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Manual ability is considered one of the factors that can predict functional independence in activities of daily living. For evaluating personal tasks such as self-care, the Pediatric Evaluation of Disability Inventory (PEDI) comprises/introduces/offers a set of useful measures that assist in enhancing the capability for self-care among children and adolescents with cerebral palsy (CP). The aim of this study was to investigate the relevant factors of self-care capability and performance in children and adolescents with spastic CP. This was a cross-sectional study. Seventy-six children and adolescents with spastic CP (between 5 and 18 years of age), representing levels I to IV of the Gross Motor Function Classification System-Expanded & Revised version (GMFCS), were analyzed. Multiple linear regression analysis with forward stepwise selection was conducted to examine which determinants were related to self-care capability and performance. Independent variables were age, CP type, GMFCS, Manual Ability Classification System, Box and Block Test, and grip strength in the dominant and non-dominant hands. Dependent variables were scores for the PEDI Functional Skills Scale and the PEDI Caregiver Assistance Scale. When considering self-care of children and adolescents with spastic CP, it is necessary to consider the evaluation of upper limb dysfunction in addition to GMFCS.

To identify suggestions for future research on spinal movement variability (SMV) in individuals with low back pain (LBP) by investigating (1) the methodologies and statistical tools used to assess SMV; (2) characteristics that influence the direction of change in SMV; (3) the methodological quality and potential biases in the published studies; and (4) strategies for optimizing SMV in LBP patients. We searched literature databases (CENTRAL, Medline, PubMed, Embase, and CINAHL) and comprehensively reviewed the relevant papers up to 5 May 2020. Eligibility criteria included studies investigating SMV in LBP subjects by measuring trunk angle using motion capture devices during voluntary repeated trunk movements in any plane. The Newcastle-Ottawa risk of bias tool was used for data quality assessment. Results were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Eighteen studies were included: 14 cross-sectional and 4 prospective studies. Seven linear and non-linear statistical tools were used. Common movement tasks included trunk forward bending and backward return, and object lifting. Study results on SMV changes associated with LBP were inconsistent. Two of the three interventional studies reported changes in SMV, one of which was a randomized controlled trial (RCT) involving neuromuscular exercise interventions. Many studies did not account for the potential risk of selection bias in the LBP population. Designers of future studies should recognize that each of the two types of statistical tools assesses functionally different aspects of SMV. Future studies should also consider dividing participants into subgroups according to LBP characteristics, as three potential subgroups with different SMV characteristics were proposed in our study. Different task demands also produced different effects. We found preliminary evidence in a RCT that neuromuscular exercises could modify SMV, suggesting a rationale for well-designed RCTs involving neuromuscular exercise interventions in future studies.

In Japan, the child development support initiative is one of the government's daycare support programs for children with disabilities. Children, aged 0-6 years, who are not attending elementary school can participate in the initiative and receive various support. Reports on the approaches taken by private child development support centers and the guardians' perceptions are increasing. Conversely, information from public child development support centers, which serve as places for initial developmental consultation, is extremely scarce. Moreover, there are no nationwide reports on the main complaints from each region, which are of concern to the parents. This study aimed to clarify children's gender and age, presence of referral sources, and characteristics of the main complaints obtained during the initial consultation with parents of children with developmental delays, who used a public developmental support center in a medium-sized city in Tokyo. This study included 1,241 parents of children with developmental delays (average 40.3 months, range 2-87 months). Five questions regarding each child's characteristics (gender, age in months, and medical diagnosis), referral sources for the use of support centers, and main complaints that they would like to discuss at the initial consultation, were asked. The participants were asked to describe their main complaints (specific consultation details) as precisely as possible. From the free-form descriptions of the main complaints, 137 codes were extracted and grouped into 13 categories. Participants were divided into two groups according to the presence (  = 122) or absence ( = 1,119) of a medical diagnosis. The -test, chi-square test, and Fisher's exact probability test were used to examine differences between the two groups. Logistic regression analysis with forced entry was performed to examine whether the factors related to the main complaints raised by parents of children with developmental delays differed depending on the presence or absence of a medical diagnosis. The most common chief complaint at the time of the initial consultation was \"language development\" (43.9%), followed by \"childcare and preschool counseling\" (15.4%), \"hyperactivity/inattention\" (13.9%), and \"general developmental issues\" (13.6%). The regression analysis revealed that gender, age (months), and general developmental issues were factors associated with the presence or absence of a medical diagnosis were gender, age in months, and general developmental issues. The odds ratios (95% confidence intervals) were 1.573 (1.056-2.343) for gender, 0.988 (0.976-1.000) for age (months), and 0.421 (0.200-0.886) for general developmental issues. Professionals involved in child development support are expected to have broad knowledge of various developmental issues as well as comprehensive knowledge of local childcare and schooling systems.

