Rui Tsukagoshi

Associations of muscle stiffness and thickness with muscle strength and muscle power in elderly women

Aim:  The aims of this study were to investigate the influence of age on muscle stiffness and to examine the relationships among muscle stiffness, muscle thickness, subcutaneous fat thickness, muscle strength and muscle power in elderly women.

Effects of high-velocity resistance training on muscle function, muscle properties, and physical performance in individuals with hip osteoarthritis: a randomized controlled trial

Objective: To investigate the effects of high-velocity resistance training on muscle function, muscle properties, and physical performance in patients with hip osteoarthritis by comparison with those of low-velocity resistance training. Design: Single-blind randomized controlled trial. Setting: Home-based exercise programmes. Subjects: A total of 46 women with hip osteoarthritis were randomly assigned to the high-velocity (n = 23) or low-velocity (n = 23) training group. Interventions: Both groups underwent an eight-week daily home-based resistance training programme using an elastic band. Exercises involved hip abduction, extension, and flexion and knee extension. Participants in the high-velocity group performed the concentric phase of each repetition as rapidly as possible and returned to the initial position eccentrically in 3 s. Participants in the low-velocity group performed both the concentric and eccentric phases in 3 s. Main measures: The following outcome measures were evaluated: isometric muscle strength, muscle power, muscle thickness, muscle echo intensity, maximum walking speed, Timed Up and Go test, 3-minute walking test, Harris Hip Score, and hip pain. Results: Decreases in the time for performing the Timed Up and Go test (mean changes: high-velocity group −0.46 s, low-velocity group −0.23 s) and echo intensity of the gluteus maximus (mean changes: high-velocity group −6.8, low-velocity group −1.0) were significantly greater in the high-velocity group than in the low-velocity group. No significant difference was observed in changes of other outcome measures between the groups. Conclusion: This study revealed that high-velocity training for patients with hip osteoarthritis has partially a greater effect on muscle properties and physical performance than low-velocity training.

Muscle Mass and Composition of the Hip, Thigh and Abdominal Muscles in Women With and Without Hip Osteoarthritis

The objective of this study was to compare muscle mass and composition between individuals with and without hip osteoarthritis. Twenty-four women with hip osteoarthritis (OA group) and 16 healthy women (healthy group) participated in this study. Muscle thickness (MT) and echo intensity (EI) were measured as indices of muscle mass and composition, respectively, using ultrasound imaging. Seven muscles were examined: gluteus maximus, gluteus medius, quadriceps femoris, rectus abdominis, external oblique, internal oblique and transversus abdominis. MT of only quadriceps femoris in the OA group was significantly thinner than that in the healthy group. EIs of gluteus medius, quadriceps femoris and rectus abdominis were significantly higher in the OA group than those in the healthy group. Thus, actual contractile tissue of gluteus medius and rectus abdominis substantially decreased, although muscle mass was similar, whereas both quantitative and qualitative changes occurred in quadriceps femoris in patients with hip OA.

Stepping exercises improve muscle strength in the early postoperative phase after total hip arthroplasty: a retrospective study.

ObjectiveThis study aimed to evaluate the effect of stepping exercises in addition to conventional physical therapy on the recovery of muscle strength and walking speed after total hip arthroplasty. DesignThis was a retrospective study with 6 wks of follow-up care and evaluation. Patients (n = 30) undergoing primary total hip arthroplasty for hip osteoarthritis were divided into two groups based on whether stepping exercises were performed after surgery. The control group (n = 15) received supervised conventional physical therapy for 6 wks. The stepping group (n = 15) performed stepping exercises with conventional physical therapy. Outcome measures were lower limb muscle strength and walking speed at 6 wks postoperatively. ResultsThe stepping group showed significantly higher recovery of the hip abductor and the knee extensor muscle strengths on the involved side compared with the control group. There were no significant differences between the two groups in walking speed and hip extensor, hip flexor and knee flexor strength on the involved side. ConclusionsOur findings suggest that stepping exercises may be effective in facilitating the muscular recovery of the hip abductors and knee extensors in the early postoperative phase after total hip arthroplasty.

