Correlation of medial longitudinal arch morphology with body characteristics and locomotive function in community-dwelling older women: A cross-sectional study.

PURPOSE: This cross-sectional study aimed to investigate the effects of foot arch deformities on physical characteristics, muscular strength, and motor function in older women depending on the presence or absence of pain. METHODS: Overall, 145 community-dwelling women aged 65 to 90 years were included in this study. We measured the foot arch height ratio (AHR, dorsal height/truncated foot length) and classified participants with AHR values above, below, or within 1.5 standard deviations into the high-arched group (HAG), Low-Arched Group (LAG), or normal-arched group (NAG), respectively. We also compared body characteristics (age, height, weight, body mass index (BMI), and skeletal mass index), muscle strength (handgrip strength and intrinsic foot strength (IFS)), and locomotive function (two-step value and gait speed) among the three groups. RESULTS: Locomotive examination and muscle strength showed significant differences among the three groups only in the presence of pain; in the two-step test, HAG, NAG, and LAG values were 0.98 cm/cm, 1.19 cm/cm, and 1.18 cm/cm, respectively. The IFS measured 19.2 N, 24.2 N, 31.0 N, respectively, in the HAG, NAG, and LAG. CONCLUSION: This study suggests that decreased IFS affects the mobility function of high-arched feet in older women. Although there was no significant difference in the evaluation of pain, HAG showed the highest average value, which is considered to contribute to the decreased two-step value. It has been suggested that a high-arched foot in the presence of pain is associated with IFS weakness and may affect the decline of mobility function in older women.

Spinal postural alignment measurements using markerless digital photography.

BACKGROUND: A device that can measure posture alignment repeatedly is important for the prevention of hyperkyphosis. OBJECTIVE: We devised a markerless measurement method for hyperkyphosis using digital photography and investigated the correlation with other noninvasive measurements and the validity and accuracy of this method. METHODS: The study included 27 participants. The craniovertebral angle in supine (CVAS) and craniohorizontal angle in supine (CHAS) were calculated from digital photographs of the head and neck areas of the studied subjects with ImageJ. The correlations of CVAS and CHAS with the kyphosis index (KI) and block method (BM) were investigated. Intrarater correlation coefficient and Bland-Altman analyses were used to verify the reliability and accuracy of the measured results. RESULTS: CHAS exhibited an excellent correlation with the KI and the BM. The intra- and interrater reliabilities of CHAS were almost perfect. Bland-Altman analysis revealed that CHAS was associated with minor addition errors. CONCLUSION: CHAS founded an excellent correlation and reliability with the conventional spinal postural alignment measurements. The addition error suggested that the manual was needed to confirm the landmark. The CHAS is a method used to measure the spinal postural alignment in a supine position without markers and without exposing the skin surface.

Novel method for evaluation of frontal plane knee alignment using bony prominences in patients with osteoarthritis.

[Purpose] Angle measurement using images of bony prominences (AMI) determines frontal plane knee alignment from the skin surface without using radiation. The purpose of this study was to assess the validity and reliability of images obtained with the AMI method. [Participants and Methods] The study included 21 patients with osteoarthritis. We measured the functional axis of the lower limb, obtained via full-leg radiography and correlated the findings with the angle of dissection and the angle measured with the AMI method. Additionally, we assessed the reliability of the AMI method. [Results] The angle obtained using the AMI method and the radiographic anatomic axis (the full-leg radiograph)/the mechanical axis were well correlated. The AMI method also showed high reliability. [Conclusion] The AMI method is a valid and reliable alternative to full-leg radiography for imaging of functional and anatomical knee axes. As AMI does not use special equipment or involve radiation exposure, the method can be used in outside medical facilities and can be repeated over time without increased risk to patients.

Association between Acute Postoperative Pain and Recovery of Independent Walking Ability after Surgical Treatment of Hip Fracture.

OBJECTIVE: The intensity of pain after surgical treatment of hip fracture has a negative effect on functional recovery. However, the effects of acute postoperative pain on the recovery of walking ability after the surgery remain unclear. This study aimed to investigate the association between acute postoperative pain and the recovery of functional gait among patients who had independent walking ability prior to hip fracture. METHODS: This was an observational study that included 41 patients with a mean age of 81.3±7.3 years who underwent surgical treatment for traumatic hip fracture at a general hospital. The primary outcome was the time to recovery of independent gait postsurgery. Based on the median time to recovery, patients were classified into an early independent walking group and an independent walking group. Stepwise logistic regression analysis was performed to identify predictive factors of the time to recovery of independent walking. RESULTS: The median time to recovery of independent gait was 24 days (range, 7-50 days). In total, 20 patients were classified in the early independent walking group and 21 in the independent walking group. On logistic regression analysis, the total pain intensity, reported during activities of daily living (ADL) on postoperative days 5 and 6, and the knee extensor strength were predictive of the time to recovery of independent walking. CONCLUSIONS: The degree of recovery of gait function of patients surgically treated for hip fracture was found to be predicted by the pain intensity measured during ADL and the knee extensor strength assessed in the acute phase. Effective management of acute pain after surgical treatment of hip fracture may help improve functional recovery of gait.

Factors Associated With Psycho-Cognitive Functions in Patients With Persistent Pain After Surgery for Femoral Neck Fracture.

BACKGROUND: The aim of the study was to address issues arising from fracture of the femoral neck in elderly individuals, the prevalence of which continues to increase in Japan. The prevalence is increasing in Japan and there have been many reports on physical functions such as prevention of a fall. However, there have been a few studies that focus on psycho-cognitive functions. We must examine factors in patients with fractured femur necks to develop methods to assist affected patients. The current study aimed to examine factors associated with psycho-cognitive functions after surgery for fractured femoral neck in the Japanese elderly. METHODS: In this study, we examined the relationships among sex, age, fracture site, operative procedure, body mass index, lifestyle, psycho-cognitive functions, and types of pain in 142 patients, performed multiple regression analysis using the mini-mental state examination (MMSE) and the Montgomery-Asberg depression rating scale (MADRS) scores as dependent variables, and created MMSE and MADRS models. RESULTS: Analysis of MMSE and MADRS models identified night pain and the number of family members as factors that affected mental function in a population with persistent pain for 1 week after surgery for fractured femoral neck. In addition, the number of family members was identified in multiple regression analysis models as a factor associated with psycho-cognitive functions. Pain, and night pain in particular, affect psycho-cognitive functions. CONCLUSIONS: We speculated that emotional changes were associated with number of family members. Patients living with family members maintained psycho-cognitive functions better than did those living alone, even when they experienced pain in their daily lives.