Shoulder kinetic during pitching in baseball players with scapular dyskinesis.

INTRODUCTION: Shoulder injuries in baseball players cause excessive shoulder load during pitching and scapular dyskinesis (SD). However, the characteristics of pitching kinetics in the shoulder joint with SD are unclear. This study aimed to investigate the effect of SD on pitching kinetics in the shoulder joint of baseball players. METHOD: Seventy-two college and independent league baseball players participated in the study. The pitching motion was measured using an 18-camera motion-capture system. SD was classified into four types (I-IV) using the scapular dyskinesis test (SDT). The pitching kinetics data were analyzed. RESULTS: The agreement of SD in this study was 56/72 (77.8%). SD were classified into 31 abnormal group (type I-Ⅲ) and 25 control group (type Ⅳ). Three participants with measurement failure during the pitching motion analysis were excluded from the analysis. The abnormal group showed a larger maximum value of the glenohumeral normalized anterior joint force than the control group. CONCLUSIONS: These results suggest that an increase in GH anterior force during pitching causes an excessive increase in external rotation of the GH with an insufficient posterior tilt of the scapula with SD. Therefore, baseball pitching with SD may involve shoulder injuries owing to excessive shoulder load during pitching.

A novel method for estimating sternoclavicular posterior rotation with promising accuracy: A validity comparison with minimizing acromioclavicular rotation approach.

The human shoulder complex's motion is modeled by nine rotational degrees of freedom (DoF) at the sternoclavicular (SC), acromioclavicular (AC), and glenohumeral joints. Non-invasive measurement of these rotations is desirable for shoulder kinematic assessment or musculoskeletal modeling. Accuracy of the conventional method for estimating SC posterior rotation is unclear and might be overestimated because it assumes no rotation in the AC joint. We aimed to explore whether our new method, allowing AC rotation, provides a more accurate estimation of SC posterior rotation than the conventional method. We compared estimates by both methods, in 18 postures among 8 healthy men, with those measured by the registration method from magnetic resonance images. Posthoc analyses showed significant differences between the registration and conventional methods in all 18 postures and in only one posture when compared to our method. While the conventional method tended toward overestimation and showed a 22.7° root-mean-square error for all postures, the new method had greater accuracy (6.8° root-mean-square error). By combining this method with the scapulothoracic rotation measurement method and other traditional methods, it should be possible to indirectly measure 3-DoF AC rotation, implying that non-invasive measurement of all 9-DoF rotations of the shoulder complex would now be possible.

Redistribution of knee and ankle joint work with different midsole thicknesses in non-rearfoot strikers during running: a cross-sectional study.

PURPOSE: The aim of this work was to i nvestigate the effects of midsole thickness on non-rearfoot strike runners' redistributions of knee and ankle joint negative and positive work. METHODS: Fourteen healthy male runners wore minimalist, traditional and maximalist shoes and ran in a straight line in each shoe in the laboratory at a speed of 15 km/h, with a ±5% difference being allowed. Whole-body kinematics and ground reaction forces were recorded, and the data of eleven non-rearfoot strikers were used for the analysis. Ankle and knee joint negative and positive work was calculated by integrating each joint's torque power. Friedman test was used for statistical comparisons. RESULTS: Running in minimalist shoes induced significantly greater ankle joint negative and positive work than in other shoes. Running in maximalist shoes induced significantly lower ankle joint positive work and greater knee joint negative work than in other shoes, and significantly greater knee joint positive work than in minimalist shoes. CONCLUSIONS: Our results indicated that nonrearfoot strikers redistributed joint negative and positive work from the knee to the ankle when using minimalist shoes or from the ankle to the knee when using maximalist shoes. It is recommended that future research employs more rigorous study designs, such as randomised controlled trials and longitudinal studies, to provide a more accurate assessment of the effect of these shoes on in.

Modulation of Muscle Synergies in Lower-Limb Muscles Associated With Split-Belt Locomotor Adaptation.

