Effect of degree of knee osteoarthritis on balancing capacity after sudden perturbation

This study aimed to assess equilibrium ability after sudden perturbation in patients with moderate and severe unilateral knee osteoarthritis (OA), with regard to age, gender, and lateral dominance. Our clinical trial included 45 female and 45 male healthy elderly subjects, 24 female and 24 male patients with moderate OA (mOA), and 24 female and 24 male patients with severe OA (sOA). Subjects were divided in two age groups: 65-69 and 70-74years. Using an oscillatory platform, we conducted provocation tests and determined the Lehr's damping ratio (D), which represents balancing capacity after sudden perturbation. D values determined for standing on both legs were similar to those of healthy individuals on the dominant limb or for OA patients on the non-affected limb; they were significantly lower for healthy individuals on the non-dominant limb and OA patients on the affected limb. For healthy subjects and mOA patients, D was significantly decreased with age and influenced by gender. sOA patients presented lower D values than other groups under all conditions, which were not influenced by age or gender. Our results demonstrate that OA patients were less capable of responding to perturbations, possibly indicating that they have an increased risk of falling.     

Structural changes of hip osteoarthritis using magnetic resonance imaging

Introduction

Few data are available concerning structural changes at the hip observed by magnetic resonance imaging (MRI) in people with or without hip osteoarthritis (OA). The aim of this study was to compare cartilage volume and the presence of cartilage defects and bone marrow lesions (BMLs) in participants with and without diagnosed hip OA.

Methods

Femoral head cartilage volume was measured by MRI for 141 community-based persons with no diagnosed hip OA, and 19 with diagnosed hip OA. Cartilage defects and BMLs were regionally scored at the femoral head and acetabulum.

Results

Compared with those without diagnosed hip OA, people with diagnosed hip OA had less femoral head cartilage volume (1763 mm³ versus 3343 mm³; p <0.001) and more prevalent cartilage defects and BMLs (all p ≤0.05) at all sites other than the central inferomedial region of the femoral head. In those with no diagnosed hip OA, cartilage defects in the anterior and central superolateral region of the femoral head were associated with reduced femoral head cartilage volume (all p ≤0.02). Central superolateral BMLs at all sites were associated with reduced femoral head cartilage volume (all p ≤0.003), with a similar trend occurring when BMLs were located in the anterior region of the hip (all p ≤0.08).

Conclusions

Compared with community-based adults with no diagnosed hip OA, people with diagnosed hip OA have less femoral head cartilage volume and a higher prevalence of cartilage defects and BMLs. For people with no diagnosed hip OA, femoral head cartilage volume was reduced where cartilage defects and/or BMLs were present in the anterior and central superolateral regions of the hip joint. Cartilage defects and BMLs present in the anterior and central superolateral regions may represent early structural damage in the pathogenesis of hip OA.     

Individual differences in the ability to discriminate the direction of spontaneous changes in peripheral finger temperature

Spontaneous fluctuations of .1° C in peripheral finger temperature were recorded for a 30-minute baseline period in 10 subjects. Those meeting specified criteria of temperature fluctuations were then asked to judge the direction of change in computer-detected temperature fluctuations of .1° C, first without feedback, then with feedback (knowledge of results). Only 1 subject produced convincing evidence of ability to make directional judgments at better than chance level, though more training with feedback might have benefited other subjects. The theoretical significance of these results for the relationship between discrimination and voluntary control is discussed.This research was supported by a grant from the Australian Research Grants Scheme.     

Effect of walking speed and severity of hip osteoarthritis on gait variability

Gait analysis in orthopaedic and neurological examinations is important; however, few studies assess gait variability at different walking speeds in patients with varying degrees of hip osteoarthritis. We aimed to clarify (1) how different controlled speeds and (2) various severities of hip osteoarthritis influence gait variability. Gait variability was described by the standard deviation (SD) of the spatial–temporal and mean standard deviation (MeanSD) of angular parameters. The spatial positions of the anatomical points for calculating gait parameters were determined in 20 healthy elderly controls and 20 patients with moderate and 20 patients with severe hip osteoarthritis with a zebris CMS-HS ultrasound-based motion analysis system at three walking speeds. The SD of the spatial–temporal and MeanSD of angular parameters of gait, which together describe gait variability, significantly depended on speed and osteoarthritis severity. The lowest variability in the gait was found near the self-selected walking speeds. Hip joint degeneration significantly worsened variability on the affected side, with non-affected joints and the pelvis compensating by increasing flexibility and adapting to step-by-step motions. Particular attention must be paid to improving gait stability and the reliability of limb movements in the presence of and increasing severity of osteoarthritis.     

