The Effects of Pre-Exercise Ginger Supplementation on Muscle Damage and Delayed Onset Muscle Soreness.

PubMed

Matsumura, Melissa D; Zavorsky, Gerald S; Smoliga, James M

2015-06-01

Ginger possesses analgesic and pharmacological properties mimicking non-steroidal antiinflammatory drugs. We aimed to determine if ginger supplementation is efficacious for attenuating muscle damage and delayed onset muscle soreness (DOMS) following high-intensity resistance exercise. Following a 5-day supplementation period of placebo or 4 g ginger (randomized groups), 20 non-weight trained participants performed a high-intensity elbow flexor eccentric exercise protocol to induce muscle damage. Markers associated with muscle damage and DOMS were repeatedly measured before supplementation and for 4 days following the exercise protocol. Repeated measures analysis of variance revealed one repetition maximum lift decreased significantly 24 h post-exercise in both groups (p < 0.005), improved 48 h post-exercise only in the ginger group (p = 0.002), and improved at 72 (p = 0.021) and 96 h (p = 0.044) only in the placebo group. Blood creatine kinase significantly increased for both groups (p = 0.015) but continued to increase only in the ginger group 72 (p = 0.006) and 96 h (p = 0.027) post-exercise. Visual analog scale of pain was significantly elevated following eccentric exercise (p < 0.001) and was not influenced by ginger. In conclusion, 4 g of ginger supplementation may be used to accelerate recovery of muscle strength following intense exercise but does not influence indicators of muscle damage or DOMS. Copyright © 2015 John Wiley & Sons, Ltd.

Specific and cross over effects of massage for muscle soreness: randomized controlled trial.

PubMed

Jay, Kenneth; Sundstrup, Emil; Søndergaard, Stine D; Behm, David; Brandt, Mikkel; Særvoll, Charlotte A; Jakobsen, Markus D; Andersen, Lars L

2014-02-01

Muscle soreness can negatively interfere with the activities of daily living as well as sports performance. In the working environment, a common problem is muscle tenderness, soreness and pain, especially for workers frequently exposed to unilateral high repetitive movements tasks. The aim of the study is therefore to investigate the acute effect of massage applied using a simple device Thera-band roller Massager on laboratory induced hamstring muscle soreness, and the potential cross over effect to the non-massaged limb. 22 healthy untrained men (Mean age 34 +/- 7 years; mean height 181.7 +/- 6.9 cm; mean weight 80.6 +/- 6.4 kg; BMI: 24.5 +/- 1.3) with no prior history of knee, low back or neck injury or other adverse health issues were recruited. Participants visited the researchers on two separate occasions, separated by 48 hours, each time providing a soreness rating (modified visual analog scale 0-10), and being tested for pressure pain threshold (PPT) and active range of motion (ROM) of the hamstring muscles. During the first visit, delayed onset muscular soreness of the hamstring muscles was induced by 10 x 10 repetitions of the stiff-legged dead-lift. On the second visit participants received either 1) 10 minutes of roller massage on one leg, while the contralateral leg served as a cross over control, or 2) Resting for 10 minutes with no massage at all. Measurement of soreness, PPT and ROM were taken immediately before and at 0, 10, 30 and 60 min. after treatment. There was a significant group by time interaction for soreness (p < 0.0001) and PPT (p = 0.0007), with the massage group experiencing reduced soreness and increasing PPT compared with the control group. There was no group by time interaction for ROM (p = 0.18). At 10 min. post massage there was a significant reduction in soreness of the non-massaged limb in the cross over control group compared to controls but this effect was lost 30 minutes post massage. Massage with a roller device reduces muscle soreness and is accompanied by a higher PPT of the affected muscle. 2c; outcomes research.

Foam Rolling for Delayed-Onset Muscle Soreness and Recovery of Dynamic Performance Measures

PubMed Central

Pearcey, Gregory E. P.; Bradbury-Squires, David J.; Kawamoto, Jon-Erik; Drinkwater, Eric J.; Behm, David G.; Button, Duane C.

2015-01-01

Context: After an intense bout of exercise, foam rolling is thought to alleviate muscle fatigue and soreness (ie, delayed-onset muscle soreness [DOMS]) and improve muscular performance. Potentially, foam rolling may be an effective therapeutic modality to reduce DOMS while enhancing the recovery of muscular performance. Objective: To examine the effects of foam rolling as a recovery tool after an intense exercise protocol through assessment of pressure-pain threshold, sprint time, change-of-direction speed, power, and dynamic strength-endurance. Design: Controlled laboratory study. Setting: University laboratory. Patients or Other Participants: A total of 8 healthy, physically active males (age = 22.1 ± 2.5 years, height = 177.0 ± 7.5 cm, mass = 88.4 ± 11.4 kg) participated. Intervention(s): Participants performed 2 conditions, separated by 4 weeks, involving 10 sets of 10 repetitions of back squats at 60% of their 1-repetition maximum, followed by either no foam rolling or 20 minutes of foam rolling immediately, 24, and 48 hours postexercise. Main Outcome Measure(s): Pressure-pain threshold, sprint speed (30-m sprint time), power (broad-jump distance), change-of-direction speed (T-test), and dynamic strength-endurance. Results: Foam rolling substantially improved quadriceps muscle tenderness by a moderate to large amount in the days after fatigue (Cohen d range, 0.59 to 0.84). Substantial effects ranged from small to large in sprint time (Cohen d range, 0.68 to 0.77), power (Cohen d range, 0.48 to 0.87), and dynamic strength-endurance (Cohen d = 0.54). Conclusions: Foam rolling effectively reduced DOMS and associated decrements in most dynamic performance measures. PMID:25415413

Effects of Light-Emitting Diode Therapy on Muscle Hypertrophy, Gene Expression, Performance, Damage, and Delayed-Onset Muscle Soreness: Case-control Study with a Pair of Identical Twins.

PubMed

Ferraresi, Cleber; Bertucci, Danilo; Schiavinato, Josiane; Reiff, Rodrigo; Araújo, Amélia; Panepucci, Rodrigo; Matheucci, Euclides; Cunha, Anderson Ferreira; Arakelian, Vivian Maria; Hamblin, Michael R; Parizotto, Nivaldo; Bagnato, Vanderlei

2016-10-01

The aim of this study was to verify how a pair of monozygotic twins would respond to light-emitting diode therapy (LEDT) or placebo combined with a strength-training program during 12 weeks. This case-control study enrolled a pair of male monozygotic twins, allocated randomly to LEDT or placebo therapies. Light-emitting diode therapy or placebo was applied from a flexible light-emitting diode array (λ = 850 nm, total energy = 75 J, t = 15 seconds) to both quadriceps femoris muscles of each twin immediately after each strength training session (3 times/wk for 12 weeks) consisting of leg press and leg extension exercises with load of 80% and 50% of the 1-repetition maximum test, respectively. Muscle biopsies, magnetic resonance imaging, maximal load, and fatigue resistance tests were conducted before and after the training program to assess gene expression, muscle hypertrophy and performance, respectively. Creatine kinase levels in blood and visual analog scale assessed muscle damage and delayed-onset muscle soreness, respectively, during the training program. Compared with placebo, LEDT increased the maximal load in exercise and reduced fatigue, creatine kinase, and visual analog scale. Gene expression analyses showed decreases in markers of inflammation (interleukin 1β) and muscle atrophy (myostatin) with LEDT. Protein synthesis (mammalian target of rapamycin) and oxidative stress defense (SOD2 [mitochondrial superoxide dismutase]) were up-regulated with LEDT, together with increases in thigh muscle hypertrophy. Light-emitting diode therapy can be useful to reduce muscle damage, pain, and atrophy, as well as to increase muscle mass, recovery, and athletic performance in rehabilitation programs and sports medicine.

