Objectives: The study was investigating the effect of a progressive resistance training program on the recovery of patients with anterior cruciate ligament reconstruction in terms of kinematics, kinetics and muscle strength. Design: Longitudinal cohort study. Setting: Hospital laboratory. Participants: Of the 42 patients were finally included: 22 patients in the progressive resistance training group and 20 in the control group. Main outcome measures: Questionnaire, single-leg vertical jump, and muscle strength were collected preoperatively and at 16, 28 weeks, and 1 year postoperatively. Results: At 28 weeks, the height of the single-leg vertical jump for the injured knee was 203 and 157 mm (p = 0.045) and the peak knee flexion angle after landing for the injured knee was 31 degrees and 23 degrees (p = 0.027) in the progressive resistance training and control groups, respectively. The progressive resistance training group showed a significant increase in the knee extensor symmetry index after the 24-week exercise training compared from 58% preoperatively to 79% (p = 0.001) after training completion, which lasted up to 1 year postoperatively. Conclusion: Progressive resistance training significantly improved knee extensor symmetry, single-leg vertical jump height, and peak knee flexion angle after landing, outperforming the control group across all measures.

Poor supervision, impaired exercise adherence, and low compliance with exercise regimens result in inconsistent effects regarding exercise interventions. A supervised-walk training regimen (9 km/week) may have a positive effect on functional recovery in female total knee arthroplasty (TKA). This study aimed to evaluate the effect of a supervised walking regimen on lower limb muscle strength, functional fitness, and patient-reported outcomes in female TKA. Twenty-eight female TKA were allocated into a control (CON) (n = 14) or walk training (WT) (n = 14) group. WT on treadmills was initiated 12 weeks after TKA. All patients were examined for lower muscle strength (including extension and flexion of hip and knee), physical function (including a 6-min walk test, 8-foot up-and-go test, and 30-s chair stand test), and Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Knee flexor (WT: CON; 64.4 ± 4.1 nm/kg: 43.7±3.3 nm/kg; p = 0.001; effect size: 5.62) and extensor strengths (WT: CON; 73.1 ± 7.5 nm/kg: 48.2 ± 2.4 nm/kg; p = 0.001; effect size: 4.47) statistically increased in the WT group compared to the CON group. The 6-min walk test (from 341.3 ± 20.5 m to 405.5 ± 30.7 m; p = 0.001; effect size: 2.46) and 8-foot up-and-go test (from 9.5 ± 0.7 s to 8.3 ± 0.7 s; p = 0.002; effect size: 1.71) tests also showed significant improvements in the WT group in the follow-up compared to the baseline. An increase in quality of life score according to the KOOS questionnaire (WT: CON; 91.0 ± 2.8: 68.1 ± 5.8; p = 0.001; effect size: 5.02) was noted in the WT group compared to the CON group in the follow-up. WT facilitated improvements in knee muscle strength and functional outcomes in TKA patients.

Background After anterior cruciate ligament reconstruction, patients still experience residual weakness, thus necessitating a comprehensive training program and assessment before returning to sports. The purpose was investigating the effect of a progressive resistance training program on the recovery of patients. Methods We prospectively enrolled 67 patients who underwent anterior cruciate ligament reconstruction. Four weeks after the reconstruction, 24 weeks of progressive resistance training was initiated. Demographic, questionnaire, single-leg vertical jump, and muscle strength were collected preoperatively and at 16, 28 weeks, and 1 year postoperatively. Results Of the 42 patients were finally included: 22 patients in the progressive resistance training group and 20 in the control group. At 28 weeks, the height of the single-leg vertical jump for the injured knee was 20.3 ± 1.7 and 15.7 ± 1.7 cm and the peak knee flexion angle for the injured knee was 31° ± 3° and 23° ± 2° in the progressive resistance training and control groups, respectively. The progressive resistance training group showed a significant increase in the knee extensor symmetry index after completing 24 weeks of the training program, which lasted up to 1 year postoperatively, and a decrease in the hamstrings/quadriceps ratio for the injured knee. Conclusion The progressive resistance training increases the single-leg vertical jump height and peak knee flexion angle after landing, which can, at least in part, be attributed to the increased muscle strength in patients with anterior cruciate ligament reconstruction. Improvement in lower-limb muscle strength can also improve biomechanical asymmetry during the single-leg vertical jump.

