Publications by authors named "Yoshihiro Hagiwara"

121 Publications

Skeletal muscle-specific Keap1 disruption modulates fatty acid utilization and enhances exercise capacity in female mice.

Redox Biol 2021 Apr 5;43:101966. Epub 2021 Apr 5.

Department of Gene Expression Regulation, IDAC, Tohoku University, Sendai, 980-8575, Japan. Electronic address:

Skeletal muscle health is important for the prevention of various age-related diseases. The loss of skeletal muscle mass, which is known as sarcopenia, underlies physical disability, poor quality of life and chronic diseases in elderly people. The transcription factor NRF2 plays important roles in the regulation of the cellular defense against oxidative stress, as well as the metabolism and mitochondrial activity. To determine the contribution of skeletal muscle NRF2 to exercise capacity, we conducted skeletal muscle-specific inhibition of KEAP1, which is a negative regulator of NRF2, and examined the cell-autonomous and non-cell-autonomous effects of NRF2 pathway activation in skeletal muscles. We found that NRF2 activation in skeletal muscles increased slow oxidative muscle fiber type and improved exercise endurance capacity in female mice. We also observed that female mice with NRF2 pathway activation in their skeletal muscles exhibited enhanced exercise-induced mobilization and β-oxidation of fatty acids. These results indicate that NRF2 activation in skeletal muscles promotes communication with adipose tissues via humoral and/or neuronal signaling and facilitates the utilization of fatty acids as an energy source, resulting in increased mitochondrial activity and efficient energy production during exercise, which leads to improved exercise endurance.
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http://dx.doi.org/10.1016/j.redox.2021.101966DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8050939PMC
April 2021

Characteristics of Parents Who Feel a Lack of Communication with Coaches of Youth Sports.

Tohoku J Exp Med 2021 03;253(3):191-198

Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine.

Communication between parents and their children's coaches is important for children's sports activities, but the relationship between parents and coaches is not well understood. It is possible that parents feel a lack of communication with coaches, which could be due to parents' experience with sports activities or the social environment of the team. This study aimed to elucidate the characteristics of parents who feel a lack of communication with their children's coaches of youth sports. A cross-sectional study was conducted on parents of young athletes (n = 6,641) and multivariate logistic regression analyses were performed to assess factors related to parents' feeling of a lack of communication with their children's coaches. Among the respondents, 29.4% of parents felt a lack of communication with their children's coaches. The factors related to the parents' feeling were a shorter duration of their children playing the present sport, an absence of experience playing the same sport as their children or playing in a team with high competition level, dissatisfaction with their children's attitude towards sports activities, and an awareness of verbal and/or physical abuse by the coaches and bullying by the teammates in their children's team. Parents' previous sports experience and awareness of interpersonal violence in their children's team were associated with their feeling of a lack of communication with coaches. Educating parents on the sport and their roles in youth sport is necessary to make appropriate mutual communication between parents and coaches, which could lead to better circumstances for young athletes.
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http://dx.doi.org/10.1620/tjem.253.191DOI Listing
March 2021

Validation and reliability of a Japanese version of the Simple Shoulder Test: a cross-sectional study.

JSES Int 2021 Mar 15;5(2):334-337. Epub 2020 Dec 15.

Department of Orthopedic Surgery, Tohoku University School of Medicine, Sendai, Japan.

Background: The Simple Shoulder Test (SST) is a widely used patient-reported outcome assessment. The purpose of this study was to develop and validate a Japanese version of the SST (SST-Jp).

Methods: A two-stage observational study was conducted to validate the cross-cultural adaptation of the SST. A total of 100 patients with shoulder disorders completed the SST-Jp; the Disability of Arm, Shoulder, and Hand assessment; and the Medical Outcomes Short-Form 36 (SF-36) at an initial visit. Thirty-four of the patients repeated the SST-Jp one week after the first examination. The test-retest reliability was quantified using the interclass correlation coefficient, and Cronbach's alpha (α) was calculated to assess internal consistency. Construct validity was assessed using Spearman's rank correlation coefficient.

Results: The internal consistency of the SST-Jp was very high (α = 0.826). The interclass correlation coefficient of the SST-Jp was also high (0.859). There was a strong, positive correlation between the Disability of Arm, Shoulder, and Hand and the SST-Jp (r = 0.717, < .001). The SST-Jp was significantly correlated with most of the SF-36 subscales. The correlations of the SST-Jp with physical subscales of the SF-36 were stronger than those with the other subscales.

Conclusions: The SST-Jp was found to be a valid and reliable measurement for shoulder joint pain and function assessment among the Japanese population.
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http://dx.doi.org/10.1016/j.jseint.2020.10.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7910716PMC
March 2021

Association of musculoskeletal pain in other body parts with new-onset shoulder pain: a longitudinal study among survivors of the Great East Japan Earthquake.

BMJ Open 2021 02 15;11(2):e041804. Epub 2021 Feb 15.

Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.

Objective: Shoulder pain is a common health problem coexisting with other musculoskeletal pain. However, the effects of pre-existing musculoskeletal pain on the development of shoulder pain are not clear. The present study aimed to elucidate the association between coexisting musculoskeletal pain at other body sites and new-onset shoulder pain among survivors of the Great East Japan Earthquake (GEJE).

Design: This is a longitudinal study.

Setting: The study was conducted at the severely damaged coastal areas in Ishinomaki and Sendai cities.

Participants: The survivors who did not have shoulder pain at 3 years after the GEJE were followed up 1 year later (n=2131).

Interventions: Musculoskeletal pain (low back, hand and/or foot, knee, shoulder and neck pain) was assessed using self-reported questionnaires.

Main Outcome Measures: The outcome of interest was new-onset shoulder pain, which was defined as shoulder pain absent at 3 years but present at 4 years after the disaster. The main predictive factor for new-onset shoulder pain was musculoskeletal pain in other body parts at 3 years after the GEJE; this was categorised according to the number of pain sites (0, 1, ≥2). Multiple regression analyses were conducted to calculate the odds ratio (OR) and 95% confidence interval (CI) for new-onset shoulder pain due to musculoskeletal pain in other body parts.

Results: The incidence of new-onset shoulder pain was 6.7% (143/2131). Musculoskeletal pain in other body parts was significantly associated with new-onset shoulder pain. Using the survivors without other musculoskeletal pain as reference, the adjusted OR and 95% CI for new-onset shoulder pain were 1.86 (1.18 to 2.94) for those with one body part and 3.22 (2.08 to 4.98) for those with ≥2 body parts presenting with musculoskeletal pain (p<0.001).

