Sacral pressure sores have been treated by a variety of surgical methods. complete treatment needs wide excision and coverage with healthy tissue which has constant and sufficient blood supply. Use of gluteus maximus muscle flap with or without overlying skin is a revolutionary method because of the reliability of blood supply. However, it is technically a little bit complicated, and future reconstruction for recurrent decubitus is especially limited in paraplegic patients. The development of gluteal perforator-based flap with para-sacral perforator introduce a new treatment modality for the sacral pressure sores. Total 10 cases of sacral pressure sores were treated with gluteal perforator-based flap. There were minimal postoperative complications except wound dehiscence in one case. This flap has a many advantage of no transection or sacrifice of the gluteus maximus muscle, elevation time for the flap is short, reliable blood flow of the perforator, large rotation arc and no post-operative hindrance to walking in patients who are not paraplegic. The disadvantages of this perforator-based flaps are the anatomical variation in the location of perforators and the need for technically careful dissection.
Humans ; Postoperative Complications ; Pressure Ulcer* ; Skin ; Walking ; Wounds and Injuries

OBJECTIVE: To investigate the feasibility of a knee proprioception evaluation using a dynamometer as a tool for evaluating proprioception of the lower extremities in patients with incomplete spinal cord injury (SCI), and to explore its usefulness in predicting the ambulatory outcome. METHODS: A total of 14 SCI patients (10 tetraplegic, 4 paraplegic; all AIS D) were included in this study. The passive repositioning error (PRE) and active repositioning error (ARE) were measured with a dynamometer, along with tibial somatosensory evoked potential (SSEP) and abductor hallucis motor-evoked potential (MEP). Ambulatory capacity was assessed with the Walking Index for Spinal Cord Injury II (WISCI-II), both at the time of the proprioception test (WISCI_i) and at least 6 months after the test (WISCI_6mo). RESULTS: The PRE showed a negative correlation with WISCI_i (r=-0.440, p=0.034) and WISCI_6mo (r=-0.568, p=0.010). Linear multiple regression showed the type of injury, lower extremities motor score, MEP, and PRE accounted for 75.4% of the WISCI_6mo variance (p=0.080). CONCLUSION: Proprioception of the knee can be measured quantitatively with a dynamometer in patients with incomplete SCI, and PRE was related to the outcome of the ambulatory capacity. Along with the neurological and electrophysiological examinations, a proprioception test using a dynamometer may have supplementary value in predicting the ambulatory capacity in patients with incomplete SCI.
Evoked Potentials, Somatosensory ; Humans ; Knee ; Lower Extremity ; Proprioception* ; Spinal Cord Injuries* ; Spinal Cord* ; Walking

The adequate treatment of tibia fracture is one of the most difficult due to severe commiuntion, open wound, delayed union, angulation deformity and infection. We treated 38 fractures of the tibia by Interlocking intramedullary nail from Feb. 1983 to Mar. 1993. 35 cases of the tibia fracture were fresh, 13 cases of fracture were open. The other 3 cases were delayed union and nonunion. The Mean follow-up was 14.0 months. The results were as followings. 1. Of the 38 fractures, 37 fractures united and the mean union time was 18.7 weeks. 2. Interlocking intramedullary nail could be used to the majority of fractures of the proximal & distal tibia shaft. fractures. 3. The Im erlocking nail had rigid rotational stability and was appropriate for the treatment in severe unstable fractures, commninution and open-with bone loss. 4. Delayed union or nonunion was a good indication for intramedullary nailling. 5. The major-complication were valgus deformity of 2 cases, varus deformity of 1 case, 1 case deep infection. 6. Interlocking intramedullary nailing provided rigid fixation of . fracture and then made early joint motion exercise and ambulation.
Congenital Abnormalities ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Joints ; Tibia ; Tibial Fractures* ; Walking ; Wounds and Injuries

