Assessing the Preservation of Lumbar Lordotic Curvature in Everyday Sitting Conditions Assessed with an Inertial Measurement System.

Background/Objectives: Lumbar lordotic curvature (LLC), closely associated with low back pain (LBP) when decreased, is infrequently assessed in clinical settings due to the spatiotemporal limitations of radiographic methods. To overcome these constraints, this study used an inertial measurement system to compare the magnitude and maintenance of LLC across various sitting conditions, categorized into three aspects: verbal instructions, chair type, and desk task types. Methods: Twenty-nine healthy participants were instructed to sit for 3 min with two wireless sensors placed on the 12th thoracic vertebra and the 2nd sacral vertebra. The lumbar lordotic angle (LLA) was measured using relative angles for the mediolateral axis and comparisons were made within each sitting category. Results: The maintenance of LLA (LLAdev) was significantly smaller when participants were instructed to sit upright (-3.7 ± 3.9°) compared to that of their habitual sitting posture (-1.2 ± 2.4°) (p = 0.001), while the magnitude of LLA (LLAavg) was significantly larger with an upright sitting posture (p = 0.001). LLAdev was significantly larger when using an office chair (-0.4 ± 1.1°) than when using a stool (-3.2 ± 7.1°) (p = 0.033), and LLAavg was also significantly larger with the office chair (p < 0.001). Among the desk tasks, LLAavg was largest during keyboard tasks (p < 0.001), followed by mouse and writing tasks; LLAdev showed a similar trend without statistical significance (keyboard, -1.2 ± 3.0°; mouse, -1.8 ± 2.2°; writing, -2.9 ± 3.1°) (p = 0.067). Conclusions: Our findings suggest that strategies including the use of an office chair and preference for computer work may help preserve LLC, whereas in the case of cueing, repetition may be necessary.

Early Quantitative Partial Weight-Bearing Exercise After Periarticular Fractures of the Tibia Using a Lower-Body Positive-Pressure Treadmill: A Case Series.

The partial weight-bearing protocol after lower limb fracture is an important issue in postoperative rehabilitation. Because it is difficult to quantify the actual weight load and provide a constant weight, the protocol is unestablished. By training with a lower-body positive-pressure treadmill and using an in-shoe pressure-measuring device, partial weight-bearing exercise can be performed with quantified loads. This case series illustrates the applicability of an early quantitative partial weight-bearing rehabilitation program using lower-body positive-pressure treadmill with an in-shoe pressure-measuring device after periarticular tibial fractures, which provides a quantitatively predetermined constant load.

Natural aging course of paraspinal muscle and back extensor strength in community-dwelling older adults (sarcopenia of spine, SarcoSpine): a prospective cohort study protocol.

INTRODUCTION: Sarcopenia in the lumbar paraspinal muscles is receiving renewed attention as a cause of spinal degeneration. However, there are few studies on the precise concept and diagnostic criteria for spinal sarcopenia. Here, we develop the concept of spinal sarcopenia in community-dwelling older adults. In addition, we aim to observe the natural ageing process of paraspinal and back muscle strength and investigate the association between conventional sarcopenic indices and spinal sarcopenia. METHODS AND ANALYSIS: This is a prospective observational cohort study with 120 healthy community-dwelling older adults over 4 years. All subjects will be recruited in no sarcopenia, possible sarcopenia or sarcopenia groups. The primary outcomes of this study are isokinetic back muscle strength and lumbar paraspinal muscle quantity and quality evaluated using lumbar spine MRI. Conventional sarcopenic indices and spine specific outcomes such as spinal sagittal balance, back performance scale and Sorenson test will also be assessed. ETHICS AND DISSEMINATION: Before screening, all participants will be provided with oral and written information. Ethical approval has already been obtained from all participating hospitals. The study results will be disseminated in peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER: NCT03962530.

Effect of extracorporeal shockwave therapy on carpal tunnel syndrome: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Although several trials have reported the use of extracorporeal shock wave therapy (ESWT) for mild to moderate carpal tunnel syndrome (CTS), little is known about the efficacy of ESWT. Thus, we performed a meta-analysis to evaluate whether ESWT can improve symptoms, functional outcomes, and electrophysiologic parameters in CTS. METHODS: Six randomized controlled trials investigating the effect of ESWT on CTS were retrieved from PubMed, Embase, and the Cochrane Library. We performed a pairwise meta-analysis using fixed- or random-effects models. RESULTS: ESWT showed significant overall effect size compared to the control (overall Hedge g pooled standardized mean difference (SMD) = 1.447; 95% confidence interval [CI], 0.439-2.456; P = .005). Symptoms, functional outcomes, and electrophysiologic parameters all improved with ESWT treatment. However, there was no obvious difference between the efficacy of ESWT and local corticosteroid injection (pooled SMD = 0.418; 95% CI, -0.131 to 0.968; P = .135). A publication bias was not evident in this study. CONCLUSION: Our meta-analysis revealed that ESWT can improve symptoms, functional outcomes, and electrophysiologic parameters in patients with CTS. Further research is needed to confirm the long-term effects and the optimal ESWT protocol for CTS.

Obesity cutoff values in Korean men with motor complete spinal cord injury: body mass index and waist circumference.

