Ikeda T1,2,3,4, Matsunaga Y1,2,3, Kanbara M1,2,3, Kamono A1,3, Masuda T5, Watanabe M6, Nakanishi R6, Jinno T4,7
1Showa University, School of Nursing and Rehabilitation Sciences, Yokohama Kanagawa, Japan, 2Showa University Fujigaoka Rehabilitation Hospital, Rehabilitation Center, Yokohama Kanagawa, Japan, 3Showa University, Research Institute for Sport and Exercise Sciences, Yokohama Kanagawa, Japan, 4Tokyo Medical and Dental University Graduate School, Department of Rehabilitation Medicine, Tokyo, Japan, 5Fukushima University, Faculty of Symbiotic Systems Science, Fukushima, Japan, 6Showa University Fujigaoka Hospital, Department of Orthopedic Surgery, Yokohama Kanagawa, Japan, 7Dokkyo Medical University, Department of Orthopedic Surgery, Saitama, Japan
Background: Total hip arthroplasty (THA) is widely performed for the purpose of alleviating pain and improving activities of daily living (ADLs). After reconstruction hip geometry: lever arm, femoral offset, hip center, Many reports showed the prolongation of recoverly hip strength. Rosenbaum reported that hip abductor muscle strength on the reconstructed side only recovers to about 80% of that on the unoperated side at 2 years. On the other hand, recent study showed that combined treatment using BCAAs with low-load high-volume exercise, even twice weekly in frail elderly persons, can effectively strengthen muscles.
Purpose: This study investigated the effects of treatment with muscle strengthening exercises and BCAA supplementation on improving muscle strength in person with THA.
Methods: The subjects were 31 women with THA who were inpatient at rehabilitation ward (age: 75.4±5.7, post-operated day: 21.2±1.2 ). Inclusion criteria were as follows: female, patients 70 and older, and patients with no deglutition disorder. A single-blinded, randomized experimental study was designed. A one-month period of supplementation was combined with exercise. The participants were randomly divided into two groups: BCAA (n=18) and control (n=13). The combined therapy was performed in rehabilitation hospital every day for 1 month in both groups. Exercise intervention involved hip abductor muscle exercise in both groups. For the nutritional intervention, 3.4 g of BCAAs or 1.2 g of starch were consumed immediately after exercise. We determined skeletal muscle mass, isometric muscle strength (hip abduction, knee extension, grip), upper limb muscle cross-sectional area, and FIM score.
Results: There was significant difference in the main effect between the groups in knee extension strength in contralateral side (pre- and post-combined therapy: p=0.028) and circumference of upper arm (pre- and post-combined therapy: p=0.012). There were no significant effects and interactions between the groups in hip abductor muscle strength, grip strength and FIM score. A comparison of improvement rates for hip abductor muscle strength showed that the contralateral side rate (BCAA group: 14.2% ± 19.4%; control group: -2.6% ± 16.5%) was significantly higher in the BCAA group. There was marginally significant difference in Skeletal muscle mass (BCAA group: 1.4% ± 4.9%; control group: -2.0% ± 5.4%).
Conclusion(s): By combining BCAA intake and exercise therapy, a significant improvement in lower limb muscle strength of the contralateral side was achieved in women with THA. In addition, the combination of BCAA intake and exercise therapy may yield significant improvement in skeletal muskle mass.
Implications: Combined treatment using BCAAs with exercise therapy, even 1 month in elderly persons with THA, can effectively strengthen muscles.
Keywords: total hip arthroplasty, branched-chain amino acid, combined therapy
Funding acknowledgements: No funding sources.
Purpose: This study investigated the effects of treatment with muscle strengthening exercises and BCAA supplementation on improving muscle strength in person with THA.
Methods: The subjects were 31 women with THA who were inpatient at rehabilitation ward (age: 75.4±5.7, post-operated day: 21.2±1.2 ). Inclusion criteria were as follows: female, patients 70 and older, and patients with no deglutition disorder. A single-blinded, randomized experimental study was designed. A one-month period of supplementation was combined with exercise. The participants were randomly divided into two groups: BCAA (n=18) and control (n=13). The combined therapy was performed in rehabilitation hospital every day for 1 month in both groups. Exercise intervention involved hip abductor muscle exercise in both groups. For the nutritional intervention, 3.4 g of BCAAs or 1.2 g of starch were consumed immediately after exercise. We determined skeletal muscle mass, isometric muscle strength (hip abduction, knee extension, grip), upper limb muscle cross-sectional area, and FIM score.
Results: There was significant difference in the main effect between the groups in knee extension strength in contralateral side (pre- and post-combined therapy: p=0.028) and circumference of upper arm (pre- and post-combined therapy: p=0.012). There were no significant effects and interactions between the groups in hip abductor muscle strength, grip strength and FIM score. A comparison of improvement rates for hip abductor muscle strength showed that the contralateral side rate (BCAA group: 14.2% ± 19.4%; control group: -2.6% ± 16.5%) was significantly higher in the BCAA group. There was marginally significant difference in Skeletal muscle mass (BCAA group: 1.4% ± 4.9%; control group: -2.0% ± 5.4%).
Conclusion(s): By combining BCAA intake and exercise therapy, a significant improvement in lower limb muscle strength of the contralateral side was achieved in women with THA. In addition, the combination of BCAA intake and exercise therapy may yield significant improvement in skeletal muskle mass.
Implications: Combined treatment using BCAAs with exercise therapy, even 1 month in elderly persons with THA, can effectively strengthen muscles.
Keywords: total hip arthroplasty, branched-chain amino acid, combined therapy
Funding acknowledgements: No funding sources.
Topic: Musculoskeletal: lower limb; Orthopaedics; Older people
Ethics approval required: Yes
Institution: Showa university
Ethics committee: The Showa university Fujigaoka hospital Ethics Committee
Ethics number: ID: 2016099
All authors, affiliations and abstracts have been published as submitted.