Effects of Short-Term Docosahexaenoic Acid Supplementation on Markers of Inflammation after Eccentric Strength Exercise in Women.

PubMed

Corder, Katherine E; Newsham, Katherine R; McDaniel, Jennifer L; Ezekiel, Uthayashanker R; Weiss, Edward P

2016-03-01

The omega-3 fatty acid docosahexaenoic acid (DHA) has anti-inflammatory and anti-nociceptive (pain inhibiting) effects. Because strenuous exercise often results in local inflammation and pain, we hypothesized that DHA supplementation attenuates the rise in markers of local muscle inflammation and delayed onset muscle soreness (DOMS) that occur after eccentric strength exercise. Twenty-seven, healthy women (33 ± 2 y, BMI 23.1±1.0 kg·m(-2)) were randomized to receive 9d of 3000 mg/d DHA or placebo in a double-blind fashion. On day 7 of the supplementation period, the participants performed 4 sets of maximal-effort eccentric biceps curl exercise. Before and 48h after the eccentric exercise, markers of inflammation were measured including measures of muscle soreness (10-point visual analog pain scale, VAS), swelling (arm circumference), muscle stiffness (active and passive elbow extension), skin temperature, and salivary C-reactive protein (CRP) concentrations. As expected, muscle soreness and arm circumference increased while active and passive elbow extension decreased. The increase in soreness was 23% less in the DHA group (48h increase in VAS soreness ratings: 4.380.4 vs. 5.600.5, p=0.02). Furthermore, the number of subjects who were able to achieve full active elbow extension 48h after eccentric exercise was greater in the DHA group (71% vs. 15%, p = 0.006), indicating significantly less muscle stiffness. No between-group differences were observed for passive elbow extension (p = 0.78) or arm swelling (p = 0.75). Skin temperature and salivary CRP concentrations did not change from baseline to 48h after exercise in either group. These findings indicate that short-term DHA supplementation reduces exercise-induced muscle soreness and stiffness. Therefore, in addition to other health benefits that n-3 fatty acids have been associated with, DHA supplementation could be beneficial for improving tolerance to new and/or strenuous exercise programs and thereby might facilitate better training adaptations and exercise adherence. Key pointsSeven days of 3000 mg/day supplementation with algae-derived docosahexaenoic acid (DHA) attenuates the delayed onset muscle soreness and stiffness, and protects against the loss of joint range of motion that is caused by strenuous eccentric exercise.This benefit was observed in women, and supports the findings from other studies that were conducted on men or a combination of men and womenThe benefits from algae-derived DHA appear to be similar to those reported in other studies that used a combination of DHA and eicosapentaenoic acid (EPA) derived from fish oilThe findings of better recovery from strenuous exercise with DHA supplementation, paired with other research which demonstrated that DHA and EPA protect against chronic diseases suggest that DHA is an attractive optionThese findings have relevance to athletic populations, in that DHA would be expected to facilitate recovery and allow for better performance during training and competition. However, DHA supplementation might also benefit non-athletic populations, such as individuals starting new exercise programs and patient populations that are prone to muscle soreness (e.g. physical therapy patients).

Effect of milk on team sport performance after exercise-induced muscle damage.

PubMed

Cockburn, Emma; Bell, Phillip G; Stevenson, Emma

2013-08-01

Exercise-induced muscle damage (EIMD) leads to increases in intramuscular proteins observed in the blood stream and delayed onset of muscle soreness, but crucial for athletes are the decrements in muscle performance observed. Previous research has demonstrated that carbohydrate-protein supplements limit these decrements; however, they have primarily used isokinetic dynamometry, which has limited applicability to dynamic sport settings. Therefore, the aim of this study was to investigate the effects of a carbohydrate-protein milk supplement consumed after muscle-damaging exercise on performance tests specific to field-based team sports. Two independent groups of seven males consumed either 500 mL of milk or a control immediately after muscle-damaging exercise. Passive and active delayed onset of muscle soreness, creatine kinase, myoglobin, countermovement jump height, reactive strength index, 15-m sprint, and agility time were assessed before and 24, 48, and 72 h after EIMD. The Loughborough Intermittent Shuttle Test was also performed before and 48 h after EIMD. At 48 h, milk had a possible benefit for limiting increases in 10-m sprint time and a likely benefit of attenuating increases in mean 15-m sprint time during the Loughborough Intermittent Shuttle Test. At 72 h, milk had a possible benefit for limiting increases in 15-m sprint time and a likely benefit for the attenuation of increases in agility time. All other effects for measured variables were unclear. The consumption of milk limits decrements in one-off sprinting and agility performance and the ability to perform repeated sprints during the physiological simulation of field-based team sports.

The effects of a repeated bout of eccentric exercise on indices of muscle damage and delayed onset muscle soreness.

PubMed

Paddon-Jones, D; Muthalib, M; Jenkins, D

2000-03-01

This study examined markers of muscle damage following a repeated bout of maximal isokinetic eccentric exercise performed prior to full recovery from a previous bout. Twenty non-resistance trained volunteers were randomly assigned to a control (CON, n=10) or experimental (EXP, n=10) group. Both groups performed 36 maximal isokinetic eccentric contractions of the elbow flexors of the non-dominant arm (ECC1). The EXP group repeated the same eccentric exercise bout two days later (ECC2). Total work and peak eccentric torque were recorded during each set of ECC1 and ECC2. Isometric torque, delayed onset muscle soreness (DOMS), flexed elbow angle and plasma creatine kinase (CK) activity were measured prior to and immediately following ECC1 and ECC2. at 24h intervals for 7 days following ECC1 and finally on day 11. In both groups, all dependent variables changed significantly during the 2 days following ECC1. A further acute post-exercise impairment in isometric torque (30 +/- 5%) and flexed elbow angle (20 +/- 4%) was observed following ECC2 (p<0.05), despite EXP subjects producing uniformly lower work and peak eccentric torque values during ECC2 (p<0.05). No other significant differences between the CON and EXP groups were observed throughout the study (p>0.05). These findings suggest that when maximal isokinetic eccentric exercise is repeated two days after experiencing of contraction-induced muscle damage, the recovery time course is not significantly altered.

