Carpometacarpal Osteoarthritis Pain of the Thumb Can Be Relieved by Commercial Beverage Carbonated Water.

Thumb carpometacarpal (CMC) arthropathy pain is treated using carbonated water-a commercially available beverage. The right hand (affected side) was bathed once daily in carbonated beverage water (37°C) for 20 min. Prior to treatment, the visual analogue scale score of pain was 73 mm; 1 week after the treatment, it was 0 mm. Commercial carbonated water immersion was effective for thumb CMC arthropathy pain. Commercial carbonated water is inexpensive and easy to obtain, making it suitable for home carbonation therapy.

Effects of spinal segmental flexion and extension exercises on spinal flexibility.

BACKGROUND: We considered spinal segmental movement exercise that voluntarily control local muscles as a convenient treatment to correct the trunk muscle recruitment pattern in individuals with global muscle overactivity. The purpose of this study was to verify the effects of segmental flexion and extension movements of the spine and overall flexion and extension movements of the spinal column on the flexibility of the spinal column among healthy university students who had completed a day of lectures and had a certain load on their lower back as a preliminary step to applying the exercise to low back pain patients with a broken trunk muscle recruitment pattern. METHODS: The subjects performed trunk flexion/extension exercises that required segmental control of the spine (segmental movement) and trunk flexion/extension exercises that do not require segmental control of the spine (total movement) in the chair position. As an evaluation task, finger floor distance (FFD) and muscle tension of the hamstrings were evaluated before and after exercise intervention. RESULTS: There was no significant difference in the FFD value and the passive pressure before the intervention between the two exercises. FFD decreased significantly after the intervention compared to that before, and passive pressure did not change in both motor tasks. The FFD change amount of segmental movement was significantly larger than that of total movement. (P < 0.01). CONCLUSIONS: It has been suggested that segmental spinal movements improve spinal mobility and may reduce global muscle tension.

Indication of C2-C7 Cervical Laminoplasty with Muscle and Ligament Preservation in Patients with Kyphosis.

OBJECTIVE: Cervical laminoplasty is generally not indicated in patients with kyphosis because of poor outcomes. Therefore, data on the effectiveness of posterior structure-preserving techniques in patients with kyphosis are limited. This study investigated how laminoplasty with muscle and ligament preservation can benefit patients with kyphosis via risk factor analyses of postoperative complications. METHODS: Clinicoradiological outcomes of 106 consecutive patients, including patients with kyphosis, who had undergone C2-C7 laminoplasty in a muscle- and ligament-preserving fashion, were retrospectively analyzed. Surgical outcomes, including neurological recovery, were assessed, and sagittal parameters were measured on radiographs. RESULTS: Surgical outcomes of patients with kyphosis were comparable to outcomes of other patients except for axial pain (AP), which was significantly more frequent in patients with kyphosis. Moreover, AP was significantly associated with alignment loss (AL) >0°. Substantial local kyphosis (local kyphosis angle >10°) and greater value of range of motion (ROM) during flexion minus ROM during extension were identified as risk factors for AP and AL >0°, respectively. Receiver operating characteristic curve analysis indicated ROM during flexion minus ROM during extension cutoff value of 0.7° for predicting AL >0° in patients with kyphosis (sensitivity: 77%; specificity: 84%). Substantial local kyphosis combined with ROM during flexion minus ROM during extension >0.7° had 56% sensitivity and 84% specificity for predicting AP in patients with kyphosis. CONCLUSIONS: Although patients with kyphosis had a significantly higher incidence of AP, C2-C7 cervical laminoplasty with muscle and ligament preservation may not be contraindicated in selected patients with kyphosis by risk stratification for AP and AL using newly identified risk factors.

Sustained Compression with a Pneumatic Cuff on Skeletal Muscles Promotes Muscle Blood Flow and Relieves Muscle Stiffness.

(1) Purpose: This study aimed to examine whether a pneumatic cuff could promote muscle blood flow and improve muscle stiffness by continuously compressing muscles with air pressure in healthy college students. (2) Method: Twenty-one healthy collegiate students participated in this study. The probe of the near-infrared spectrometer was attached to the upper surface of the left gastrocnemius muscle, and a cuff was wrapped around the left lower leg. The cuff was inflated to 200 mmHg. After 10 min, the cuff was deflated, and the patient rested for 10 min. Muscle stiffness and fatigue were assessed before and after the intervention. (3) Results: During 10 min of continuous compression, StO2 continued to decrease until seven min of compression. After 10 min of continuous compression, StO2 was 30.8 ± 10.4%, which was approximately half of 69.2 ± 6.1% at rest. After the release of the pneumatic cuff compression, the StO2 remained higher than that at rest from 1 to 10 min. Muscle hardness was 19.0 ± 8.0 before intervention was 8.7 ± 4.8 after the intervention. Muscle fatigue was 6.6 ± 1.7 cm before the intervention and 4.0 ± 1.6 cm after the intervention. (4) Conclusions: This study suggests that sustained muscle compression using a pneumatic cuff can promote muscle blood flow and improve muscle stiffness and fatigue.

