Knee extension deficit during gait and knee extensor weakness persisting after saucerization and repair of discoid lateral meniscus tears.

BACKGROUND: Physical function and knee kinematics recovery after discoid lateral meniscus (DLM) tear surgery are essential for a better prognosis. However, these alterations remain unclear. Therefore, this study aimed to investigate changes in physical function and knee kinematics following saucerization and DLM tear repair. METHODS: We enrolled 16 patients who underwent saucerization and DLM tear repair. Postoperative changes in knee kinematics during gait, and physical function, were evaluated at 3, 6, and 12 months. RESULTS: The peak flexion angle of the operated limb during weight acceptance was significantly higher than that of the contralateral limb at 3 (operated limb: 34.6 ± 8.9°, contralateral limb: 23.7 ± 8.3°; P < 0.01) and 6 months (operated limb: 32.1 ± 9.7°, contralateral limb: 24.6 ± 8.2°; P = 0.03) postoperatively, but not at 12 months (operated limb: 27.1 ± 7.1°, contralateral limb: 23.1 ± 9.5°; P = 0.22) postoperatively. The knee extensor strength of the operated limb was significantly lower than that of the contralateral limb at 3 (operated limb: 1.00 ± 0.59 Nm/kg, contralateral limb: 1.37 ± 0.59 Nm/kg; P = 0.01), 6 (operated limb: 1.22 ± 0.55 Nm/kg, contralateral limb: 1.48 ± 0.60 Nm/kg; P < 0.01), and 12 months (operated limb: 1.39 ± 0.57 Nm/kg, contralateral limb: 1.55 ± 0.64 Nm/kg; P = 0.04) postoperatively. CONCLUSION: Knee extension deficits and extensor weakness persisted at 6 months after saucerization and repair of DLM tears. Postoperative rehabilitation should be focused on knee extension function.

Vertically aligned MXene bioelectrode prepared by freeze-drying assisted electrophoretic deposition for sensitive electrochemical protein detection.

Two-dimensional (2D) carbides, MXenes, have attracted attention as electrode materials of electrochemical biosensors because of their metallic conductivity, hydrophilicity, and mechanical stability. However, when fabricating electrodes, the nanosheets tend to re-stack and generally align horizontally with respect to the current collector due to the highly anisotropic nature of MXene, resulting in low porosity and poor utilization of the MXene surface. Here we report the electrochemical biosensing of antibody-antigen reactions with a vertically aligned Ti3C2Tx MXene (VA-MXene) electrode prepared by freeze-drying assisted electrophoretic deposition. The macroporous VA-MXene electrode exhibited a better electrochemical response towards the immunoreaction between the allergenic buckwheat protein (BWp16) and the antibody compared to a non-porous, horizontally (in-plane) stacked MXene (HS-MXene) and the sensors reported in the literature. The sensor responsiveness, defined as the ratio of the obtained current density of the electrode to the antigen concentration, was much higher for the VA-MXene electrode (238 µA cm-2 (ng mL-1) -1) than for the HS-MXene electrode. The proposed technique is applicable to other exfoliated nanosheets, and will open a new avenue for porous nanosheet electrodes to improve the sensing characteristics of electrochemical biosensors.

Phase angle is related to physical function and quality of life in preoperative patients with lumbar spinal stenosis.

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.

Relationships Between Trunk Movement Patterns During Lifting Tasks Compared With Unloaded Extension From a Flexed Posture.

OBJECTIVES: The purpose of this study was to investigate between movement patterns of trunk extension from full unloaded flexion and lifting techniques, which could provide valuable information to physical therapists, doctors of chiropractic, and other manual therapists. METHODS: A within-participant study design was used. Whole-body kinematic and kinetic data during lifting and full trunk flexion were collected from 16 healthy male participants using a 3-dimensional motion analysis system (Vicon Motion Systems). To evaluate the relationships of joint movement between lifting and full trunk flexion, Pearson correlation coefficients were calculated. RESULTS: There was no significant correlation between the amount of change in the lumbar extension angle during the first half of the lifting trials and lumbar movement during unloaded trunk flexion and extension. However, the amount of change in the lumbar extension angle during lifting was significantly negatively correlated with hip movement during unloaded trunk flexion and extension (P < .05). CONCLUSIONS: The findings that the maximum hip flexion angle during full trunk flexion had a greater influence on kinematics of lumbar-hip complex during lifting provides new insight into human movement during lifting. All study participants were healthy men; thus, findings are limited to this group.