BACKGROUND: The stimulation and selection of an effective acupoint is important for producing effective analgesia in electraoacupuncture. This study examined the effect of electroacupuncture to different acupoints and investigated the effective acupoint for ankle-sprained pain in rats. METHODS: A Sprain was produced by manually overextending the lateral ligament of the right ankle in rats. Electrical stimulation was delivered individually to five acupoints: bilateral Yangno (SI6s), contralateral Zusanli (ST36), Hapko (LI4) and Sanyinjiao (SP6). The level of pain evoked by ankle sprain was measured by the stepping force of the sprained paw during walking at pre-sprain and 24 hrs after the sprain. The effect of electroacupuncture was evaluated by the % full recovery of the stepping force at 1, 2, 4 hr after terminating electroacupuncture. RESULTS: Electrical stimulation to SI6 and ST36 among the five acupoints produced a significant increase in the % full recovery of the stepping force of the ankle-sprained paw during walking. CONCLUSIONS: The effective acupoints for electroacupuncture on ankle-sprained pain in rats is SI6 and ST36. These points are relatively specific to ankle-sprain. It is important to select the appropriate acupoint for effective electroacupuncture-induced analgesia.
Acupuncture Points* ; Analgesia ; Animals ; Ankle ; Ankle Injuries ; Collateral Ligaments ; Electric Stimulation ; Electroacupuncture* ; Rats* ; Sprains and Strains ; Walking

Biomechanics is the application of mechanical principles to living organisms. Evaluation of sporting techniques such as running biomechanics and swim stroke biomechanics and understanding of the biomechanics of different sporting activities is a vital foundation for the sports medicine practitioners. The purpose of this article is to provide the clinicians with relevant and easily applicable descriptions of the common sporting techniques. The key for the better sports performance and prevention of injury is exercising with correct biomechanics. Understanding normal sporting biomechanics makes the clinician to apply injury prevention strategies. Biomechanics of lower limb including standing, walking, running and biomechanics of upper limb during throwing and overhead activities are described.
Athletic Injuries ; Athletic Performance ; Biomechanics ; Lower Extremity ; Running ; Sports ; Sports Medicine ; Stroke ; Tennis ; Upper Extremity ; Walking

Biomechanics is the application of mechanical principles to living organisms. Evaluation of sporting techniques such as running biomechanics and swim stroke biomechanics and understanding of the biomechanics of different sporting activities is a vital foundation for the sports medicine practitioners. The purpose of this article is to provide the clinicians with relevant and easily applicable descriptions of the common sporting techniques. The key for the better sports performance and prevention of injury is exercising with correct biomechanics. Understanding normal sporting biomechanics makes the clinician to apply injury prevention strategies. Biomechanics of lower limb including standing, walking, running and biomechanics of upper limb during throwing and overhead activities are described.
Athletic Injuries ; Athletic Performance ; Biomechanics ; Lower Extremity ; Running ; Sports ; Sports Medicine ; Stroke ; Tennis ; Upper Extremity ; Walking

OBJECTIVES: To investigate the effect of torso training on unstable surface on lower limb motor function in patients with incomplete spinal cord injury. METHODS: A total of 80 patients with incomplete spinal cord injury caused by thoracolumbar fracture admitted in Ningbo Yinzhou No.2 Hospital from April 2020 to December 2021 were randomly divided into control group and study group, with 40 cases in each group. In addition to routine training, the control group received torso training on stable surface and the study group received torso training on unstable surface. The gait, lower limb muscle strength, balance function, lower limb function, mobility and nerve function of the two groups were compared. RESULTS: After treatment, the stride length, stride frequency and comfortable walking speed improved in the two groups (all P<0.05), and the improvements in study group were more significant (all P<0.05). The muscle strength of quadriceps femoris, gluteus maximus, hamstring, anterior tibialis and gastrocnemius were improved in the two groups (all P<0.05), and the improvements in study group were more significant (all P<0.05); the total trajectories of static eye opening and static eye closing gravity center movement in the two groups were significantly shorter (all P<0.05), and the improvements in the study group were more significant (all P<0.05). The dynamic stability limit range and the American Spinal Injury Association (ASIA) lower extremity motor score, Berg balance scale, modified Barthel index scale in the two groups were significantly higher (all P<0.05), and these scores in study group were significantly higher than those in the control group (all P<0.05). Both groups showed a significant improvement in ASIA grade (all P<0.05), and the improvement in the study group was significantly better (P<0.05). CONCLUSIONS Torso training on unstable surface can effectively improve the gait and lower limb muscle strength of patients with incomplete spinal cord injury and improve the lower limb motor function.
Humans ; Walking/physiology* ; Spinal Cord Injuries ; Gait/physiology* ; Lower Extremity ; Torso