The relevance of stretch intensity and position—a systematic review

PubMed Central

Apostolopoulos, Nikos; Metsios, George S.; Flouris, Andreas D.; Koutedakis, Yiannis; Wyon, Matthew A.

2015-01-01

Stretching exercises to increase the range of motion (ROM) of joints have been used by sports coaches and medical professionals for improving performance and rehabilitation. The ability of connective and muscular tissues to change their architecture in response to stretching is important for their proper function, repair, and performance. Given the dearth of relevant data in the literature, this review examined two key elements of stretching: stretch intensity and stretch position; and their significance to ROM, delayed onset muscle soreness (DOMS), and inflammation in different populations. A search of three databases, Pub-Med, Google Scholar, and Cochrane Reviews, identified 152 articles, which were subsequently categorized into four groups: athletes (24), clinical (29), elderly (12), and general population (87). The use of different populations facilitated a wider examination of the stretching components and their effects. All 152 articles incorporated information regarding duration, frequency and stretch position, whereas only 79 referred to the intensity of stretching and 22 of these 79 studies were deemed high quality. It appears that the intensity of stretching is relatively under-researched, and the importance of body position and its influence on stretch intensity, is largely unknown. In conclusion, this review has highlighted areas for future research, including stretch intensity and position and their effect on musculo-tendinous tissue, in relation to the sensation of pain, delayed onset muscle soreness, inflammation, as well as muscle health and performance. PMID:26347668

Fatigue and Recovery in Rugby: A Review.

PubMed

Tavares, Francisco; Smith, Tiaki Brett; Driller, Matthew

2017-08-01

The physical demands and combative nature of rugby lead to notable levels of muscle damage. In professional rugby, athletes only have a limited timeframe to recover following training sessions and competition. Through the implementation of recovery strategies, sport scientists, practitioners and coaches have sought to reduce the effect of fatigue and allow athletes to recover faster. Although some studies demonstrate that recovery strategies are extensively used by rugby athletes, the research remains equivocal concerning the efficacy of recovery strategies in rugby. Moreover, given the role of inflammation arising from muscle damage in the mediation of protein synthesis mechanisms, some considerations have been raised on the long-term effect of using certain recovery modalities that diminish inflammation. While some studies aimed to understand the effects of recovery modalities during the acute recovery phase (<48 h post-match), others investigated the effect of recovery modalities during a more prolonged timeframe (i.e. during a training week). Regarding the acute effectiveness of different recovery modalities, cold water immersion and contrast baths seem to provide a beneficial effect on creatine kinase clearance, neuromuscular performance and delayed onset of muscle soreness. There is support in the literature concerning the effect of compression garments on enhancing recovery from delayed onset of muscle soreness; however, conflicting findings were observed for the restoration of neuromuscular function with the use of this strategy. Using a short-duration active recovery protocol seems to yield little benefit to recovery from rugby training or competition. Given that cold modalities may potentially affect muscle size adaptations from training, their inclusion should be treated with caution and perhaps restricted to certain periods where athlete readiness is more important than increases in muscle size.

Various Treatment Techniques on Signs and Symptoms of Delayed Onset Muscle Soreness

PubMed Central

Gulick, Dawn T.; Kimura, Iris F.; Sitler, Michael; Paolone, Albert; Kelly, John D.

1996-01-01

Eccentric activities are an important component of physical conditioning and everyday activities. Delayed onset muscle soreness (DOMS) can result from strenuous eccentric tasks and can be a limiting factor in motor performance for several days after exercise. An efficacious method of treatment for DOMS would enhance athletic performance and hasten the return to activities of daily living. The purpose of this study was to identify a treatment method which could assist in the recovery of DOMS. In the selection of treatment methods, emphasis was directed toward treatments that could be rendered independently by an individual, therefore making the treatment valuable to an athletic trainer in team setting. DOMS was induced in 70 untrained volunteers via 15 sets of 15 eccentric contractions of the forearm extensor muscles on a Lido isokinetic dynamometer. All subjects performed a pilot exercise bout for a minimum of 9 weeks before data collection to assure that DOMS would be produced. Data were collected on 15 dependent variables: active and passive wrist flexion and extension, forearm girth, limb volume, visual analogue pain scale, muscle soreness index, isometric strength, concentric and eccentric wrist total work, concentric and eccentric angle of peak torque. Data were collected on six occasions: pre- and post-induced DOMS, 20 minutes after treatment, and 24, 48, and 72 hours after treatment. Subjects were randomly assigned to 1 of 7 groups (6 treatment and 1 control). Treatments included a nonsteroidal anti-inflammatory drug, high velocity concentric muscle contractions on an upper extremity ergometer, ice massage, 10-minute static stretching, topical Amica montana ointment, and sublingual A. montana pellets. A 7 × 6 ANOVA with repeated measures on time was performed on the delta values of each of the 15 dependent variables. Significant main effects (p < .05) were found for all of the dependent variables on time only. There were no significant differences between treatments. Therefore, we conclude that none of the treatments were effective in abating the signs and symptoms of DOMS. In fact, the NSAID and A. montana treatments appeared to impede recovery of muscle function. PMID:16558388

A Comparison between Chocolate Milk and a Raw Milk Honey Solution’s Influence on Delayed Onset of Muscle Soreness

PubMed Central

Hatchett, Andrew; Berry, Christopher; Oliva, Claudia; Wiley, Douglas; St. Hilaire, Jacob; LaRochelle, Alex

2016-01-01

This investigation sought to examine the effect that a chocolate milk solution (CMS) and a raw milk solution (RMS) had on lower extremity induced delayed onset of muscle soreness (DOMS). Twenty trained male participants completed a set of questionnaires, prior to completing a lower extremity DOMS protocol, to determine the level of discomfort and functional limitations. Once the DOMS protocol was completed, participants were randomly assigned to either the CM or RM group. Once assigned, participants ingested 240 mL of the respective solution and completed the same set of questionnaires immediately post, 24-, 48- and 72-h post DOMS protocol. Additionally, for 10 days post-ingestion participants were contacted to learn if any negative effects were experienced as a result of ingesting either solution. Both groups reported an increase in lower extremity discomfort at each data collection interval post-DOMS protocol (post, 24-, 48- and 72-h). Participants assigned to the RM group reported high discomfort post and a relative decline in discomfort from immediately post-DOMS protocol to 72-h post. The RMS group reported substantially less discomfort at 72-h when compared to the CMS group. Ingestion of a raw milk solution immediately post strength exercise can substantially reduce the level of self-reported discomfort associated with DOMS. PMID:29910267

Reduced inflammatory and muscle damage biomarkers following oral supplementation with bioavailable curcumin.

