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TENDON RESEARCH GROUP

 

Faculty: CLINICAL SCIENCES

Background/Research Issues of the Group:

There has recently been an increased awareness on the need for people to participate in physical activities as part of preventive measures against several non-communicable diseases such as hypertension and diabetes.  This increased participation in recreational sports has resulted in an upsurge in tendon injuries and ruptures especially the Achilles tendon. The management of tendon injury poses a considerable challenge to clinicians due to the slow rate of healing. The continual use of the injured tendon coupled with the poor healing results in a vicious cycle of failed healing and re-injury known as tendinopathy. Tendinopathy is a common and significant problem, with a prevalence of 14% in elite athletes (Lian et al., 2005) and requiring a recovery time of three to six months with conservative management (Khan et al., 1999). It is characterized by activity-related pain, focal tendon tenderness and intra-tendinous imaging changes which results in mechanical weakening of the afflicted tendon with the risk of tendon rupture.

Tendinopathies of the Achilles tendon also affect 2% of the general adult population with prevalence in active individuals between 9%‐40% depending on the type and level of sporting activity engaged in. Achilles tendon ruptures most commonly occur during sports and are responsible for a considerable amount of morbidity among the young to middle aged involved in leisure sports with a reported annual incidence of 18 per 100,000. Injuries to the Achilles tendon can be devastating with unpredictable outcomes.

Objectives:

  1. To ascertain the prevalence of tendinopathy in both sporting and general population in Nigeria
  2. To determine the risk factors for tendinopathy
  3. To determine the role of genomics in tendinopathy
  4. To investigate modalities that can prevent tendinopathy
  5. To develop a biomechanical device that can detect tendinopathy in human subjects
  6. To investigate modalities that can be used to treat tendinopathy and thus restore normal tendon morphology and function

Research Areas/Focus:

In view of the foregoing, our research focus which is multidisciplinary will cut across laboratory animal studies, pharmacological, genomics and clinical trials and is enumerated as follows:

  1. To conduct epidemiological studies to ascertain the prevalence of tendinopathy and associated risk factors both in the sporting and general population in view of a lack of data in Nigeria

 

  1. To develop in conjunction with the biomedical engineers, a device that can detect intrinsic weakness in the human tendon to allow for preventive rehabilitation that will prevent tendon rupture.

 

  1. To undertake studies on mechanical, biomechanical, kinesiotherapeutic and natural modalities that will either prevent degeneration or restore tendon morphology and function in tendinopathy.

 

  1. As a follow-up to our previous study, we intend to formulate and evaluate the efficacy of the aqueous extract of the pineapple fruit in preventing and or reversing the degenerative changes in tendinopathy thereby restoring tendon morphology and function.

 

 

Team members and their speciality

Name

Role

Speciality

Department

Telephone (+234)

Email

Dr A.I Aiyegbusi (Team Lead)

BSc, MSc, PhD

Research Concept, Research designs, Bench work, Clinical trials

Musculoskeletal and Sports Physiotherapy

Physiotherapy

8023212513

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Prof F.I.O Duru

MBBS, PhD

Stereological analysis, Quantitative analysis

Quantitative microscopy

Anatomy

8030537354

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Dr T.A Samuel

BSc, MPhil, PhD

Biochemical analysis

Molecular Oncology and Biomarkers

Biochemistry

8023070884

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Dr N.K Irurhe

MBBS, MSc, FMCR

Ultrasonography and tendon imaging

Radiology/ Medical Imaging

RRRR

8023450029

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Dr M.O Ilomuanya

BPharm, MSc, PhD

Formulation of extract of pineapple fruit into dosage forms

Drug Design and Formulation Development

Pharmaceutics and Pharmaceutical Technology

 

8033295077

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Dr. O.A Ajibola

BSc, MSc, PhD

 

Development of a digital biomechanical device to detect tendinopathy

Biomedical Engineering Modelling and Simulation. BME Designs and Devices

 