Archery is a fine-motor-skill sport, in which success results from multiple factors including a fine neuromuscular tuning. The present study hypothesised that lower trapezius specific training can improve archers' performance with concomitant changes in muscle activity and shoulder kinematics. We conducted a prospective study in a university archery team. Athletes were classified into exercise and control groups. A supervised lower trapezius muscle training program was performed for 12 weeks in the exercise group. The exercise program focused on a lower trapezius-centred muscular training. Performance in a simulated game was recorded as the primary outcome, and shoulder muscle strength, kinematics, and surface electromyography were measured and analysed. In the exercise group, the average score of the simulation game increased from 628 to 639 after the training regimens (maximum score was 720), while there were no such increases in the control group. The lower trapezius muscle strength increased from 8 to 9 kgf after training regimens and shoulder horizontal abductor also increased from 81 to 93 body weight% for the exercise group. The upper/lower trapezius ratio decreased from 2.2 to 1.1 after training. The lower trapezius exercise training regimen could effectively improve the performance of an archer with a simultaneous increase in shoulder horizontal abductor and lower trapezius muscle strength.

BACKGROUND:Anterior cruciate ligament (ACL) injury is one of the most common injuries of the area surrounding the knee. Muscle strength deficiency is observed following an ACL injury. Determining differences in muscle strength and gait between patients with acute and chronic ACL injury will provide crucial information for assessments and treatment plans.METHODS:We evaluated 60 patients with ACL rupture. Patients were classified into acute and chronic groups. We compared measurements of anthropometric parameters, muscle strength, gait and functional questionnaire.FINDINGS:The muscle strength of both knee extensors and flexors was higher in the chronic group than in the acute group. The muscle strength index for extensors was 57% in the acute group and 73% in the chronic group. However, the hamstring-to-quadriceps ratio for peak torque of the injured leg in the acute and chronic groups was similarly high at 98% and 101%, respectively. In gait, asymmetry in the hip and knee was observed in the acute group but not in the chronic group. The Knee Injury and Osteoarthritis Outcome Scores (KOOS) for symptoms, pain, activities of daily living, sports and recreational activities were higher in the chronic group than in the acute group.INTERPRETATION:Compared with the acute group, the gait of the chronic group is more symmetrical, and the score of KOOS is also higher. The muscle training protocols could be strategically planned according to these differences. Patients with ACL injury are characterized high hamstrings-to quadriceps peak torque ratio.

Background: After total knee arthroplasty (TKA) surgery, a decline in muscle strength is associated with a decrease in function. The aim of this study was to demonstrate the effect of a further 24 weeks of hospital-based resistance training under supervision, and precise dose on knee functional recovery and daily activities for female TKA patients. Methods: Twenty-nine patients who underwent unilateral primary TKA were allocated into either resistance training (RT) (n = 14) or control (CON) (n = 15) groups. All patients were assessed, with an isokinetic dynamometer, for hip and knee flexor and extensor muscle strength, physical function test, and Knee Injury and Osteoarthritis Outcome Score (KOOS). Resistance training was initiated three months after index surgery. The assessments were performed before exercise (Baseline), in the middle of the resistance training at 12 weeks (Mid-exercise), completion of the resistance training (Post-exercise), and 12 weeks after resistance training completion (Follow-up). A statistical test was performed by using generalized estimating equations. Results: Patients in RT had more of an increase in both knee extensor and flexor muscle strength than those in CON at the Post-exercise assessment. The six-minute walk test distance was more in RT compared with CON at the same Post-exercise assessment. Furthermore, the RT group had increases in Activities of daily living and Sports subscales compared to the CON group. Conclusions: A further 24 weeks of hospital-based progressive resistance training facilitated improvement in knee muscle strength and functional outcome in TKA patients. Active hospital based progressive resistance training is recommended for rehabilitation following TKA surgery. (C) 2019 Elsevier B.V. All rights reserved.