Conclusions: Pre-existing musculoskeletal pain in other body parts was significantly associated with new-onset shoulder pain among survivors; this provides useful information for clinical and public health policies.
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http://dx.doi.org/10.1136/bmjopen-2020-041804DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887348PMC
February 2021

A histoanatomical study of the fiber bundle forming the 'Comma Sign,' a critical marker of the torn edge of the subscapularis tendon.

Arch Orthop Trauma Surg 2021 Jan 17. Epub 2021 Jan 17.

Department of Orthopaedic Surgery, Graduate School of Medicine and Faculty of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto City, Kyoto, 606-8507, Japan.

Introduction: The "Comma sign" is a well-known indicator of the subscapularis torn edge of the shoulder. We undertook a histoanatomical study of the fiber bundle forming Comma sign (FBCS) to determine why FBCS is maintained even in cuff tear cases.

Materials And Methods: Part 1: five tissue blocks including the supraspinatus tendon (SSP), rotator interval (RI), and subscapularis tendon (SSC) out of 5 cuff-intact cadavers were histologically observed in serial sections. Part 2: another tissue blocks of 6 cuff-intact cadavers were serially sectioned along the estimated FBCS direction based on the Part 1 findings. Additionally, 5 tissue blocks of cuff-torn cadavers including the three components, SSP, FBCS, and SSC, were serially sectioned along the apparent FBCS. In one slice clearly demonstrating FBCS fibers out of each section series, the components were measured of the sound speed and visualized through a scanning acoustic microscope (SAM).

Results: At the lateral portion, RI tissue with the joint capsule became thick and tightly surrounded SSP. Similarly, thicker RI tissue adhered to SSC from the superior and bursal side. More laterally, the borders of SSP/FBCS and FBCS/SSC were unclear with intermingled fibers. At the lateral most portion, RI tissue formed a fiber bundle, FBCS, extending from SSP to the bursal side of SSC. The sound speeds of SSP and SSC were significantly faster than FBCS in both cuff-intact and cuff-torn slices. In SAM images of cuff-torn specimens the FBCS borders were all unclear.

Conclusions: As FBCS extends from the capsule beneath SSP and to the bursal surface of SSC, the FBCS connection to SSP and SSC is hardly lost, even though SSP or SSC detaches from the greater or lesser tubercle, respectively. Additionally, as degeneration make the elasticity difference gradual, the stress concentration at the borders may be diminished, leading to less breakage of FBCS.
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http://dx.doi.org/10.1007/s00402-021-03775-6DOI Listing
January 2021

Reply to the Park and Lee regarding: "Effects of joint capsular release on range of motion in patients with frozen shoulder".

J Shoulder Elbow Surg 2021 Apr 10;30(4):e177. Epub 2021 Jan 10.

Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.

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http://dx.doi.org/10.1016/j.jse.2020.11.020DOI Listing
April 2021

Clinical outcomes of arthroscopic pan-capsular release with or without entire coracohumeral ligament release for patients with frozen shoulder.

JSES Int 2020 Dec 14;4(4):826-832. Epub 2020 Oct 14.

Department of Orthopaedic Surgery, Funabashi Orthopaedic Hospital, Funabashi, Japan.

Background: We aimed to retrospectively determine the effects of arthroscopic pan-capsular release with or without entire coracohumeral ligament (CHL) release and diabetes mellitus (DM) in patients with frozen shoulder (FS).

Methods: The study included 34 patients (20 male and 14 female patients) who underwent arthroscopic pan-capsular release without entire CHL release (group 1) and 26 patients (6 male and 20 female patients) who underwent entire CHL release for FS (group 2). Patients with a minimum of 12 months of follow-up were included, and range of motion (ROM) and the shoulder rating scale of the University of California at Los Angeles (UCLA) scoring system were evaluated.

Results: In group 2, external rotation and hand-behind-the-back (HBB) ROMs were significantly increased compared with group 1 at the final follow-up (external rotation, 53.1° ± 15.2° vs. 41.3° ± 20.5° [ = .044]; HBB level, T6 [interquartile range, T5-T9] vs. T11 [interquartile range, T8-L4] [ < .001]). Total UCLA scores and UCLA scores for pain (9.2 ± 1.5 vs. 10.0,  = .003), function (8.5 ± 1.4 vs. 10.0, < .001), and active forward flexion (4.6 ± 0.6 vs. 4.9 ± 0.2, < .011) were significantly greater in group 2 at the final follow-up. Patients without DM tended to have greater recovery of forward flexion and HBB ROMs and better total, pain, and function UCLA scores compared with those with DM. In group 2, there were no significant differences in ROMs and UCLA scores between the patients with DM and those without DM.

Conclusion: Arthroscopic entire CHL release is an essential treatment option for FS patients to regain ROMs and function and to reduce pain.
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http://dx.doi.org/10.1016/j.jseint.2020.08.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738570PMC
December 2020

A 5-year Longitudinal Study of Low Back Pain in Survivors of the Great East Japan Earthquake.

Spine (Phila Pa 1976) 2021 May;46(10):695-701

Department of Orthopedic Surgery, Tohoku University School of Medicine, Sendai, Miyagi, Japan.

Study Design: A longitudinal panel study.

Objective: The aim of this study was to examine the occurrence of low back pain (LBP), especially the association of previous LBP with further episodes of LBP, in survivors of the Great East Japan Earthquake (GEJE) during the course of 5 years.

Summary Of Background Data: LBP is common among survivors of natural disasters, but its long-term course is not clear.

Methods: A 5-year longitudinal study was conducted among survivors of the GEJE (n = 1821). The presence of LBP was assessed using a self-reported questionnaire at 2, 4, and 7 years after the disaster (termed the first, second, and third time points, respectively). Multiple logistic regression analysis was performed to assess a potential association between LBP at the first and second time points with LBP at the third time point, and the odds ratios (ORs) and 95% confidence intervals (CI) were calculated.

Results: The prevalence of LBP was 25.3%, 27.3%, and 27.2% at the first, second, and third time points, respectively. The occurrence of LBP at the first time point was significantly associated with LBP at the third time point, and the adjusted odds ratio (OR) (95% confidence interval [CI]) was 5.47 (4.28-6.98). Furthermore, LBP at the first and second time points was significantly associated with LBP at the third time point. Compared to no LBP at the first and second time points, the adjusted OR (95% CIs) for LBP at the third time point was 4.12 (3.14-5.41) in the case of LBP at either of the first or second time points and 10.73 (7.80-14.76) for LBP at both time points (P for trend < 0.001).