STUDY DESIGN: Cross-sectional. OBJECTIVES: To determine the obesity cutoff values for body mass index (BMI) and waist circumference (WC) in Korean men with motor complete spinal cord injury (SCI). SETTING: Tertiary level hospital in Seoul, Korea. METHODS: BMI (kg/m2) was calculated and WC (cm) was measured in each participant in the supine position. Percentage of total body fat (%) was determined using whole-body dual-energy X-ray absorptiometry. Receiver operating characteristic curves were generated to determine the obesity cutoff values for BMI and WC. The optimal cutoff values were determined using the Youden index. Identified cutoff values were compared with those of 195 age- and BMI-matched men in the general population (GP), obtained from the Korea National Health and Nutrition Examination Survey. RESULTS: This study included 52 Korean men with motor complete SCI. A BMI of 20.2 kg/m2 and WC of 81.3 cm were identified as obesity cutoff values in Korean men with motor complete SCI. The area under the curve (AUC) was 0.928, specificity was 100%, and sensitivity was 84.8% according to the ROC curve of BMI for participants. AUC was 0.964, specificity was 100%, and sensitivity was 84.8% in the ROC curve of WC for participants. A BMI of 22.5 kg/m2 and WC of 85.5 cm were identified as obesity cutoff values in age- and BMI-matched men in the GP. CONCLUSIONS: The obesity cutoff values in Korean men with motor complete SCI that were determined in this study were lower than those of the Korean GP and western people with SCI.

Clinical Experience of Sturdy Elevation of the Reconstructed Auricle.

BACKGROUND: The ear is composed of elastic cartilage as its framework, and is covered with a thin layer of skin. Auricular reconstruction using autogenous cartilage in microtia patients requires delicacy. This paper reports clinical experiences related to elevation of reconstructed ear in the last 11 years. METHODS: This study was based on 68 congenital microtia patients who underwent auricular elevation in our hospital. Among these 68 patients, 47 patients were recruited. We compared the differences in the ear size, auriculocephalic angle, and conchal depth with those in the opposite ear, and the patients' satisfaction levels were investigated using a survey. RESULTS: The difference in the sizes of the two ears was less than or equal to 5 mm in 32 patients, 5 to 10 mm in 10 patients, and greater than or equal to 10 mm in 5 patients. The difference in the auriculocephalic angles of the two ears was less than or equal to 10 degrees in 14 patients, 10 to 20 degrees in 26 patients, and greater than or equal to 20 degrees in 7 patients. The difference in the conchal depths of the two ears was less than or equal to 5 mm in 24 patients, 5 to 10 mm in 19 patients, and greater than or equal to 10 mm in 4 patients. The average grade of 3.9 points out of 5 points was obtained by the patients with satisfactory surveys. CONCLUSION: We could make enough protrusion and maintain the three-dimensional shape for a long time to satisfy our patients.

Correction of the supratip deformity of the nose.

BACKGROUND: A supratip deformity can develop either congenitally or after a poorly executed rhinoplasty, as a result of fullness or convexity just above the nasal tip. OBJECTIVE: In this article, the authors describe the causes of the supratip deformity and present their technique for surgical correction. METHODS: A retrospective chart review was conducted for 62 consecutive patients (24 primary rhinoplasty and 38 secondary rhinoplasty) treated between January 2005 and February 2010. The authors' approach to managing supratip deformity included a combination of wide undermining of the nasal skin through the open technique; resection of excessive soft tissue and the bony, cartilaginous dorsum; suturing to advance the supratip; and augmentation of the nasal tip and dorsum with cartilage, crushed cartilage, silicone implants, and/or septal extension grafts. RESULTS: No infection or nasal bleeding was recorded during postoperative follow-up. The supratip and tip projection showed adequate shape in all cases. To assess satisfaction, all patients and 2 independent plastic surgeons were asked to rate the result on a 5-point scale. The average patient satisfaction rating was 4.2 and the average independent rating was 4.4 points. CONCLUSIONS: Supratip deformities should be corrected according to their unique cause and shape. The authors' method of repairing these deformities has resulted in a low complication rate and yielded satisfactory results.

Perceptual speech assessment after maxillary advancement osteotomy in patients with a repaired cleft lip and palate.

BACKGROUND: Maxillary hypoplasia refers to a deficiency in the growth of the maxilla commonly seen in patients with a repaired cleft palate. Those who develop maxillary hypoplasia can be offered a repositioning of the maxilla to a functional and esthetic position. Velopharyngeal dysfunction is one of the important problems affecting speech after maxillary advancement surgery. The aim of this study was to investigate the impact of maxillary advancement on repaired cleft palate patients without preoperative deterioration in speech compared with non-cleft palate patients. METHODS: Eighteen patients underwent Le Fort I osteotomy between 2005 and 2011. One patient was excluded due to preoperative deterioration in speech. Eight repaired cleft palate patients belonged to group A, and 9 non-cleft palate patients belonged to group B. Speech assessments were performed preoperatively and postoperatively by using a speech screening protocol that consisted of a list of single words designed by Ok-Ran Jung. Wilcoxon signed rank test was used to determine if there were significant differences between the preoperative and postoperative outcomes in each group A and B. And Mann-Whitney U test was used to determine if there were significant differences in the change of score between groups A and B. RESULTS: No patients had any noticeable change in speech production on perceptual assessment after maxillary advancement in our study. Furthermore, there were no significant differences between groups A and B. CONCLUSIONS: Repaired cleft palate patients without preoperative velopharyngeal dysfunction would not have greater risk of deterioration of velopharyngeal function after maxillary advancement compared to non-cleft palate patients.