Showing papers in "Journal of Musculoskeletal & Neuronal Interactions in 2019"

Efficacy of deep core stability exercise program in postpartum women with diastasis recti abdominis: a randomised controlled trial

Abstract: Objectives: This study was aimed at discovering the efficacy the deep core stability exercise program has on the closure of diastasis recti and on the overall improvement in the quality of life for postpartum women. Methods: The study group consisted of forty women with diastasis recti, aged between 23 and 33 who were randomly divided into two groups. The 20 women in the first group underwent a deep core stability-strengthening program plus traditional abdominal exercises program, 3 times a week, for a total duration of 8 weeks. The other 20 women. forming the second group, only underwent the traditional abdominal exercises program, 3 times a week for 8 weeks. Following this procedure, the inter-recti separation was measured using digital nylon calipers while the quality of life was measured by Physical Functioning Scale (PF10) for all the participants. Results: As a result of the use of the deep core stability exercise program, inter-recti separation had a high statistically relevant decrease. (P<0.0001). showing a highly statistically relevant improvement with regard to the quality of life in the study groups (p<0.0001). Conclusions: The deep core stability exercise program is effective in treating diastasis recti and improving postpartum women's quality of life.

How do tendons adapt? Going beyond tissue responses to understand positive adaptation and pathology development: A narrative review.

Abstract: Understanding how tendons adapt to load is crucial to understanding how training can improve performance, minimise the risk of injury and aid rehabilitation. Adaptation is the positive response of an organism or tissue to benefit its function. In tendons, numerous tissue responses to load have been identified in vivo. Changes in tendon dimensions, structure on imaging, mechanical properties, and blood flow have been reported in response to mechanical stimuli. However, research has focused on tissue level changes with little understanding of how changes at the tissue level affect the person, their athletic performance or injury risk. Tendons can have a paradoxical response to load, load can induce positive adaptation, however it is also a major factor in the development of tendon pathology and pain. Tendon pathology is a risk factor for developing symptoms, yet the high rate of asymptomatic pathology suggests that the pathological tendon must adapt to be able to tolerate load. Similarly, there is mounting evidence to suggest that tendon remodelling or repair is not necessary for a positive clinical outcome following rehabilitation, suggesting that the tendon must adapt via other mechanisms. This narrative review synthesises evidence of how normal and pathological tendons adapts to load, and how this relates to adaptation of load capacity and function of the individual.

Lower limb muscle strength in patients with low back pain: a systematic review and meta-analysis.

Abstract: Objective To systematically review the published studies that compare lower limb muscle strength in patients with low back pain to matched healthy controls. Methods We searched Medline, SciELO, Cumulative Index to Nursing and Allied Health (CINAHL), and Scopus up until December 2017. Studies comparing lower limb muscle strength in people diagnosed with low back pain to healthy control participants were included in the systematic review. Results 14 studies, which included 951 healthy controls and 919 patients with low back pain, fulfilled the inclusion criteria. Meta-analysis revealed a lower muscle strength of hip abductor/extensors and knee extensors in patients with low back pain in comparison to healthy controls. The average strength of hip abductors (Five studies, SMD=0.7 95% CI: 0.49 to 0.9) and hip extensors (Two studies, SMD=0.93, 95% CI: 0.62 to 1.23) was significantly lower in patients with low back pain compared to that of healthy controls. Knee extensor muscle strength was significantly lower in patients with low back pain compared to healthy controls (Three studies, WMD=0.31 Nm/kg, 95% CI: 0.1 to 0.5). The meta-analysis indicated a no significant difference in knee flexor muscle strength in patients with low back pain compared to healthy controls. Conclusions Lower limb muscle is impaired in patients with low back pain.

The effectiveness of McKenzie method compared to manual therapy for treating chronic low back pain: a systematic review.

Abstract: The aim of this study was to evaluate the effectiveness of the McKenzie method compared to manual therapy in the management of patients with chronic low back pain (CLBP). Randomised controlled trials evaluating the McKenzie method in treating CLBP in adults compared to manual therapy (MT) were searched in MEDLINE, CINAHL, Cochrane Library, and PEDro. The primary outcomes were pain and disability. Five trials were eligible for inclusion in the review, of which, most had a score of 8 out of 11 on the PEDro scale. At 2-3 months, all studies reported significant improvement in the pain level in the McKenzie group, and more than that in the MT group. At 6 months, significant improvements had occurred in the disability index reported by two trials in the McKenzie group than the MT group. At 12 months follow-up, there were no significant differences in measures of LBP, but three studies reported that the McKenzie method group had a better disability level than the MT group. In patients with CLBP, many pain measures showed that the McKenzie method is a successful treatment to decrease pain in the short term, while the disability measures determined that the McKenzie method is better in enhancing function in the long term.