Conclusion: Previous LBP was associated with LBP 5 years later among survivors of the GEJE. Furthermore, the effect on subsequent LBP was stronger with a higher frequency of previous LBP episodes.Level of Evidence: 3.
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http://dx.doi.org/10.1097/BRS.0000000000003860DOI Listing
May 2021

Mitochondrial dysfunction underlying sporadic inclusion body myositis is ameliorated by the mitochondrial homing drug MA-5.

PLoS One 2020 2;15(12):e0231064. Epub 2020 Dec 2.

Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

Sporadic inclusion body myositis (sIBM) is the most common idiopathic inflammatory myopathy, and several reports have suggested that mitochondrial abnormalities are involved in its etiology. We recruited 9 sIBM patients and found significant histological changes and an elevation of growth differential factor 15 (GDF15), a marker of mitochondrial disease, strongly suggesting the involvement of mitochondrial dysfunction. Bioenergetic analysis of sIBM patient myoblasts revealed impaired mitochondrial function. Decreased ATP production, reduced mitochondrial size and reduced mitochondrial dynamics were also observed in sIBM myoblasts. Cell vulnerability to oxidative stress also suggested the existence of mitochondrial dysfunction. Mitochonic acid-5 (MA-5) increased the cellular ATP level, reduced mitochondrial ROS, and provided protection against sIBM myoblast death. MA-5 also improved the survival of sIBM skin fibroblasts as well as mitochondrial morphology and dynamics in these cells. The reduction in the gene expression levels of Opa1 and Drp1 was also reversed by MA-5, suggesting the modification of the fusion/fission process. These data suggest that MA-5 may provide an alternative therapeutic strategy for treating not only mitochondrial diseases but also sIBM.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0231064PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7710105PMC
January 2021

Joint hemorrhage accelerates cartilage degeneration in a rat immobilized knee model.

BMC Musculoskelet Disord 2020 Nov 19;21(1):761. Epub 2020 Nov 19.

Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.

Background: Joint hemorrhage is caused by trauma, ligament reconstruction surgery, and bleeding disorders such as hemophilia. Recurrence of hemorrhage in the joint space induces hemosiderotic synovitis and oxidative stress, resulting in both articular cartilage degeneration and arthropathy. Joint immobilization is a common treatment option for articular fractures accompanied by joint hemorrhage. Although joint hemorrhage has negative effects on the articular cartilage, there is no consensus on whether a reduction in joint hemorrhage would effectively prevent articular cartilage degeneration. The purpose of this study was to investigate the effect of joint hemorrhage combined with joint immobilization on articular cartilage degeneration in a rat immobilized knee model.

Methods: The knee joints of adult male rats were immobilized at the flexion using an internal fixator from 3 days to 8 weeks. The rats were randomly divided into the following groups: immobilized blood injection (Im-B) and immobilized-normal saline injection (Im-NS) groups. The cartilage was evaluated in two areas (contact and non-contact areas). The cartilage was used to assess chondrocyte count, Modified Mankin score, and cartilage thickness. The total RNA was extracted from the cartilage in both areas, and the expression of metalloproteinase (MMP)-8, MMP-13, interleukin (IL)-1β, and tumor necrosis factor (TNF)-α was measured by quantitative real-time polymerase chain reaction.

Results: The number of chondrocytes in the Im-B group significantly decreased in both areas, compared with that in the Im-NS group. Modified Mankin score from 4 to 8 weeks of the Im-B group was significantly higher than that of the Im-NS group only in the contact area. The expression of MMP-8 and MMP-13 from 2 to 4 weeks and TNF-α from 2 to 8 weeks significantly increased in the Im-B group compared with those in the Im-NS group, but there was no significant difference in IL-1β expression.

Conclusions: The results showed that joint hemorrhage exacerbated immobilization-induced articular cartilage degeneration. Drainage of a joint hemorrhage or avoidance of loading may help prevent cartilage degeneration during joint immobilization with a hemorrhage.
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http://dx.doi.org/10.1186/s12891-020-03795-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678279PMC
November 2020

Bladder perforation by orthopedic implants 26 years after limb-sparing surgery for left proximal femoral chondrosarcoma: A case report.

Int J Surg Case Rep 2020 16;76:441-445. Epub 2020 Oct 16.

Department of Orthopedic Surgery, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Japan.

Introduction: The need for implant use during orthopedic surgeries has been increasing. Accordingly, increased implant failures have been reported. However, bladder perforation remains a rare complication after orthopedic surgery. Although a few reports have described bladder perforation after total hip arthroplasty, no previous studies have reported the migration of staples into the bladder after limb-sparing surgery.

Presentation Of Case: A 65-year-old patient underwent limb-sparing surgery to remove a chondrosarcoma in the left proximal thigh. Twenty-six years after surgery, a staple that had been used to fix artificial ligaments to the pubis migrated to perforate the bladder, resulting in painful urination. The staple was removed, and her symptoms improved.

Discussion: In this case, bladder perforation by the staple resulted in painful urination. The bladder perforation was not detected until 26 years after the initial surgery.

Conclusion: Our observations emphasize that implant complications may occur even after a long postoperative period, and the possibility of delayed bladder perforation from previous pelvic surgeries should be considered in patients presenting with urinary tract symptoms.
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http://dx.doi.org/10.1016/j.ijscr.2020.09.175DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7586051PMC
October 2020

Imaging of muscle activity-induced morphometric changes in fibril network of myofascia by two-photon microscopy.

J Anat 2021 Mar 19;238(3):515-526. Epub 2020 Oct 19.

Department of Nursing, Tohoku Fukushi University, Sendai, Japan.

