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Jingami S, Matsubara S, Kaburagi M, Sakuma K, Takano Y, Kume S, Okawa T, Matsuse H, Shiba N. Range of Motion Measurements of the Hip Joint Are Useful in Screening for Acetabular Dysplasia in Healthy Young Japanese Women. Kurume Med J 2024:MS7012011. [PMID: 38763737 DOI: 10.2739/kurumemedj.ms7012011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
The purpose of this study is to clarify whether a hip range of motion (ROM) measurement is useful in screening for early hip osteoarthritis with acetabular dysplasia (AD). Subjects were 58 healthy Japanese women volunteers (21.1 ± 0.7 (20 - 22)). We evaluated a total of 116 hip joints in these 58 cases. Sharp angle and centeredge angle were 44.1° ± 3.1° (37.0° - 51.5°) and 30.7°± 6.2° (19.5° - 47.0°), respectively. AD was present in 47.4%, but there were no severe cases. First, we compared the ROM of the hip joints with AD (AD group) and without AD (control group) according to the Mann-Whitney U test. Extension angles and external rotation angles in the AD group were significantly smaller than in the control group (18.9°± 6.1° VS. 22.1°± 4.2°, p= 0.01636, 26.3°± 8.9° VS. 34.1°± 8.8°, p= 0.001362, respectively). Next, we evaluated the following factors associated with AD by logistic regression analysis after adjustment for age: flexion, extension and internal and external rotation angles of the hip joint. As a result, internal rotation and external rotation were extracted as related factors. The area under the ROC curve was determined to have a moderate accuracy (0.72996). Cut off values of internal rotation and external rotation angles were 50 degrees and 35 degrees, respectively. Our findings suggest that ROM measurement of the internal and external rotation angles would be useful as a screening for AD in healthy young Japanese women without symptoms.
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Affiliation(s)
- Syuichi Jingami
- Department of Physical Therapy, Faculty of Health Science, Kumamoto Health Science University
- Kurume University Graduate School of Medicine
| | - Shigehito Matsubara
- Department of Physical Therapy, Faculty of Health Science, Kumamoto Health Science University
| | - Makoto Kaburagi
- Department of Physical Therapy, Faculty of Health Science, Kumamoto Health Science University
| | - Katsuhiko Sakuma
- Department of Orthopedic and Rehabilitation, Kumamoto Seijo Hospital
| | - Yoshio Takano
- Department of Physical Therapy School of Health Sciences at Fukuoka, International University Health and Welfare
| | - Shinichiro Kume
- Department of Orthopedic Surgery, Kurume University Hospital
| | - Takahiro Okawa
- Department of Orthopedic Surgery, Kurume University Hospital
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital
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2
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Nakamura H, Jimbo K, Morito S, Haraguchi T, Kawasaki Y, Gotoh M, Shirahama M, Yoshida K, Shiba N. Postoperative Rotation Deformity of Head-Neck Fragments in Unstable Intertrochanteric Fractures Fixed with Intramedullary Nails. Kurume Med J 2023; 69:1-9. [PMID: 37793889 DOI: 10.2739/kurumemedj.ms6912007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
BACKGROUND Our purpose was to quantify the postoperative rotation deformity (RD) after osteosynthesis of unstable intertrochanteric fractures (ITFx) using 3D-CT / image processing software, and to clarify the clinical meaning of RD. METHODS Forty-six consecutive patients with unstable intertrochanteric fractures were enrolled in this study. All were fixed with Gamma 3 Trochanteric nail and RC Lag Screw® (Stryker). We performed 3D-CT evaluations for the rotational deformity of head-neck fragments, the medial cortex support (MCS) between main fragments and bone healing at 3 months postoperatively. RESULTS The RD was significantly larger in the patients without the MCS (5.1 ± 4.0°, N = 9) than those with the MCS (2.4 ± 2.6°, N = 37) (P = 0.006*). Delayed healing (N=3) was observed in patients without the MCS, and the association between RD and delayed healing was significant (P = 0.003*, cut-off value 6.4°, sensitivity 100% and specificity 90.7%, AUC 0.91). CONCLUSIONS This study proposed a novel method of measuring postoperative RD. Lack of MCS may lead to RD and consequent delayed healing in unstable ITFx fixed with intramedullary nails.
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Affiliation(s)
| | - Kotaro Jimbo
- Department of Orthopedic Surgery, St. Mary's Hospital
| | - Shinji Morito
- Department of Orthopedic Surgery, Kurume University School of Medicine
| | | | - Yuji Kawasaki
- Department of Orthopedic Surgery, St. Mary's Hospital
| | - Masafumi Gotoh
- Department of Orthopedic Surgery, Kurume University Medical Center
| | | | - Kenji Yoshida
- Department of Orthopedic Surgery, St. Mary's Hospital
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University School of Medicine
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Sato K, Yokosuka K, Yoshida T, Shimazaki T, Saruwatari R, Nishida K, Matsuo A, Morito S, Fudo T, Goto M, Matsubara T, Yamada K, Shiba N. Preliminary Clinical Experience with a High-Definition Three Dimensional Exoscope for Spinal Surgery. Kurume Med J 2023; 69:47-51. [PMID: 37793885 DOI: 10.2739/kurumemedj.ms6912011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
We retrospectively evaluated spinal surgeries performed using the high-definition three-dimensional exoscopic system, which became available at our institution in August 2020. Eleven patients (4 with cervical disease and 7 with lumbar disease) underwent surgery with the system. There were no surgical complications related to the system, and the results were satisfactory. The small, flexible camera of the exoscope allows the surgeon to view the surgical field from various angles, facilitating both the approach and technique. In addition, it allows the surgeon to operate in an upright position without strain on the head and neck. Although further surgical experience is needed, this system has the potential to improve the visualization of the surgical field in spinal surgery.
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Affiliation(s)
- Kimiaki Sato
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Kimiaki Yokosuka
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Tatsuhiro Yoshida
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | | | - Rikiya Saruwatari
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Kota Nishida
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Atsushi Matsuo
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Shinji Morito
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Takuma Fudo
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Masafumi Goto
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | | | - Kei Yamada
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Naoto Shiba
- Department of Orthopaedic Surgery, Kurume University School of Medicine
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Nakae I, Hashida R, Otsubo R, Iwanaga S, Matsuse H, Yokosuka K, Yoshida T, Fudo T, Morito S, Shimazaki T, Yamada K, Sato K, Shiba N, Hiraoka K. Impact of spinal surgery on locomotive syndrome in patients with lumbar spinal stenosis in clinical decision limit stage 3: a retrospective study. BMC Musculoskelet Disord 2023; 24:851. [PMID: 37898742 PMCID: PMC10612310 DOI: 10.1186/s12891-023-06966-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/14/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Locomotive syndrome (LS) is characterized by reduced mobility. Clinical decision limit (CDL) stage 3 in LS indicates physical frailty. Lumbar spinal canal stenosis (LSS) is one of the causes of LS, for which lumbar surgery is considered to improve the CDL stage. This study aimed to investigate the efficacy of lumbar surgery and independent factors for improving the CDL stage in patients with LSS. METHODS This retrospective study was conducted at the Department of Orthopaedic Surgery at our University Hospital. A total of 157 patients aged ≥ 65 years with LSS underwent lumbar surgery. The 25-Question Geriatric Locomotive Function scale (GLFS-25) was used to test for LS, and the Timed Up and Go test (TUG) was used to evaluate functional ability. Lower limb pain was evaluated using a visual analog scale. Patients with at least one improvement in the CDL stage following lumbar surgery were included in the improvement group. Differences in lower limb pain intensity between the groups were evaluated using the Wilcoxon rank-sum test. The Spearman's rank correlation coefficient was used to determine correlations between Δ lower limb pain and Δ GLFS-25. Logistic regression analysis was used to identify factors associated with improvement in LS. RESULTS The proportion of patients with improved CDL stage was 45.1% (improvement/non-improvement: 32/39). Δ Lower limb pain was significantly reduced in the improvement group compared with that in the non-improvement group (51.0 [36.3-71.0] vs 40.0 [4.0-53.5]; p = 0.0107). Δ GLFS-25 was significantly correlated with Δ lower limb pain (r = 0.3774, p = 0.0031). Multiple logistic regression analysis revealed that TUG and age were significantly associated with improvement in LS (odds ratio, 1.22; 95% confidence interval: 1.07-1.47). CONCLUSIONS Lumbar surgery effectively improved the CDL stage in patients with LSS. In addition, TUG was an independent factor associated with improvement in the CDL.
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Affiliation(s)
- Ichiro Nakae
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Ryuki Hashida
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan.
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Ryota Otsubo
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Sohei Iwanaga
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hiroo Matsuse
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Kimiaki Yokosuka
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Tatsuhiro Yoshida
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Takuma Fudo
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Shinji Morito
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Takahiro Shimazaki
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Kei Yamada
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Kimiaki Sato
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Naoto Shiba
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Koji Hiraoka
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
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Yamada K, Shinozaki T, Ito J, Nakajima S, Nakagawa K, Furuya T, Wada K, Kobayashi N, Shiba N, Kajino Y, Kawamura N, Hamada D, Tome Y, Nishimoto A, Sakai T, Hasegawa K, Iijima Y, Takeshita K, Nakashima Y. The influence of COVID-19 epidemic on the number of orthopaedic surgeries in Japan. J Orthop Sci 2023:S0949-2658(23)00255-5. [PMID: 37863684 DOI: 10.1016/j.jos.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/24/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND There is limited data on the impact of COVID-19 epidemic on the number of orthopaedic surgeries in Japan. METHODS We conducted a nationwide hospital survey asking for the monthly number of orthopaedic surgeries performed at each facility from January 2019 to June 2021. Those facilities that had performed at least 100 surgeries in 2019 were included for analyses. The facilities were further grouped by prefecture and by hospital characteristics. A brief health economic evaluation was also performed. Risk ratios were compared using univariate analyses with P < 0.05 considered statistically significant. RESULTS Questionnaire was sent to 1988 hospitals with 1671 hospitals (84%) responding. The survey data indicated a total number of orthopaedic surgeries decreased in 2020 compared to 2019 (1,061,541 vs 1,119,955 P < 0.01), and also for the first six months of 2021 compared to the same period in 2019 (530,388 vs 550,378 P < 0.01). In 2020, over 50% of all facilities in nearly all of the prefectures saw a decline in surgical procedures. The risk of incurring more than a 25% decease in the number of surgeries was significantly higher in 2020 for class I designated medical institutions compared to those that were not designated for any types of infectious diseases among the institutions with a tertiary emergency medical center in 2020 (crude risk ratio 2.9: 95% CI 1.2-7.4, p = 0.02) and in 2021 (crude risk ratio 4.7: 95% CI 1 0.9-12.1, p < 0.01). The estimated total nationwide decrease of revenue were in the range of approximately ¥29.2 to ¥116.8 billion per year for orthopaedic surgeries alone. CONCLUSION There was a statistically significant decrease in the number of orthopaedic surgeries in Japan. The magnitude of the decline varied by prefectures and hospital characteristics, with the greater impact imposed on medical institutions with higher classification functions. The estimated immediate health economic impact was sizable.
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Affiliation(s)
- Koji Yamada
- Department of Orthopaedic Surgery, Nakanoshima Orthopaedics, Kanagawa, Japan.
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Junji Ito
- Department of Orthopaedic Surgery, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Susumu Nakajima
- Department of Patient Safety, Toranomon Hospital, Tokyo, Japan
| | - Koichi Nakagawa
- Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Chiba, Japan
| | - Takeo Furuya
- Department of Orthopaedic Surgery, Chiba University Hospital, Chiba, Japan
| | - Kanichiro Wada
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Naomi Kobayashi
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Kanagawa, Japan
| | - Naoto Shiba
- Department of Orthopaedic Surgery, Kurume University Hospital, Fukuoka, Japan
| | - Yoshitomo Kajino
- Department of Orthopedic Surgery, Kanazawa University School of Medical Sciences, Ishikawa, Japan
| | - Naohiro Kawamura
- Department of Orthopaedic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Daisuke Hamada
- Department of Orthopedics, Tokushima University Graduate School, Tokushima, Japan
| | - Yasunori Tome
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Akira Nishimoto
- Department of Orthopaedic Surgery, Nishimoto Hospital, Ehime, Japan
| | - Toshinori Sakai
- Department of Orthopedics, Tokushima University Graduate School, Tokushima, Japan
| | | | - Yuki Iijima
- Department of Orthopaedic Surgery, Jichi Medical University Hospital, Tochigi, Japan
| | - Katsushi Takeshita
- Department of Orthopaedic Surgery, Jichi Medical University Hospital, Tochigi, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Kyushu University Hospital, Fukuoka, Japan
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Saruwatari R, Yamada K, Sato K, Yokosuka K, Yoshida T, Nakae I, Shimazaki T, Morito S, Shiba N. Risk Factors for Surgical Site Infection in Spinal Surgery and Interventions: A Retrospective Study. Kurume Med J 2023; 68:201-207. [PMID: 37316293 DOI: 10.2739/kurumemedj.ms6834004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Surgical site infection following spinal surgery causes prolonged delay in recovery after surgery, increases cost, and sometimes leads to additional surgical procedures. We investigated risk factors for the occurrence of surgical site infection events in terms of patient-related, surgery-related, and postoperative factors. METHODS This retrospective study included 1000 patients who underwent spinal surgery in our hospital between April 2016 and March 2019. RESULTS Patient-related factors were dementia, length of preoperative hospital stay (≥ 14 days), and diagnosis at the time of surgery (traumatic injury or deformity). The one surgery-related factor was multilevel surgery (≥ 9 intervertebral levels), and the one postoperative factor was time to ambulation (≥ 7 days) were statistically significant risk factors for spinal surgical site infection. CONCLUSION One risk factor identified in this study that is amenable to intervention is time to ambulation. As delayed ambulation is a risk factor for postoperative surgical site infection, how medical staff can intervene in postoperative ambulation to further reduce the incidence of surgical site infection is a topic for future research.
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Affiliation(s)
- Rikiya Saruwatari
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Kei Yamada
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Kimiaki Sato
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Kimiaki Yokosuka
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Tatsuhiro Yoshida
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Ichiro Nakae
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | | | - Shinji Morito
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Naoto Shiba
- Department of Orthopaedic Surgery, Kurume University School of Medicine
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Otsubo R, Hashida R, Murotani K, Iwanaga S, Hirota K, Koya S, Tsukada Y, Ogata Y, Yokosuka K, Yoshida T, Nakae I, Fudo T, Morito S, Shimazaki T, Yamada K, Sato K, Matsuse H, Shiba N, Hiraoka K. Phase angle is related to physical function and quality of life in preoperative patients with lumbar spinal stenosis. Sci Rep 2023; 13:13909. [PMID: 37626144 PMCID: PMC10457364 DOI: 10.1038/s41598-023-40629-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Lumbar spinal stenosis (LSS) can interfere with daily life and quality of life (QOL). Evaluating physical function and QOL and helping patients to improve is the focus of rehabilitation. Phase angle (PhA) assessment is widely used to measure body composition and is considered an indicator of physical function and QOL. This study investigated the relationship between PhA and physical function, physical activity, and QOL in patients with LSS. PhA, handgrip strength, walking speed, Timed Up and Go test (TUG), Life Space Assessment (LSA), Prognostic Nutritional Index (PNI), Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and EQ-5D were assessed and statistically analyzed. The study included 133 patients with LSS. Multiple regression analysis of PhA adjusted for age, sex, and body mass index (Model 1) and for Model 1 + PNI (Model 2) showed significant correlations (P < 0.05) with handgrip strength, walking speed, TUG, and LSA. Regarding QOL, PhA was significantly correlated (P < 0.05) with lumbar function in JOABPEQ. PhA was associated with physical function and QOL in patients with LSS and might be a new clinical indicator in this population.
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Affiliation(s)
- Ryota Otsubo
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan, 830-0011
| | - Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan, 830-0011.
