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Background and objectives: Para-sports have become increasingly competitive, necessitating greater physical activity; secondary disorder prevention is therefore crucial. Among secondary disorders, the female athlete triad (FAT) is defined as low energy availability (EA), menstrual dysfunction, and low bone mineral density (BMD); although studied in able-bodied athletes, reports on female para-athletes are scarce. We retrospectively investigated the FAT in wheelchair basketball players in the Japanese national team. Materials and Methods: Thirteen female wheelchair basketball players (mean age: 28.9 ± 8.1 years) were enrolled. The medical history (underlying diseases, gynecological disorders, and stress fractures), athletic and sport-specific parameters (wheelchair basketball classification, and wheelchair usage conditions), hematological status (hemoglobin, iron, estradiol, progesterone, total P1NP, and TRACP-5b levels), nutritional status (total energy, protein, calcium, and iron intake), body composition (BMD and lean body mass (LBM)), and EA were assessed. Results: Two (15.4%) had pertinent gynecological histories and six (46.2%) had menstrual cycle disorders. Three (23.1%) experienced excessive menstrual flow and nine (69.2%) had menstrual pain. No stress fractures were reported. All laboratory data were within normal limits. Total energy and iron intakes based on age-specific requirements were 99.8% and 59.8%, respectively. Iron and hemoglobin levels correlated with menstrual flow (ρ = -0.63, p = 0.019 and ρ = -0.56, p = 0.046, respectively). The mean total BMD was 109.2%, and the mean EA (41.4 kcal/kg LBM) was lower than recommended levels. The leg BMD in spinal disorders was significantly lower than that in skeletal disorders (p = 0.003). The arm LBM was higher (150.6%) than that of age-matched controls. Conclusion: Among female wheelchair basketball players with FAT, the total BMD was comparable to that of age-matched controls; however, leg BMD in spinal disorders was significantly lower than that in skeletal disorders. Players with heavy menstrual flow had lower hemoglobin and iron levels. Further research is needed on the FAT to optimize health and sports performance among para-athletes.
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Síndrome da Tríade da Mulher Atleta/diagnóstico , Paratletas , Adulto , Basquetebol/fisiologia , Doenças Ósseas Metabólicas/etiologia , Fadiga/etiologia , Feminino , Síndrome da Tríade da Mulher Atleta/complicações , Humanos , Japão , Distúrbios Menstruais/etiologia , Estudos RetrospectivosRESUMO
Background and objectives: Wheelchair basketball players are classified into four functional classes according to the player's "volume of action", characterized by trunk movement and stability. As this classification is based on a kinematic point of view, test items might be differentially affected by the functional classification level. We aimed to clarify field-based skill test items closely related to the functional classification level. Materials and Methods: Twenty-six female wheelchair basketball athletes (Japan National Team candidates) completed seven field-based skill tests (20 m sprint, agility T-test, figure-eight with a ball test, the Yo-Yo 10 m recovery test, and three types of maximal passes), and anthropometric measurements were applied. Results: Significant differences among the classification levels were found for one-hand maximal passes (baseball and hook passes) and the figure-eight with a ball test. Furthermore, performance in the 20 m sprint and 10 m Yo-Yo recovery tests significantly differed between classes 1 and 4. Conclusions: The test items most influenced by the classification levels were one-hand passes, which require trunk stability and balance not only in the horizontal plane, but also in the sagittal and frontal planes. Coaches should consider which test items are strongly affected by the functional classification level when assessing a player's performance.
