Mesenchymal stem cells (MSCs) have emerged as a cell type with great potential for cell-based articular cartilage repair in patients with knee osteoarthritis (OA). However, meta-analysis of clinical trials of the MSC treatment revealed that current evidence about articular cartilage regeneration and objectively measured functional improvement in people with knee OA was inconclusive. Research for regenerative rehabilitation, a recently emerged interdisciplinary field, could contribute to establish effective cell-based therapy that maximizes cartilage regeneration and functional improvement in people with knee OA. We herein summarize our cross-disciplinary approaches toward establishing effective regenerative rehabilitation in MSC-based treatment for people with knee OA. This review would serve as the foundation for future studies investigating the effects of rehabilitative approaches in regenerative medicine that lead clinical success of cell-based treatment.

The prevalence of chronic diseases, including cardiovascular diseases, type 2 diabetes, and cancer, are escalating at an alarming rate in many countries. These diseases are associated with, at least in part, insufficient physical activity, and physical activity has beneficial effects on a variety of health outcomes such as decreased mortality and risk of these diseases. For these positive effects, moderate to vigorous physical activity has been recommended. However, there are many patients who cannot perform adequate exercise because of severe diseases, several complications and/or their exercise intolerance. This issue highlights a need for alternative therapies. There is growing body of literature that recognizes the positive effects of neuromuscular electrical stimulation (NMES) on muscle strength, cardiorespiratory fitness, physical performance and metabolism in healthy adults and clinical setting. The present review introduces the effect of NMES on muscle strength and glucose metabolism as well as NMES-induced physiological responses including myokines related to preventing dementia and cancer.

Neuropathic pain can occur as a result of injuries and diseases of nervous system. Animal models using rodents have been developed and characterized to reveal plastic changes underlying neuropathic pain. However, structures and functions of some brain areas that are associated with pain perception differ between rodents and primates. Therefore, animal models using non-human primates, such as the macaque monkey, with brain structures and functions closer to those of humans are important for elucidating the mechanisms underlying pain in human patients. Recently, we measured brain activity using functional magnetic resonance imaging (fMRI) in a macaque model of chemotherapy-induced neuropathic pain and reported abnormal activation of pain-related brain regions including insular and secondary somatosensory cortices. In the monkey model of central post stroke pain, moreover, the increased activation of pain-related areas as seen in the patients was confirmed by fMRI. These results indicate that fMRI measurement of brain activity combined with behavioral outcomes in macaque models could be used not only to understand the pathogenetic mechanisms but also to test therapeutic interventions for neuropathic pain.

The relative increase of non-contraction tissue within skeletal muscle, such as the increase of adipose and fibrous tissue, is known to the loss of muscle quality. Quantitative muscle quality in ultrasound images assessed from muscle echo intensity (EI), are calculated by means of 8-bit gray scale. Recent previous report has showed that the extracellular water to intracellular water ratio measured by using segmental bioelectrical impedance spectroscopy (BIS) can also assess muscle quality. Ultrasound imaging and segmental BIS method are non-invasive and convenient tools for assessing muscle quality, and therefore are expected to be useful for establishing methods of muscle quality assessment in clinical setting. We have applied skeletal muscle quality assessment in older adult and osteoarthritis patients, and have carried out several studies. The present paper focuses on the introduction of the basic concept of muscle quality assessment, and clinical applications based on the result of our previous studies.

Shoulder complex consists of sternoclavicular, acromioclavicular, glenohumeral, and scapulothoracic joint and is one of the largest and most complex joint in human body. The normal movement of these joint is required for shoulder function. In particular, to keep the large range of motion of shoulder complex, the movement of scapulothoracic joint referred to as scapular movement is essential for its flexible movement. Scapular dyskinesis has been defined as the set of abnormal position and movement of scapula and was seen in patient with shoulder disease such as impingement syndrome and rotator cuff tear. One cause of scapular dyskinesis is the increase in stiffness of soft tissue such as muscles. Shear wave elastography is an attractive technique to quantify muscle mechanical property. We applied this technique to verify the efficiency of stretching maneuvers for individual muscle used in physical therapy. In this review article, we focused pectoralis minor muscle, which is one of the causes of scapular dyskinesis, and provided the knowledges about effective stretching maneuver for this muscle and interaction between scapular movement and muscle stiffness of this muscle.

