OBJECTIVE: The tissue destruction around knee joint is considered to involve medial knee contact force overload. However, no report has examined the relationship between the medial knee contact force and dysfunction. In this study, we investigated the medial knee contact force during gait in elderly subjects using musculoskeletal model-based simulation analysis and revealed its connection with pain and dysfunction. METHODS: We separated 122 elderly participants into 2 groups, the pain group and non-pain group, according to the existence of knee pain. Medial knee contact force was calculated based on the previously published inverse dynamics solution for normal walking. The muscle and joint reaction forces were used to determine the medial knee contact force during the stance phase. Japanese knee osteoarthritis measurement was used to assess the severity of symptoms for knee pain subjects. RESULTS: The medial knee contact force was significantly correlated with total Japanese knee osteoarthritis measurement scores and subscale dysfunction scores for pain subjects, although there was no difference in the medial knee contact force between the 2 groups. CONCLUSION: An increased medial knee contact force during gait might relate to dysfunction among elderly individuals with knee pain.

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The purpose of this study is to investigate the validity of trunk accelerometric gait analysis in comparison with analysis by force plate for healthy young subjects. The trunk acceleration during normal gait was measured by the accelerometer attached at the level of third lumber vertebra (L3) and second sacral vertebra (S2). The Cross-correlation coefficients (CC) between the trunk acceleration and the center of body mass (COM) acceleration calculated from ground reaction force in lateral, antero-posterior, and vertical axis were evaluated. The CCs in antero-posterior and vertical axis showed high values, especially at the level of L3 were significantly higher than S2 (p<0.05). In contrast, the CCs in lateral axis showed low values regardless of accelerometer level. It was suggested that the trunk accelerations in antero-posterior and vertical axis at the level of L3 are useful as substitution of the COM accelerations for gait analysis.

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In Japan, Cochlear implant surgery began to be performed in 1985. Since then, more than 10,000 patients have received cochlear implant surgery. Cochlear implant is the only means to restore hearing ability in highly hearing-impaired patients that is not enough to hear with the wearing of a hearing aid. In spite of the good results from the point of view of hearing ability, several problems have been reported in the limit of cochlear implant, for example, the speech perception in noisy environments wearing a cochlear implant is difficult. In this paper, the system, the history, current trends, and issues of cochlear implant are explained. We discuss the bilateral, the bimodal, the integrated education of children wearing cochlear implants, and the role of speech therapist in cochlear implant, because especially we are expected the increase of bilateral children by having revised the criteria and indications for cochlear implant surgery in children.

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The number of patients with cancer and the number of patients with bone metastases are increasing recently. Patients with bone metastases frequently develop skeletal related events (SREs; i.e.,pathological fracture, surgery to bone, and paralysis). SREs have been associated with Activities of daily living (ADL) and Quality of life (QOL). When the ADL decrease, chemotherapy cannot be administered in some patients. Then, the ADL are associated with the prognosis. Various interventions are required in order to improve the ADL of patients with bone metastases. In this study, we describe the way to evaluate the pathologic fracture risk before the start of rehabilitation, the team approach in medical care, exercise therapy, patient education, and environment and adjustment to improve the ADL and the QOL of patients with bone metastases.

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