Myofascia, deep fascia enveloping skeletal muscles, consists of abundant collagen and elastin fibres that play a key role in the transmission of muscular forces. However, understanding of biomechanical dynamics in myofascia remains very limited due to less quantitative and relevant approaches for in vivo examination. The purpose of this study was to evaluate the myofascial fibril structure by means of a quantitative approach using two-photon microscopy (TPM) imaging in combination with intravital staining of Evans blue dye (EBD), a far-red fluorescence dye, which potentially labels elastin. With focus on myofascia of the tibial anterior (TA) muscle, the fibril structure intravitally stained with EBD was observed at the depth level of collagen fibrous membrane above the muscle belly. The EBD-labelled fibril structure and orientation in myofascia indicated biomechanical responses to muscle activity and ageing. The orientation histograms of EBD-labelled fibrils were significantly modified depending upon the intensity of muscle activity and ageing. Moreover, the density of EBD-labelled fibrils in myofascia decreased with habitual exercise but increased with muscle immobilization or ageing. In particular, the diameter of EBD-labelled fibrils in aged mice was significantly higher. The orientation histograms of EBD-labelled fibrils after habitual exercise, muscle immobilization and ageing showed significant differences compared to control. Indeed, the histograms in bilateral TA myofascia of exercise mice made simple waveforms without multiple sharp peaks, whilst muscular immobilization or ageing significantly shifted a histogram with sustaining multiple sharp peaks. Therefore, the dynamics of fibre network with EBD fluorescence in response to the biomechanical environment possibly indicate functional tissue adaptation in myofascia. Furthermore, on the basis of the knowledge that neutrophil recruitment occurs locally in working muscles, we suggested the unique reconstruction mechanism involving neutrophilic elastase in the myofascial fibril structure. In addition to the elastolytic susceptibility of EBD-labelled fibrils, distinct immunoreactivities and activities of neutrophil elastase in the myofascia were observed after electric pulse stimulation-induced muscle contraction for 15 min. Our findings of EBD-labelled fibril dynamics in myofascia through quantitative approach using TPM imaging and intravital fluorescence labelling potentially brings new insights to examine muscle physiology and pathology.
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http://dx.doi.org/10.1111/joa.13339DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7855069PMC
March 2021

Visualization of Shoulder Ligaments Motion by Ultrasound Speckle Tracking Method

Annu Int Conf IEEE Eng Med Biol Soc 2020 07;2020:2084-2087

There is no unified consensus on the pathophysiology of adhesive capsulitis which is also called as frozen shoulder. Some studies have suggested that coracohumeral ligament (CHL) played an important role in adhesive capsulitis. These studies showed relation between disease prevalence and CHL thickness by means of ultrasound or MRI. Other possible etiology of the disease is the adhesion of shoulder ligament with each other. In the present study, shoulder ligaments motion is visualized with velocity vector by speckle tracking and temporal outlier removal algorithm to process ultrasound movie during forced movement of shoulder joint. The measurement with a typical subject has demonstrated an improvement of velocity vector deviation of up to 43% by the proposed outlier removal technique.
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http://dx.doi.org/10.1109/EMBC44109.2020.9176374DOI Listing
July 2020

Effects of arthroscopic pancapsular release for proximal humeral fractures treated with intramedullary nailing: a retrospective study.

JSES Int 2020 Sep 29;4(3):546-550. Epub 2020 May 29.

Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.

Background: Proximal humeral fractures are one of the most common fractures in adults. Some patients treated operatively have restriction in range of motion (ROM) after surgery. This study aimed to evaluate arthroscopic pancapsular release in patients with severe stiffness after treatment with intramedullary nailing for proximal humeral fractures.

Methods: This study included 12 patients (7 women and 5 men) who underwent arthroscopic pancapsular release in the beach-chair position between May 2015 and February 2018. Intraoperative findings were recorded, and ordinary (with scapulothoracic motion) and true (without scapulothoracic motion) glenohumeral ROMs were measured with a goniometer. The American Shoulder and Elbow Surgeons shoulder score, Shoulder Rating Scale score of the University of California, Los Angeles scoring system, and Constant score were compared before and after the release. The Wilcoxon signed rank and Mann-Whitney tests were used to analyze data.

Results: The average age of the patients was 65.1 years (standard deviation, 9.5 years), and the mean follow-up period after the release was 30.6 months (standard deviation, 11.7 months). All ROMs on the affected side after surgery were significantly greater than those before surgery in all directions. However, ROMs in forward flexion, lateral elevation, and external rotation with the arm at the side and at 90° of forward flexion on the affected side postoperatively were significantly lower than those on the unaffected side. All scores were significantly greater after surgery than before surgery.

Conclusion: Arthroscopic pancapsular release is effective for patients with proximal humeral fractures treated with intramedullary nailing.
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http://dx.doi.org/10.1016/j.jseint.2020.03.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479035PMC
September 2020

Validation and reliability of a Japanese version of the Shoulder Pain and Disability Index: A cross-sectional study.

J Orthop Sci 2020 Aug 20. Epub 2020 Aug 20.

Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.

Background: The Shoulder Pain and Disability Index (SPADI) is a simple disease specific questionnaire that is used to evaluate the impact of shoulder disorders. The purpose of this study was to translate the SPADI into Japanese (SPADI-Jp) and evaluate its reliability and validity in Japanese patients with shoulder disorders.

Methods: Cross-cultural adaptation of the SPADI was performed according to international guidelines. A total of 100 patients with shoulder disorders participated in this study. Each participant was asked to finish the SPADI-Jp, Disability of Arm, Shoulder and Hand (DASH), and the Short-Form 36 (SF-36) at the initial visit. Thirty-four patients repeated the SPADI-Jp to assess the test-retest reliability. The test-retest reliability was quantified using the interclass correlation coefficient (ICC), while Cronbach's alpha was calculated to assess the internal consistency. The construct validity was assessed using Spearman's rank correlation coefficients.

Results: Internal consistency in the SPADI-Jp was very high (0.969), as measured by the Cronbach's alpha. The ICC of the SPADI-Jp was 0.930. There was a strong, positive correlation between the DASH and the SPADI-Jp (r = 0.837, p < 0.001). The SPADI-Jp was significantly correlated with most of the SF-36 subscales. The correlations of the SPADI-Jp with physical subscales of the SF-36 were stronger than those with the other subscales.

Conclusions: We demonstrated that the SPADI-Jp is a reliable and valid self-assessment tool. Because cross-cultural adaptation, validation, and reliability of the disease-specific questionnaire for shoulder pain and disability have not been evaluated in Japan, the SPADI-Jp can be useful for evaluating such patients in the Japanese population.
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http://dx.doi.org/10.1016/j.jos.2020.06.007DOI Listing
August 2020

Low Back Pain in School-Aged Martial Arts Athletes in Japan: A Comparison among Judo, Kendo, and Karate.

Tohoku J Exp Med 2020 08;251(4):295-301

Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine.

