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Background: The Landing Error Scoring System (LESS) has been utilized on the field or in the clinic to identify patients with an increased risk for anterior cruciate ligament (ACL) injuries; however, its validity and efficacy have not been fully confirmed. Purpose: To assess the efficacy of the LESS in identifying the ACL injury risk by examining the correlation between the LESS score and motion patterns on 3-dimensional kinematic analysis. Study Design: Controlled laboratory study. Methods: The jump-landing motion was analyzed for 16 female basketball or badminton players who volunteered to participate in the study. All study participants were aged 19 or 20 years. The sequence of motion was evaluated with the LESS, while kinematic data were simultaneously acquired with a 3-dimensional motion analysis system utilizing the point cluster method. The correlation between the LESS score and knee kinematics was statistically analyzed. Results: When a LESS score ≥6 was defined to be a risk factor for ACL injuries, 7 of the 16 participants (43.8%) were found to exhibit risky motion patterns. Significant correlations were noted between the LESS score and knee valgus (r = 0.87; P < .0001) and internal tibial rotation (r = 0.57; P = .02) at landing. By contrast, a substantial variability was present in knee flexion, showing no correlation with the LESS score. Conclusion: Significant correlations were found between the LESS score and knee valgus and internal tibial rotation during a jump-landing task. Clinical Relevance: The LESS can be regarded as an effective measure to identify risky motion patterns that may increase the likelihood of ACL injuries.
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An eleven-year-old male gymnast felt right wrist pain when performing handstands on the floor without any major traumas. Displaced scaphoid fracture was observed on the anteroposterior view of the radiograph. Both on the T1-weighted image from magnetic resonance imaging (MRI) and on the short TI inversion recovery (STIR) image from MRI, low intensity was detected at the middle of the ossification center of the scaphoid and the physis and the articular cartilage covering the scaphoid bone were preserved without any injury. The patient was diagnosed with stress fracture of the ossification center of the scaphoid and successfully treated conservatively.
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Fracturas por Estrés/diagnóstico , Fracturas por Estrés/etiología , Gimnasia/lesiones , Hueso Escafoides/lesiones , Niño , Fracturas por Estrés/terapia , Humanos , Imagen por Resonancia Magnética , Masculino , Osteogénesis , Radiografía , Traumatismos de la MuñecaRESUMEN
PURPOSE: Brain-derived neurotrophic factor (BDNF) is well known for its potential to promote brain plasticity. It has been proposed that combining cognitive and physical exercise (CCPE) may have the potential to generate more synergistic benefits in cognitive function than either cognitive exercise (CE) or physical exercise (PE) alone. The purpose of this study was to examine acute responses of peripheral BDNF levels and cognitive performance to CE, PE, and CCPE. METHODS: Thirteen healthy adult men participated in four experimental sessions; a 30-min CE, a 30-min cycling PE at an intensity of 60% peak oxygen uptake, a 30-min CCPE at the same intensity as PE, and a 30-min session of complete rest. Plasma BDNF levels and cognitive performance were measured before and after each session. RESULTS: Both PE and CCPE significantly increased plasma BDNF levels (p < .05). CE led to no significant increase (p ≥ .05), and there was no significant difference in peripheral BDNF levels between PE and CCPE (p ≥ .05). No session induced a significant change in cognitive performance (p ≥ .05). CONCLUSIONS: Our study suggests that CE and PE have different responses of peripheral BDNF levels and that CCPE had no additional or synergistic effect on peripheral BDNF levels compared with PE alone. This study offers further insights into the potential mechanisms underlying the respective roles of CE, PE, and CCPE for peripheral BDNF levels and cognitive performance.