PubMed

McFarlin, Brian K; Venable, Adam S; Henning, Andrea L; Sampson, Jill N Best; Pennel, Kathryn; Vingren, Jakob L; Hill, David W

2016-06-01

Exercise-Induced Muscle Damage (EIMD) and delayed onset muscle soreness (DOMS) impact subsequent training sessions and activities of daily living (ADL) even in active individuals. In sedentary or diseased individuals, EIMD and DOMS may be even more pronounced and present even in the absence of structured exercise. The purpose of this study was to determine the effects of oral curcumin supplementation (Longvida® 400 mg/days) on muscle & ADL soreness, creatine kinase (CK), and inflammatory cytokines (TNF-α, IL-6, IL-8, IL-10) following EMID (eccentric-only dual-leg press exercise). Subjects (N = 28) were randomly assigned to either curcumin (400 mg/day) or placebo (rice flour) and supplemented 2 days before to 4 days after EMID. Blood samples were collected prior to (PRE), and 1, 2, 3, and 4 days after EIMD to measure CK and inflammatory cytokines. Data were analyzed by ANOVA with P < 0.05. Curcumin supplementation resulted in significantly smaller increases in CK (- 48%), TNF-α (- 25%), and IL-8 (- 21%) following EIMD compared to placebo. We observed no significant differences in IL-6, IL-10, or quadriceps muscle soreness between conditions for this sample size. Collectively, the findings demonstrated that consumption of curcumin reduced biological inflammation, but not quadriceps muscle soreness, during recovery after EIMD. The observed improvements in biological inflammation may translate to faster recovery and improved functional capacity during subsequent exercise sessions. These findings support the use of oral curcumin supplementation to reduce the symptoms of EIMD. The next logical step is to evaluate further the efficacy of an inflammatory clinical disease model.

Whole-Body Vibration While Squatting and Delayed-Onset Muscle Soreness in Women.

PubMed

Dabbs, Nicole C; Black, Christopher D; Garner, John

2015-12-01

Research into alleviating muscle pain and symptoms in individuals after delayed-onset muscle soreness (DOMS) has been inconsistent and unsuccessful in demonstrating a useful recovery modality. To investigate the effects of short-term whole-body vibration (WBV) on DOMS over a 72-hour period after a high-intensity exercise protocol. Randomized controlled clinical trial. University laboratory. Thirty women volunteered to participate in 4 testing sessions and were assigned randomly to a WBV group (n = 16; age = 21.0 ± 1.9 years, height = 164.86 ± 6.73 cm, mass = 58.58 ± 9.32 kg) or a control group (n = 14; age = 22.00 ± 1.97 years, height = 166.65 ± 8.04 cm, mass = 58.69 ± 12.92 kg). Participants performed 4 sets to failure of single-legged split squats with 40% of their body weight to induce muscle soreness in the quadriceps. The WBV or control treatment was administered each day after DOMS. Unilateral pressure-pain threshold (PPT), range of motion (ROM), thigh circumference, and muscle-pain ratings of the quadriceps were collected before and for 3 days after high-intensity exercise. Each day, we collected 3 sets of measures, consisting of 1 measure before the WBV or control treatment protocol (pretreatment) and 2 sets of posttreatment measures. We observed no interactions for PPT, thigh circumference, and muscle pain (P > .05). An interaction was found for active ROM (P = .01), with the baseline pretreatment measure greater than the measures at baseline posttreatment 1 through 48 hours posttreatment 2 in the WBV group. For PPT, a main effect for time was revealed (P < .05), with the measure at baseline pretreatment greater than at 24 hours pretreatment and all other time points for the vastus medialis, greater than 24 hours pretreatment through 48 hours posttreatment 2 for the vastus lateralis, and greater than 24 hours pretreatment and 48 hours pretreatment for the rectus femoris. For dynamic muscle pain, we observed a main effect for time (P < .001), with the baseline pretreatment measure less than the measures at all other time points. No main effect for time was noted for thigh circumference (P = .24). No main effect for group was found for any variable (P > .05). The WBV treatment approach studied did not aid in alleviating DOMS after high-intensity exercise. Further research is needed in various populations.

Effect of an herbal/botanical supplement on recovery from delayed onset muscle soreness: a randomized placebo-controlled trial

PubMed Central

2014-01-01

Background We examined the effects of a proprietary herbal/botanical supplement (StemSport, Stemtech, San Clemente, CA.) suggested to increase circulating stem cells, decrease inflammation, and attenuate exercise induced muscle damage on recovery from delayed onset muscle soreness (DOMS). Methods Sixteen subjects (male = 7, female = 9; age 23.8 ± 10 years; height 171.9 ± 10 cm, mass 72.2 ± 15 kg) were randomized in a crossover, double-blind, placebo controlled trial to receive a placebo or StemSport supplement (6150 mg/day) for 14 days. DOMS was induced on day 7 for both placebo and active conditions in the non-dominant elbow flexor group with repeated eccentric repetitions. Muscle swelling (biceps girth), elbow flexor isometric strength (hand held dynamometer), muscle pain/tenderness (visual analog scale), range of motion (active elbow flexion and extension), and inflammation (hsCRP, IL6, and TNF-α) were measured at baseline and at 24 h, 48 h, 72 h, and 168 h (1 week) post eccentric exercise. The crossover washout period was ≥14 days. Results No significant condition-by-time interactions between placebo and StemSport supplementation were observed with regard to measures of pain (p = 0.59), tenderness (p = 0.71), isometric strength (p = 0.32), elbow flexion (p = 0.45), muscle swelling (p = 0.90), or inflammation (p > 0.90). Decrements in elbow extension range of motion 48 h post-exercise were less after StemSport supplementation (Δ elbow extension 48 h post; StemSport, −2.0 deg; placebo, −10 deg; p = 0.003). Conclusions These data suggest that compared to placebo, StemSport supplementation does not improve outcome measures related to muscle recovery after acute upper-arm induced DOMS. PMID:24966805

Use of Cold-Water Immersion to Reduce Muscle Damage and Delayed-Onset Muscle Soreness and Preserve Muscle Power in Jiu-Jitsu Athletes

PubMed Central

Fonseca, Líllian Beatriz; Brito, Ciro J.; Silva, Roberto Jerônimo S.; Silva-Grigoletto, Marzo Edir; da Silva, Walderi Monteiro; Franchini, Emerson

2016-01-01

Context:  Cold-water immersion (CWI) has been applied widely as a recovery method, but little evidence is available to support its effectiveness. Objective:  To investigate the effects of CWI on muscle damage, perceived muscle soreness, and muscle power recovery of the upper and lower limbs after jiu-jitsu training. Design:  Crossover study. Setting:  Laboratory and field. Patients or Other Participants:  A total of 8 highly trained male athletes (age = 24.0 ± 3.6 years, mass = 78.4 ± 2.4 kg, percentage of body fat = 13.1% ± 3.6%) completed all study phases. Intervention(s):  We randomly selected half of the sample for recovery using CWI (6.0°C ± 0.5°C) for 19 minutes; the other participants were allocated to the control condition (passive recovery). Treatments were reversed in the second session (after 1 week). Main Outcome Measure(s):  We measured serum levels of creatine phosphokinase, lactate dehydrogenase (LDH), aspartate aminotransferase, and alanine aminotransferase enzymes; perceived muscle soreness; and recovery through visual analogue scales and muscle power of the upper and lower limbs at pretraining, postrecovery, 24 hours, and 48 hours. Results:  Athletes who underwent CWI showed better posttraining recovery measures because circulating LDH levels were lower at 24 hours postrecovery in the CWI condition (441.9 ± 81.4 IU/L) than in the control condition (493.6 ± 97.4 IU/L; P = .03). Estimated muscle power was higher in the CWI than in the control condition for both upper limbs (757.9 ± 125.1 W versus 695.9 ± 56.1 W) and lower limbs (53.7 ± 3.7 cm versus 35.5 ± 8.2 cm; both P values = .001). In addition, we observed less perceived muscle soreness (1.5 ± 1.1 arbitrary units [au] versus 3.1 ± 1.0 au; P = .004) and higher perceived recovery (8.8 ± 1.9 au versus 6.9 ± 1.7 au; P = .005) in the CWI than in the control condition at 24 hours postrecovery. Conclusions:  Use of CWI can be beneficial to jiu-jitsu athletes because it reduces circulating LDH levels, results in less perceived muscle soreness, and helps muscle power recovery at 24 hours postrecovery. PMID:27575565