Systems Engineering

 

 

8023025053

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Dr O.A Fapojuwo

BSc, MSc, PhD

 

Biomechanical and kinesiotherapeutic interventions in clinical studies

 

Orthopaedics, Sport and Recreational Physiotherapy 

 

Physiotherapy

 

8060081382

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Pictures of Team members (Smiling Please!):

 

  Dr A.I Aiyegbusi

 Dr N.K Irurhe

   Dr O.A Fapojuwo

 

 Dr Ilomuanya

 

   Dr Samuel

 

 

Description of Notable Research findings /Outstanding Research findings:

  1. The first study in tendon research was to determine if the administration of high intensity therapeutic ultrasound was necessary in the healing of acute tendon injury. This was necessary considering the fact that high intensity therapeutic ultrasound had been implicated by prior studies in causing cavitation and tissue damage. A comparative study was done between low and high intensities and the results obtained showed that high intensity therapeutic ultrasound was not necessary in the healing of acute tendon injury as there was no significant difference in their impact on cell proliferation.

 

  1. We investigated treatment modalities that would accelerate healing by causing cell proliferation and also prevent or minimize oxidative stress which usually results from acute injuries as well as the effects of Non-steroidal anti-inflammatory drugs (NSAIDs) on the healing tendon. NSAIDs were found to arrest cell proliferation and cause the collagen fibres of the healing tendon to be disorganized.

Natural products like pineapple, virgin coconut oil and commercial bromelain which is an enzyme extracted from the pineapple stem were found to increase cell proliferation and reduce the oxidative stress markers in the healing of acute tendon injuries.

 

  1. On further studies on the healing of acute tendon injuries, we also investigated the role of intrasound therapy, a mechanical device which operates on the principle of audible sound waves. The intrasound therapy device is portable, easy to operate and  has no complicated choices of treatment parameters. This study was novel because there was no prior scientific study on this device except for subjective accounts of efficacy by clients and patients. Comparative studies were done with therapeutic ultrasound as well as on animals previously fed with alcohol. The intrasound waves were found to significantly increase cell proliferation and lower the oxidative stress, even in animals that had prior ingestion of alcohol. It also augmented the healing of the tendon of animals that had NSAIDs concurrently. Finally, our findings show that the dosage intensity does not affect healing but rather the frequency of treatment.

 

 

  1. Following the positive impact intrasound therapy had on the healing tendon in animal studies, the first clinical trial was conducted on patients with osteoarthritis of the knee and compared with TENS and close chain exercises. Intrasound therapy was found to be an effective adjunct in the management of OA knee.

 

  1. A preliminary epidemiological study on the prevalence of Achilles tendinopathy (AT) and associated risk factors was carried out in a population of recreational sports participants in Lagos, Nigeria. Results show that 21% of the participants had AT. It was concluded that AT is common among recreational sports individuals in Lagos, Nigeria; age being a contributing factor while other physical characteristics had no significant impact.

 

 

Bio-sketches:

 

Dr Ayoola Ibifubara Aiyegbusi             

Dr Aiyegbusi is a Senior Lecturer in Physiotherapy and a Visiting Lecturer in Anatomy at the College of Medicine, University of Lagos, Nigeria. She had her basic training in Physiotherapy and Post-graduate degrees in Musculoskeletal Anatomy from the University of Lagos in addition to over 25 years’ experience in clinical and industrial physiotherapy. One of her core objectives is to ensure the students have a solid anatomical background which will be an invaluable asset to them in the course of their clinical training and practice.

With Research interest in Rheumatology and Musculoskeletal physiotherapy, her teaching experience include the development of academic programmes especially for physiotherapy students, students' assessment and compilation of results as well as supervision of students' projects at both undergraduate and postgraduate levels. Her areas of teaching specialty include Applied and Clinical Anatomy, Gross and Applied Neuro-anatomy, Problem-Based Learning (PBL) and Musculo-skeletal Physiotherapy.  Others are Orthopaedic and Sports Physiotherapy and Ergonomics and industrial Physiotherapy.

