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Changes of the central aponeurosis of the rectus femoris muscle and muscle alignment in individuals with knee osteoarthritis
eS1474
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1238–eS1642
Research Report Poster Presentation Number: RR-PO-09-07-Sun Sunday 3 May 2015 12:15 Exhibit halls 401–403 CHANGES OF THE CENTRAL APONEUROSIS OF THE RECTUS FEMORIS MUSCLE AND MUSCLE ALIGNMENT IN INDIVIDUALS WITH KNEE OSTEOARTHRITIS Y. Takahashi 1 , K. Okada 2 , A. Saito 2 , I. Saito 3 , K. Kinoshita 4 , H. Sato 5 , K. Shibata 5 1 Akita
University Hospital, Department of Rehabilitation Medicine, Akita City, Japan; 2 Akita University Graduate School of Health Sciences, Department of Physical Therapy, Akita City, Japan; 3 Ugo Municipal Hospital, Department of Rehabilitation, Ugo Town, Japan; 4 Sanno Hospital, Akita City, Japan; 5 Akita University Graduate School of Health Science, Akita City, Japan Background: Pennate muscle fibers align oblique to the aponeurosis running in the muscle, called the central aponeurosis (CA). Previous studies reported that mechanical loading affects the tensile strength and stiffness of tendons. Since abnormal deformities were observed in individuals with knee osteoarthritis (OA), changes of the tendon-aponeurosis may occur in these individuals. Purpose: To clarify the morphological characteristics of the CA of the rectus femoris (RF) muscle and muscle alignment in individuals with medial knee OA by ultrasonography. Methods: Forty legs of 26 individuals with medial knee OA (OA group; mean age, 72.4 years), 41 legs of 21 elderly individuals (elderly group; mean age, 72.1 years), and 40 legs of 20 young healthy individuals (young group; mean age, 20.3 years) were evaluated. The RF muscle was examined by ultrasonography with short axial views using a 14-MHz probe placed perpendicularly on the skin (HI VISION AVIUS, Hitachi Aloka Medical, Japan). The following parameters were measured on relaxed sitting position: (1) CA length, expressed as the percentage of the RF muscle length; (2) CA morphological type (Type C having one curve, Type linear having no curve, Type S having two curves, and Type irregular having an unclassified shape); (3) CA direction, defined as the direction of the line from the anterior to posterior end of the CA, and classified as “lateral direction” or “medial direction”; (4) intercondylar distance (ICD); and (5) positional relationship between the perpendicular line from the anterior end of the CA to the anterior surface of the femur. When the line was centrally, medially, or laterally located in relation to the anterior surface of the femur, the position
was classified as “central muscle alignment”, “medial muscle alignment”, or “lateral muscle alignment”, accordingly. Results: The CA length in the OA group was significantly lower than that of the elderly or young groups (0.67 ± 0.04 vs. 0.71 ± 0.05 and 0.70 ± 0.03, p < .001 and p = .002, respectively). Type C was significantly more frequent in the young group than the OA or elderly groups (p < .001). Type irregular was observed only in 7 legs of the OA group (p < .001). In the young group, the CA direction was classified as “medial direction” in all cases. “Lateral direction” was observed in 5 (12.5%) and 7 legs (17.1%) in the OA and elderly group, respectively. Within the OA group, the ICD of the cases with “lateral direction” was significantly higher than that of the cases classified as having “medial direction” (6.0 ± 1.8 vs. 3.4 ± 2.7 cm, p = .037). In the young group, all muscles had “central muscle alignment”. Nine legs (22.0%) in the elderly group and 13 legs (32.5%) in the OA group were classified as having “medial muscle alignment”. Conclusion(s): The CA of the RF muscle in individuals with medial knee OA was shorter, and occasionally showed abnormal shapes, directions, and/or alignments. These morphological changes might be associated with knee OA. Implications: We should pay attention to the “tendonaponeurosis complex” in individuals with knee OA who undergo physical therapy. Keywords: Ultrasonography; Central aponeurosis; Knee osteoarthritis Funding acknowledgements: We thank our research staff for technical support. Ethics approval: Ethics approval was obtained the review board of Akita Kousei Medical Center, September 2012. http://dx.doi.org/10.1016/j.physio.2015.03.1444 Research Report Poster Presentation Number: RR-PO-22-17-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 CUTOFF VALUES OF PREDICTIVE RISK FACTORS FOR FALLS IN INPATIENTS WITH STROKE Y. Takamatsu 1 , Y. Kuno 1 , A. Morino 2 1 National
Hospital Organization Higashi Nagoya National Hospital, Department of Rehabilitation, Nagoya, Japan; 2 Hokkaido Chitose Institute of Rehabilitation Technology, Chitose, Japan Background: Falls are common events among inpatients with stroke and impact on their functional prognosis, activities of daily living and health related quality of life. It is beneficial on stroke rehabilitation to predict for falls based on simple and easily assessments at admission. Risk factors for falls have been widely studied. However, cutoff values of