Due to the COVID-19 pandemic, university education has shifted from face-to-face classes to online and distance learning. Effects of exposure may manifest in terms of psychological, cognitive, or musculoskeletal impairments that affect an individual's daily functioning and quality of life. There is a dearth of studies exploring anxiety states, occupational dysfunction, and mental health associated with the new standard of increased telecommunication. Accordingly, the present study aimed to identify the differences in occupational dysfunction, health literacy, positive and negative emotions, and stress response considering the anxiety states of college students during the COVID-19 pandemic. Another purpose is to identify relationships among the parameters such as occupational dysfunction and mental health. This cross-sectional study included 358 students (average age: 18.5 years, age range: 18-29 years). Five tools were used: the State-Trait Anxiety Inventory (STAI), Classification and Assessment of Occupational Dysfunction (CAOD), European Health Literacy Survey Questionnaire (HLS-EU-Q47), Profile of Mood States 2nd Edition (POMS-2), and Stress Response Scale-18 (SRS-18). Based on the cutoff value of state and trait anxiety of the STAI, the participants were classified into four groups and compared using one-way analysis of variance and multiple comparison tests. The relationship between all parameters was analyzed using Pearson's correlation coefficient. The group with high trait anxiety and high state anxiety had the highest CAOD total score, Total Mood Disturbance score on the POMS-2, SRS-18 score, and scores on many sub-items of the three parameters. The prevalence of occupational dysfunction was 47% for university students, and there was a variation of from 19 to 61% in each group. The correlation coefficients of the state and trait anxiety scores of the STAI, Total Mood Disturbance score, and SRS-18 ranged from .64 to .75. Additionally, the correlation coefficient between the CAOD total score and these parameters ranged from .44 to .48. The prevalence of occupational dysfunction was highest in the group with high trait anxiety and high state anxiety, and occupational dysfunction, negative emotions, and stress responses were strongest in this group. Our findings point to potential areas for targeted support and interventions.

Background Suction drainages are commonly used after total knee arthroplasty (TKA) procedures; however, their use is somewhat controversial. Recently, some reports have claimed that the administration of tranexamic acid (TXA) may prevent postoperative bleeding following TKAs. Although numerous studies have reported regarding different dosages, timings of administration, or drain clamping times for intravenous and intra-articular TXA injections (IA-TXAs), few have examined whether suction drainage is necessary when TXA is administered. In this study, we compared using suction drainage without TXA administration and IA-TXA without suction drainage and aimed to examine the need for suction drainage during IA-TXA. Methods This retrospective study was conducted on 217 patients who had received TKA for osteoarthritis; 104 were placed on suction drainage after TKA without TXA (Group A), whereas the remaining 113 received IA-TXA immediately after surgery without suction drainage (Group B). Our clinical evaluation included assessments of the need for transfusion, presence of postoperative complications, incidence of deep vein thrombosis (DVT), and changes in hemoglobin (Hb), hematocrit (Hct), and D-dimer levels. Results No significant differences were observed in terms of postoperative complications and preoperative Hb, Hct, or D-dimer levels between the two groups. Although the prevalence of DVT was significantly higher in Group B ( p  < 0.05), all cases were asymptomatic. Hb and Hct levels were significantly lower in Group A than in Group B at 1, 3, 7, and 14 days postoperatively ( p  < 0.05), although none of the cases required blood transfusions. D-dimer levels were significantly higher in Group A than in Group B at 1 and 3 days postoperatively ( p  < 0.05). Conclusion Suction drainage might not be necessary when IA-TXA is administered after TKA procedures.