Dr Aiyegbusi has won a number of awards which include theBest PhD thesis in Medicine and Pharmacy’ in 2009/2010 graduating set by the Postgraduate School, University of Lagos Nigeria. Her area of general research interest is musculoskeletal physiotherapy with specific interest in tendon and tendinopathy research. She has over 30 publications in Peer-reviewed international and National Journals.

 

Prof FIO Duru

Professor Francis Duru is a Professor and former head of Department of Anatomy, College of Medicine of the University of Lagos, Idi-Araba Campus in Lagos, Nigeria. He holds a Bachelor of Medicine, Bachelor of Surgery degree (M.B.B.S) and a PhD in Anatomy. Prof Duru is an experienced clinician, lecturer and researcher with interest in male reproductive biology and quantitative microscopy. As a teacher, he has been involved in the teaching of undergraduate Human Gross Anatomy, Histology and Embryology to Medical, Dental, Physiotherapy, Nursing, Medical Laboratory Technology, Pharmacy and Physiology Students. At the post-graduate level, he has taught advanced Gross Anatomy since 2008 and supervised over twenty M.Sc. projects and six PhD theses in a range of topic areas.  Currently, he is supervising four M.Scs. and five PhDs

He is one of the lead investigators in the Reproductive Biology unit of his Department. His current research include:  Evaluation of testicular function on the offspring of pregnant rat fed with modern wheat Lectin and the evaluation of testicular oxidative stress by juby formula (A polyherbal Nigerian product). With his interest in quantitative microscopy, Stereological tools have recently been introduced in his department for the unbiased estimation of first order stereological parameters from microscopic profiles.

Francis has published over sixty papers in peer reviewed scientific journals covering testicular oxidative stress syndromes, testicular toxicology and the modulatory activity of several Nigerian Medicinal plants on testicular function. He has made several presentations in workshops, seminars, symposia and conferences.

His scholarly work has reported on testicular ischaemic preconditioning, melatonin modulation of testicular lipid peroxidation following torsion-detorsion, histological changes and testicular dysfunction following severe burns and alteration of the testicular parameters in the Africa giant rat following vasectomy. In 2013, he reported the role of Zinc and Selenium in the regeneration of the germinal epithelium of the male Wistar rat following Lead toxicity, a study that was supported by a grant from the Petroleum Trust Fund (PTF).

Apart from headship of his department, he has been a resource person to the National Postgraduate Medical College, a member of the Board of Postgraduate studies of the University of Lagos and an undergraduate and postgraduate external examiner to several Universities.

 

Dr Titilola Aderonke Samuel

Dr. Samuel is a Biochemist, committed researcher and Teacher of the subject in one of Nigeria’s foremost Universities. She received a B.Sc. (Hons) in 1987, Master of Philosophy (M phil) 1993, and a PhD Biochemistry 2009 all from the University of Lagos, Lagos.  She has been a Lecturer in the department of Biochemistry since 2005 till date. She has been involved in teaching Medical, Dental, para Medical and Biochemistry students both at undergraduate and postgraduate levels. She was also the Sub-dean of the faculty of Basic Medical Sciences from 2014-2016. She has a broad background in Biochemistry and her research interest includes Endocrinology and Metabolism, Biochemical biomarkers, Foetal programming, Nutraceuticals and Cancer research. She has been exposed to some equipment needful for her research. Thus far she has used the spectrophotometer, polyacrylamide gel electrophoresis, polymerase chain reaction technique, the workings of Atomic absorption spectrophotometer, Enzyme Linked Immunosorbent assay (ELISA) technique for measuring biochemical biomarkers. She won the Best researcher award of Faculty of Basic Medical Science, University of Lagos annual research conference and fair in 2014. She is also a member of various national and international professional associations.