Use of Cold-Water Immersion to Reduce Muscle Damage and Delayed-Onset Muscle Soreness and Preserve Muscle Power in Jiu-Jitsu Athletes.

PubMed

Fonseca, Líllian Beatriz; Brito, Ciro J; Silva, Roberto Jerônimo S; Silva-Grigoletto, Marzo Edir; da Silva, Walderi Monteiro; Franchini, Emerson

2016-07-01

Cold-water immersion (CWI) has been applied widely as a recovery method, but little evidence is available to support its effectiveness. To investigate the effects of CWI on muscle damage, perceived muscle soreness, and muscle power recovery of the upper and lower limbs after jiu-jitsu training. Crossover study. Laboratory and field. A total of 8 highly trained male athletes (age = 24.0 ± 3.6 years, mass = 78.4 ± 2.4 kg, percentage of body fat = 13.1% ± 3.6%) completed all study phases. We randomly selected half of the sample for recovery using CWI (6.0°C ± 0.5°C) for 19 minutes; the other participants were allocated to the control condition (passive recovery). Treatments were reversed in the second session (after 1 week). We measured serum levels of creatine phosphokinase, lactate dehydrogenase (LDH), aspartate aminotransferase, and alanine aminotransferase enzymes; perceived muscle soreness; and recovery through visual analogue scales and muscle power of the upper and lower limbs at pretraining, postrecovery, 24 hours, and 48 hours. Athletes who underwent CWI showed better posttraining recovery measures because circulating LDH levels were lower at 24 hours postrecovery in the CWI condition (441.9 ± 81.4 IU/L) than in the control condition (493.6 ± 97.4 IU/L; P = .03). Estimated muscle power was higher in the CWI than in the control condition for both upper limbs (757.9 ± 125.1 W versus 695.9 ± 56.1 W) and lower limbs (53.7 ± 3.7 cm versus 35.5 ± 8.2 cm; both P values = .001). In addition, we observed less perceived muscle soreness (1.5 ± 1.1 arbitrary units [au] versus 3.1 ± 1.0 au; P = .004) and higher perceived recovery (8.8 ± 1.9 au versus 6.9 ± 1.7 au; P = .005) in the CWI than in the control condition at 24 hours postrecovery. Use of CWI can be beneficial to jiu-jitsu athletes because it reduces circulating LDH levels, results in less perceived muscle soreness, and helps muscle power recovery at 24 hours postrecovery.

Myocellular enzyme leakage, polymorphonuclear neutrophil activation and delayed onset muscle soreness induced by isokinetic eccentric exercise.

PubMed

Croisier, J L; Camus, G; Deby-Dupont, G; Bertrand, F; Lhermerout, C; Crielaard, J M; Juchmès-Ferir, A; Deby, C; Albert, A; Lamy, M

1996-01-01

To address the question of whether delayed onset muscular soreness (DOMS) following intense eccentric muscle contraction could be due to increased production of the arachidonic acid derived product prostaglandin E2 (PGE2). 10 healthy male subjects were submitted to eccentric and concentric isokinetic exercises on a Kin Trex device at 60 degrees/s angular velocity. Exercise consisted of 8 stages of 5 maximal contractions of the knee extensor and flexor muscle groups of both legs separated by 1 min rest phases. There was an interval of at least 30 days between eccentric and concentric testing, and the order of the two exercise sessions was randomly assigned. The subjective presence and intensity of DOMS was evaluated using a visual analogue scale, immediately, following 24 h and 48 h after each test. Five blood samples were drawn from an antecubital vein: at rest before exercise, immediately after, after 30 min recovery, 24 h and 48 h after the tests. The magnitude of the acute inflammatory response to exercise was assessed by measuring plasma levels of polymorphonuclear elastase ([EL]), myeloperoxidase ([MPO]) and PGE2 ([PGE2]). Using two way analysis of variance, it appeared that only eccentric exercise significantly increased [EL] and DOMS, especially of the hamstring muscles. Furthermore, a significant decrease in eccentric peak torque of this muscle group only was observed on day 2 after eccentric work (- 21%; P < 0.002). Serum activity of creatine kinase and serum concentration of myoglobin increased significantly 24 and 48 h after both exercise tests. However, these variables reached significantly higher values following eccentric contractions 48 h after exercise. Mean [PGE2] in the two exercise modes remained unchanged over time and were practically equal at each time point. On the basis of these findings, we conclude that the magnitude of polymorphonuclear (PMN) activation, muscle damage, and DOMS are greater after eccentric than after concentric muscle contractions. However, the hypothesized interplay between muscle damage, increased PGE2 production, DOMS sensations, and reduced isokinetic muscle performance was not substantiated by the present results.

Visually induced analgesia in a deep tissue experimental pain model: A randomised crossover experiment.

PubMed

van Selm, M J; Gibson, W I; Travers, M J; Moseley, G L; Hince, D; Wand, B M

2018-04-20

Visualizing one's own painful body part appears to have an effect on reported pain intensity. Furthermore, it seems that manipulating the size of the viewed image can determine the direction and extent of this phenomenon. When visual distortion has been applied to clinical populations, the analgesic effects have been in opposition to those observed in some experimental pain models. To help resolve this problem, we explored the effect of visualisation and magnification of the visual image on reported pain using a delayed onset muscle soreness (DOMS) pain model. We induced DOMS in the quadriceps of 20 healthy volunteers. Forty-eight hours later, participants performed a series of painful contractions of the DOMS-affected muscle under four randomised conditions: (1) Viewing the injured thigh; (2) Viewing the contralateral thigh; (3) Viewing a neutral object; and (4) Viewing the injured thigh through magnifying glasses. For each condition, participants rated their pain intensity during a series of painful contractions. We observed that direct visualisation of the injured thigh had no effect on pain intensity when compared to viewing the contralateral thigh or neutral object. However, magnification of the DOMS-affected leg during the performance of painful contractions caused participants to report more pain than when viewing the injured thigh normally. These results further demonstrate that the effect of visualisation varies between different pain conditions. These results may have implications for the integration of visual feedback into clinical practice. We present delayed onset muscle soreness as a model for exploring visually induced analgesia. Our findings suggest that this phenomenon is expressed differently in exogenous and endogenous experimental pain models. Further exploration may offer a potential pathway for the integration of visual analgesia into the management of clinical pain. © 2018 European Pain Federation - EFIC®.

