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Background: After anterior cruciate ligament reconstruction (ACLR), asymmetry is likely to persist in single-leg (SL) vertical jump and drop jump performance than in SL hop distance. However, its relationship with the return to sport (RTS) remains unclear., Hypothesis/purpose: This study aimed to determine the association between vertical jump performance after primary ACLR using hamstring tendon autograft and RTS at a pre-injury competitive level., Study Design: Cross-sectional study., Methods: Patients who underwent primary ACLR using hamstring tendon autograft were recruited for this study. Participants who returned to pre-injury competition after ACLR were recruited at least eight months postoperatively. Knee condition was assessed, including joint laxity, range of motion, muscle strength, and knee pain intensity during sports activities. Performance variables were also assessed, including SL hop distance, jump height in SL vertical jump, and reactive strength index (RSI; jump height/contact time) in SL drop jump. Participants were asked to subjectively report whether they had returned to the same level of competition as pre-injury and their perceived sport performance intensity. Those who answered "Yes" to the dichotomous question and had a postoperative subjective athletic performance of > 80% were categorized into the Yes-RTS group. The primary outcome was the ability to achieve RTS at the preinjury level., Results: Sixty-five patients (female, 35; male, 30) at 13.0 (13.0) [median (interquartile)] months after ACLR participated in this study. Thirty-nine (60%) were assigned to the Yes-RTS group. Regarding knee conditions, the No-RTS group had a significantly higher knee pain intensity, as assessed using a numerical rating scale (p<0.001, effect size -0.45). In the performance tests, the No-RTS group exhibited a significantly lower limb symmetry index of RSI during the SL drop jump compared to the Yes-RTS group (p=0.002, effect size 0.81)., Conclusion: Patients unable to achieve RTS after primary ACLR using hamstring grafts are more likely to exhibit asymmetric performance during the SL drop jump test, suggesting the significance of assessing jump symmetry when evaluating post-ACLR rehabilitation success., Level of Evidence: 3c., Competing Interests: The authors certify that there are no conflicts of interest with any financial organization regarding the material discussed in the manuscript., (© The Author(s).)

Objectives: The objectives were to compare forward head posture (FHP) in natural and corrected head postures between patients with nonspecific neck pain (NSNP) and controls and to clarify the relationship between natural and corrected head posture angle differences and deep cervical flexor function. This study aimed to provide useful evidence for postural assessment and treatment in patients with NSNP., Methods: In this cross-sectional study, 19 patients with NSNP reporting a pain score of 3-7 for at least 3 months and 19 participants with no neck pain within the previous 12 months were recruited. To evaluate FHP, the cranial rotation and vertical angles were measured using lateral head and neck photographs. The craniocervical flexion test was used to evaluate deep cervical flexor activation and endurance. We evaluated the head and neck alignment in natural and corrected head postures and the relationship between the degree of change and deep cervical flexor function., Results: FHP in the natural head posture did not differ between groups. In the corrected head posture, FHP was significantly smaller in the NSNP group than in the control group. In the NSNP group, the cranial rotation and vertical angles were significantly different between the natural and corrected head postures, and the angle difference correlated significantly with deep cervical flexor function., Conclusions: Patients with NSNP show hypercorrection in the corrected head posture, which may be correlated with deep cervical flexor dysfunction. Further investigation into the causal relationship between hypercorrection, deep neck flexor dysfunction, and neck pain is required., Competing Interests: Declaration of Competing interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

This study aimed to determine differences in the hip abductor muscle activity during clam exercise at different hip flexion and femoral anteversion angles. Thirty healthy females were divided into two groups based on the femoral anteversion angle: the excessive femoral anteversion group and the normal group. Clam exercise was performed at three different hip flexion angles (60°, 45°, and 30°). Tensor fascia latae, gluteus medius, and superior portion of gluteus maximus activities were measured during the exercise, and the results were normalized to the activity during maximum voluntary isometric contraction to calculate the gluteal-to-tensor fascia latae muscle activation index. The superior portion of gluteus maximus activities at a hip flexion of 60° and 45° were greater than that at 30°. The excessive femoral anteversion group had a lower gluteal-to-tensor fascia latae muscle activation index than the normal group; the gluteal-to-tensor fascia latae muscle activation index for hip flexion at 60° was higher than that at 45°, and the gluteal-to-tensor fascia latae muscle activation index for hip flexion at 60° and 45° were higher than that at 30°. Therefore, the femoral anteversion angle and hip joint position were related to the activity of the hip abductor muscles during clam exercise. These findings may provide a rationale for instructing exercises to maximize the activity of the hip abductor muscles in individuals with an excessive femoral anteversion angle., Competing Interests: The authors declare no competing interests., (Copyright: © 2024 Mitomo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Purpose: This study aimed to investigate the intricate relationship between physical function factors and each subcategory score of the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale among patients following ACL reconstruction., Methods: Participants comprised 59 patients who had undergone primary ACL reconstruction using hamstring tendon. The ACL-RSI was completed 6 months after reconstruction and five physical functions were measured in patients on the same day. Simple linear regression was performed multiple times to investigate the relationship between ACL-RSI subcategory scores as a dependent variable and each independent variable (knee strength, leg anterior reach distance, single-leg hop [SLH] distances, side bridge endurance, and subjective running ability). Multiple regression analysis was performed using a stepwise method, with factors showing a risk rate <0.05 in simple linear regression analyses as independent variables and the ACL-RSI in each subcategory score as the dependent variable., Results: Multiple regression analysis showed that subjective running ability affected all subcategories ( p  ≤ 0.001), and that the limb symmetry index of medial SLH distance affected both the Emotions ( p  = 0.047) and Confidence ( p  = 0.009) subcategories. Higher subjective running ability and greater limb symmetry in the medial SLH were thus positively associated with each dimension of psychological readiness., Conclusions: This study highlights the differential impact of physical function factors on specific subcategories of the ACL-RSI scale, providing clinicians with insights for designing targeted rehabilitation strategies. This original paper suggests the importance of analysing factors related to subcategory scores in addition to total ACL-RSI score, and could contribute to the understanding of determinants for a successful return to sport following ACL reconstruction., Level of Evidence: Level IV., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s). Journal of Experimental Orthopaedics published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)