Plyometric exercise improves jumping performance and skeletal muscle contractile properties in seniors.

Abstract: OBJECTIVE This study investigated the effects of an 8-week plyometric training (PT) session on countermovement jump (CMJ) height, take-off velocity, and Tensiomyography (TMG) derived contractile parameters in seniors. METHODS Twenty-three senior adults (age 66.7±5.2 years) were randomly divided into two groups: PLYO (n=11) and CTRL (n=12). Tensiomyography was measured in vastus lateralis (VL), biceps femoris (BF), tibialis anterior (TA), gastrocnemius medialis (GM), and lateralis (GL). Additionally, the electromechanical efficiency (EME) index was calculated in GM as a ratio between amplitudes of peak-to-peak M-wave and TMG (Dm) responses. Biochemical markers of muscle damage and inflammation were evaluated to provide indirect indices of exercise protocol safety. RESULTS The main effect of time (for take-off velocity p=.023; ɳ2= .236) and group x time interactions (for CMJ, Tc (BF, GM), Dm (BF) and EME p<.05; ɳ2= .136 - .236) were observed. Post hoc analysis showed a significant increase in CMJ height and take-off velocity, namely by 14.2% (p=.001) and 8.2% (p=.01) in PLYO, respectively. Contraction time (Tc) decreased in BF -5.7% (p=.001) and GM -9.6% (p=.001). Dm decreased only in BF -20.8% (p=.001), while the EME index of the GM improved by 22.9% (p=.002). There were no differences between groups or assessment time points for C-reactive protein (p=.122). CONCLUSION The present study clearly supports the application of supervised PT exercise in seniors, since explosive power, muscle contractility, and EME of the lower limbs were markedly improved after training.

Plyometric exercises: subsequent changes of weight-bearing symmetry, muscle strength and walking performance in children with unilateral cerebral palsy.

Abstract: Objective: To evaluate the subsequent effects of plyometric training on weight-bearing symmetry, muscle strength, and gait performance in children with unilateral cerebral palsy. Methods: Thirty-nine children with spastic hemiplegia (age 8-12 years) were randomly divided into either the PLYO group (n=19, received a 30-minute plyometric exercise program plus the traditional physical rehabilitation, twice/week for eight consecutive weeks) or Non-PLYO group (n=20, received the traditional physical rehabilitation only). The weight-bearing symmetry index (WB-SI), maximum isometric muscle strength (MIMS) of quadriceps and hamstring muscles, and spatial-temporal gait parameters were assessed pre and post-intervention. Results: From pre- to post-intervention, changes of WB-SI among PLYO and Non-PLYO groups did not differ significantly (P=.81; hindfoot and P=.23; forefoot). MIMS of quadriceps and hamstring muscles at 90° knee flexion (P=.008 and .013 respectively) increased significantly in PLYO compared to Non-PLYO group. Walking speed (P=.033), stride length (P=.002), and step time (P<.001) improved markedly in PLYO group more than in Non-PLYO group. The proportion of single leg support (P=.14) among PLYO and Non-PLYO groups did not differ significantly. Conclusion: Addition of plyometric exercises to the physical rehabilitation programs of children with unilateral CP could achieve greater improvement in muscle strength and walking performance, but not in WB-SI.

Proprioceptive neuromuscular facilitation techniques in adhesive capsulitis: a systematic review and meta-analysis.

Abstract: This systematic review aims to determine the effectiveness of proprioceptive neuromuscular facilitation (PNF) treatment techniques in adhesive capsulitis for decreasing pain and disability and increasing range of motion (ROM) and function. A thorough, computerized search was done using database search engines by two reviewers. After meticulous scrutiny and screening of 410 studies, according to the selection criteria, 10 full-text articles were included in the review and meta-analysis. All 10 studies had undergone a methodological quality assessment by the Physiotherapy Evidence Database Scale. Meta-analysis was done for external rotation, abduction ROM and pain. The most common PNF techniques used by most of the studies were, hold-relax and contract-relax in upper limb D2 flexion, abduction, and an external rotation pattern, while some studies used scapular PNF patterns. Among the 10 included studies, nine showed that the PNF group is superior in decreasing pain and reducing disability, increasing ROM, improving function. The meta-analysis also showed a significant effect size and that the PNF is superior than conventional physical therapy in decreasing pain, increasing external rotation, and abduction ROM.

Translation and cross-cultural adaptation of the extended version of the Nordic musculoskeletal questionnaire into Turkish.