It remains unclear if computer-assisted surgery (CAS) technique actually improves the clinical outcomes of total knee arthroplasty (TKA) and decreases the failure rate. The purpose of this retrospective study was to compare the functional results of TKA in a series of patients who underwent staged bilateral TKAs with CAS TKA in 1 knee and conventional TKA in the contralateral knee. From January 1997 to December 2010, we collected 60 patients who were randomly assigned to receive CAS TKA in 1 limb and conventional TKA in the other. The Brainlab Vector Vision navigation system was used for CAS TKA, and the DePuy press-fit condylar sigma guide system was used for conventional TKA. Patients were assessed before surgery, 3 months and 1 year after surgery, and annually thereafter. IKS criteria were used for radiographic evaluation. Clinical and functional evaluation using the scoring system of hospital for special surgery (HSS), international knee society (IKS), Western Ontario and McMaster University osteoarthritis index (WOMAC), and short form-36 (SF-36) were obtained on each knee, before surgery, and at each follow-up visit. Pertinent statistical methods were adopted for data analysis. Fifty-six patients were available for analysis and 44 of the patients were female. The mean duration of follow-up was 8.1 years. Less blood loss (P = .007) and longer operation time were noted for CAS TKAs when compared with conventional TKAs. Precise alignment and fewer outliers of the lower limb and prosthetic component positions were found for CAS TKAs (P < .001). There were no differences between the 2 groups before surgery and at the latest follow-up with regard to scores for HSS, IKS, WOMAC, and SF-36 as well as active range of motion. The clinical outcomes of CAS TKAs at the 8-year follow-up were similar to those of conventional TKAs despite the better radiographic alignment and fewer outliers achieved with navigation assistance.

The number of patients receiving total knee arthroplasty (TKA) has been rising every year due to the aging population and the obesity epidemic. Post-operative rehabilitation is important for the outcome of TKA.

Background: Accurate femoral rotational alignment is critical for successful total knee arthroplasty (TKA). Debates exist about whether computer-assisted surgery-TKA (CAS-TKA) improves the accuracy of femoral rotational alignment. We hypothesize that it is related to the severity of the preoperative genu varus deformity and that CAS-TKA is beneficial under certain circumstances. Methods: Patients who had osteoarthritis with genu varus deformity and underwent conventional TKA or CAS-TKA between January 2007 and July 2013 at our hospital were enrolled. Based on the degree of preoperative deviation from the mechanical axis (MA), the patients were divided into three subgroups at 5-degree intervals: (1) varus deformity of ＜ 10 degrees, (2) 10–14.9 degrees, and (3) ≥ 15 degrees. Computed tomography was used to determine whether CAS-TKA provided better femoral rotational alignment than did conventional TKA. Component and limb alignment were also radiographically compared. Results: One hundred seventy-three knees on 128 patients met the inclusion criteria. For patients in the ＜ 10 degrees and 10–14.9 degrees groups, the component alignments and postoperative mechanical axes were not significantly different between conventional and CSA-TKA. For patients in the ≥ 15 degrees group, however, the femoral flexion angle was significantly (p ＜ 0.001) better for CSA-TKA, but not for the femoral valgus, tibial valgus, tibial flexion, or femoral rotational angles. Conclusions: CAS-TKA does not improve the accuracy of rotational alignment of the femoral component in patients with genu varus deformity. Level of Evidence: Therapeutic Level III.

Background: For osteoporotic femoral neck fractures, suitable bone-implant stability is critical for pain relief, early return to daily activities and reduction of complications. Teriparatide (parathyroid hormone [PTH1-34]) can improve bone-implant stability in some basic studies. However it's use in osteoporotic femoral neck fractures treated by cementless hemiarthroplasties for the beneficial effects on bone-implant stability is sparse in the literature. The aim of this study was to determine if post-operative teriparatide administration can reduce femoral stem migration and improve early functional recovery and health-related quality of life (HRQoL).Methods: Between 2010 and 2014, patients with osteoporotic femoral neck fracture who underwent cementless bipolar hemiarthroplasty were included into this retrospective cohort study. Group A included patients treated with cementless bipolar hemiarthroplasty only; Group B patients had additional teriparatide. Demographic data, complications, radiographic and functional outcomes as well as health-related quality of life (HRQoL) were compared.Results: There were 52 hips in group A (no teriparatide) and 40 hips in group B (patient who received teriparatide). The subsidence of the femoral stem tended to be significantly decreased in the teriparatide group at 6 and 12 weeks post-operatively (p = 0.003 and p = 0.008, respectively). The Harris Hip Score (HHS) increased significantly from pre-operation to 6 weeks post-operatively and thereafter up to one year in both groups. However, there were no significant differences in terms of subsequent fracture, mortality, HHS, and HRQoL between two groups during the entire study period.Conclusions: Teriparatide significantly reduces the subsidence of the cementless femoral stem in elderly patients in the early post-operative period, but this benefit does not reflect better functional outcomes and HRQoL. Further prospective randomized large-scale cohort study is warranted for evidence-based recommendations.