Martial arts, such as judo, kendo, and karate, are popular worldwide, not only among adults but also among children and adolescents. Although low back pain (LBP) is considered to be a common problem in these sports, it has been scarcely studied, especially in young athletes. The purpose of this study was to elucidate the point prevalence of and factors related to LBP among school-aged athletes in judo, kendo, and karate. A cross-sectional study was conducted in school-aged athletes (age, 6-15 years; n = 896) using a self-reported questionnaire. Multiple logistic regression models were used to assess the factors related to LBP along with the odds ratio (OR) and 95% confidence interval (95% CI). Variables included in the analysis were sex, age, body mass index, team level, number of days and hours of training, frequency of participation in games, practice intensity, and lower extremity pain. The prevalence of LBP was 6.9% in judo, 4.7% in kendo, and 2.9% in karate. Older age was significantly associated with LBP in judo (adjusted OR, 2.12 [95% CI, 1.24-3.61]), kendo (1.77 [1.27-2.47]), and karate (2.22 [1.14-4.33]). Lower extremity pain was significantly associated with LBP in judo (6.56 [1.57-27.34]) and kendo (21.66 [6.96-67.41]). Coaches should understand the characteristics of LBP in each martial art to develop strategies to prevent LBP among school-aged martial arts athletes.
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http://dx.doi.org/10.1620/tjem.251.295DOI Listing
August 2020

High prevalence of low back pain among young basketball players with lower extremity pain: a cross-sectional study.

BMC Sports Sci Med Rehabil 2020 6;12:40. Epub 2020 Jul 6.

Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575 Japan.

Background: Low back pain (LBP) is a common problem among young basketball players in addition to lower extremity injuries. However, studies that focus on LBP with lower extremity pain are limited. From the perspective of the kinematic chain, disrupted lower extremity function can lead to LBP. The association between these two symptoms in basketball players, however, has not been reported. Therefore, this study aimed to clarify the association between lower extremity pain and LBP among young basketball players.

Methods: This cross-sectional study was conducted on school-aged basketball players ( = 592). Information regarding their sporting activities was collected using a self-reported questionnaire. Musculoskeletal pain such as low back, knee, and ankle pain was assessed. The sports players with knee and/or ankle pain were defined as having lower extremity pain. Multivariate logistic regression analysis was used to assess the association between lower extremity pain and LBP. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. The associations of knee or ankle pain with LBP were similarly assessed.

Results: School-aged basketball players had a point prevalence of 12.8% for LBP. Compared with the players without lower extremity pain, the players with lower extremity pain had higher rates of LBP, with an adjusted OR (95% CI) of 6.21 (3.57-10.80). There was also a significant association of knee and ankle pain with LBP. Compared with the players without knee or ankle pain, the adjusted ORs (95% CI) for LBP were 4.25 (2.55-7.07) in the players with knee pain and 3.79 (2.26-6.36) in the players with ankle pain.

Conclusions: Lower extremity pain was associated with LBP among school-aged basketball players. Further research is needed to clarify the mechanism of this association, which will provide useful information for prevention and treatment of LBP among young basketball players.
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http://dx.doi.org/10.1186/s13102-020-00189-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7339456PMC
July 2020

Social trust predicts sleep disorder at 6 years after the Great East Japan earthquake: data from a prospective cohort study.

BMC Psychol 2020 Jul 1;8(1):69. Epub 2020 Jul 1.

Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.

Background: The physical and psychological health impacts on victims of the Great East Japan Earthquake (GEJE) have lasted for a long time. Some cross-sectional studies have reported a relationship between social networks and/or social support and mental health among victims. Previous studies were cross-sectional observations at one time point after a disaster, it remains unclear whether the lack of social trust soon after the GEJE predicts long-term mental health outcomes among the victims. The objective of the present study was to examine prospectively the association between social trust soon after the GEJE and trends in sleep disorders up to 6 years after the GEJE.

Methods: We conducted a health survey on residents living in two areas affected by the GEJE. We analyzed data from 1293 adults (aged ≥18 years) who had participated in an initial health survey. The participants responded to a self-administrated questionnaire composed of items on health condition, mental health, including sleep disorders (based on the Athens Insomnia Scale [AIS]), and social trust. We classified the participants into two categories (high or low) based on the level of social trust at the first health survey. A linear mixed model was used to estimate trends in AIS scores in relation to social trust at the first health survey.

Results: The AIS scores of participants in the low social trust group were significantly higher than those in the high social trust group throughout the 6 years after the GEJE (P < 0.01). After adjusting for some covariates, the AIS score estimate for the participants who had low social trust was 1.30 point higher than those for the participants who had high social trust.

Conclusion: Social trust at 3 to 5 months after the GEJE predicted AIS scores at 6 years after the GEJE among victims. This finding suggests that it may be possible to identify people who have a lower potential for mental resilience from disaster damage over the long term. Further, health interventions for this high-risk group could help promote resilience after a disaster.
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http://dx.doi.org/10.1186/s40359-020-00436-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7329408PMC
July 2020

A new pathophysiology of atraumatic rotator cuff tears: adduction restriction of the glenohumeral joint.

JSES Int 2020 Jun 27;4(2):333-340. Epub 2020 Apr 27.

Department of Orthopaedic Surgery, East Japan Railway Sendai Hospital, Miyagi, Japan.

Background: The pathophysiology of atraumatic rotator cuff tears (ATTs) has not been fully understood. Adduction restriction of the glenohumeral joint can cause pain and disability in patients with ATTs. We aimed to use our adduction test (pushing the humerus toward the side in the coronal plane with scapular fixation) to fluoroscopically measure the glenohumeral adduction angle (GAA) and to assess the effectiveness of adduction manipulation.

Materials And Methods: Fifty-five patients with ATTs were included in the study. The GAAs of the patients vs. healthy subjects without ATTs were measured fluoroscopically and compared. During the test, patients showed restriction and expressed pain. The visual analog scale (VAS) score, passive range of motion (ROM), and the American Shoulder and Elbow Surgeons score at the initial visit were compared with those after adduction manipulation.

Results: Of the patients, 41 (75%) had positive adduction test results. A higher percentage of positive adduction test results was observed in smaller tears. The average GAA was -21.4° on the affected side, which was smaller than that on the unaffected side, at -2.8° ( < .001), and that in healthy subjects, at 4.8° ( < .001). After manipulation, the GAA was -0.8° ( < .001) and the VAS score, the American Shoulder and Elbow Surgeons score, and all ROM values significantly improved up to the level on the unaffected side.