切断海马伞对大鼠硬性脑挫伤后运动行为恢复的影响

硬性挫伤运动皮层诱发大鼠偏瘫及其随后的行为代偿是研究中枢神经可塑性的一个理想模型。本工作观察了切断海马伞对脑挫伤后行为恢复的影响。结果表明：与对照组相比,(1)切断海马伞—穹隆通路明显延缓了大鼠运动平衡能力的恢复;(2)切断海马伞—穹隆通路后,银杏类黄酮(FGb)失去了促进脑挫伤后运动平衡能力恢复的作用;(3)原位杂交显示,脑损伤后海马DG(齿状回)和CA3区中生长相关蛋白(GAP—43)mRNA的水平明显提高;(4)FGb促进脑损伤后海马DG和CA3区中的GAP—43mRNA水平的上调。这些信息提示,海马参与脑硬性挫伤后的运动代偿,FGb促进脑损伤后的运动行为的恢复可能与海马相关[动物学报49(2)：211-217,2003]。     

Impact of the method of exposure in total hip arthroplasty on balancing ability in response to sudden unidirectional perturbation in the first six months of the postoperative period

Introduction and objectiveTotal hip arthroplasty affects 3–5% of the elderly population. Therefore, the effectiveness of surgery and the ensuing rehabilitation is of great significance. This study investigated balancing ability in response to sudden unidirectional perturbation changes during the first 6 months of the postoperative period with respect to different methods of joint exposure during the operation (antero-lateral, direct-lateral and posterior to preserve the joint capsule). Our hypothesis is that the results may provide a tool to improve the rehabilitation procedures.Materials and methodsThe dynamic balancing ability of 25 patients with direct-lateral exposure, 22 with antero-lateral exposure and 25 with posterior exposure during a total hip arthroplasty was examined using ultrasound-based provocation tests prior to and at 6 weeks, 12 weeks and 6 months after total hip arthroplasty. The control group was represented by 45 healthy subjects of identical age. The dynamic balancing ability after unidirectional perturbation was characterised by Lehr’s damping ratio calculated from the results of tests performed with the patient standing on both limbs, standing on the affected limb and standing on the non-affected limb.ResultsIn the case of direct-lateral and antero-lateral exposure, Lehr’s damping ratio significantly decreased compared to the preoperative values at 6 weeks postoperatively, but it increased steadily afterwards. Lehr’s damping ratio while standing on the affected limb was significantly lower – even at 6 months postoperatively – than that of the control group. In the case of posterior exposure, Lehr’s damping ratio continuously increased in the postoperative period and corresponded to that of the control group at 6 months after total hip arthroplasty.Discussion and conclusionFor patients operated on using direct-lateral and antero-lateral exposure methods, the dynamic balancing ability continuously improved in the first 6 months of the postoperative period, but the dynamic balancing ability of the affected limb differed from that of the control group. In the case of posterior exposure to preserve the joint capsule the dynamic balancing ability evaluated a more rapidly compared to the other two exposure methods. There was no significant difference in the balancing ability of the control group at 6 months after total hip arthroplasty with posterior exposure. The increasing range of joint motion, muscle development, and the development of the dynamic balancing ability should be taken into account when compiling rehabilitation protocols. Differences related to the method of exposure should be considered when developing the dynamic balancing ability and abandoning therapeutic aids.     

Jumping ability is related to change of direction ability in elite handball players

PurposeThis study investigated the relationship between vertical and horizontal jumping ability and change of direction (COD) to measure athletic performance in 51 elite male handball players.Scope.Countermovement jump (CMJ), peak power, and standing long jump (SLJ) were measured. Participants performed a 20-m sprint test (time measured at 5, 10, and 20 m) and a zigzag test (COD: 135°, 90°, and 45°). The COD deficit, an index of the time required for COD, was calculated. The correlations between CMJ height and zigzag test times were relatively large (at 135°, r =  − 0.607; at 90°, r =  − 0.594; at 45°, r =  − 0.613; p < 0.01), whereas those between CMJ height and COD deficit were moderate (at 135°, r =  − 0.399, p < 0.01; at 90°, r =  − 0.350, p < 0.05; at 45°, r =  − 0.323, p < 0.05). SLJ showed a negative moderate correlation with COD deficit (at 135°, r =  − 0.439, p < 0.01; at 90°, r =  − 0.469, p < 0.01; at 45°, r =  − 0.380, p < 0.01).ConclusionsThis study is the first to analyse SLJ ability and COD deficit parameters of handball players. We found that SLJ ability is moderately related to COD time and deficit; therefore, SLJ measurement may be a useful predictor of athletic performance.     