Trunk lean gait decreases multi-segmental coordination in the vertical direction.

[Purpose] The strategy of trunk lean gait to reduce external knee adduction moment (KAM) may affect multi-segmental synergy control of center of mass (COM) displacement. Uncontrolled manifold (UCM) analysis is an evaluation index to understand motor variability. The purpose of this study was to investigate how motor variability is affected by using UCM analysis on adjustment of the trunk lean angle. [Subjects and Methods] Fifteen healthy young adults walked at their preferred speed under two conditions: normal and trunk lean gait. UCM analysis was performed with respect to the COM displacement during the stance phase. The KAM data were analyzed at the points of the first KAM peak during the stance phase. [Results] The KAM during trunk lean gait was smaller than during normal gait. Despite a greater segmental configuration variance with respect to mediolateral COM displacement during trunk lean gait, the synergy index was not significantly different between the two conditions. The synergy index with respect to vertical COM displacement during trunk lean gait was smaller than that during normal gait. [Conclusion] These results suggest that trunk lean gait is effective in reducing KAM; however, it may decrease multi-segmental movement coordination of COM control in the vertical direction.

Rear foot kinematics when wearing lateral wedge insoles and foot alignment influence the effect of knee adduction moment for medial knee osteoarthritis.

Lateral wedge insoles (LWIs) are prescribed for patients with medial knee osteoarthritis to reduce the external knee adduction moment (KAM). However, the biomechanical effects of LWIs are limited in some patients. The purpose of this study was to investigate whether the biomechanical effects of LWIs depend on individual foot alignment and to examine the relationship between change in KAM and changes in foot and ankle biomechanics when wearing LWIs. Twenty-one patients participated in this study. They were categorized into normal or abnormal foot groups based on the foot posture index (FPI). All patients were requested to perform a normal gait under barefoot and LWI conditions. A three-dimensional motion analysis system was used to record 1st and 2nd KAM, knee adduction angular impulse (KAAI), center of pressure displacement, and knee-ground reaction force lever arm. Furthermore, the foot and ankle frontal plane kinematic parameters were evaluated. The 1st KAM was significantly reduced under the LWI condition compared to that under the barefoot condition in the normal foot group. In contrast, there was no significant difference in 1st KAM between both conditions in the abnormal foot group. Decreased rear foot eversion strongly correlated with reduction in the 1st KAM in the normal foot group. These findings suggested that it is helpful to assess individual foot alignment to ensure adequate insole treatment for patients with medial knee osteoarthritis and that decreased rear foot eversion during the early stance phase is significantly involved in the reduction of 1st KAM when wearing LWIs with normal feet.

Foot alignments influence the effect of knee adduction moment with lateral wedge insoles during gait.

Lateral wedge insoles (LWIs) reduce the peak external knee adduction moment (KAM). However, the efficacy of LWIs is limited in certain individuals for whom they fail to decrease KAM. Possible explanations for a lack of desired LWI response are variations in foot alignments. The purpose of this study was to evaluate whether the immediate biomechanical effects of LWIs depend on individual foot alignments during gait. Fifteen healthy adults participated in this study. Their feet were categorized as normal, pronated, and supinated using the foot posture index. All subjects were subsequently requested to perform a normal gait under barefoot and LWI conditions. A three-dimensional motion analysis system was used to record the kinematic and kinetic data, included peak KAM, KAM impulse (KAAI), center of pressure displacement, and knee-ground reaction force lever arm (KLA). Furthermore, lower limb frontal plane kinematic parameters at the rear foot, ankle, knee, and hip were evaluated. Among all feet, there was no significant difference in the peak KAM and KAAI between the conditions. In contrast, the peak KAM was significantly reduced under the LWI condition relative to the barefoot condition in the normal foot group. Reductions in the peak KAM were correlated with a more lateral center of pressure and reduced KLA. In addition, a reduced KLA was correlated with decreased hip adduction. LWIs significantly reduced the peak KAM in normal feet, indicating that biomechanical effects of LWIs vary between individual foot alignments. Our findings suggest that it is helpful to assess individual foot alignment to ensure adequate insole treatment for patients with knee osteoarthritis.

Influences of trunk flexion on mechanical energy flow in the lower extremities during gait.

