Associations of Lower-Limb Phase Angle with Locomotion and Motor Function in Japanese Community-Dwelling Older Adults.

Whole-body phase angle (PhA) is associated with motor function and geriatric diseases. However, it was unclear which parts of the upper- or lower-limb PhA were involved. This study investigated the differences in the PhA of the upper and lower extremities and their relationships with frailty, locomotive syndrome indices, and motor function in community-dwelling older adult participants. This study was a cross-sectional observational study. In 69 community-dwelling older adults, the PhA at each measurement site (whole body, upper limbs, and lower limbs), motor function, Kihon Checklist (KCL), and 25-Geriatric Locomotive Function Scale (GLFS-25) were measured. This study examined differences in each PhA and its relationship with motor function and geriatric diseases. Multiple regression analysis was performed using GLFS-25 as the dependent variable and sex and lower-limb PhA as independent variables. In this cohort (mean age: 72.3 ± 5.7 years; 18 males and 51 females), lower-limb PhA was significantly lower than upper-limb PhA. Unlike other PhAs, lower-limb PhA was related to grip strength, TUG, F/w, and GLFS-25. Multiple regression analysis showed that the lower-limb PhA was independently related to GLFS-25. Cellular health of the lower extremity is associated with gait, standing function, and indicators of locomotive syndrome.

Relationship between the Hip Abductor Muscles and Abduction Strength in Patients with Hip Osteoarthritis.

This study aimed to determine which muscle the gluteus maximus, gluteus medius, gluteus minimus (Gmin), or tensor fasciae latae (TFL) contributes most to hip abduction strength and to identify effective sites for cross-sectional area (CSA) Gmin and TFL measurement in hip osteoarthritis (OAhip) patients. Twenty-eight patients with OAhip were included. The muscle CSA and volume were determined using magnetic resonance imaging. Peak isometric strength was determined using hand-held dynamometry. Muscle volumes were normalized to the total muscle volume of hip abductors. Multiple regression analysis was performed. The difference between the CSA of Gmin and TFL was calculated, and correlations with volume and muscle strength were determined. Gmin volume was related to abductor muscle strength (p=0.042). The peak CSA of the Gmin correlated with muscle volume and strength. The CSA of the TFL correlated with volume, with no difference between the CSA of the most protruding part of the lesser trochanter and peak CSA. Gmin volume was strongly related to abductor muscle strength. Peak CSA is a useful parameter for assessing the CSA of the Gmin among patients with OAhip. The CSA of the TFL should be measured at the most protruding part of the lesser trochanter.

Analysis of Phase Angle and Balance and Gait Functions in Pre-Frail Individuals: A Cross-Sectional Observational Study.

We measured the muscle mass and phase angle of each body part to evaluate the relationship between balance and gait functions in individuals with a pre-frailty status. This cross-sectional observational study determined the skeletal muscle mass-to-body weight ratio and phase angles of 21 control (robust) and 29 pre-frail subjects. Their Brief-Balance Evaluation Systems Test, Timed Up-and-Go (TUG) test, Life-Space Assessment, and Modified Fall Efficacy Scale scores plus the relationship between muscle mass, phase angle, and motor function were evaluated. In the pre-frailty group (three males, 26 females, aged 75.58±7.60 years), significant correlations were noted between the Brief-Balance Evaluation Systems Test score and lower-limb (r=0.614) and wholebody (r=0.557) phase angles, and between the TUG test score and lower-limb muscle mass-to-body weight ratio (r=-0.616), lower-limb phase angle (r=-0.616), and whole-body phase angle (r=-0.527). Evaluating the phase angle of the lower extremities of pre-frail patients and intervening accordingly may help clinicians maintain and improve these patients' balance and gait functions.

Appropriate sites for the measurement of the cross-sectional area of the gluteus maximus and the gluteus medius muscles in patients with hip osteoarthritis.