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan.
| | - Kenta Murotani
- Biostatistics Center, Kurume University, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Sohei Iwanaga
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan, 830-0011
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Keisuke Hirota
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan, 830-0011
| | - Shunji Koya
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan, 830-0011
| | - Yuya Tsukada
- Institute of Health and Sports Sciences, Kurume University, Kurume, Japan
| | - Yuta Ogata
- Division of Rehabilitation, Kurume University Medical Center, Kurume, Japan
| | - Kimiaki Yokosuka
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Tatsuhiro Yoshida
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Ichiro Nakae
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Takuma Fudo
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Shinji Morito
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Takahiro Shimazaki
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Kei Yamada
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Kimiaki Sato
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan, 830-0011
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan, 830-0011
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Koji Hiraoka
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
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Eshima K, Ohzono H, Gotoh M, Shimokobe H, Tanaka K, Nakamura H, Kanazawa T, Okawa T, Shiba N. Effect of suprascapular nerve injury on muscle and regenerated enthesis in a rat rotator cuff tear model. Clin Shoulder Elb 2023; 26:131-139. [PMID: 37316174 DOI: 10.5397/cise.2022.01207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/08/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Massive rotator cuff tears (RCTs) are complicated by muscle atrophy, fibrosis, and intramuscular fatty degeneration, which are associated with postoperative tendon-to-bone healing failure and poor clinical outcomes. We evaluated muscle and enthesis changes in large tears with or without suprascapular nerve (SN) injury in a rat model. METHODS Sixty-two adult Sprague-Dawley rats were divided into SN injury (+) and SN injury (-) groups (n=31 each), comprising tendon (supraspinatus [SSP]/infraspinatus [ISP]) and nerve resection and tendon resection only cases, respectively. Muscle weight measurement, histological evaluation, and biomechanical testing were performed 4, 8, and 12 weeks postoperatively. Ultrastructural analysis with block face imaging was performed 8 weeks postoperatively. RESULTS SSP/ISP muscles in the SN injury (+) group appeared atrophic, with increased fatty tissue and decreased muscle weight, compared to those in the control and SN injury (-) groups. Immunoreactivity was only positive in the SN injury (+) group. Myofibril arrangement irregularity and mitochondrial swelling severity, along with number of fatty cells, were higher in the SN injury (+) group than in the SN injury (-) group. The bone-tendon junction enthesis was firm in the SN injury (-) group; this was atrophic and thinner in the SN injury (+) group, with decreased cell density and immature fibrocartilage. Mechanically, the tendon-bone insertion was significantly weaker in the SN injury (+) group than in the control and SN injury (+) groups. CONCLUSIONS In clinical settings, SN injury may cause severe fatty changes and inhibition of postoperative tendon healing in large RCTs. Level of evidence: Basic research, controlled laboratory study.
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Affiliation(s)
- Kenichiro Eshima
- Department of Orthopedic Surgery, Kurume University Hospital, Fukuoka, Japan
| | - Hiroki Ohzono
- Department of Orthopedic Surgery, Kurume University Medical Center, Fukuoka, Japan
| | - Masafumi Gotoh
- Department of Orthopedic Surgery, Kurume University Medical Center, Fukuoka, Japan
| | - Hisao Shimokobe
- Department of Orthopedic Surgery, Kurume University Hospital, Fukuoka, Japan
| | - Koji Tanaka
- Department of Orthopedic Surgery, Kurume University Hospital, Fukuoka, Japan
| | - Hidehiro Nakamura
- Department of Orthopedic Surgery, Kurume University Medical Center, Fukuoka, Japan
| | - Tomonoshin Kanazawa
- Department of Orthopedic Surgery, Kurume University Hospital, Fukuoka, Japan
| | - Takahiro Okawa
- Department of Orthopedic Surgery, Kurume University Medical Center, Fukuoka, Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University Hospital, Fukuoka, Japan
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Omoto M, Tsukada Y, Hashida R, Matsuse H, Tajima H, Iwanaga S, Takano Y, Nago T, Tagawa Y, Shiba N. Effect of Cycling Exercise Resisting Electrically Stimulated Antagonist Muscle Contractions in Healthy Males. Metabolites 2023; 13:metabo13050604. [PMID: 37233645 DOI: 10.3390/metabo13050604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/26/2023] [Accepted: 03/31/2023] [Indexed: 05/27/2023] Open
Abstract
A hybrid training system (HTS) combining antagonist muscle electrical stimulation and voluntary muscle contraction has been developed using eccentric antagonist muscle contractions with electrical stimulation as resistance to voluntary muscle contractions. We devised an exercise method using HTS combined with a cycle ergometer (HCE). The purpose of this study was to compare the muscle strength, muscle volume, aerobic functions and lactate metabolism of HCE and a volitional cycle ergometer (VCE). A total of 14 male participants performed exercise on a bicycle ergometer for 30 min per session, 3 times per week for 6 weeks. We divided 14 participants into an HCE group (7 participants) and a VCE group (7 participants). The workload was set at 40% of each participant's peak oxygen uptake (V.O2peak). Electrodes were placed over each motor point on the quadriceps and hamstrings. The V.O2peak and anaerobic threshold significantly increased before and after training when using HCE rather than VCE. The HCE group had significantly increased extension and flexion muscle strength at 180 degrees/s in post-training measurements over pre-training measurements. Knee flexion muscle strength at 180 degrees/s tended to increase in the HCE group compared to the VCE group. The quadricep muscle cross-sectional area was significantly increased in the HCE group compared to the VCE group. Additionally, the HCE group had significantly decreased maximal lactate, measured every 5 min during exercise at the end of study, between pre and post-training. Thus, HCE may be a more effective training method for muscle strength, muscle mass and aerobic functions at 40% of each participant's V.O2peak than conventional cycling exercise. HCE could be applied not only as aerobic exercise but also as resistance training.
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Affiliation(s)
- Masayuki Omoto
- Department of Orthopedics, Kurume University School of Medicine, Kurume 830-0011, Fukuoka, Japan
- Rehabilitation Center, Kurume University, Kurume 830-0011, Fukuoka, Japan
| | - Yuya Tsukada
- Rehabilitation Center, Kurume University, Kurume 830-0011, Fukuoka, Japan
| | - Ryuki Hashida
- Department of Orthopedics, Kurume University School of Medicine, Kurume 830-0011, Fukuoka, Japan
- Rehabilitation Center, Kurume University, Kurume 830-0011, Fukuoka, Japan
| | - Hiroo Matsuse
- Department of Orthopedics, Kurume University School of Medicine, Kurume 830-0011, Fukuoka, Japan
- Rehabilitation Center, Kurume University, Kurume 830-0011, Fukuoka, Japan
| | - Hiroshi Tajima
- Department of Orthopedics, Kurume University School of Medicine, Kurume 830-0011, Fukuoka, Japan
- Rehabilitation Center, Kurume University, Kurume 830-0011, Fukuoka, Japan
| | - Sohei Iwanaga
- Department of Orthopedics, Kurume University School of Medicine, Kurume 830-0011, Fukuoka, Japan
- Rehabilitation Center, Kurume University, Kurume 830-0011, Fukuoka, Japan
| | - Yoshio Takano
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Okawa 831-8501, Fukuoka, Japan
| | - Takeshi Nago
- Department of Orthopedics, Kurume University School of Medicine, Kurume 830-0011, Fukuoka, Japan
- Rehabilitation Center, Kurume University, Kurume 830-0011, Fukuoka, Japan
| | - Yoshihiko Tagawa
- Department of Orthopedics, Kurume University School of Medicine, Kurume 830-0011, Fukuoka, Japan
- Rehabilitation Center, Kurume University, Kurume 830-0011, Fukuoka, Japan
| | - Naoto Shiba
- Department of Orthopedics, Kurume University School of Medicine, Kurume 830-0011, Fukuoka, Japan
- Rehabilitation Center, Kurume University, Kurume 830-0011, Fukuoka, Japan
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Matsuda K, Shiba N, Hiraoka K. New Insights into the Role of Synovial Fibroblasts Leading to Joint Destruction in Rheumatoid Arthritis. Int J Mol Sci 2023; 24:ijms24065173. [PMID: 36982247 PMCID: PMC10049180 DOI: 10.3390/ijms24065173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/30/2023] Open
Abstract
Rheumatoid arthritis (RA), one of the most common autoimmune diseases, is characterized by multiple-joint synovitis with subsequent destruction of bone and cartilage. The excessive autoimmune responses cause an imbalance in bone metabolism, promoting bone resorption and inhibiting bone formation. Preliminary studies have revealed that receptor activator of NF-κB ligand (RANKL)-mediated osteoclast induction is an important component of bone destruction in RA. Synovial fibroblasts are the crucial producers of RANKL in the RA synovium; novel analytical techniques, primarily, single-cell RNA sequencing, have confirmed that synovial fibroblasts include heterogeneous subsets of both pro-inflammatory and tissue-destructive cell types. The heterogeneity of immune cells in the RA synovium and the interaction of synovial fibroblasts with immune cells have recently received considerable attention. The current review focused on the latest findings regarding the crosstalk between synovial fibroblasts and immune cells, and the pivotal role played by synovial fibroblasts in joint destruction in RA.
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Affiliation(s)
- Kotaro Matsuda
- Department of Orthopedic Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
| | - Koji Hiraoka
- Department of Orthopedic Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
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Oka S, Takano Y, Matsuse H, Tagawa Y, Shiba N. A Standing Low-frequency Vibration Exercise Device for Improving Balance in Community-dwelling Older Adults: A Single-blind Randomized Controlled Trial. Phys Ther Res 2023; 26:24-31. [PMID: 37181485 PMCID: PMC10169311 DOI: 10.1298/ptr.e10192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 12/13/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This study aimed to compare the effects of the standing low-frequency vibration exercise device (SLVED) and walking training on balance ability on an unstable surface in community-dwelling elderly people. METHODS Thirty-eight older adults were randomly allocated to the SLVED sessions: the intervention group (n = 19), and the walking sessions: the control group (n = 19). Each group session lasted 20 min and was performed twice a week for 12 weeks. Standing balance was assessed by the change in center-of-gravity sway of the participant standing on foam rubber with eyes open (EO) and eyes closed (EC). The primary outcome measures were the root mean square (RMS) values of the center of foot pressure in the mediolateral and anteroposterior directions and the RMS area. Secondary outcome measures were the results of the 10-m walking time test (10 MWT), five-times sit-to-stand (5T-STS) test, and timed up-and-go (TUG) test. RESULTS Analysis of variance showed a significant group × time interaction for the TUG test. Significant improvements were observed in Y-RMS for EO condition; RMS, X-RMS, Y-RMS, and RMS area for EC condition; and 10 MWT, 5T-STS test, and TUG test for the main effect of the time factor. CONCLUSION SLVED for intervention in community-dwelling older adults showed a greater improvement than walking training in the TUG test. In addition, SLVED improved the Y-RMS for the EO condition on foam rubber; RMS, X-RMS, Y-RMS, and RMS area for the EC condition on foam rubber in standing balance; and the 10 MWT and 5T-STS test, suggesting that it has similar effects to walking training.
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Affiliation(s)
- Shinichiro Oka
- Department of Physical Therapy, Faculty of Rehabilitation, Reiwa Health Sciences University, Japan
| | - Yoshio Takano
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Japan
| | - Hiroo Matsuse
- Department of Orthopedics, Kurume University School of Medicine, Japan
| | - Yoshihiko Tagawa
- Department of Orthopedics, Kurume University School of Medicine, Japan
| | - Naoto Shiba
- Department of Orthopedics, Kurume University School of Medicine, Japan
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Iwanaga S, Matsuse H, Hashida R, Bekki M, Kawaguchi T, Shiba N. The Effect of Walking Combined with Neuromuscular Electrical Stimulation on Liver Stiffness and Insulin Resistance in Patients with Non-alcoholic Fatty Liver Disease: An Exploratory Randomized Controlled Trial. Kurume Med J 2023; 67:137-146. [PMID: 36450482 DOI: 10.2739/kurumemedj.ms674001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Increased liver stiffness and insulin resistance are important therapeutic targets in patients with nonalcoholic fatty liver disease (NAFLD). A hybrid training system (HTS) has been developed which combines application of electrical stimulation and volitional contractions. We compared the effect of walking exercise (5.6 km/h) both with and without simultaneous HTS on liver stiffness and insulin resistance. In a single-blind, controlled trial, 32 subjects with NAFLD were randomized to 12 weeks of triweekly 30 minute walking exercise with either HTS (HTS group) or without HTS (control group). Transient elastography for the assessment of liver stiffness, body weight, visceral fat, the homeostasis model assessment of insulin resistance, fasting blood glucose, serum aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transpeptidase were evaluated. Data were evaluated using the linear model after adjusting the baseline value. In the subjects with BMI of 27 kg/m2 or more, the decrement of transient elastography in the HTS group was significantly larger than in the control group (mean ± standard error: Δ2.13 ± 0.64 kPa vs. Δ-0.67 ± 0.42 kPa, p=0.0009). There were no significant differences between groups in other endpoints. These results showed that simultaneously combining electrical stimulation with walking exercise could potentially improve liver stiffness in people who have NAFLD. In fact, because the exercise effect was increased by HTS without increasing the walking speed, this HTS could be especially useful for obese or overweight subjects, in whom NAFLD and joint problems often coexist. However, its effects on insulin resistance and body composition were not clear.
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Affiliation(s)
- Sohei Iwanaga
- Division of Rehabilitation, Kurume University Hospital
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital
| | - Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital
| | | | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital
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13
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Matsubara T, Yamada K, Kanazawa T, Sato K, Yokosuka K, Shiba N. Improved intervertebral bone union in ALIF rat model with porous hydroxyapatite/collagen combined with platelet-rich plasma. Spine J 2023; 23:325-335. [PMID: 36064089 DOI: 10.1016/j.spinee.2022.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 08/23/2022] [Accepted: 08/26/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Platelet-rich plasma (PRP) can accelerate bone union in spinal fusion surgery with an autogenous bone graft. However, it is unclear whether bone union can be obtained by using artificial bone and PRP together in spinal interbody fusion surgery. PURPOSE This study aimed to determine whether interbody fusion can be achieved by transplanting porous hydroxyapatite/collagen(HAp/Col) which is an artificial bone material frequently used in spinal fusion surgery, together with PRP in the intervertebral disc space in rats. STUDY DESIGN AND SETTING A controlled laboratory study. METHODS A total of fourty 10-week old Sprague-Dawley rats were used in this study and assigned to three groups as follow: disc curettage only (control group, n=10), disc curettage + HAp/Col transplant (H group, n=10), and disc curettage + HAp/Col + PRP transplant (H+P group, n=10). The other 10 rats were sacrificed as blood donors for acquisition of PRP. Microcomputed tomography (μCT) examinations were performed to evaluate bone union, bone volume (BV), and bone mineral density (BMD) at 4, 8, and 12 weeks following surgery. Twelve weeks postoperatively, each group of three of L4-L5 spines was harvested to perform histological examination (hematoxylin & eosin stain) and the others were subjected to biomechanical testing (compression properties). RESULTS The platelet count in PRP was approximately 4.1 times greater than that in whole blood (260.6±26.2 × 104 mg/dL and 64.3±2.9 × 104 mg/dL in PRP and whole blood, respectively). All the L4-L5 lumbar discs were fused in the H+P group, whereas only one case was fused in the H group and none in the control group at 12 weeks after surgery. BV was significantly higher in the H+P group than in the H group or control groups (both p<.01), although BMD was not significantly different among the three groups. Upon histological analysis, mature bone formation was observed at the transplanted space in all cases in the H+P group, whereas fibrous tissue was observed at the location in the H and control groups. Regarding biomechanical properties, the ultimate load to failure was significantly higher in the H+P group than in the H group or control group (p=.021 and .013, respectively), although stiffness was not significantly different between the three groups. CONCLUSION The combination of porous HAp/Col and PRP at an appropriate concentration can promote bone union in the intervertebral disc space without using an autologous bone graft in the rat model. Bone tissue formation was histologically confirmed, and it was mechanically strong. CLINICAL SIGNIFICANCE This preclinical study showed that porous HAp/Col, when combined with PRP at an appropriate concentration, can induce bone union without autologous bone grafts. The results may eliminate the need for autologous bone collection for spinal fusion surgery in the future.