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Factor Neurotrófico Derivado del Encéfalo/fisiología , Encéfalo/fisiología , Cognición , Ejercicio Físico , Ciclismo/fisiología , Humanos , Aprendizaje , Masculino , Memoria , Consumo de Oxígeno , Test de Stroop , Adulto JovenRESUMEN
INTRODUCTION: Increased physical activity (PA) is a crucial factor in the prevention of physical deterioration, and resistance training (RT) is also a common and effective intervention for older adults. However, the effects of PA as an adjunct to RT on frailty status remains unclear; therefore, we clarified the effect of a PA intervention with feedback, as an adjunct to resistance strength training, on the physical and mental outcomes of frail older adults. MATERIALS AND METHODS: We employed a randomized controlled trial. Community-dwelling frail older adults in Japan were recruited to participate. Forty-one participants (mean age 81.5) were randomly assigned to engage in a resistance training with PA (RPA group) or RT group for six months. Frailty status and frailty scores, which were measured according to the Cardiovascular Health Study criteria-muscle strength, mobility, instrumental activities of daily living, and health-related quality of life-were assessed. RESULTS: Participants in the RPA group exhibited a significant increase in light-intensity PA, the number of steps taken daily (pâ¯<â¯0.05), and lower-limb muscle strength (pâ¯<â¯0.05) and a significant decrease in frailty scores. However, pre- and postintervention frailty status, instrumental activities of daily living, and health-related quality of life did not differ significantly. CONCLUSIONS: Implementation of a PA intervention as an adjunct to RT is feasible, as it reduced frailty scores and increased lower-limb muscle strength and mobility in older adults with frailty symptoms.
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Terapia por Ejercicio/métodos , Ejercicio Físico/fisiología , Fragilidad/rehabilitación , Vida Independiente , Fuerza Muscular/fisiología , Calidad de Vida , Entrenamiento de Fuerza/métodos , Anciano , Anciano de 80 o más Años , Femenino , Anciano Frágil , Fragilidad/fisiopatología , Humanos , Masculino , PronósticoRESUMEN
Brain-derived neurotrophic factor (BDNF) has been considered an essential mediator responsible for the beneficial effects of physical activity in preventing cognitive impairment. This study aimed at examining the effects of a single bout of neuromuscular electrical stimulation (NMES) on levels of BDNF in the plasma and on cognitive performance in healthy adult men. Thirteen healthy adult men participated in three experimental sessions. The first session was 30 min of NMES to both legs, the second was 30 min of cycling exercise at the intensity of 60% peak oxygen uptake, and the third was 30 min of complete rest. Blood was examined for plasma BDNF levels and glucose concentrations, and cognitive performance tests were performed before and after each session. A single bout of NMES significantly increased plasma BDNF levels (p<0.05), which were equivalent to the amount of plasma BDNF released during the exercise session (p>0.05). However, there were no significant changes in cognitive performance between the sessions (p>0.05). The present study found that a single bout of NMES significantly increased plasma BDNF to levels normally present during moderate voluntary exercise. Therefore, NMES could serve as an alternative method of exercise, and might shed light on individuals for whom voluntary physical exercise is contraindicated.
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Factor Neurotrófico Derivado del Encéfalo/sangre , Cognición/fisiología , Estimulación Eléctrica , Ejercicio Físico/fisiología , Glucemia/metabolismo , Humanos , Ácido Láctico/sangre , Consumo de Oxígeno/fisiología , Adulto JovenRESUMEN
Malunion at the shaft of the middle phalanx yields less functional problems compared with malunion at the shaft of the proximal phalanx and metacarpal bones. In the present report, the patient sustained a minimally displaced fracture at the distal portion of the distal middle phalanx of the ring finger spraining the finger during playing flag football. Fracture was treated conservatively and fracture union was completed. However, the patient complained of functional problems in activities of daily living due to the malrotational deformity of the finger. We treated the malrotational deformity close to the distal interphalangeal joint of the middle phalanx with step-cut osteotomy at the affected bone successfully.