Lengthening our perspective: morphological, cellular, and molecular responses to eccentric exercise.

PubMed

Hyldahl, Robert D; Hubal, Monica J

2014-02-01

The response of skeletal muscle to unaccustomed eccentric exercise has been studied widely, yet it is incompletely understood. This review is intended to provide an up-to-date overview of our understanding of how skeletal muscle responds to eccentric actions, with particular emphasis on the underlying molecular and cellular mechanisms of damage and recovery. This review begins by addressing the question of whether eccentric actions result in physical damage to muscle fibers and/or connective tissue. We next review the symptomatic manifestations of eccentric exercise (i.e., indirect damage markers, such as delayed onset muscle soreness), with emphasis on their relatively poorly understood molecular underpinnings. We then highlight factors that potentially modify the muscle damage response following eccentric exercise. Finally, we explore the utility of using eccentric training to improve muscle function in populations of healthy and aging individuals, as well as those living with neuromuscular disorders. Copyright © 2013 Wiley Periodicals, Inc.

Dissociated time course of recovery between genders after resistance exercise.

PubMed

Flores, Débora F; Gentil, Paulo; Brown, Lee E; Pinto, Ronei S; Carregaro, Rodrigo L; Bottaro, Martim

2011-11-01

Comparisons between men and women of time course responses of strength, delayed-onset muscle soreness (DOMS), and muscle swelling after a resistance training session are still controversial. Therefore, this study examined gender differences in strength loss, muscle thickness (MT), and DOMS between young men and women. Thirty apparently healthy, untrained volunteers (14 women and 16 men) participated in the study protocol. The resistance exercise session consisted of 8 sets at 10 repetition maximum load of the elbow flexor muscles of their dominant arm. Maximum isokinetic peak torque (PT), MT, and DOMS were recorded at baseline (TB), immediately after exercise (T0), and at 1 (T1), 2 (T2), 3 (T3), and 4 (T4) days after exercise. Baseline strength was expressed as 100%. There were no significant differences between the sexes for relative PT loss immediately after exercise (T0 = 74.31 ± 8.26% for men and 76.00 ± 6.31% for women). Also, PT was still significantly less than baseline from T1 to T4 for both genders. In contrast, recovery from PT was longer in women when compared with that in men. Muscle thickness responded similarly to PT in both genders. However, there was no significant difference between genders for DOMS at any time point. The time point that showed the greatest degree of mean soreness was T2 (4.94 ± 2.38 mm for men and 4.45 ± 2.07 mm for women). Our data suggest that after resistance exercise, women and men experience similar immediate strength loss; however they have dissimilar strength recovery across 4 days of recovery. Likewise, both genders experience a different time course of MT response after a traditional resistance exercise protocol. In contrast, men and women develop and dissipate muscle soreness in a similar manner.

Effect of hydrotherapy on the signs and symptoms of delayed onset muscle soreness.

PubMed

Vaile, Joanna; Halson, Shona; Gill, Nicholas; Dawson, Brian

2008-03-01

This study independently examined the effects of three hydrotherapy interventions on the physiological and functional symptoms of delayed onset muscle soreness (DOMS). Strength trained males (n = 38) completed two experimental trials separated by 8 months in a randomised crossover design; one trial involved passive recovery (PAS, control), the other a specific hydrotherapy protocol for 72 h post-exercise; either: (1) cold water immersion (CWI: n = 12), (2) hot water immersion (HWI: n = 11) or (3) contrast water therapy (CWT: n = 15). For each trial, subjects performed a DOMS-inducing leg press protocol followed by PAS or one of the hydrotherapy interventions for 14 min. Weighted squat jump, isometric squat, perceived pain, thigh girths and blood variables were measured prior to, immediately after, and at 24, 48 and 72 h post-exercise. Squat jump performance and isometric force recovery were significantly enhanced (P < 0.05) at 24, 48 and 72 h post-exercise following CWT and at 48 and 72 h post-exercise following CWI when compared to PAS. Isometric force recovery was also greater (P < 0.05) at 24, 48, and 72 h post-exercise following HWI when compared to PAS. Perceived pain improved (P < 0.01) following CWT at 24, 48 and 72 h post-exercise. Overall, CWI and CWT were found to be effective in reducing the physiological and functional deficits associated with DOMS, including improved recovery of isometric force and dynamic power and a reduction in localised oedema. While HWI was effective in the recovery of isometric force, it was ineffective for recovery of all other markers compared to PAS.

The Effect of Omega-3 Fatty Acid Supplementation on the Inflammatory Response to eccentric strength exercise.

PubMed

Jouris, Kelly B; McDaniel, Jennifer L; Weiss, Edward P

2011-01-01

Omega-3 fatty acids (omega-3) have anti-inflammatory properties. However, it is not known if omega-3 supplementation attenuates exercise-induced inflammation. We tested the hypothesis that omega-3 supplementation reduces inflammation that is induced by eccentric arm curl exercise. Healthy adult men and women (n=11; 35 ± 10 y) performed eccentric biceps curls on two occasions, once after 14d of dietary omega-3 restriction (control trial) and again after 7d of 3,000 mg/d omega-3 supplementation (omega-3 trial). Before and 48 h after eccentric exercise, signs of inflammation was assessed by measuring soreness ratings, swelling (arm circumference and arm volume), and temperature (infrared skin sensor). Arm soreness increased (p < 0.0001) in response to eccentric exercise; the magnitude of increase in soreness was 15% less in the omega-3 trial (p = 0.004). Arm circumference increased after eccentric exercise in the control trial (p = 0.01) but not in the omega-3 trial (p = 0.15). However, there was no difference between trials (p = 0.45). Arm volume and skin temperature did not change in response to eccentric exercise in either trial. These findings suggest that omega-3 supplementation decreases soreness, as a marker of inflammation, after eccentric exercise. Based on these findings, omega-3 supplementation could provide benefits by minimizing post-exercise soreness and thereby facilitate exercise training in individuals ranging from athletes undergoing heavy conditioning to sedentary subjects or patients who are starting exercise programs or medical treatments such as physical therapy or cardiac rehabilitation. Key pointsDietary supplementation with omega-3 fatty acids has been shown to reduce inflammation in numerous inflammatory diseases such as rheumatoid arthritis, inflammatory bowel disease, and Chrohn's disease.Although strenuous exercise is known to cause acute increases in inflammation, it is not clear if omega-3 fatty acid supplementation attenuates this adverse response to exercise.Our research demonstrates that 3000 mg·d-1 omega-3 fatty acid supplementation minimizes the severe, delayed-onset muscle soreness that results from strenuous eccentric strength exercise.This information, along with a plethora of information showing that omega-3 fatty acid supplementation has other health benefits, demonstrates that a readily available over the counter nutritional supplement (i.e. omega-3 fatty acids) reduces delayed-onset soreness caused by strenuous strength exercise.This information has obvious relevance to athletic populations but also to other groups such as physical therapy patients and newly admitted cardiac rehabilitation patients, as muscle soreness, if left unchecked, can slow the progress in adapting to a new exercise program.Furthermore, as inflammation is known to be involved in the pathogenesis if numerous diseases, including heart disease, cancer, and diabetes, it is likely prudent for individuals to use inflammation-attenuating interventions, such as omega-3 supplementation, to keep inflammatory responses to physical activity at a minimum.

Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise.

PubMed

Bleakley, Chris; McDonough, Suzanne; Gardner, Evie; Baxter, G David; Hopkins, J Ty; Davison, Gareth W

2012-02-15

Many strategies are in use with the intention of preventing or minimising delayed onset muscle soreness and fatigue after exercise. Cold-water immersion, in water temperatures of less than 15°C, is currently one of the most popular interventional strategies used after exercise. To determine the effects of cold-water immersion in the management of muscle soreness after exercise. In February 2010, we searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (The Cochrane Library (2010, Issue 1), MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health (CINAHL), British Nursing Index and archive (BNI), and the Physiotherapy Evidence Database (PEDro). We also searched the reference lists of articles, handsearched journals and conference proceedings and contacted experts.In November 2011, we updated the searches of CENTRAL (2011, Issue 4), MEDLINE (up to November Week 3 2011), EMBASE (to 2011 Week 46) and CINAHL (to 28 November 2011) to check for more recent publications. Randomised and quasi-randomised trials comparing the effect of using cold-water immersion after exercise with: passive intervention (rest/no intervention), contrast immersion, warm-water immersion, active recovery, compression, or a different duration/dosage of cold-water immersion. Primary outcomes were pain (muscle soreness) or tenderness (pain on palpation), and subjective recovery (return to previous activities without signs or symptoms). Three authors independently evaluated study quality and extracted data. Some of the data were obtained following author correspondence or extracted from graphs in the trial reports. Where possible, data were pooled using the fixed-effect model. Seventeen small trials were included, involving a total of 366 participants. Study quality was low. The temperature, duration and frequency of cold-water immersion varied between the different trials as did the exercises and settings. The majority of studies failed to report active surveillance of pre-defined adverse events.Fourteen studies compared cold-water immersion with passive intervention. Pooled results for muscle soreness showed statistically significant effects in favour of cold-water immersion after exercise at 24 hour (standardised mean difference (SMD) -0.55, 95% CI -0.84 to -0.27; 10 trials), 48 hour (SMD -0.66, 95% CI -0.97 to -0.35; 8 trials), 72 hour (SMD -0.93; 95% CI -1.36 to -0.51; 4 trials) and 96 hour (SMD -0.58; 95% CI -1.00 to -0.16; 5 trials) follow-ups. These results were heterogeneous. Exploratory subgroup analyses showed that studies using cross-over designs or running based exercises showed significantly larger effects in favour of cold-water immersion. Pooled results from two studies found cold-water immersion groups had significantly lower ratings of fatigue (MD -1.70; 95% CI -2.49 to -0.90; 10 units scale, best to worst), and potentially improved ratings of physical recovery (MD 0.97; 95% CI -0.10 to 2.05; 10 units scale, worst to best) immediately after the end of cold-water immersion.Five studies compared cold-water with contrast immersion. Pooled data for pain showed no evidence of differences between the two groups at four follow-up times (immediately, 24, 48 and 72 hours after treatment). Similar findings for pooled analyses at 24, 48 and 72 hour follow-ups applied to the four studies comparing cold-water with warm-water immersion. Single trials only compared cold-water immersion with respectively active recovery, compression and a second dose of cold-water immersion at 24 hours. There was some evidence that cold-water immersion reduces delayed onset muscle soreness after exercise compared with passive interventions involving rest or no intervention. There was insufficient evidence to conclude on other outcomes or for other comparisons. The majority of trials did not undertake active surveillance of pre-defined adverse events. High quality, well reported research in this area is required.

Exercise-induced muscle damage and running economy in humans.

PubMed

Assumpção, Cláudio de Oliveira; Lima, Leonardo Coelho Rabello; Oliveira, Felipe Bruno Dias; Greco, Camila Coelho; Denadai, Benedito Sérgio

2013-01-01

Running economy (RE), defined as the energy demand for a given velocity of submaximal running, has been identified as a critical factor of overall distance running performance. Plyometric and resistance trainings, performed during a relatively short period of time (~15-30 days), have been successfully used to improve RE in trained athletes. However, these exercise types, particularly when they are unaccustomed activities for the individuals, may cause delayed onset muscle soreness, swelling, and reduced muscle strength. Some studies have demonstrated that exercise-induced muscle damage has a negative impact on endurance running performance. Specifically, the muscular damage induced by an acute bout of downhill running has been shown to reduce RE during subsequent moderate and high-intensity exercise (>65% VO₂max). However, strength exercise (i.e., jumps, isoinertial and isokinetic eccentric exercises) seems to impair RE only for subsequent high-intensity exercise (~90% VO₂max). Finally, a single session of resistance exercise or downhill running (i.e., repeated bout effect) attenuates changes in indirect markers of muscle damage and blunts changes in RE.

Dance as an eccentric form of exercise: practical implications.

PubMed

Paschalis, Vassilis; Nikolaidis, Michalis G; Jamurtas, Athanasios Z; Owolabi, Emmanuel O; Kitas, George D; Wyon, Matthew A; Koutedakis, Yiannis

2012-06-01

The eccentric action is an integral part of the stretch-shortening (or eccentric-concentric) cycle of muscle movement, especially when repositioning of the centre of gravity is required. Jumps and landing tasks are examples of this cycle and are incorporated in most dance activities. However, unaccustomed eccentric muscle action can cause muscle damage, which is characterised by the development of delayed-onset muscle soreness and swelling, decline of pain-free range of motion, as well as sustained loss of muscle force and range of motion. Furthermore, unaccustomed eccentric muscle action can induce disturbances in movement economy and energy expenditure, so dancers spend more energy during a routine than usual. Such negative effects are gradually reduced and eventually disappear due to physiological adaptations to this form of muscular activity. Given that eccentric exercises also appear to induce greater muscle performance improvements than other forms of muscle conditioning, it is advised that they should be integrated into dancers' weekly schedules. The purpose of the present review is to examine the possible effects of the eccentric component of dance on the performance and health status of dancers.

Effect of eicosapentaenoic acids-rich fish oil supplementation on motor nerve function after eccentric contractions.