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Basquetebol/classificação , Destreza Motora/classificação , Paratletas/classificação , Adulto , Análise de Variância , Basquetebol/estatística & dados numéricos , Teste de Esforço/métodos , Teste de Esforço/estatística & dados numéricos , Feminino , Humanos , Japão , Paratletas/estatística & dados numéricos , Cadeiras de RodasRESUMO
[Purpose] The contributions of male wheelchair basketball players with different capability classifications to the team score at the Rio 2016 Paralympics were evaluated. The roles required for team members belonging to each such classification were determined. [Participants and Methods] Statistics obtained from the official box scores of all 42 games included at the Rio 2016 Paralympics were used in this study. Players who participated for >20 minutes in each game were included in the analysis. Players were divided into 3 groups (low, middle, and high) based on their capability classification. The mean statistical data related to each group were compared, and the covariance structure was analyzed to determine the role of each player group. [Results] Many statistical values were higher in players belonging to the high group. In the high group, the relevant variables were field goals scored, field goals attempted, assists, and turnovers. In the low group, the relevant variables were field goals scored, steals, and turnovers. [Conclusion] Many plays related to the ball depended on the high group. High-group players are required to demonstrate strong scoring ability and to reduce turnovers. Conversely, low-group players should increase the numbers of field goals made, increase steals, and reduce turnovers.
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[Purpose] This study clarified differences in players' contributions to the team's score in female wheelchair basketball at the 2016 Rio Paralympics by physical capacity classification, and examined the roles required in the team. [Subjects and Methods] This study used stats (record of play contents) for players who played for more than 20 minutes from the official box scores of all 31 games at the 2016 Paralympics. Players were divided into three groups by physical capacity classification: low, middle, and high. The average stats for each group were compared and the covariance structure was analyzed to determine the role of each group during the game. [Results] Comparisons showed that the higher the class, the higher the value of many stats items. Important elements were defensive rebound, steal, and turnover in the low group; and score, offensive rebound, and turnover in the high group. [Conclusion] Players in the high group have more plays related to the ball. Those in the low group should increase the numbers of steals and defensive rebounds and reduce turnover. High group players are required to have scoring ability, acquire offensive rebound, and reduce turnover.
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[Purpose] Sufficient sleep is required for maximal performance and good mood. Japan has three national wheelchair basketball teams: Top male, Top female, and Under-23 (U23) male teams. Using these team members as model, this study investigated the difference of sleep status of wheelchair basketball players by age and gender. [Subjects and Methods] There were 44 participants: 14 in the Top male team (29.5 ± 5.2â years), 18 in the Top female team (30.6 ± 9.2â years), and 12 in the U23 team (19.1 ± 2.0â years). Sleep status was assessed with the Pittsburgh Sleep Quality Index (PSQI); higher scores indicate poor sleep quality. [Results] PSQI scores in the Top male and female teams were higher than in the U23 team. The Top teams showed shorter sleep duration and worse sleep efficacy than the U23 team. Time spent in bed and sleep duration in the female team were shorter than in the Top male and U23 teams. More male players reported "feel too hot" as the reason for sleep disturbance than female players. [Conclusion] Players in the Top Japanese national wheelchair basketball teams had poorer sleep status than U23 players. Among female players, the reason for insomnia was less sleep duration. For males, the reason for insomnia was "feel too hot."
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This study examined the influence of immobilization on chondrocyte apoptosis and histological features of the anterior cruciate ligament (ACL) insertion and knee articular cartilage in rabbits. Forty-eight male Japanese white rabbits were assigned to an immobilization (n = 24) or sham (n = 24) group. Rabbits in the immobilization group underwent complete unilateral surgical knee immobilization and rabbits in the sham group underwent a sham surgery. The average thickness of the glycosaminoglycan (GAG) stained red area by safranin O staining, the chondrocyte apoptosis rate and the chondrocyte proliferation rate in the cartilage layer in the ACL insertion and the articular cartilage of the medial tibial condyle were measured at one, two, four and eight weeks in six animals from each group. In the ACL insertion, the chondrocyte apoptosis rate was higher in the immobilization group than in the sham group at two and eight weeks after surgery (p < 0.05). The chondrocyte proliferation rate gradually decreased from two weeks to eight weeks in the immobilization group. The GAG layer was thinner in the immobilization group than in the sham group at two, four and eight weeks after surgery (p < 0.05). In the articular cartilage, the chondrocyte apoptosis rate in the immobilization group was higher than in the sham group at four and eight weeks after surgery (p < 0.05). The GAG layer was significantly thinner in the immobilization group than that in the sham group at four and eight weeks after surgery (p < 0.05). Knee immobilization significantly increased chondrocyte apoptosis at two and eight weeks after surgery in the ACL insertion and at four and eight weeks after surgery in the articular cartilage of the medial tibial condyle, and decreased GAG layer thickness from two to eight weeks after surgery in the ACL insertion and from four to eight weeks after surgery in the articular cartilage.
