Search Results (68)

Background and Objectives: Type 2 diabetes mellitus (T2DM) is a major public health issue worldwide that leads to reductions in skeletal muscle mass and lower-limb function, thereby increasing the risk of locomotive syndrome (LS), a mobility-limiting condition. This study investigated the effects of a 5-month, lower limb-focused, low-intensity resistance exercise program using slow movements (slow exercise) on LS in patients with T2DM. Materials and Methods: Nineteen patients with T2DM (69.3 ± 7.3 years, 10 men and 9 women) performed slow exercises three times per week for 5 months. The program consisted of bodyweight and machine-based exercises with a load of 30–50% one-repetition maximum using slow concentric–isometric–eccentric phases. Assessments included HbA1c, LS stage distribution (non-LS, LS-1, LS-2, LS-3), LS risk tests (two-step, stand-up, and GLFS-25), five-time sit-to-stand test, four-meter gait speed, and skeletal muscle mass index (SMI) and phase angle (PhA) by bioelectrical impedance analysis. Statistical comparisons were performed using repeated one-way ANOVA with Tukey’s post hoc test and Cochran’s Q test. Results: HbA1c decreased from 7.5 ± 0.7% to 7.2 ± 0.8% (p < 0.05). LS stage distribution improved significantly (stage 3: 4 to 0; non-LS: 1 to 5; each p < 0.05). The two-step test and GLFS-25 improved (1.17 ± 0.15 to 1.27 ± 0.17; 14.6 ± 13.1 to 7.6 ± 6.3; each p < 0.05). Five-time sit-to-stand time improved from 9.28 ± 2.53 s to 7.73 ± 1.54 s, and four-meter gait speed improved from 3.58 ± 0.95 s to 3.07 ± 0.55 s (each p < 0.05). SMI and PhA increased (6.82 ± 1.00 to 6.95 ± 0.92 kg/m²; 4.35 ± 0.67 to 4.56 ± 0.78 degrees; each p < 0.05). Conclusions: A 5-month slow exercise program significantly improved LS severity, muscle quantity and quality, and lower-limb function in patients with T2DM. Slow exercise may be a safe and effective intervention to improve mobility and maintain independence in this population. Full article

Fibromyalgia syndrome (FMS) is a chronic disorder marked by widespread musculoskeletal pain, fatigue, mood disturbances, and cognitive impairments. Current treatments primarily focus on symptom management. Ashwagandha (Withania somnifera), a traditional Ayurvedic herb, is known for its adaptogenic and neuroprotective properties. This study evaluated the protective effects of the methanolic root extract of Ashwagandha (ARE) in a reserpine-induced fibromyalgia model in male Swiss albino mice. Mice received oral ARE (100 mg/kg) for 17 days and reserpine (0.5 mg/kg, subcutaneously) for three consecutive days to induce fibromyalgia-like symptoms. Behavioral assessments included Von Frey, tail suspension, rotarod, and Y-maze tests. Histological analysis was conducted on the hippocampus and thalamus; however, neurochemical analysis focused on markers such as serotonin, norepinephrine, IL-1β, TNFα, MDA, and NO. Results indicated that ARE significantly reduced pain and depressive-like behavior and improved motor function (p < 0.0001); however, no significant changes were observed in open-field locomotion. Histological examination revealed protection of Ashwagandha against neurodegeneration and improved hippocampal integrity, accompanied by increased serotonin and norepinephrine levels and decreased pro-inflammatory cytokines. These findings suggest that Ashwagandha root extract may offer therapeutic benefits for managing fibromyalgia symptoms. Full article

Background: Periprosthetic hip fractures (PPFs) are one of the major complications in total hip arthroplasty (THA). Therefore, it is important to identify a mechanism for fracture resistance in THA. This study aimed to clarify the differences in fracture torque and fracture type analysis between two different types of cemented stems. Methods: We conducted biomechanical testing of bone analogues using six cemented stems of two different types with osteoporotic bone models: Anterior minimally invasive surgery (AMIS)-K and Charnley-Marcel-Kerboull (CMK) stems. Experienced surgeons implanted each of these types of stems into six bone analogues, and the analogues were compressed and internally rotated until failure. Torque-to-fracture and fracture type were recorded. Results: There was no significant difference in fracture torque of AMIS-K stem, compared to the CMK stem (p = 0.94). The AMIS-K stem showed one comminuted oblique fracture of Vancouver type B2 and five fractures of type C at the tip of the stem. The CMK stem showed five comminuted oblique fracture of Vancouver type B2 and one of type C at the tip of the stem. Conclusion: The AMIS-K stem demonstrated comparable fracture resistance to the CMK stem in an osteoporotic model. Full article

