Journal of Exercise, Sports & Orthopedics

6

Authors: Lee Herrington* and Allan Munro

Objective: The present study aimed to investigate the criterion validity of a novel qualitative assessment scheme to assess limb alignment during single leg loading activities. Design and setting: Observational laboratory study Main outcome measures: Performance of 5 participant’s single leg squat and hop landing was assessed using 3-D motion capture and the findings of this compared to the qualitative scoring scheme. Results: The range of percentage of agreement between the qualitative and 3-D score was for all subjects across both tasks 95.6- 100%. The kappa measure of agreement was k = 0.9 for hop landing and k = 0.97 for single leg squat. Conclusion: The scores generated by the qualitative scoring scheme used showed excellent association with the corresponding data from 3-D motion capture, implying the measurement tool shows criterion validity. Keywords: Assessment; Lower limb; Movement

7

Authors: Danica D. Vance*, Liyong Wang, Evadnie Rampersaud, Bryson P. Lesniak, Jeffery M. Vance, Margaret A. Pericak-Vance and Lee D. Kaplan

Purpose: We hypothesize that molecular changes leading to Osteoarthritis (OA) occur soon after a meniscal tear and long before the manifestation of OA. We sought to characterize the gene expression profile in synovial fluid at different time points following a meniscal tear with a focused examination on inflammatory and arthritis related genetic markers. Methods: Synovial fluid was collected from 8 male patients (24~48yrs old) with evidence of meniscal injury on Magnetic Resonance Imaging (MRI). Illumina humanht-12 microarray and RNA-Seq were used to characterize gene expression profile in cell pellets and supernatant, respectively. Unsupervised clustering analysis was performed to identify patterns of gene expression profile among samples. Metacore was utilized to perform pathway analysis. T-tests with False Discovery Rate (FDR) corrections were used to compare subset of genes among individuals. Results: Individuals with short injury duration (< 2 months) had distinct expression signatures than the rest, in both cell pellet and supernatant analyses. In the cell pellets, among genes previously linked to inflammatory or arthritic conditions, IL 1B, IL1RN, ILF2, NFKB1, IL10RB, IL18BP, ILF3, IL13RA, BMP2K and IL10RB were significantly upregulated (adjusted p < 0.05) in individuals with long duration compared to individuals with shorter injury duration in the microarray analysis. In the cell-free supernatant, 764 RNA species were identified and 65 RNA species were down-regulated and 78 RNA species were up-regulated (FDR < 0.05) in individuals with short compared to individuals with long injury duration. The most differentially expressed gene in the supernatant is SLC2A9 (P = 1.2x10-13; FDR = 9.6x10-11). In the cell pellet, the top 5% expressed genes are enriched for inflammatory and cytoskeleton remodeling pathways. Among them LAIR 1, TMSB4X, CCR6, IL18 and IL10; all have been implicated in arthritic conditions. Conclusions: Molecular changes contributing to OA development occur earlier than previously described and potentially evolve or change over time. Clinical Relevance: Our data suggest the potential for early interventions to halt detrimental molecular changes following meniscal injury, thereby reducing the susceptibility of patients to OA following a meniscal tear. Keywords: Meniscus; Meniscal tear; Gene expression; Synovial fluid; Microarray; Osteoarthritis

7

Authors: Nilza Aparecida de Almeida Carvalho*, Simoni Bittar, Bruna Eriko Matsuda Marangoni and Cláudio Santili

The reduction in Bone Mineral Density is important during the ageing process because it can be a potential manifestation of osteoporosis. Aim: The objective was to assess the impact of exercise on bone mineral density in women. Materials and Methods: This research was conducted under the supervision of a physical therapist focused on the bone mineral density of ageing women. One hundred women, 60 years of age or older, were included in the study and underwent bone mineral density evaluation before and after administering two types of exercise. Results: Only 58.8% of the participants had undergone bone mineral density evaluation at some time before the study, and 74.4% were sedentary. No significant difference was found between vertebral and femoral bone mineral density before and after the intervention in both groups. No correlation was found between the evolution of bone mineral density and the age of menarche. Conclusion: Exercise, with or without supervision, also helped to maintain bone mineral density in postmenopausal women, who would have a natural tendency to experience bone mineral density loss. Keywords: Osteoporosis; Motor activity; Bone mineral density; Exercise; Muscle stretching exercises; Resistance training