Effect of single bout downhill running on the serum irisin concentrations in rats.

This study aimed to characterize the effect of different running modes on serum irisin concentrations in rats. A total of 18, 10-week-old rats were divided into three groups; control group, 16° uphill running group (concentric exercise; CON) and, -16° downhill running group (eccentric exercise; ECC). The running group's rats ran on the inclined treadmill at 16 m/min, for a total of 90 min. Blood was drawn from the rats, 48 h after running, after which the rats were anesthetized. The serum concentrations of irisin were measured using enzyme-linked immunosorbent assays. Vastus intermedius was collected for immunohistochemical analysis. After multiple comparisons, the ECC showed a significantly high serum irisin concentration (ECC: 28.42 ± 6.31 ng/ml, CON: 21.27 ± 3.03 ng/ml) and a larger irisin antibody reactive cross-sectional area in vastus intermedius compared to the CON (p < 0.05). This is the first study to reveal that single bout downhill running increases serum irisin concentrations in rats.

Two cases of spontaneous cervical epidural hematoma without back or neck pain in elderly Japanese men.

Cases: Spontaneous spinal epidural hematoma (SSEH) is an uncommon disease. Most SSEH cases involve back and/or neck pain. We report the cases of two men who experienced SSEH with dysstasia but without back or neck pain. Outcomes: This study presents two cases involving elderly Japanese men who visited an emergency department because of sudden dysstasia without back or neck pain. The results of the neurological examinations revealed ataxic gait. Cervical spinal epidural hematomas were observed by computed tomography and magnetic resonance imaging. One patient underwent hematoma removal and decompression by corpectomy, whereas the other patient received conservative treatment and observation. The patients were discharged without sequelae. Conclusion: Spinal epidural hematomas are difficult to diagnose, and a delayed diagnosis can adversely affect the patient's quality of life. These hematomas should be considered in the differential diagnosis of cerebrovascular diseases.

Clinical Validation of Pain Management Manipulative Therapy for Knee Osteoarthritis With the Squeeze-Hold Technique: A Case Series.

OBJECTIVE: The purpose of this case series was to describe the short-term and long-term clinical effects of a manual technique for treating osteoarthritis (OA) knee pain. METHODS: This study measured of the immediate effect and long-term effect by using a case series of different groups of subjects. Knee OA and activity restriction in patients were evaluated by using the Kellgren-Lawrence (K/L) Grading Scale and the Japanese Knee Osteoarthritis Measure (JKOM) index. In the intervention, lower limb muscles were squeezed by hand for 20 seconds. Each squeeze was performed for both lower limbs. Passive range-of-motion (ROM) exercise was performed on the knee joint. In one set of cases, immediate effects were measured after a one-time treatment with pretreatment and posttreatment outcome measures. Eleven people with knee OA participated in the study. On a visual analogue scale (VAS) for pain, muscle stiffness, and muscular hemodynamics for estimation of muscle blood flow were recorded before and after the squeeze-hold treatment. In another set of cases, the treatment was given to all patients once a week for 6 months, and long-term effects were measured. Data on 5 subjects with knee OA were collected for 6 months after initial treatment. The VAS for pain and JKOM were recorded every month for 6 months. RESULTS: For immediate effects, the VAS was 69 ± 21 mm before treatment and 26 ± 22 mm after treatment. Muscle stiffness was 8.8 ± 3.6 (absolute number) before treatment and 3.5 ± 2.1 after treatment. Tissue (muscle) oxygen saturation was 60.1 ± 5.7% before treatment and 65.3 ± 4.8% after treatment. Total hemoglobin was 24.3 ± 3.3 (absolute number) before treatment and 25 ± 2.3 after treatment. A tendency for reduction in OA knee pain and muscle stiffness was observed, and a tendency for increase was observed in the blood flow in the muscle. For long-term effects in all 5 participants (any K/L grade, any JKOM score), OA knee pain and JKOM score improved gradually through 6 months. CONCLUSIONS: The participants in this case series showed improvement in pain and function. These findings indicate the feasibility of a larger study on the squeeze-hold intervention for OA knee pain.

Early tissue formation on whole-area osteochondral defect of rabbit patella by covering with fibroin sponge.