Abstract: OBJECTIVES The purpose of this study was to translate and culturally adapt the Extended Version of the Nordic Musculoskeletal Questionnaire (NMQ-E) for use in Turkey. METHODS The cross-cultural adaptation was achieved by translating the items from the original version, with back-translation performed by independent mother-tongue translators, followed by committee review. Reliability (internal consistency and test-retest) was examined for 132 students (97 females, 35 males; mean±SD age: 19.91±1.24 years, mean±SD body mass index: 21.77±3.31 kg/m2) who completed the NMQ-E twice (with a 1 week interval). Construct validity was analyzed with the Cornell Musculoskeletal Discomfort questionnaire. Cronbach alpha was used to assess internal consistency. Intraclass correlation coefficient (ICC) and prevalence-adjusted bias-adjusted kappa (PABAK) were used to estimate the test-retest reliability. All of the statistical analyses were performed by using SPSS (version 22.0). RESULTS The Turkish version of the NMQ-E showed adequate internal consistency (Cronbach coefficient α=.78). The test-retest reliability was examined with PABAK and all items showed moderate to almost perfect reliability (PABAK=0.610-0.955), excellent ICC= 0.88 and good construct validity (p<0.001). CONCLUSIONS The Turkish version of the NMQ-E has applicable psychometric properties, including good test-retest reliability, internal consistency and construct validity.

Bone matrix mineralization and osteocyte lacunae characteristics in patients with chronic kidney disease - mineral bone disorder (CKD-MBD).

Abstract: OBJECTIVES Little is known about bone mineralization and osteocyte lacunae properties in chronic kidney disease mineral bone disorder (CKD-MBD). METHODS In this retrospective study, we measured the bone mineralization density distribution (BMDD) and osteocyte lacunar section (OLS) 2D-characteristics by quantitative backscatter electron imaging in Straumann drill biopsy samples from n=58 patients with CKD-MBD. Outcomes were studied in relation to serum parathyroid hormone (PTH), alkaline phosphatase (APH), histomorphometric bone turnover and treatment with cinacalcet or phosphate binders. RESULTS Lower calcium concentrations in bone from high turnover (average degree of bone mineralization -6.2%, p<0.001) versus low turnover patients were observed. OLS-characteristics were distinctly different (p<0.01 to p<0.05) in patients with highest compared to those with lowest turnover. Patients with cinacalcet had different OLS-characteristics (p<0.05) compared to those without cinacalcet. Furthermore, patients with phosphate binders had differences in BMDD and OLS-characteristics (p<0.05) compared to patients without phosphate binders. CONCLUSIONS Our findings suggest that in patients with CKD-MBD secondary hyperparathyroidism and increased bone turnover decrease the average degree of bone matrix mineralization. Conversely, density and lacunar size of the osteocytes are increased compared to adynamic bone disease pointing at distinct patterns of bone mineralization and osteocyte lacunar properties in these two disease entities.

Effect of adding whole-body vibration training to squat training on physical function and muscle strength in individuals with knee osteoarthritis.

Abstract: Objectives This study aims to investigate the effects of adding whole-body vibration (WBV) exercise to squat training (ST) on the physical function and muscle strength of patients with knee osteoarthritis (KOA). Methods 41 participants completed the intervention and measurements (ST group; n=21, age=65.00±4.39 years, BMI=23.01±2.95 kg/m2; WBV+ST group; n=20, age=64.10±4.95 years, BMI=24.79±3.12 kg/m2). The supervised eight-week intervention was performed three times per week with the intensity and duration increased gradually. Visual analog scale, Timed Up and Go test (TUG), 6-min Walk Distance test, and isokinetic measurements were performed at baseline and post-intervention. Results The peak torque (PT) of the extensors at 180°/s increased significantly in the WBV+ST group compared with the ST group (p = 0.046). The peak work of the extensors and the PT of the flexors at 180°/s improved only in the WBV+ST group (p 0.05). Conclusions Adding 8 weeks of WBV training to ST can more effectively improve the muscular strength of knee extensors compared with ST in patients with KOA.

The longitudinal association between alcohol consumption and muscle strength: A population-based prospective study.

Abstract: Objectives Studies have investigated the association between alcohol consumption and muscle mass and muscle disease. However, the relationship between alcohol consumption and muscle strength remains unclear. This study aimed to prospectively investigate the association between alcohol consumption and changes in muscle strength. Methods This study evaluated 326 Japanese men and women over a 2-year period, assessing alcohol consumption using a brief, self administered diet-history questionnaire. Muscle strength was assessed using a digital grip dynamometer. Results In a non-adjusted model, alcohol consumption was positively correlated with a decline in muscle strength (p for trend = 0.002). After adjusting model 1 for age, sex, and body mass index, adjusting model 2 for health status and fully adjusting model 3, there was a significant positive association between alcohol consumption and a decline in muscle strength, and this association showed no change over the 2-year period (p for trend = 0.006). Conclusion In this Japanese population, high alcohol consumption was associated with a greater decline in muscle strength. Future studies are needed to ascertain whether this relationship is present in other populations.