Humans have great locomotor adaptability to environmental demands, which has been investigated using a split-belt treadmill with belts on both the left and right sides. Thus far, neuromuscular control in split-belt locomotor adaptation has been evaluated by analyzing muscle activities at the individual muscle level. Meanwhile, in the motor control field, the muscle synergy concept has been proposed. Muscle synergies are considered the fundamental building blocks of movement and are groups of coactive muscles and time-varying activation patterns, thereby, reflecting the neurophysiological characteristics of movement. To date, it remains unclear how such muscle synergies change during the adaptation and de-adaptation processes on the split-belt treadmill. Hence, we chronologically extracted muscle synergies while walking on the split-belt treadmill and examined changes in the number, muscle weightings, and temporal activation patterns of muscle synergies. Twelve healthy young males participated, and surface electromyography (EMG) signals were recorded bilaterally from 13 lower-limb muscles. Muscle synergies were extracted by applying non-negative matrix factorization to the EMG data of each leg. We found that during split-belt walking, the number of synergies in the slow leg increased while an extra synergy appeared and disappeared in the fast leg. Additionally, the areas under the temporal activation patterns in several synergies in both legs decreased. When both belts returned to the same speed, a decrease in the number of synergies and an increase in the areas under the temporal activation patterns of several synergies were temporally shown in each leg. Subsequently, the number of synergies and the areas under the temporal activation patterns returned to those of normal walking before split-belt walking. Thus, changes in the number, muscle weightings, and temporal activation patterns of synergies were noted in the split-belt locomotor adaptation, suggesting that the adaptation and de-adaptation occurred at the muscle synergy level.

Scapular dyskinesis type is associated with glenohumeral joint and scapular kinematic alteration during pitching motion in baseball players.

INTRODUCTION: Scapular dyskinesis (SD) is associated with an increased risk of throwing-related shoulder injury onset, resulting in abnormalities in glenohumeral joint (GH) and scapular motions during pitching. The effects of SD on shoulder motion during pitching remain unknown. This study aimed to investigate kinematic alterations in GH and scapular motions during pitching in baseball players with type I SD. METHODS: Sixty-seven university and independent-league baseball players with and without SD were included. Pitching motion was measured using an optical three-dimensional motion capture system, and a SD test was conducted to evaluate SD. SD was classified into types I-IV. The inter-rater reliability of SD assessment was calculated using kappa coefficients. Three-dimensional GH and scapular kinematics during pitching motion were analyzed. RESULTS: The percentage of agreement representing the inter-rater reliability of SD assessment was 77.6% (52/67; kappa coefficient: 0.72). Overall, 24 and 27 participants were categorized into abnormal (type I SD) and normal group (type IV SD), respectively, with normal scapular motion; one individual with type III SD was excluded. The abnormal group exhibited a significantly increased GH external rotation angle (9°) and decreased scapular posterior tilt angle (6°) during the maximum external rotation period compared with the normal group. CONCLUSIONS: Baseball players in the abnormal group showed increased GH motion and decreased scapular motion during pitching. The SD test for the evaluation of type I SD can help predict excessive GH external rotation and decreased scapular posterior tilt during pitching.

Time-series changes in intramuscular coherence associated with split-belt treadmill adaptation in humans.

Humans can flexibly modify their walking patterns. A split-belt treadmill has been widely used to study locomotor adaptation. Although previous studies have examined in detail the time-series changes in the spatiotemporal characteristics of walking during and after split-belt walking, it is not clear how intramuscular coherence changes during and after split-belt walking. We thus investigated the time-series changes of intramuscular coherence in the ankle dorsiflexor muscle associated with split-belt locomotor adaptation by coherence analysis using paired electromyography (EMG) signals. Twelve healthy males walked on a split-belt treadmill. Surface EMG signals were recorded from two parts of the tibialis anterior (TA) muscle in both legs to calculate intramuscular coherence. Each area of intramuscular coherence in the beta and gamma bands in the slow leg gradually decreased during split-belt walking. Significant differences in the area were observed from 7 min compared to the first minute after the start of split-belt walking. Meanwhile, the area of coherence in both beta and gamma bands in the fast leg for the first minute of normal walking following split-belt walking was significantly increased compared with normal walking before split-belt walking, and then immediately returned to the normal walking level. These results suggest that cortical involvement in TA muscle activity gradually weakens when adapting from a normal walking pattern to a new walking pattern. On the other hand, when re-adapting from the newly adapted walking pattern to the normal walking pattern, cortical involvement might strengthen temporally and then weaken quickly.