Computer-assisted surgery (CAS) has been used in orthopaedic surgery for over 20 years. Through real-time and quantitative feedback, it provides the surgeons the visibility of surgical anatomy, improves accuracy, reduces the outlier of the surgical results and maximizes the outcomes. CAS has been popularly applied in joint arthroplasty, bone osteotomy, implantation of screws in spine surgery, reconstruction of ligaments in sports medicine, open reduction and internal fixation of long-bone fracture and tumor surgery. The article is to overview the current CAS clinical application status and related outcomes. Whether the better postoperative images can translate into improved clinical functional outcomes deserves long term follow up.

BackgroundThe Russel-Taylor type 2B fractures compromised the trochanteric region and medial buttress of proximal femur. This fracture pattern limits the choice of implants and raises the risk of adverse outcomes. We aimed to (i) determine the outcome of Russel-Taylor type 2B fractures treated using reverse less invasive stabilization system plates (LISS-DF) and to (ii) learn what factors affected outcomes after osteosynthesis with reverse LISS plates.DesignA retrospective studySettingThe study was conducted at a Level III trauma center in Taiwan.MethodsTwenty-five consecutive patients presenting with a Russel-Taylor type 2B fracture were enrolled. All cases were treated with reverse LISS plates. A Modified Radiographic Union Scale for Femur (RUSF), Radiographic parameters, functional scores, and complications were assessed.ResultsUnion occurred in 21 cases at an average of 18.8 weeks. The average immediate postoperative neck-shaft angle was 130° (range: 122–135°) compared with 139° (range: 135–141°, p=0.05) on the contralateral side. Two cases had complications of proximal screws cutting out and two cases had broken implants. Finally, all 4 cases required repeated surgeries (16%). Malunion occurred in 4 patients and early mechanical failure (proximal screws cut out) occurred in 2. There was a significant difference in the purchase index of the proximal screws between cases with redisplacement and those without (26.4mm and 98.6mm, p=0.01).ConclusionsThe use of reverse LISS plate appeared to be an alternative procedure for the specific pattern in the present study. We recommend using this reverse locking plate to treat unstable proximal femoral fractures with meticulous techniques of placing plates. Adequate purchase of the proximal locking screws might decrease the risks of complications.

Osteoporotic intertrochanteric fractures result in serious health problems and decrease health-related quality of life (HRQoL). Faster time-to-union is important for early return to daily activities and reduction of complications. Teriparatide has been shown to accelerate fracture healing, but the literature is sparse on this topic. The aim of this study is to assess whether teriparatide accelerates fracture healing.Between 2008 and 2014, patients with osteoporotic intertrochanteric fractures who underwent surgical interventions were enrolled in this retrospective cohort study. Group 1 included patients who were not on any osteoporosis medication prior to fracture and who postoperatively received only calcium and vitamin D; patients in Group 2 were not on any osteoporosis medication prior to fracture, and received teriparatide and calcium and vitamin D postoperatively. Patients in Group 3 were those who were on alendronate prior to fracture and postfracture received teriparatide as well as calcium and vitamin D. Demographics, time-to-union, HRQoL (short-form health survey [SF]-12 physical component summary [PCS] and SF-12 mental component summary [MCS]), morbidities, mortalities, and radiographic and functional outcomes between groups were compared.A total of 189 patients were enrolled in this study. There were 83 patients in Group 1, 47 patients in Group 2, and 59 patients in Group 3. A significantly shorter time-to-union was found in the teriparatide-treated groups (mean, 13.6, 12.3, and 10.6 weeks, respectively [P=0.002]). With regard to SF-12 PCS, the scores were significantly better in teriparatide-treated groups at 3 months (mean, 19, 28, and 29, respectively [P=0.002]) and 6 months (mean, 28, 37, and 38, respectively [P=0.008]). Similar inter-group differences were noted when comparing the pain scores, the ability to get around the house, the ability to get out of the house, and the ability to go shopping at 3 and 6 months. Complications and mortality were also markedly reduced in the teriparatide-treated groups.Postoperative use of teriparatide for 6 months appears to be an effective adjunct therapy in the treatment of patients with osteoporotic intertrochanteric fractures. However, because of the limited power of the study, a prospective, randomized, large-scale cohort study is still required for determining the efficacy of teriparatide.