This study aimed to describe the risk factors for locomotive syndrome (LS) in Brazilian oldest old individuals. Study subjects were older adults aged ≥80 years who were cognitively healthy, independent for activities of daily living and had been followed since 2011 by a Brazilian cohort study entitled the Longevos Project. A nested case–control study evaluating demographic and clinical characteristics was conducted. Physical tests including the 5 times sit-to-stand, hand-grip strength, 4-m gait speed and two-step test were performed. The World Health Organization Quality of Life Questionnaire short form (WHOQOL-BREF) and Numerical Rating Scale plus Verbal Rating Scale were applied to assess quality of life (QOL) and chronic pain (CP), respectively. LS was diagnosed using the Brazilian version of the 25-question Geriatric Locomotive Function Scale (GLFS-25-p), and sarcopenia by the SARC-F screening tool. The study sample included 52 participants, had a mean age of 89.3 years (±3.9 years) and was predominantly female (76.9%). Of this sample, 24 were diagnosed with LS and 28 were not. The prevalence of osteoporosis (20%), osteoarthritis (22%), depression (13%) and use of a walking device (14%) was higher in the LS group. Participants with LS had worse performance in physical tests. A multivariate logistic regression analysis identified the main risk factors for LS as osteoporosis (OR 10.80, 95%CI 1.08–108.48) and presence of moderate-to-severe chronic musculoskeletal pain (OR 8.92, 95%CI 1.25–63.89). Full article

Background and Aim: Neuropathic pain leads to a significant deterioration in health-related quality of life (HRQOL). Treating neuromusculoskeletal pain is especially important to prevent and improve physical frailty and the locomotive syndrome. Varied pharmacotherapies could be applicable for neuropathic pain patients, but evidence has been limited for a wide range of neuropathic pain conditions with different etiologies. The aim of this review was to highlight mirogabalin, a novel calcium channel α2δ ligand which was first approved in Japan, and which is effective for various types of neuropathic pain diseases. Methods: We conducted a narrative review of the recent evidence that mirogabalin has significant analgesic potency for varied types of neuropathic pain conditions. Futher, this review highlighted specific advantages over other calcium channel ligands. Results: Analgesic potency of mirogabalin could cover peripheral neuropathic pain conditions including post-herpetic neuralgia, diabetic peripheral neuropathy, cauda equina syndrome caused by lumbar spinal stenosis, radiculopathy caused by cervical spondylosis, and also central neuropathic pain conditions like spinal cord injury. Mirogabalin consistently demonstrated daytime sleepiness and dizziness as adverse effects, but most of these were mild. Conclusions: Mirogabalin is recommended as the first-line drug against most molecular mechanisms that cause neuropathic pain regardless of whether they have a peripheral or central origin. Mirogabalin demonstrates relatively less daytime sleepiness, making it age-friendly in the current global situation where population aging is accelerated. Considering the epidemic of ‘opiophobia’ in Japan and other countries, pharmacotherapy using mirogabalin could treat neuropathic pain associated with cancer and its treatment (e.g., chemotherapy-induced peripheral neuropathy), as well as non-cancer etiologies worldwide. Full article

Background: The purpose of this study was to determine the normative perioperative plasmatic levels of presepsin in patients undergoing primary total hip arthroplasty (THA), and to evaluate whether presepsin measurements can effectively distinguish the presence of periprosthetic joint infection (PJI) following THA. Methods: In study 1, we evaluated multiple inflammatory markers before and at several time points after surgery in 31 primary THA patients. The Kruskal–Wallis test was used to compare sequential changes in each variable followed by the Sheffe post hoc comparison. In study 2, we evaluated the diagnostic accuracy of the inflammatory markers for PJI using five cases with confirmed PJI without bacteremia. ROC curve analysis was performed comparing these PJI cases with the 31 preoperative cases from study 1. Results: In study 1, presepsin levels were not significantly different from the baseline throughout the monitoring period. In study 2, the AUCs of CRP (1.0, p < 0.001) and ESR-1h (0.83, p < 0.05) in the ROC curve were able to discriminate PJI, but those of presepsin (0.51, p = 0.96) and WBC (0.65, p = 0.28) failed to discriminate PJI. Conclusions: Our findings suggest that presepsin levels remain stable following THA and may have limited utility in detecting periprosthetic joint infection, particularly in the absence of systemic infection. Full article