Comparison of extracorporeal shock wave therapy with custom foot orthotics in plantar fasciitis treatment: A prospective randomized one-year follow-up study.

Abstract: Purpose Plantar fasciitis (PF) is characterized by the degeneration of the plantar fascia, leading to heel pain. We aimed to investigate the effectiveness of extracorporeal shock wave therapy (ESWT) and custom foot orthotics (CFO). Method The study was planned as a prospective randomized controlled study. In total, 83 patients were evaluated. The patients were divided into two groups: patients treated with ESWT (group I, n=40) and patients treated with CFO (group II, n=43). Visual analogue scale (VAS) was used to evaluate pain in the morning, evening, at rest and while walking. Foot Function Index (FFI) was used to evaluate foot functions, and Foot Health Status Questionnaire (FHSQ) was used to evaluate foot health. Results Both group I and group II achieved significant improvements in our evaluation parameters (morning and evening pain) at 4, 12 and 24 weeks compared with their baseline values (P 0.05). Conclusion Both treatment ESWT and CFO can use interchangebably. Neither method was superior in treating plantar fasciitis.

The selective TrkA agonist, gambogic amide, promotes osteoblastic differentiation and improves fracture healing in mice.

Abstract: OBJECTIVES To study effects of the selective TrkA agonist, gambogic amide (GA), on fracture healing in mice and on an osteoprogenitor cell line in vitro. METHODS Mice were given bilateral fibular fractures and treated for two weeks with vehicle or 1 mg/kg/day GA and euthanized at 14-, 21-, and 42-days post-fracture. Calluses were analysed by micro-computed tomography (µCT), three-point bending and histology. For RT-PCR analyses, Kusa O cells were treated with 0.5nM of GA or vehicle for 3, 7, and 14 days, while for mineralization assessment, cells were treated for 21 days. RESULTS µCT analysis found that 21-day GA-treated calluses had both decreased tissue volume (p<0.05) and bone surface (p<0.05) and increased fractional bone volume (p<0.05) compared to controls. Biomechanical analyses of 42-day calluses revealed that GA treatment increased stiffness per unit area by 53% (p<0.01) and load per unit area by 52% (p<0.01). GA treatment increased Kusa O gene expression of alkaline phosphatase and osteocalcin (p<0.05) by 14 days as well as mineralization at 21 days (p<0.05). CONCLUSIONS GA treatment appeared to have a beneficial effect on fracture healing at 21- and 42-days post-fracture. The exact mechanism is not yet understood but may involve increased osteoblastic differentiation and matrix mineralization.

Five minutes static stretching influences neural responses at spinal level in the background of unchanged corticospinal excitability.

Abstract: Objectives Corticospinal tract excitability and spinal reflex pathways are transiently affected by short applications of static stretching. However, it remains unclear whether the duration and magnitude of these neurophysiological responses can be increased with a longer duration of the applied stretch. The purpose of this study was to investigate alterations in cortical and spinal excitability following five minutes static stretching. Methods Seventeen participants (22.8±2.3 years old) were tested for the tendon tap reflex (T-reflex), Hoffman reflex (H-reflex) and motor-evoked potentials (MEPs) after transcranial magnetic stimulation (TMS) of the ankle flexor muscles in two separate occasions: before and after 5 minute static stretching or 5 minute control period, in a randomized order. Results No changes were observed following the control condition. H/M ratio increased by 16.2% after stretching (P=.036). Furthermore, immediately after stretching it was observed a strong inhibition of the T-reflex (57.6% inhibition, P=.003) that persisted up to five minutes after stretching (16.2% inhibition, P=.013) but returned to baseline following 10 minutes. MEPs were not affected by stretching. Conclusions This study suggests that the neuromuscular responses that follow five minute of static stretching do not influence the excitability of the corticospinal tract and follow a different time course within spinal reflex pathways.