Dr Samuel has won a number of research grants which include:

  1. CRC/TETFUND/ No 2014/13

Mechanism of maternal magnesium deficiency on adiposity and insulin resistance in rat pups

Morakinyo AO, Samuel TA

  1. UNIVERSITY OF LAGOS GRANT CRC2015/12

Impact of prenatal and perinatal folic acid supplementation on glucose tolerance, insulin resistance and methylation of INSR gene in rat offspring

Morakinyo, OA, Samuel TA, Awobajo FO, Adegoke OA

  1. CRC/TETFUND/ no 2015/02

DNA methylation analysis of BRCA1 AND BRCA 2 genes of breast cancer patients attending Radiotherapy clinic  Lagos University Teaching Hospital, Lagos, Nigeria.

Samuel TA, Magbagbeola OA, Oshodi TA, Habeeb MY

  1. UNIVERSITY OF LAGOS CRC 2013/13

Characterization of the Mineral composition of commonly consumed local foods in Nigeria

Morakinyo  AO, Samuel TA, Adegoke OA :COMPLETED

Dr Samuel is a reviewer of  Protocols/Proposals for the Health Research Ethics Committee (HREC) of the College of Medicine, University of Lagos.

 

Dr Olawale Ajibola

Dr. Ajibola is a Senior Lecturer in Systems Engineering and a Visiting Lecturer in Biomedical Engineering at the College of Medicine, University of Lagos, Nigeria. He had his basic training in Mathematics from University of Ibadan and Post-graduate degrees in Engineering Analysis and Systems Engineering from the University of Lagos in addition to over 25 years’ experience in Teaching and Research.

His research interest spans all facets of medical devices design from modelling and simulation to all areas of design processes. One of his core objectives is to ensure the students have well-grounded foundation in Engineering education, and understand what it takes to build on it. He has developed many innovative medical devices. He has also worked extensively on renewable energy, witricity and Engineering education. He won the Best Research in Engineering award at the University of Lagos annual research fair and conference in 2011. The first ever to be awarded the Best Teacher, Biomedical Engineering and in the Faculty of Basic Medical Sciences CMUL in 2015, he has published widely both in National and International Journal.

Dr Oluseun Akinleye Fapojuwo

Dr Fapojuwo graduated from the University of Ibadan in 2001 with a Bachelor’s degree of Science specialized in Physiotherapy. He pursued his studies by completing a Master’s in Orthopaedics, Sport and Recreational Physiotherapy   in 2006 through the University of Ibadan. In pursuit of further academic excellence, he completed his Doctoral programme in the University of Ibadan in 2015.

Dr Fapojuwo is a licensed physiotherapist by the Medical Rehabilitation Therapists Board of Nigeria and the Health Professions Council of the United Kingdom. He is also a member of the Nigeria Society of Physiotherapy, Society of the Study of Pain in Nigeria, Manual therapy group of the Nigeria Society of Physiotherapy and the Nigeria Association of Sports Physiotherapists. He regularly attends (and has presented at) the annual National Physiotherapy Congress to keep up-to-date with the knowledge of the country’s leading experts. In hopes of pushing the current knowledge in physiotherapy, he has published scholarly research papers, in peer reviewed journals.

Dr Fapojuwo research interests are Orthopaedics, Ergonomics, Development and Evaluation of evidence based physiotherapy techniques for diagnosis and management of orthopaedic conditions, Epidemiology, prevention, management and rehabilitation of Orthopaedic disorders, Fitness and Health.

Dr Fapojuwo is committed to self-directed lifelong learning, performance of quality research, teaching and disseminating knowledge in the field of musculoskeletal physiotherapy, frequently consulting research papers, books, Internet blogs, podcasts, and videos.