Purpose: To identify the factors associated with anterior cruciate ligament return to sport after injury (ACL-RSI) scores in patients awaiting ACL reconstruction (ACLR)., Methods: This was a retrospective cross-sectional observational study conducted at a single clinical center. We recruited patients scheduled for primary ACLR, aged 16-45 years, and with modified Tegner activity scale scores ≥5 before ACL injury. The main outcome was psychological readiness to return to sport (RTS), as measured using the ACL-RSI scale. Participants' personal and injury-related information were obtained, and their psychological status (Tampa Scale for Kinesiophobia [TSK] and athletic identity measurement scale) and knee functions (effusion, range of motion, joint stability, and knee flexion angle during a single-leg squat) were examined. All variables were assessed the day before the surgery., Results: A total of 105 patients (median [interquartile range]: age, 20.0 [9.0] years; body mass index, 22.8 [4.3] kg/m 2 ; days from injury to surgery, 63.0 [65.0] days; 44% female) were enrolled. Univariate analysis indicated that only the TSK score was associated with the ACL-RSI scores (r = -0.305; P = .02). Multiple regression analysis of factors, including sex, preinjury Tegner activity scale score, and days from injury to surgery, further showed that only the TSK score was associated with the ACL-RSI scores (P = .002; 95% confidence interval -1.738 to -0.394)., Conclusions: In patients awaiting ACLR, kinesiophobia was moderately negatively associated with psychological readiness to RTS, while other factors were not., Level of Evidence: Level III, retrospective cross-sectional observational study., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Introduction: Kinesiophobia is a fear of physical movement and activity and is known to affect return to sports and second injury after anterior cruciate ligament reconstruction., Objective: To determine the association among landing biomechanics, knee pain, and kinesiophobia in athletes following anterior cruciate ligament reconstruction., Design: A cross-sectional study., Setting: Clinical center of sports medicine., Participants: This study included 31 athletes who participated in sports after primary, unilateral anterior cruciate ligament reconstruction (age, median [interquartile range]: 20.0 [7.0] years; body mass index: 22.2 [2.6] kg/m 2 ; time from anterior cruciate ligament reconstruction: 24.0 [23.0] months)., Interventions: Not applicable., Main Outcome Measures: Kinesiophobia was measured using the Tampa Scale for Kinesiophobia-11. Knee function included joint laxity, strength, and single-leg hop distance. Knee pain intensity during sports activities was measured using a numerical rating scale. Vertical ground reaction force was measured, and electromyography data for the vastus medialis and semitendinosus muscles during single-leg jump landing were collected. Univariate correlation analysis and multiple regression analysis were performed to identify the associations between the Tampa Scale for Kinesiophobia-11 score and outcome measures., Results: There was no correlation between peak vertical ground reaction force and Tampa Scale for Kinesiophobia-11 score (Spearman's r = -0.17, p = .355). On multiple regression analyses, lower preparatory vastus medialis activity during landing (beta coefficient = -0.51, p < .001) and knee pain intensity (beta coefficient = 0.57, p < .001) were significantly associated with greater Tampa Scale for Kinesiophobia-11 scores., Conclusions: In athletes who have participated in sports following anterior cruciate ligament reconstruction, lower preparatory vastus medialis activity during landing and knee pain intensity are associated with greater kinesiophobia. These findings indicate that interventions to address the landing muscle activity pattern and pain control should be performed to decrease kinesiophobia after anterior cruciate ligament reconstruction., (© 2022 American Academy of Physical Medicine and Rehabilitation.)

Background: Medial tibial stress syndrome (MTSS) is a running-related injury of the lower extremities. After returning to competition, there are often recurring episodes of MTSS. Therefore, it is important to prevent the onset and recurrence of MTSS among long-distance runners. This case-control study aimed to compare the kinematics and kinetics of runners with and without previous MTSS during running to clarify the biomechanical characteristics of the lower extremity of runners with previous MTSS., Methods: Thirteen male long-distance runners aged over 18 years and asymptomatic at the time of measurement were divided into an MTSS group and a non-MTSS group based on their history of MTSS as reported in a questionnaire. The kinetics and kinematics of running were analyzed when participants ran at a speed of 2.0 ± 0.2 m/s by a three-dimensional motion analysis system and two force plates. Data regarding the joint angles, moments, and powers of the ankle, knee, and hip during the stance phase while running were extracted and compared between the two groups using the Mann-Whitney U test., Results: Of the 13 participants, 5 and 8 were included in the MTSS (10 legs) and non-MTSS (16 legs) groups, respectively. The ankle maximum eversion moment was significantly larger in the MTSS group than in the non-MTSS group (p = 0.04). There were no significant differences in other parameters., Conclusions: This study found that the ankle maximum eversion moment during the stance phase of running was larger in the MTSS group than in the non-MTSS group. Even after the disappearance of the symptoms of MTSS, the running biomechanics of participants with previous MTSS differed from those of participants without previous MTSS., (© 2023. The Author(s).)

Purpose: To determine characteristic changes in subjective knee function, kinesiophobia, and psychological readiness to return to sports between scores taken before anterior cruciate ligament reconstruction (ACLR) and those taken 6 months post-ACLR., Methods: Thirty-two participants (median age, 20.0 years) were included. Subjective knee function was assessed using the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF). The Tampa Scale for Kinesiophobia (TSK-11) and Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) scale were used to evaluate kinesiophobia and psychological readiness to return to sport, respectively. Questionnaires were administered 1 day before surgery and at 6 months post-ACLR. A positive change was defined as an increase in IKDC-SKF and ACL-RSI scores and a decrease in TSK-11 score. The change in each score from pre-ACLR to 6 months post-ACLR was analyzed using a paired t-test. The percentage change in scores was calculated, and the correlations of the percentage change in the TSK-11 and ACL-RSI scores and that in the IKDC-SKF score were analyzed., Results: All scores differed significantly positively from pre-ACLR to 6 months post-ACLR. The proportion of participants whose scores did not change positively from pre-ACLR to 6 months post-ACLR was higher for the TSK-11 (38.0%) and ACL-RSI (38.0%) than for the IKDC-SKF (6.3%). No correlation was observed between the percentage change in the IKDC-SKF score and that in the TSK-11 or ACL-RSI scores from pre-ACLR to 6 months post-ACLR., Conclusions: Changes in subjective knee function and psychological status from pre-ACLR and 6 months post-ACLR may not be interdependent., (© 2022. The Author(s).)

Context: Deficits in knee extension strength after anterior cruciate ligament reconstruction have been a major problem. The inadequate recovery of the knee extension strength of surgical limb reportedly delays return to sports and increases reinjury risk. Accordingly, the early detection of knee extension strength deficits after reconstruction may help plan early interventions to manage impairment. This study aimed to clarify the association between knee extension strength at 3 and 6 months after anterior cruciate ligament reconstruction., Design: Retrospective study., Methods: Fifty patients who underwent primary anterior cruciate ligament reconstruction using hamstring grafts were included. At 3 months postoperatively, the limb symmetry index (LSI) of isokinetic knee extension strength (IKE) at 60°/s, degree of swelling, passive range of motion of knee flexion and extension, and anterior leg reach distance were measured. At 6 months postoperatively, the LSI of IKE was measured at 60°/s, which was used as the main outcome. A correlation analysis was performed with the LSI of IKE at 6 months postoperatively as the dependent variable and the LSI of IKE at 3 months postoperatively as the independent variable. Subsequently, a multiple regression analysis was performed, with LSI of IKE at 6 months postoperatively as the dependent variable; LSI of IKE at 3 months postoperatively as the independent variable; and other variables, demographic information, and surgical data as covariates., Results: The correlation analysis revealed that the LSIs of IKE at 3 and 6 months postoperatively were correlated (r = .535, P < .001). In the multiple regression analysis, the LSI of IKE at 3 months postoperatively was significantly associated with that at 6 months postoperatively, even when other variables were included as covariates (R2 = .349, P = .004)., Conclusion: Asymmetry of knee extension strength at 3 months postoperatively could be more useful than other variables related to knee strength in predicting the asymmetry of knee extension strength at 6 months postoperatively.