Changes in motor unit activity and respiratory oxygen uptake during 6 weeks of progressive whole-body vibration combined with progressive, high intensity resistance training

Abstract: OBJECTIVES We hypothesized that the additional activation of motor units (MU) and the elevation of metabolic energy turnover resulting from whole-body vibration (WBV) superimposed to high intensity resistance training on a smith machine persist after 6 weeks of training with progressively increasing loads and vibration frequencies. METHODS Two groups of healthy male subjects performed either 6 weeks of Resistive Vibration Exercise (RVE, squats and heel raises with WBV, n=13) or Resistive Exercise (RE using the same protocol, n=13). During the first (pre) and the last training session (post), we determined the oxygen uptake changes normalized to total training weight (∆V'O2/ttw) and the normalized MU activity from rectus femoris (squats) and gastrocnemius lateralis (heel raise) muscles filtered for vibration frequencies and harmonics (EMG/ttw). RESULTS At pre measurement, RVE induced higher EMG/ttw (squats) than RE alone (group effect, P=0.006). At post measurement, EMG/ttw was reduced (time effects between P=0.087 and P<0.001 for both groups and exercises). At pre and post measurement, ∆V'O2/ttw was higher during RVE than during RE (group effects between P=0.005 and P=0.099 for both exercises). CONCLUSIONS RVE permanently elevated metabolic energy turnover, although the initially observed additional MU activity by RVE could not be preserved in the working musculature.

Two cases of myositis ossificans in children, after prolonged immobilization.

Abstract: Myossitis ossificans (MO) is a benign disorder characterized by heterotopic bone formation in skeletal muscle. It is divided in three types, fibrodysplasia ossificans progressive (FOP), myositis ossificans circumscripta or traumatica (MOT) and myositis ossificans without a history of trauma (non traumatic or pseudomalignant MO). Myositis ossificans is extremely rare in children younger than 10 years. We present the clinical and radiological findings of two 5-year-old children with pseudomalignant MO due to prolonged immobilization. Plain x-ray films and CT scan with their characteristic findings of mature bone in the periphery of the lesion with smooth contour and well separated from the bone, enabled us to diagnose the lesion. To the best of our knowledge, no such cases have been reported in the literature.

Which method for frozen shoulder mobilization: manual posterior capsule stretching or scapular mobilization?

Abstract: Objectives This study aimed to compare the superiority of scapular mobilization, manual capsule stretching, and the combination of these two techniques in the treatment of frozen shoulder patients to evaluate the acute effects of these techniques on shoulder movements. Methods This study designed to a single-blinded, randomized, and pre-post assessment study. This study was included 54 patients diagnosed with stage 3 frozen shoulder. Group 1 (n=27) received scapular mobilization, and Group 2 (n=27) received manual posterior capsule stretching. After the patients were assessed, the interventions were re-applied with a crossover design to obtain results for the combined application (n=54). The range of motion, active total elevation, active internal rotation, and posterior capsule tensions of the shoulder joint were recorded before and immediately after mobilization. Results Statistical analysis showed an increase in all range of motion values (p 0.05), without significant difference among the groups (p>0.05). The posterior capsule flexibility did not change in any group (p>0.05). Conclusions Scapular mobilization and manual posterior capsule interventions were effective in improving the acute joint range of motion in frozen shoulder patients.

Relationship between serum and synovial fluid CCL20 concentrations with disease severity in primary knee osteoarthritis.

Abstract: Objectives The current study was performed to examine serum and synovial fluid (SF) CCL20 levels and their correlations with disease severity in primary knee osteoarthritis patients. Methods A total of 99 patients diagnosed with primary knee OA were enrolled in the study, and 95 healthy individuals receiving regular medical examination were recruited as controls. Serum and SF CCL20 concentrations were determined using an enzyme-linked immunosorbent assay. The radiographic severity of OA was assessed by the Kellgren-Lawrence (K-L) classification system. The Lequesne algofunctional index and a visual analogue scale (VAS) were used to evaluate the clinical severity of knee OA in patients. Results The serum CCL20 levels were not significantly different between patients with knee OA and controls. Patients with a K-L grade of 4 had significantly higher SF CCL20 levels than those with K-L grades of 2 and 3. Knee OA patients with a K-L grade of 3 showed significantly higher levels of CCL20 in SF than those with a K-L grade of 2. In addition, SF CCL20 levels were significantly related to the Lequesne algofunctional index and VAS score. Conclusions These findings suggest that local CCL20 levels may reflect the disease severity of knee OA.

Whole body vibration at low-frequency can increase trabecular thickness and width in adult rats.

