A Prospective Study of Long-term Outcomes in Female Patients with Nonalcoholic Steatohepatitis Using Age- and Body Mass Index-matched Cohorts

In patients with nonalcoholic steatohepatitis (NASH), the prevalence of cirrhosis is higher among women than men, and hepatocellular carcinoma (HCC) develops mainly in the cirrhotic stage among women. However, the long-term outcomes in female patients with NASH have not been fully elucidated, and age, gender and BMI were not simultaneously adjusted in previous studies on the prognosis of NASH. To elucidate the outcomes in female patients with NASH, we prospectively compared NASH patients with advanced fibrosis (advanced NASH) with hepatitis C virus-related advanced fibrosis (advanced CHC) patients and NASH patients with mild fibrosis (mild NASH) using study cohorts that were adjusted for body mass index (BMI) in addition to age. The median follow-up period was 92.5 months. Liver-related complication-free survival was significantly reduced in the advanced NASH group compared to the mild NASH group. No liver-related complications developed in the mild NASH group. The overall survival, liver-related complication- and cardiovascular/cerebrovascular disease-free survival were not significantly different between the advanced NASH and CHC groups. Female patients with NASH and advanced fibrosis may have a less favorable prognosis for liver-related complications than the matched cohorts with NASH and mild fibrosis, but may have a similar prognosis to the matched cohorts with CHC

LATEST RESEARCHES ON RUNNING-SPECIFIC PROSTHESES: TOWARD SOCIAL IMPLEMENTATIONS OF BIOMECHANICS

Recent developments in running-specific prostheses (RSPs) have allowed individuals with lower extremity amputation (ILEAs) to regain the functional capability of running and jumping. However, the biomechanical characteristics of ILEAs using RSPs remain largely unknown. Understanding the biomechanical adaptations that occur during running and jumping with RSPs will assist clinicians and coaches in making objective decisions regarding the most appropriate prostheses, as well as in the fitting and alignment of these devices, for performance improvements in ILEAs. This presentation introduces our project regarding biomechanics of amputee athletes wearing RSPs, and its applications to athletes, prosthetists, manufacturers, and clinicians for the promotion of activity among amputees

COMPARISONS OF SPATIOTEMPORAL PARAMETERS OF 100-M SPRINT AMONG ELITE-, SUB-ELITE AND NON-ELITE AMPUTEE SPRINTERS

We investigated differences of the spatiotemporal parameters in a 100-m sprint among elite, sub-elite, and non-elite sprinters with a unilateral transtibial amputation. Using publicly available Internet broadcasts, we analyzed 125, 19, and 33 records from 30 elite, 12 sub-elite, and 22 non-elite sprinters, respectively. Average speed, step frequency, and step length were calculated Average speed was greatest in elite sprinters, followed by the sub-elite and non-elite groups. Although there was no significant differences in average step frequency, the average step length was longest in elite sprinters, followed by the sub-elite and non-elite groups. These results suggest that the differences in sprint performance between the three groups is mainly due to the average step length rather than step frequency

BRAKING AND PROPULSIVE IMPULSES ACROSS A RANGE OF RUNNING SPEEDS IN UNILATERAL TRANSFEMORAL AMPUTEES

Braking and propulsive ground reaction force impulses (GRIs) are mechanical parameters affecting the running performance. The purpose of this study was to determine the braking and propulsive GRIs across a range of speeds in unilateral transfemoral amputees. Ten unilateral transfemoral amputees ran on an instrumented treadmill at incremental speeds of 30%, 40%, 50%, 60%, and 70% of their maximum speed. At all given speeds, the braking GRI of affected limb was significantly smaller than unaffected limb; however, the propulsive GRIs were similar for both limbs. Consequently, the net anteroposterior GRI was positive in affected limb and negative in unaffected limb. These results suggest that the functional role of braking and propulsion is not the same between the limbs. Training for unilateral transfemoral amputees could focus on reducing the braking GRI of unaffected limb

RUNNING MECHANICS IN UNILATERAL TRANSFEMORAL AMPUTEES ACROSS A RANGE OF SPEEDS

Running-specific prostheses (RSP) allows individuals with lower extremity amputations to participate in running activities. The aim of this study was to investigate the average vertical ground reaction force (Favg), step frequency (Freqstep) and contact length (Lc) between intact and prosthetic limb across a range of running speeds. Nine unilateral transfemoral amputees with RSP performed running on instrumented treadmill at incremental speeds of 30, 40, 50, 60 and 70% of their maximum speed. We found that prosthetic limb generated smaller Favg than intact limb, and had similar Freqstep between limbs. However, prosthetic limb had longer Lc than intact limb at faster speeds. These results suggest that unilateral transfemoral amputees using RSP have asymmetrical running mechanics between limbs to adapt to the increasing running speed

LEG AND VERTICAL STIFFNESS OF TRANSFEMORAL AMPUTEES USING RUNNING-SPECIFIC PROSTHESES

Since running-specific prostheses (RSPs) emulate spring-like leg functions, human musculoskeletal system is often modelled as a spring-mass model. In the model, the leg (KM) and vertical stiffness (KM) is known to strongly influence running performance. The purpose of this study was to quantify the asymmetry in stiffness between the intact limbs and prosthetic limbs during sprinting. Eight sprinters with unilateral transfemoral amputation performed overground sprinting at maximum speed. & and Kw,t were calculated from vertical ground reaction force data in both the intact and prosthetic limbs. & was significantly greater in intact limbs than prosthetic limbs. Although there was no significant difference on Kvert, cohen's d of Kvert between legs was 1.28. Therefore KM might have potential significant difference

COMPARISON OF GROUND REACTION FORCES IN TWO RUNNING-SPECIFIC PROSTHESES (SPRINTER 1 E90 AND CHEETAH XTREME): A CASE STUDY

The purpose of this study was to describe the difference in ground reaction forces (GRF) between tvm different running-specific prostheses (RSPs) during maximal sprinting in a transfemoral amputee. One male sprinter performed maximal sprinting with two types of RSP (Sprinter 1E90 and Xtreme) on over 40 m runway with 7 force plates located halfway. Sprint velocity was found to be greater in the trials performed with Sprinter 1 E9O than with Xtreme. The peak VGRF, zero fore-aft shear and impulse of the anteriorposterior component of the GRF with PST limb differed among the two RSPs. These results suggest that the participant in this study would show the differences in variables influencing on the sprint velocity between two types of RSPs