Background: The association of the reactive strength index (RSI) during single-limb vertical continuous jumps (SVCJs) with single-limb hop tests in athletes after anterior cruciate ligament reconstruction (ACLR) is unclear. Thus, this study aimed to confirm the measurement properties of the RSI during SVCJs in athletes with ACLR at the phase of determining the timing of their return to sport., Methods: RSI during SVCJs and single-limb hop (single, triple, and crossover) tests were measured for post-ACLR and healthy athletes. The limb symmetry index (LSI) was calculated using the measurements of each parameter. For each test, patients were divided into two subgroups according to their LSI score (≥ 90%, satisfactory; < 90%, unsatisfactory). Fisher's exact test was used to examine the association of single-limb hop tests with RSI during the SVCJs., Results: A total of 21 post-ACLR and 17 healthy athletes completed all the tests. RSI during SVCJs was significantly lower on the involved limb than on the uninvolved limb in post-ACLR athletes (P < 0.001). The LSI of RSI during SVCJs of post-ACLR athletes was significantly lower than that of the healthy athletes (P < 0.01). Among the post-ACLR athletes, < 30% of those with LSIs > 90% in the single-limb hop tests had an LSI > 90% of the RSI during SVCJs., Conclusions: RSI during SVCJs of post-ACLR athletes was significantly lower on the involved limb than on the uninvolved limb, and the asymmetry was more remarkable in the SVCJs than in the single-limb hop tests., (© 2022. The Author(s).)

Background: Information about specific factors of physical function that contribute to psychological readiness is needed to plan rehabilitation for a return to sports. The purpose of this study was to identify specific physical functions related to the psychological readiness of patients aiming to return to sports 6 months after reconstruction. We hypothesized that the knee strength is a factor related to the Anterior Cruciate Ligament-Return to Sport after Injury scale (ACL-RSI) cutoff score for a return to sports., Methods: This was a cross-sectional study. Fifty-four patients who had undergone primary reconstruction using hamstring tendon participated in this study. Psychological readiness was measured using the ACL-RSI in patients at 6 months after reconstruction. To identify specific physical functions related to the ACL-RSI score, participants were divided into groups with ACL-RSI scores of ≥ 60 or < 60. Non-paired t-tests or the Mann-Whitney test were performed to analyze group differences in objective variables in physical function: (1) knee strength in both legs; (2) leg anterior reach distance on both sides; and (3) single-leg hop (SLH) distances in three directions for both legs., Results: Significant differences between groups were identified in knee flexion strength (60°/s) for the uninvolved limb, hamstring-to-quadriceps ratio (60°/s) for the uninvolved limb, knee flexion strength (180°/s) for the involved limb, limb symmetry index (LSI) of leg anterior reach distance, the ratio of the distance to the height of the patient and LSI of SLH distances in lateral and medial directions., Conclusion: This study revealed that at 6 months after reconstruction, increased knee flexion strength (ratio of peak torque measured to body mass of the patient), hamstring-to-quadriceps ratio, leg anterior reach distance LSI, and lateral and medial SLH appear important to exceed the ACL-RSI cutoff for a return to sports. The present results may be useful for planning post-operative rehabilitation for long-term return to sports after reconstruction., (© 2022. The Author(s).)

The cranial vertical angle (CVA) and cranial rotation angle (CRA) are used in clinical settings because they can be measured on lateral photographs of the head and neck. We aimed to clarify the relationship between CVA and CRA photographic measurements and radiographic cervical spine alignment. Twenty-six healthy volunteers were recruited for this study. Lateral photographs and cervical spine radiographs were obtained in the sitting position. The CVA and CRA were measured using lateral photographs of the head and neck. The C2-7 sagittal vertical axis (SVA), cervical lordosis (C2-7), and occipito-C2 lordosis (O-C2) were measured using radiographic imaging as a standard method of evaluating cervical spine alignment. Correlations between the CVA and CRA on photographs and cervical spine alignment on radiographs were analyzed. The CVA and SVA were significantly negatively correlated (ρ = −0.51; p < 0.05). Significant positive correlations were found between CVA and C2-7 (ρ = 0.59; p < 0.01) and between CRA and O-C2 (ρ = 0.65; p < 0.01). Evaluating the CVA and CRA on photographs may be useful for ascertaining head and neck alignment in the mid-lower and upper parts of the sagittal plane.

Purpose: We aimed to evaluate the relationship between the daily wheelchair self-propulsion distance and functional recovery in subacute stroke survivors., Methods: Seventy-four patients with stroke were prospectively recruited from four convalescent rehabilitation hospitals. All participants were unable to walk independently and required manual wheelchairs for locomotion on admission. The daily wheelchair self-propulsion distance was measured using a cycle computer that was connected to a touch switch to exclude the assistance-propulsion distance. The outcome measures were represented as the relative gain of the Functional Independence Measure (FIM) effectiveness during hospitalization. Moreover, a better functional recovery was defined as a FIM effectiveness > 50%. Participants were categorized into three groups according to tertiles of the average daily wheelchair self-propulsion distance: lowest tertile (T1, ≤0.59 km/day); middle tertile (T2, 0.60-1.23 km/day); and highest tertile (T3, ≥1.24 km/day)., Results: Multivariate logistic regression analysis adjusted for baseline characteristics showed that the T2 and T3 groups had a significant association with better FIM effectiveness, and their odds ratios (95% confidence interval, p) were 7.26 (1.13-45.85, p  = .038), and 10.19 (1.15-91.75, p  = .035), respectively., Conclusions: The daily wheelchair self-propulsion distance was significantly associated with functional recovery in subacute stroke survivors.IMPLICATIONS FOR REHABILITATIONNon-ambulatory stroke survivors can obtain extra independent physical activity by using wheelchair self-propulsion, when they do not have someone to assist them with walking.This multicenter observational study revealed that the self-propulsion distance of a manual-wheelchair was significantly associated with functional recovery in subacute stroke survivors.

Background: /objectives: For biomechanical studies using jump-landing tasks, many researchers set the criteria for judging success or failure of the trial. Failed trials are usually removed from the analysis. However, the kinetics and kinematics during tasks included in failed trials might be important for understanding the mechanisms and risk factors of non-contact sports injuries. However, few studies have attempted to analyze failed trials. Therefore, the main objective of this study was to investigate the characteristics associated with ground reaction force (GRF) and two-dimensional frontal body movements during a failed trial of single-leg lateral drop jump-landing., Methods: Ten healthy women and 16 healthy men participated in this study. Spearman's rank correlation coefficients were calculated using the total number of failed trials and GRF data of successful trials. The association between frontal body movement and kinetics data was identified using correlation analyses. Wilcoxon signed-rank tests were performed to compare the GRF data of successful trials and failed trials of the same subject. Additionally, a two-way repeated measure analysis of variance was used to determine significant interactions of each trial and time after initial contact in the frontal body movement., Results: A total of 137 trials including successful and failed trials were recorded. There were 59 failed jump trials. There was a significant negative correlation between the number of failed jump trials and the elapsed time from initial contact to peak vertical GRF (peak vGRF time) during successful trials (r = -0.427). The majority of failed trials were judged to be due to rearfoot movement patterns (rearfoot medial slip or rearfoot lateral slip). During rearfoot medial slip, we observed shorter peak vGRF time, larger trunk medial motions, and larger hip adduction movements after landing than that during successful trials. During rearfoot lateral slip, we observed larger trunk lateral motions and hip abduction movements after landing than that during successful trials., Conclusions: Athletes who frequently failed during single-leg lateral drop jump-landing had poor skills absorbing jump-landing impact, which is related to various sports injuries. It is possible to identify the risk factors for sports injuries by analyzing failure patterns., Competing Interests: The authors have no conflicts of interest relevant to this article., (© 2021 Asia Pacific Knee, Arthroscopy and Sports Medicine Society. Published by Elsevier (Singapore) Pte Ltd.)