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Affiliation(s)
| | - Kei Yamada
- Department of Orthopedic Surgery, Kurume University, Fukuoka, Japan.
| | | | - Kimiaki Sato
- Department of Orthopedic Surgery, Kurume University, Fukuoka, Japan
| | - Kimiaki Yokosuka
- Department of Orthopedic Surgery, Kurume University, Fukuoka, Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University, Fukuoka, Japan
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Harada N, Ishitani E, Gotoh M, Shiba N. The clinical outcomes of infraspinatus rotational transfer for irreparable posterosuperior rotator cuff tears: a preliminary report. Clin Shoulder Elb 2022; 25:195-201. [PMID: 35791682 PMCID: PMC9471820 DOI: 10.5397/cise.2021.00731] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 03/29/2022] [Indexed: 11/25/2022] Open
Abstract
Background This study aimed to examine the preliminary clinical results of the infraspinatus rotational transfer procedure for irreparable posterosuperior rotator cuff tears. Methods This study included 34 patients (mean age, 68.4 years). Their mean tear width and length measurements were 50.9 mm and 50.6 mm, respectively. The functional outcomes, including physician-determined and patient-reported scores, were evaluated before and at 1 year after surgery. The structural outcomes determined using the magnetic resonance imaging examination results were also assessed. Results The clinical scores significantly improved after surgery compared with the scores before surgery: the Constant-Murley score (53.3±21.1 to 76.8±10.5), University of California at Los Angeles Shoulder score (15.6±3.6 to 27.8±6.7), American Shoulder and Elbow Surgeons Shoulder score (51.8±18.3 to 89.1±13.5), and WORC score (925.0±436.8 to 480.3±373.2) (all p<0.001). Postoperative re-tears were noted in two patients (5.9%). Conclusions One year postoperatively, the patient’s clinical scores significantly improved, with a re-tear rate of 5.9%.
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Satou N, Yagi M, Yoshida K, Shiba N. Morphological Changes in Flexor Tendon Adhesion Following Early Exercise After Tendon Repair. Kurume Med J 2022; 67:23-29. [PMID: 35135935 DOI: 10.2739/kurumemedj.ms671008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Adhesion is a common complication following surgical repair of flexor tendons, resulting in the restriction of tendon gliding. We investigated the effect of early exercise on adhesion formation. To create an adhesion model, the proximal region of the second phalanx of the third toe in 4-month-old White Leghorn chickens was cut. The gliding side of the flexor digitorum profundus was hemiresected and the bony floor was crushed to enhance adhesion formation. The resected area was fixed in an extended position for 1, 2, or 3 weeks. Following 1, 2, or 3 weeks of active exercise, the chickens were sacrificed and morphological changes in the adhesions were assessed. In the 1- and 2-week fixed groups, 1, 2, or 3 weeks of active exercise resulted in mesotenon-like adhesion that was elastic and had no effect on tendon gliding. However, in the 3-week fixed group, a mature adhesion remained with limited change and tendon gliding was inhibited even after 3 weeks of active exercise. Thus, we concluded that adhesions become more elastic with early exercise within 2 weeks after tendon repair, but that adhesions following tendon repair tend not to show any further elastic changes when exercise is started 3 weeks after the repair.
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Affiliation(s)
- Naoto Satou
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Masaharu Yagi
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Kenji Yoshida
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Naoto Shiba
- Department of Orthopaedic Surgery, Kurume University School of Medicine
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16
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Nakamura H, Gotoh M, Honda H, Mitsui Y, Ohzono H, Shiba N, Kume S, Okawa T. Posterior decentering of the humeral head in patients with arthroscopic rotator cuff repair. Clin Shoulder Elb 2022; 25:22-27. [PMID: 35255649 PMCID: PMC8907500 DOI: 10.5397/cise.2021.00507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/26/2021] [Indexed: 11/25/2022] Open
Abstract
Background: In some patients with rotator cuff tear (RCT), the axial view of magnetic resonance imaging (MRI) shows subtle posterior decentering (PD) of the humeral head from the glenoid fossa. This is considered to result from a loss of centralization that is typically produced by rotator cuff function. There are few reports on PD in RCT despite the common occurrence of posterior subluxation in degenerative joint disease. In this study, we investigated the effect of PD in arthroscopic rotator cuff repair (ARCR). Methods: We conducted a retrospective study of consecutive patients who underwent ARCR at our institute and were followed-up for at least 1 year. PD was identified as a 2 mm posterior shift of the humeral head relative to the glenoid fossa in the axial MRI view preoperatively. The tear size and fatty degeneration (FD, Goutallier classification) were also evaluated using preoperative MRI. Retears were evaluated through MRI at 1 year postoperatively. Results: We included 135 shoulders in this study. Ten instances of PD (including seven retears) were observed preoperatively. Fifteen retears (three and 12 retears in the small/medium and large/massive tear groups, respectively) were observed postoperatively. PD was significantly correlated with tear size, FD, and retear occurrence (p<0.01 each). The odds ratio for PD in retears was 33.8, which was greater than that for tear size ≥3 cm and FD grade ≥3. Conclusions: We concluded that large tear size and FD contribute to the occurrence of PD. Furthermore, PD could be a predictor of retear after ARCR.
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Iwahashi S, Hashida R, Matsuse H, Higashi E, Bekki M, Iwanaga S, Hara K, Higuchi T, Hirakawa Y, Kubota A, Imagawa H, Muta Y, Minamitani K, Yoshida T, Yokosuka K, Yamada K, Sato K, Shiba N. The impact of sarcopenia on low back pain and quality of life in patients with osteoporosis. BMC Musculoskelet Disord 2022; 23:142. [PMID: 35148724 PMCID: PMC8832799 DOI: 10.1186/s12891-022-05086-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 02/03/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Osteoporosis combined with sarcopenia contributes to a high risk of falling, fracture, and even mortality. However, sarcopenia's impact on low back pain and quality of life (QOL) in patients with osteoporosis is still unknown. The purpose of this study is to investigate low back pain and QOL in osteoporosis patients with sarcopenia. METHODS We assessed 100 ambulatory patients who came to our hospital for osteoporosis treatment. Low back pain was evaluated using the Visual Analogue Scale (VAS) with 100 being an extreme amount of pain and 0 no pain. The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) score was used to assess QOL after adjustment for age, history of vertebral fracture, and adult spinal deformity. Differences in low back pain intensity assessed by VAS between groups were evaluated by the Willcoxon rank-sum test. Covariance analysis was used to assess QOL. All data are expressed as either median, interquartile range, or average, standard error. RESULTS Patients were classified into the sarcopenia group (n = 32) and the non-sarcopenia group (n = 68). Low back pain intensity assessed by VAS was significantly higher in the sarcopenia group than in the non-sarcopenia group (33.0 [0-46.6] vs. 8.5 [0-40.0]; p < 0.05). The subscales of the JOABPEQ for low back pain were significantly lower in the sarcopenia group than in the non-sarcopenia group (65.0 ± 4.63 vs. 84.0 ± 3.1; p < 0.05). CONCLUSION In this cross-sectional study, sarcopenia affected low back pain and QOL in ambulatory patients with osteoporosis. Sarcopenia may exacerbate low back pain and QOL.
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Affiliation(s)
- Shoji Iwahashi
- Department of Orthopedics, Kurume University School of Medicine, 830-0011, Kurume, Japan
| | - Ryuki Hashida
- Department of Orthopedics, Kurume University School of Medicine, 830-0011, Kurume, Japan. .,Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan.
| | - Hiroo Matsuse
- Department of Orthopedics, Kurume University School of Medicine, 830-0011, Kurume, Japan.,Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan
| | - Eriko Higashi
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan
| | - Masafumi Bekki
- Department of Orthopedics, Kurume University School of Medicine, 830-0011, Kurume, Japan.,Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan
| | - Sohei Iwanaga
- Department of Orthopedics, Kurume University School of Medicine, 830-0011, Kurume, Japan.,Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan
| | - Koji Hara
- Department of Orthopedics, Kurume University School of Medicine, 830-0011, Kurume, Japan.,Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan
| | - Takahiko Higuchi
- Munakata Suikokai General Hospital, 5-7-1 Himakino, 811-3298, Fukutsu, Japan
| | - Yohei Hirakawa
- Department of Orthopaedics, Munakata Suikokai General Hospital, 5-7-1 Himakino, 811-3298, Fukutsu, Japan
| | - Asami Kubota
- Munakata Suikokai General Hospital, 5-7-1 Himakino, 811-3298, Fukutsu, Japan
| | - Hiromi Imagawa
- Munakata Suikokai General Hospital, 5-7-1 Himakino, 811-3298, Fukutsu, Japan
| | - Yoko Muta
- Munakata Suikokai General Hospital, 5-7-1 Himakino, 811-3298, Fukutsu, Japan
| | - Kazuhito Minamitani
- Department of Orthopaedics, Munakata Suikokai General Hospital, 5-7-1 Himakino, 811-3298, Fukutsu, Japan
| | - Tatsuhiro Yoshida
- Department of Orthopedics, Kurume University School of Medicine, 830-0011, Kurume, Japan
| | - Kimiaki Yokosuka
- Department of Orthopedics, Kurume University School of Medicine, 830-0011, Kurume, Japan
| | - Kei Yamada
- Department of Orthopedics, Kurume University School of Medicine, 830-0011, Kurume, Japan
| | - Kimiaki Sato
- Department of Orthopedics, Kurume University School of Medicine, 830-0011, Kurume, Japan
| | - Naoto Shiba
- Department of Orthopedics, Kurume University School of Medicine, 830-0011, Kurume, Japan.,Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan
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18
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Hara K, Matsuse H, Hashida R, Iwanaga S, Bekki M, Hara M, Aramaki K, Tsutsumi K, Tagawa Y, Shiba N. The effect of rotator cuff physical exercise combined with electrically stimulated antagonist on shoulder rotator cuff strength. J Orthop Sci 2022; 27:126-130. [PMID: 33384217 DOI: 10.1016/j.jos.2020.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 11/13/2020] [Accepted: 11/19/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND An elastic band (EB) is generally used with a low load for rotator cuff physical exercise, but the resulting increase in muscle strength is insufficient. We assessed the efficacy on external rotator muscle strength of the shoulder joint; of a hybrid training system (HTS) that resists the motion of a volitionally contracting agonist muscle using the force generated by its electrically stimulated antagonist vs. general rotator cuff exercise with EB. METHODS Twenty healthy men with no shoulder joint disorders were randomized to 6 weeks of triweekly 10-min rotator cuff exercise with HTS or EB in a clinical research laboratory. Isokinetic concentric external rotator muscle strength at angular velocities of 60°/s and 180°/s (CON60, CON180, respectively) and isokinetic eccentric external rotator muscle strength at an angular velocity of 60°/s (ECC60) were measured as rotator cuff function before and after 6 weeks of intervention. RESULTS There were no significant intergroup differences in baseline characteristics. There were statistically significant differences (p = 0.0358, p = 0.0213, respectively) in the increase in CON180 (mean ± SD) and ECC60 between the HTS group (Δ6.0 ± 6.0Nm, p = 0.015; Δ7.5 ± 4.7Nm p = 0.0007, respectively) and the EB group (Δ0.3 ± 5.2Nm, p = 0.8589; Δ1.8 ± 5.3 Nm p = 0.3133, respectively). There was a trend toward CON60 increasing in the HTS group (Δ4.7 ± 6.5Nm, p = 0.0494) which was greater than in the control group (Δ-0.9 ± 6.3Nm, p = 0.6637) (inter-group, p = 0.0677). CONCLUSIONS The results of this study support the conclusion that HTS is more effective for increasing external rotator muscle strength more effectively than EB. HTS would be useful for rotator cuff physical exercise.
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Affiliation(s)
- Koji Hara
- Division of Rehabilitation, Kurume University Hospital, Kurume, Fukuoka, Japan; Department of Orthopedics, Hisatsune Hospital, Fukuoka, Japan; Department of Orthopaedics, Kurume University, Kurume, Fukuoka, Japan
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital, Kurume, Fukuoka, Japan.
| | - Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital, Kurume, Fukuoka, Japan; Department of Orthopaedics, Kurume University, Kurume, Fukuoka, Japan
| | - Sohei Iwanaga
- Division of Rehabilitation, Kurume University Hospital, Kurume, Fukuoka, Japan; Department of Orthopaedics, Kurume University, Kurume, Fukuoka, Japan
| | - Masafumi Bekki
- Division of Rehabilitation, Kurume University Hospital, Kurume, Fukuoka, Japan; Department of Orthopaedics, Kurume University, Kurume, Fukuoka, Japan
| | - Masafumi Hara
- Department of Orthopedics, Hisatsune Hospital, Fukuoka, Japan
| | - Kei Aramaki
- Department of Orthopedics, Hisatsune Hospital, Fukuoka, Japan
| | - Koji Tsutsumi
- Department of Orthopedics, Hisatsune Hospital, Fukuoka, Japan
| | - Yoshihiko Tagawa
- Division of Rehabilitation, Kurume University Hospital, Kurume, Fukuoka, Japan; Department of Orthopaedics, Kurume University, Kurume, Fukuoka, Japan
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital, Kurume, Fukuoka, Japan; Department of Orthopaedics, Kurume University, Kurume, Fukuoka, Japan
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19
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Hashida R, Matsuse H, Bekki M, Iwanaga S, Higuchi T, Hirakawa Y, Kubota A, Imagawa H, Muta Y, Miruno Y, Minamitani K, Shiba N. Grip Strength as a Predictor of the Functional Outcome of Hip-Fracture Patients. Kurume Med J 2021; 66:195-201. [PMID: 34690206 DOI: 10.2739/kurumemedj.ms664005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Patients with hip fracture are limited as to physical activity. It is difficult to evaluate the physical function of the legs at admission; however, it is easy to measure grip strength, which has been reported to be correlated with systemic muscular strength and physical function. The objective of this study was to investigate the utility of grip strength in predicting functional outcome after hip fracture. METHODS Fifty-seven patients who underwent surgery for hip fracture were evaluated for height, weight, Body Mass Index (BMI), grip strength, bone density (femoral neck), hemoglobin, Hemoglobin A1c (HbA1c), Hasegawa's Dementia Scale-Revised (HDS-R), and albumin at admission and Functional Independence Measure (FIM) at discharge. Spearman's rank correlation coefficient was used to evaluate the relation between grip strength and the above variables. Furthermore, factors of walking acquisition were analyzed by logistic regression analysis and decision-tree analysis. RESULTS Correlation analysis showed that grip strength was positively correlated with bone density at admission and FIM at discharge and negatively correlated with age. In the logistic regression analysis, the independent factor associated with walking acquisition was grip strength (OR 1.26; 95%CI 1.018-1.566; p=0.0339). In the decisiontree analysis, grip strength was the initial divergence variable for walking acquisition (the percentage with walking acquisition was 80.0% of the patients with grip strength ≧13.2 kg VS. 18.7% of the patients with grip strength < 13.2 kg). CONCLUSIONS Grip strength at admission was definitive in predicting the functional outcome of patients with hip fracture who underwent surgery.