Large osteochondral defects have been difficult to repair via tissue engineering treatments due to the lack of a sufficient number of source cells for repairing the defect and to the severe mechanical stresses affecting the replacement tissue. In the present study, whole-area osteochondral defects of rabbit patella were covered and wrapped with a fibroin sponge containing chondrocytes, with or without Green Fluorescent Protein (GFP) transgenic marking, on the surface facing the osteochondral defect. Five of eight osteochondral defects that were covered with the chondrocyte-seeded fibroin sponges showed hyaline cartilage-like repair containing no fibroin fragments at 6 weeks after surgery. The repaired tissue showed a layer formation, which showed intensive safranin-O and toluidine blue staining, and which showed positive type II collagen immunostaining. The average surface coverage of the repaired cartilage was 53%. On average, 48% of the cells in the repaired tissue were derived from GFP transgenic chondrocytes, which had been seeded in the fibroin sponge. The fibroin-sponge covering had the potential to allow the early repair of large osteochondral defects. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1474-1482, 2016.

Magnitude of muscle activity of the lumbar multifidus using the Core-Noodle device with varied upper extremity postures.

BACKGROUND: Lumbar Multifidus (LM) exercise is a treatment in patients with low back pain. We designed a new exercise using device ``Core-Noodle'' (Copyright has been observed in Japan). OBJECTIVE: The purpose of this study was to record the electromyographic (EMG) activity of the lumbar multifidus during a novel exercise. METHODS: Twenty-one healthy young volunteers performed the LM exercise using Core-Noodle in three conditions: no-weight (NW), 1 kg weight (1W), 2 kg-weight (2W). This exercise was performed in supine with left shoulder abduct 90 degrees and right shoulder flexed 90 degrees. EMG activity was recorded from surface electrodes on the LM and the thoracic part of the iliocostalis lumborum (ICLT), and normalized to values derived from maximal isometric trials (%MVIC). In addition, the ratio of the LM to ICLT (L/G ratio) was calculated to compare selectivity of LM activity. One-way ANOVA and Bonferroni method were used to draw comparisons among the three conditions. RESULTS: Muscle activation of LM was gradually increased in proportion to the loading dose. L/G ratio increased by weight loading significantly, but slightly decreased at 2W. CONCLUSIONS: The results suggest that characteristic EMG patterns of LM ``selective contraction'' and ``adjustment of load'' are obtained concurrently.

The effect of trunk coordination exercise on dynamic postural control using a Core Noodle.

OBJECTIVE: To investigate the influence of trunk coordination exercise on dynamic postural control relative to postural sway. METHOD: The effects of trunk coordination exercises were examined using a Core Noodle for the postural sway in healthy students who were assigned to an exercise or control group. The independent variable was the extent of exposure to Core Noodle exercise, and the dependent variable was dynamic postural control. A stabilometer, which measures dynamic postural control, was used to evaluate the effectiveness of the exercises. In addition, center of gravity movements were assessed using a Gravicorder G-620 stabilometer in which the subject was asked to shift their center of gravity between 2 circles on a computer monitor. Pre- and post-intervention dynamic postural control was statistically evaluated between the exercise group and control group using the Mann-Whitney test. Finally, we investigated the application of these exercises for a stroke patient. RESULTS AND CONCLUSION: For post-intervention, the envelop area, mean length of the pathways between 2 circles, and the number of circles were significantly higher in the exercise group. Trunk coordination exercise performed Core Noodle may be used to enhance the dynamic postural balance of healthy young adults, and it can also be adapted for stroke patients.

Core exercises elevate trunk stability to facilitate skilled motor behavior of the upper extremities.

OBJECTIVE: The purpose of this study was to investigate the influence of core exercises on upper extremity function relative to skilled motor behavior and postural sway. METHOD: We examined the effects of core exercises on the skilled motor behavior and postural sway of 40 healthy students who were assigned randomly to the core exercise group or the control group. Independent variable is extent of exposure to core exercise and dependent variables are skilled motor behavior and postural sway. A Purdue pegboard which measures skilled motor behavior and a stabilometer which measures postural sway were used to evaluate the influence of core exercises. Pre-intervention and post-intervention skilled motor behavior and postural sway were compared between the core exercise group and control group using the Wilcoxon rank sum test; a significance level of α = 0.05 was considered statistically significant. Also, we investigated the application of core exercises in a clinical setting for one patient with cerebral vascular disease. RESULTS: The post intervention skilled motor behavior (p = 0.04) and postural sway, LNG (p = 0.05), LNG/TIME (p = 0.04) and X LNG (p = 0.02) were significantly higher in the core exercise group than control group. In the case report, there were good results; function of the upper extremity improved after doing the exercises. There were positive changes in some daily living activities. DISCUSSION: Core exercises are likely to enhance trunk stabilization to improve upper extremity function. It is possible for core exercises to be adapted for patients.

Static magnetic field effects on impaired peripheral vasomotion in conscious rats.