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Falanges de los Dedos de la Mano/lesiones , Fracturas Óseas/cirugía , Fracturas Mal Unidas/cirugía , Osteotomía/métodos , Actividades Cotidianas , Adolescente , Femenino , HumanosRESUMEN
[Purpose] The objective of this study was to clarify the effects of increased number of steps on body composition, physical functions, vascular functions, health-related quality of life (HR-QOL) and self-efficacy in elderly people. [Subjects and Methods] The subjects were 47 elderly persons who resided in Port Island in the Chuo Ward of Kobe City in Hyogo Prefecture, Japan. After the calculation of the mean preintervention physical activity (PA), the subjects were instructed to increase their PA to a target baseline + 1,300 steps/day. Body composition, physical functions, vascular functions, HR-QOL, and self-efficacy were measured at baseline, after 3 and 6 months. These items were compared between a group that increased their PA and a group that did not. [Results] After 6 months, 26.1% of the subjects achieved the PA target. No significant improvements were observed in body composition, physical functions, vascular functions, or self-efficacy for either group after 3 and 6 months. However, the HR-QOL improved significantly after 6 months in the achievement group. [Conclusion] Although the intervention to increase PA did not produce significant improvements after 6 months in body composition, physical functions, vascular functions, or self-efficacy, the HR-QOL improved significantly during this relatively short period.
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BACKGROUND/AIMS: We present a rare case of stress fracture of the diaphysis of the ulna in a softball pitcher. CASE: A thirteen-year-old girl felt pain over the distal third of the right forearm during pitching. Stress fracture was detected as callus formation of the ulna before fracture displacement. When windmill pitching for softball, the pitcher rotates their arm around the shoulder joint and powerfully hits their forearm to their thigh, which is accompanied by simultaneous pronation of the forearm and flexion of the wrist. The ball is then released and this movement is known as "brushing". CONCLUSIONS: The typical throwing form in a softball pitcher can play an important role in stress fractures of the ulna.
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We report the case of a 32-year-old Japanese female with a giant cell tumor of bone involving multiple midfoot bones. Giant cell tumors of bone account for approximately 5% of all primary bone tumors and most often arise at the ends of long bones. The small bones, such as those of the hands and feet, are rare sites for giant cell tumors. Giant cell tumors of the small bones tend to exhibit more aggressive clinical behavior than those of the long bones. The present patient underwent en bloc tumor excision involving multiple tarsals and metatarsals. We reconstructed the longitudinal arch of the foot with a free vascularized fibular graft. At the 2-year follow-up visit, bony union had been achieved, with no tumor recurrence.
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Neoplasias Óseas/cirugía , Trasplante Óseo/métodos , Tumor Óseo de Células Gigantes/diagnóstico por imagen , Tumor Óseo de Células Gigantes/cirugía , Huesos Tarsianos/cirugía , Adulto , Biopsia con Aguja , Neoplasias Óseas/diagnóstico por imagen , Terapia Combinada , Femenino , Peroné/irrigación sanguínea , Peroné/trasplante , Estudios de Seguimiento , Supervivencia de Injerto , Humanos , Inmunohistoquímica , Imagen por Resonancia Magnética/métodos , Imagen Multimodal/métodos , Osteotomía/métodos , Procedimientos de Cirugía Plástica/métodos , Medición de Riesgo , Huesos Tarsianos/patología , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
Avascular necrosis of the humeral capitellum (Panner's disease), a relatively rare disorder in the juvenile. We diagnosed three patients using radiographs and magnetic resonance imaging, who were previously misdiagnosed with osteochondritis dissecans of the humeral capitellum. All patients were successfully treated by restriction of sports activities using the upper extremities. It is often difficult to distinguish Panner's disease from osteochondritis dissecans of the humeral capitellum. Panner's disease has been reported to occur in boys between 7 and 10 years old, which is younger than susceptible age of osteochondritis dissecans. In MRI, low intensity area in the ossification center of the humeral capitellum in T1-weighted image is useful findings for diagnosis. For the treatment, the conservative treatment has been recommended in the early stage of Panner's disease, while surgical intervention is required in some cases of osteochondritis dissecans.
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Húmero/patología , Osteonecrosis/diagnóstico , Osteonecrosis/terapia , Traumatismos en Atletas/diagnóstico , Traumatismos en Atletas/diagnóstico por imagen , Traumatismos en Atletas/terapia , Béisbol , Niño , Errores Diagnósticos , Humanos , Húmero/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Osteocondritis Disecante/diagnóstico , Osteonecrosis/diagnóstico por imagen , RadiografíaRESUMEN
We report a rare case of posterior interosseous nerve (PIN) paralysis in a tennis player. The PIN, a 2 cm section from a bifurcation point of the radial nerve, presented increased stiffness in the surgical findings and treated with free sural nerve grafting after excision of the degenerative portion of the PIN. We speculate that PIN paralysis associated with hourglass-like constriction can be caused and exacerbated by repetitive forearm pronation and supination in playing tennis.
