Possible Duration of WISH-type Hip Brace Use: Prognostic Value of Timed Up and Go Test.

Objectives: The WISH-type S-form hip brace (WISH brace) has significantly improved hip function and functional mobility in patients with hip osteoarthritis (OA). However, most patients later undergo surgery. The main purpose of this study was to evaluate how long the orthosis can be effectively used by patients with hip OA, and to reveal the associated prognostic factors. Methods: This prospective study examined the survival curve of the equipment by using surgery as an endpoint and investigated how the duration of use affects patients. Harris Hip Score, muscle strength, and the Timed Up and Go test (TUG) were evaluated as prognostic factors. Results: By drawing the survival curves of 26 patients, approximately one third were expected to be still using the brace after 7 years. A rapid decrease in use was observed at around 1 year. A significant difference between patients with and without bracing at 1 year was found for the TUG result with the unaffected leg inside (ULI) at the start of bracing. A cut-off value of 9.5 s for the TUG with ULI significantly differentiated patients with and without bracing at 1 year, suggesting a possible predictor of brace survivorship in the early phase. Conclusions: The TUG with ULI with a cut-off value of 9.5 s, or at most 10 s, may be a possible predictor of persistence of brace use in the early phase.

Biomechanical analysis of the pitching characteristics of adult amateur baseball pitchers throwing standard and lightweight balls.

[Purpose] The purpose of this study was to determine the relationship between pitching weight and pitching mechanics, including ball reaction force (BRF) and temporal parameters, for the prevention of throwing injury in adult amateur pitchers. [Participants and Methods] Twenty adult male amateur pitchers (mean age, height, and body mass: 26 ± 3.4 years, 1.7 ± 0.03 m, and 71.6 ± 9.5 kg, respectively) randomly pitched light (110 g) and heavy (145 g) baseballs at maximum velocity. Kinematic, kinetic, and temporal parameters were compared between the light and heavy balls. [Results] Pitching heavy balls significantly increased the BRF to 9.2 N and maximum trunk rotation angular velocity to 26.2°/sec, and decreased the ball speed to 1.4 m/sec and upper limb joint torque efficiency and shoulder internal rotation angular velocity at the moment of ball release at 250.8°/sec. Furthermore, the peak temporal kinetic parameters until ball release appeared early in the throwing of the heavy ball. [Conclusion] Adult amateur pitchers who pitched heavy balls had greater BRF; had decreased upper limb joint torque efficiency, ball speed, and arm angular velocity; and reached maximum kinetics early. Adult amateur pitchers may be at risk of throwing injuries due to throwing of heavy balls.

Muscle activity of the vastus medialis obliquus during squat motion after static stretching of the tensor fasciae latae.

[Purpose] The purpose of this study was to investigate the changes of muscle activity during squat motion after stretching the tensor fasciae latae muscle. [Participants and Methods] The participants comprised 19 healthy males. The test muscles were the vastus medialis obliquus and vastus lateralis. The participants performed the squat motion before and after stretching the tensor fasciae latae. We measured the muscle activities and the onset timing of the vastus medialis obliquus relative to that of the vastus lateralis during squat motions. [Results] The onset timing of the vastus medialis obliquus relative to that of the vastus lateralis was decreased, and the vastus medialis obliquus activity and vastus medialis obliquus/vastus lateralis activity ratio were increased after stretching the tensor fasciae latae. [Conclusion] This study revealed that stretching of the tensor fasciae latae increases the relative vastus medialis obliquus muscle activity.

Effects of the WISH-type S-form Hip Brace on Muscle Strength in Patients with Osteoarthritis of the Hip: A Short-term Longitudinal Study.