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Ligamento Cruzado Anterior/patologia , Apoptose , Cartilagem Articular/patologia , Condrócitos/patologia , Imobilização , Articulação do Joelho/patologia , Animais , Ligamento Cruzado Anterior/cirurgia , Cartilagem Articular/cirurgia , Glicosaminoglicanos/metabolismo , Marcação In Situ das Extremidades Cortadas , Masculino , Antígeno Nuclear de Célula em Proliferação/metabolismo , Coelhos , Coloração e Rotulagem , Tíbia/patologiaRESUMO
[Purpose] Although some studies suggest the importance of getting adequate sleep for enhancing mood, there is not yet sufficient evidence on the relationship between sleep and mood states in athletes, especially for athletes with physical disability. The purpose of this study is to reveal relationships between sleep and psychological mood states in female wheelchair basketball players. [Subjects and Methods] Seventeen female wheelchair basketball players (30.9 ± 9.4â years old) on a Japanese national team participated. Sleep states were assessed with the Pittsburgh Sleep Quality Index (PSQI), and mood states with the Japanese version of the Profile of Mood States short form (POMS-SF). Spearman's rank correlations were computed. [Results] The mean PSQI score was 5.4 ± 2.6 points, and 9 athletes (52.9%) exceeded the cutoff point (5.5) for insomnia. Higher sleep efficiency (rS=0.58), fewer sleep disturbances (rS=-0.58), and lower total PSQI score (rS=-0.51) were significantly correlated with higher vigor. Lower likelihood of daytime dysfunction was also significantly correlated with lower tension (rS=0.50). [Conclusion] Vigor was the mood state most frequently correlated with sleep variables. Because vigor is a known key psychological factor in optimal performance, the findings are valuable for wheelchair basketball players.
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The purpose of this study was to examine the histological changes at the patella tendon (PT) insertion site under gradual elongation in rabbits. Gradual elongation of the PT was performed using external fixation for 4 weeks, with a lengthening speed of 0.5 mm/day (elongation group; n = 24). Rabbits in the sham group underwent the same surgical procedure without gradual elongation (sham group; n = 24). Eight animals were sacrificed 1, 2 and 4 weeks after surgery in each group, respectively. Average thicknesses of stained glycosaminoglycan (GAGs) areas by Safranin-O staining in the total cartilage layer and the uncalcified fibrocartilage layer in the elongation group were significantly higher than that in the sham group at 4 weeks (p < 0.05) and that in the intact PT group (n = 6, p < 0.05). In the elongation group, the peak in the average thicknesses of the stained GAGs areas in the total cartilage layer and the uncalcified fibrocartilage layer were observed at 4 weeks. Gradual elongation of PT insertion significantly affected the increase in the average thicknesses of the stained GAGs areas in the cartilage layer especially in the uncalcified fibrocartilage layer at 4 weeks in rabbits. Clinically, insertions of tendon and ligament can extend during gradual elongation using external fixation more than 4 weeks after the operation.
