The relationship between trans-femoral prosthesis alignment and the center trajectory of plantar pressure in the frontal plane.

[Purpose] It is difficult to identify by visual observation whether alignment abnormalities in trans-femoral prostheses in the frontal plane are attributable to the adduction angle or the abnormal alignment of the positions of the medial and lateral sides of the socket in relation to the foot. Therefore, we focused on the trajectory of the center of plantar pressure during walking, and we proposed a method for differentiating these two alignment abnormalities. [Subjects and Methods] We recruited 4 trans-femoral unilateral amputees. Bench alignment was achieved initially. We compared the amplitude of the trajectory of the center of plantar pressure when walking under 2 conditions: 1) when changing the adduction angle and 2) when changing the positional relationship between the socket and the foot. [Results] It was not possible to distinguish between the 2 types of malalignment on the prosthesis side. There was a significant difference when changing the positional relationship on the contralateral side. Thereby, the plantar pressure of the contralateral side could be used to distinguish between the 2 types of malalignment. [Conclusion] The results of this study suggested that trans-femoral prosthesis malalignment could be evaluated through the plantar pressure of the contralateral side in amputees.

[The effect of unsupervised home exercise program for patients with chronic obstructive pulmonary disease].

PURPOSE: This study assessed the effects of an unsupervised exercise training program at home on exercise function and health related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD). METHODS: Forty-two patients with COPD (age 72.9+/-7.7 years; all males) were assigned to the exercise group (n=32) or the no-exercise group (n=10). The exercise group received a video recording of respiratory exercises to help them perform this program at home for six months. The no-exercise group did not receive any exercise program. The outcome measures were forced expiratory volume in one second (FEV(1)), vital capacity (VC), MRC dyspnea scale, 6 min walking distance (6MWD), shuttle walking distance (SWD), Borg scale and chronic respiratory disease questionnaire (CRQ) which includes four domains: dyspnea, fatigue, emotional function, and mastery. RESULTS: Patients completing this study consisted of: 19 patients in the exercise group, and 7 patients in the no-exercise group. Seventeen of the patients in the exercise group performed respiratory exercises every day for six months. We did not find any significant change in pulmonary function and dyspnea in either group. Significant improvements were achieved in 6MWD, SWD, CRQ (Dyspnea, Mastery) in the exercise group only. CONCLUSION: Our study suggested that unsupervised exercise training program at home consisting of respiratory exercise improved of exercise tolerance and HRQOL in patients with COPD.