Daisuke Uritani

Clinical Phenotype Classifications Based on Static Varus Alignment and Varus Thrust in Japanese Patients With Medial Knee Osteoarthritis.

To investigate the association between knee pain during gait and 4 clinical phenotypes based on static varus alignment and varus thrust in patients with medial knee osteoarthritis (OA).

Reference values for toe grip strength among Japanese adults aged 20 to 79 years: a cross-sectional study

BackgroundNo standardised method has been adopted for measuring toe-grip strength (TGS), and no reference values have been established for evaluating it. The present study investigated age-related changes in TGS and the association of TGS with various descriptive characteristics.MethodsTGS was measured in both feet of 1842 community-dwelling individuals aged 20–79 years using a toe-grip dynamometer. The participants were classified by decade into six age groups: 20–29, 30–39, 40–49, 50–59, 60–69, and 70–79 years. Correlations for TGS between the dominant and non-dominant sides were analysed according to decade and sex using Pearson’s correlation coefficient. The mean TGS and TGS-to-weight ratio (TGS/Wt%) were compared between sexes by each decade and among all decades by sex using two-way analysis of variance with post-hoc tests. To assess relationships between mean TGS and various descriptive characteristics, we determined Pearson’s correlation coefficient by sex and performed a stepwise multiple-regression analysis. Significance was set at 5%.ResultsCorrelations for TGS between the dominant and non-dominant sides were significant in all decades by sex, ranging from 0.73 for men in their 70s to 0.91 for women in their 50s. Mean TGS and TGS/Wt% significantly differed between the sexes in all decades and in all decades except the 40s, respectively. In men, the mean TGS and TGS/Wt% significantly decreased with aging after the 50s and 60s, respectively. In women, both the mean TGS and TGS/Wt% significantly decreased between the 40s and 50s and between the 60s and 70s. TGS significantly correlated with age, height, and weight in both sexes. The stepwise multiple-regression analysis revealed TGS was significantly associated with sex, age, height, and weight (adjusted R2 = 0.31).ConclusionsTGS was closely correlated between the dominant and non-dominant sides. TGS and TGS/Wt were significantly reduced with aging after the 50s in men and significantly reduced between the 40s and 50s and between the 60s and 70s in women. Age, sex, height, and weight accounted for only 30.8% of the variance in TGS. Therefore, other factors (e.g. toe flexibility, structural characteristics) should be considered for improving the accuracy of predicting TGS.

Association of Varus Thrust With Pain and Stiffness and Activities of Daily Living in Patients With Medial Knee Osteoarthritis

Background Increasing evidence highlights potential associations between varus thrust and health domains associated with knee osteoarthritis (OA). Objective The aim of this study was to investigate the association between varus thrust and 2 subcategories—“pain and stiffness” and “activities of daily living (ADL)”—of the Japanese Knee Osteoarthritis Measure (JKOM). Design This was a cross-sectional study. Methods In total, 296 outpatients with knee OA visiting orthopedic clinics were enrolled. The inclusion criteria were age ≥50 years, medial knee OA and Kellgren-Lawrence (K/L) grade ≥1 in one or both knees, and the ability to walk independently. Standard posterior-anterior knee radiographs were measured for varus alignment. Participants were video recorded while walking and were evaluated for the presence or absence of varus thrust. Pain and stiffness of the knee joint and ADL were evaluated using the JKOM. Multivariate regressions (outcomes: pain and stiffness and ADL; predictor variable: varus thrust) were performed. Results Varus thrust was present in 46 (16.2%) of 284 patients. Multivariate regression analyses demonstrated that varus thrust is independently associated with pain and stiffness, adjusted for age, sex, body mass index, K/L grade, and varus alignment (β=.17, P=.005). However, the association between varus thrust and ADL was not significant (β=.11, P=.058). Based on sensitivity analyses, including participants of K/L grade 1 had little influence on this analysis. Limitations Only 16.2% of participants had a varus thrust. Moreover, a cause-effect relationship between varus thrust and pain and stiffness remains unknown due to the cross-sectional design of this study. Conclusions Varus thrust was associated with pain and stiffness in patients with medial knee OA. However, the association between varus thrust and ADL did not reach significance.