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Affiliation(s)
- Ryuki Hashida
- Department of Orthopedics, Kurume University School of Medicine
| | - Hiroo Matsuse
- Department of Orthopedics, Kurume University School of Medicine
| | - Masafumi Bekki
- Department of Orthopedics, Kurume University School of Medicine
| | - Sohei Iwanaga
- Department of Orthopedics, Kurume University School of Medicine
| | | | - Yohei Hirakawa
- Department of Orthopedics, Munakata Suikokai General Hospital
| | - Asami Kubota
- Department of Nursing, Munakata Suikokai General Hospital
| | - Hiromi Imagawa
- Department of Nursing, Munakata Suikokai General Hospital
| | - Yoko Muta
- Department of Nursing, Munakata Suikokai General Hospital
| | - Yumi Miruno
- Department of Nursing, Munakata Suikokai General Hospital
| | | | - Naoto Shiba
- Department of Orthopedics, Kurume University School of Medicine
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20
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Abe R, Ohzono H, Gotoh M, Nakamura Y, Honda H, Nakamura H, Kume S, Okawa T, Shiba N. Neurotropin protects rotator cuff tendon cells from lidocaine-induced cell death. Clin Shoulder Elb 2021; 24:224-230. [PMID: 34875729 PMCID: PMC8651596 DOI: 10.5397/cise.2021.00360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/04/2021] [Indexed: 12/04/2022] Open
Abstract
Background Local anesthetics often are used in rotator cuff tears as therapeutic tools, although some cases have reported that they have detrimental effects. Neurotropin (NTP) is used widely in Japan as a treatment for various chronic pain conditions and is shown to have protective effects on cartilage and nerve cells. In this study, we investigated the protective effect of NTP against lidocaine-induced cytotoxicity. Methods Tenocytes from rotator cuff tendons were incubated with lidocaine, NTP, lidocaine with NTP, and a control medium. Cell viability was evaluated using the WST-8 assay. Cell apoptosis was detected via annexin V staining using flow cytometry. The expression of BCL-2 and cytochrome c, which are involved in the intrinsic mitochondrial pathway of apoptosis, was evaluated via Western blotting and immunohistochemical staining. Results In the cell viability assay, lidocaine decreased cell viability in a dose-dependent manner, and NTP did not affect cell viability. Moreover, NTP significantly inhibited the cytotoxic effect of lidocaine. The flow cytometry analysis showed that lidocaine significantly induced apoptosis in tenocytes, and NTP considerably inhibited this lidocaine-induced apoptosis. Western blotting experiments showed that lidocaine decreased the protein expression of BCL-2, and that NTP conserved the expression of BCL-2, even when used with lidocaine. Immunohistochemical staining for cytochrome c showed that 0.1% lidocaine increased cytochrome c-positive cells, and NTP suppressed lidocaine-induced cytochrome c expression. Conclusions NTP suppresses lidocaine-induced apoptosis of tenocytes by inhibiting the mitochondrial apoptotic pathway. Intra-articular/ bursal injection of NTP with lidocaine could protect tenocytes in rotator cuff tendons against lidocaine-induced apoptosis.
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Affiliation(s)
- Ryunosuke Abe
- Department of Orthopedic Surgery, Kurume University Hospital, Fukuoka, Japan
| | - Hiroki Ohzono
- Department of Orthopedic Surgery, Kurume University Hospital, Fukuoka, Japan
| | - Masafumi Gotoh
- Department of Orthopedic Surgery, Kurume University Hospital, Fukuoka, Japan
| | - Yosuke Nakamura
- Department of Orthopedic Surgery, Kurume University Hospital, Fukuoka, Japan
| | - Hirokazu Honda
- Department of Orthopedic Surgery, Kurume University Hospital, Fukuoka, Japan
| | - Hidehiro Nakamura
- Department of Orthopedic Surgery, Kurume University Hospital, Fukuoka, Japan
| | - Shinichiro Kume
- Department of Orthopedic Surgery, Kurume University Hospital, Fukuoka, Japan
| | - Takahiro Okawa
- Department of Orthopedic Surgery, Kurume University Hospital, Fukuoka, Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University Hospital, Fukuoka, Japan
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21
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Tajima H, Matsuse H, Hashida R, Nago T, Bekki M, Iwanaga S, Higashi E, Shiba N. Electrically stimulated eccentric contraction during non-weight bearing knee bending exercise in the supine position increases oxygen uptake: A randomized, controlled, exploratory crossover trial. PLoS One 2021; 16:e0259856. [PMID: 34793521 PMCID: PMC8601547 DOI: 10.1371/journal.pone.0259856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/24/2021] [Indexed: 12/02/2022] Open
Abstract
It is well known that prolonged bed rest induces muscle weakness, muscle atrophy, cardiovascular deconditioning, bone loss, a loss of functional capacity, and the development of insulin resistance. Neuromuscular electrical stimulation is anticipated to be an interventional strategy for disuse due to bed rest. A hybrid training system (HTS), synchronized neuromuscular electrical stimulation for voluntary exercise using an articular motion sensor, may increase the exercise load though bed rest. We assessed oxygen uptake or heart rate during knee bending exercise in the supine position on a bed both simultaneously combined with HTS and without HTS to evaluate exercise intensity on different days in ten healthy subjects (8 men and 2 women) by a randomized controlled crossover trial. The values of relative oxygen uptake during knee bending exercise with HTS were significantly greater than those during knee bending exercise without HTS (7.29 ± 0.91 ml/kg/min vs. 8.29 ± 1.06 ml/kg/min; p = 0.0115). That increment with HTS was a mean of 14.42 ± 13.99%. Metabolic equivalents during knee bending exercise with HTS and without HTS were 2.08 ± 0.26 and 2.39 ± 0.30, respectively. The values of heart rate during knee bending exercise with HTS were significantly greater than those during knee bending exercise without HTS (80.82 ± 9.19 bpm vs. 86.36 ± 5.50 bpm; p = 0.0153). HTS could increase exercise load during knee bending exercise which is easy to implement on a bed. HTS might be a useful technique as a countermeasure against the disuse due to bed rest, for example during acute care or the quarantine for infection prophylaxis.
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Affiliation(s)
- Hiroshi Tajima
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
| | - Hiroo Matsuse
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
- * E-mail:
| | - Ryuki Hashida
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
| | - Takeshi Nago
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
| | - Masafumi Bekki
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
| | - Sohei Iwanaga
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
| | - Eriko Higashi
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
| | - Naoto Shiba
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
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22
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Inoue M, Tanaka S, Gotoh M, Mitsui Y, Moriyama H, Nakamura H, Ohzono H, Okawa T, Shiba N. Incidence of Re-Dislocation/Instability After Arthroscopic Bankart Repair: Analysis via Telephone Interviews. Kurume Med J 2021; 66:203-207. [PMID: 34690207 DOI: 10.2739/kurumemedj.ms664006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Current advances in arthroscopic surgery have led to good outcomes for arthroscopic Bankart repair (ABR) for recurrent anterior shoulder dislocation. However, recent studies have reported recurrence rates of 4%-19% after ABR. In our survey conducted from February 2002 to December 2010, the post-ABR re-dislocation rate was 8.8%. In 2011, we began performing the ABR with open Bristow (B) procedure or Remplissage (R) procedure in patients with large glenoid or humeral head bone defects and in patients who play collision sports. Therefore, the present study is the second series evaluating the incidence of re-dislocation and instability after recurrent anterior shoulder dislocation. METHOD Surgery was performed for 84 cases of shoulder instability from January 2011 to August 2017. After excluding 7 open surgeries, 6 reoperations, and 2 patients with multidirectional instability, telephone interviews were conducted with 69 patients. The average follow-up duration was 46.9 months (range, 13-92 months). RESULT ABR alone was performed 61 patients; the B procedure was added for 3 patients, and the R procedure was added for 5 patients. Telephone interviews were conducted with 61 patients. There were no cases of re-dislocation or reoperation. Four patients who underwent only ABR experienced postoperative instability, but not to the extent that their daily lives were affected. CONCLUSION This study showed that the addition of R or B technique to ABR for recurrent anterior shoulder dislocation resulted in a 0% re-dislocation rate.
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Affiliation(s)
| | - Suguru Tanaka
- Department of Orthopedics, Kurume University Hospital
| | - Masafumi Gotoh
- Department of Orthopedics, Kurume University Medical Center
| | | | | | | | - Hiroki Ohzono
- Department of Orthopedics, Kurume University Hospital
| | - Takahiro Okawa
- Department of Orthopedics, Kurume University Medical Center
| | - Naoto Shiba
- Department of Orthopedics, Kurume University Hospital
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23
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Tanaka S, Gotoh M, Tanaka K, Mitsui Y, Nakamura H, Ozono H, Okawa T, Shiba N. Functional and Structural Outcomes After Retears of Arthroscopically Repaired Large and Massive Rotator Cuff Tears. Orthop J Sports Med 2021; 9:23259671211035752. [PMID: 34631904 PMCID: PMC8493310 DOI: 10.1177/23259671211035752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 04/14/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Most studies have shown acceptable clinical results in patients with large or massive tears treated by arthroscopic rotator cuff repair (ARCR); however, the effects of retears after surgery in these patients remain unknown. Purpose: To evaluate functional and structural outcomes after retears of large and massive rotator cuff tears treated by ARCR. Study Design: Case series; Level of evidence, 4. Methods: A total of 196 consecutive patients with large to massive rotator cuff tears underwent physical examination and magnetic resonance imaging before and after ARCR at 6, 12, and 24 months. Of these, 9 patients were lost at 6 months after surgery. Therefore, 187 patients were followed up for 24 months after surgery; 148 patients showed no postsurgical ruptures. Consequently, the remaining 39 patients with postsurgical ruptures were included in this study (mean age at surgery, 64.2 ± 8.7 years). Functional outcome measures comprised the University of California, Los Angeles (UCLA) and Japanese Orthopaedic Association (JOA) scores. Structural outcome measures consisted of the global fatty degeneration index (GFDI), mediolateral tear size, and residual tendon attachment area as evaluated by our own scoring system. Results: The mean UCLA and JOA scores significantly improved from 16.3 ± 3.9 and 63.2 ± 10.7 preoperatively to 27.9 ± 5.5 (P < .0001) and 84.5 ± 9.4 (P < .0001) at final follow-up, respectively. The mean mediolateral tear size (P = .03, .02, and .02, respectively) and residual tendon attachment area (P = .04, .03, and .04, respectively) significantly improved from preoperatively to 6, 12, and 24 months postoperatively. The correlation analysis between the functional and structural variables confirmed significant associations between the residual tendon attachment area, the JOA and UCLA scores at 24 months postoperatively, and the preoperative GFDI (r = –0.81 to 0.78). Conclusion: The residual tendon attachment area after a retear was significantly larger at 24 months after surgery than before surgery. In addition, significant associations were confirmed between preoperative fatty degeneration, the residual tendon attachment area, and functional outcomes after a retear. These results may explain why functional outcomes significantly improved even after retears in this series.
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Affiliation(s)
- Suguru Tanaka
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Masafumi Gotoh
- Department of Orthopedic Surgery, Kurume University Medical Center, Kurume, Japan
| | - Koji Tanaka
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yasuhiro Mitsui
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hidehiro Nakamura
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hiroki Ozono
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Takahiro Okawa
- Department of Orthopedic Surgery, Kurume University Medical Center, Kurume, Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, Japan
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24
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Iwanaga S, Hashida R, Takano Y, Bekki M, Nakano D, Omoto M, Nago T, Kawaguchi T, Matsuse H, Torimura T, Shiba N. Hybrid Training System Improves Insulin Resistance in Patients with Nonalcoholic Fatty Liver Disease: A Randomized Controlled Pilot Study. TOHOKU J EXP MED 2021; 252:23-32. [PMID: 32863329 DOI: 10.1620/tjem.252.23] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Insulin resistance is associated with the progression of nonalcoholic fatty liver disease (NAFLD). Insulin resistance is regulated by various cytokines, including interleukin-6 (IL-6), a proinflammatory myokine, and selenoprotein P (SeP), a liver-derived secretory hepatokine. High levels of IL-6 and/or SeP have been shown to contribute to insulin resistance, and exercise is a first-line therapy for NAFLD. We have developed a hybrid training system (HTS): a neuromuscular electrical stimulation device to enhance exercise results. We aimed to investigate the effects of HTS on insulin resistance as well as serum IL-6 and SeP in patients with NAFLD. This is a randomized, single-blind (assessor), controlled trial. Subjects with NAFLD walked on a treadmill with or without HTS (9 subjects each) for 30 minutes three times a week for six weeks (HTS vs. control group; median age 45 vs. 45; male/female 5/4 vs. 6/3). We examined subjects before the first session and at the end of the final session. Serum SeP levels were measured by ELISA which measures the fragment of SeP. In the HTS group, HOMA-IR values were significantly reduced compared to the control group (Δ-0.71 vs. Δ0.05; P < 0.05). IL-6 and SeP levels in serum were also significantly reduced compared to that of the control group (IL-6; Δ-0.6 vs. Δ0.29 pg/mL; P < 0.05, SeP; Δ-1288.5 vs. Δ-435.4 ng/mL; P < 0.05, respectively). In conclusion, we propose that HTS improves insulin resistance by reducing serum IL-6 and SeP levels in patients with NAFLD.
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Affiliation(s)
- Sohei Iwanaga
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Yoshio Takano
- Department of Physical Therapy School of Health Sciences at Fukuoka, International University Health and Welfare
| | - Masafumi Bekki
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Dan Nakano
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
| | - Masayuki Omoto
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Takeshi Nago
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Takuji Torimura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
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25
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Hashida R, Matsuse H, Kawaguchi T, Yoshio S, Bekki M, Iwanaga S, Sugimoto T, Hara K, Koya S, Hirota K, Nakano D, Tsutsumi T, Kanto T, Torimura T, Shiba N. Effects of a low-intensity resistance exercise program on serum miR-630, miR-5703, and Fractalkine/CX3CL1 expressions in subjects with No exercise habits: A preliminary study. Hepatol Res 2021; 51:823-833. [PMID: 34014020 DOI: 10.1111/hepr.13670] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/03/2021] [Accepted: 05/14/2021] [Indexed: 12/12/2022]
Abstract
AIMS Exercise is effective for the prevention of liver cancer. Exercise exerts biological effects through the regulation of microRNAs (miRNAs) and cytokines/myokines. We aimed to investigate the effects of low-intensity resistance exercise on serum miRNA and cytokine/myokine expressions in subjects with no exercise habits. METHODS We enrolled seven male subjects with no exercise habits in this prospective before-after study. All subjects performed a low-intensity resistance exercise program (three metabolic equivalents, approximately 20 min/session). Serum miRNA expressions were evaluated using microarrays. We performed Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of differentially expressed miRNAs before and after exercise. Serum cytokine/myokine expressions were evaluated using a multiplex panel. RESULTS All subjects completed the exercise program with no adverse events. In the microarray analysis, seven miRNAs showed a significant change between before and after exercise. Of these, microRNA (miR)-630 and miR-5703 showed a >1.5-fold increase (miR-630: 40.7 vs. 69.3 signal intensity, p = 0.0133; miR-5703: 30.7 vs. 55.9 signal intensity, p = 0.0051). KEGG pathway enrichment analysis showed that miR-630- and miR-5703-related genes were enriched in 37 and 5 pathways, including transforming growth factor-beta and Wnt signaling pathways, respectively. In the multiplex analysis, 12 cytokines/myokines showed significant alteration after exercise compared to before exercise. Of these, fractalkine/CX3CL1 showed the most significant up-regulation by exercise (94.5 vs. 109.1 pg/ml, p = 0.0017). CONCLUSIONS A low-intensity resistance exercise program was associated with upregulation of serum miR-630, miR-5703, and fractalkine/CX3CL1 expressions in subjects with no exercise habits. Thus, even low-intensity exercise may alter miRNA and cytokine/myokine expressions in humans.