PURPOSE: To evaluate the relationship between the volume, cross-sectional area, and peak isometric muscle strength of the gluteus maximus and gluteus medius muscles in patients with hip osteoarthritis, and to use this information to identify effective sites for measurement of the cross-sectional area of these muscles. METHODS: Twenty-four patients with hip osteoarthritis were included. The muscle cross-sectional area and volume were calculated from magnetic resonance images. The cross-sectional area was calculated at three levels: the inferior point of the sacroiliac joint, just above the femoral head, and at the greatest muscle diameter. Peak isometric strength was assessed using hand-held dynamometry, using the extension and external rotation for the gluteus maximus and abduction and internal rotation for the gluteus medius. Measured outcomes were compared between the two muscles, and the association between muscle volume, cross-sectional area, and peak isometric muscle strength was evaluated using Pearson's correlation. RESULTS: Volume was correlated with the cross-sectional area in the gluteus maximus (r ≥ 0.707) and with the cross-sectional area (r ≥ 0.637) and peak isometric strength (r ≥ 0.477) in the gluteus medius. There was no difference between the cross-sectional area measured at the greatest muscle diameter and just above the femoral head (p = 0.503) for the gluteus maximus and at the inferior point of the sacroiliac joint (p = 0.651) for the gluteus medius. CONCLUSION: The cross-sectional area, when used to calculate the muscle volume, should be evaluated just above the femoral head for the gluteus maximus and at the inferior point of the sacroiliac joint for the gluteus medius.

Three-dimensional Evaluation of Abnormal Gait in Patients with Hip Osteoarthritis.

Indexes for objectively evaluating abnormal gait in hip osteoarthritis (OA) patients and determining effective interventions are unclear. We analyzed the abnormal gait of hip OA patients by focusing on movements of the trunk and pelvis to establish an effective evaluation index for each direction of motion. We studied 28 patients with secondary hip OA due to developmental dysplasia of the hip and 16 controls. The trunk and pelvic movements during gait were measured in the medial-lateral (x), vertical (y), and back-and-forth (z) directions by a triaxial angular accelerometer. Gait speed, steps, step length, muscle strength, range of motion, and timed up-and-go (TUG) test performance were measured. We determined the correlations between physical function and the index of abnormal gait in the hip OA patients. Movements other than trunk and pelvic motions in the y-direction indicated abnormal gait in the patients. Significant correlations were found between abnormal gait and range of motions (extension, internal rotation), TUG score, stride length, and steps. The TUG test, stride length and steps were important for evaluating abnormal gait in hip OA patients. Individual interventions for each movement direction are required.

Investigation on the measurement sites of the cross-sectional areas of the gluteus maximus and gluteus medius.

PURPOSES: To verify the relationship between muscle volume and muscular strength of different cross-sectional areas (CSAs) of the gluteus maximus and medius, and to clarify the effective evaluation index. METHODS: Twenty healthy adults were enrolled in this cross-sectional study. Magnetic resonance images were evaluated, and CSAs of the gluteus maximus and medius were calculated. Calculation sites were the peak CSA, lowest end of the sacroiliac joint CSA, and just above the femoral head CSA. Muscle volume and muscular strength were measured. The correlation between muscular CSA, muscle volume, and muscular strength was verified using Pearson's correlation coefficient (p < 0.05). One-way analysis of variance and the Tukey-Kramer test were used to verify differences in each CSA (p < 0.05). RESULTS: A significantly positive correlation was found between muscular CSA, muscle volume, and muscular strength of both muscles (p < 0.05). For the gluteus maximus, the muscular CSA calculated just above the femoral head showed a significantly larger value than that calculated at the lowest end of the sacroiliac joint (p < 0.05). For the gluteus medius, the peak CSA and muscular CSA calculated at the lowest end of the sacroiliac joint were significantly larger than that calculated just above the femoral head (p < 0.05). CONCLUSIONS: The maximum CSA of the gluteus maximus was found just above the femoral head and that of the gluteus medius was near the lowest end of the sacroiliac joint; hence, CSAs should be calculated at these sites. The CSA reflected muscle volume and strength.

Effects of Nordic walking on pelvis motion and muscle activities around the hip joints of adults with hip osteoarthritis.