Stride-Phase Kinematic Parameters That Predict Peak Elbow Varus Torque.

BACKGROUND: During baseball pitching, a high amount of elbow varus torque in the arm cocking-to-acceleration phase is thought to be a biomechanical risk factor for medial elbow pain and injury. The biomechanics of the stride phase may provide preparation for the arm cocking-to-acceleration phase that follows it. PURPOSE: To determine the kinematic parameters that predict peak elbow varus torque during the stride phase of pitching. STUDY DESIGN: Descriptive laboratory study. METHODS: Participants were 107 high school baseball pitchers (age range, 15-18 years) without shoulder or elbow problems. Whole-body kinematics and kinetics during fastball pitching were analyzed using 3-dimensional measurements from 36 retroreflective markers. A total of 26 kinematic parameters of the upper and lower limbs during the stride phase leading up to the stride foot contact were extracted for multiple regression analysis to assess their combined effect on the magnitude of peak elbow varus torque. RESULTS: Increased wrist extension, elbow pronation, knee flexion on the leading leg, knee extension on the trailing leg at stride foot contact, and upward displacement of the body's center of mass in the stride phase were significantly correlated with decreased peak elbow varus torque (all P < .05). Moreover, 38% of the variance in peak elbow varus torque was explained by a combination of these 5 significant kinematic variables (P < .001). CONCLUSION: We found that 5 kinematic parameters during the stride phase and the combination of these parameters were associated with peak elbow varus torque. The stride phase provides biomechanical preparation for pitching and plays a key role in peak elbow varus torque in subsequent pitching phases. CLINICAL RELEVANCE: The present data can be used to screen pitching mechanics with motion capture assessment to reduce peak elbow varus torque. Decreased peak elbow varus torque is expected to reduce the risk of elbow medial pain and injury.

A new method of estimating scapular orientation during various shoulder movements: A comparison of three non-invasive methods.

The conventional acromion marker cluster (AMC) method used to estimate scapular orientation cannot adequately represent complex shoulder movements due to soft tissue artifacts. The regression method may have nonlinear error changes depending on humeral elevation angle and elevation plane. Therefore, we aimed to develop a new method of estimating scapular orientation using curved surface interpolation during various shoulder movements, and to compare its accuracy with conventional and regression methods. Thirteen healthy men were recruited. AMC and refractive markers for bony landmarks were placed on the skin. During the preprocess, several shoulder postures, including different arm elevations and elevation planes, were measured using the motion capture system. Premeasured data were used to calibrate the positional relationship between AMC and scapula using curved surface interpolation. Subsequently, scapular orientations were estimated by measuring AMC and body markers of any shoulder posture. To evaluate the accuracy of our methods, 25 elevation postures and six tasks involving postures common to activities of daily living were applied. For tasks requiring greater arm elevation angles, the root mean square error was less in our method than in the conventional and regression methods. Therefore, our method could improve the accuracy of estimating scapular orientation in various elevation postures.

Estimation of Shoulder Behavior From the Viewpoint of Minimized Shoulder Joint Load Among Adolescent Baseball Pitchers.