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Ligamento Patelar/cirurgia , Animais , Apoptose/fisiologia , Proliferação de Células , Condrócitos/citologia , Glicosaminoglicanos/metabolismo , Masculino , Ligamento Patelar/metabolismo , CoelhosRESUMO
BACKGROUND: Among injuries in wheelchair athletes, shoulder injury is the most common. An easy and valid assessment tool is required to monitor the shoulder status in wheelchair athletes anytime. The present study aimed to investigate the association of wheelchair user's shoulder pain index (WUSPI) with physical examinations for tendinitis in the long head of the biceps tendon (LHBT) and range of motion (ROM) of shoulder movements among female wheelchair basketball players from the Japanese national team. METHODS: A total of 21 female players (mean age, 32.0 ± 7.9 years) participated in this study. LHBT tendinitis was assessed using findings of tenderness in the bicipital groove point (TBGP) and speed test. Shoulder ROMs were evaluated in three movements-namely, abduction, flexion, and extension. RESULTS: The mean total WUSPI score was 9.55 ± 13.35 points. The players were more likely to experience shoulder pain during activities related to wheelchair pushing and object lifting. A higher total WUSPI score was strongly and moderately associated with positive findings of TBGP (effect size r = 0.82) and speed test (r = 0.49), respectively. Furthermore, the total WUSPI score was significantly associated with limited ROM in shoulder abduction (r = 0.47) and flexion (r = 0.43). Receiver operating characteristic analysis showed that the total WUSPI score had a significant area under the curve (AUC) for positive findings of TBGP (AUC = 0.98), speed test (AUC = 0.83), and limited ROM in abduction (AUC = 0.84). When optimal cut-points were set by the Youden index, total WUSPI scores of 4.1 points (sensitivity = 1.00, specificity = 0.92), 11.3 points (sensitivity = 0.80, specificity = 0.81), and 3.3 points (sensitivity = 1.00, specificity = 0.65) were recommended for screening positive findings of TBGP, speed test, and limited ROM in abduction, respectively. CONCLUSION: TBGP, which is a major finding of LHBT tendinitis, was strongly associated with the total WUSPI score in physical examinations. Hence, pain assessed by WUSPI could reflect the presence of LHBT tendinitis. The WUSPI is a superior tool for monitoring the shoulder status of wheelchair basketball players.
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BACKGROUND: Fitting a stump prosthesis is difficult in transhumeral amputees because of the stump's conical form. Shoulder harnesses for suspension can cause neck and shoulder pain. We developed a novel spiral socket transhumeral prosthesis to overcome these difficulties. We investigated its safety and effects in transhumeral amputees. CASE REPORT: Five transhumeral amputees with a mean age of 50.8±23.8 (range, 19-75 years) were fitted with the spiral socket between April 2013 and February 2017. Spiral sockets can adapt to changes in the shape of the stump, even in early stages when stump shape can change. It can also adapt to an hourglass-shaped stump. CLINICAL REHABILITATION IMPACT: The novel spiral socket transhumeral prosthesis might be useful for socket-stump adaptation at various stages after amputation. It may also be used for irregularly shaped stumps and can possibly prevent secondary complications, including neck and shoulder pain and skin disorders.
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Cotos de Amputação , Amputação Cirúrgica/reabilitação , Amputados/reabilitação , Desenho de Prótese/métodos , Adulto , Idoso , Membros Artificiais , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ajuste de Prótese , Suporte de Carga , Adulto JovemRESUMO
BACKGROUND: The Hybrid Assistive Limb (HAL®) is an exoskeleton wearable robot suit that assists in voluntary control of knee and hip joint motion. There have been several studies on HAL intervention effects in stroke, spinal cord injury, and cerebral palsy. However, no study has investigated HAL intervention for patients with cerebral palsy after surgery. CASE PRESENTATION: We report a case of using HAL in a postoperative patient with cerebral palsy. A 15-year-old boy was diagnosed with spastic diplegia cerebral palsy Gross Motor Function Classification System level IV, with knee flection contracture, equinus foot, and paralysis of the right upper extremity with adduction contracture. He underwent tendon lengthening of the bilateral hamstrings and Achilles tendons. Although the flexion contractures of the bilateral knees and equinus foot improved, muscle strength decreased after the soft tissue surgery. HAL intervention was performed twice during postoperative months 10 and 11. Walking speed, stride, and cadence were increased after HAL intervention. Post HAL intervention, extension angles of the knee in stance phase and hip in the pre-swing phase were improved. In the gait cycle, the proportion of terminal stance in the stance and swing phase was increased. CONCLUSIONS: Hybrid Assistive Limb intervention for postoperative patients with cerebral palsy whose muscle strength decreases can enhance improvement in walking ability. Further studies are needed to examine the safety and potential application of HAL in this setting.