 

Selected Publications;

  1. Akinbo S.R.A, Aiyegbusi A.I (2000). The effect of Low intensity Therapeutic Ultrasound on fibroblast proliferation during the early stages of tendon healing. Nigeria Quarterly Journal of Hospital Medicine 10 (4):263-266

 

2.      N.M Ibeabuchi, S.R.A Akinbo, A.I Aiyegbusi (2004). Comparison of the effects of Low and High intensity Therapeutic Ultrasound on the early stages of tendon healing.  Nigeria Journal of Medical Rehabilitation 9, No 1&2, (17)

 

  1. Aiyegbusi A.I, Duru F.I.O, Awelimobor D, Noronha C.C, Okanlawon A.O (2010).The Role of Aqueous Extract of Ananas Sativus Fruit Parts in the Healing on Acute Crush Tendon Injury.Nigeria Quarterly Journal of Hospital Medicine. 20 (4) 223-227

 

  1. Aiyegbusi AI, Akinbo SR, Noronha CC, Okanlawon AO (2010). The effects of varied intensities of intrasound therapy with indomethacin on the morphology of the healing tendon. Nigeria Quarterly Journal of Hospital Medicine. 20(1):19-23

 

  1. Aiyegbusi A.1 Olabiyi O.O, Duru F.I.O, Noronha C.C, Okanlawon A.O (2011). A comparative study of the effects of Bromelain and fresh Pineapple juice on the early phase of healing in acute crush Achilles tendon injury. Journal of Medicinal Food : 14 (4): 348-352

 

  1. Aiyegbusi A.I, Duru F.I.O, Anunobi C.C, Noronha C.C, Okanlawon A.O (2011). Bromelain in the early phase of healing in acute crush Achilles tendon injury    Phytotherapy Research. 25( 1): 49–52

 

  1. Aiyegbusi A.I¹, Samuel T.A, Anunobi C.C, Duru F.I.O, Akinfeleye A. (2014). Comparative Efficacy of Bromelain and Ascorbic Acid in the Healing of Acute Crush Achilles Tendon Injury: A Preliminary Study. Nigeria Quarterly Journal of Hospital Medicine. 24(3): 222-226

 

  1. Aiyegbusi AI, Duru F.I.O, Akinbo S.R, Noronha C.C, Okanlawon A.O (2010).Intrasound therapy in tendon healing: Is intensity a factor?Open Access Journal of Rheumatology: Research and Reviews:2 45–52

 

  1. Aiyegbusi A.I,Okoko I.E Akinbo S.R.A,Noronha C.C, Okanlawon A.O (2012). The effect of intrasound therapy and ascorbic acid on the healing of acute tendon injury: a preliminary histological study. Journal of Clinical Sciences. 9:(1); 15-19

 

  1. I Aiyegbusi, F.I.O Duru, SRA Akinbo (2012). The morphology of the healing tendon: A comparison of the effects of Intrasound therapy and therapeutic pulsed Ultrasound. Connective Tissue Research: 53 (6): 478-484

 

  1. Ayoola I Aiyegbusi, Olufunke O Dosumu, Titilola A Samuel, Charles C Anunobi, Francis I Duru, Adegoke Akinfeleye (2014). Intrasound Therapy Reverses the Effects Of Alcohol Consumption On The Healing Tendon And Augments Healing. Br J Sports Med; 48:A2-A3 doi:10.1136/bjsports-2014-094114

 

  1. Aiyegbusi A.I, Dosumu O.O, Samuel T.A, Anunobi C.C, Duru F.I.O, Akinfeleye A, Okafor U.A (2015). The Effects Of Intrasound Therapy On The Healing Of Tendon Exposed To Alcohol. J Basic Medical Sciences. 3:13:1 (Jan-June).

 

  1. Aiyegbusi A.I, Okafor U.A.C, Akinfeleye A.M, Adejugbagbe A.K, Fapojuwo O.A (2015). Intrasound therapy is an effective adjunct in the management of Osteoarthritis of the knee: A preliminary clinical trial. Clinical Medicine Reviews in Therapeutics. 7:11-17

 

 

 

 

 

 

 

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