Whether the mechanical axis should be restored to neutral remains controversial when the patient has marked coronal femoral bowing. Eighty-four total knee arthroplasties were retrospectively reviewed. In the neutral-aligned group A the immediate postoperative mechanical axis of 179 ± 1° held stable (P = 0.841). The postoperative mechanical axis decreased from 176 ± 1° to 173 ± 1° (P = 0.024) in the outlier group. Progressive varus in the outlier group at follow-up was probably due implant instability and ligament imbalance as well as excessive polyethylene wear. At a mean follow-up of 75.8 months, no statistically significant difference was detected between the two groups. Long-term follow up will be needed to determine if the maintenance in radiographic results translates to better clinical outcomes.

Transpedicular screw (TPS) fixation in unstable thoracic and lumbar (TL) spine fractures remains technically difficult because of destroyed anatomical landmarks, unstable gross segments, and discrepancies in anatomic orientation using conventional anatomic landmarks, fluoroscopic guidance, or computed tomography (CT)-based navigation. In this study, we evaluated the safety and accuracy of TPS placement under intraoperative computed tomography (iCT) navigation in managing unstable TL spine fractures.From 2010 to 2013, we retrospectively reviewed the Spine Operation Registry records of patients who underwent posterior instrumented fusion to treat unstable TL spine fractures via the iCT navigation system. An unstable spine fracture was identified as AO/Magerl classification type B or type C.In all, 316 screws in 37 patients with unstable TL spine fractures were evaluated and involved 7 thoracic, 23 thoracolumbar junctional, and 7 lumbar fractures. The accuracy of TPS positioning in the pedicle without breach was 98% (310/316). The average number of iCT scans per patient was 2.1 (range 2-3). The average total radiation dose to patients was 15.8 mSv; the dose per single level exposure was 2.7 mSv. The TPS intraoperative revision rate was 0.6% (2/316) and no neurovascular sequela was observed. TPS fixation using the iCT navigation system obtained a 98% accuracy in stabilizing unstable TL spine fractures. A malplaced TPS could be revised during real-time confirmation of the TPS position, and no secondary operation was required to revise malplaced screws.The iCT navigation system provides accurate and safe management of unstable TL spine fractures. In addition, operating room personnel, including surgeons and nurses, did not need to wear heavy lead aprons as they were not exposed to radiation.

Accurate femoral rotational alignment is of vital importance for successful total knee arthroplasty (TKA). The value of computer-assisted surgery TKA (CAS-TKA) in increasing the accuracy of femoral rotational alignment remains controversial. We hypothesize that outcomes are related to the severity of preoperative varus and valgus deformity and that CAS-TKA may be beneficial under certain circumstances. Between January 2007 and December 2013, patients with osteoarthritis and varus angulation in the mechanical axis (MA) ≥ 15° and valgus angulation in the MA ≥ 10° (based on hip-to-ankle standing radiography) who underwent TKA were divided into four groups. CAS-TKA and conventional TKA outcomes were compared in patients who had preoperative advanced genu varum and advanced genu valgum deformities. The accuracy of component alignment and postoperative limb alignment was determined using radiographic parameters and computed tomography (CT). One hundred and eight patients (144 knees) were included in the analysis. For patients with preoperative advanced genu varum deformity, a significant difference was detected in the sagittal femoral angle (p < 0.001), but no significant improvement of femoral rotational alignment was noted (p = 0.127). In patients with preoperative advanced genu valgum deformity, a significant difference was found in the sagittal femoral angle (p = 0.034). The femoral rotational angle was significantly closer to the proper position in the CAS-TKA group (p < 0.001). When comparing the percentage of knees achieving the proper alignment, there was a decrease in the amount of outlier for the femoral rotational angle for CAS-TKA in advanced genu valgum deformity (p = 0.011). Our data demonstrate that CAS-TKA is beneficial in obtaining proper femoral rotational alignment in patients with advanced genu valgum deformity (preoperative MA ≥ 10° valgus). In patients with advanced genu varum deformity (preoperative MA ≥ 15° varus), CAS-TKA did not improve the femoral rotational alignment.

