord (SIcord) was calculated per the following formulae: CRedema=(SIedema–SIcord)/(SIedema+SIcord). The CR of the normal pedicle was measured as a control per the following formulae: CRcontrol=(SIcontrol–SIcord)/(SIcontrol+SIcord). Results: The study enrolled 32 men and one woman; the mean patient age was 15.2 years (range, 12–18 years). The average CR of the edema and normal pedicle at the first visit was 0.506 (range, 0.097–0.804) and 0.137 (range, -0.741 to 0.572), respectively. The CR of the edema was significantly higher as compared to that of the normal pedicle (p<0.01). MRI that was performed 1 month after the first visit showed that the CR of the edema had decreased to 0.204 (range, -0.152 to 0.517). The CR of the edema 1 month thereafter was significantly lower than that at the first visit (p<0.01). Conclusions Quantitative assessment of BME using CR on MRI is useful in the evaluation of the healing process of spondylolysis.

OBJECTIVE: To assess the effectiveness of our devised hybrid physiotherapy regime using an anti-gravity treadmill and a low-frequency electrical stimulation device, as measured in patients with hip osteoarthritis after total hip arthroplasty (THA). METHODS: The outcomes of the postoperative rehabilitation in 44 patients who underwent THA for hip osteoarthritis were retrospectively examined. The conventional group (n=22) underwent the postoperative rehabilitation according to our protocol, while the hybrid group (n=22) underwent the same training, along with training on an anti-gravity treadmill and training using a low-frequency therapeutic device. The outcome measures were recorded and reviewed with the Numerical Rating Scale for pain, which rates pain on an 11-point scale from 0 to 10, surgical side knee joint extension force, 10-m walking test, Timed Up and Go test, and the 6-minute walking distance (6MD). The outcome measurement was taken 2 weeks after conducting pre-operation and antigravity treadmill training and electrical muscle stimulation, and compared the respective results. RESULTS: At the timeframe of 2 weeks from the surgery after conducting a devised hybrid physiotherapy, the values of knee extension muscle strength and 6MD were not worse in the hybrid group than conventional group. In the evaluation at 2 weeks after surgery, the knee extension muscle strength and 6MD values significantly decreased compared with the preoperative values only in the conventional group. CONCLUSION: Lower limb muscular strength and endurance were maintained in the hybrid group, which suggested that hybrid physiotherapy could maintain physical functions early after THA operation.
Arthroplasty, Replacement, Hip ; Electric Stimulation ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Lower Extremity ; Muscle Strength ; Osteoarthritis, Hip ; Outcome Assessment (Health Care) ; Rehabilitation ; Retrospective Studies ; Walking

STUDY DESIGN: Retrospective case-control study. PURPOSE: To evaluate the primary outcomes and radiographic results of percutaneous vertebroplasty (PVP) in patients with singlelevel osteoporotic vertebral fracture (OVF) with intravertebral cleft (IVC) to identify the risk factors for cement loosening after PVP. OVERVIEW OF LITERATURE: PVP is a widely accepted method for managing painful OVF; however, cement loosening occasionally occurs with poor outcomes. METHODS: This retrospective study involved 195 patients treated with PVP for single-level OVF with IVC. Six months thereafter, the primary outcomes were evaluated using the Visual Analog Scale (VAS) for back pain and the modified Oswestry Disability Index. Computed tomography was conducted to detect cement loosening. Possible risk factors, such as age, sex, wedging angle, intravertebral instability, Parkinson’s disease, spinous process fracture, ankylosing spinal hyperostosis, split vertebrae, and adjacent intervertebral vacuum, were assessed. RESULTS: Forty-nine patients (25%) experienced cement loosening 6 months after PVP. The mean VAS scores were significantly higher in patients with cement loosening than in those without (50 vs. 26 mm, respectively; p < 0.01). Cement loosening was closely associated with intravertebral instability (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.04–1.40; p =0.015), Parkinson’s disease (OR, 54.31; 95% CI, 4.47–659.53; p =0.002), spinous process fracture (OR, 7.11; 95% CI, 1.65–30.60; p =0.009), and split vertebrae (OR, 11.59; 95% CI, 1.64–82.02; p =0.014). CONCLUSIONS: Patients with cement loosening experienced worse back pain than those without cement loosening. The important risk factors that influenced cement loosening after PVP were high intravertebral instability, Parkinson’s disease, spinous process fracture, and split vertebrae.
Back Pain ; Case-Control Studies ; Humans ; Hyperostosis ; Methods ; Retrospective Studies ; Risk Factors ; Spine ; Vacuum ; Vertebroplasty ; Visual Analog Scale