F-1-03-03
The role of weakness of the bilateral triceps surae muscles in astasia without abasia
Kenji Hachisuka, Koichiro Dozono, Mari Ueta, and Hajime Ogata (University of Occupational and Environmental Health, Kitakyushu, Japan)
Makio Yamaga (Kumamoto University, Kumamoto, Japan)
Purpose: Hirayama reported astasia without abasia, that is, ability to walk with inability to stand still, and it may be called "stilts phenomenon" [Arch Neurol 1994]. This curious disability can be found in patients suffering peripheral neuropathies or other diseases. We investigated the role of weakness of the bilateral triceps surae muscles in astasia without abasia and whether compensating for muscle weakness with ankle-foot orthoses improved this disability.
Method: Subjects were 23 patients with astasia without abasia [stilts group], and 50 controls without astasia without abasia [non-stilts group]. Clinical findings were examined, and the length of the center of foot pressure (COP) while standing was measured before and after wearing ofthoses.
Results: Weakness of the bilateral triceps surae muscles was the only finding that was sensitive and specific to astasia without abasia. Bilateral ankle-foot ofthoses improved the COPs of 14 out of 16 patients.
Conclusion: The main cause of astasia without abasia is weakness of the bilateral triceps surae muscles, and this disability is improved by bilateral ankle-foot orthoses.
F-1-03-04
MULTIMODALITY THERAPY OF DERMATOMYOSITIS IMPROVES THE PROGNOSIS
Tamara A. Glavinskaya, Irina A. Clemienova (Nizhny Novgorod institute for Skin and Venerial Diseases, Nizhny Novgorod, Russia)
Dermatomyositis (Dm) often manifests itself in the muscular atrophy and contractures, which limits the living ability of the patients, so the restoration problem in Dm patients turns to be the most actual.
On the basis of the clinicolaboratory investigations we have developed the way of the complex Dm pathogenic treatment.
The immunomodulatored and fermental therapy with the corticosteroids added was carried out in 19 idiopathic Dm patients. As a result of this treatment carried out, the complete restoration of the working capacity and at the same time the reduction of the relapses frequency in 2 times, if compared with those patients, who received the traditional corticosteroids therapy is archived.
Thus, the inclusion of the immunomodulatorings and emzyme in Dm patients therapy improves the disease forecast.
