In this study we sought to determine the effects of various daily weight-bearing periods on rat soleus muscle during hindlimb suspension. Weight-bearing was performed on either rats essentially free in cages, for 1, 3, 6, 12, or 18h/day, or ones restricted in movement, for 1 or 3h/day. The cross-sectional area of type I fibers decreased on two weeks suspension to 54% of the control area. With weight-bearing of up to 18h/day, it decreased less, i. e. to 74-81% of the control area. Weight-bearing for at least 6h/day also limited the decrease in the percentage of type I fibers. The movement-restricted animals showed results similar to those for free ones with the same weight-bearing duration, except that the former showed considerably less fiber necrosis. Alterations in the time to peak tension and tension of twitch contraction were ameliorated by a 3h/day weight-bearing stimulus, but weight-bearing for at least 18h/day was required to maintain tetanic tension. These data demonstrate a need for extended weight-bearing to prevent alterations in the soleus muscle.

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X-ray measurements were used to compare the suspension effect of a TSB below-knee prosthesis with an ICEROSS system to that of a PTB below-knee prosthesis. The suspension effect was measured as the movement of the tibia between the suspension position and the weight-bearing position. The suspension effect of the TSB prosthesis (2.53±0.90cm) was superior to that of the PTB prosthesis (3.60±0.56cm) (p<0.05). Although the suspension effect of the TSB prosthesis was less effective in reducing tibial movement in cases with stump pain or an abundance of soft tissue, a higher level of satisfaction was obtained by using the TSB prosthesis with stump socks than by using the PTB prosthesis.

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We studied whether finger deformity due to peripheral neuritis affects the bone mineral density (BMD). The study subjects consisted of 170 male leprosy patients (48-93 years of age, average age 71 years). We divided the subjects into 3 groups according to the type of finger deformity (finger contracture, finger defect following amputation due to infection and normal). The 3 groups were matched for age and body mass index. We measured the cortical bone mineral density of the 2nd metacarpal bone (ΣGS/D) and the cortical thickness index (MCI) by computed X-ray densitometry (Bonalyzer^TR; Teijin). We also measured the Barthel index (BI) in each group. Three items of BI (bathing, dressing and feeding) were used to evaluate the activities of daily living (ADL) that required use of the upper extremity. Differences among groups were analyzed by one-way analysis of variance (ANOVA). There were no statistically significant differences between the 3 groups in ΣGS/D, MCI or BI. Finger contracture or finger defect did not affect the bone mineral density or ADL that required use of the upper extremity in male leprosy patients.

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Herein is reported the case of a 63-year-old man who underwent surgery for wrist disarticulation, but who has made skillful use of a work arm with C hook in his livelihood as a gardener for 35 years. The patient has a sensitive touch sense for discrimination at the tip of his C hook, which I believe could be a sensory projection from his stump. Sensory projection is a phenomenon in which a person experiences a spatial sensation outside his or her body. In the case of an amputee, this is felt where a limb or digits no longer exist. I believe that sensitive two-point discrimination at 3mm intervals distributed in the stump skin is projected to the C hook as a touch sense. This case was able to identify a good position with his C hook without looking at an object or place. He said that he recognized the orientation of the tip points of C hook respectively as the index finger and the thumb of his phantom limb. With his eyes closed, he was able to tie a rope very quickly with his work arm. I think these actions could be achieved by using sensory projection with the phantom limb.

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