NEW CORRECTIVE SHOES FOR DUCHENNE MUSCULAR DYSTROPHY
N. Ando*, Y. Fujimoto*, M. Ando**, T. Takayanagi**, Y. Mano***
(*National Nishinara Hospital, Nara, Japan. **Nara Medical University, Kashihara, Japan. ***Hokkaido University, Sapporo, Japan)
Purpose: We developed new corrective shoes which corrected the abnormal foot pressure pattern on gait in Duchenne muscular dystrophy (DMD) to a normal pattern by use of the foot pressure analyzing system F-SCAN.
Method: We analyzed 5 patients with DMD (aged 9〜11). Firstly, we made the gait analyzing shoes with a built-in F-SCAN sensor seat. Using the gait analyzing shoes, we repeated to measure the foot pressure by attaching and removing the <heel elevation adjusting boards> and the <wedge adjusting boards> on the outsole of the gait analyzing shoes in order to get a proper shape of the sole of the corrective shoes. Next, we made the corrective shoes from the result of this analysis.
Result: In order to improve the patient's foot pressure pattern, adequate heel elevation and lateral wedge was required. This corrective shoes improved the patient's gait remarkably and prolonged the duration of their ambulatory phase.
X-RAYS COMPUTED TOMOGRAPHIC (CT) SCANS OF LOWER LIMB AND TRUNK MUSCLES IN FACIOSCAPULOHUMERAL MUSCULAR DYSTROPHY (FSHD)
H Horikawa (Gojo Hospital, Gojo, Japan), K Takahashi (Hyogo-chuo Hospital), Yukio Mano (Hokkaido University), Tetsuya Takayanagi (Nara Medical University)
Purpose: We evaluated muscular involvement in FSHD by CT scans.
Method: We studied CT scans of muscles of the lower limbs and the trunk in 14 patients with FSHD.
Result: The CT scans showed that the affected muscles were decreased in density and size. The laterality of muscular involvement was sometimes observed. The muscular lesions in the lower limbs showed proximal distribution. In the thigh, the hamstrings were affected first, the adductor muscles second, and then the muscular involvement progressed to the quadriceps femoris muscle. In the lower leg, the gastrocnemius and soleus muscles were relatively spared as compared with the tibialis anterior muscle. In the lumbar girdle, the abdominal muscles were involved first, the gluteal muscles second, the back muscles third, and the psoas major muscle were relatively spared. The muscular weakness of this distribution exacerbated lumbar lordosis. The neck muscles were less affected than those of the lumbar girdle.
Conclusion: The CT scans in FSHD demonstrated the characteristic pattern of muscular involvement, which differed from the inherited muscular diseases such as Duchenne muscular dystrophy, myotonic dystrophy, and others.