[Purpose] The time-series waveforms of mechanical energy generation, absorption, and transfer through the joints indicate how movements are produced and controlled. Previous studies have used these waveforms to evaluate and describe the efficiency of human movements. The purpose of this study was to examine the influence of trunk flexion on mechanical energy flow in the lower extremities during gait. [Subjects and Methods] The subjects were 8 healthy young males (mean age, 21.8 ± 1.3 years, mean height, 170.5 ± 6.8 cm, and mean weight, 60.2 ± 6.8 kg). Subjects walked at a self-selected gait speed under 2 conditions: normal gait (condition N), and gait with trunk flexion formed with a brace to simulate spinal curvature (condition TF). The data collected from initial contact to the mid-stance of gait was analyzed. [Results] There were no significant differences between the 2 conditions in the mechanical energy flow in the knee joint and negative mechanical work in the knee joint. However, the positive mechanical work of the knee joint under condition TF was significantly less than that under condition N. [Conclusion] Trunk flexion led to knee flexion in a standing posture. Thus, a strategy of moving of center of mass upward by knee extension using less mechanical energy was selected during gait in the trunk flexed posture.

Role of prokaryotic type I and III pantothenate kinases in the coenzyme A biosynthetic pathway of Bacillus subtilis.

Pantothenate kinases (CoaAs) catalyze the phosphorylation of pantothenate in the first step of the coenzyme A (CoA) biosynthetic pathway. These bacterial enzymes have been categorized into 3 types, the prokaryotic type I, II, and III CoaAs. Bacteria typically carry a single CoaA gene on their genome, but Bacillus subtilis possesses 2 proteins homologous to type I and III CoaAs, known as BsCoaA and BsCoaX, respectively. Both recombinant proteins exhibited the expected kinase activity and the characteristic properties of type I and III CoaAs, i.e., regulation by CoASH and acyl-CoAs in BsCoaA and the requirement of a monovalent cation in BsCoaX. Both gene disruptants appeared to grow in a manner similar to the wild-type strain. With the BsCoaX disruptant, the BsCoaA had the ability to completely fill the intracellular CoA pool, whereas the BsCoaA disruptant did not. These findings clearly indicate that these 2 CoaAs are employed together in the CoA biosynthetic pathway in B. subtilis and that the contribution of the type I CoaA (BsCoaA) to the formation of the intracellular CoA pool is larger than that of the type III CoaA (BsCoaX).

Antimicrobial activity of pantothenol against staphylococci possessing a prokaryotic type II pantothenate kinase.

Pantothenol is a provitamin of pantothenic acid (vitamin B5) that is widely used in healthcare and cosmetic products. This analog of pantothenate has been shown to markedly inhibit the phosphorylation activity of the prokaryotic type II pantothenate kinase of Staphylococcus aureus, which catalyzes the first step of the coenzyme A biosynthetic pathway. Since type II enzymes are found exclusively in staphylococci, pantothenol suppresses the growth of S. aureus, S. epidermidis, and S. saprophyticus, which inhabit the skin of humans. Therefore, the addition of this provitamin to ointment and skincare products may be highly effective in preventing infections by opportunistic pathogens.

Effect of diet composition on coenzyme A and its thioester pools in various rat tissues.

Three coenzyme A (CoA) molecular species, i.e., acetyl-CoA, malonyl-CoA, and nonesterified CoA (CoASH), in 13 types of fasted rat tissue were analyzed. A relatively larger pool size of total CoA, consisting of acetyl-CoA, malonyl-CoA, and CoASH, was observed in the medulla oblongata, liver, heart, and brown adipose tissue. Focusing on changes in the CoA pool size in response to the nutrient composition of the diet given, total CoA pools in rats continuously fed a high-fat diet for 4 weeks were significantly higher in the hypothalamus, cerebellum, and kidney, and significantly lower in the liver and skeletal muscle than those of rats fed a high-carbohydrate or high-protein diet. In particular, reductions in the liver were remarkable and were caused by decreased CoASH levels. Consequently, the total CoA pool size was reduced by approximately one-fifth of the hepatic contents of rats fed the other diets. In the hypothalamus, which monitors energy balance, all three CoA molecular species measured were at higher levels when rats were fed the high-fat diet. Thus, it was of interest that feeding rats a high-fat diet affected the behaviors of CoA pools in the hypothalamus, liver, and skeletal muscle, suggesting a significant relationship between CoA pools, especially malonyl-CoA and/or CoASH pools, and lipid metabolism in vivo.