Abstract: Objective This study aimed to examine whether WBV becomes a possible modality for the primary prevention of osteoporosis by exploring WBV frequency that has positive effects on bone properties in adult rats. Methods Thirty-six 24-week-old rats were divided into one control and 5 experimental groups, which underwent WBV at various frequencies (15, 30, 45, 60 or 90 Hz), with a magnitude of 0.5 g, for 15 min/day, 5 days/week, for 8 weeks. Bone size, muscle weight and bone mechanical strength were measured at the end of experimental period. Bone mass, trabecular bone microarchitecture (TBMA) and cortical bone geometry were analyzed by micro-CT. Circulating bone formation/resorption markers were determined by ELISA. Results Body weight-corrected soleus weight in all experimental groups and body weight-corrected extensor digitorum longus muscle weight in the 15 and 30 Hz groups were significantly higher than those of the control group, respectively. Femur trabecular thickness and width were significantly higher in the 15 Hz group than in the control group. However, there was no difference in bone mechanical strength or bone formation/resorption markers among all groups. Conclusion These results suggest that WBV at low-frequencies may become a potent modality for the primary prevention of osteoporosis in adults.

Effects of virtual dance exercise on skeletal muscle architecture and function of community dwelling older women

Abstract: OBJECTIVES The aim of this study was to analyze the effects of virtual dance exercise on skeletal muscle architecture and function in community-dwelling older women. METHODS Forty-two moderately active older women participated in this study and chose to join either the control group (CG; n=20; 70.3 ± 5.6 years) or exercise group (EG; n=22; 69.3 ± 3.7 years). Participants in the CG maintained their lifestyle and those in the EG performed group dance exercise using Dance Central game for Xbox 360® and Kinect for 40 min, 3 times/week, for 12 weeks. The primary outcomes were: ankle plantar flexion and dorsiflexion peak torque (PT), medial gastrocnemius muscle thickness (MT), fascicle length (FL), and pennation angle (PA). The secondary outcomes were: lower limbs range of motion (ROM), calf circumference (CC), 6 m customary gait speed, and handgrip strength. Data were analyzed using an ANOVA mixed model test (p<0.05). RESULTS EG participants improved plantar flexion PT at 60°/s (16.3%; p<0.01), MT (8.7%; p<0.01) and ankle dorsiflexion ROM (5.1%; p=0.04) when compared to baseline, and exhibited enhanced CC values compared to CG (1.7%; p=0.03). CONCLUSIONS Virtual dance exercise can be recommended to increase muscle mass. Moreover, ankle plantar flexion strength and dorsiflexion ROM gains may contribute to improve functionality and fall avoidance in moderately active older women.

Myostatin dysfunction does not protect from fasting-induced loss of muscle mass in mice.

Abstract: Objectives The aim of the study was to investigate if myostatin dysfunction can ameliorate fasting-induced muscle wasting. Methods 18-week old males from Berlin high (BEH) strain with myostatin dysfunction and wild type myostatin (BEH+/+) strain were subjected to 48-h food deprivation (FD). Changes in body composition as well as contractile properties of soleus (SOL) and extensor digitorum longus (EDL) muscles were studied. Results BEH mice were heavier than BEH+/+ mice (56.0±2.5 vs. 49.9±2.8 g, P 0.05), but only BEH mice experienced wasting of the gastrocnemius, tibialis anterior and plantaris muscles. FD induced a marked decrease in specific muscle force of SOL. EDL of BEH mice tended to be protected from this decline. Conclusion Myostatin dysfunction does not protect from loss of muscle mass during fasting.

Effects of progressive resistance exercises on quality of life and functional capacity in pediatric patients with chronic kidney disease: a randomized trail.

Abstract: AIM To investigate the effects of progressive resistance exercises on quality of life and functional capacity in pediatric patients with chronic kidney disease. METHODS Thirty-two children with chronic kidney disease from both genders, age ranged from 8 to 12 years participated in this study. They were allocated randomly into two groups of equal numbers, standard medical care (SC) and exercise (EX) groups. The SC group received standard medical care with no change of their regular daily activities. The EX group received progressive resistance exercises for 60 minutes two times a week in addition to the standard medical care for six successive months. OUTCOME MEASURES Included the pediatric quality of life inventory and six-minutes walking test to assess quality of life and functional capacity respectively. RESULTS There were statistically significant improvements in the post-test quality of life and functional capacity in the EX group (p<0.05). The SC group showed significant decrease of quality of life and non-significant change was recorded regarding their functional capacity (p<0.05). The post-test comparison between the two groups revealed significant difference in favor of the EX group in all measured variables. CONCLUSION Progressive resistance exercises contributed to the improvement of quality of life and functional capacity in pediatric patients with chronic kidney disease.

Bilateral and ipsilateral peak torque of quadriceps and hamstring muscles in elite judokas.