Conclusion: Adduction restriction of the glenohumeral joint was identified in 75% of all the patients with ATTs. Adduction manipulation significantly reduces the VAS score and restores the ROM. Adduction restriction is considered a crucial pathophysiology of ATTs.
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http://dx.doi.org/10.1016/j.jseint.2020.02.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7256894PMC
June 2020

Preceding Poor Physical Function Is Associated with New-Onset Musculoskeletal Pain among Older Natural Disaster Survivors: A Longitudinal Study after the Great East Japan Earthquake.

Tohoku J Exp Med 2020 05;251(1):19-26

Department of Orthopaedic Surgery, Tohoku University School of Medicine.

Musculoskeletal pain is a major problem among survivors of natural disasters. Functional disabilities in older adults increase after disasters and can lead to musculoskeletal pain. However, the effects of poor physical function on musculoskeletal pain after natural disasters remain unclear. This study aimed to elucidate the association of poor physical function with new-onset musculoskeletal pain among older survivors after the Great East Japan Earthquake (GEJE). Survivors aged ≥ 65 years, 3 years after the GEJE, were assessed longitudinally for 1 year (n = 646). Musculoskeletal pain was assessed using a self-reported questionnaire, and new-onset musculoskeletal pain was defined as absence and presence of pain at 3 years and 4 years, respectively, after the disaster. Physical function at 3 years after the disaster was assessed using the Kihon Checklist physical function score, which consists of 5 yes/no questions, and poor physical function was defined as a score of ≥ 3/5. Multivariate logistic regression analyses were used to assess the association of poor physical function with new-onset musculoskeletal pain. The incidence of new-onset musculoskeletal pain was 22.4%. Participants with poor physical function had a significantly higher rate of new-onset musculoskeletal pain. Compared with high physical function, the adjusted odds ratio (95% confidence interval) for new-onset musculoskeletal pain was 2.25 (1.37-3.69) in poor physical function (P = 0.001). Preceding poor physical function was associated with new-onset musculoskeletal pain among older survivors after the GEJE. There is need to focus on the maintenance of physical function to prevent musculoskeletal pain after natural disasters.
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http://dx.doi.org/10.1620/tjem.251.19DOI Listing
May 2020

Effects of joint capsular release on range of motion in patients with frozen shoulder.

J Shoulder Elbow Surg 2020 Sep 12;29(9):1836-1842. Epub 2020 May 12.

Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.

Background: A thickened joint capsule is believed to be one of the most specific manifestations of and the primary restraint against range of motion (ROM) in frozen shoulders. The purpose of this study was to evaluate the relationship among ROMs under general anesthesia before surgery and the effects of each joint capsular release on ROM.

Methods: ROM was measured using a goniometer with scapular fixation. Arthroscopic pan-capsular release was performed with the patient in the beach-chair position in the following order: (1) rotator interval, (2) coracohumeral ligament, (3) superior capsule, (4) middle glenohumeral ligament, (5) anterior inferior glenohumeral ligament, and (6) posterior inferior glenohumeral ligament. ROMs in forward flexion (FF), lateral elevation (LE), external rotation with the arm at the side (ER1), external rotation at 90° of LE (ER2), internal rotation at 90° of LE (IR2), horizontal flexion, external rotation at 90° of FF (ER3), and internal rotation at 90° of FF (IR3) were evaluated before and after each release.

Results: A total of 32 consecutive shoulders were included. After each capsular release, the ROM recovered; the final ROM was significantly greater on the affected side than on the unaffected side. Significant correlations were found between FF and LE, FF and ER1, ER1 and ER2, ER1 and ER3, ER2 and ER3, and IR2 and IR3 on both sides, regardless of surgery.

Conclusion: Each segment of the joint capsule affected ROM in all directions, supporting the need for whole-joint capsular release; ROM was significantly greater on the affected side than on the unaffected side after surgery.
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http://dx.doi.org/10.1016/j.jse.2020.01.085DOI Listing
September 2020

Musculoskeletal pain in other body sites is associated with new-onset low back pain: a longitudinal study among survivors of the great East Japan earthquake.

BMC Musculoskelet Disord 2020 Apr 13;21(1):227. Epub 2020 Apr 13.

Department of Orthopaedic Surgery, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.

Background: Low back pain (LBP) is a common health problem experienced after natural disasters. LBP is often concurrent with other musculoskeletal pain; however, the effects of preexisting musculoskeletal pain on the development of LBP are not clear. The purpose of this study was to elucidate the association of musculoskeletal pain in other body sites with new-onset LBP among survivors of the Great East Japan Earthquake (GEJE).

Methods: A longitudinal study was conducted with survivors of the GEJE. The survivors who did not have LBP at the 3 year time period after the GEJE were followed up 1 year later (n = 1782). Musculoskeletal pain, such as low back, hand and/or foot, knee, shoulder, and neck pain, were assessed with self-reported questionnaires. The outcome of interest was new-onset LBP, which was defined as LBP absent at 3 years but present at 4 years after the disaster. The main predictor was musculoskeletal pain in other body sites 3 years after the GEJE, which was categorized according to the number of pain sites (0, 1, ≥ 2). Multiple regression analyses were performed to calculate the odds ratio (OR) and 95% confidence interval (CI) for new-onset LBP due to musculoskeletal pain in other body sites.

Results: The incidence of new-onset LBP was 14.1% (251/1782). Musculoskeletal pain in other body sites was significantly associated with new-onset LBP. Including people without other musculoskeletal pain as a reference, the adjusted OR and 95% CI for new-onset LBP were 1.73 (1.16-2.57) for people with one musculoskeletal pain site and 3.20 (2.01-5.09) for people with ≥ 2 sites (p <  0.001).

Conclusions: Preexisting musculoskeletal pain in other body sites was associated with new-onset LBP among survivors in the recovery period after the GEJE.
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http://dx.doi.org/10.1186/s12891-020-03234-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7155269PMC
April 2020

RAGE-dependent NF-kB inflammation processes in the capsule of frozen shoulders.

J Shoulder Elbow Surg 2020 Sep 9;29(9):1884-1891. Epub 2020 Apr 9.

Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.

Background: The etiology of frozen shoulder (FS) remains uncertain. Advanced glycation end-products (AGEs) cause the cross-linking and stabilization of collagen and are increased in FS. The purpose of this study was to elucidate the pathogenesis of FS by evaluating the receptor of AGE (RAGE)-dependent pathways.

