Relationship between ankle plantar flexor force steadiness and postural stability on stable and unstable platforms

[Purpose]This study was aimed at determining the relationship between ankle plantar flexor force steadiness and postural control during single leg standing on stable and unstable platforms.[Methods]For the thirty-three healthy participants, force steadiness, at target torques of 5%, 20%, and 50% of the maximum voluntary torque (MVT) of the ankle plantar flexors, was measured. Force steadiness was calculated as the coefficient of variation of force. Single leg standing on stable and unstable platforms was performed using the BIODEX Balance System SD. The standard deviation of the anteroposterior center of pressure (COP) displacements was measured as the index for postural control. During both measurements, muscle activities of the soleus were collected using surface electromyography.[Results]On the stable platform, the COP fluctuation significantly correlated with force steadiness at 5% of MVT (r = 0.512, p = 0.002). On the unstable platform, the COP fluctuation significantly correlated with force steadiness at 20% of MVT (r = 0.458, p = 0.007). However, the extent of muscle activity observed for a single leg standing on both stable and unstable platforms was significantly greater than the muscle activity observed while performing force steadiness tasks at 5% and 20% of MVT, respectively.[Conclusion]Postural stability during single leg standing on stable and unstable platforms may be related to one’s ability to maintain constant torque at 5% and 20% of MVT regardless of the muscle activity. These results suggest that the required abilities to control muscle force differ depending on the postural control tasks

Relationship between the Arthroscopic Findings and Pathology of Greater Trochanteric Pain Syndrome

In recent publications on greater trochanteric pain syndrome (GTPS), the pathology receiving the most attention has been gluteus medius muscle tendinous injury, and surgical techniques such as gluteus medius tendon repair and their outcomes for GTPS have been reported. In our department-related facilities, arthroscopic surgeries are routinely performed for the patients with recalcitrant GTPS. A total of 51 patients were diagnosed with GTPS. Surgical treatment was carried out 22 patients (24 joints; 4 males and 18 females; mean age at surgery of 52.0 years). Arthroscopic findings confirmed bursitis in all 24 joints. In all cases, debridement of the greater trochanter bursa provided rapid relief of greater trochanter pain. The Numerical Rating Scale showed significant improvement, from the preoperative mean of 7.8 (range, 6-10) to the postoperative day 7 mean of 1.6 (range, 0-3). The modified Harris Hip Score was significantly improved from the preoperative mean of 65.5 (range, 52.5-78.3) to the final follow-up (average 2.9 months) mean of 96.0 (range, 85.2-100). Fascial damage of the gluteus medius muscle was observed in 21 joints while only 2 patients had a gluteus medius tendinous injury. Greater trochanteric bursitis and fascia or muscle-fiber injury of the gluteus medius muscle are the most common pathologies in patients with lateral hip pain

Characteristics of adolescent athletes with pain during sports activities: evaluation of flexibility using ultrasound elastography

Medical checkups for adolescent athletes aim to prevent or detect sports injuries and manage them before they hamper future sports activities and daily life. However, effective items for evaluation, as well as the areas of intervention to prevent sports injuries, remain unclear. We aimed to clarify the checkup items and intervention areas to prevent sports injuries in adolescent athletes. This is a cross-sectional observational study that investigated the presence or absence of pain in adolescent athletes and associated factors at the time of checkup. We investigated joint laxity, range of motion (ROM), finger-floor distance (FFD), heel–buttock distance (HBD), straight leg raising (SLR) angle, too many toes sign, and presence or absence of low back pain during lumbar extension in 301 junior high school athletes. Additionally, after confirming the developmental stage of the tibial tuberosity using ultrasonography, ultrasound elastography was used to quantify the elasticity of the quadriceps femoris, and items related to pain during sports activities were extracted. Items related to pain included the too many toes sign, low back pain during lumbar extension, and elasticity of the quadriceps femoris. Athletes with a positive too many toes sign were less likely to experience pain; conversely, the harder the quadriceps femoris, the more likely they were to experience pain. Medical checkups focusing on these items are effective for adolescent athletes who are prone to knee pain

Pyogenic Spondylitis Caused by Methicillin-Resistant Staphylococcus aureus Associated with Tracheostomy followed by Resection of Ossification of the Anterior Longitudinal Ligament

Symptomatic ossification of the anterior longitudinal ligament (OALL) is rare. However, when the osteophyte enlarges and obstructive symptoms occur, the patient may require surgery. We present a case of pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus associated with tracheostomy followed by resection of OALL. A 69-year-old woman with OALL complained of dysphagia and suffocation, which was caused by prominent OALL at C4-5. Tracheostomy was performed, followed by osteophytectomy 6 weeks later. Two months after osteophytectomy, she complained of muscle weakness of the extremities, neck pain, and elevated temperature. Magnetic resonance imaging showed an intensity change at the C4-5 vertebrae and an epidural abscess that was causing cord compression requiring urgent decompression. Cultures identified methicillin-resistant Staphylococcus aureus. As osteolytic change and muscle weakness gradually progressed, she underwent anterior and posterior reconstruction with an autograft and instrumentation. Bone union was confirmed at 1 year postoperatively with improvement in neurological status. OALL has potentially the risk of airway obstruction. Therefore, appropriate diagnosis and prompt osteophytectomy are needed in cases of a large prominent ossification that puts the patient at risk of suffocation. However, it is noted that osteophytectomy following urgent tracheostomy carries the possible risk of infection