title: Rehabilitation program after mesenchymal stromal cell transplantation augmented by vascularized bone grafts for idiopathic osteonecrosis of the femoral head: a preliminary study.
abstract: OBJECTIVE
  To determine the feasibility and safety of implementing a 12-week rehabilitation program after mesenchymal stromal cell (MSC) transplantation augmented by vascularized bone grafting for idiopathic osteonecrosis (ION) of the femoral head.
  
  
  METHODS
  A prospective case series.
  
  
  METHODS
  University clinical research laboratory.
  
  
  METHODS
  Participants (N=10) with ION who received MSC transplantation augmented by vascularized bone grafting.
  
  
  METHODS
  A 12-week exercise program, which included range-of-motion (ROM) exercises, muscle-strengthening exercises, and aerobic training.
  
  
  METHODS
  Measures of ROM, muscle strength, Timed Up and Go test, and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) were collected before surgery and again at 6 and 12 months after surgery.
  
  
  RESULTS
  All participants completed the 12-week program. External rotation ROM as well as extensor and abductor muscle strength significantly improved 6 months after treatment compared with that before treatment (P<.05). Significant improvements were also seen in physical function, role physical, and bodily pain subgroup scores of the SF-36 (P<.05). No serious adverse events occurred.
  
  
  CONCLUSIONS
  This study demonstrates the feasibility and safety of a multiplex rehabilitation program after MSC transplantation and provides support for further study on the benefits of rehabilitation programs in regenerative medicine.
authors.affiliation: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: blue@hs.med.kyoto-u.ac.jp.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Aoyama
authors.affiliation: Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Fujita
authors.affiliation: Department of Rehabilitation, Kyoto Hakuaikai Hospital, Kyoto, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Madoba
authors.affiliation: Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Nankaku
authors.affiliation: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Yamada
authors.affiliation: Department of Rehabilitation, Kyoto Hakuaikai Hospital, Kyoto, Japan.
authors.forename: Motoko
authors.initials: M
authors.lastname: Tomita
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Goto
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Ikeguchi
authors.affiliation: Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan; Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Kakinoki
authors.affiliation: Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan; Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Matsuda
authors.affiliation: Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan; Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Tissue Regeneration, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan; Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Toguchida
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D005081:Exercise Therapy; D005240:Feasibility Studies; D005271:Femur Head Necrosis / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome
keywords: Mesenchymal stromal cells; Osteonecrosis; Rehabilitation