基于近红外光出射分布特性的膝骨性关节炎病程检测

膝骨性关节炎是中老年人群中常见的慢性、不可逆关节疾病。为了解决常规的CT扫描、核磁共振成像等检测手段存在的辐射影响较大,无法作为常规体检项目,以及无法检测出早期膝关节内部组织病变等缺点,本文提出了一种基于近红外光的无损、快速病程检测手段,结合临床膝关节CT图片用蒙特卡洛方法模拟红外光子在关节内部的运动轨迹,通过高斯函数分析和拟合不同病程下的出射光子分布特征,以有效光子出射率和拟合函数对称轴位置作为指标判定患者病情。该方法的优点在于,对人体不造成任何辐射损害,且能够通过计算机数据分析快速给出判定结果,可作为常规体检项目,便于发现早期病症并及时治疗。仿真实验结果表明该方法的准确率达到92%以上,在膝骨性关节炎的临床检测应用上具有较大的应用价值。     

Effect of amizil and the ACTH4-10 fragment on the ability of mice to extrapolate the direction of movement

Mice possessing the ability to extrapolate the direction of movement (100% of correct choices) were injected i.p. with different doses of m-cholinolytic amizil 2 hours before experiment. Doses of 2-5 mg/kg reduced the percentage of correct choices, the adequate solving strategy being replaced by stereotyped unidirectional reactions or stereotyped alternating responses. Doses of 8-12 mg/kg induced "refusals" to solve extrapolation problem. When amizil treated mice were intraventricularly injected with 1 mg/kg of ACTH4-10, their extrapolation ability was restored. This compensatory action of peptide could be mediated by its influence on cholinergic as well as on other neurotransmitter systems.     

Effect of obesity on inpatient rehabilitation outcomes after total hip arthroplasty

Objective: This study examined whether obesity affected inpatient rehabilitation outcomes after total hip arthroplasty (THA). Research Methods and Procedures: This was a retrospective, comparative study conducted using a computerized medical database derived from THA patients at a university‐affiliated rehabilitation hospital (data from 2002 to 2005). Patients were divided into four brackets based on BMI: non‐obese (<25 kg/m²), overweight (25 to 29.9 kg/m²), moderate obesity (30 to 39.9 kg/m²), and severe obesity (≥40 kg/m²). All patients completed an interdisciplinary inpatient rehabilitation program after THA. Functional independence measure (FIM) scores, length of stay (LOS), FIM efficiency scores (FIM/LOS), hospital charges, and discharge disposition location were collected. Results: FIM scores improved from admission to discharge similarly in all groups (25 to 29.5 points). However, FIM efficiency, LOS, and total charges were curvilinearly related with BMI (all p < 0.05). Total hospital charges were highest in the severely obese group compared with the overweight group (p < 0.05). Non‐homebound discharge disposition rates were lower in non‐obese (13.1%) and severely obese groups (10.5%). Discussion: Elevated BMI does not prevent FIM gains in THA patients during inpatient rehabilitation. However, BMI is related with FIM efficiency, LOS, and hospital charges in a curvilinear fashion. Severely obese patients can achieve physical improvements but at a lower efficiency and greater cost.     

Primary osteoarthritis of the hip in monozygotic and dizygotic male twins.

Population and total hip replacement surveys show that primary osteoarthritis of the hip is uncommon in African Americans and rare in Asians, suggesting a genetic basis for this disease. We studied genetic influences on primary osteoarthritis of the hip by estimating monozygotic (MZ) and dizygotic (DZ) twin correlations using a two-stage data collection. A total of 6419 male veteran twins of the NAS-NRC Twin Registry, born between 1917 and 1927, were contacted by telephone (first stage). Telephone interview determined that 2% reported a total hip replacement for arthritis rather than fracture. X-rays of twin pairs in which one twin had undergone total hip replacement were sought and reviewed (second stage), and concordance for primary arthritis was determined based on x-ray diagnosis. Heritability of primary osteoarthritis, Kellgren & Lawrence Grade II and higher, was estimated using a covariance structure analysis for 2-stage data. The best-fitting model included only components for additive genetics and for unique environment. Additive genetics accounted for 53% (95% confidence interval 30-72%) in the liability for self reported hip replacement surgery and unique environment for the remaining 47% (95% confidence interval 28-70%). Additive genetics accounted for 61% (95% confidence interval 18-86%) of the variance in liability for x-ray determined primary osteoarthritis with unique environment accounting for the remaining 39%. These data establish a genetic influence on primary osteoarthritis of the hip in male twins and suggest that further work is indicated to isolate the genes responsible for this disease.     

Intraspecific variation in the direction and degree of sex-biased dispersal among sea-snake populations

Higher rates of dispersal in one sex than the other are widespread, and often attributed to the genetic advantages of reduced inbreeding. The direction of sex-biased dispersal shows strong phylogenetic conservatism (e.g. males disperse more than females in most mammals, but the reverse is true in most birds). By contrast, our genetic data reveal strong inter-population variation in the relative dispersal rates of two species of sea snakes (Laticauda saintgironsi and L. laticaudata) in the Noumea Lagoon of New Caledonia. Assignment methods using microsatellite data identified parallel variation in sex-specific dispersal in both species: dispersal was female-biased in the north-west of the sampling area (in islands far from the main island), but male-biased in the south-east (in islands closer to the main island). This flexibility may reflect sex differences in diets, with spatial variation in sex-specific resources generating spatial variation in sex-specific dispersal distances.