Abstract: Objective To examine bilateral and ipsilateral peak torque values of quadriceps (Q) and hamstring (H) muscles in elite judokas. Methods 16 elite male judokas were tested in concentric isokinetic strength of the quadriceps (Q) and hamstrings (H) muscles at 60° and 180° sec-1. Variables comprised average peak torque and the traditional H/Q, Q/Q, H/H ratios. Asymmetries between legs and differences between isokinetic muscle strength ratios were examined using paired t-tests and Cohen's d. Results In right (Rs) and left (Ls) extremity peak torque values, no significant difference was found between 60° and 180° sec-1 angular velocities (p>0.05). In peak torque values between PLs and NPLs, significant difference was found only in extension (Ex) phase at 60° sec-1 angular velocity p=0.001). (Significance was identified between (Q/Q) and (H/H) muscle ratios at 60° sec-1 (p=0.029). No significant difference was found in ipsilateral strength ratios at 60° and 180° sec-1 angular velocity (p>0.05). Conclusions The Ex knee strength of PLs was high, particularly at low angular velocities, leading to differences of bilateral asymmetry in the Q muscle group. Regarding ipsilateral strength ratios, there were no differences in the H and Q muscle groups at both angular velocities, indicating that both legs were similar in terms of ipsilateral asymmetry.

Are multifactorial and multiple component interventions effective in preventing falls in older people living in the community? A Cochrane Review summary with commentary.

Abstract: The aim of this commentary is to discuss, from a rehabilitation perspective, the recently published Cochrane Review “Multifactorial and multiple component interventions for preventing falls in older people living in the community” by Hopewell et al.. This review was produced with the support of the Cochrane Bone, Joint and Muscle Trauma Group. This Cochrane Corner is produced in agreement with Journal of Musculoskeletal and Neuronal Interactions by Cochrane Rehabilitation.

Slow torque recovery after eccentric exercise and the repeated bout effect; the role of primary and secondary muscle damage.

Abstract: OBJECTIVES To determine the role of primary and secondary damage in the variation between people of maximum voluntary contraction (MVC) torque recovery following eccentric exercise and the faster recovery following a repeated bout of exercise. METHODS Twenty-one healthy, active but untrained young female subjects undertook eccentric exercise of the elbow flexors and 11 repeated the exercise 28 days later. Changes of MVC torque and creatine kinase (CK) were followed for 7 days after each bout of exercise. RESULTS Following the first bout, 45% of subjects showed a continuing decline in MVC torque, suggesting secondary damage, which was correlated with a large delayed CK release (R2=0.54, p<0.001). After the second bout of exercise, the initial MVC torque loss was similar to that after the first bout while torque recovery was faster, but only for the previously slow recovering subjects. Comparing the time course of MVC torque recovery of first and second bouts suggests secondary damage develops over 4 days. CONCLUSIONS The data are consistent with primary damage being similar between subjects and unaffected by the repeated bout while it is secondary damage which accounts for differences in MVC torque recovery and is suppressed following a repeated bout of exercise.

Effect of simultaneous proprioceptive-visual feedback on gait of children with spastic diplegic cerebral palsy.

Abstract: Objective To evaluate the effect of simultaneous proprioceptive - visual training on gait parameters in children with spastic diplegic cerebral palsy. Method Gait parameters of 30 spastic diplegic children (age range 4-6 years) were evaluated before and after treatment by Tekscan's Walkway Pressure system. They were randomly and equally assigned into two groups (study and control). All children received regular therapeutic exercise program for one hour. In control group walked for 30 minutes without feedback, while those in study group walked for 30 minutes with proprioceptive-visual feedback. Duration of treatment was 3 times/week for 8 successive weeks. Results There were significant differences after treatment in spatial parameters and temporal parameters of both groups with more improvement in study group than control one, and insignificant difference in kinetic gait parameters. Conclusion The simultaneous proprioceptive - visual training might improve spatial and temporal gait parameters with no effect on kinetic gait parameters of children with spastic diplegic cerebral palsy.

Is somatosensory electrical stimulation effective in relieving spasticity? A systematic review

Abstract: Spasticity is a sensorimotor disorder widely recognized as one of the features that contribute to patients' disability. Transcutaneous electric neural stimulation (TENS/SES) has been adopted in spasticity rehabilitation as an alternative to pharmacological agents. Although previous studies have reported clinical benefits of TENS/SES in relieving spasticity, there is no clarity on how and whether this therapeutic modality affects specific neural circuitries. Thus, this systematic review aimed to verify the efficacy of TENS/SES in the control of spasticity and its consequences in spinal and corticospinal excitability. This study was carried out according to PRISMA recommendations using SCOPUS, PubMed, BVS, Google Scholar and BASE databases screening, which provided 483 references. Six additional records were found from other sources. All these records were submitted to a filtering process following the eligibility criteria, and 44 studies were selected for further analysis. Ten were replicas. Consequently, 34 studies were read in full with the aim of checking their eligibility criterion, which resulted in 10 manuscripts for qualitative synthesis. Even though they evaluated the effects of TENS/SES both at the spinal and/or corticospinal levels, the electrophysiological results seem to be inconsistent, corroborating the lack of agreement between them and with clinical outcomes.