Dynamic hip joint stiffness in individuals with total hip arthroplasty: relationships between hip impairments and dynamics of the other joints.

BACKGROUND Little is known about hip joint stiffness during walking (dynamic joint stiffness) and the effect of hip impairments on biomechanical alterations of other joints in patients with total hip arthroplasty. METHODS Twenty-four patients (mean age 61.7 years) who underwent unilateral (n=12) or bilateral total hip arthroplasty (n=12) and healthy subjects (n=12) were recruited. In addition to kinematic and kinetic variables, dynamic hip joint stiffness which was calculated as an angular coefficient of linear regression of the plot of the hip flexion moment vs. hip extension angle during the late stance of gait, was measured. Group differences were compared using one-way ANOVA and Tukeys post-hoc test, and relationships between primary hip impairments and secondary gait impairments were found using partial correlation coefficients adjusted for gait speed and stride length. FINDINGS Dynamic hip joint stiffness was 47% higher on the side with the more pronounced limp in patients with bilateral arthroplasty than in healthy controls. In the same patients, increased dynamic hip joint stiffness was significantly associated especially with increased ankle plantarflexion moment on the ipsilateral side. In patients with unilateral arthroplasty, decreased hip power was significantly related to increased ankle plantarflexor power, only on the non-operated side. INTERPRETATION We found that dynamic hip joint stiffness was an important factor in assessing relationships between hip impairments and dynamics in other joints, especially in patients with bilateral total hip arthroplasty. The effects of altering hip joint stiffness on gait biomechanics need to be explored.

Age-Related Ultrasound Changes in Muscle Quantity and Quality in Women

This study investigated the age-related changes in muscle quantity and quality in the trunk and limbs of women. A total of 128 females were divided into four age groups: young, middle-aged, young-old and old-old. Muscle thickness (MT) and echo intensity (EI) of the biceps brachii, quadriceps femoris, rectus abdominis, external oblique, internal oblique and transversus abdominis were measured using B-mode ultrasonography. The EIs of the biceps brachii, quadriceps femoris and transversus abdominis were significantly higher in the middle-aged group than in the young group; however, there were no significant differences in MT. Compared with the young group, all other groups had significant changes in both MT and EI of the rectus abdominis, external oblique and internal oblique muscles. Thus, qualitative changes in muscle may occur earlier than quantitative changes, and loss of muscle mass may occur earlier in the superficial abdominal muscles than in the other muscles.

Association of sagittal spinal alignment with thickness and echo intensity of lumbar back muscles in middle-aged and elderly women

OBJECTIVE Quantitative changes, such as a decrease in muscle mass, and qualitative changes, such as an increase in the amount of intramuscular non-contractile tissue, occur with aging. However, it is unclear whether quantitative or qualitative changes in back muscles are associated with spinal alignment in the standing position. We investigated the association of sagittal spinal alignment with muscle thickness as an index of the mass of lumbar back muscles and muscle echo intensity as an index of the amount of non-contractile tissue within these muscles. METHODS Study participants comprised 36 middle-aged and elderly women. Thickness and echo intensity of erector spinae, psoas major, and lumbar multifidus muscles were measured using an ultrasound imaging device. Standing sagittal spinal alignment, determined from thoracic kyphosis and lumbar lordosis angles, and the sacral anterior inclination angle was measured using the Spinal Mouse. RESULTS Stepwise regression analysis performed using muscle thickness, echo intensity, and age as independent variables showed that erector spinae muscle thickness was a significant determinant of the thoracic kyphosis angle. Psoas major muscle thickness and echo intensity of the lumbar multifidus muscle were significant determinants of the sacral anterior inclination angle. CONCLUSION Our results suggest that an increase in thoracic kyphosis is associated with a decrease in the mass of the erector spinae muscle, and that a decrease in pelvic anterior inclination is associated with a decrease in the mass of the psoas major muscle and an increase in the amount of non-contractile tissue within the lumbar multifidus muscle.

