F-3-19-08
The study of disuse osteoporosis with cerebrovascular disorder
Kazunari KASHIWAGI (Iwate Rehabilitation Center, Iwate, JAPAN), R. HANAKAGO, A. TAKAHASHI, S. OKUDA, S. MAKITA, T. KIKUCHI, and K. FURUMACHI (Iwate Medical University, Iwate, JAPAN)
PURPOSE: In routine clinical practice, we sometimes encounter bone fractures in patients paralyzed by cerebrovascular disorder (CVD). It is known that physical inactivity is a risk factor for bone fractures and disuse osteoporosis in CVD patients. Furthermore, movement is intimately related to activities of daily living (ADL). We investigated the relationship between ambulation and change in bone mineral density (BMD) with CVD patients.
MATERIALS and METHODS: Subjects consisted of 28 male CVD patients and 17 female CVD patients with a mean age of 62.8 years and a mean CVD duration of 2.47 months. We obtained BMD and gait speed on the first consultation and again after about 3 months of training. BMD was measured with a DEXA (QDR-2000, Hologic) for examination, and we measured maximal walking velocity for 10 meters on a flat floor. Statistical analysis was performed by t-test and comparison of two regression slopes.
RESULTS and CONCLUSION: The mean value of BMD at the neck of the femur was 0.794 g/cm2 on the affected side and 0.797 on the normal side at first visit, and 0.759 on the affected side and 0.789 on the normal side after about 3 months of training. The mean gait speed was 19.56 m/min at the initial consultation, and 36.95 after about 3 months. From a statistical perspective, there was a significant difference between BMD on the affected side at the initial consultation and after 3 months. However, there was no significant difference on comparison of the two regression slopes between gait speed and BMD.
P-3-01-01
SELF-CARE SKILLS AND SOCIAL ACTIVITY IN TRAUMATIC QUADRIPLEGIA
Yoshifumi Kiyono, Ryouhei Ashizawa, Kuniyoshi Ohstuka (Nagano Rehabilitation Center, Nagano, Japan), Chyozo Hashizume (New-Life Hospital, Nagano, Japan)
The aim of the present study was to examine self care skills (transfers, dressing, toileting and bathing), social activity (engagement in work and sports, ability to drive a car) in relation with the lowest functioning level in patients with complete tetraplesia following cervical spinal cord injury. A total of 54 patients, 51 men and 3 women were included in this study. The lowest functioning cord level was determined by Zancolli's classification.
Sixty-three percent of C6 and 85 percent of C7 or C8 cases could transfer from bed to wheel chair independently. All cases who can drive were able to transfer toilet independently and 80 percent of cases who can transfer to toilet were able to drive. Lower extremity dressing was independent in 60 percent of C6 and 70 percent of C7 or C8 cases. Only nine percent of C6 and 15 percent of C7 or C8 cases can take a bath for themselves.
Twelve cases were engaged in regular employment (government employee, self-employed, word processor input, computer programmer, dentist in C6 level, Jyusan home in C6 or C7 levels), and 5 in irregular one (word processor input in C6 level). The case of dentist received the reconstructive surgery of the hand (Zancolli). Eleven cases were engaged in regular sports. Twin basket ball and road-racing were the major sports in the C6 or C7 tetraplegics. Twenty-two cases could drive their own car. C6A was the highest level who could drive and transfer independently. Engagement in social activity and ability to drive a car were closely associated with levels of mental well-being and of perceived overall quality of life.