Objective: To determine the association of psychological readiness to return to sports preoperative and 6 months post-reconstruction in athletes with anterior cruciate ligament (ACL) injury., Design: Retrospective cohort study., Setting: Clinical center of sports medicine., Participants: Fifty athletes, aged 16-45 years, were included in this study. Participants had a modified Tegner activity scale score ≥5 before ACL injury., Main Outcome Measures: Participants were divided into High and Low groups based on ACL-return to sport after injury scale (ACL-RSI) scores 6 months post-ACL reconstruction (ACLR) (cutoff: 56 points)., Results: The Low group had lower ACL-RSI scores than the High group preoperatively (P < 0.001) and 6 months post-ACLR (P < 0.001). The High group had a significantly greater amount of change in ACL-RSI scores preoperatively to 6 months post-ACLR than the Low group (P = 0.003). Preoperative ACL-RSI scores increased significantly to 6 months post-ACLR in the entire group of participants (P < 0.001) and in the High group (P < 0.001). However, in the Low group, ACL-RSI scores did not increase significantly (P = 0.714)., Conclusions: Participants with low ACL-RSI scores 6 months post-ACLR had low preoperative ACL-RSI scores that did not improve preoperatively to 6 months post-ACLR., Competing Interests: Declaration of competing interest None declared., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Most patients with anterior cruciate ligament (ACL) injury undergo ACL reconstruction (ACLR) with the expectation of being able to return to sport (RTS) at the same level of the competition as before the injury. The magnitude and asymmetry of landing impact are important post-ACLR functional variables related to increased ACL strain and poor athletic performance. However, the association between the RTS status and landing impact in post-ACLR patients is unknown., Objective: To investigate the association between RTS status and landing impact during single-leg landing in post-ACLR patients., Methods: Forty-four patients after primary, unilateral ACLR participated in this study. They had already participated in sports post-ACLR. Questionnaires were used to assess whether the participants achieved the same competitive level of RTS as before the injury. The magnitude and symmetry of the peak vertical ground reaction force (pVGRF) were collected and analysed during single-leg jump landings. Additionally, knee functions (range of motion, laxity, effusion, strength, and single-leg hop distance) were measured., Results: A total of 28 (64%) patients reported RTS at their pre-injury competition levels. The no-RTS group had a lower pVGRF magnitude on the operated side than the yes-RTS group ( P  = .019). The no-RTS group had a higher rate of pVGRF asymmetry (50%) than the yes-RTS group (18%) ( P  = .040). Logistic regression analysis revealed that pVGRF magnitude and asymmetry were significantly associated with the RTS status. Logistic regression analysis adjusted for knee function revealed that the pVGRF magnitude was significantly associated with the RTS status., Conclusion: In patients who are unable to RTS at their pre-injury competition level after ACLR, the pVGRF is lower and more likely to be asymmetrical than in those able to RTS at their pre-injury competition level., Competing Interests: None declared., (© 2021 Asia Pacific Knee, Arthroscopy and Sports Medicine Society. Published by Elsevier (Singapore) Pte Ltd.)

Background: When planning rehabilitation and conditioning for performance enhancement and a return to sports after anterior cruciate ligament reconstruction, identifying the elements of physical function associated with single-leg hop is important. The purpose of this study was to clarify the relationship between single-leg hop distances in three directions and knee extensor and flexor strengths at 6 months after reconstruction., Methods: Participants were 47 patients taking part in training sessions for sports involving cutting, pivoting, and jump-landing 6 months after reconstruction using a hamstring tendon. Single-leg hop distances in 3 directions (anterior, lateral, and medial) and isokinetic concentric strengths of knee extension and flexion were assessed at an angular velocity of 60°/s and 180°/s. Simple regression analyses using Spearman's rank correlation coefficient were performed to assess relationships between single-leg hop distances and knee strengths., Results: In the involved limb, correlations between single-leg hop distances in 3 directions and knee strengths were significant (P < 0.01) and correlation coefficients ranged from 0.48 to 0.65. Correlation coefficients between all single-leg hop parameters and knee extension/flexion strengths at an angular velocity of 180°/s were greater than those of 60°/s., Conclusions: In this cross-sectional study of patients who participated in sports training sessions that required jump-landings and cutting approximately 6 months after reconstruction using hamstring grafts, isokinetic knee flexor, and extensor torques were moderately to strongly associated with single-leg hop distances in lateral, medial, and anterior directions. Given these relationships, assessments and exercises for knee strength and single-leg hop distances should be planned.

Background: This study aimed to determine the relationships between athletic identity and sport commitment and return to sports (RTS) status in athletes after anterior cruciate ligament reconstruction (ACLR)., Methods: Thirty-nine participants post-ACLR (8-24 months) were included in this cross-sectional study. Measures included the athletic identity measurement scale and sport commitment scale. In addition, we measured kinesiophobia and psychological readiness using the Tampa Scale for Kinesiophobia and ACL-Return to sport after injury scale. The subjects were categorized into Yes-RTS or No-RTS based on two questions to determine whether they were returning to sport at the same level of competition as before the injury. A Chi-squared test, Fisher's exact test, unpaired t-test, and Mann-Whitney's U test were used to analyze the data., Results: The Yes-RTS group had significantly higher scores on the athletic identity measurement scale (P = 0.023, effect size [ES] = - 0.36), sport commitment scale (P = 0.027, ES = - 0.35), and ACL-Return to sport after injury scale (P = 0.002, ES = - 0.50) and significantly lower Tampa Scale for Kinesiophobia scores (P = 0.014, ES = - 0.39) compared to the No-RTS group., Conclusion: Athletes who returned to sports at the same level of competition as before the injury had higher athletic identity and sport commitment and lower kinesiophobia compared to those who did not return to sports at the same level of competition. These self-beliefs regarding sport may play an important role in post-ACLR athletes' RTS.

Background/objective: Injury-related fear during sport activities are major psychological factors inhibiting a person's return to sports (RTS) following anterior cruciate ligament reconstruction (ACLR). Currently, there are no studies that quantitatively analyse the open-ended questionnaire for knee injury-related fear in post-ACLR athletes.The purpose of this study was to identify knee injury-related fear in athletes who return to ball-centric sports via the use of an open-ended questionnaire. We aimed to determine the main concepts of injury-related fear according to sex, type of sport, and participation level., Methods: In this study, a quantitative analysis of an open-ended questionnaire was used to examine the type of fear athletes experience after returning to ball-centric sports. The RTS and fear questionnaire collected open-ended questionnaire to knee injury-related fear during sport activities; this questionnaire was completed at the outpatient visit post-RTS. Quantitative content analysis was performed to extract frequently occurring words from the responses to the questionnaire to create a co-occurrence network. The resulting co-occurrence network and extracted words were used to create concepts regarding knee injury-related fear. The relationship between each concept and subject demographics (sex, returned sports events, and participation level) were analysed using the chi-squared test., Results: Fifty-four athletes (30 females and 24 males) aged 16-45 [median age: 21.2; interquartile range (IQR): 11.0] years with an average RTS of 8.0 (IQR: 3.3) months from ACLR participated in the study. A total of 79 responses were included in the analysis. The knee injury-related fear can be summarized as follows: (1) Quick response to the opponent; (2) Ball-related play; (3) Jump-landing; (4) Contact; (5) Loss of balance; and (6) Athletic movement. Chi-squared tests showed that athletes participating in sport events with potential contact with an opponent (soccer, futsal, basketball, handball, lacrosse, and ultimate (frisbee)) were more likely to experience fear in quick response to the opponent (P < 0.01, adjusted residual = 2.943, ϕ = 0.301)., Conclusion: The knee injury-related fear can be summarized into six concepts. Post-ACLR athletes participating in ball-centric sports need to assess fear in situations such as quick responses to the opponent's movements and ball-related play, in addition to simple movements such as jumping, cutting, and contact., Competing Interests: None declared., (© 2021 Asia Pacific Knee, Arthroscopy and Sports Medicine Society. Published by Elsevier (Singapore) Pte Ltd.)