Background: Locomotive syndrome (LS), a condition characterized by impaired mobility due to locomotive organ dysfunction, is highly prevalent among patients with cancer. The phase angle (PhA), measured via bioelectrical impedance analysis (BIA), reflects cellular health and nutritional status. This study aimed to investigate the association between LS and the PhA in patients with cancer. Methods: This cross-sectional study included hospitalized patients who underwent cancer treatment. The assessed variables included age, sex, body mass index (BMI), gait speed, grip strength, PhA, and the outcomes of LS risk assessment using the stand-up test, two-step test, and the 25-Geriatric Locomotive Function Scale (GLFS25). Results: A total of 190 patients (57 females, 133 males; mean age, 62.6 ± 17.2 years) were analyzed. The PhA was significantly negatively correlated with the LS stage (rs = −0.507, p < 0.001). Similarly, a significant negative correlation was observed between the PhA and each LS risk test, namely, the stand-up test, two-step test, and GLFS25. Furthermore, the PhA was identified as an independent and significant factor associated with LS progression (odds ratio, 0.361; 95% confidence interval, 0.221–0.588; p < 0.001). More effective and rapid than completing the full range of LS risk tests, measuring the PhA represents a convenient and practical tool for the early screening of mobility decline. Conclusions: The PhA is a simple and effective parameter for assessing mobility decline in patients with cancer. It is a potential clinical indicator for initiating rehabilitation interventions aimed at preventing the onset and progression of LS. Full article

Objective: The increasing number of aging patients with total hip arthroplasties (THA) causes an increased incidence of periprosthetic fractures (PPF). The study aimed to evaluate the impacts of two different materials in the same-sized cemented stems on PPF in bone models. Methods: This study compared the maximum rotational torque leading to PPF when stems made of cobalt–chromium–molybdenum (Co–Cr–Mo) alloy and stainless use steel (SUS) were implanted using simulated bone models (Sawbones, 3403). The maximum destruction torque was compared statistically for each material (Co–Cr–Mo alloy vs. SUS stainless steel) in this model, and fracture patterns were examined. Results: The PPF occurred with a spiral propagation from the proximal femur towards the diaphysis, with breakage occurring near the distal end of the stem. There were no significant differences in the destruction torque values between the Co–Cr–Mo alloy (103.0 ± 14.9 Nm) and SUS (98.7 ± 15.1 Nm) samples (p = 0.575). The fractures using the bone models exhibited similar patterns in all specimens, resembling clinical PPF fracture types clinically, specifically Vancouver classification B2. Conclusions: The comparison of the maximum destruction torques of the Co–Cr–Mo alloy and SUS cemented stems in simulating PPF showed no significant differences. The results suggest that the materials of the cemented stems might not significantly affect the occurrence of PPF in THA. Full article

Human fall detection is a significant healthcare concern, particularly among the elderly, due to its links to muscle weakness, cardiovascular issues, and locomotive syndrome. Accurate fall detection is crucial for timely intervention and injury prevention, which has led many researchers to work on developing effective detection systems. However, existing unimodal systems that rely solely on skeleton or sensor data face challenges such as poor robustness, computational inefficiency, and sensitivity to environmental conditions. While some multimodal approaches have been proposed, they often struggle to capture long-range dependencies effectively. In order to address these challenges, we propose a multimodal fall detection framework that integrates skeleton and sensor data. The system uses a Graph-based Spatial-Temporal Convolutional and Attention Neural Network (GSTCAN) to capture spatial and temporal relationships from skeleton and motion data information in stream-1, while a Bi-LSTM with Channel Attention (CA) processes sensor data in stream-2, extracting both spatial and temporal features. The GSTCAN model uses AlphaPose for skeleton extraction, calculates motion between consecutive frames, and applies a graph convolutional network (GCN) with a CA mechanism to focus on relevant features while suppressing noise. In parallel, the Bi-LSTM with CA processes inertial signals, with Bi-LSTM capturing long-range temporal dependencies and CA refining feature representations. The features from both branches are fused and passed through a fully connected layer for classification, providing a comprehensive understanding of human motion. The proposed system was evaluated on the Fall Up and UR Fall datasets, achieving a classification accuracy of 99.09% and 99.32%, respectively, surpassing existing methods. This robust and efficient system demonstrates strong potential for accurate fall detection and continuous healthcare monitoring. Full article