Clinical Impact of Coexisting Patellofemoral Osteoarthritis in Japanese Patients With Medial Knee Osteoarthritis

To evaluate the clinical impact in knee osteoarthritis (OA) of coexisting patellofemoral (PF) joint OA (PFOA) in Japanese patients with medial tibiofemoral (TF) joint OA (TFOA).

Associations between toe grip strength and hallux valgus, toe curl ability, and foot arch height in Japanese adults aged 20 to 79 years: a cross-sectional study

BackgroundThe associations between toe grip strength (TGS) and foot structure are not well known, although foot structure is inferred to affect TGS. This study investigated the associations between TGS and hallux valgus angle (HVA), toe curl ability, and foot arch height (FAH).MethodsThis study analysed 227, 20 to 79-year-old, community-dwelling participants. TGS, HVA formed by the first metatarsal bone and the proximal phalanx of the hallux, toe curl ability (percentage) calculated as (foot length–flexed foot length)/foot length, and FAH (percentage) calculated as navicular height/truncated foot length were measured. To elucidate associations between TGS and foot structure, a correlation analysis and stepwise multivariate linear regression analyses were performed, based on the participant’s sex. Pearson’s correlation coefficients for TGS with age, height, weight, HVA, toe curl ability, and FAH were also calculated. In the stepwise, multivariate linear regression analyses, the independent variable was TGS and the dependent variables were those that significantly correlated with TGS, as shown by the Pearson’s correlation coefficients. The significance level was set at 5%.ResultsAccording to the Pearson’s correlation coefficients, in men, TGS was significantly correlated with age, height, toe curl ability, and FAH. According to the stepwise multiple regression analysis, TGS correlated with age and toe curl ability (adjusted R2=0.22). In women, TGS was significantly correlated with age, height, and toe curl ability (adjusted R2=0.40).ConclusionsTGS was associated with toe curl ability in both men and women. However, TGS was not associated with HVA and FAH in men or women. The results of this study may lead to the development of effective interventions to improve TGS. However, factors other than structure of the foot require more detailed investigation to clarify the factors contributing to TGS.

Effects of regular exercise and nutritional guidance on body composition, blood pressure, muscle strength and health-related quality of life in community-dwelling Japanese women.

OBJECTIVE This study aimed to investigate the effects of 6-month regular exercise and nutritional guidance for body composition, blood pressure, muscle strength and health-related quality of life (HRQOL) in community-dwelling Japanese women aged 40-74 years. METHODS Participants were divided into an intervention group (n = 48) comprising women registered for health guidance and a control group without intervention (n = 66). The intervention group received 6-month exercise and nutritional guidance to modify lifestyle. Before and after the intervention period, body mass index (BMI), waist circumference, body fat percentage, blood pressure, muscle strength and HRQOL using the 36-item Short-Form Health Survey version 2 (SF-36) questionnaire were measured. RESULTS At baseline, no significant differences were found between intervention and control groups. Waist circumference decreased significantly in the intervention group (from 82.4 to 79.9 cm) compared to the control group (from 80.5 to 79.7 cm). BMI and body fat percentage also decreased significantly more in the intervention group than in the control group. General health perception, vitality and social functioning in the SF-36 showed significantly greater improvements in the intervention group than in the control group. CONCLUSIONS Six-month regular exercise and nutritional guidance had beneficial effects on body composition and health-related quality of life especially for mental components of SF-36. Based on these findings, our intervention was expected to provide benefits to mental components of HRQOL and facilitate sustained participation and motivation in modify lifestyles. As a result, beneficial effects on body composition might also be sustained.