Purpose: To investigate the relationship between single-leg hop distance (SLHD), normalized body height, and return-to-sports (RTS) status after anterior cruciate ligament reconstruction (ACLR) and to identify the cut-off value for SLHD on the operated side., Methods: Seventy-three patients after primary ACLR (median 13.5 months) participated in this cross-sectional study. Participants were divided into ''Yes-RTS'' (YRTS) or ''No-RTS'' (NRTS) groups based on a self-reported questionnaire. SLHD was measured, and the limb symmetry index (LSI) and SLHD (%body height) were calculated. A minimum p-value approach was used to calculate the SLHD cut-off points (%body height) on the operated side that were strongly associated with the RTS status. Logistic regression analysis was used to analyse the association between RTS status and SLHD cut-off point (%body height). Isokinetic strength and Tampa scale for kinesiophobia (TSK) were measured as covariates., Results: Among 73 patients, 43 (59%) were assigned to the YRTS and 30 (41%) to the NRTS group. The 70% body height cut-off point for SLHD on the operated side was most strongly associated with RTS status. In a logistic regression analysis including other covariates, SLHD (%body height) < 70% and TSK were negatively associated with RTS status. Except for two participants, the LSI of the SLHD exceeded 90% and there was no significant association between the LSI of the SLHD and RTS status., Conclusion: Even after improvement in the LSI of the SLHD, planning rehabilitation with the goal of achieving SLHD over 70% body height may be important for supporting RTS after ACLR., Level of Evidence: Cross-sectional study, Level IV.

Objective: Although the propulsion distance of a wheelchair is measured by some devices, measuring self-propulsion distance, excluding assistance propulsion distance by the caregiver, is difficult. This is a pilot study conducted to verify whether the propulsion distance of wheelchair users, excluding the assistance propulsion distance, can be measured using a cycle computer by attaching the touch switch. Methods: The wheelchair propulsion distance was measured using a cycle computer. We connected the touch switch and the cycle computer to the wheelchair to exclude assistance propulsion distance. We set the cycle computer to stop recording while the caregiver was touching the sensor. To confirm the propulsion distance using the cycle computer, the volunteer propelled the wheelchair on a rectangular facility with a total distance of 181 m, and the examiner confirmed the propulsion distance. The validation test to confirm the accuracy of the touch switch attached to the cycle computer was performed on a 50-m straight runway. The volunteer and caregiver propelled the wheelchair alternately by 10 m and continued until 50 m. The examiner confirmed the distance after 50-m propulsion. Results: In the 181-m rectangular facility, the propulsion distance that the volunteer propelled the wheelchair with the cycle computer was 180 m. In the 50-m straight runway, the propulsion distance was 30 m with caregiver assistance for 20 m. Conclusion: The present study showed that our modified device could measure the self-propulsion distance, excluding assistance propulsion distance in wheelchair users.

Background: A single-leg vertical jump height (SLVJ) may reflect knee extension strength more than a single-leg hop for distance (SLH). This study aimed to examine the relationships between the isokinetic knee extension torque, SLH, and SLVJ after anterior cruciate ligament reconstruction (ACLR)., Methods: Forty-four patients post-ACLR (median 12.0 months) participated in the study. The isokinetic knee extension peak torque at 60°/s and 180°/s (Ext 60, 180), SLH, and SLVJ were measured. The limb symmetry index (LSI) was calculated as the ratio of the operated side to the unoperated side., Results: There were moderate-to-strong positive correlations between isokinetic knee extension torque and both SLH (r = 0.72-0.77, P < 0.001) and SLVJ (r = 0.73-0.79, P < 0.001). Significant side-to-side differences in isokinetic knee extension torque and SLVJ between the operated and unoperated sides were found (P < 0.05), but not for SLH (P = 0.065). The results of the analysis of variance (ANOVA) and post hoc analyses showed that the LSI of SLH (98.2%) was higher than that of the LSI of Ext 180 and SLVJ (P < 0.05). Fisher's exact test showed a significant relationship between the LSI of Ext 180 and that of SLVJ (cut-off 85%; P = 0.041). No patients had LSI < 85% in SLH., Conclusions: Even though SLH asymmetry improved approximately 12 months after ACLR, the asymmetry of isokinetic knee extension torque and SLVJ remained. The LSI of SLVJ could be an indicator of the recovery of isokinetic knee extension torque., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: High psychological readiness is an important element for returning to sports after anterior cruciate ligament (ACL) reconstruction. Identifying factors that contribute to psychological readiness is essential for planning interventions to return to play. No studies have used multivariate analysis to clarify factors associated with psychological readiness to return to specific sports., Hypothesis: To identify factors that contribute to an athlete's psychological readiness to return after ACL reconstruction to sports that require cutting, pivoting, and jump-landings., Study Design: Cross-sectional study; Level of evidence, 3., Methods: Study participants were athletes who before injury had participated in sports with limited contact that required cutting, pivoting, and jump-landings (basketball, soccer, futsal, volleyball, badminton, tennis, and frisbee) and hoped to return to the same sport after reconstruction. Psychological readiness was measured using the Anterior Cruciate Ligament-Return to Sport After Injury Scale (ACL-RSI) in athletes more than 6 months after primary ACL reconstruction. To clarify factors associated with the ACL-RSI, univariate regression analysis and multivariate regression analysis were performed using the following independent variables: age, sex, body mass index, time from injury to reconstruction, time from reconstruction to testing, meniscal surgery, modified Tegner activity scale before injury, kinesiophobia, limb symmetry index of knee strength, limb symmetry indices of single-leg hop (SLH) distances, and subjective running ability., Results: Higher subjective running ability, a lower kinesiophobia score, and greater limb symmetry in the lateral SLH were positively associated with psychological readiness., Conclusion: The psychological readiness of athletes aiming to return after ACL reconstruction to limited-contact sports that require cutting, pivoting, and jump-landings was affected by subjective running ability, kinesiophobia, and asymmetry of lateral SLH distance. This information may be useful in planning appropriate interventions and thereby increasing the likelihood of an athlete's returning to such sports., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: This work was supported by the JSPS KAKENHI (grant No. JP26350606). AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2020.)

Objective: The aim of this study was to investigate the relationship between tongue muscle quality index, which was represented as tongue muscle pressure divided by tongue muscle mass, and swallowing speed in community-dwelling older women., Methods: The inclusion criteria for this cross-sectional study were that participants be community-dwelling older women aged 65 years and above without dysphagia. The exclusion criteria were stroke and Parkinson's disease that directly cause dysphagia. We measured tongue muscle thickness and maximum tongue pressure and the tongue muscle quality index, which was defined as the maximum tongue pressure divided by tongue muscle thickness. We investigated swallowing speed via a 100 ml water swallowing test. To assess the relationship between tongue muscle characteristics and swallowing speed, we performed stepwise multiple regression analysis., Results: Ninety-three participants were enrolled in this study (mean age: 84.2 ± 4.7 years). A stepwise multiple regression analysis showed that age (β = - 0.292, p < 0.01) and tongue muscle quality index (β = 0.267, p < 0.01) were related to swallowing speed., Conclusion: We found that tongue muscle quality index was related to swallowing speed in community-dwelling older women. According to our findings, it is possible that the tongue muscle quality index is a useful parameter for assessing swallowing speed in older women without dysphagia.

