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Additional file 2. Skin changes noted in each case.

Additional file 1. Video record of patient 2 demonstrating the patient���s inability to walk and the subsequent improvement in pain and walking ability after asfotase alfa (AA) initiation. Description of data: At the age of 10 years, the patient could not attend school on account of her inability to walk, carry her bag by herself, or play with her friends because of pain. The pain in her extremities gradually improved after the introduction of AA treatment. Three to four months after AA treatment initiation, she could join an athletic festival without the support of any anti-inflammatory drugs. Six months after AA treatment initiation, she did not have any difficulty attending school.

The purpose of this study was to clarify differences in the kinematic and kinetic profiles of the trunk and lower extremities during baseball pitching in collegiate baseball pitchers, in relation to differences in the pitched ball velocity. The subjects were 30 collegiate baseball pitchers aged 18 to 22 yrs, who were assigned to high- (HG, 37.4 ± 0.8 m·s-1) and low-pitched-ball-velocity groups (LG, 33.3 ± 0.8 m·s-1). Three-dimensional motion analysis with a comprehensive lower-extremity model was used to evaluate kinematic and kinetic parameters during baseball pitching. The ground-reaction forces (GRF) of the pivot and stride legs during pitching were determined using two multicomponent force plates. The joint torques of hip, knee, and ankle were calculated using inverse-dynamics computation of a musculoskeletal human model. To eliminate any effect of variation in body size, kinetic and GRF data were normalized by dividing them by body mass. The maxima and minima of GRF (Fy, Fz, and resultant forces) on the pivot and stride leg were significantly greater in the HG than in the LG (p < 0.05). Furthermore, Fy, Fz, and resultant forces on the stride leg at maximum shoulder external rotation and ball release were significantly greater in the HG than in the LG (p < 0.05). The hip abduction, hip internal rotation and knee extension torques of the pivot leg and the hip adduction torque of the stride leg when it contacted the ground were significantly greater in the HG than in the LG (p < 0.05). These results indicate that, compared with low-ball-velocity pitchers, high-ball-velocity pitchers can generate greater momentum of the lower limbs during baseball pitching.