The depressed protein synthetic response, a phenomenon termed as anabolic resistance, has been shown to be involved in muscle wasting induced by cancer cachexia. Moreover, a positive relationship between protein synthetic rate and intracellular glutamine (GLN) concentration has been found in skeletal muscles. We here investigated the effects of neuromuscular electrical stimulation (ES) and GLN administration on muscle wasting and GLN metabolism in colon 26 (C-26) tumor bearing mice. CD2F1 mice were divided into 8 groups; control (CNT), CNT+ES, CNT+GLN, CNT+ES+GLN, C-26, C-26+ES, C-26+GLN, C-26+ES+GLN. Cancer cachexia was induced by a subcutaneous injection of C-26 cells and was developed for four weeks. ES was performed to the left plantar flexor muscles every other day and GLN (1 g/kg) was daily intraperitoneally administered starting one day following C-26 injection. Tumor-free body mass and fast-twitch gastrocnemius (Gas) muscle weight were lower in the C-26 group than in the CNT group (-19% and -17%, respectively). Niether ES training nor GLN administration, alone or in combination, ameliorated the loss of Gas muscle weight in the C-26 mice. ES training in combination with GLN administration inhibited the increased GLN synthetase (GS) expression in the C-26 muscles. Thus, it is unlikely that GLN plays a critical role in muscle protein metabolism and thereby can be targeted as a tentative treatment of cancer cachexia.

The purpose of this study was to examine the reliability of ultrasound evaluation of muscle thickness and intensity of the rectus femoris (RF) and vastus intermedius (VI). The subjects were 10 healthy adult males whose 20 limbs had no orthopedic disease, and they were supposed to refrain from any vigorous physical activity during the study period. The RF and VI were measured by two examiners on two separate days. Intra- and inter-observer reliability was evaluated using intraclass correlation coefficient (ICC) and Bland-Altman analysis. The ICC in intra-observer reliability of muscle thickness is 0.84 for the RF and 0.78 for the VI, and of muscle intensity, 0.71 for the RF and 0.88 for the VI. Ninety-five percent (95%) confidence intervals of minimal detectable change (MDC_95s) for intra-observer reliability of muscle thickness are 0.23cm for the RF and 0.32 cm for the VI, and of muscle intensity, 18.17 a.u. for the RF and 13.74 a.u. for the VI. The MDC_95s for inter-observer reliability of muscle thickness are 0.26 cm for the RF and 0.29 cm for the VI, and of muscle intensity, 20.21 a.u. for the RF and 13.52 a.u. for the VI. The results suggest that ultrasound imaging is a reliable technique for examining muscle thickness and intensity of the RF and VI.

This study aimed to test our hypothesis that a fall of blood pressure (BP) attenuates flow-mediated dilation (FMD) as an index of endothelial function in healthy young men. Eleven men (age: 21.9±0.5 yrs, body mass index: 22.4±0.5 kg/m², mean±SE) participated in this study. We measured brachial FMD in normal FMD protocol (control trial) and protocol with a fall in BP via thigh-cuff deflation technique (BP fall trial) in a random order. During FMD measurements, brachial arterial diameter and blood velocity were recorded simultaneously using Doppler ultrasound. FMD was calculated on the basis of the percentage increase in the arterial diameter followed by cuff release. To adjust the effects of shear rate (SR) on FMD, we calculated Normalized-FMD. Mean arterial pressure during hyperemia showed a marked fall in the BP fall trial (-24±2 mmHg), but no change in the control trial. FMD was smaller in the BP fall trial than the control trial (P<0.001, Control; 7.3±1.0%; BP fall, 3.6±0.5%). Normalized-FMD also showed smaller FMD in the BP fall trial than the control trial (P=0.004). These results indicate that arterial pressure is a key factor to regulate endothelial function in young adults.