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BACKGROUND: Soft tissues of the shoulder undergoes substantial stresses due to humeral head movement, and this may contribute to throwing shoulder injuries in baseball pitchers. Prevention and management of throwing shoulder injuries critically rely on reduction of shear force at the shoulder joint. However, the amount and direction of the force applied to the shoulder during the throwing motion have not been clarified. The purpose of this study was to analyze forces applied to the shoulder during a baseball pitch. METHODS: We performed biomechanical analysis of 213 baseball pitchers of various ages and skill levels. Throwing motion was analyzed with a 3-dimensional motion capture system. The Euler angle sequence was adopted to describe angular values of the upper arm relative to the trunk for shoulder rotation, and inverse dynamics was used to estimate the resultant joint forces at the shoulder. RESULTS: There was a significant relation between horizontal abduction/adduction angle and resultant anterior/posterior force at the point of maximum external rotation (MER) (r = -0.63, P < .01), whereby increased horizontal abduction was associated with increased resultant anterior force. There was a significant but weak correlation between abduction/adduction angle and superior/inferior force at MER (r = 0.24, P < .01). Comparison among the groups with variable ages and skill levels showed larger horizontal abduction and smaller external rotation angles at MER in the adult amateur player group, whereas normalized compression force and internal rotation torque values at MER were smaller in the junior high school- and elementary school-aged groups. DISCUSSION: These results suggest that excessive horizontal abduction at MER increases anterior shear force in the shoulder and may lead to shoulder injuries. Focusing on reducing horizontal abduction at MER in the throwing motion may be key to preventing and managing shoulder injuries in baseball pitchers.
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Béisbol/fisiología , Articulación del Hombro/fisiología , Hombro/fisiología , Adolescente , Adulto , Fenómenos Biomecánicos , Niño , Humanos , Masculino , Rango del Movimiento Articular , Rotación , Adulto JovenRESUMEN
PURPOSE: We have previously reported that a cylindrical bioabsorbable synthetic polymer scaffold made of poly (DL-lactide-co-glycolide) (PLG) can be used to repair osteochondral defects without using cultured cells in a rabbit model. This cylindrical scaffold has a solid and pre-formed design, which limits its widespread application. Therefore, we created a cotton-textured PLG scaffold, which would be superior to other scaffolds in terms of plastic property and operability. The purpose of the present study was to examine the efficacy of the cotton-textured PLG scaffold in the repair of osteochondral defects. METHODS: Cotton-textured PLG scaffolds were prepared using the electrospinning method and used to repair osteochondral defects produced on the right femoral condyle in 36 rabbits. As a control, the defect was left untreated. The outcomes of repair were examined histologically at postoperative weeks four, eight, and 12. RESULTS: In the untreated control group, the surface of the defect remained concave and the regenerated cartilaginous tissue partially covered the articular surface even at postoperative week 12. In the scaffold group, cartilaginous tissue covered the surface of the defect at postoperative week four, and the surface was smooth and the cartilaginous tissue was well regenerated and integrated with the native cartilage at postoperative week 12. CONCLUSIONS: The cotton-textured PLG scaffold could repair the osteochondral defect with good outcomes similar to those previously reported for the cylindrical scaffold, with its characteristic advantages of better plasticity and operability. We conclude that the cotton-textured PLG scaffold has potential for clinical application in comminuted osteochondral injury.
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Cartílago Articular/cirugía , Regeneración , Cicatrización de Heridas , Animales , Femenino , Fémur/cirugía , Polímeros , Conejos , Regeneración/fisiología , Andamios del Tejido , Cicatrización de Heridas/fisiologíaRESUMEN
AIMS: Navicular fracture is still challenging disorder to treat because there is a risk of nonunion, avascular necrosis and symptomatic osteoarthritis. PATIENTS METHODS AND RESULTS: A 40-year-old woman with an ununited fracture of the tarsal navicular bone was treated with localized naviculocuneiform arthrodesis (arthrodesis of the navicular, the middle cuneiform, and the lateral cuneiform). Fusion with the navicular, the middle cuneiform, and the lateral cuneiform as well as union of fracture of the navicular was confirmed on the radiographs. CONCLUSION: Localized naviculocuneiform arthrodesis using a locked plating system is one of the options to treat nonunion of the navicular bone.