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Paralisia Cerebral/reabilitação , Paralisia Cerebral/cirurgia , Exoesqueleto Energizado , Terapia Passiva Contínua de Movimento/métodos , Adolescente , Fenômenos Biomecânicos , Paralisia Cerebral/fisiopatologia , Humanos , Joelho/fisiopatologia , Masculino , Terapia Passiva Contínua de Movimento/instrumentação , Músculo Esquelético/fisiopatologia , Cuidados Pós-Operatórios/métodos , Caminhada/fisiologiaRESUMO
Objective: Postoperative knee range of motion (ROM) is among the most important factors influencing patient satisfaction after total knee arthroplasty (TKA). The purpose of this study was to clarify the time course of improvement in knee ROM up to 12 months after TKA, including intraoperative knee ROM after implantation, and to clarify a target ROM for rehabilitation after TKA. Patients and Methods: In total, 39 knee joints in 26 patients with osteoarthritis who underwent TKA (retaining the posterior cruciate ligament) were evaluated. Goniometry was used to measure the knee range of extension and flexion preoperatively; intraoperatively; at 1 and 2 weeks after TKA; and then at 1, 3, 6, and 12 months after TKA. Results: The postoperative extension range gradually improved up to a maximum at 6 months after TKA; there were no significant differences in the extension range between intraoperative and 6 months after TKA, intraoperative and 12 months after TKA, or 6 and 12 months after TKA. The postoperative flexion range gradually improved, with the maximum improvement observed at 3 months after TKA; there were no significant differences in the flexion range before TKA and 3, 6, and 12 months after TKA. There were no significant differences between flexion ROM measured at 3, 6, and 12 months after TKA. Conclusions: The changes in the knee range of extension plateaued 6 months after TKA, and those in the knee range of flexion plateaued 3 months after TKA. The target range of extension for rehabilitation from 6 months to 12 months after TKA was the intraoperative range, and the target range of flexion for rehabilitation from 3 months to 12 months after TKA was the preoperative range.
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Objectives: To investigate the details of patients' status on admission and at discharge at our hospital, to compare the ambulatory group and non-ambulatory group at discharge, and to assess the factors associated with ambulatory ability at discharge in patients aged ≥ 90 years with proximal femoral fractures (PFFs). Patients/Materials and Methods: Twenty patients admitted to our hospital for rehabilitation after surgery for a PFF were evaluated retrospectively. The rate of regaining ambulatory ability, presence of dementia, body mass index, serum albumin level, hemoglobin level, lymphocyte count, and functional independence measure (FIM) were assessed on admission and at discharge. Relationships between patients' ambulatory ability and ambulatory parameters were compared between the ambulatory and non-ambulatory groups. Results: The rate of regaining ambulatory ability was 55% at discharge. The serum albumin level at discharge was significantly higher in the ambulatory group than that in the non-ambulatory group. More patients had dementia on admission in the non-ambulatory group than in the ambulatory group. On admission, scores for the cognitive items of the FIM ("expression" and "memory") were significantly higher in the ambulatory group than those in the non-ambulatory group. Conclusions: The rate of ambulatory ability at discharge was 55% in those with a PFF, who were aged ≥ 90 years. The presence of dementia on admission and serum albumin level at discharge were factors related to ambulatory ability. It is very important to use a general rehabilitation protocol that takes cognitive function and nourishment into account, in addition to the physical aspect.
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Objectives: This study was performed to elucidate the characteristics of amputees in our hospital. We also evaluated whether the causes and characteristics of the amputations influenced the patients' prosthetic walking ability. Materials and Methods: We retrospectively examined 47 amputees in our hospital from December 1996 to April 2016 with respect to the causes and levels of amputation. Of 28 lower limb amputees from April 2008 to April 2016, 22 received prostheses and were divided into 2 groups according to the cause of the amputation, as follows: the internal cause group (e.g., vascular deficiency and infection) and the external cause group (e.g., trauma, burn injury, and crush syndrome). The characteristics and process of achieving prosthetic ambulation were compared between these groups. Results: Trauma was the most common cause of both upper (70.0%) and lower limb amputations (40.5%). Unilateral amputation was performed in 93.2% of patients (upper limb amputation, 100.0%; lower limb amputation, 91.9%). Patients were older in the internal than in the external cause group (P = 0.026). The serum albumin (P = 0.003) and total cholesterol concentrations (P = 0.046) on admission were significantly lower in the internal than in the external cause group. All patients in the internal cause group had comorbidities. The proportions of patients with diabetes mellitus (P = 0.011) and cerebrovascular disease (P=0.036) were significantly higher in the internal than in the external cause group. No significant difference in walking ability was found between the internal and external cause groups at the time of discharge. Conclusion: Most amputees in our hospital underwent unilateral lower limb amputation due to trauma. Although the patients with internal causes of amputation were older, more frequently had malnutrition, and had more comorbidities than those with external causes, they achieved prosthetic walking with statistically insignificant difference at the end of hospitalization, excluding six patients who had no prosthetic prescription.