An aerobic bacterium, designated strain 5N-3 (NBRC 113055), that degrades cis-dichloroethene (cDCE) was isolated from a sea sediment in Japan. Strain 5N-3 was able to degrade a certain amount of cDCE in the presence of pyruvate without the action of inducers. In the presence of inducers, such as phenol and benzene, the strain completely removed cDCE. By the application of 16S ribosomal RNA (16S rRNA) gene sequencing and average nucleotide identity analyses, the strain 5N-3 was identified as Marinobacter salsuginis. On the other hand, identified species of Marinobacter are not known to degrade cDCE at all. A draft genome sequence analysis of the strain 5N-3 suggested that the dmp-homologous operon (operon for phenol degradation) may be contributing to the aerobic degradation of cDCE. This is the first report on an aerobic marine bacterium that has been found to degrade cDCE.

Background: On a questionnaire administered to athletes who had undergone anterior cruciate ligament reconstruction (ACLR), some answered "yes" to a question regarding return to sports (RTS) at the preinjury level despite having lower postoperative subjective athletic performance (PoSAP) intensity compared with preoperative levels., Purpose: To investigate the agreement between responses regarding RTS and PoSAP intensity after ACLR., Study Design: Cohort study (diagnosis); Level of evidence, 3., Methods: A total of 44 individuals, 24.8 ± 18.4 months after ACLR, participated in this study. They completed a questionnaire in which PoSAP was graded as a percentage of preoperative performance level. They also gave dichotomous responses (yes/no) to the question of whether they had been able to RTS at the same level as before their injury (RTS question). Participants were divided into 2 groups according to their PoSAP scores using different cutoff values (100%, 90%, 80%, and 70%), and an exploratory analysis was conducted of the cutoff value for dividing PoSAP scores that provided the greatest agreement with the response to the RTS question., Results: The mean PoSAP score was 87.5% ± 14.9%, and 33 participants (75%) answered "yes" to the RTS question. The agreement between the PoSAP score and the RTS question was lowest when the cutoff value was 100% (κ = 0.294) and highest when the cutoff value was 80% (κ = 0.676) and 90% (κ = 0.632)., Conclusion: More athletes who had undergone ACLR answered "yes" to the RTS question even when their PoSAP score was around 80%. Asking only for dichotomous responses may result in overestimating the level to which these athletes' performance has recovered after ACLR., Competing Interests: The authors declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2020.)

Purpose: The anterior cruciate ligament-return to sports after injury (ACL-RSI) scale assesses the psychological impact of returning to sports (also referred to as psychological readiness) after ACL reconstruction. The aim of this study was to evaluate important measurement properties of the Japanese version of ACL-RSI scale., Methods: Ninety-three participants who underwent ACL reconstruction filled out the Japanese version of ACL-RSI scale, the Tampa scale for kinesiophobia (TSK), the International Knee Documentation Committee-Subjective Knee Form (IKDC-SKF), and Knee injury and Osteoarthritis Outcome Score (KOOS). To assess test re-test reliability, 50 of the 93 participants re-answered the Japanese version of ACL-RSI scale within 10 days. Floor and ceiling effects, internal consistency, construct validity, and reliability of the Japanese version of ACL-RSI scale were analysed., Results: There were no floor and ceiling effects. The Japanese version of ACL-RSI scale showed good internal consistency (Cronbach's alpha = 0.912). It was positively correlated with total points of IKDC-SKF and the Lysholm score, and with the all sub-categories of the KOOS, and it was negatively correlated with the TSK. Reliability of the Japanese version of ACL-RSI scale was satisfactory., Conclusion: The Japanese version of ACL-RSI scale has acceptable measurement properties. It can be a useful for evaluation of psychological readiness for return to sports in Japanese athletes who undergo primary ACL reconstruction. Information provided by the Japanese version of the ACL-RSI scale may also help to identify athletes who find return to sport a challenge, and guide conversations regarding treatment and rehabilitation plans., Level of Evidence: II.

Subculturing is frequently used for the preservation of basidiomycetes. In this study, to assess and verify the risks of repeated subculturing on the long-term preservation of strains of culture collections, we performed single nucleotide polymorphism (SNP) analysis in genes encoding enzymes of the mevalonate pathway, 1,3-β-glucan synthesis, lignin degradation, and the tricarboxylic acid (TCA) cycle of mycelia before and after preserving for a 4-year period by the subculturing 30 times every 45 days of Ganoderma lucidum NBRC 8346. As a result of analyzing 60 genes of the strain, SNPs were found in 18 genes, and 14 of them were found in the exon region. Nonsynonymous coding SNPs were found in two genes ( atoB&#95;2 , hmgr ) encoding enzymes of mevalonate pathway and five genes ( lcc1&#95;9 , lcc1&#95;11 , lcc1&#95;13 , dslcc6 , aa5&#95;1&#95;9 ) encoding enzymes of lignin degradation after subculturing of G. lucidum NBRC 8346.

Factors associated with functional recovery after stroke may differ by age demographics because the aging process leads to various regressive changes. The aim of this study was to identify factors related to functional recovery in Japanese patients with convalescent stroke stratified by age. A multicenter retrospective observational study was conducted in 243 patients from six convalescent inpatient rehabilitation wards. Participants were categorized into three groups: 40-64, 65-74, and ≥75 years. Demographic data, laboratory data, physical function, and cognitive function were collected upon admission, and outcome measures were represented using the relative gain of the Functional Independence Measure (FIM effectiveness) during hospitalization. Stepwise multivariate logistic analysis was performed to identify the significant factors for functional recovery in each group. In the 40-64 years group, stroke type [odds ratio (OR), 10.38; 95% confidence interval (CI), 2.22-48.59], spatial neglect (OR, 7.61; 95% CI, 2.07-28.00), and memory disorder (OR, 4.68; 95% CI, 1.08-20.30) were shown to be significant factors. In the 65-74 years group, only memory disorder (OR, 3.42; 95% CI, 1.19-9.81) was significant. In the ≥75 years group, low albumin level (OR, 3.35; 95% CI, 1.05-10.67), severe motor impairment (OR, 5.11; 95% CI, 1.14-22.97), and memory disorder (OR, 4.34; 95% CI, 1.43-13.23) were significantly related to poor functional recovery. In conclusions, the findings showed that there were different trends among the factors related to poststroke functional recovery among the three age groups.

