First developed e-PTFE should be carefully trimmed in augmentation because of its potential to decrease in size over time, whereas new e-PTFE is more likely to show migration and instability.

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ObjectiveTo provide the off-loading knee brace was designed relief for the pain associated with osteoarthritis by reduce loads on the degenerative compartment of the knee. This study examined the effects of the off-loading knee brace on activation of femoral muscles during squatting, slow and fast walking exercise in healthy young individuals.MethodTen healthy male subjects without a history of knee pain were recruited. Each subject was asked to do squatting, slow and fast walking exercises with a brace secured to the dominant leg. The same exercises were repeated without the brace. Surface electromyographic (sEMG) data was collected from the vastus medialis oblique (VMO), vastus lateralis (VL) and biceps femoris (BF) muscles from the dominant side of the leg. All dynamic root mean squre (RMS) values of sEMG were standardized to static RMS values of the maximal isometric contraction and expressed as a percentage of maximal activity.ResultsWe found that VMO activity was significantly decreased with application of the off-loading knee brace during squatting and fast walking exercise. However there were no significant differences in VMO activity with application of the off-loading knee brace during slow walking exercise.ConclusionThese results suggest that the external moment of the brace which effectively stabilized the patella in the movement in which the knee joints become relatively unstable. The brace could be useful in the short term, but for long-term use, weakening of the VMO is predicted. Therefore the program of selective muscular strength strengthening for the VMO should be emphasized.

Dear Sirs,Brachial plexus neuritis was originally diagnosed by clinical signs and symptoms in addition to electrophysiological studies [1][2][3][4][5]. Therefore, initially, brachial plexopathy was misdiagnosed as a shoulder disorder, cervical radiculopathy, or myelopathy [4]. Herpes zoster brachioplexopathy is a rare complication characterized by motor weakness of the arm, which may occur in limbs affected by herpes zoster. Varicella zoster virus can induce inflammatory brachial plexopathy [1][2][3][4]6]. It is still under-recognized by clinicians and misdiagnosis or delay in treatment can occur as a consequence. Magnetic resonance (MR) imaging studies have been attempted for diagnosis of brachial plexus disorders [6-9]. However, there are very few reports about MR neurography for zoster-induced brachial neuritis [6]. We present a 68-yearold male patient with monoparesis resulting from brachial plexopathy caused by varicella zoster virus infection and report the findings of MR neurography in this patient.A 68-year-old man noted a skin rash, vesicles, and pain in his left arm. At that time, he was not treated. Four days later, he developed weakness in his left arm and visited the emergency department at our hospital for this complaint. Upon admission, the patient had multiple erythematous crusted plaques on the left arm (Fig. 1). Neurologic examination revealed weakness of shoulder abduction (grade 2/5) and elbow flexion (grade 2/5), and the left biceps reflex was diminished. He had dysesthesia and hyperalgesia over the left C6-7 dermatomes. The level of IgG antibodies against varicella zoster virus was elevated. However, the IgM antibody level against varicella zoster was negative. We performed MR neurography of the brachial plexus with a 1.5-T MR imaging system (Gyroscan Intera, Philips Medical Systems, Netherlands) 10 days after admission. Among the MR neurography images, the coronal short tau inversion recovery (STIR, TR/TE: 3558.39/60.00, time inversion: 160 ms) image depicted edema and thickening of the superior trunk of the left brachial plexus compared to the unaffected right side (Fig. 2). MR imaging also showed denervation edema of the left supraspinatus muscle (Fig. 3). Needle electromyography showed fibrillations and positive sharp waves in the left deltoid and biceps muscles and only positive sharp waves in the left supraspinatus muscle. The patient was treated with intravenous acyclovir and physical therapy for his left arm. After discharge, he was followed in the outpatient department for 6 months. His left-arm weakness improved to grade 3.Herpes zoster brachial plexus neuritis-associated motor weakness may be due to a demyelinating process related to inflammation [1-3, 5, 6]. Inflammatory changes in the brachial plexus result in swelling and thickening of divisions or cords of the brachial plexus. MRI can demonstrate inflammatory changes in neural tissue and MR neurography can detect inflammatory changes in the brachial plexus and denervation edema of affected muscle [6][7][8][9]. Especially STIR ...

ObjectiveTo explore the experiences of athletes with spinal cord injury (SCI) in Korea with respect to dilemmas of participating in sports with regards to the facilitators and barriers, using the International Classification of Functioning, Disability and Health (ICF).MethodsThe facilitators and barriers to sports participation of individuals with SCI were examined using 112 ICF categories. A questionnaire in dichotomous scale was answered, which covered the subjects 'Body functions', 'Body structures', 'Activity and participation' and 'Environmental factors'. Data analysis included the use of descriptive statistics to examine the frequency and magnitude of reported issues.ResultsSixty-two community-dwelling participants were recruited. Frequently addressed barriers in 'Body functions' were mobility related problems such as muscle and joint problems, bladder and bowel functions, pressure ulcers, and pain. In 'Activity and participation', most frequently reported were mobility and self-care problems. Highly addressed barriers in 'Environmental factors' were sports facilities, financial cost, transportation problems and lack of information. Relationships such as peer, family and friends were the most important facilitators.ConclusionNumerous barriers still exist for SCI survivors to participate in sports, especially in the area of health care needs and environmental factors. Our results support the need for a multidisciplinary approach to promote sports participation.

In the rehabilitation, the real executive movement has been considered the main tool for motor recovery and motor learning. Many studies reported that active exercising creates a flow of sensory information which can change neuroplasticity. Recently the numerous studies report that both the imagery and the observation of a movement increase corticospinal excitability of primary motor cortex and activation of M1 area similar to the real execution of the movement. And the studies also report that these central activations occur in a specific manner. Now many people consider the imagery and observation can be a new therapeutic tool in rehabilitation especially for who can not execute a real motion at all due to neurologic deficit. We will review the articles reported the central nerve system changes by the imagery and observation of an action compared with the executive motion. And most of these experimental studies were based on the results of the healthy subjects, we discussed about the limitation of these therapeutic strategies according to the aging process and to the brain dysfunction.