Methods: Tissue samples of the coracohumeral ligament (CHL) and anterior inferior glenohumeral ligament (IGHL) were collected from 33 patients with FS, with severe stiffness, and 25 with rotator cuff tears (RCTs) as controls. Gene expression levels of RAGE, high-mobility group box 1 (HMGB1), Toll-like receptor 2 (TLR2), TLR4, nuclear factor-kappa B (NF-kB), and cytokines were evaluated using a quantitative real-time polymerase chain reaction. The immunoreactivities of carboxymethyllysine (CML), pentosidine, and RAGE were also evaluated. CML and pentosidine were further evaluated using high-performance liquid chromatography.

Results: Gene expression levels of RAGE, HMGB1, TLR2, TLR4, and NF-kB were significantly greater in the CHLs and IGHLs from the FS group than in those from the RCT group. Immunoreactivities of RAGE and CML were stronger in the CHLs and IGHLs from the FS group than in those from the RCT group. Pentosidine was weakly immunostained in the CHLs and IGHLs from the FS group. CML using high-performance liquid chromatography was significantly greater in the CHLs and IGHLs from the FS group than in those from the RCT group.

Conclusions: AGEs and HMGB1 might play important roles in the pathogenesis of FS by binding to RAGE and activating NF-kB signaling pathways. Suppression of these pathways could be a treatment option for FS.
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http://dx.doi.org/10.1016/j.jse.2020.01.076DOI Listing
September 2020

Osteochondritis dissecans of the glenoid in gymnasts: Report of two cases.

J Orthop Sci 2020 Feb 24. Epub 2020 Feb 24.

Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan.

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http://dx.doi.org/10.1016/j.jos.2020.01.015DOI Listing
February 2020

Association between lower back pain and lower extremity pain among young volleyball players: A cross-sectional study.

Phys Ther Sport 2020 May 18;43:65-69. Epub 2020 Feb 18.

Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan; Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.

Background: Lower back pain (LBP), as well as lower extremity injuries, are major problems among young volleyball players. Nevertheless, only few studies have focused on the relationship between lower extremity injuries and LBP.

Objective: This study investigated the association between LBP and lower extremity pain, including knee and ankle pain, among young volleyball players.

Design: Cross-sectional study.

Setting: Amateur sports association.

Participants: Elementary and middle school-aged athletes (6-15 years of age).

Main Outcome Measures: LBP and lower extremity pain.

Results: A total of 566 young volleyball players participated in this study. The point prevalence of LBP among young volleyball players was 9.5%. Using absence of lower extremity pain as a reference, the adjusted odds ratio (95% confidence interval) for LBP was 11.07 (5.64-21.71) in the presence of lower extremity pain.

Conclusions: LBP is associated with Lower extremity pain among young volleyball players. Careful attention should be paid to lower extremity complaints to prevent and treat LBP among young volleyball players.
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http://dx.doi.org/10.1016/j.ptsp.2020.02.005DOI Listing
May 2020

Upper Extremity Pain Is Associated with Lower Back Pain among Young Basketball Players: A Cross-Sectional Study.

Tohoku J Exp Med 2020 02;250(2):79-85

Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine.

Basketball is a major sport worldwide among different age groups that leads to a high frequency of injuries at multiple body sites. Upper and lower extremities and lower back are common pain sites in basketball players; however, there is little information about the relationship between upper or lower extremity pain and lower back pain. This study elucidated the associations between upper extremity (shoulder and elbow) pain and lower back pain (LBP) among young basketball players. We conducted a cross-sectional study using self-reported questionnaires mailed to 25,669 young athletes; the final study population comprised 590 basketball players, and their median age was 13 years (range: 6-15 years). The point prevalence rates of lower back, shoulder, elbow, and upper extremity pain among young basketball players were 12.9% (76/590), 4.6% (27/590), 2.7% (16/590), and 7.1% (42/590), respectively. Multivariate logistic regression analyses revealed that upper extremity pain was significantly associated with LBP (adjusted odds ratio [OR]: 7.86; 95% confidential interval [CI], 3.93-15.72). Shoulder pain was significantly associated with training per week (> 4 days) (adjusted OR: 4.15; 95% CI: 1.29-13.40) and LBP (adjusted OR: 13.77; 95% CI: 5.70-33.24). This study indicates that upper extremity and shoulder pain is associated with LBP among young basketball players. Assessing for lower back pain, as well as elbow and/or shoulder pain, may help prevent severe injuries in young basketball players. In conclusion, parents and coaches should be properly re-educated to help improve lower back, upper extremity, and shoulder pain among young basketball players.
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http://dx.doi.org/10.1620/tjem.250.79DOI Listing
February 2020

Correlations Between Range of Motion and Elasticity of the Coracohumeral Ligament Evaluated With Shear-Wave Elastography.

J Sport Rehabil 2020 Jan 24:1-7. Epub 2020 Jan 24.

Context: Range of motion (ROM) in the glenohumeral joint decreases with age in healthy subjects; however, the underlying mechanism remains unclear. The process of aging of the joint capsule, including the coracohumeral ligament (CHL), could affect ROM limitation.

Objective: This study investigated correlations between elasticity of the CHL, evaluated by means of shear-wave elastography, and age, side dominance, and ROM in healthy individuals.

Design: Experimental study.

Setting: Laboratory.

Subjects: Eighty-four healthy volunteers (39 men and 45 women, mean age: 42.6 y) were included.

Main Outcome Measures: Subjects were divided into 3 age groups: younger (20-39 y), middle (40-59 y), and older (≥60 y) age groups. With participants in the supine position, CHL elasticity in both shoulders was evaluated in both neutral and 30° external rotation, with arms at the sides. ROM, including forward flexion, lateral elevation, external rotation, 90° abduction with external rotation, and hand behind the back were measured with participants in the standing position.

Results: The CHL elastic modulus was higher in the older group than in the younger group in the neutral (78.4 kPa [SD: 37.1] and 56.6 kPa [SD: 31.7], respectively) and 30° external rotation positions (135.5 kPa [SD: 63.5] and 71.4 kPa [SD: 32.2], respectively). Negative correlations were found between the CHL elastic modulus and ROM in terms of 30° external rotation and both external rotation (R = -.59, P = .02) and 90° abduction with external rotation (R = -.71, P = .003) in the older group, with correlation coefficients increasing with age.

