Glucosamine-containing supplement improves locomotor functions in subjects with knee pain - a pilot study of gait analysis.

BACKGROUND: Previously, we demonstrated that glucosamine-containing supplementation was effective for improving locomotor functions, especially walking speed. However, the biomechanical mechanism of efficacy has not been elucidated. This study aimed to address this challenge in subjects with knee pain, using a motion capture system. METHODS: An open label study was conducted in 30 Japanese subjects with knee pain. The subjects were administered a daily supplement containing 1,200 mg of glucosamine hydrochloride, 60 mg of chondroitin sulfate, 45 mg of type II collagen peptides, 90 mg of quercetin glycosides, 10 mg of imidazole peptides, 1 mg of proteoglycan, and 5 µg of vitamin D (GCQID). The intervention continued for 16 weeks. Efficacy for locomotor functions involving the knee joint was evaluated mainly using the Japanese Knee Osteoarthritis Measure (JKOM) and the 5-question Geriatric Locomotive Function Scale (GLFS-5). To examine the biomechanical mechanism of efficacy for locomotor functions, motions of subjects in a normal walking state were captured. Gait analysis was conducted and efficacy for gait parameters such as normal walking speed, stride length, cadence, and angle of soles was evaluated. RESULTS: GCQID significantly improved total scores on the JKOM and GLFS-5. In gait analysis, normal walking speed, stride length, and angle of soles at the end of the stance phase were all significantly increased, but cadence did not change significantly during the intervention period. There were significant intercorrelations of changes in normal walking speed, stride length, and angle of soles at the end of the stance phase, and between changes in stride length and total JKOM score. CONCLUSION: A GCQID supplement may increase walking speed through increased stride length and angle of kicking from the ground during steps, which might be mainly associated with alleviated knee pain.

Catastrophic head and neck injuries in judo players in Japan from 2003 to 2010.

BACKGROUND: Few studies have documented catastrophic head and neck injuries in judo, but these injuries deserve greater attention. PURPOSE: To determine the features of catastrophic head and neck injuries in judo. STUDY DESIGN: Descriptive epidemiological study. METHODS: This study was based on the accident reports submitted to the All Japan Judo Federation's System for Compensation for Loss or Damage. A total of 72 judo injuries (30 head, 19 neck, and 23 other injuries) were reported between 2003 and 2010. The investigated parameters were mechanism of injury, age at time of injury, length of judo experience, diagnosis, and outcome. RESULTS: Among head injuries, 27 of 30 (90%) occurred in players younger than 20 years of age. The relationship between age, mechanism, and location of injury was more relevant when players younger than 20 years incurred head injury while being thrown (P = .0026). Among neck injuries, 13 of 19 (68%) occurred in players with more than 36 months of experience. The relationship between experience, mechanism, and location of injury was more relevant when experienced players incurred neck injury while executing an offensive maneuver (P = .0294). Acute subdural hematoma was diagnosed in 94% of head injuries. The outcomes of head injury were as follows: 15 players died; 5 were in a persistent vegetative state; 6 required assistance because of higher brain dysfunction, hemiplegia, or aphasia; and 4 had full recovery. Among neck injuries, 18 players were diagnosed with cervical spine injury, 11 of whom had fracture-dislocation of the cervical vertebra; there was also 1 case of atlantoaxial subluxation. The outcomes of neck injury were as follows: 7 players had complete paralysis, 7 had incomplete paralysis, and 5 had full recovery. CONCLUSION: Neck injuries were associated with having more experience and executing offensive maneuvers, whereas head injuries were associated with age younger than 20 years and with being thrown.

Neer modified inferior capsular shift procedure for recurrent anterior instability of the shoulder in judokas.

BACKGROUND: Little has been written about the operative repair of recurrent anterior instability of the shoulder in a single sport: in this case, Judo. PURPOSE: The clinical efficacy of the Neer modified inferior capsular shift as an open procedure for injured judokas was investigated. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Fifty athletes (42 male and 8 female, 52 shoulders) took part in this study. The average age at surgery was 20 years (range, 14-38 years), and the mean follow-up period was 61 months (range, 24-172 months). The operation was performed on 29 tsurité (a lapel grip) shoulders and on 23 hikité (a sleeve grip) shoulders. The 2 grips are functionally and technically different from each other. RESULTS: Three cases of shoulder instability (5.8%) recurred after surgery. The average loss of external rotation was 9.6 degrees with the arm at the side and 11.6 degrees with the arm in 90 degrees of abduction. The average Rowe and UCLA scores were 37.3 and 20.8 points preoperatively and 86.7 and 32.4 points at the final follow-up, respectively (P < .05). The return rate to the near-preinjury sports activity levels (>90% recovery: grades 1 and 2) was significantly lower in the tsurité shoulders (48.1%) than in the hikité shoulders (85.7%). CONCLUSION: The overall recovery of more than 90% of preinjury activity levels in judo was 65% after modified inferior capsular shift for traumatic anterior instability of the shoulder. The tsurité shoulder should be treated with minimal restriction limitation in external rotation so that it is not limited postoperatively.