Locomotive syndrome (LS) predisposes older adults to falls and functional dependency. In older adults with LS, the validity of the Lower Quarter Y Balance Test (YBT-LQ)—a dynamic balance assessment tool—remains unclear. This cross-sectional study aimed to assess the convergent validity of the YBT-LQ with the Two-Step and Timed Up and Go (TUG) tests and compare YBT-LQ performance between individuals with and without LS. Sixty Thai community-dwelling older adults (≥60 years) were equally divided into LS and non-LS groups and performed the YBT-LQ, Two-Step test, and TUG test. Correlation analyses and independent t-tests assessed relationships and between-group comparisons, respectively. The YBT-LQ exhibited moderate positive correlations with the Two-Step test (r = 0.366, p = 0.004) and moderate negative correlations with the TUG test (r = −0.412, p = 0.001). The LS group exhibited significantly lower YBT-LQ scores across all reach directions than the non-LS group (p < 0.05), highlighting impaired balance in individuals with LS. The YBT-LQ is a valid and reliable tool for assessing dynamic balance and postural control, as well as identifying multidirectional stability deficits in older adults, particularly those with LS. Implementing the YBT-LQ in routine geriatric evaluations could enhance early detection and targeted interventions to reduce fall risk and improve mobility in aging populations. Full article

The state of frailty is a clinical–biological syndrome that affects the older population with a higher risk of functional dependence. Animal models can provide a tool to study this complex scenario. In the present work, we analyzed the physical and behavioral hallmarks of end-point status in 16-month-old mice (C57BL/6J) according to animal welfare regulations compared to age-matched counterparts with normal aging. A group of 6-month-old mice was added to control for age bias. First, we identified ‘structural kyphosis’ (visible and unmodifiable deformation in locomotion) correlated with piloerection as the hallmarks of the physical frailty phenotype compared to the ‘postural kyphosis’ (adjustment to counteract increased visceral volume but attenuated during locomotion) of old mice with normal aging. Alopecia (barbering) was presented in both old groups. Normal levels of exploratory activity in the corner test for neophobia and triceps surae muscle weight but an increased latency of rearing indicated the poorest emotional phenotype, with a possible contribution of structural kyphosis. The presence of hepatomegaly and splenomegaly counteracted the significant WAT loss commonly associated with end-of-life traits, which should have a normal body weight but preserved muscle mass. Full article

Background: The fimbria-fornix is a nerve fiber bundle that connects various structures of the limbic system in the brain and plays a key role in cognition. It has become a major target of deep brain stimulation (DBS) to treat memory impairment in both dementia patients and animal models of neurological diseases. Previously, we have reported the beneficial memory effects of chronic forniceal DBS in mouse models of intellectual disability disorders. In Rett syndrome and CDKL5 deficiency disorder models, DBS strengthens hippocampal synaptic plasticity, reduces dentate inhibitory transmission or increases adult hippocampal neurogenesis that aids memory. However, the underlying neuronal circuitry mechanisms remain unknown. This study we explored the neural network circuits involved in forniceal DBS treatment. Methods: We used acute forniceal DBS-induced expression of c-Fos, an activity-dependent neuronal marker, to map the brain structures functionally connected to the fornix. We also evaluated the mouse behavior of locomotion, anxiety, and fear memory after acute forniceal DBS treatment. Results: Acute forniceal DBS induces robust activation of multiple structures in the limbic system. DBS-induced neuronal activation extends beyond hippocampal formation and includes brain structures not directly innervated by the fornix. Conclusions: Acute forniceal DBS activates multiple limbic structures associated with emotion and memory. The neural circuits revealed here help elucidate the neural network effect and pave the way for further research on the mechanism by which forniceal DBS induces benefits on cognitive impairments. Full article