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1238–eS1642
Research Report Poster Presentation Number: RR-PO-09-07-Sun Sunday 3 May 2015 12:15 Exhibit halls 401–403 CHANGES OF THE CENTRAL APONEUROSIS OF THE RECTUS FEMORIS MUSCLE AND MUSCLE ALIGNMENT IN INDIVIDUALS WITH KNEE OSTEOARTHRITIS Y. Takahashi 1 , K. Okada 2 , A. Saito 2 , I. Saito 3 , K. Kinoshita 4 , H. Sato 5 , K. Shibata 5 1 Akita
University Hospital, Department of Rehabilitation Medicine, Akita City, Japan; 2 Akita University Graduate School of Health Sciences, Department of Physical Therapy, Akita City, Japan; 3 Ugo Municipal Hospital, Department of Rehabilitation, Ugo Town, Japan; 4 Sanno Hospital, Akita City, Japan; 5 Akita University Graduate School of Health Science, Akita City, Japan Background: Pennate muscle fibers align oblique to the aponeurosis running in the muscle, called the central aponeurosis (CA). Previous studies reported that mechanical loading affects the tensile strength and stiffness of tendons. Since abnormal deformities were observed in individuals with knee osteoarthritis (OA), changes of the tendon-aponeurosis may occur in these individuals. Purpose: To clarify the morphological characteristics of the CA of the rectus femoris (RF) muscle and muscle alignment in individuals with medial knee OA by ultrasonography. Methods: Forty legs of 26 individuals with medial knee OA (OA group; mean age, 72.4 years), 41 legs of 21 elderly individuals (elderly group; mean age, 72.1 years), and 40 legs of 20 young healthy individuals (young group; mean age, 20.3 years) were evaluated. The RF muscle was examined by ultrasonography with short axial views using a 14-MHz probe placed perpendicularly on the skin (HI VISION AVIUS, Hitachi Aloka Medical, Japan). The following parameters were measured on relaxed sitting position: (1) CA length, expressed as the percentage of the RF muscle length; (2) CA morphological type (Type C having one curve, Type linear having no curve, Type S having two curves, and Type irregular having an unclassified shape); (3) CA direction, defined as the direction of the line from the anterior to posterior end of the CA, and classified as “lateral direction” or “medial direction”; (4) intercondylar distance (ICD); and (5) positional relationship between the perpendicular line from the anterior end of the CA to the anterior surface of the femur. When the line was centrally, medially, or laterally located in relation to the anterior surface of the femur, the position
was classified as “central muscle alignment”, “medial muscle alignment”, or “lateral muscle alignment”, accordingly. Results: The CA length in the OA group was significantly lower than that of the elderly or young groups (0.67 ± 0.04 vs. 0.71 ± 0.05 and 0.70 ± 0.03, p < .001 and p = .002, respectively). Type C was significantly more frequent in the young group than the OA or elderly groups (p < .001). Type irregular was observed only in 7 legs of the OA group (p < .001). In the young group, the CA direction was classified as “medial direction” in all cases. “Lateral direction” was observed in 5 (12.5%) and 7 legs (17.1%) in the OA and elderly group, respectively. Within the OA group, the ICD of the cases with “lateral direction” was significantly higher than that of the cases classified as having “medial direction” (6.0 ± 1.8 vs. 3.4 ± 2.7 cm, p = .037). In the young group, all muscles had “central muscle alignment”. Nine legs (22.0%) in the elderly group and 13 legs (32.5%) in the OA group were classified as having “medial muscle alignment”. Conclusion(s): The CA of the RF muscle in individuals with medial knee OA was shorter, and occasionally showed abnormal shapes, directions, and/or alignments. These morphological changes might be associated with knee OA. Implications: We should pay attention to the “tendonaponeurosis complex” in individuals with knee OA who undergo physical therapy. Keywords: Ultrasonography; Central aponeurosis; Knee osteoarthritis Funding acknowledgements: We thank our research staff for technical support. Ethics approval: Ethics approval was obtained the review board of Akita Kousei Medical Center, September 2012. http://dx.doi.org/10.1016/j.physio.2015.03.1444 Research Report Poster Presentation Number: RR-PO-22-17-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 CUTOFF VALUES OF PREDICTIVE RISK FACTORS FOR FALLS IN INPATIENTS WITH STROKE Y. Takamatsu 1 , Y. Kuno 1 , A. Morino 2 1 National
Hospital Organization Higashi Nagoya National Hospital, Department of Rehabilitation, Nagoya, Japan; 2 Hokkaido Chitose Institute of Rehabilitation Technology, Chitose, Japan Background: Falls are common events among inpatients with stroke and impact on their functional prognosis, activities of daily living and health related quality of life. It is beneficial on stroke rehabilitation to predict for falls based on simple and easily assessments at admission. Risk factors for falls have been widely studied. However, cutoff values of