Spine Alignment in Standing and Maximal Upper Limb Elevation in Baseball Players with Lumbar Spondylolysis and Those without Low Back Pain

The changes in lumbar lordosis angle (LL) and sacral slope angle (SS) related to upper limb elevation and thoracic kyphosis angle (TK) in baseball players with spondylolysis remain unclear. Herein, we investigated baseball players with spondylolysis and those without low back pain, comparing LL and SS with upper limb elevation within and between groups and TK between groups. Baseball players with spondylolysis were enrolled as subjects, and baseball players without low back pain were enrolled as controls (n = 8 each). X-rays were obtained in the standing position and with maximal elevation position of the upper limb (elevation position). LL and SS were measured in the standing and elevated positions, and TK was measured in the standing position. LL was significantly larger in individuals with spondylolysis than controls. The SS of the control group was significantly larger in the elevated position than in the standing position, while the SS of the spondylolysis group was not significantly different between positions. SS was significantly larger in the spondylolysis group than in the control group, only in the standing position. Physical therapy for spondylolysis should focus on hyperlordosis alignment in the standing and maximal elevation positions of both upper limbs, sacral hyper-slope alignment in the standing position, and decreased sacral slope motion

Range of motion patterning in trunk and upper and lower extremities of high school baseball pitchers

Evaluating range of motion (ROM) using several joints is essential for rehabilitating throwing injuries. We used multivariate analysis to elucidate the ROM patterns in baseball pitchers. This cross-sectional study measured the variable ROM in the upper extremities, trunk, and lower extremities. High school baseball pitchers participated (N = 121). Factor analysis of ROM was performed using the maximum likelihood method. We analyzed the characteristics of pitchers with positive findings by classifying all players using cluster analysis (Ward’s method). Factor analysis showed a seven-factor solution was shown to be appropriate. Cluster analysis indicated that we could divide the players into three clusters that we named according to their characteristics and ROM: Cluster A: “Low flexibility” type, Cluster B: “High rotation” type, and Cluster C: “Poor rotation” type. The results indicated that most positive players were in Cluster A (46.4%). Players in Cluster A had lower ROM in the trunk, hip rotation, and SLR (straight leg raise) test than the other groups. This is the first study to identify the patterns of ROM in high school baseball pitchers with positive findings. These results are useful for conditioning baseball players

Case Report : Hereditary Fibrosing Poikiloderma With Tendon Contractures, Myopathy, and Pulmonary Fibrosis (POIKTMP) Presenting With Liver Cirrhosis and Steroid-Responsive Interstitial Pneumonia

Background: Hereditary fibrosing poikiloderma with tendon contractures, myopathy, and pulmonary fibrosis (POIKTMP) is an extremely rare disease caused by mutations in FAM111B, and only approximately 30 cases have been reported worldwide. Some patients develop interstitial pneumonia, which may lead to progressive pulmonary fibrosis and poor prognosis. However, no effective treatment for interstitial pneumonia associated with POIKTMP has been reported. Here, we report an autopsy case of POIKTMP, wherein interstitial pneumonia was improved by corticosteroids.Case Presentation: A 44-year-old Japanese man was referred to our hospital due to poikiloderma, hypotrichosis, and interstitial pneumonia. He developed progressive poikiloderma and muscle weakness since infancy. He also had tendon contractures, short stature, liver cirrhosis, and interstitial pneumonia. Mutation analysis of FAM111B revealed a novel and de novo heterozygous missense mutation, c.1886T > G (p(Phe629Cys)), through which we were able to diagnose the patient with POIKTMP. 3 years after the POIKTMP diagnosis, interstitial pneumonia had worsened. After 2 weeks of administrating 40 mg/day of prednisolone, his symptoms and lung shadows improved. However, he subsequently developed severe hepatic encephalopathy and eventually died of respiratory failure due to bacterial pneumonia and pulmonary edema. Autopsy revealed an unclassifiable pattern of interstitial pneumonia, as well as the presence of fibrosis and fatty degeneration in several organs, including the liver, kidney, skeletal muscle, heart, pancreas, and thyroid.Conclusions: We report a case of POIKTMP in which interstitial pneumonia was improved by corticosteroids, suggesting that corticosteroids could be an option for the treatment of interstitial pneumonia associated with this disease