[Purpose] Increased compensatory pelvic movement is remarkable in limping patients with hip osteoarthritis (OA). However, a method of improving limping has not been established. The purpose of this study was to identify the effects of two types of Nordic walking by analyzing the pelvic movement and muscle activities of adults with hip OA. [Subjects and Methods] Ten patients with OA of the hip performed Japanese-style Nordic walking (JS NW), European-style Nordic walking (ES NW), and Ordinary walking (OW), and the muscle activities around the hip joint and pelvic movements were analyzed. [Results] The pelvic rotation angle was significantly larger in ES NW than in JS NW. In the stance phase, hip abductor muscle activity was significantly decreased in JS NW compared to both OW and ES NW. In the swing phase, rectus abdominis muscle activity was significantly increased in both JS NW and ES NW compared to OW and lumbar erector spinae activity was significantly lower in JS NW than in OW. [Conclusion] JS NW style may reduce the compensatory pelvic rotation in patients with hip OA. JS NW might be better for joint protection and prevention of secondary disorders of the hip in OA patients.

Self-Healing Capability of Fiber-Reinforced Cementitious Composites for Recovery of Watertightness and Mechanical Properties.

Various types of fiber reinforced cementitious composites (FRCCs) were experimentally studied to evaluate their self-healing capabilities regarding their watertightness and mechanical properties. Cracks were induced in the FRCC specimens during a tensile loading test, and the specimens were then immersed in static water for self-healing. By water permeability and reloading tests, it was determined that the FRCCs containing synthetic fiber and cracks of width within a certain range (<0.1 mm) exhibited good self-healing capabilities regarding their watertightness. Particularly, the high polarity of the synthetic fiber (polyvinyl alcohol (PVA)) series and hybrid fiber reinforcing (polyethylene (PE) and steel code (SC)) series showed high recovery ratio. Moreover, these series also showed high potential of self-healing of mechanical properties. It was confirmed that recovery of mechanical property could be obtained only in case when crack width was sufficiently narrow, both the visible surface cracks and the very fine cracks around the bridging of the SC fibers. Recovery of the bond strength by filling of the very fine cracks around the bridging fibers enhanced the recovery of the mechanical property.

Specific recognition of the collagen triple helix by chaperone HSP47. II. The HSP47-binding structural motif in collagens and related proteins.

The endoplasmic reticulum-resident chaperone heat-shock protein 47 (HSP47) plays an essential role in procollagen biosynthesis. The function of HSP47 relies on its specific interaction with correctly folded triple-helical regions comprised of Gly-Xaa-Yaa repeats, and Arg residues at Yaa positions have been shown to be important for this interaction. The amino acid at the Yaa position (Yaa(-3)) in the N-terminal-adjoining triplet containing the critical Arg (defined as Arg(0)) was also suggested to be directly recognized by HSP47 (Koide, T., Asada, S., Takahara, Y., Nishikawa, Y., Nagata, K., and Kitagawa, K. (2006) J. Biol. Chem. 281, 3432-3438). Based on this finding, we examined the relationship between the structure of Yaa(-3) and HSP47 binding using synthetic collagenous peptides. The results obtained indicated that the structure of Yaa(-3) determined the binding affinity for HSP47. Maximal binding was observed when Yaa(-3) was Thr. Moreover, the required relative spatial arrangement of these key residues in the triple helix was analyzed by taking advantage of heterotrimeric collagen-model peptides, each of which contains one Thr(-3) and one Arg(0). The results revealed that HSP47 recognizes the Yaa(-3) and Arg(0) residues only when they are on the same peptide strand. Taken together, the data obtained led us to define the HSP47-binding structural epitope in the collagen triple helix and also define the HSP47-binding motif in the primary structure. A motif search against human protein database predicted candidate clients for this molecular chaperone. The search result indicated that not all collagen family proteins require the chaperoning by HSP47.

Self-complementary peptides for the formation of collagen-like triple helical supramolecules.

Collagen is acknowledged as one of the most prominent biomaterials on account of its high biocompatibility and biostability. The development of artificial collagens to replace the animal-derived collagens presents a challenge in the formation of safer and highly functionalized biomaterials. Here, a novel peptide-based system for obtaining collagen-like supramolecules via a spontaneous self-assembling process is described. The designed collagen-like peptides are self-complementary trimers in which each of the 24-mer peptide strands is tethered by two cystine knots forming a staggered arrangement. Their self-assembling ability in aqueous solution was analyzed by circular dichroism, ultrafiltration, and laser diffraction particle size estimation. The obtained results indicate that the staggered trimers form large supramolecular architectures through intermolecular triple helix-formation.