Tensiomyography (TMG) is a non-invasive instrument for measuring mechanical muscle contraction characteristics and measuring the maximum displacement of the muscle belly in the radial direction with respect to the muscle and the time needed to achieve this from electrical stimulation. There have been only been a reports of TMG in healthy adults. A systematic review of TMG reported a low proportion of female participants, with a small sample size. Therefore, it is unclear whether there is a difference in TMG parameters according to sex and between dominant and non-dominant feet. Furthermore, the relationship between TMG parameters and evaluations commonly used in clinical practice has not been clarified. This study aimed to clarify the characteristics of muscle contraction of the rectus femoris using TMG according to sex among healthy college students and its relationship with muscle function evaluation, such as lower limb muscle mass and muscle strength. This cross-sectional study included 91 healthy university students (18-24 years). Five tools were used: TMG, lower-limb muscle mass, rectus femoris thickness, isometric knee joint extension torque, and thigh circumference. Each parameter was compared by the generalized linear mixed model (GLMM) and Bonferroni's multiple comparison test, with sex as the without-subject factor and dominant/non-dominant foot as the within-subject factor. The correlation between the TMG parameters and other parameters was examined using Pearson's correlation coefficient for both males and females. The results of the GLMM, in terms of the TMG parameters, an interaction was observed for maximum displacement (Dm); in the results of the multiple comparison test, Dm for the non-dominant leg was significantly lower in females than in males. A main effect and interaction were not observed for delay time (Td) and contraction time (Tc) by sex, dominant foot, or non-dominant foot. There was a main effect of sex on muscle function evaluation parameters (ρ ≤ 0.05). The correlation between TMG parameters for males and females and lower limb muscle mass, muscle thickness, joint torque, and thigh circumference were significantly correlated with some TMG parameters, lower limb muscle mass and muscle thickness (ρ ≤ 0.05). The absolute value of the correlation coefficient was low overall (0.20-0.38). In healthy college students, TMG parameters for the rectus femoris showed sex differences in Dm, and there was a weak correlation between TMG parameters and lower limb muscle mass. TMG parameter evaluation may indicate a different function compared to the traditional muscle function assessment used in clinical practice. When using the Dm of the TMG as an evaluation battery for the rectus femoris muscle, it is important to consider sex-related differences.

Background In primary total knee arthroplasty (TKA), tibial bone defects ≥ 10 mm in depth often become uncontained defects, a condition most surgeons find challenging to treat. Although the allogenous bone graft is a useful method, complications such as infection and nonunion are likely to occur. There are several reports on the use of allogenous bone graft in revision TKA; however, few studies have investigated its use in primary TKA. We performed primary TKA using the allogenous bone graft as a structural bone graft to treat uncontained defects ≥ 10 mm in depth. This study aimed to assess the clinical and radiographical results after primary TKA with allogenous structural bone graft (ASBG). Methods Seventeen patients (mean age, 69.2 years) with a follow-up period of at least 7 years, were retrospectively reviewed. All cases had been treated for medial bone defects using the ipsilateral medial tibial allogenous bone. Clinical evaluation included the assessment of the knee and function scores and knee angle, and the hip-knee-ankle (HKA) angle, bone union, and radiolucent line (RL) were assessed radiologically. Results The mean depth of the medial tibial defects after tibia cutting was 16.8 mm. Nonunion occurred in one case, and RL occurred in another. We observed a significant difference when the preoperative knee score and HKA angle of patients was compared with that at 1 year postoperatively and the final evaluation. No major complications were observed. Conclusion The ASBG technique produced favorable surgical outcomes and may be an acceptable procedure for managing uncontained tibial bone defects ≥ 10 mm in depth in primary TKA.