We investigated the SMF effects on hemodynamics in the caudal artery-ligated rat as an in vivo ischemia model using noninvasive near-infrared spectroscopy (NIRS) combined with power spectral analysis by fast Fourier transform. Male Wistar rats in the growth stage (10 weeks old) were randomly assigned into four groups: (i) intact and nonoperated cage control (n = 20); (ii) ligated alone (n = 20); (iii) ligated and implanted with a nonmagnetized rod (sham magnet; n = 22); and (vi) ligated and implanted with a magnetized rod (n = 22). After caudal artery ligation, a magnetized or unmagnetized rod (maximum magnetic flux density of 160 mT) was implanted transcortically into the middle diaphysis of the fifth caudal vertebra. During the experimental period of 7 weeks, NIRS measurements were performed in 3- , 5- , and 7-week sessions and the vasomotion amplitude and frequency were analyzed by fast Fourier transform. Exposure for 3-7 weeks to the SMF significantly contracted the increased vasomotion amplitude in the ischemic area. These results suggest that SMF may have a regulatory effect on rhythmic vasomotion in the ischemic area by smoothing the vasomotion amplitude in the early stage of the wound healing process.

In vivo mechanical condition plays an important role for appearance of cartilage tissue in ES cell transplanted joint.

The objective of this study was to evaluate the effects of the mechanical environment on the formation of cartilage tissue in transplanted embryonic stem (ES) cells. Full-thickness osteochondral defects were created on the patella groove of SD rats, and ES cells (CCE ES cells obtained from 129/Sv/Ev mice and Green ES FM260 ES cells obtained from 129SV [D3] - Tg [NCAG-EGFP] CZ-001-FM260Osb mice) were transplanted into the defects embedded in collagen gel. The animals were randomly divided into either the joint-free group (JF group) or the joint-immobilized group (JI group) for 3 weeks after a week postoperatively. The results showed that cartilage-like tissue formed in the defects of the JF group whereas large teratomatous masses developed in the defects of the JI group. Some parts of the cartilage-like tissue and the teratomatous masses were positively stained with immunostain for GFP when the Green ES FM260 ES cells were transplanted. It is suggested that the environment plays an important role for ES cells in the process of repairing cartilage tissue in vivo.

Effect of low loading and joint immobilization for spontaneous repair of osteochondral defect in the knees of weightless (tail suspension) rats.

BACKGROUND: Mechanical stimulation has a great influence on articular cartilage regeneration. The objective of this study was to clarify the temporal sequences of spontaneous repair of weightless or immobilized joints. METHODS: An osteochondral defect was created in the femoral patellar groove of F344 rats. A tail-suspension procedure was performed to control the mechanical environment of the hindlimbs. The experimental knee joints were classified into three conditions: CONT, normal gait; LLB, low load-bearing; LLI, low load and immobilized. The repair processes up to 4 weeks were evaluated histologically. RESULTS: The knee defects in the CONT and LLB conditions were repaired to a smooth surface with fibrous tissue and highly developed subchondral bone. The knees in the LLI condition had the lowest reformation rate of subchondral bone, although partial regeneration of hyaline cartilage-like tissue was seen at 4 weeks after the operation. Bulges of fibrous tissue from the defects were observed in the LLI condition. CONCLUSIONS: These results, combined with our previous report, suggest that dynamic compressive strain stimulates regeneration of the joint surface structures. They also suggest that the contact condition of the defect with surface cartilage may play a role in the hyaline cartilage repair.

Electromyographic analysis of a modified maneuver for quadriceps femoris muscle setting with co-contraction of the hamstrings.

A "quadriceps femoris muscle setting" is isometric quadriceps femoris exercise which can be widely used in early knee rehabilitation. However this exercise cannot obtain enough co-contraction of the hamstrings. Isolated quadriceps femoris contraction in knee extension imposes severe strain to anterior cruciate ligament. We succeeded in developing a simple training maneuver that is effective in obtaining co-contraction of the hamstrings--a modified maneuver for the quadriceps femoris muscle setting with the contralateral lower limb raised (MQS). In this study, we analyzed the effect of this maneuver by EMG quantification. Twenty-eight healthy young adult men performed sequential trials consisting of normal quadriceps femoris muscle setting (NQS) and MQS. Electromyographic activity was recorded from surface electrodes on the gluteus maximus, vastus medialis, rectus femoris, vastus lateralis, semitendinosus and biceps femoris (long head), and normalized to values derived from maximal isometric trials. The % maximal voluntary isometric contraction (%MVIC) of the vastus medialis, vastus lateralis and rectus femoris did not vary in the each maneuver. However, the %MVIC of the hamstrings varied significantly in the MQS. This study suggests that effective co-contraction of the hamstrings can be obtained in MQS by adjusting the load to the raised lower limb.