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Affiliation(s)
- Ryuki Hashida
- Department of Orthopedics, School of Medicine, Kurume University, Kurume, Japan.,Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Hiroo Matsuse
- Department of Orthopedics, School of Medicine, Kurume University, Kurume, Japan.,Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Sachiyo Yoshio
- Department of Liver Disease, Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Masafumi Bekki
- Department of Orthopedics, School of Medicine, Kurume University, Kurume, Japan.,Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Sohei Iwanaga
- Department of Orthopedics, School of Medicine, Kurume University, Kurume, Japan.,Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Takahiro Sugimoto
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Koji Hara
- Department of Orthopedics, School of Medicine, Kurume University, Kurume, Japan.,Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Shunji Koya
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Keisuke Hirota
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Dan Nakano
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Tsubasa Tsutsumi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Tatsuya Kanto
- Department of Liver Disease, Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Takuji Torimura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Naoto Shiba
- Department of Orthopedics, School of Medicine, Kurume University, Kurume, Japan
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26
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Bekki M, Matsuse H, Hashida R, Nago T, Iwanaga S, Kawaguchi T, Takano Y, Shiba N. Electrically Stimulated Eccentric Contractions during Walking Increases Oxygen Uptake. Kurume Med J 2021; 66:93-100. [PMID: 34135203 DOI: 10.2739/kurumemedj.ms662008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Neuromuscular electrical stimulation (NMES) is used to increase not only muscle strength but also whole-body metabolism. A hybrid training system (HTS) in which NMES is synchronized to voluntary exercise by an articular motion sensor may increase exercise load during aerobic walking exercise. We assessed the metabolic cost during walking exercise (5 minutes at 4 km/h and 5.6 km/h) on a treadmill simultaneously combined with HTS (HTSW) or without HTS (CON). We evaluated oxygen uptake ( VO·2) and heart rate (HR) during HTSW or CON on different days in fifteen subjects. The values ofVO·2 during HTSW at 4 km/h and 5.6 km/h were signifi cantly greater than those during CON (16.6 ± 1.85 ml/min/kg vs 15.3 ± 1.48 ml/min/kg; p < 0.05, 21.0 ± 2.17 ml/min/kg vs 19.4 ± 2.13 ml/min/kg; p < 0.01, respectively). The values of HR during HTSW at 4 km/h, 5.6 km/h were significantly greater than those during CON (106.7 ± 8.1 bpm vs 101.7 ± 10.3 bpm; p < 0.05, 126.5 ± 11.1 bpm vs 121.5 ± 12.5 bpm; p < 0.05, respectively). HTS added significantly to the exercise load by 8.3 ± 12.0% or 9.1 ± 9.9% during aerobic walking exercise at 4 km/h or 5.6 km/h, respectively. HTS might be useful for health promotion by increasing metabolic cost during aerobic walking exercise without increasing the perceived difficulty.
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Affiliation(s)
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital
| | - Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital
| | - Takeshi Nago
- Division of Rehabilitation, Kurume University Hospital
| | - Sohei Iwanaga
- Division of Rehabilitation, Kurume University Hospital
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
| | - Yoshio Takano
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital
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27
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Imai T, Gotoh M, Fukuda K, Ogino M, Nakamura H, Ohzono H, Shiba N, Okawa T. Clinical outcome in patients with hand lesions associated with complex regional pain syndrome after arthroscopic rotator cuff repair. Clin Shoulder Elb 2021; 24:80-87. [PMID: 34078015 PMCID: PMC8181840 DOI: 10.5397/cise.2021.00080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/18/2021] [Indexed: 12/23/2022] Open
Abstract
Background Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR. Methods Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups. Results Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (p<0.001). Comparisons between the two groups were not significantly different, except for SF-36 “general health perception” (p<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema. Conclusions CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.
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Affiliation(s)
- Takaki Imai
- Department of Rehabilitation, Kyushu University of Nursing and Social Welfare, Kumamoto, Japan
| | - Masafumi Gotoh
- Department of Orthopedic Surgery, Kurume University Medical Center, Fukuoka, Japan
| | - Keiji Fukuda
- Department of Orthopedic Surgery, Keishinkai Hospital, Saga, Japan
| | - Misa Ogino
- Department of Orthopedic Surgery, Keishinkai Hospital, Saga, Japan
| | - Hidehiro Nakamura
- Department of Orthopedic Surgery, Kurume University Medical Center, Fukuoka, Japan
| | - Hiroki Ohzono
- Department of Orthopedic Surgery, Kurume University, Kurume, Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University, Kurume, Japan
| | - Takahiro Okawa
- Department of Orthopedic Surgery, Kurume University Medical Center, Fukuoka, Japan
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Hashida R, Takano Y, Matsuse H, Kudo M, Bekki M, Omoto M, Nago T, Kawaguchi T, Torimura T, Shiba N. Electrical Stimulation of the Antagonist Muscle During Cycling Exercise Interval Training Improves Oxygen Uptake and Muscle Strength. J Strength Cond Res 2021; 35:111-117. [PMID: 29278576 DOI: 10.1519/jsc.0000000000002393] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Hashida, R, Takano, Y, Matsuse, H, Kudo, M, Bekki, M, Omoto, M, Nago, T, Kawaguchi, T, Torimura, T, and Shiba, N. Electrical stimulation of the antagonist muscle during cycling exercise interval training improves oxygen uptake and muscle strength. J Strength Cond Res 35(1): 111-117, 2021-A hybrid training system (HTS) is a resistance exercise method that combines voluntary concentric muscle contractions and electrically stimulated eccentric muscle contractions. We devised an exercise technique using HTS on cycle ergometer (HCE). The purpose of this study was to compare cardiorespiratory function and muscle strength when cycling exercise is combined with electrical stimulation over an extended period. Twenty-nine healthy young men were divided into an HCE group (n = 14) and a volitional cycle ergometer (VCE alone) group (n = 15). All subjects performed 30-minute cycling exercise interval training sessions 3 times a week for 6 weeks. The V̇o2peak of both groups significantly increased compared with the pretraining period (HCE group: from 31.3 ± 4.4 [ml·kg-1·min-1] pretraining to 37.6 ± 6.7 [ml·kg-1·min-1] post-training [p = 0.0024] and VCE group: from 34.0 ± 7.1 [ml·kg-1·min-1] pretraining to 38.4 ± 8.2 [ml·kg-1·min-1] [p = 0.0057]). After the training, there was no significant difference of changes in V̇o2peak between the HCE and the VCE groups (p = 0.7107). In the VCE group, the maximal isokinetic torque of knee extension (60°·s-1) post-training did not significantly increase compared with the pretraining period (VCE group: from 2.4 ± 0.5 [N·m·kg-1] pretraining to 2.5 ± 0.4 [N·m·kg-1] [p = 0.4543]). By contrast, in the HCE group, the maximal isokinetic torque of knee extension (60°·s-1) post-training significantly increased compared with pretraining period (HCE group: from 2.5 ± 0.3 [N·m·kg-1] pretraining to 2.8 ± 0.3 [N·m·kg-1] [p < 0.0001]). The change in knee extension torque was significantly greater for the HCE group than for the VCE group (p = 0.0307). In conclusion, cardiopulmonary function and knee extension strength were improved by the use of HCE.
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Affiliation(s)
- Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Yoshio Takano
- Department of Physical Therapy, School of Health Sciences, International University Health and Welfare, Enokizu, Okawa, Japan; and
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Mei Kudo
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Masafumi Bekki
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Masayuki Omoto
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Takeshi Nago
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takuji Torimura
- Department of Physical Therapy, School of Health Sciences, International University Health and Welfare, Enokizu, Okawa, Japan; and
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
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Haraguchi T, Kume S, Jimbo K, Gotoh M, Shiba N, Okawa T. Saphenous Nerve Entrapment Neuropathy After Closed Tibial Fracture: A Case Report. JBJS Case Connect 2021; 11:01709767-202106000-00017. [PMID: 33835945 DOI: 10.2106/jbjs.cc.20.00670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE A 43-year-old man who underwent intramedullary nailing for a closed tibial fracture developed saphenous nerve entrapment neuropathy. He developed severe medial leg pain, which was worse on walking or standing, 2 years postoperatively. Surgical neurolysis resulted in complete pain relief and functional recovery of the limb without recurrence of symptoms. CONCLUSION Clinicians should consider several etiologies in the diagnostic evaluation of a patient with chronic pain after limb trauma. If a patient complains of lower extremity pain after intramedullary fixation of closed fractures of the tibial shaft, the possibility of saphenous nerve entrapment neuropathy should be considered.
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Affiliation(s)
- Toshiaki Haraguchi
- Department of Orthopedic Surgery, Kurume University Medical Center, Kurume, Fukuoka, Japan.,Department of Orthopedic Surgery, St. Mary's Hospital, Kurume, Fukuoka, Japan
| | - Shinichiro Kume
- Department of Orthopedic Surgery, Kurume University Medical Center, Kurume, Fukuoka, Japan
| | - Kotaro Jimbo
- Department of Orthopedic Surgery, St. Mary's Hospital, Kurume, Fukuoka, Japan
| | - Masafumi Gotoh
- Department of Orthopedic Surgery, Kurume University Medical Center, Kurume, Fukuoka, Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Takahiro Okawa
- Department of Orthopedic Surgery, Kurume University Medical Center, Kurume, Fukuoka, Japan
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Moriyama H, Gotoh M, Tanaka K, Mitsui Y, Nakamura H, Ozono H, Okawa T, Shiba N. Midterm Functional and Structural Outcomes of Large/Massive Cuff Tears Treated by Arthroscopic Partial Repair. Orthop J Sports Med 2021; 9:2325967120988795. [PMID: 34250157 PMCID: PMC8226377 DOI: 10.1177/2325967120988795] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 10/02/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Previous studies have shown good clinical outcomes in patients with
irreparable large or massive rotator cuff tears treated using arthroscopic
partial repair (APR); however, few studies have evaluated both functional
and structural outcomes in these patients. Purpose: To evaluate both functional and structural outcomes in patients with large or
massive rotator cuff tears treated using APR. Study Design: Case series; Level of evidence, 4. Methods: Between March 2009 and November 2016, a total of 30 patients underwent APR
because of the irreparability of their large or massive rotator cuff tears
during surgery. Of these patients, 24 completed the minimum 24-month
follow-up (mean, 61.8 ± 27.1 months; range, 24-112 months) and were included
in this study. Functional outcome measures included the Japanese Orthopaedic
Association (JOA) and University of California Los Angeles (UCLA) scores and
the visual analog scale for pain. Structural outcome measures comprised
preoperative fatty degeneration, mediolateral tear size, residual tendon
attachment area, and glenohumeral (GH) arthritic changes evaluated on
magnetic resonance imaging scans or plain radiographs before and after
surgery. Functional and structural outcomes were evaluated preoperatively,
at 3 months postoperatively, and at the final follow-up. Results: The JOA scores for all patients significantly improved from 67.9 ± 11.3
preoperatively to 85.4 ± 15.6 postoperatively (P <
.0001). Similarly, the UCLA scores significantly improved from 15.8 ± 4.20
preoperatively to 29 ± 6.69 at final follow-up postoperatively
(P < .0001). The mediolateral tear size were
significantly decreased at 3 months postoperatively (P <
.001) and at the final follow-up (P < .001). Compared
with preoperative scores, the novel score evaluating the residual tendon
attachment area improved from 3.08 ± 0.46 to 3.54 ± 0.41 (P
< .001) after surgery overall, although it significantly deteriorated
from 3 months postoperatively to the final follow-up. GH osteoarthritis
progressed in 6 patients (25%). Patients who developed osteoarthritis had
lower JOA and UCLA scores than did those who did not (JOA,
P = .010; UCLA, P = .037). Conclusion: In irreparable large or massive rotator cuff tears treated using APR,
functional outcome improved after surgery. Although the residual tendon
attachment area improved, functional outcome after APR corresponded to the
GH alterations at the midterm follow-up. Longer-term follow-up is needed to
further elucidate the effect of APR on clinical outcomes in these
patients.
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Affiliation(s)
- Hiroaki Moriyama
- Department of Orthopedic Surgery, Kurume University, Kurume, Fukuoka, Japan
| | - Masafumi Gotoh
- Department of Orthopedic Surgery, Kurume University Medical Center, Kurume, Fukuoka, Japan
| | - Koji Tanaka
- Department of Orthopedic Surgery, Kurume University, Kurume, Fukuoka, Japan
| | - Yashuhiro Mitsui
- Department of Orthopedic Surgery, Kurume University, Kurume, Fukuoka, Japan
| | - Hidehiro Nakamura
- Department of Orthopedic Surgery, Kurume University Medical Center, Kurume, Fukuoka, Japan
| | - Hiroki Ozono
- Department of Orthopedic Surgery, Kurume University, Kurume, Fukuoka, Japan
| | - Takahiro Okawa
- Department of Orthopedic Surgery, Kurume University Medical Center, Kurume, Fukuoka, Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University, Kurume, Fukuoka, Japan
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Yoshida S, Sakai K, Nakama K, Matsuura M, Okazaki S, Jimbo K, Shirahama M, Shiba N. Treatment of Capitellum and Trochlea Fractures Using Headless Compression Screws and a Combination of Dorsolateral Locking Plates. Cureus 2021; 13:e13740. [PMID: 33842118 PMCID: PMC8021482 DOI: 10.7759/cureus.13740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction This study aimed to evaluate the clinical outcomes of 16 patients with capitellum and trochlea fractures that were treated using isolated headless compression screws or a combination of dorsolateral locking plates and anterior-to-posterior screws. We also investigated the presence of lateral epicondyle fragments because this fragment is especially important when making decisions regarding the surgical approach and implants. Materials and methods We conducted a retrospective analysis of 16 patients with capitellum and trochlea fractures. Clinical, radiographic (based on CT scans), and elbow-specific outcomes, including the Mayo Elbow Performance Index (MEPI), were evaluated at a mean of 23.5 months postoperatively. Results The average MEPI scores in patients with Dubberley type A (non-posterior comminution) and type B (posterior comminution) fractures were 88 and 78, respectively (p=0.08). Headless compression screws were used in 10 cases of type A fracture and one case of type B fracture. A combination of dorsolateral locking plates and anterior-to-posterior screws was used in five cases of type B fracture. Hardware loosening was seen in one case of type B fracture with isolated screw fixation. The presence of a lateral epicondyle fragment was significantly associated with the type B group (6/6 patients; 100%). In contrast, patients in the type A group rarely had posterior comminution of the lateral epicondyle fragment (2/10 patients; 20%). Conclusions Capitellum and trochlea fractures with posterior comminution, which typically presented with lateral epicondylar fragments, were safely and effectively treated with a combination of dorsolateral locking plates and anterior-to-posterior screws through lateral approaches. Cases without posterior comminution were treated with headless compression screws with no complications. The Dubberley classification system provides helpful information to determine the fixation strategy.
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Affiliation(s)
- Shiro Yoshida
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, JPN.,Department of Orthopedic Surgery, St. Mary's Hospital, Kurume, JPN
| | - Kensuke Sakai
- Department of Orthopedic Surgery, St. Mary's Hospital, Kurume, JPN
| | - Kenjiro Nakama
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, JPN
| | - Mitsuhiro Matsuura
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, JPN
| | - Shingo Okazaki
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, JPN
| | - Kotaro Jimbo
- Department of Orthopedic Surgery, St. Mary's Hospital, Kurume, JPN
| | - Masahiro Shirahama
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, JPN
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, JPN
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Harada N, Gotoh M, Ishitani E, Kakuma T, Yano Y, Tatara D, Kawakami J, Imai T, Karasuyama M, Kudoh Y, Shiba N. Combination of risk factors affecting retear after arthroscopic rotator cuff repair: a decision tree analysis. J Shoulder Elbow Surg 2021; 30:9-15. [PMID: 32838953 DOI: 10.1016/j.jse.2020.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 05/01/2020] [Accepted: 05/04/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Several risk factors for postoperative retear after arthroscopic rotator cuff repair (ARCR) have been cited in a large number of reports; various combinations of these seem to be present in the clinical setting. PURPOSE Using a combination model for decision tree analysis, we aimed to investigate the combination of risk factors that affect postoperative retear the most. METHODS A total of 286 patients who underwent magnetic resonance (MR) imaging at 6 months after surgery were included in this study. Based on the structural integrity of the MR images taken 6 months after surgery, the patients were divided into a healed group (intact tendon, 254 patients) and a retear group (ruptured tendon, 32 patients). Using univariate and decision tree analyses, we selected a combination of 11 risk factors that drastically affected postoperative retear. RESULTS The mean age was 64.9 ± 7.1 years, and the mean symptom duration was 9.7 ± 11.6 months. The tear was small/medium in 177 patients and large/massive in 109 patients. The technique for surgical repair was single row in 42 patients, double row in 60 patients, and suture bridging in 216 patients. On univariate analysis, both groups had significant differences in the anteroposterior (AP) tear size (P < .0001), mediolateral tear size (P < .0001), hyperlipidemia (P = .0178), global fatty degeneration index (P < .0001), supraspinatus fatty degeneration stage (P < .0001), and critical shoulder angle (CSA) (P = .0015). All of these 5 risk factors, except for mediolateral tear size, were selected as candidates for the decision tree analysis. Eight combination patterns were determined to have prediction probabilities that ranged from 4.3% to 86.1%. In particular, the combination of an AP tear size of ≥40 mm, hyperlipidemia, and a CSA of ≥37° affected retear after ARCR the most. CONCLUSIONS Decision tree analysis lead to the extraction of different retear factor combinations, which were divided into 5 retear groups. The worst combination was of AP tear size ≥40 mm, hyperlipidemia, and CSA ≥37°, and the prediction probability of this combination was 86.2%. Therefore, our data may offer a new index for the prediction of retear after ARCR.