Aim: The objective of this trial was to investigate the synergistic effects of bodyweight resistance exercise and a protein supplement with vitamin D on skeletal muscle in sarcopenic or dynapenic older adults., Methods: This was a four-arm randomized controlled trial. Sarcopenic or dynapenic older adults were recruited for this trial. After screening, a total of 112 older adults were randomly allocated among four groups; 28 older adults each were enrolled in the combined resistance exercise and nutritional supplementation group, the exercise alone group, the nutritional supplementation alone group, and the control group. Participants in the combined group and exercise alone groups took part in a bodyweight resistance exercise program for 12 weeks. Protein and vitamin D supplements were provided every day for 12 weeks for the participants in the combined group and nutritional supplementation alone groups. We assessed the echo intensity of participants' thigh muscle using ultrasonography, measured their appendicular muscle mass using a bioelectrical impedance data acquisition system, and tested their knee extension strength and physical function., Results: Participants in the combined group had a significantly greater improvement in rectus femoris echo intensity and knee extension torque than those in the other groups (P < 0.05). Furthermore, the combined program increased appendicular muscle mass in sarcopenic older adults (P < 0.05), but not in older adults with low physical function with normal muscle mass., Conclusions: The present study confirmed the synergistic effect of bodyweight resistance exercise and protein supplement with vitamin D on muscle quality and muscle strength in sarcopenic or dynapenic older adults. Geriatr Gerontol Int 2019; 19: 429-437., (© 2019 Japan Geriatrics Society.)

Purpose: To examine the relationship between oral function and sarcopenia staging, including dynapenia and presarcopenia, in community-dwelling older adults., Methods: A cross-sectional study was performed in community-dwelling older women aged 65 years and above. We measured oral muscle strength using maximum tongue pressure, oral muscle performance using oral diadochokinesis, and subjective swallowing difficulties using the Eating Assessment Tool. We measured skeletal muscle mass and function and other variables. All participants were divided into 4 groups (normal, presarcopenia, dynapenia, and sarcopenia) using an algorithm that operationally defines sarcopenia staging by skeletal muscle characteristics. A general linear model was used to analyze differences in oral function among the 4 groups., Results: A total of 245 participants were enrolled (median age [IQR], 81.0 [75.0-85.0]). The proportion of normal participants and those with presarcopenia, dynapenia, and sarcopenia was 48.6% (n = 119), 9.4% (n = 23), 30.2% (n = 74), and 11.8% (n = 29), respectively. The sarcopenia and dynapenia groups had significantly lower maximum tongue pressure and oral diadochokinesis than the normal group. In the multivariate analysis, after adjusting for age, maximum tongue pressure and oral diadochokinesis were found to be significantly lower in the sarcopenia and dynapenia groups than in the normal group., Conclusions: In this study, participants with sarcopenia and dynapenia showed low oral function, and similar trends were indicated for oral function and skeletal muscle according to progression of sarcopenia staging. Future research should clarify the characteristics of swallowing-related muscles, including muscle mass, strength, and performance at each sarcopenia stage., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Type strains of 72 validated Nocardia species were phylogenetically analyzed based on the multilocus sequence analysis (MLSA) concatenated atpD-groL1-groL2-recA-rpoA-secY-sodA-ychF. Furthermore, their similarity based on digital DNA-DNA hybridization (dDDH) was calculated. Nocardia soli, Nocardia cummidelens and Nocardia salmonicida, Nocardia nova and Nocardia elegans, Nocardia exalbida and Nocardia gamkensis, and Nocardia coubleae and Nocardia ignorata formed coherent clades, respectively. Moreover, each set showed over 70% relatedness by dDDH and shared common phenotypic characteristics. Therefore, we propose a reclassification of Nocardia soli and Nocardia cummidelens as a later heterotypic synonym of Nocardia salmonicida, Nocardia elegans as a later heterotypic synonym of Nocardia nova, Nocardia gamkensis as a later heterotypic synonym of Nocardia exalbida, and Nocardia coubleae as a later heterotypic synonym of Nocardia ignorata.

[Purpose] The purpose of this study was to examine limb-dominance and gender differences in the magnitude of the ground reaction force during single-leg lateral jump-landings. We hypothesized that the peak ground reaction force would be larger in the non-dominant leg compared to that in the dominant leg and would be larger in females compared to that in men. [Subjects and Methods] Fifteen females and 15 males performed jump-landings sideways from a height of 20 cm, with a lateral distance of 60 cm. Vertical and medial ground reaction forces were measured, and the elapsed time from the initial contact to the peak ground reaction force was determined. The loading rate was calculated as the peak ground reaction force divided by the elapsed time from the initial contact to the peak ground reaction force. [Results] The vertical and medial peak ground reaction forces during single-leg lateral jump-landings were larger in females compared to that in males. In addition, the medial peak ground reaction force was larger for the non-dominant leg compared to that for the dominant leg. [Conclusion] The results suggest that in rehabilitation and conditioning settings, evaluations and instructions regarding attenuation are especially important for females and the non-dominant leg.

Nonalcoholic fatty liver disease (NAFLD) is now the most common liver disease in the world. NAFLD can progress to nonalcoholic steatohepatitis (NASH), cirrhosis and eventually hepatocellular carcinoma. Acquired hepatic iron overload is seen in a number of patients with NAFLD; however, its significance in the pathology of NAFLD is still debated. Here, we investigated the role of dietary iron supplementation in experimental steatohepatitis in rats. Rats were fed a control, high-fat (HF), high-fat high-iron (HFHI) and high-iron (HI) diet for 30 weeks. Blood biochemical, histopathological and gut microbiota analyses were performed. Rats in HF and HFHI groups showed an ALT-dominant elevation of serum transaminases, hepatic steatosis, hepatic inflammation, and upregulation of proinflammatory cytokines. The number of large inflammatory foci, corresponding to lobular inflammation in NASH patients, was significantly higher in HFHI than in HF group; within the lesion, macrophages with intense iron staining were observed. Hepatic expression of TNFα was higher in HFHI than that in HF group. There was no significant change in hepatic oxidative stress, gut microbiota or serum endotoxin levels between HF and HFHI groups. These results suggested that dietary iron supplementation enhances experimental steatohepatitis induced by long-term high-fat diet feeding in rats. Iron-laden macrophages can play an important role in the enhancement of hepatic inflammation., Competing Interests: The authors declare no conflict of interest.

Background: Sarcopenia is diagnosed on the basis of skeletal muscle mass and muscle strength/function. However, more simple and accurate measures for muscle mass and muscle strength/function should be explored., Objective: The aim of this study was to compare the skeletal muscle characteristics at each stage of sarcopenia (normal, presarcopenia, dynapenia, and sarcopenia) via ultrasonography, multifrequency bioelectrical impedance analysis (BIA), and physical assessment batteries in community-dwelling older adults. By evaluating the relationship between muscle quality/quantity indicators and muscle mass/muscle function, we attempted to identify better muscle quantity and quality indicators for the diagnosis of sarcopenia., Setting and Subjects: Community-dwelling older men (n = 100, 81.6 ± 7.4 years) and women (n = 247, 79.7 ± 6.9 years) participated in this study., Measurements: Skeletal muscle quantity and quality were measured by ultrasonography and multifrequency BIA. Ultrasonographic (thickness and echo intensity) and multifrequency BIA (volume and density) indicators, as well as physical assessment measures, were compared among each stage of sarcopenia. In addition, receiver-operating characteristic analysis was used to assess the sensitivity and specificity of each indicator., Results: Most of the muscle quantity indicators were lower in the sarcopenia and presarcopenia groups than in the other groups, whereas most of the muscle quality indicators were lower in the sarcopenia and dynapenia groups than in the other groups. According to the receiver-operating characteristic analysis, quadriceps muscle thickness and thigh muscle volume were better indicators of muscle mass, whereas the quadriceps muscle echo intensity and thigh muscle density were more robust indicators of muscle function., Conclusions: In this study, we found potential muscle quality and quantity indicators for sarcopenia diagnosis by ultrasonography and multifrequency BIA. Future longitudinal studies are warranted to define the role of these indicators for the diagnosis of sarcopenia., (Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