BACKGROUND:Tibial eminence avulsion fracture often co-occurs with tibial plateau fracture, which leads to difficult concomitant management. The value of simultaneous arthroscopy-assisted treatment continues to be debated despite its theoretical advantages. We describe a simple arthroscopic suture fixation technique and hypothesize that simultaneous treatment is beneficial.METHODS:Patients with a tibial eminence avulsion fracture and a concurrent tibial plateau fracture who underwent simultaneous arthroscopically assisted treatment between 2005 and 2008 were enrolled in this retrospective study. Second-look arthroscopic evaluation and Rasmussen scores of clinical and radiographic parameters were used to assess simultaneous treatment.RESULTS:Forty-one patients (41 knees) met the inclusion criteria. All 41 fractures were successfully united. All patients had side-to-side differences of less than 3 mm and negative findings in Lachman and pivot-shift tests at their final follow-up. The mean postoperative Rasmussen clinical score was 27.3 (range: 19-30), and the mean radiologic score was 16.5 (range: 12-18). Clinical and radiographic outcomes in 98 % of the patients were good or excellent. There were no complications directly associated with arthroscopy in any patient.CONCLUSIONS:Simultaneous arthroscopic suture fixation of associated tibial eminence avulsion fracture did not interfere with the plates and screws used to stabilize the tibial plateau fracture. It gave the knee joint adequate stability, minimal surgical morbidity, and satisfactory radiographic and clinical outcomes in a minimum follow-up of 5 years and in the arthroscopic second-look assessments.

The aim of this study was to compare the gray-level value of the supraspinatus tendon of a painful shoulder with that of a normal shoulder measured by ultrasonography, and to investigate whether a low mean gray-level value of the supraspinatus tendon could indicate a partial-thickness or incomplete full-thickness tear.

Background: The value of computer-assisted surgery-total knee arthroplasty (CAS-TKA) for osteoarthritic knees with excessive coronal femoral bowing deformity continues to be debated. We hypothesized that computer-assisted navigation may be beneficial when the coronal bowing deformity is severe.Methods: Patients with osteoarthritic knees in conjunction with excessive coronal femoral bowing deformity (＞ 5° by the Mullaji method) who underwent CAS-TKA were enrolled in this retrospective study. The usefulness of computer-assisted navigation was analyzed by the accuracy of placement of the components and postoperative alignment determined by five radiographic parameters. The Hospital for Special Surgery (HSS) and International Knee Society (IKS) functional scores were obtained for all patients preoperatively and postoperatively. Results: From January 2005 to December 2010, eighty-three patients (83 knees) met the inclusion criteria. Of these, eighty-one patients (97.6%) achieved the targeted goal of a leg axis within 3° of the neutral axis. There was a significant improvement between the preoperative and postoperative mechanical axes (164 ± 4° vs. 179 ± 2°, p ＜ 0.001). After a mean follow-up of 50 months, improvements in the IKS pain score, IKS clinical knee score, IKS functional knee score, and the HSS knee score were noted. Conclusions: Computer-assisted navigation was a valuable adjunct for obtaining proper alignment in patients with excessive coronal femoral bowing deformity, in whom accurate placement of components and restoration of the mechanical axis may be challenging.

AimTo investigate the impact of circuit exercise and Tai Chi exercise on body composition in middle‐aged and older women.MethodsThe present cohort study included 180 women (aged 45–75 years) who were divided into a circuit exercise group, Tai Chi group and control group. The exercise program consisted of 60 min of exercise three times per week for 12 weeks. The circuit exercises were carried out with intensity controlled by heart rate (60–80% of work). The Tai Chi group practiced Yang style with the same frequency, but with intensity of 50–60% of work. Blood pressure and body composition were assessed. The differences in all variables and the relative changes between baseline and 12 weeks' follow up were evaluated.ResultsThe circuit exercise group showed a significant decrease in body mass index, systolic blood pressure and body fat mass, and an increase in total body muscle mass, lean body mass, bone mineral content and basal metabolic rate. The Tai Chi group showed a decrease in systolic blood pressure. Increases in the basal metabolic rate (1.3 ± 3.0%), total body muscle mass (1.8 ± 4.3%), lean body mass (1.9 ± 4.3%) and bone mineral content (1.8 ± 4.2%), and decreases in body mass index (–2.2 ± 7.8%), body fat (–6.5 ± 10.7%) and diastolic pressure (–1.2 ± 9.4%) were significantly greater in the circuit exercise group than in Tai Chi or control group.ConclusionCircuit exercise for 12 weeks increases lean body mass and basal metabolic rate more effectively than Tai Chi exercise. Geriatr Gerontol Int 2015; 15: 282–288.