Lessons learned from the management of Hungry Bone Syndrome following the removal of an Atypical Parathyroid Adenoma.

Abstract: Hungry Bone Syndrome (HBS) refers to rapid, profound, and prolonged hypocalcemia associated with hypophosphatemia and hypomagnesemia occurring in patients with increased bone turnover after successful management of the underlying disorder. We describe a male patient with primary hyperparathyroidism (PHPT), in whom HBS was diagnosed 6 months after parathyroidectomy. Histopathologic examination revealed an atypical parathyroid adenoma (APA), while immunohistochemistry showed cell proliferation index Ki-67 10% and overexpression of cyclin D1 (>90%). Preoperative treatment with vitamin D3 had normalized 25OHD and alkaline phosphatase levels, reflected in an improvement in bone turnover prior to surgery. Postoperative treatment for HBS with alfacalcidol, calcium, vitamin D3 and magnesium was administered for a long period. This treatment prevented severe postoperative hypocalcemia and he was discharged two days later. Preoperative cinacalcet treatment did not reduce hypercalcemia implying that the tumor had lack of calciumsensing receptors (CaSR). In conclusion, preoperative restoration of low 25OHD levels is essential for prevention of HBS. Postoperative treatment with active metabolites of vitamin D must be initiated as early as possible, in order to prevent or minimize the development of HBS, and to reduce the duration of hospitalization.

Neuromuscular dysfunction, independent of gait dysfunction, modulates trabecular bone homeostasis in mice.

Abstract: Objectives To clarify the effects of neuromuscular dysfunction on hindlimb loading, muscle atrophy, and bone homeostasis. Methods We quantified changes to hindlimb loading, muscle atrophy, and bone morphology following either Botulinum toxin A (BTxA) induced muscle paralysis or peripheral nerve injury (PNI) in mice; two in vivo models that we anticipated would differently alter gait and mechanical loading patterns due to their distinct effects on neuromuscular signaling. To confirm the expected behavioral effects of PNI, we assessed mechanical allodynia of the ipsilateral hindlimb using von Frey testing and activity (distance traveled and speed) was monitored in both groups using open field testing. Peak vertical ground reaction forces (GRF) and ankle and knee kinematics during normal locomotion were quantified and used to estimate peak mid-diaphyseal normal strains. Muscle atrophy and trabecular and cortical bone morphology were assessed via high-resolution microCT imaging. Results BTxA-induced calf paralysis caused severe muscle atrophy and altered gait kinetics and kinematics and reduced gait-induced normal strains. PNI increased mechanical allodynia but did not alter gait, nor did it cause muscle atrophy. We observed that muscle paralysis and PNI both led to severe trabecular bone loss but only BTxA-induced paralysis increased cortical bone resorption. Conclusions While mechanical stimuli clearly have essential functions in bone development and adaptation, these data emphasize that neuromuscular signaling, independent of load-induced mechanical strains, may modulate trabecular bone homeostasis in normal and disease states.

Chondroprotective effect of Nigella sativa oil in the early stages of osteoarthritis: an experimental study in rabbits.

Abstract: Purpose Nigella sativa oil possesses a well-known ability to protect certain organs from oxidative, neoplastic, and inflammatory damage. This study investigated the potential chondroprotective effects of intraarticular injections of Nigella sativa oil in a rabbit osteoarthritis model. Methods Osteoarthritis models were created by performing anterior cruciate ligament transections in 20 New Zealand rabbits. Rabbits were randomly divided into two groups of 10 and given intraarticular injections in their right knees weekly for 5 weeks, beginning in the third week post-operation. Injections given to the first group contained whole Nigella sativa oil, whereas the second group was injected with a saline solution. Knee joints were harvested 8 weeks after surgery. Knee joint surfaces were examined macroscopically, and medial femoral condyle sections were examined microscopically. Results There was a statistically significant difference in the macroscopic grading results of the groups, with the Nigella sativa group having better results (p=0.001). The Nigella sativa group also received significantly better total Osteoarthritis Research Society International (OARSI) scores (p=0.035). Conclusions Intraarticular administration of Nigella sativa oil has the potential to protect cartilage from degeneration in the early stages of osteoarthritis.