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Advanced carpal tunnel syndrome presents severe thenar atrophy with the absence of electrophysiological motor and sensory responses. Because of severity of these conditions, a substantial period of recovery after surgery is required before improvement becomes evident. In this electrophysiological-based study, the reappearance of distal motor latency (DML) at the abductor pollicis brevis and/or sensory nerve conduction velocity (SCV) after wrist stimulation were evaluated 1 year and 2 years after carpal tunnel release . To categorize outcomes, the following grading scale was used: stage I, normal DML and SCV; stage II, DML ≥ 4.5 ms and normal SCV; stage III, DML ≥ 4.5 ms and SCV < 40.0 ms; stage IV, DML ≥ 4.5 ms and nonmeasurable SCV; stage V: nonmeasurable DML and SCV. The authors found measurable DML and/or SCV and significant improvement both 1 year and 2 years postoperatively. Furthermore, the percentage of patients who recovered to the extent that they presented as mild carpal tunnel syndrome (stage I or II) increased significantly. They conclude that electrophysiological assessment of DML and SCV of advanced carpal tunnel syndrome using the above grading scale was effective as an objective evaluation tool of recovery after carpal tunnel release.
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Síndrome del Túnel Carpiano/cirugía , Descompresión Quirúrgica , Nervio Mediano/cirugía , Neuronas Motoras/fisiología , Conducción Nerviosa/fisiología , Adulto , Anciano , Anciano de 80 o más Años , Síndrome del Túnel Carpiano/fisiopatología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Nervio Mediano/fisiopatología , Persona de Mediana Edad , Periodo Posoperatorio , Tiempo de Reacción/fisiología , Resultado del TratamientoRESUMEN
The present study is a report of retrospective case series of stress fracture of the olecranon. Six patients presented posterior elbow pain in throwing in baseball and softball, but fracture was not diagnosed in radiographs. We detected stress fracture of the olecranon using computed tomographic (CT) scan and treated the patient with internal fixation with a headless cannulated double threaded screw through a small skin incision. All patients returned to competitive level without elbow complaints after the operation.When throwing athletes present with unusual posterior elbow pain and no significant findings on radiographs, a CT scan examination should be performed. We recommend surgical treatment of internal fixation with a screw through a small skin incision, as a good option for stress fracture of the olecranon in order to allow early return to sports activity in competitive athletes.
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PURPOSE: The purpose of this study was to evaluate an application of poly(d,l-lactide-co-glycolide) (PLG) scaffold created by electrospinning in a rabbit rotator cuff defect model. METHODS: Forty-two Japanese white rabbits were used in this study. Defects of the infraspinatus tendon were created, and the PLG scaffolds were implanted. Contralateral infraspinatus tendons were reattached without creating defects. Histologic analyses were performed 4, 8, and 16 weeks after the operation, and mechanical evaluations were performed 0, 4, 8, and 16 weeks after the operation. RESULTS: Scaffold fibers remained without dissolution and spindle-shaped cells were observed inside of the scaffold at 4 weeks postoperatively. At 8 weeks, the PLG scaffold had dissolved and bone formation was observed at the scaffold-bone interface. At 16 weeks, the scaffold-bone interface matured and expression of type II collagen was observed. A statistical difference in ultimate failure load was not seen between the scaffold group and reattachment group or normal tendon after 8 weeks postoperatively. The stiffness in the scaffold group was not significantly different from that in the reattachment group at each time point. However, it was significantly weaker than normal tendon at each time point. CONCLUSIONS: Transplantation of cell-free PLG scaffold showed cell migration and type II collagen and proteoglycan expression at the scaffold-bone junction by 16 weeks postoperatively with a sufficient ultimate failure load in a rabbit rotator cuff defect model. CLINICAL RELEVANCE: The PLG scaffold could be applied to bridge rotator cuff defects. The results showed that bridging with scaffold can be equivalent to reattachment.