Pelvic instability and trunk and hip muscle recruitment patterns in patients with total hip arthroplasty.

Hip and lumbar spine disorders often coexist in patients with total hip arthroplasty (THA). The current study aimed to reveal pelvic motion pathology and altered trunk and hip muscle recruitment patterns relating to pelvic motion in patients with THA. Twenty-one women who underwent THA and 12 age-matched healthy women were recruited. Pelvic kinematics and muscle recruitment patterns (i.e., amplitude, activity balance, and onset timing) of the gluteus maximus, semitendinosus, multifidus, and erector spinae were collected during prone hip extension. Compared with healthy subjects, the patients showed increased pelvic motion, especially ventral rotation, decreased multifidus muscle activity relative to the hip extensors, and delayed onset of multifidus activity, despite reaction times and speeds of leg motion not being significantly different between the groups. Furthermore, while contributing factors associated with ventral pelvic rotation were not found, delayed onset of multifidus activity was detected as a factor related to the increased anterior tilt of the pelvis (r = 0.47, p < 0.05) in patients with THA. These results suggest that patients with THA have dysfunction of the stabilizer muscles of the lumbopelvic region along with increased pelvic motion.

Compensatory turning strategies while walking in patients with hip osteoarthritis

The ability to change directions while walking is an integral component of adaptive locomotor behavior. Patients with hip osteoarthritis (OA) experience prolonged hip dysfunction. Gait compensation adopted by the patients with hip OA may become more pronounced while they turn. The purposes of this study were to identify the turning strategy while walking in patients with hip OA, and to examine the relationship between the turning strategy and the patients functional level. Fourteen patients with hip OA and 13 age-matched healthy controls were recruited. The hip, knee, and ankle joint angles and moments, and the foot progression angle were measured under three walking conditions (straight walking, 45° step turn, and 45° crossover turn), and the gait variables for each walking condition were compared between the 2 groups. The relationship between the increasing rate of knee and ankle joint moments in the turning to the straight walking and the functional point in the Harris hip score (HHS) was examined. The OA group showed decreased hip flexion, extension, and abduction angles, and hip flexion moment during the step turn, and decreased hip flexion, extension, and adduction angles, and hip abduction moment during the crossover turn. Furthermore, the ankle plantarflexion moment and the change in the foot angle during the stance phase were significantly increased during the crossover turn in the OA group. The increasing rate of the ankle plantarflexion moment correlated significantly with the functional point in the HHS. Patients with hip OA rely primarily on the ankle plantarflexors to compensate for the hip dysfunction while changing the walking direction.

Associations of radiographic degeneration and pain with daily cumulative hip loading in patients with secondary hip osteoarthritis.

The purpose of this study was to investigate the associations of radiographic and clinical variables of hip osteoarthritis (OA) with alterations in gait and joint loading in patients with secondary hip OA. Fifty females with secondary hip OA were participated. The minimum joint space width (mJSW) of the hip as a degenerative sign and Sharp and center edge (CE) angles as morphological variables were measured radiographically. Hip joint pain was assessed using a visual analog scale. As gait variables, walking speed, range of hip motion, hip moment peak, and hip moment impulse were calculated. Daily cumulative hip loading was calculated as the hip moment impulse multiplied by the mean number of steps per day. After bivariate correlation analyses between dependent (mJSW and pain) and independent variables (age, body mass index, sharp/CE angles, steps per day, and gait variables), separate forward‐backward stepwise multiple regression analyses were performed for each dependent variable. Daily cumulative hip loading in the sagittal plane (β = 0.30, p = 0.021) and age (β = −0.36, p = 0.007) were significantly associated with the mJSW. Walking speed (β = −0.36, p = 0.008) and age (β = 0.29, p = 0.031) were significantly associated with hip joint pain. Decrease in daily cumulative hip loading in the sagittal plane was associated with mJSW independently of age. Although the causal relationship was not clear, patients with hip OA reduced total exposure to hip joint loading adaptively rather than lowering the hip moment peak concerning worsening of hip degeneration.