BACKGROUND: During pitching, an overloaded joint reaction force exerted on the shoulder and excessive shoulder horizontal abduction at ball release are considered risk factors causing anterior shoulder pain for young baseball pitchers. Hypothesis/Purpose: The first aim was to examine the relationship between shoulder horizontal abduction position and force on the shoulder at ball release. The second was to identify the relative rotational position of the shoulder and the range of shoulder motion at ball release that minimize force on the shoulder. It was hypothesized that the amount of force on the shoulder would be exacerbated by excessive shoulder horizontal abduction. STUDY DESIGN: Descriptive laboratory study. METHODS: Participants were 183 adolescent baseball pitchers (mean ± SD age, 15.5 ± 1.2 years) without shoulder/elbow problems. Each pitcher threw 5 fastballs to a catcher behind a home plate. The kinematics and kinetics of the throwing shoulder during fastball pitching were calculated with 3-dimensional measurements from 36 reflective markers. In data analysis, the correlations were calculated between the relative rotational positions of the shoulder (abduction, horizontal adduction-abduction) and the forces on the shoulder (anterior-posterior, proximal, and superior-inferior) at ball release. Subsequently, the specific rotational position and range of motion of the shoulder at ball release that minimized forces on the shoulder were determined. RESULTS: Statistically significant correlations were identified between the magnitude of superior-inferior force on the shoulder and shoulder abduction position ( R2 = 0.44, P < .001) as well as between the magnitude of anterior-posterior force on the shoulder and shoulder horizontal adduction-abduction position ( R2 = 0.72, P < .001). Minimal anterior-posterior and superior-inferior forces were obtained with a combination of 80.6° of shoulder abduction and 10.7° of shoulder horizontal adduction. Any deviation >5° from this position significantly increased the anterior-posterior and superior-inferior forces on the shoulder. CONCLUSION: Increasing shoulder horizontal abduction position significantly increased the magnitude of anterior force on the shoulder at ball release. The combination of 80.6° of shoulder abduction and 10.7° of horizontal shoulder adduction minimized the shear forces on the shoulder at this point. CLINICAL RELEVANCE: The present data can be useful for screening pitching technique to prevent shoulder pain and injury with motion capture assessment.

Ecological thresholds of hypoxia and sedimentary H2S in coastal soft-bottom habitats: A macroinvertebrate-based assessment.

Ecological thresholds of dissolved oxygen (DO) and sedimentary hydrogen sulfide (H2S) for macrozoobenthos were examined during a 30-month monitoring of two stations in a highly eutrophic canal in inner Tokyo Bay, Japan. Bottom DO and H2S concentrations fluctuated seasonally, and were significantly correlated with water and sediment temperatures. Red tide-derived phytodetritus was a major source of sediment organic matters in the canal bottom, and the sediment became highly reduced and sulfidic condition in warmer months (sedimentary H2S; up to 8.5 mM). Dominant opportunistic taxa, including polychaetes and amphipods, were eliminated under low DO and high H2S conditions (i.e., population thresholds), and devastation of community structure occurred at 2.4-3.3 mg l-1 DO and 1.8-2.7 mM H2S (i.e., community thresholds). To maintain ecosystem function in anthropogenically degraded habitats and ensure colonization by macrozoobenthos throughout the year, DO and H2S levels should be maintained below these thresholds.

Seasonal changes in infaunal community structure in a hypertrophic brackish canal: Effects of hypoxia, sulfide, and predator-prey interaction.

We conducted a one-year survey of macrozoobenthic community structure at 5 stations in a eutrophic canal in inner Tokyo Bay, focusing on the impacts of hypoxia, sediment H2S, and species interaction in the littoral soft-bottom habitats. Complete defaunation or decreasing density of less-tolerant taxa occurred under hypoxia during warmer months, especially at subtidal or sulfidic stations; this was followed by rapid recolonization by opportunistic polychaetes in fall-winter. Sedimentary H2S increased the mortality of macroinvertebrates under hypoxia or delayed population recovery during recolonization. The density of several polychaetes (e.g., Pseudopolydora reticulata) declined in winter, coincident with immigration of the predator Armandia lanceolata. This suggests that absence of A. lanceolata under moderate hypoxia enabled the proliferation of prey taxa. We conclude that oxygen concentration, sediment H2S, and hypoxia-induced changes in species interactions are potential drivers for spatiotemporal changes in macrozoobenthic assemblage structure in hypoxia-prone soft-bottom communities.

Once-weekly teriparatide increases bone mineral density in the distal 1/10 radius, but not in the distal 1/3 radius.