The aim of this study was to analyze the effect of teeth clenching on dynamic balance at jump landing. Twenty-five healthy subjects performed jump-landing tasks with or without teeth clenching. The first 3 trials were performed with no instruction; subsequently, subjects were ordered to clench at the time of landing in the following 3 trials. We collected the data of masseter muscle activity by electromyogram, the maximum vertical ground reaction force (vGRFmax) and center of pressure (CoP) parameters by force plate during jump-landing. According to the clenching status of control jump-landing, all participants were categorized into a spontaneous clenching group and no clenching group, and the CoP data were compared. The masseter muscle activity was correlated with vGRFmax during anterior jump-landing, while it was not correlated with CoP. In comparisons between the spontaneous clenching and the no clenching group during anterior jump-landing, the spontaneous clenching group showed harder landing and the CoP area became larger than the no clenching group. There were no significant differences between pre- and postintervention in both spontaneous clenching and no clenching groups. The effect of teeth clenching on dynamic balance during jump-landing was limited.

Pseudomonas putida is well-known for degradation activities for a variety of compounds and its infections have been reported. Thus, P. putida includes both clinical and nonclinical isolates. To date, no reports have examined the phylogenetic relationship between clinical and nonclinical isolates of the P. putida group. In this study, fifty-nine strains of P. putida group containing twenty-six clinical, and thirty-three nonclinical, isolates, were subjected to phylogenetic and taxonomic analyses based on 16S rRNA gene sequences and nine housekeeping gene sequences, including argS, dnaN, dnaQ, era, gltA, gyrB, ppnK, rpoB, and rpoD, to obtain insights into the diversity of species in this group. More than 97.6% similarity was observed among the 16S rRNA gene sequences of all the strains examined, indicating that the resolution of 16S rRNA gene sequences is inadequate. Phylogenetic analysis based on the individual housekeeping genes listed above improved the resolution of the phylogenetic trees, which are different from each other. Multilocus sequence analysis (MLSA) based on the concatenated sequences of the nine genes significantly improved the resolution of the phylogenetic tree, and yielded approximately the same results as average nucleotide identity (ANI) analysis, suggesting its high reliability. ANI analysis classified the fifty-nine strains into twenty-six species containing seventeen singletons and nine strain clusters based on the 95% threshold. It also indicated the mixed distribution of clinical and nonclinical isolates in the six clusters, suggesting that the genomic difference between clinical and nonclinical isolates of the P. putida group is subtle. The P. putida type strain NBRC 14164 T is a singleton that is independently located from the P. putida strains distributed among the six clusters, suggesting that the classification of these strains and the differentiation of species in the P. putida group should be re-examined. This study greatly expands insights into the phylogenetic diversity of the P. putida group.

[Purpose] The correlations of peak vertical ground reaction force and sagittal angles during single-leg lateral jump-landing with noncontact anterior cruciate ligament injury remain unknown. This study aimed to clarify the correlations between kinematics and impact force during lateral jump-landing. [Subjects and Methods] Twenty active males were included in the analysis. A sagittal-view movie camera and force plate were time synchronized. Trunk and lower extremity sagittal angles were measured 100 ms before initial contact and at peak vertical ground reaction force. Peak vertical ground reaction force, time between initial contact and peak vertical ground reaction force, and loading rate were calculated. [Results] The mean sagittal angle was 40.7° ± 7.7° for knee flexion during the flight phase and 16.4° ± 6.3° for pelvic anterior inclination during the landing phase. The mean peak vertical ground reaction force was four times the body weight. The median time to peak vertical ground reaction force was 63.8 ms. The knee flexion during the flight phase and pelvic anterior inclination angles during the landing phase were related to the peak vertical ground reaction force. [Conclusion] Increasing knee flexion and decreasing pelvic anterior inclination might reduce the impact during single-leg lateral jump-landing.

Bacteria capable of degrading cis-dichloroethene (cDCE) were screened from cDCE-contaminated soil, and YKD221, a bacterial strain that exhibited a higher growth on minimal salt agar plates in the presence of cDCE than in the absence of cDCE, were isolated. Phylogenetic studies of the 16S rRNA as well as gyrB, rpoD, and recA in YKD221 indicated that this strain is closely related to the type strains of Pseudomonas plecoglossicida, monteilii, and putida. An average nucleotide identity analysis indicated that YKD221 is most closely related to P. putida strains, including the type strain, which suggests that YKD221 belongs to P. putida. Although the genome of YKD221 was very similar to that of P. putida F1, a toluene-degrading strain, the YKD221 genome has 15 single-nucleotide polymorphisms and 4 insertions compared with the F1 genome. YKD221 caused the release of sufficient chloride ions from cDCE to suggest that the strain is able to completely dechlorinate and degrade cDCE. YKD221 also degraded trichloroethene but was unable to degrade trans-dichloroethene and tetrachloroethene. The degradation activity of YKD221 was elevated after growth on toluene. Inactivation of todC1, which encodes for a large subunit of the catalytic terminal component in toluene dioxygenase, resulted in a complete loss of growth on toluene and cDCE degradation activity. This is the first evidence of the involvement of todC1C2BA-coded toluene dioxygenase in cDCE degradation. YKD221 did not appear to grow on cDCE in a minimal salt liquid medium. However, YKD221 did exhibit an enhanced increase in cell concentration and volume of cells during growth on minimal salt agar plates with cDCE when first grown in LB medium. This behavior appears to have led us to misinterpret our initial results on YKD221 as an indication of improved growth in the presence of cDCE.

Multilocus sequence analysis based on hypervariable housekeeping proteins was utilized to differentiate closely related species in the family Enterobacteriaceae. Of 150 housekeeping proteins, the top 10 hypervariable proteins were selected and concatenated to obtain distance data. Distances between concatenated proteins within the family were 0.9-41.2%, whereas the 16S rRNA and atpD-gyrB-infB-rpoB concatenated sequence (4MLSA) distances were 0.8-6.0% and 0.9-22.1%, respectively. These data indicate that phylogenetic analysis by concatenation of hypervariable proteins is a powerful tool for discriminating species in the family Enterobacteriaceae. To confirm the discriminatory power of the 10 chosen concatenated hypervariable proteins (C10HKP), phylogenetic trees based on C10HKP, 4MLSA, and the 16S rRNA gene were constructed. Comparison of average bootstrap values among C10HKP, 4MLSA and 16S rRNA genes indicated that the C10HKP tree was the most reliable. Location via the C10HKP tree was consistent with existing assignments for almost all species in the family Enterobacteriaceae. However, the C10HKP tree suggested that several species (including Enterobacter massiliensis, Escherichia vulneris, Escherichia hermannii, and Salmonella subterranea) should be reassigned to different clusters than those defined in previous analyses. Furthermore, E. hermannii and S. subterranea appeared to fall onto a branch independent from those occupied by the other Enterobacteriaceae. Therefore, we propose Atlantibacter gen. nov., such that E. hermannii and S. subterranea would be transferred to genus Atlantibacter as Atlantibacter hermannii, comb. nov. and Atlantibacter subterranea. comb. nov., respectively., (© 2016 The Societies and John Wiley & Sons Australia, Ltd.)