Reliability of Upper Quadrant Posture Analysis Using an Ultrasound-based Three-dimensional Motion Analyzer

[Purpose] The aim of this study was to evaluate the reliability of upper quadrant posture analysis using an ultrasound-based three-dimensional motion analyzer. [Subjects] Subjects were 72 healthy young adults. [Methods] Neck inclination angle formed by a line connecting C7 and the tragus with a horizontal line, angle of the shoulder formed by a line connecting C7 and the acromial angle with a horizontal line, and cranial rotation angle formed by a line connecting the tragus and corner of the eye with a horizontal line were measured using an ultrasound-based three-dimensional motion analyzer. Intra- and inter-rater reliabilities of two testers, standard error of measurements, minimal detectable change at the 95% confidence level, and systematic bias were evaluated. [Results] Intra-class correlation coefficients (1,1) were 0.65 to 0.82. Intra-class correlation coefficients (2,1) were 0.76 to 0.82. High measurement error was found in the cranial rotation angle. Fixed bias was found for the angle of the shoulder in the inter-rater reliability. [Conclusion] Posture analysis using an ultrasound-based three-dimensional motion analyzer appears useful for assessing neck inclination angle and the angle of the shoulder in individuals, and cranial rotation angle in patient groups.

The Relationship Between Toe Grip Strength and Dynamic Balance or Functional Mobility Among Community-Dwelling Japanese Older Adults: A Cross-Sectional Study

Evaluating toe flexor strength may be an important method for predicting and preventing walking dysfunction and falls, particularly among older adults. In this study, toe grip strength (TGS), the functional reach (FR, a measure of dynamic balance) test, the timed up and go (TUG) test (a measure of functional ability), isometric knee extension strength (IKES), sex, age, weight, and height were analyzed among 665 healthy Japanese older adults. Statistical analyses were used to assess the relationships between TGS and FR or TUG and to investigate whether TGS was independently associated with FR or TUG. Our results indicate that, among both men and women, TGS was associated with TUG, independent of age, height, weight, and IKES, but TGS was not associated with FR. These results may facilitate the development of strategies for improving functional mobility through physical therapy.

Children with flat feet have weaker toe grip strength than those having a normal arch.

[Purpose] This study investigated the relationship between toe grip strength and foot posture in children. [Subjects and Methods] A total of 619 children participated in this study. The foot posture of the participants was measured using a foot printer and toe grip strength was measured using a toe grip dynamometer. Children were classified into 3 groups; flatfoot, normal, and high arch, according to Staheli’s arch index. The differences in demographic data and toe grip strength among each foot posture group were analyzed by analysis of variance. Additionally, toe grip strength differences were analyzed by analysis of covariance, adjusted to body mass index, age, and gender. [Results] The number of participants classified as flatfoot, normal, and high arch were 110 (17.8%), 468 (75.6%), and 41 (6.6%), respectively. The toe grip strength of flatfoot children was significantly lower than in normal children, as shown by both analysis of variance and analysis of covariance. [Conclusion] A significant difference was detected in toe grip strength between the low arch and normal foot groups. Therefore, it is suggested that training to increase toe grip strength during childhood may prevent the formation of flat feet or help in the development of arch.

Characteristics of Upper Quadrant Posture of Young Women with Temporomandibular Disorders

[Purpose] This study aimed to investigate the characteristics of upper quadrant posture of young women with temporomandibular disorders. [Subjects] The participants were 19 female patients with temporomandibular disorders (patient group: mean age, 30.1 years) and 14 controls (control group: mean age, 24.6 years). [Methods] Outcome measures were the neck inclination angle (formed by a line connecting C7 and the ear tragus with a horizontal line), the angle of the shoulder (formed by a line connecting C7 and the acromial angle with a horizontal line), the cranial rotation angle (formed by a line connecting the ear tragus and the corner of the eye with a horizontal line), and the neck-length/shoulder-width ratio [the ratio of the neck length (from C7 to the tragus) to the width of the shoulder between the acromial angle]. The maximum range of mouth opening was measured using a scale. [Results] The neck inclination angle and maximum range of mouth opening were significantly smaller in the patient group than in the control group. No significant differences were observed in the other outcome measures between the two groups. [Conclusion] Temporomandibular disorders with limited mouth opening in young females are associated with the head position relative to the trunk.