Teriparatide significantly increases bone mineral density (BMD) of the lumbar vertebrae and femur and has a strong effect in reducing the risk of bone fractures. However, few detailed investigations with dual-energy X-ray absorptiometry (DXA) of the effects of teriparatide on the radius have been reported; specifically, there are no reports of the use of once-weekly teriparatide. In this study, the effect of once-weekly teriparatide in increasing BMD was examined in the distal 1/10 of the radius and the distal 1/3 of the radius using a DXA system for the radius. In addition, the effect of radius positioning, especially accurate correction of rotation and inclination before and after administration of teriparatide, was evaluated in an assessment of its efficacy. It was found that when positioning was corrected, a significant increase in BMD in the distal 1/10 of the radius was observed after 6 months of once-weekly teriparatide. In the distal 1/3 of the radius, no significant increase of BMD was observed. This suggests that when DXA scans of the radius are analyzed with appropriate positioning, weekly teriparatide significantly increases BMD in the distal 1/10 of the radius, which is rich in cancellous bone.

Temporal changes in carbon and nitrogen stable isotope ratios of macrozoobenthos on an artificial tidal flat facing a hypertrophic canal, inner Tokyo Bay.

Temporal changes in benthic food web structure were analyzed in an artificial tidal flat in inner Tokyo Bay, Japan, using carbon and nitrogen stable isotope ratios (δ(13)C and δ(15)N). Microphytobenthos were the most important food sources of macrozoobenthos, due to high microphytobenthic biomass on the tidal flat, while phytoplankton in canal water (canal POMPP), terrestrial materials from urban surface runoff (canal POMTM), and marsh plants were less important. Dietary contribution of microphytobenthos was highest in April to June, while decreased towards December owing to the supply of canal POMPP and canal POMTM following red tides and heavy rainfall events in summer to fall. Temporal changes in δ(15)N (Δδ(15)N) of consumer corresponded well to the (15)N-enrichment in canal POMPP in summer. A meta-analysis showed that the consumer-Δδ(15)N was considerably larger in inner Tokyo Bay than those in other estuaries, which may be a specific characteristic of benthic food web in highly urbanized estuaries.

[Evidence in the treatment of osteoporosis using weekly teriparatide injections].

Parathyroid hormone (PTH) has long been of interest due to its stimulatory effect on bone formation and its potential for osteoporosis treatment. However, accelerated bone resorption associated with increased bone turnover has been reported with daily administration of hPTH (1-34) in animal experiments and clinical studies. Weekly teriparatide [hPTH (1-34) ] administration was promoted in Japan because it did not increase bone resorption. Weekly teriparatide administration delivered superior bone mineral density increases and powerful fracture prevention efficacy without increasing bone turnover in fracture prevention trials and was approved in September 2011. Weekly teriparatide administration is thus expected to greatly contribute to the treatment of high fracture-risk osteoporotic patients.

Loss of glenohumeral internal rotation in little league pitchers: a biomechanical study.

Glenohumeral internal rotation deficit (GIRD) is a significant shoulder problem for throwing athletes. GIRD, however, has not been reported in little league pitchers. The purpose of this study was to investigate GIRD in little leaguers. The range of motion of both shoulders was measured in 25 male little league pitchers. All pitchers underwent motion analyses of their pitching to evaluate shoulder kinematics. GIRD was found in 10 of the 25 pitchers. External rotation in the dominant arm in the GIRD group was not significantly different compared to the contralateral or dominant arm in the non-GIRD group. This biomechanical study showed that the GIRD group had increased external rotation while throwing compared to the non-GIRD group. These findings indicate that GIRD can occur prior to development of the increased external rotation in the dominant arm seen in adult throwers.

Effects of opioid subtypes on detrusor overactivity in rats with cerebral infarction.