Conclusions: Significant correlations were identified between CHL elasticity and ROM in both external rotation and 90° abduction with external rotation with increasing age. Decreased CHL elasticity was strongly associated with decreased shoulder ROM in middle-aged and older individuals.
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http://dx.doi.org/10.1123/jsr.2019-0279DOI Listing
January 2020

Parents' Own Experience of Verbal Abuse Is Associated with their Acceptance of Abuse towards Children from Youth Sports Coaches.

Tohoku J Exp Med 2019 12;249(4):249-254

Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine.

Verbal or physical abuse from coaches has negative effects on young athletes, and the parents of athletes also have an influence on the sports environment. It is therefore important to understand parents' attitudes towards abuse against their children from the coaches. This study aimed to elucidate the characteristics of parents who accept the infliction of verbal or physical abuse on their children from coaches of youth sports teams. A cross-sectional study using self-report questionnaires was conducted with parents of young athletes (n = 6,493). Multivariate logistic regression models were used to assess the factors associated with parents' acceptability of verbal or physical abuse against their children. The proportion of parents who were accepting of verbal or physical abuse was 21.5%. Acceptability of verbal or physical abuse was significantly associated with male (odds ratio: 1.67, 95% confidence interval: 1.43-1.95), younger age (1.24, 1.09-1.41), lower educational attainment (1.32, 1.17-1.50), smoking habits (1.42, 1.23-1.63), experience of playing on a team with high levels of competition during their junior or high school days (1.31, 1.15-1.50), and experience of verbal and physical abuse by their own former coaches (3.59, 3.03-4.26 and 1.17, 1.02-1.35). About 58% and 28% of parents had experienced verbal and physical abuse from their own former coaches, and parents who had experienced verbal abuse themselves were most likely to be accepting of verbal or physical abuse towards their children. Educating parents is considered to be important for preventing and eradicating abuse against young athletes.
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http://dx.doi.org/10.1620/tjem.249.249DOI Listing
December 2019

Exercise-evoked intramuscular neutrophil-endothelial interactions support muscle performance and GLUT4 translocation: a mouse gnawing model study.

J Physiol 2020 01 13;598(1):101-122. Epub 2019 Dec 13.

Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan.

Key Points: Fractalkine receptor antagonist inhibited neutrophil recruitment to masseter muscles and exacerbated fatigability during masticatory activity. Fractalkine-mediated neutrophil recruitment is required for both upregulation of myokines (CXCL1, interleukin-6) and enhanced GLUT4 translocation in response to masticatory activity. Fractalkine and intercellular adhesion molecule-1 expression in endothelial cells increased in response to masticatory activity. In vitro experiments demonstrated that contracting myotubes lack the ability to upregulate fractalkine but revealed that endothelial fractalkine upregulation is induced using a conditioned medium of contracting myotubes.

Abstract: Physical exercise stimulates neutrophil recruitment within working skeletal muscle, although its underlying mechanisms remain ill-defined. By employing a masticatory behaviour (gnawing) model, we demonstrate the importance of intramuscular paracrine and autocrine systems that are triggered by muscle contractile activity and reliant upon fractalkine/CX3CL1-mediated signals. These signals were revealed to be required for achieving proper GLUT4 translocation and glucose uptake to meet the glucose demands for fatigue alleviation. Specifically, fractalkine expression and neutrophil recruitment both increased in the masseter muscle tissues upon masticatory activity. Importantly, a fractalkine antagonist inhibited neutrophil accumulation and exacerbated fatigability during masticatory activity. We found that fractalkine-dependent neutrophil recruitment is required for both upregulation of myokines (i.e. CXCL1 and interleukin-6) and enhanced GLUT4 translocation in response to gnawing activity. Immunofluorescence analysis of masseter muscles demonstrated that fractalkine and intercellular adhesion molecule-1 expression are both upregulated in endothelial cells but not in myofibres. The in vitro exercise model further revealed that contractile activity failed to stimulate fractalkine upregulation in myotubes, implying that fractalkine is not a myokine (myofibre-derived factor). Nevertheless, endothelial fractalkine expression was markedly stimulated by a conditioned medium from the contracting myotubes. Moreover, intercellular adhesion molecule-1, a key adhesion molecule for neutrophils, was upregulated in endothelial cells by fractalkine. Taken together, our findings strongly suggest that endothelial fractalkine serves as a key factor for organizing a physiologically beneficial intramuscular microenvironment by recruiting neutrophils in response to relatively mild exercise (i.e. masticatory muscle activity).
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http://dx.doi.org/10.1113/JP278564DOI Listing
January 2020

Musculoskeletal pain and new-onset poor physical function in elderly survivors of a natural disaster: a longitudinal study after the great East Japan earthquake.

BMC Geriatr 2019 10 17;19(1):274. Epub 2019 Oct 17.

Department of Orthopaedic Surgery, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.

Background: Functional disability is a significant problem after natural disasters. Musculoskeletal pain is reported to increase after disasters, which can cause functional disability among survivors. However, the effects of musculoskeletal pain on functional decline after natural disasters are unclear. The present study aimed to examine the association between musculoskeletal pain and new-onset poor physical function among elderly survivors after the Great East Japan Earthquake.

Methods: A longitudinal study was conducted on survivors aged ≥65 years at three and 4 years after the Great East Japan Earthquake. A total of 747 persons were included in this study. Physical function was assessed using the Kihon Checklist. New-onset poor physical function was defined as low physical function not present at 3 years but present at 4 years after the disaster. Knee, hand or foot, low back, shoulder, and neck pain was assessed using a self-reported questionnaire and was defined as musculoskeletal pain. Musculoskeletal pain at 3 years after the disaster was categorized according to the number of pain regions (0, 1, ≥ 2). Multiple logistic regression analyses were performed to calculate the odds ratio (OR) and 95% confidence interval (95% CI) for new-onset poor physical function due to musculoskeletal pain.

Results: The incidence of new-onset poor physical function was 14.9%. New-onset poor physical function was significantly associated with musculoskeletal pain. Compared with "0" musculoskeletal pain region, the adjusted ORs (95% CI) were 1.39 (0.75-2.58) and 2.69 (1.52-4.77) in "1" and "≥ 2" musculoskeletal pain regions, respectively (p for trend = 0.003).

Conclusions: Musculoskeletal pain is associated with new-onset poor physical function among elderly survivors after the Great East Japan Earthquake. Monitoring musculoskeletal pain is important to prevent physical function decline after natural disasters.
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http://dx.doi.org/10.1186/s12877-019-1283-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6798362PMC
October 2019