2

Authors: Gennady Kolodenker*, Michael Heaslet and David Yang

This article is a case presentation of a rare finding in tendon injuries. Atraumatic extensor hallucis longus tendon rupture with surgical repair and recovery. Patients do well with primary repair of the tendon. Keywords: Atraumatic Extensor Hallucis Longus Rupture; Spontaneous Tear

5

Authors: Claudia Puzzoni Volpato, Marco Aurélio Nemitalla Added, Graziella Candido de Paula X. Richter, Valter Tanaka, Nilza Aparecida Almeida de Carvalho and Diego Galace de Freitas

Low back pain (LBP) is one of the principal causes of incapacity. One treatment approach for this pathology involves segmental stabilization. The iliopsoas muscle is also considered a potential stabilizer of the lumbar spine. Objective: To compare the effects of stretching and strengthening of the iliopsoas muscle associated with segmental stabilization versus stabilization alone, in the treatment for LBP. Methods: Fourteen patients were randomized into three groups. The first group was given only segmental stabilization training (ST); the second was submitted to ST and stretching of the iliopsoas muscle (ST-Stretch), and the third was given ST and strengthening of the iliopsoas (ST-Strength). Results: The group ST (p = 0.006) and ST-Strength (p=0.092) showed significant improvement in the VAS scale. The extension flexibility showed statistically significant improvement in the group ST- strength group (p=0.038). Conclusion: ST alone, or associated with strengthening of the iliopsoas, proved more effective for improving lumbar pain and flexibility compared to ST Stretch. Keywords: Low Back Pain; Lumbar Spine; Stability; Psoas Muscle

10

Authors: Pinheiro Pedro Carlos

Treatment of tuberculosis remains controversial to date as it comprises a serious public health problem issue. Over the last 50 years, many empirical therapeutic compositions have been made. Throughout the world, immunodeficiency virus infection entails one of the diseases responsible for the increase in the number of cases in children. Its eradication has not been effected. Some works on spine tuberculosis (involving from 25% to 60% of cases) in children, support the conservative method, while others prefer surgical procedures. The purpose of this study is to investigate treatment results in children displaying skeletal osteoarticular tuberculosis manifestations, using the modern multidrug chemotherapy treatment protocol and cast immobilization. Methods: The research was performed based on a study of the records of a conservative series of 94 patients diagnosed with osteoarticular tuberculosis. The sample enclosed in the study was that of children with pure bone tuberculosis or associated with other tuberculosis foci. All the patients were treated by our department´s standard protocol, based on antituberculous drugs (rifampicim, isoniazid, pyrazinamide and ethambutol) plus cast immobilization. Statistical analysis was performed by means of a “one-way” study of variance and Kruskal-Wallis (nonparametric test). Tukey`s test was also used as well as the chi-square X2 or the Fisher accuracy test at a 5% level. Results: A satisfactory result was obtained with conservative treatment (antituberculous drugs and cast immobilization) using our department´s standard protocol. Significant relationship exists between the affected site and the age (p=0.012). The hip group showed a significant higher average age than the affected thoracic and lumbar spine group. A Significant relationship was observed between the affected hip and time in cast (p=0.0001). This means that the hip group presented a median time in cast significantly lower than the affected thoracic and lumbar spine group. There is no significant difference in follow-up time (p=0.54) between the hip, the thoracic and the lumbar spine. Conclusions: After analyzing the therapy method based on antituberculous drugs and plaster cast immobilization, we conclude that employment of the standard protocol treatment, together with modern multidrug chemotherapy and cast were operational, justifiable and productive; it can also be used as an alternative therapeutic procedure for this specific disease. Keywords: Tuberculosis; Bone tuberculosis; Cast immobilization Level of evidence: Level – I Therapeutic Studies-Investigating the results of treatment Prognostic Studies.