BACKGROUND: Simultaneous acupuncture to two or more acupoints has been used to improve acupuncture-induced effects in clinical practice. However, there is little evidence supporting the effects of simultaneous electroacupuncture (EA). This study examined whether simultaneous EA with 2 and 2 Hz or 2 and 100 Hz can produce synergic effects on ankle-sprained pain in rats. METHODS: Ankle sprain pain was induced by manually overextending the lateral ligament of the right ankle in rats. Electrical stimulation with 2 Hz was delivered to the Yangno acupoint (SI6) and with 2 or 100 Hz to the Zusanli (ST36), either individually or simultaneously. The level of pain evoked by the ankle sprain was measured by the stepping force of the sprained paw during walking. The analgesic effects of simultaneous EA was evaluated by the percentage recovery of the stepping force at 1, 2 and 4hr after EA and compared to that of individual EA. RESULTS: Individual EA significantly increased the stepping force of the ankle-sprained paw during walking, but there is no difference in the effect between electrical stimulation with 2 and 100 Hz EA. Simultaneous EA with 2 and 2 Hz or 2 and 100 Hz showed no significant improvement of the stepping force compared to individual EA. CONCLUSIONS: Individual EA with 2 and 100 Hz produced comparable analgesic effects. Simultaneous EA applied to the SI6 and ST36 acupoints produced no synergic interaction, therefore has no beneficial effect for ankle-sprained pain compared to individual EA.
Acupuncture ; Acupuncture Points ; Animals ; Ankle Injuries* ; Ankle* ; Collateral Ligaments ; Electric Stimulation ; Electroacupuncture* ; Rats* ; Sprains and Strains ; Walking

OBJECTIVE: To investigate the effect of functional electrical stimulation (FES) on the motor function of lower limb in hemiplegic patients with stroke or brain injury. METHOD: Fifty subjects (age, 56.66+/-9.85 years old; prevalence duration, 113.49+/-79.94 days after stroke or brain injury) were assigned randomly to 1 of 2 groups; the experimental group (n=25) received conventional rehabilitation with FES and the control group (n=25) received conventional rehabilitation without FES. FES was applied 20 minutes concomitant with rehabilitation, 5 days per week for 4 weeks. Outcome measurements included muscle strength, modified Ashworth scale, Brunnstrom stage, motricity index, 10 meter walking test (10 MWT), and circumference ratios of lower extremity (including thigh and calf). Subjects were evaluated before treatment and at 4 weeks after treatment. RESULTS: No significant differences were found in the baseline measurements. After 4 weeks of treatment, there was significant improvement in thigh circumference ratio and 10 MWT in the FES group, when compared with the control group (p<0.05). CONCLUSION: Twenty sessions of FES, applied to postacute stroke or brain injured patients plus conventional rehabilitation, improved their motor and walking ability.
Brain ; Brain Injuries ; Electric Stimulation ; Humans ; Lower Extremity ; Muscle Strength ; Prevalence ; Stroke ; Thigh ; Walking

OBJECTIVE: To delineate the role of antidiuretic hormone (ADH) in relation to nocturnal polyuria, and to identify the factors influencing on the diurnal antidiuretic hormone level. METHOD: The ADH was measured by radioimmuoassay at daytime (2:00 PM) and at nighttime (2:00 AM) with nocturnal polyuria group (11) and without nocturnal polyuria group (8). Urine volume, serum osmolarity, urine osmolarity, and blood pressure were also measured at the same time. RESULTS: 1) The ADH at 2:00 AM did not increase in nocturnal polyuria group, although it increased in no-symptom group. 2) There was a statistically significant correlation between wheelchair ambulation time and daytime ADH level. 3) The difference of ADH level between daytime and nighttime showed decrease in orthostatic hypotension group. CONCLUSION: There was relationship between nocturnal polyuria and diurnal variation of ADH level. The ADH concentration seems to be influenced by the postural factors and sympathetic factors.
Blood Pressure ; Hypotension, Orthostatic ; Osmolar Concentration ; Polyuria* ; Spinal Cord Injuries* ; Spinal Cord* ; Walking ; Wheelchairs