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Affiliation(s)
- Nobuya Harada
- Department of Rehabilitation, Fukuoka Shion Hospital, Fukuoka, Japan; Kurume University School of Medicine Graduate School, Fukuoka, Japan
| | - Masafumi Gotoh
- Department of Orthopedic Surgery, Kurume University Medical Center, Fukuoka, Japan.
| | - Eiichi Ishitani
- Department of Orthopedic Surgery, Fukuoka Shion Hospital, Fukuoka, Japan
| | - Tatsuyuki Kakuma
- Department of Biostatistics, Kurume University School of Medicine, Fukuoka, Japan
| | - Yuka Yano
- Department of Rehabilitation, Fukuoka Shion Hospital, Fukuoka, Japan
| | - Daisuke Tatara
- Department of Rehabilitation, Fukuoka Shion Hospital, Fukuoka, Japan
| | - Junichi Kawakami
- Department of Physical Therapy, Kyushu Nutrition Welfare University, Fukuoka, Japan
| | - Takaki Imai
- Department of Rehabilitation, Keishinkai Hopital, Saga, Japan
| | - Masaki Karasuyama
- Department of Physical Therapy, Kyushu Nutrition Welfare University, Fukuoka, Japan
| | - Yu Kudoh
- Kurume University School of Medicine Graduate School, Fukuoka, Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University, Fukuoka, Japan
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Shimazaki T, Yamada K, Sato K, Jimbo K, Nakamura H, Goto M, Matsubara T, Mizokami K, Iwahashi S, Sasaki T, Shiba N. Primary treatment of atlantoaxial rotatory fixation in children: a multicenter, retrospective series of 125 cases. J Neurosurg Spine 2020:1-8. [PMID: 33276329 DOI: 10.3171/2020.7.spine20183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/01/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The primary treatment for atlantoaxial rotatory fixation (AARF) remains controversial. The aim of this study was to investigate the primary treatment for AARF and create an algorithm for primary treatment. METHODS The authors analyzed the data of 125 pediatric patients at four medical institutions from April 1989 to December 2018. The patients were reported to have neck pain, torticollis, and restricted neck range of motion and were diagnosed according to the Fielding classification as type I or II. As a primary treatment, 88 patients received neck collar fixation, and 28 of these patients did not show symptom relief and required Glisson traction. Thirty-seven patients were primarily treated with Glisson traction. In total, 65 patients, including neck collar treatment failure patients, underwent Glisson traction in hospitals. RESULTS The success rate of treatment was significantly higher in the Glisson traction group (97.3%) than in the neck collar fixation group (68.2%) (p = 0.0001, Wilcoxon test). In the neck collar effective group, Fielding type I was more predominant (p = 0.0002, Wilcoxon test) and the duration from onset to the first visit was shorter (p = 0.02, Wilcoxon test) than that in the neck collar ineffective group. Using multivariate logistic regression analysis with the above items, the authors generalized from the estimated formula: logit [p(success group by neck collar fixation group)|duration from onset to the first visit (x1), Fielding type (x2)] = 0.4(intercept) - 0.15x1 + 1.06x2, where x1 is the number of days and x2 = 1 (for Fielding type I) or -1 (for Fielding type II). In cases for which the score is a positive value, the neck collar should be chosen. Conversely, in cases for which the score is a negative value, Glisson traction should be the first choice. CONCLUSIONS According to this formula, in patients with Fielding type I AARF, neck collar fixation should be allowed only if the duration from onset is ≤ 10 days. In patients with Fielding type II, because the score would be a negative value, Glisson traction should be performed as the primary treatment.
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34
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Hirota K, Matsuse H, Koya S, Hashida R, Bekki M, Yanaga Y, Johzaki K, Tomino M, Mouri F, Morishige S, Oya S, Yamasaki Y, Nagafuji K, Shiba N. Risks of Muscle Atrophy in Patients with Malignant Lymphoma after Autologous Stem Cell Transplantation. Phys Ther Res 2020; 24:69-76. [PMID: 33981529 DOI: 10.1298/ptr.e10041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 09/25/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Muscle atrophy is associated with autologous stem cell transplantation (ASCT)-related outcomes in patients with malignant lymphoma (ML). However, the impact of ASCT on muscle mass remains unclear in patients with ML. The aims of this study were to investigate changes in muscle mass and risk profiles for muscle atrophy after ASCT. METHOD We enrolled 40 patients with refractory ML (age 58 [20-74] years, female/male 16/24, body mass index (BMI) 21.1 kg/m2 [17.1-29.6]). Psoas muscle mass was assessed using the psoas muscle index (PMI) before and after ASCT. STATISTICAL ANALYSIS USED Independent factors associated with a severe decrease rate of change in PMI were evaluated by decision-tree analysis, respectively. RESULTS PMI was significantly decreased after ASCT (4.61 vs. 4.55 cm2/m2; P=0.0425). According to the decision-tree analysis, the regimen was selected as the initial split. The rates of change in PMI were -5.57% and -3.97% for patients administered MCEC and LEED, respectively. In patients who were administered LEED, the second branching factor was BMI. In patients with BMI < 20.3 kg/m2, the rate of change in PMI was -7.16%. On the other hand, the rate of change in PMI was 4.05% for patients with BMI ≥ 20.3 kg/m2. CONCLUSION We demonstrated that muscle mass decreased after ASCT in patients with ML. Patients who received MCEC and patients with low BMI were at risk for a decrease in muscle mass.
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Affiliation(s)
- Keisuke Hirota
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Hiroo Matsuse
- Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Shunji Koya
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Ryuki Hashida
- Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Masafumi Bekki
- Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Yoko Yanaga
- Department of Nursing, Kurume University Hospital, Kurume, Japan
| | - Kiyoko Johzaki
- Department of Nursing, Kurume University Hospital, Kurume, Japan
| | - Mami Tomino
- Department of Nursing, Kurume University Hospital, Kurume, Japan
| | - Fumihiko Mouri
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Satoshi Morishige
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Shuki Oya
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yoshitaka Yamasaki
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Koji Nagafuji
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Naoto Shiba
- Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
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Sasaki KI, Kakuma T, Sasaki M, Ishizaki Y, Fukami A, Enomoto M, Adachi H, Matsuse H, Shiba N, Ueno T, Fukumoto Y. The prevalence of sarcopenia and subtypes in cardiovascular diseases, and a new diagnostic approach. J Cardiol 2020; 76:266-272. [DOI: 10.1016/j.jjcc.2020.03.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/16/2020] [Accepted: 03/05/2020] [Indexed: 01/12/2023]
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36
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Nakamura Y, Gotoh M, Mitsui Y, Nakamura H, Ohzono H, Okawa T, Shiba N. Preoperative hyaluronic acid injection modulates postoperative functional outcome in patients undergoing arthroscopic rotator cuff repair. J Orthop Surg Res 2020; 15:204. [PMID: 32493376 PMCID: PMC7268750 DOI: 10.1186/s13018-020-01715-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/20/2020] [Indexed: 02/06/2023] Open
Abstract
Background Arthroscopic rotator cuff repair (ARCR) generally yields acceptable clinical results. Hyaluronic acid (HA), a high-molecular-weight polysaccharide, is present in the extracellular matrix of soft connective tissue and synovial fluid, and its injection is known to significantly improve pain and clinical outcomes after rotator cuff injury. Some studies have described the role of HA injections as conservative therapy for rotator cuff tears. Since the subacromial bursa is believed to be the main source of shoulder pain in rotator cuff tears, subacromial injection is frequently used before surgery; however, its relationship with the clinical outcome after surgery remains unclarified. Therefore, we aimed to examine effects of preoperative subacromial HA injection on postoperative clinical outcome in patients with ARCR. Methods Ninety-eight patients were divided into a HA injection group and a non-injection group. The functional outcome measured was the University of California, Los Angeles (UCLA) score. Univariate analysis was performed to obtain variables with p values less than 0.1; we then used propensity score analysis, adjusting for pre- and post-operative confounding factors. Results The UCLA scores of all patients significantly improved 1 year postoperatively (PO) (p < 0.05). Subacromial HA injections were performed in patients with worse preoperative function. Univariate analysis showed significantly greater improvements in the injection group than in the non-injection group in terms of preoperative UCLA score, trauma, diabetes mellitus, UCLA score 3 months PO, abduction strength 4 months PO, and internal rotation (IR) strength 6 and 12 months PO. Propensity score analysis demonstrated that UCLA scores 3 months PO and IR strength 12 months PO in the injection group were significantly greater than those in the non-injection group. There were no significant differences in postoperative re-tear rates between the groups. In sub-analysis of the injection group, propensity scores showed that concurrent use of local anesthetics did not affect the data, suggesting that HA was effective. Conclusion Subacromial injection was administered to patients with worse function before ARCR. Propensity score analysis successfully demonstrated that functional outcome after surgery was improved in patients who were administered this injection compared with patients who were not administered this injection before surgery.
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Affiliation(s)
- Yosuke Nakamura
- Department of Orthopedic Surgery, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Masafumi Gotoh
- Department of Orthopedic Surgery, Kurume University Medical Center, 155-1 Kokubu-machi, Kurume, Fukuoka, 839-0863, Japan.
| | - Yasuhiro Mitsui
- Department of Orthopedic Surgery, Kurume University Medical Center, 155-1 Kokubu-machi, Kurume, Fukuoka, 839-0863, Japan
| | - Hidehiro Nakamura
- Department of Orthopedic Surgery, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hiroki Ohzono
- Department of Orthopedic Surgery, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Takahiro Okawa
- Department of Orthopedic Surgery, Kurume University Medical Center, 155-1 Kokubu-machi, Kurume, Fukuoka, 839-0863, Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
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Karasuyama M, Gotoh M, Tahara K, Kawakami J, Madokoro K, Nagamatsu T, Imai T, Harada N, Kudo Y, Shiba N. Clinical results of conservative management in patients with full-thickness rotator cuff tear: a meta-analysis. Clin Shoulder Elb 2020; 23:86-93. [PMID: 33330239 PMCID: PMC7714327 DOI: 10.5397/cise.2020.00031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/21/2020] [Accepted: 03/24/2020] [Indexed: 01/27/2023] Open
Abstract
Background Several systematic reviews have reported on the conservative treatment of full-thickness rotator cuff tears; however, clinical results of this treatment still remain determined. Methods PubMed, Cochrane Library, PEDro, and CINAHL databases were systematically searched for randomized clinical trials and observational studies. Two independent researchers reviewed a total of 2,981 articles, 28 of which met the criteria for inclusion in the study. Clinical outcome measures included Constant score, visual analog scale score for pain, range of motion, and short-form 36 questionnaires. The meta-analysis used a linear mixed model weighted with the variance of the estimate. Results The meta-analysis showed a significant improvement after surgery. Pain score is 26.2 mm (1 month) to 26.4 mm (3 months), and 24.8 mm (12 months) (P<0.05); active abduction: 153.2º (2 months), 159.0º (6 months), 168.1º (12 months) (P<0.05); Constant score: 67.8 points (2 months) to 77.2 points (12 months) (P<0.05); short-form 36 questionnaires "vitality" section: 57.0 points (6 months) to 70.0 points (12 months) (P<0.05). Conclusions Our data confirmed the effectiveness of conservative treatment in patients with full-thickness rotator cuff tears 12 months post-intervention. The results suggest that conservative treatment for patients with full-thickness rotator cuff tears should be the first line of treatment before considering surgery.
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Affiliation(s)
- Masaki Karasuyama
- Department of Physical Therapy, Kyushu Nutrition Welfare University, Kitakyushu, Japan
| | - Masafumi Gotoh
- Department of Orthopedic Surgery, Kurume University Medical Center, Kurume, Japan
| | - Keiji Tahara
- Department of Orthopedic Surgery, Tahara Orthopedic Clinic, Kitakyushu, Japan
| | - Junichi Kawakami
- Department of Physical Therapy, Kyushu Nutrition Welfare University, Kitakyushu, Japan.,Kurume University School of Medicine Graduate School, Kurume, Japan
| | - Kazuya Madokoro
- Department of Physical Therapy, Technical School of Medical and Welfare Ryokuseikan, Tosu, Japan
| | | | - Takaki Imai
- Department of Rehabilitation, Keishinkai Hospital, Tosu, Japan
| | - Nobuya Harada
- Kurume University School of Medicine Graduate School, Kurume, Japan
| | - Yu Kudo
- Kurume University School of Medicine Graduate School, Kurume, Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University, Kurume, Japan
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Kawakami J, Gotoh M, Matsuura K, Shin K, Fujito I, Tanaka A, Matsunaga S, Imai T, Nagamatsu T, Karasuyama M, Ohota T, Madokoro K, Shiba N. Usefulness of Shoulder36 in rotator cuff tears: Comparison with Simple Shoulder Test. J Orthop Surg (Hong Kong) 2020; 27:2309499018819060. [PMID: 30798742 DOI: 10.1177/2309499018819060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In patients with rotator cuff tears, Shoulder36 (Sh36) was compared to the Simple Shoulder Test (SST) to determine a broader use of Sh36 worldwide. METHODS Sh36, SST, "Constant score," and the Japanese Orthopaedic Association score (JOA) were used to evaluate 230 patients (male, 116; female, 114) during the first visit, analyzed by staff blinded to the study. Pearson's correlation coefficient was used for the statistical analysis. RESULTS The correlation coefficient between the Constant score and each domain in Sh36 was as follows: r = 0.68 (vs. pain, p < 0.01); r = 0.69 (vs. range of motion, p < 0.01); r = 0.74 (vs. muscle strength, p < 0.01); r = 0.62 (vs. general health, p < 0.01); r = 0.66 (vs. ability of daily living, p < 0.01); and r = 0.65 (vs. ability for sports, p < 0.01). The correlation coefficient between the JOA and each domain in Sh36 was as follows: r = 0.76 (vs. pain, p < 0.01); r = 0.73 (vs. range of motion, p < 0.01); r = 0.78 (vs. muscle strength, p < 0.01); r = 0.68 (vs. general health, p < 0.01); r = 0.71 (vs. ability of daily living, p < 0.01); and r = 0.70 (vs. ability for sports, p < 0.01). The correlation coefficient between the SST and each domain in Sh36 was as follows: r = 0.73 (vs. pain, p < 0.01); r = 0.70 (vs. range of motion, p < 0.01); r = 0.75 (vs. muscle strength, p < 0.01); r = 0.67 (vs. general health, p < 0.01); r = 0.69 (vs. ability of daily living, p < 0.01); and r = 0.64 (vs. ability for sports, p < 0.01). CONCLUSION A strong association exists between the SST and each domain in the Sh36, in patients with rotator cuff tears ( r = 0.64-0.73), suggesting the usefulness of Sh36 for patient-based scoring.