3

Authors: Kiyohito NAITO

Usually, radius styloid process fractures without displacement are treated with immobilization. However, surgeons have to attend the wrist contracture after immobilization. We report the case of 2 patients (Case 1: a 45-year-old male and Case 2: a 37-year-old male) with radius styloid process fracture without displacement who were operated with break-away screws. Both patients recovered to excellent in the modified Mayo wrist score and no soft tissue complications were recognized.

6

Authors: Shukoh Haga, Takuya Sakurai*, Shogo Sato, Michiko Sasahara, Fumio Aita, Kazuki Esaki, Koji Toshinai, Etsuo Ueya, Noboru Hashimoto, Junetsu Ogasawara,Takako Kizaki, Yoshinaga Ishibashi,Tomonobu Sakurai, Shuji Oh-ishi, Hideki Ohno and Eimatsu Takakuwa

The purpose of this study was to clarify the effect of long-term exercise on the maintenance of concentration, as an indicator of the activity level of the cerebral cortex, and on the Profile of Mood States (POMS) in healthy elderly persons. Forty-six subjects were divided into three groups: a long-term exercise group (LTE-G) of 21 subjects (mean age: 67 years); a health exercise group (HE-G) of 12 subjects (mean age: 69 years); and a sedentary control group (SC-G) of 13 subjects (mean age: 70 years). We assessed the target aiming function (TAF), the POMS, and the presence in the urine of the following compounds: 8-hydroxydeoxyguanosine (8-OHdG) and acrolein (ACR) as indicators of oxidative stress; adrenaline, noradrenaline, and dopamine as indicators of sympathetic nervous activity. The mean TAF-L values, which represent the level of mental concentration, were statistically lower in the LTE-G and HE-G than in the SC-G. The mean TAF-D values, indicating deviation levels, were significantly lower in the HE-G than in the SC-G. Total Mood Disturbance (TMD) scores, which are the scored totals of POMS tests, and the scores on the “Confusion” factor were clearly lower in the LTE-G and HE-G than in the SC-G. On the other hand, there were no significant differences in 8-OHdG, ACR, adrenaline, noradrenaline or dopamine values among the three groups. These results suggest that the continuation of exercise improves the cerebral cortical activity, the maintenance of concentration, and the POMS scores of healthy elderly persons. Keywords: Healthy exercise; Long-term exercise; Maintenance of concentration; Cerebral cortical activity; Profile of Mood States

12

Authors: Matthew S Thiese*, Kurt T Hegmann, Timothy K Behrens, Arun Garg and Christina Porucznik

Background: Accurate physical activity assessment is becoming increasingly important in epidemiologic research. There is an increasing body of evidence suggesting that physical activity can prevent or reduce severity of disease. Utilizing accelerometers as an objective quantification of physical activity is a cost effective way to assess physical activity, yet there is little research on the agreement between different proposed cut points in a free-living, healthy adult population. Methods: This study investigated the correlation, sensitivity and specificity of different cut points for light, moderate, and vigorous activity in an occupational cohort of 78 participants. All participants wore the accelerometer for at least 12 hours a day for at least 5 days, including one weekend day. Results: There was a broad range of minutes of light and moderate activity and few minutes of vigorous activity. In general, correlations between free-living derived cut points were lower than those comparing laboratory derived cut points. Sensitivity and specificity values covered a broad range of values with lower sensitivity values in the light and moderate activity level categories and lowest specificity values in the light activity category. Conclusions: Cut points derived from laboratory studies are generally more congruous but may not be more accurate. There is little agreement between cut points at light and moderate activity levels. Consideration of the population being studied should be taken into account when deciding on what set of cut points to use.