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Ácido Láctico/uso terapéutico , Ácido Poliglicólico/uso terapéutico , Regeneración/fisiología , Manguito de los Rotadores/fisiología , Andamios del Tejido , Animales , Movimiento Celular , Colágeno Tipo II/metabolismo , Femenino , Osteogénesis/fisiología , Copolímero de Ácido Poliláctico-Ácido Poliglicólico , Proteoglicanos/metabolismo , Conejos , Reimplantación/métodos , Rotura/patología , Rotura/cirugía , Factores de TiempoRESUMEN
PURPOSE: Ligaments are frequently damaged in sports activities and trauma, and severe ligament injury can lead to joint instability and osteoarthritis. In this study, we aimed to regenerate the medial collateral ligament (MCL) using an absorbable stent-shaped poly-L-lactic acid (PLLA) scaffold in a rabbit model to examine the biocompatibility and mechanical properties. METHODS: Twenty-three Japanese white rabbits were used in this study. MCL defects were surgically created in the knee joints and then reconstructed using stent-shaped PLLA scaffolds. As controls, flexor digitorum longus (FDL) tendons were implanted into the contralateral knees. Seven rabbits were sacrificed at three time points, conducted four, eight and 16 weeks after the operation. The regenerated tissues were histologically evaluated using fibre alignment scoring, morphology of fibroblast scoring and immunohistochemical analysis of types I and III collagen. The regenerated tissues were also biomechanically evaluated by measuring the ultimate failure load and stiffness. RESULTS: At four weeks post-operation, spindle-shaped cells were observed on the inside of the scaffolds. At eight weeks, maturation of the regenerated tissues and collagen fibre alignment parallel to the ligaments was observed. At 16 weeks, the fibre alignment had become denser. The fibre alignment and morphology of fibroblast scores significantly increased in a time-dependent manner. Expression of type I collagen was more strongly observed in the scaffold group at eight and 16 weeks post-operation than at four weeks. Type III collagen was also observed at four, eight and 16 weeks post-operation. A thin layer of fibrocartilage was observed at the ligament-bone junction at eight and 16 weeks. The ultimate failure load of the scaffold group was 46.7 ± 20.7 N, 66.5 ± 11.0 N and 74.3 ± 11.5 N at four, eight and 16 weeks post-operation, respectively. There was no statistical difference between the normal MCL and the scaffold group at 16 weeks post-operation. CONCLUSIONS: The stent-shaped PLLA scaffold allowed for MCL regeneration with type I collagen expression and fibrocartilage formation and resulted in sufficient mechanical function.
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Traumatismos de la Rodilla/cirugía , Ácido Láctico , Ligamento Colateral Medial de la Rodilla/lesiones , Polímeros , Rodilla de Cuadrúpedos/lesiones , Andamios del Tejido , Cicatrización de Heridas/fisiología , Animales , Materiales Biocompatibles , Fenómenos Biomecánicos , Colágeno Tipo I/metabolismo , Modelos Animales de Enfermedad , Elasticidad , Femenino , Fibroblastos/metabolismo , Fibroblastos/patología , Fibrocartílago/metabolismo , Fibrocartílago/patología , Regeneración Tisular Dirigida , Implantes Experimentales , Traumatismos de la Rodilla/metabolismo , Traumatismos de la Rodilla/patología , Ligamento Colateral Medial de la Rodilla/metabolismo , Ligamento Colateral Medial de la Rodilla/patología , Poliésteres , Falla de Prótesis , Conejos , Stents , Rodilla de Cuadrúpedos/patología , Tendones/trasplante , Resultado del TratamientoRESUMEN
A case of a 62 year-old woman with true aneurysm of the superficial palmar arch with no previous history of trauma is described. The aneurysm was resected without reconstruction based on intraoperative evidence of adequate finger perfusion after clumping the distal and proximal ends. Three years after the operation, there has been no recurrence of the aneurysm and the patient has neither complaints nor symptoms.