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OBJECTIVE: To investigate deep tissue injuries (DTIs) in elite female wheelchair basketball players and identify factors associated with their occurrence. METHODS: Study participants were 22 female wheelchair basketball players on the Japanese national team. The sacral and bilateral ischial regions of each participant were examined using ultrasonography to detect DTIs. RESULTS: DTIs were found in 15 players (68.2%). DTIs were more frequent in players with a central nervous system disorder (CNSd) (85.7%) than in those with skeletal system disease (SSd) (37.5%, p = 0.020), and in players using a wheelchair in daily life (84.6%) than those using a wheelchair only for basketball (44.4%, p = 0.046). Players with pelvic instability were more likely to have DTIs (90.9% vs. 45.5%, p = 0.017). DTIs were deeper in the ischial region than the sacral region (p = 0.022). Players with CNSd had more DTIs in sacral regions (90% vs. 10%, p = 0.014). Players with DTIs had lower systolic blood pressure (sBP), red blood cell (RBC) count, and serum creatinine levels (sCr) (all p < 0.05). CONCLUSIONS: Ischial DTIs were deeper than sacral DTIs. Players with CNSd had more sacral DTIs than those with SSd. CNSd, wheelchair use in daily life, pelvic instability, and lower sBP, RBC, and sCr increased the risk of DTIs.
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Traumatismos em Atletas/epidemiologia , Basquetebol/lesões , Úlcera por Pressão/epidemiologia , Esportes para Pessoas com Deficiência , Adulto , Traumatismos em Atletas/diagnóstico por imagem , Feminino , Humanos , Japão/epidemiologia , Úlcera por Pressão/diagnóstico por imagem , Inquéritos e Questionários , Ultrassonografia , Cadeiras de Rodas , Adulto JovemRESUMO
BACKGROUND: To overcome the challenges of rehabilitation of bilateral transfemoral amputees, we developed a novel "hip prosthesis in the sitting posture." Case Description and Methods: A 64-year-old male bilateral transfemoral amputee was transferred for rehabilitation 4 months following a burn injury. His wounds remained unhealed for 20 months; thus, he was unable to participate in standing training with the standard prosthetic sockets. Hip prosthesis in the sitting posture has very little friction between the sockets and residual limbs, which facilitated our patient to begin standing and walking exercises. Findings and Outcomes: The patient's refractory wounds healed 1 month after initiating exercises using hip prosthesis in the sitting posture, and he could begin rehabilitation with the standard prostheses. DISCUSSION AND CONCLUSION: Hip prosthesis in the sitting posture enabled a bilateral transfemoral amputee with unhealed residual limbs to stand, walk, and begin balance training. Hip prosthesis in the sitting posture is an effective temporary prosthesis to prevent disuse until wounds are healed and to continue rehabilitation with standard prostheses. Clinical relevance Hip prosthesis in the sitting posture is useful for bilateral transfemoral amputees with unhealed residual limbs after burn injuries to prevent disuse and maintain motivation for walking.