AIM: In order to determine the influence of different opioid receptor subtypes on detrusor overactivity after left middle cerebral artery (MCA) occlusion, cystometric recordings were obtained in conscious rats. METHODS: Female Sprague-Dawley rats were used in this study. Control cystometrography was followed by left MCA occlusion. The sham-operated (SO) rats underwent the same procedures except for MCA occlusion. [D-Ala(2), Phe(4), Gly(5)]-enkephalin (DAGO; mu-opioid agonist), [D-Pen(2,5)]-enkephalin (DPDPE; delta1-opioid agonist), deltorpin II (delta2-opioid agonist), and U-50488 (kappa-opioid agonist) were administered intracerebroventricularly at graded doses. The bladder capacity, residual volume, micturition threshold pressure, and bladder contraction pressure were determined. Finally, the volume of the infarction was measured. RESULTS: The intracerebroventricular administration of DAGO and DPDPE significantly increased the bladder capacity in the cerebrally infarcted (CI) and SO rats, but differences in the changes in bladder capacity between the CI and SO rats were not significant. Deltorpin II did not produce any changes in the bladder capacity in the CI or SO rats at any dose examined. However, the intracerebroventricular administration of U-50488 significantly increased the bladder capacity in the CI rats but not in the SO rats. None of the drugs affected the residual volume, micturition threshold pressure or bladder contraction pressure at any dosage examined. The mean infarcted volumes were not significantly different from those in the vehicle-treated rats. CONCLUSION: These results suggest that the opioid receptor subtypes, mu and delta1 in the brain, are related to the micturition reflex. Furthermore, the kappa opioid agonist might be useful for the suppression of detrusor overactivity caused by cerebral infarction.

Computer-aided determination of occlusal contact points for dental 3-D CAD.

Present dental CAD systems enable us to design functional occlusal tooth surfaces which harmonize with the patient's stomatognathic function. In order to avoid occlusal interferences during tooth excursions, currently available systems usually use the patient's functional occlusal impressions for the design of occlusal contact points. Previous interfere-free design, however, has been done on a trial-and-error basis by using visual inspection. To improve this time-consuming procedure, this paper proposes a computer-aided system for assisting in the determination of the occlusal contact points by visualizing the appropriate regions of the opposing surface. The system can designate such regions from data of the opposing occlusal surfaces and their relative movements can be simulated by using a virtual articulator. Experiments for designing the crown of a lower first molar demonstrated that all contact points selected within the designated regions completely satisfied the required contact or separation during tooth excursions, confirming the effectiveness of our computer-aided procedure.

Central muscarinic receptor subtypes regulating voiding in rats.

PURPOSE: Muscarinic receptors are distributed widely in the brain. A recent study revealed that central muscarinic receptors are involved in voiding regulation. However, to our knowledge the role of each muscarinic receptor subtype has not been resolved. Therefore, we evaluated the effect of intracerebroventricular administration of selective muscarinic M1 to M4 receptor antagonists on voiding function in rats. MATERIALS AND METHODS: Female Sprague-Dawley rats were cannulated for intracerebroventricular infusion under halothane anesthesia. In experiment 1 cystometry was performed in conscious rats, and BC and maximal voiding pressure were measured. In experiment 2 a catheter was inserted via the bladder dome to the bladder neck and UPP was measured by saline infusion. Repeat cystostomy was performed, and saline infusion and discharge saline, BC, maximal IVP and minimal UPP were measured in conscious rats. Pirenzepine, methoctramine, pFHHSiD and MT-3 were used as selective M1, M2, M3 and M4 muscarinic receptor antagonists, respectively, which were injected intracerebroventricularly. RESULTS: In experiment 1 pirenzepine and pFHHSiD increased BC and decreased maximal voiding pressure. Methoctramine and MT-3 decreased BC. In experiment 2 pirenzepine and pFHHSiD increased BC and minimal UPP, and decreased maximal IVP. Methoctramine and MT-3 decreased BC and maximal IVP. Minimal UPP remained unchanged. CONCLUSIONS: Intracerebroventricular administration of muscarinic M1 and M3 receptor antagonists inhibited urination in conscious rats, while M2 and M4 receptor antagonists induced excitatory changes.

Use of virtual, interactive, musculoskeletal system (VIMS) in modeling and analysis of shoulder throwing activity.

Our purpose in this study was to apply the virtual, interactive, musculoskeletal system (VIMS) software for modeling and biomechanical analysis of the glenohumeral joint during a baseball pitching activity. The skeletal model was from VIMS library and muscle fiber attachment sites were derived from the visible human dataset. The muscular moment arms and function changes are mainly due to the large humeral motion involved during baseball pitching. The graphic animation of the anatomic system using VIMS software is an effective tool to model and visualize the complex anatomical structure of the shoulder for biomechanical analysis.