Background Slow walking speed as one indicator of physical frailty has been found to be associated with deterioration of the health status. Although many reports have shown that exercise training improves motor function, it is unclear whether a group-based and short-term health promotion intervention will improve motor function in older adults. Aims This study aimed to examine the effectiveness of a short-term health promotion intervention on motor function in community-dwelling older adults. Methods A 6-month middle-term and moderate-intensity programme (MTMIP) and a 6-week short-term high-intensity programme (STHIP) were conducted. There were 28 and 29 subjects selected for the MTMIP and STHIP, respectively. The difference in motor function test outcomes was compared by assessment of comfortable walking speed, maximal walking speed, a sit-to-stand test (STS), and a timed up-and-go test (TUG). Results Comfortable walking speed, maximum walking speed, STS and TUG were significantly improved at end of the programme in the STHIP group ( p  = 0.02, p  = 0.03, p  < 0.001 and p  = 0.002). Multiple regression analysis revealed that implementation of STHIP had a significant effect on end-of-programme comfortable walking speed ( β  = 0.19, p  = 0.006, 95% CI 0.06 to 0.32). Discussion It was assumed that the training content of the STHIP, with its emphasis on high intensity and physical performance, was the main factor in improved walking speed. Conclusions Our results demonstrated the effectiveness of STHIP on motor function. These findings could help support development of more effective intervention methods in community-dwelling older adults.

The recognition of required treatments for cerebral palsy (CP) patients, including orthopedic surgery, differs according to region. This study was performed to identify factors associated with satisfactory changes in physical function after orthopedic surgery. 358 patients were selected for the questionnaire survey. The following information was collected: gender, primary disease, age of initial surgery, total procedural count, operated sites, satisfaction of postoperative rehabilitation frequency, ideal amount of postoperative rehabilitation sessions per week, frequency of voluntary home training per week, satisfaction of the timing of surgery and the current satisfaction with the changes in physical function after the orthopedic surgery. We classified the patients into the satisfied and dissatisfied group according to satisfactory changes in physical function after the surgery. We performed unpaired t-tests and chi-square tests to determine the variables that differed significantly between the groups. Variables with a p value of <0.2 were included in the multivariate logistic regression analysis. The logistic model was revised and summed up to two potential predictors of postsurgical satisfaction with physical function: satisfaction with the frequency of postoperative rehabilitation sessions and the orthopedic surgery of the hip (distinction hit ratio, 75.4%). This study demonstrated that the frequency of postoperative rehabilitation and history of hip surgery seemed to be related to the satisfaction with the changes in physical function after orthopedic surgery.

Background Elderly adults undergoing hemodialysis (HD) have multiple comorbidities, physical frailty, and functional dependence with activities of daily living (ADL). ADL difficulty is an early predictor of ADL dependency in community-dwelling elderly adults. However, the characteristics of ADL difficulty in patients undergoing HD have not yet been reported. The present study aimed to examine the current status and characteristics of physical function and ADL difficulty in ambulatory elderly patients undergoing HD. Methods In all, 136 elderly outpatients undergoing HD and 40 community-dwelling controls participated in the present study. The characteristics, physical function (SARC-F score, grip strength, five-times sit-to-stand test time, usual gait speed, maximum gait speed, and short physical performance battery score), and scores from the ADL difficulty questionnaires [difficulty related to upper limb (U/L) and lower limb (L/L) functions] were compared between the HD and control groups. Multiple regression analysis was performed to examine whether the characteristics of physical function were able to discriminate ADL difficulty in the HD group. Results The HD group had a significantly greater SARC-F score, lower grip strength, longer five-times sit-to-stand test time, slower usual gait speed, slower maximum gait speed, lower short physical performance battery score, and lower U/L and L/L ADL difficulty scores compared to the control group (all P < 0.001). The distribution of U/L and L/L ADL difficulty scores showed a wider variation in the HD group than in the control group. The U/L ADL difficulty score was independently associated with the SARC-F score (β = −0.52, P < 0.001) and grip strength (β = 0.21, P = 0.02). The L/L ADL difficulty score was independently associated with the SARC-F score (β = −0.56, P < 0.001) and usual gait speed (β = 0.35, P < 0.001). Conclusions The elderly HD group had a poorer physical function and experienced stronger ADL difficulty than the control group. There was an association between ADL difficulty and sarcopenia or poor physical function among patients undergoing HD. These findings provide useful data for effective clinical management to prevent decline of ADL in ambulatory elderly patients undergoing HD.