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Amputação Cirúrgica/métodos , Artroplastia de Quadril/métodos , Membros Artificiais , Queimaduras/complicações , Articulação do Quadril/cirurgia , Posicionamento do Paciente/métodos , Amputação Cirúrgica/reabilitação , Fêmur/cirurgia , Seguimentos , Articulação do Quadril/fisiopatologia , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Postura , Medição de Risco , Resultado do Tratamento , Caminhada/fisiologiaRESUMO
The catechins in green tea have antioxidative and antimutagenic effects. We examined the effect of green tea enriched with catechins on the presence of mitochondrial DNA (mtDNA) with a common 4977-bp deletion mutation (mtDNA4977) in human leucocytes. Ten healthy females [aged 20.80 +/- 1.03 years] drank 350 ml of catechin-rich tea daily after supper for 5 weeks. Blood samples were collected twice before, and twice after 5 weeks of consuming the tea. Deletions in mtDNA were analyzed using the nested polymerase chain reaction (PCR). We identified a common mtDNA4977 deletion in nine participants before drinking the tea. However, this mtDNA4977 deletion was not evident in leucocytes from most of the participants 5 weeks after drinking the tea. Catechins found in tea might contribute to the maintenance of health status by reducing damage to mtDNA and by maintaining the capacity of mtDNA for oxidative phosphorylation.
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Pareamento de Bases/genética , Catequina/farmacologia , DNA Mitocondrial/genética , Leucócitos/efeitos dos fármacos , Deleção de Sequência/efeitos dos fármacos , Chá/química , Adulto , Feminino , Humanos , Leucócitos/metabolismo , Deleção de Sequência/genéticaRESUMO
BACKGROUND: The knee joint movement during the stance phase is affected by altered ankle movement and the center of pressure (COP). However the relationships between changes in the center of pressure (COP) and the altered kinematics and kinetics of the ankle and knee joints in patients with osteoarthritis (OA) of the knee are not well understood. The purpose of this study was to determine the relationships between changes in the COP and the altered kinematic and kinetic variables in ankle and knee joints during the stance phase in patients with medial knee OA. METHODS: Fourteen patients with knee OA (21 knees) and healthy subjects were assessed by gait analysis using an eight-camera motion analysis system to record forward and lateral shifts in the COP and the angle and net internal moments of the knee and ankle joint. Spearman rank-correlation coefficients were used to determine the relationship between these results. RESULTS: In knees with medial OA, lateral shifts in the COP were correlated with knee flexion angle. Lateral shifts in the COP were correlated with the second peak of the knee extensor moment and correlated with the knee abductor moment. CONCLUSIONS: In patients with medial knee OA, lateral shifts in the COP were negatively correlated with the kinematic and kinetic variables in the sagittal plane of the knee joints. Controlling such lateral shifts in the COP may thus be an effective intervention for mechanical loads on the knee during the stance phase in patients with knee OA.
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Articulação do Tornozelo/diagnóstico por imagem , Marcha/fisiologia , Genu Varum/diagnóstico por imagem , Articulação do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Articulação do Tornozelo/fisiopatologia , Fenômenos Biomecânicos , Feminino , Genu Varum/fisiopatologia , Humanos , Articulação do Joelho/fisiopatologia , Masculino , Movimento/fisiologia , Osteoartrite do Joelho/fisiopatologia , Pressão , Amplitude de Movimento Articular , Análise e Desempenho de TarefasRESUMO
OBJECTIVE: To reveal correlates of shoulder pain in wheelchair basketball players from the Japanese national team. METHODS: Study participants were 19 males (29.7 ± 5.2 years) and 21 females (29.0 ± 8.2 years) players. We assessed shoulder pain using the wheelchair user's shoulder pain index (WUSPI). As potential correlates of shoulder pain, age, ability class, practice time and years of experience in wheelchair basketball were collected. RESULTS: The total WUSPI score for men (16.18 ± 17.39 points) was significantly higher than that for women (8.62 ± 15.70 points). In men, higher age was significantly correlated with greater shoulder pain for total WUSPI score and on two WUSPI items. Lower ability in wheelchair basketball was correlated with men's greater shoulder pain on three WUSPI items. In men, there were also significant correlations between longer years of experience and greater shoulder pain for total WUSPI score and on three WUSPI items. For women, there were significant correlations between longer practice time and less pain for total WUSPI score and on four WUSPI items. CONCLUSIONS: Because top male wheelchair basketball players have a higher risk of shoulder pain than female players, daily care of shoulder and periodic medical checkups are needed, especially for older male players with lower ability and more experience.