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Affiliation(s)
- Junichi Kawakami
- 1 Kurume University School of Medicine Graduate School, Asahi-machi, Kurume, Fukuoka, Japan.,2 Department of Rehabilitation, Saiseikai Yahata General Hospital, Haruno-machi, Kitakyushu, Fukuoka, Japan
| | - Masafumi Gotoh
- 3 Department of Orthopedic Surgery, Kurume University Medical Center, Kokubu-machi, Kurume, Fukuoka, Japan
| | - Koumei Matsuura
- 4 Department of Orthopedic Surgery, Saiseikai Yahata General Hospital, Haruno-machi, Kitakyushu, Fukuoka, Japan
| | - Kunichika Shin
- 4 Department of Orthopedic Surgery, Saiseikai Yahata General Hospital, Haruno-machi, Kitakyushu, Fukuoka, Japan
| | - Ikuhisa Fujito
- 2 Department of Rehabilitation, Saiseikai Yahata General Hospital, Haruno-machi, Kitakyushu, Fukuoka, Japan
| | - Aya Tanaka
- 5 Department of Rehabilitation, Kugimiya Orthopedic & Rehabilitation Clinic, Tsurumi, Beppu, Oita, Japan
| | - Saho Matsunaga
- 2 Department of Rehabilitation, Saiseikai Yahata General Hospital, Haruno-machi, Kitakyushu, Fukuoka, Japan
| | - Takaki Imai
- 1 Kurume University School of Medicine Graduate School, Asahi-machi, Kurume, Fukuoka, Japan
| | - Takashi Nagamatsu
- 1 Kurume University School of Medicine Graduate School, Asahi-machi, Kurume, Fukuoka, Japan
| | - Masaki Karasuyama
- 1 Kurume University School of Medicine Graduate School, Asahi-machi, Kurume, Fukuoka, Japan
| | - Toshiaki Ohota
- 1 Kurume University School of Medicine Graduate School, Asahi-machi, Kurume, Fukuoka, Japan
| | - Kazuya Madokoro
- 6 Department of Physical Therapy, Technical School of Medical and Welfare Ryokuseikan, Nishishinmachi-machi, Tosu, Saga, Japan
| | - Naoto Shiba
- 7 Department of Orthopedic Surgery, Kurume University, Asahi-machi, Kurume, Fukuoka, Japan
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Hirota K, Kawaguchi T, Koya S, Nagamatsu A, Tomita M, Hashida R, Nakano D, Niizeki T, Matsuse H, Shiba N, Torimura T. Clinical utility of the Liver Frailty Index for predicting muscle atrophy in chronic liver disease patients with hepatocellular carcinoma. Hepatol Res 2020; 50:330-341. [PMID: 31721387 DOI: 10.1111/hepr.13453] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/11/2019] [Accepted: 11/01/2019] [Indexed: 01/27/2023]
Abstract
AIM Muscle atrophy is a prognostic factor for patients with chronic liver disease (CLD) and hepatocellular carcinoma (HCC). The Liver Frailty Index (LFI) is a simple physical function test; however, an association between LFI and muscle mass remains unclear. We aimed to investigate the utility of LFI for predicting muscle atrophy in CLD patients with HCC. METHODS We enrolled 138 CLD patients with HCC (aged 77 years, female/male 34.8%/65.2%). Muscle mass was assessed by skeletal muscle index, and patients were classified into the muscle atrophy group (n = 109) or the non-muscle atrophy group (n = 29). Physical frailty was assessed by LFI. The optimal cut-off value of LFI for predicting muscle atrophy was identified by receiver operating characteristic analysis. RESULTS In the muscle atrophy group, the prevalence of pre-frail/frail was significantly higher than the non-muscle atrophy group (87.2% vs. 58.6%, P = 0.0005). In the logistic regression analysis, being female and pre-frail/frail were identified as independent factors associated with muscle atrophy (pre-frail/frail; OR 3.601, 95% CI 1.381-9.400, P = 0.0088). In patients with normal grip strength, 71.1% of patients were pre-frail/frail, in which 82.8% of patients showed muscle atrophy. Receiver operating characteristic statistics provided an area under the curve of 0.74, and an LFI cut-off value of 2.94 for predicting muscle atrophy (sensitivity 88.06%, specificity 52.17%, accuracy 77.91%). CONCLUSIONS We showed that pre-frail/frail was an independent factor for muscle atrophy in CLD patients with HCC. Furthermore, LFI predicted muscle atrophy with high sensitivity, even in patients with normal grip strength. Thus, LFI might be a useful screening tool for muscle atrophy in CLD patients with HCC.
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Affiliation(s)
- Keisuke Hirota
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Shunji Koya
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Ayu Nagamatsu
- Division of Nutrition, Kurume University Hospital, Kurume, Japan
| | - Manabu Tomita
- Department of Rehabilitation, Saga Central Hospital, Saga, Japan
| | - Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Dan Nakano
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takashi Niizeki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Takuji Torimura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
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40
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Yamamura S, Kawaguchi T, Nakano D, Tomiyasu Y, Yoshinaga S, Doi Y, Takahashi H, Anzai K, Eguchi Y, Torimura T, Shiba N. Profiles of advanced hepatic fibrosis evaluated by FIB-4 index and shear wave elastography in health checkup examinees. Hepatol Res 2020; 50:199-213. [PMID: 31634983 DOI: 10.1111/hepr.13436] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 02/08/2023]
Abstract
AIM Advanced hepatic fibrosis is seen in individuals with potential hepatocellular carcinoma and cardiovascular disease. Hepatic fibrosis can be assessed using a combination of the FIB-4 index and imaging modalities, including shear wave elastography. We aimed to investigate the prevalence of advanced fibrosis in the general population and the profiles associated with advanced fibrosis using a data-mining analysis. METHODS We enrolled 1155 health checkup examinees (median age 53 years, 685 women, 470 male). Advanced fibrosis was defined by FIB-4 index ≥1.3 and liver stiffness ≥8.07 kPa using shear wave elastography. Participants were classified as normal-mild fibrosis (n = 1035) or advanced fibrosis (n = 120). Factors associated with advanced fibrosis were analyzed by logistic regression and decision-tree analyses. RESULTS Advanced fibrosis was observed in 10.4% of participants (120/1155). In the logistic regression analysis, independent factors for advanced fibrosis were age (≥75 years; OR 2.12, 95% CI 1.021-4.415; P = 0.0419) and the presence of metabolic syndrome (OR 2.51, 95% CI 1.416-4.462; P = 0.0017). The decision-tree analysis showed two profiles associated with advanced fibrosis: profile 1 - individuals aged ≥65 years with metabolic syndrome and mild-to-moderate alcohol consumption (prevalence of advanced fibrosis 73.3%); and profile 2 - individuals without metabolic syndrome, aged ≥75 years, with no exercise habit (prevalence of advanced fibrosis 56.3%). CONCLUSIONS Advanced fibrosis was observed in 10.4% of health checkup examinees. Furthermore, we showed that aging, metabolic syndrome with mild-to-moderate alcohol consumption, and physical inactivity were associated with advanced fibrosis. Thus, prevention of metabolic syndrome and alcohol withdrawal, as well as exercise habits, might inhibit the progression of hepatic fibrosis.
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Affiliation(s)
- Sakura Yamamura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Dan Nakano
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yoshiko Tomiyasu
- Medical Examination Section, Medical Examination Part Facilities, Public Utility Foundation Saga Prefectural Health Promotion Foundation, Saga, Japan
| | - Shinobu Yoshinaga
- Medical Examination Section, Medical Examination Part Facilities, Public Utility Foundation Saga Prefectural Health Promotion Foundation, Saga, Japan
| | - Yumi Doi
- Medical Examination Section, Medical Examination Part Facilities, Public Utility Foundation Saga Prefectural Health Promotion Foundation, Saga, Japan
| | - Hirokazu Takahashi
- Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan
| | - Keizo Anzai
- Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan
| | - Yuichiro Eguchi
- Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan
- Liver Center, Saga University Hospital, Saga, Japan
| | - Takuji Torimura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Naoto Shiba
- Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
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Hashida R, Kawaguchi T, Koya S, Hirota K, Goshima N, Yoshiyama T, Otsuka T, Bekki M, Iwanaga S, Nakano D, Niizeki T, Matsuse H, Kawaguchi A, Shiba N, Torimura T. Impact of cancer rehabilitation on the prognosis of patients with hepatocellular carcinoma. Oncol Lett 2020; 19:2355-2367. [PMID: 32194735 PMCID: PMC7039060 DOI: 10.3892/ol.2020.11345] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 11/25/2019] [Indexed: 12/18/2022] Open
Abstract
Sarcopenia is a prognostic factor for patients with hepatocellular carcinoma (HCC). Cancer rehabilitation (CR) improves patients' physical function and muscle mass. We investigated the effects of CR on the prognosis of patients with HCC. The present study was a prospective observational study, which analyzed 152 patients with HCC who underwent transcatheter arterial chemoembolization (TACE) between 2013 and 2016. Patients were classified into the CR (n=85) and control (n=67) groups. The effects of CR on muscle mass were evaluated by changes in the skeletal muscle index (SMI) before and after TACE. Independent factors associated with survival were evaluated by Cox regression analysis. Kaplan-Meier analysis was used to compare the survival rate between the CR and control groups. The difference in survival rate between the two groups was also examined after propensity score matching. SMI was significantly increased in the CR group compared with the control group. In Cox regression analysis, independent factors associated with survival were CR and Child-Pugh class A (estimate 1.760, 95% CI 0.914–3.226, P=0.001; estimate 1.602, 95% CI 0.426–2.998, P=0.0129). The survival rate was significantly higher in the CR group than in the control group (median 552 vs. 424 days; P=0.0359). The survival rate was also significantly higher in the CR group than that in the control group after propensity score matching (median 529 vs. 369 days; P=0.0332). CR was associated with prolonged survival in patients with HCC who underwent TACE. Patients with cancer are recommended to maintain physical activity even during cancer treatment.
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Affiliation(s)
- Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Shunji Koya
- Division of Rehabilitation, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Keisuke Hirota
- Division of Rehabilitation, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Norihiro Goshima
- Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Teruhito Yoshiyama
- Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Takashi Otsuka
- Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Masafumi Bekki
- Division of Rehabilitation, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Sohei Iwanaga
- Division of Rehabilitation, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Dan Nakano
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Takashi Niizeki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Atsushi Kawaguchi
- Center for Comprehensive Community Medicine Faculty of Medicine, Saga University, Saga, Saga 849-8501, Japan
| | - Naoto Shiba
- Department of Orthopedics, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Takuji Torimura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
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Tsukada Y, Matsuse H, Shinozaki N, Takano Y, Nago T, Shiba N. Combined Application of Electrically Stimulated Antagonist Muscle Contraction and Volitional Muscle Contraction Prevents Muscle Strength Weakness and Promotes Physical Function Recovery After Total Knee Arthroplasty: A Randomized Controlled Trial. Kurume Med J 2020; 65:145-154. [PMID: 31723080 DOI: 10.2739/kurumemedj.ms654007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Osteoarthritis of the knee (KOA) is the most common cause of disability in both the United States and in Japan. The Hybrid training system (HTS) has been developed as a resistance exercise method combining electrical stimulation with voluntary exercise. The purpose of the present study is to compare the effects of a conventional rehabilitation program with or without HTS on knee muscle strength and physical function after Total knee arthroplasty (TKA). METHODS We conducted a 12-week randomized controlled trial, using standard rehabilitation (the control group, n = 27) or standard rehabilitation plus HTS (the HTS group, n= 26), in 53 female patients after TKA. The HTS group underwent HTS three times per week for twelve weeks after TKA. Muscle strength, thigh circumference, physical functional testing, QOL and knee pain were assessed before surgery, 6 and 12 weeks after TKA. RESULTS There was a significant decrease in quadriceps strength and thigh circumference on the operative side in the control group, but not in the HTS group at 6 weeks. Hamstring strength on the operative side in the HTS group significantly increased and thigh circumference was bigger than in the control group at 12 weeks. Physical function improved at 6 weeks in the HTS group, but not in the control group. Knee pain significantly improved in both groups at 6 weeks. CONCLUSIONS HTS was effective in preventing quadriceps weakness and in improving physical function and QOL after TKA.
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Affiliation(s)
- Yuya Tsukada
- Division of Rehabilitation, Kurume University Hospital
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital
| | | | - Yoshio Takano
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University Health and Welfare
| | - Takeshi Nago
- Division of Rehabilitation, Kurume University Hospital
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital
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Nagamatsu A, Kawaguchi T, Hirota K, Koya S, Tomita M, Hashida R, Kida Y, Narao H, Manako Y, Tanaka D, Koga N, Nakano D, Niizeki T, Matsuse H, Torimura T, Shiba N. Slow walking speed overlapped with low handgrip strength in chronic liver disease patients with hepatocellular carcinoma. Hepatol Res 2019; 49:1427-1440. [PMID: 31273895 DOI: 10.1111/hepr.13405] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/17/2019] [Accepted: 07/01/2019] [Indexed: 12/14/2022]
Abstract
AIM Walking speed and grip strength are parameters of muscle function; however, evaluating walking speed is not always available in clinical practice. We aimed to investigate the impact of walking speed on the evaluation of muscle dysfunction in chronic liver disease (CLD) patients with hepatocellular carcinoma (HCC). METHODS We enrolled 107 consecutive CLD patients with HCC in this study (age 76 years [range 60-92 years]; female/male 39/68; body mass index 22.9 [range 20.0-25.3]; chronic hepatitis/liver cirrhosis 25/82). Muscle dysfunction was evaluated using the Asian Working Group for Sarcopenia criteria (grip strength or walking speed) and the Japan Society of Hepatology criteria (grip strength). A correlation between walking speed and skeletal muscle index was evaluated. Independent factors for slow walking speed were evaluated using a logistic regression analysis. RESULTS There was no significant correlation between walking speed and skeletal muscle index (r = 0.14, P = 0.16). For both the Asian Working Group for Sarcopenia and Japan Society of Hepatology criteria, 33.6% of all patients were classified as having muscle dysfunction. All patients with slow walking speed (4.7% of all patients) also showed low handgrip strength. The logistic regression analysis identified grip strength as an independent factor for slow walking speed (OR 0.65; 95% CI 0.432-0.838; P = 0.008). CONCLUSIONS No difference was seen in the prevalence of muscle dysfunction between the Asian Working Group for Sarcopenia and Japan Society of Hepatology criteria in CLD patients with HCC. Furthermore, all patients with slow walking speed also showed low handgrip strength. Thus, for the evaluation of muscle dysfunction, grip strength might be a suitable proxy for walking speed in CLD patients with HCC.
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Affiliation(s)
- Ayu Nagamatsu
- Division of Nutrition, Kurume University Hospital, Kurume, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Keisuke Hirota
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Shunji Koya
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Manabu Tomita
- Department of Rehabilitation, Saga Central Hospital, Saga, Japan
| | - Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Yohei Kida
- Department of Gastroenterology, Kainan Iryou Center, Kainan, Japan
| | - Hayato Narao
- Division of Rehabilitation, Yame General Hospital, Yame, Japan
| | - Yuta Manako
- Division of Rehabilitation, Yame General Hospital, Yame, Japan
| | - Daisuke Tanaka
- Division of Rehabilitation, Chikugo City Hospital, Chikugo, Japan
| | - Noboru Koga
- Division of Rehabilitation, Chikugo City Hospital, Chikugo, Japan
| | - Dan Nakano
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takashi Niizeki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Takuji Torimura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
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Sato K, Yamada K, Yokosuka K, Yoshida T, Goto M, Matsubara T, Iwahashi S, Shimazaki T, Nagata K, Shiba N. Pyogenic Spondylitis: Clinical Features, Diagnosis and Treatment. Kurume Med J 2019; 65:83-89. [PMID: 31406038 DOI: 10.2739/kurumemedj.ms653001] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Although pyogenic spondylitis is an infrequent infection, its incidence is increasing because of the growing number of elderly people and immunocompromised patients. Diagnosis is often difficult and appropriate imaging, blood cultures and/or biopsy are essential in making an early diagnosis. Most of the cases can be treated non-operatively. Surgical treatment is indicated in patients with spinal cord or cauda equine compression with progressive neurological deficits and/or patients who have failed conservative treatment. Early and accurate diagnosis of pyogenic spondylitis is important for timely and effective management, in order to reduce the occurrence of spinal deformity and dysfunction.