Locomotive syndrome (LS) refers to a condition where individuals face challenges in performing activities of daily living. Early detection of such deterioration is crucial to reduce the need for nursing care. The Geriatric Locomotive Function Scale (GLFS-25), a 25-question assessment, has been proposed for categorizing individuals into different stages of LS. However, its subjectivity has prompted interest in technology-based quantitative assessments. In this study, we utilized machine learning and an instrumented five-time sit-to-stand test (FTSTS) to assess LS stages. Younger and older participants were recruited, with older individuals classified into LS stages 0–2 based on their GLFS-25 scores. Equipped with a single inertial measurement unit at the pelvis level, participants performed the FTSTS. Using acceleration data, 144 features were extracted, and seven distinct machine learning models were developed using the features. Remarkably, the multilayer perceptron (MLP) model demonstrated superior performance. Following data augmentation and principal component analysis (PCA), the MLP+PCA model achieved an accuracy of 0.9, a precision of 0.92, a recall of 0.9, and an F1 score of 0.91. This underscores the efficacy of the approach for LS assessment. This study lays the foundation for the future development of a remote LS assessment system using commonplace devices like smartphones. Full article

Locomotive Syndrome (LS), a condition related to impaired mobility, is influenced by balance control, which comprises six components. Deficiencies in these components can lead to reduced mobility and decreased quality of life. This study aimed to evaluate the relationship between the components of postural control and LS in older adults using the Brief-BESTest. Therefore, this cross-sectional study involved 122 elderly participants from Tha Sala District, Nakhon Si Thammarat Province, both with and without LS. Participants underwent assessments using the Instrumental Activities of Daily Living (IADL) assessment, the Thai Mental State Examination (TMSE), the Two-Step Test, and the Brief-BESTest. The Brief-BESTest covers six balance components: Biomechanical Constraints, Stability Limits, Anticipatory Postural Adjustments, Postural Responses, Sensory Orientation, and Stability in Gait. Descriptive statistics were used to summarize participant characteristics, and Chi-square tests were conducted to examine the relationship between each balance component and LS. Cramer’s V was used to assess the strength of the relationships. The results showed the average age of the sample was 67.67 ± 6.01 years with 85.20 percent female and 14.80 percent male. There were significant relationships between LS and three balance components: Biomechanical Constraints (Chi-square = 5.35, p = 0.021, Cramer’s V = 0.209), Stability Limits (Chi-square = 5.00, p = 0.025, Cramer’s V = 0.204), and Anticipatory Postural Adjustments (left: Chi-square = 4.12, p = 0.042, Cramer’s V = 0.213; right: Chi-square = 5.50, p = 0.019, Cramer’s V = 0.213). No significant associations were found for Reactive Postural Response, Sensory Orientation, and Stability in Gait. These findings suggest that targeted interventions focusing on specific balance components consist of Biomechanical Constraints, Stability Limits, and Anticipatory Postural Adjustments could help reduce the risk of LS in older adults. Full article

Objective: Osteoarthritis is linked to dementia, but no longitudinal studies have established this connection. This prospective cohort study from the Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS) aimed to determine if knee osteoarthritis (KOA) independently predicts dementia in adults aged 65 and above. Methods: Participants were classified by the Kellgren–Laurence scale into no/minimal KOA (grades 0 and I) and definitive KOA (grade II or higher). We analyzed dementia incidence from 2009 to 2015 using long-term care insurance data, adjusting for age, sex, vascular risks, depressive symptoms, and activity levels. Results: Out of 1089 participants (58.9% female, average age 72.5), 72.0% had definitive KOA. Dementia occurrence was significantly higher in the definitive group (8.4%) compared to the no/minimal group (3.0%) (p < 0.001). A log-rank test and Cox regression analysis confirmed these findings, showing an adjusted hazard ratio of 2.29 (confidence interval: 1.12–4.68) for dementia in those with definitive KOA. Conclusions: These results suggest that KOA is a significant risk factor for dementia, highlighting the importance of addressing contributing factors in KOA patients to potentially slow the progression of dementia. Full article