BACKGROUND: The WISH-type S-form hip brace (WISH brace) has been shown to significantly improve hip function, functional mobility, and gait biomechanics in patients with hip osteoarthritis. The aim of the current study was to evaluate the effects of the WISH brace over time on the strength of muscles around the hip and knee joints. METHODS: A prospective short-term longitudinal study with a 6-month follow-up was conducted. Muscle strengths were measured using a handheld dynamometer. RESULTS: The muscle strengths of hip flexion, hip abduction, and knee extension were lower in the affected limb than in the unaffected limb, whereas hip adduction muscle strength was reduced to the same extent in both the affected and unaffected limbs. This short-term longitudinal study revealed that only hip adduction and knee extension exhibited significant interaction between legs and time when measurement was performed without the WISH brace. Furthermore, the inherent hip abduction muscle strength of the affected limb was improved by the WISH brace so that the strength became the same as the unaffected limb. CONCLUSIONS: Improvement in abduction muscle strength of the affected limb by daily walking exercise with the WISH brace, which occurred with little interaction with the unaffected limb, may improve hip function.

Effect of the WISH-type hip brace on functional mobility in patients with osteoarthritis of the hip: evaluation using the Timed Up & Go Test.

BACKGROUND: The WISH-type S-form brace, is considered to improve hip function and gait in patients presenting with painful hip osteoarthritis (OA). OBJECTIVES: To evaluate the effects of the brace on functional mobility. STUDY DESIGN: Cross sectional survey. METHODS: The Timed Up & Go Test (TUG) was performed with right and left turns separately in each subject. RESULTS: In the patients with the bilateral hip brace, the average time to complete the TUG (8.3 ± 1.7 seconds) was significantly shorter than in those without the brace (9.4 ± 2.9 seconds). On the other hand, for the patients with unilateral hip OA, the improvement of TUG with the hip brace was significant in turning the unbraced leg inside (7.4 ± 1.1 vs. 7.6 ± 1.2 seconds), while not turning the braced leg inside (7.5 ± 1.1 vs. 7.6 ± 1.2 seconds). Furthermore, significant improvement of TUG was found at three-month follow-up and maintained until the 12-month follow-up assessment. This improvement was independent of the application of the brace at the assessment. CONCLUSIONS: The direct effect of the hip brace may be related to the hip function in the turning phase of TUG. In addition, mechanical improvements due to daily exercise may provide an indirect, but essential, effect of the brace on TUG performance.

Biomechanical analysis of gait in patients with painful osteoarthritis of the hip treated with WISH-type hip brace.

BACKGROUND: A hip brace, the WISH-type S-form brace, improved hip function scores markedly in patients with painful hip osteoarthritis (OA). To evaluate the biomechanical effects of the brace, gait analysis using a force plate was performed. METHODS: For the gait of seven patients with this hip brace, characteristic parameters calculated from three-dimensional (i.e., vertical, forward, and medial) components of the floor reaction force were analyzed using a flat force plate. RESULTS: Gait analyses revealed several tendencies: a shorter time for one step, a stronger step, and a shift of the center of gravity of the body to the contralateral side. In particular, stronger vertical reaction force at the first peak in the early stance and earlier switch from backward to forward reaction force vectors were observed as effects of the hip brace, with statistically significant difference. CONCLUSIONS: These biomechanical assessments suggest that abnormal gait in hip OA may be closer to normal gait in patients using this brace, although the deceleration and weighing-off effects, which are indicators useful for observing gait recovery, did not reach significance.

Extended application of WISH type S-form hip brace for patients with bilateral painful hip osteoarthritis: report of two cases.

Dynamic lateral instability of the femoral head develops in patients with osteoarthritis (OA) of the hip. Recently we have developed a hip brace, called the WISH-type hip brace, and showed successful response of the patients quantitatively. However, a negligible effect was observed in patients with bilateral involvement. Here, we extended the application of the WISH-type hip brace for two patients with bilateral OA joints. The resultant WISH-type hip brace with two S-form portions for bilateral thighs provided good recovery in hip function. Interestingly Timed Up & Go (TUG) test performed for one patient revealed a positive effect of the brace on the functional mobility. To the best of our knowledge, this is the first report elucidating the therapeutic effect of brace therapy with bilateral hip stabilization from hip functional and functional mobility points of view. Application of the present brace should be taken into account for patients with painful bilateral hip OA before easy application of invasive surgery such as total hip arthroplasty.