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Affiliation(s)
- Kimiaki Sato
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Kei Yamada
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Kimiaki Yokosuka
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Tatsuhiro Yoshida
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Masafumi Goto
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | | | - Shoji Iwahashi
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | | | - Kensei Nagata
- Department of Orthopaedic Surgery, Kurume University School of Medicine
| | - Naoto Shiba
- Department of Orthopaedic Surgery, Kurume University School of Medicine
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Hashida R, Matsuse H, Bekki M, Omoto M, Morimoto S, Hino T, Harano Y, Iwasa C, Miyamoto K, Haraguchi M, Nago T, Shiba N. Evaluation of Motor-Assisted Gloves (SEM Glove) for Patients with Functional Finger Disorders: A Clinical Pilot Study. Kurume Med J 2019; 65:63-70. [PMID: 30853689 DOI: 10.2739/kurumemedj.ms652007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The SEM Glove developed by Bioservo Technologies AB is a new device that increases grip and pinch force. The purpose of this study was to evaluate the effectiveness of the device on the grip and pinch strength of patients with functional disorders of the fingers. MATERIALS AND METHOD 30 hospitalized patients with upper limb functional disorder were enrolled. The assistance of the device for the grip and pinch strength of each subject were assessed by the difference between the measured values with and without the SEM Glove. The 95% confidence interval of the difference was calculated across the subjects, and statistical significance was defined as when the lower limit was a positive value (corresponding with a paired t-test at a significance level of 0.05). The odds ratio was calculated in the study of subject adaptation, with statistical significance set using Fisher's exact test at a significance level of 0.05. RESULTS Grip strength significantly decreased (worn-not worn difference (kg): mean = -3.7, CI95 (-5.4, -2.1)). Pinch strength (thumb - middle finger) significantly increased (worn-not worn difference (N): mean = -4.1, CI95 (1.6, 6.6)). Analysis of factors related to improvement in hand function when wearing the SEM Glove extracted manual muscle tests (MMTs) of the upper extremity 4 or higher. The odds ratio was 6.11. CONCLUSIONS Use of the SEM Glove improved the pinch strength of patients with functional disorders of the hands.
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Affiliation(s)
- Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Masafumi Bekki
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Masayuki Omoto
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Shimpei Morimoto
- Innovation Platform & Office for Precision Medicine, Graduate School of Biomedical Sciences, Nagasaki University
| | - Tomoko Hino
- Division of Rehabilitation, Kurume University Hospital
| | - Yuuji Harano
- Division of Rehabilitation, Kurume University Hospital
| | | | | | | | - Takeshi Nago
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
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Koya S, Kawaguchi T, Hashida R, Hirota K, Bekki M, Goto E, Yamada M, Sugimoto M, Hayashi S, Goshima N, Yoshiyama T, Otsuka T, Nozoe R, Nagamatsu A, Nakano D, Shirono T, Shimose S, Iwamoto H, Niizeki T, Matsuse H, Koga H, Miura H, Shiba N, Torimura T. Effects of in-hospital exercise on sarcopenia in hepatoma patients who underwent transcatheter arterial chemoembolization. J Gastroenterol Hepatol 2019; 34:580-588. [PMID: 30402913 DOI: 10.1111/jgh.14538] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 10/14/2018] [Accepted: 10/28/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM Sarcopenia is a prognostic factor in hepatocellular carcinoma (HCC) patients. HCC patients who underwent transcatheter arterial chemoembolization (TACE) are at a risk of muscle atrophy. We aimed to investigate the effects of in-hospital exercise on muscle mass and factors associated with muscle hypertrophy in HCC patients who underwent TACE. METHODS We enrolled 209 HCC patients who underwent TACE. Patients were classified into either an exercise (n = 102) or control (n = 107) group. In the exercise group, patients were treated with in-hospital exercise (median 2.5 metabolic equivalents/20-40 min/day). The effects of exercise on muscle mass were evaluated by changes in skeletal muscle index (ΔSMI) between before and after TACE. Factors associated with an increase in SMI were analyzed by logistic regression and decision-tree analyses. RESULTS There was no significant difference in serum albumin and bilirubin levels between the two groups. ΔSMI was significantly higher in the exercise group than in the control group (0.28 cm2 /m2 vs -1.11 cm2 /m2 , P = 0.0029). In the logistic regression analysis, exercise was an independent factor for an increase in SMI (hazard ratio 2.13; 95% confidence interval 1.215-3.846; P = 0.0085). Moreover, the decision-tree analysis showed that exercise was the initial divergence variable for an increase in SMI (the ratio of increased SMI: 53% in the exercise group vs 36% in the control group). CONCLUSIONS In-hospital exercises increased muscle mass in HCC patients who underwent TACE. In addition, exercise was an independent factor for muscle hypertrophy. Thus, in-hospital exercise may prevent sarcopenia in HCC patients who underwent TACE.
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Affiliation(s)
- Shunji Koya
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume, Japan
| | - Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, School of Medicine, Kurume University, Kurume, Japan
| | - Keisuke Hirota
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Masafumi Bekki
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, School of Medicine, Kurume University, Kurume, Japan
| | - Emiko Goto
- Department of Nursing, Kurume University Hospital, Kurume, Japan
| | - Maiko Yamada
- Department of Nursing, Kurume University Hospital, Kurume, Japan
| | - Masako Sugimoto
- Department of Nursing, Kurume University Hospital, Kurume, Japan
| | - Saki Hayashi
- Department of Nursing, Kurume University Hospital, Kurume, Japan
| | | | | | | | - Ryosuke Nozoe
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Ayu Nagamatsu
- Department of Nutrition, Kurume University Hospital, Kurume, Japan
| | - Dan Nakano
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume, Japan
| | - Tomotake Shirono
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume, Japan
| | - Shigeo Shimose
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume, Japan
| | - Hideki Iwamoto
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume, Japan
| | - Takashi Niizeki
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume, Japan
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, School of Medicine, Kurume University, Kurume, Japan
| | - Hironori Koga
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume, Japan.,Liver Cancer Research Division, Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Japan
| | - Hiroko Miura
- Department of Nursing, Kurume University Hospital, Kurume, Japan
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.,Department of Orthopedics, School of Medicine, Kurume University, Kurume, Japan
| | - Takuji Torimura
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume, Japan
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Imai T, Gotoh M, Hagie K, Fukuda K, Ogino M, Madokoro K, Nagamatsu T, Kawakami J, Ohota T, Karasuyama M, Shiba N. Factors Affecting Return to Work in Patients Undergoing Arthroscopic Rotator Cuff Repair. Prog Rehabil Med 2019; 4:20190006. [PMID: 32789253 DOI: 10.2490/prm.20190006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 02/04/2019] [Indexed: 12/22/2022] Open
Abstract
Objective Although clinical outcomes after arthroscopic rotator cuff repair are generally favorable, postoperative return to work is also an important issue. This study aimed to assess clinical outcomes and clarify the factors affecting return to work in patients who had undergone arthroscopic rotator cuff repair. Methods In total, 63 patients who had undergone arthroscopic rotator cuff repair were included in this study. Clinical assessment was performed using Japanese Orthopaedic Association (JOA) scores, along with measurements of pain, range of motion, muscle strength, cuff integrity, and fatty infiltration. Depending on their return-to-work status at the final follow-up, subjects were assigned to either the complete return group (the patient returned to work) or the incomplete return group (the patient had quit or had changed their occupation at final follow-up). Various clinical parameters affecting the return to work outcome were examined through univariate and multivariate analyses. Results Of the 63 subjects, 42 belonged to the complete return group and 21 belonged to the incomplete return group. Therefore, the working capability recovery rate following arthroscopic rotator cuff repair was 66.7%. Both groups showed significant improvement from their preoperative status, but there were statistically significant differences in JOA scores between the groups at 9 and 12 months postoperatively (P <0.01). Multivariate stepwise logistic regression analysis showed that heavy work and female sex were significantly adversely associated with return to work (P <0.05). Conclusion The working capability recovery rate following arthroscopic rotator cuff repair was 66.7%, and the preoperative factors affecting recovery of working capability were heavy work and female sex.
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Affiliation(s)
- Takaki Imai
- Kurume University School of Medicine Graduate School, Asahi-machi, Kurume, Fukuoka, Japan.,Department of Rehabilitation, Keishinkai Hospital, Haru-machi, Tosu, Saga, Japan
| | - Masafumi Gotoh
- Department of Orthopedic Surgery, Kurume University Medical Center, Kokubu-machi, Kurume, Fukuoka, Japan
| | - Keita Hagie
- Department of Rehabilitation, Keishinkai Hospital, Haru-machi, Tosu, Saga, Japan
| | - Keiji Fukuda
- Department of Orthopedic Surgery, Keishinkai Hospital, Haru-machi, Tosu, Saga, Japan
| | - Misa Ogino
- Department of Orthopedic Surgery, Keishinkai Hospital, Haru-machi, Tosu, Saga, Japan
| | - Kazuya Madokoro
- Department of Physical Therapy, Technical School of Medical and Welfare Ryokuseikan, Nishishin-machi, Tosu, Saga, Japan
| | - Takashi Nagamatsu
- Kurume University School of Medicine Graduate School, Asahi-machi, Kurume, Fukuoka, Japan
| | - Junichi Kawakami
- Kurume University School of Medicine Graduate School, Asahi-machi, Kurume, Fukuoka, Japan
| | - Toshiyuki Ohota
- Kurume University School of Medicine Graduate School, Asahi-machi, Kurume, Fukuoka, Japan
| | - Masaki Karasuyama
- Kurume University School of Medicine Graduate School, Asahi-machi, Kurume, Fukuoka, Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University, Asahi-machi, Kurume, Fukuoka, Japan
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Abstract
BACKGROUND Rotator cuff retears after surgical repair are a concern, despite advances in operative techniques, but few studies have investigated the effects of the estrogen-deficient state on tendon-to-bone healing at the repair site. PURPOSE We evaluated the effect of the estrogen-deficient state on tendon-to-bone healing after rotator cuff repair in an ovariectomized rat model. STUDY DESIGN Controlled laboratory study. METHODS Female Sprague Dawley rats underwent detachment and immediate repair of the supraspinatus tendon. Surgery was performed in 24 rats at 4.5 weeks of age 17 weeks after ovariectomy (OVX group) and in 24 age-matched control rats without ovariectomy (control group). Animals were sacrificed at 2, 4, 8, and 12 weeks after surgery for biomechanical and histological evaluations of reattachment. Bone mineral density (BMD) at the insertion site and cancellous bone in the humeral head was assessed by micro-computed tomography. RESULTS BMD was significantly lower both at the insertion site and in cancellous area in the OVX group than in the control group at weeks 2 to 12. Ultimate load to failure, ultimate stress, linear stiffness, and the Young modulus were significantly lower in the OVX group than in the control group at 2 and 4 weeks, but the difference was no longer significant at 8 and 12 weeks. At 2 and 4 weeks, relatively immature granulation tissue was observed in the OVX group compared with the control group. At 8 and 12 weeks after surgery, there were differences in the tendon-bone interface in the 2 groups: Direct insertion with well-established chondroid tissue was seen in the control group, and indirect insertion without chondroid tissue was seen in the OVX group. Consistently, the amount of chondroid tissue was greater and collagen organization was better in the control group than in the OVX group. Cells expressing cathepsin K were significantly more numerous both at the insertion site and in cancellous bone in the OVX group than in the control group. CONCLUSION The estrogen-deficient state by ovariectomy, compared with control rats, led to decreased biomechanical properties and poor development of chondroid tissue that influenced the repair of the tendon insertion after surgery. CLINICAL RELEVANCE Agents that modulate bone metabolism might improve tendon-to-bone healing in patients with an estrogen-deficient state, such as postmenopausal women who undergo rotator cuff surgery.
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Affiliation(s)
- Koji Tanaka
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Tomonoshin Kanazawa
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Masafumi Gotoh
- Department of Orthopaedic Surgery, Kurume University Medical Center, Kurume, Japan
| | - Ryo Tanesue
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hidehiro Nakamura
- Department of Orthopaedic Surgery, Kurume University Medical Center, Kurume, Japan
| | - Hiroki Ohzono
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Takahiro Okawa
- Department of Orthopaedic Surgery, Kurume University Medical Center, Kurume, Japan
| | - Naoto Shiba
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Kurume, Japan
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Kanazawa T, Soejima T, Noguchi K, Tabuchi K, Noyama M, Nakamura K, Shiba N. Tendon-to-bone healing using autologous bone marrow-derived mesenchymal stem cells in ACL reconstruction without a tibial bone tunnel-A histological study-. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.02.2014.20] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- T. Kanazawa
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Fukuoka, Japan
- Division of Microscopic and Development Anatomy, Department of Anatomy, Kurume University School of Medicine, Fukuoka, Japan
| | - T. Soejima
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - K. Noguchi
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - K. Tabuchi
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - M. Noyama
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - K. Nakamura
- Division of Microscopic and Development Anatomy, Department of Anatomy, Kurume University School of Medicine, Fukuoka, Japan
| | - N. Shiba
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Fukuoka, Japan
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50
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Nakamura Y, Gotoh M, Mitsui Y, Nakamura H, Ohzono H, Okawa T, Shiba N. Prognostic factors affecting clinical outcomes after arthroscopic rotator cuff repair: importance of functional recovery by 3 months after surgery. J Orthop Surg Res 2018; 13:310. [PMID: 30518384 PMCID: PMC6282280 DOI: 10.1186/s13018-018-1014-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 11/21/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND To examine important factors that affect clinical outcomes following arthroscopic rotator cuff repair (ARCR). METHODS Among 163 patients who underwent ARCR, we included 71 shoulders in 71 patients whose progress was monitored for > 2 years, postoperatively. We divided the patients into groups A (scores ≥ 83 points, 59 patients) and B (scores < 83 points, 12 patients) using the Japanese Orthopedic Association (JOA) score at 24 months. We then conducted univariate and multivariate analyses of pre- and postoperative (2 and 3 months, respectively) factors. RESULTS The mean JOA score for all patients significantly improved from 63.7 ± 11.5 points preoperatively to 90.3 ± 9.6 points at 24 months postoperatively (P < 0.05). However, there were no significant between-group differences in the preoperative scores. In addition, there were no significant differences in the postoperative re-tear rate. Univariate analysis revealed that the range of motion (preoperative abduction and postoperative elevation, abduction, internal rotation, and external rotation), muscle strength (external rotation 3 months postoperatively), postoperative pain level [visual analog scale (VAS) maximum score, 10 points], partial repair, Cofield classification, and preoperative width were significant factors (P < 0.05 for all factors). Multivariate and receiver operating characteristic curve analyses showed that VAS at 2 months postoperatively and elevation at 3 months postoperatively were significant factors. CONCLUSIONS To obtain a JOA score of ≥ 83 points at 24 months postoperatively, following ARCR, a postoperative VAS of < 5 points at 2 months and postoperative elevation of ≥ 110° at 3 months should be achieved.
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Affiliation(s)
- Yosuke Nakamura
- Department of Orthopedic Surgery, Kurume University Medical Center, 155-1 Kokubu-machi, Kurume, Fukuoka, 839-0863, Japan
| | - Masafumi Gotoh
- Department of Orthopedic Surgery, Kurume University Medical Center, 155-1 Kokubu-machi, Kurume, Fukuoka, 839-0863, Japan.
| | - Yasuhiro Mitsui
- Department of Orthopedic Surgery, Kurume University Medical Center, 155-1 Kokubu-machi, Kurume, Fukuoka, 839-0863, Japan
| | - Hidehiro Nakamura
- Department of Orthopedic Surgery, Kurume University Medical Center, 155-1 Kokubu-machi, Kurume, Fukuoka, 839-0863, Japan
| | - Hiroki Ohzono
- Department of Orthopedic Surgery, Kurume University Medical Center, 155-1 Kokubu-machi, Kurume, Fukuoka, 839-0863, Japan
| | - Takahiro Okawa
- Department of Orthopedic Surgery, Kurume University Medical Center, 155-1 Kokubu-machi, Kurume, Fukuoka, 839-0863, Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University Medical Center, 155-1 Kokubu-machi, Kurume, Fukuoka, 839-0863, Japan
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