PubMed

Ochi, Eisuke; Tsuchiya, Yosuke; Yanagimoto, Kenichi

2017-01-01

This study investigated the effect of supplementation with fish oil rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on the M-wave latency of biceps brachii and muscle damage after a single session of maximal elbow flexor eccentric contractions (ECC). Twenty-one men were completed the randomized, double-blind, placebo-controlled, and parallel-design study. The subjects were randomly assigned to the fish oil group ( n  = 10) or control group ( n  = 11). The fish oil group consumed eight 300-mg EPA-rich fish oil softgel capsules (containing, in total, 600 mg EPA and 260 mg DHA) per day for 8 weeks before the exercise, and continued this for a further 5 days. The control group consumed an equivalent number of placebo capsules. The subjects performed six sets of ten eccentric contractions of the elbow flexors using a dumbbell set at 40% of their one repetition maximum. M-wave latency was assessed as the time taken from electrical stimulation applied to Erb's point to the onset of M-wave of the biceps brachii. This was measured before and immediately after exercise, and then after 1, 2, 3, and 5 days. Changes in maximal voluntary isometric contraction (MVC) torque, range of motion (ROM), upper arm circumference, and delayed onset muscle soreness (DOMS) were assessed at the same time points. Compared with the control group, M-wave latency was significantly shorter in the fish oil group immediately after exercise ( p  = 0.040), MVC torque was significantly higher at 1 day after exercise ( p  = 0.049), ROM was significantly greater at post and 2 days after exercise (post; p  = 0.006, day 2; p  = 0.014), and there was significantly less delayed onset muscle soreness at 1 and 2 days after exercise (day 1; p  = 0.049, day 2; p  = 0.023). Eight weeks of EPA and DHA supplementation may play a protective role against motor nerve function and may attenuate muscle damage after eccentric contractions. This trial was registered on July 14th 2015 (https://upload.umin.ac.jp/cgi-open-bin/ctr/index.cgi).

Muscle changes with eccentric exercise: Implications on earth and in space

NASA Technical Reports Server (NTRS)

Hargens, Alan R.; Parazynski, Scott; Aratow, Michael; Friden, Jan

1989-01-01

Recent investigations of fluid pressure, morpholo gy, and enzyme activities of skeletal muscle exercised eccentrically or concentrically in normal human subjects are reviewed. Intramuscular pressures were measured before, during, and after submaximal exercise and correlated with subjective muscle soreness, fiber size, water content, and blood indices of muscle enzymes. High intensity eccentric exercise is characterized by post exercise pain, elevated intramuscular pressures, and swelling of both type 1 and 2 fibers as compared to concentric exercise. Thus, long periods of unaccustomed, high level eccentric contraction may cause muscle injury, fiber swelling, fluid accumulation, elevated intramuscular pressure, and delayed muscle soreness. Training regimens of progressively increasing eccentric exercise, however, cause less soreness and are extremely efficacious in increasing muscle mass and strength. It is proposed that on Earth, postural muscles are uniquely adapted to low levels of prolonged eccentric contraction that are absent during weightlessness. The almost complete absence of eccentric exercise in space may be an important contributor to muscle atrophy and therefore equipment should be designed to integrate eccentric contractions into exercise protocols for long-term spaceflight.

Quercetin Inhibits Peripheral and Spinal Cord Nociceptive Mechanisms to Reduce Intense Acute Swimming-Induced Muscle Pain in Mice

PubMed Central

Borghi, Sergio M.; Pinho-Ribeiro, Felipe A.; Fattori, Victor; Bussmann, Allan J. C.; Vignoli, Josiane A.; Camilios-Neto, Doumit; Casagrande, Rubia; Verri, Waldiceu A.

2016-01-01

The present study aimed to evaluate the effects of the flavonoid quercetin (3,3´,4´,5,7-pentahydroxyflavone) in a mice model of intense acute swimming-induced muscle pain, which resembles delayed onset muscle soreness. Quercetin intraperitoneal (i.p.) treatment dose-dependently reduced muscle mechanical hyperalgesia. Quercetin inhibited myeloperoxidase (MPO) and N-acetyl-β-D- glucosaminidase (NAG) activities, cytokine production, oxidative stress, cyclooxygenase-2 (COX-2) and gp91phox mRNA expression and muscle injury (creatinine kinase [CK] blood levels and myoblast determination protein [MyoD] mRNA expression) as well as inhibited NFκB activation and induced Nrf2 and HO-1 mRNA expression in the soleus muscle. Beyond inhibiting those peripheral effects, quercetin also inhibited spinal cord cytokine production, oxidative stress and glial cells activation (glial fibrillary acidic protein [GFAP] and ionized calcium-binding adapter molecule 1 [Iba-1] mRNA expression). Concluding, the present data demonstrate that quercetin is a potential molecule for the treatment of muscle pain conditions related to unaccustomed exercise. PMID:27583449

Pain-evoked trunk muscle activity changes during fatigue and DOMS.

PubMed

Larsen, L H; Hirata, R P; Graven-Nielsen, T

2017-05-01

Muscle pain may reorganize trunk muscle activity but interactions with exercise-related muscle fatigue and delayed onset muscle soreness (DOMS) is to be clarified. In 19 healthy participants, the trunk muscle activity during 20 multi-directional unpredictable surface perturbations were recorded after bilateral isotonic saline injections (control) and during unilateral and bilateral hypertonic saline-induced low back pain (LBP) in conditions of back muscle fatigue (Day-1) and DOMS (Day-2). Pain intensity and distribution were assessed by visual analogue scale (VAS) scores and pain drawings. The degree of fatigue and DOMS were assessed by Likert scale scores. Root-mean-square electromyographic (RMS-EMG) signals were recorded post-perturbation from six bilateral trunk muscles and the difference from baseline conditions (Delta-RMS-EMG) was extracted and averaged across abdominal and back muscles. In DOMS, peak VAS scores were higher during bilateral control and bilateral saline-induced pain than fatigue (p < 0.001) and during bilateral compared with unilateral pain (p < 0.001). The saline-induced pain areas were larger during DOMS than fatigue (p < 0.01). In response to surface perturbations during fatigue and DOMS, the back muscle Delta-RMS-EMG increased during bilateral compared with unilateral pain and control injections (p < 0.001) and decreased during unilateral pain compared with control injections (p < 0.04). In DOMS compared with fatigue, the post-perturbation Delta-RMS-EMG in back muscles was higher during bilateral pain and lower during unilateral pain (p < 0.001). The abdominal Delta-RMS-EMG was not significantly affected. Facilitated and attenuated back muscle responses to surface perturbations in bilateral and unilateral LBP, respectively, was more expressed during exercise-induced back muscle soreness compared with fatigue. Back muscle activity decreased during unilateral and increased during bilateral pain after unpredictable surface perturbations during muscle fatigue and DOMS. Accumulation effects of DOMS on pain intensity and spreading and trunk muscle activity after pain-induction. © 2017 European Pain Federation - EFIC®.

Benefits of dietary phytochemical supplementation on eccentric exercise-induced muscle damage: Is including antioxidants enough?

PubMed

Pereira Panza, Vilma Simões; Diefenthaeler, Fernando; da Silva, Edson Luiz

2015-09-01

The purpose of this review was to critically discuss studies that investigated the effects of supplementation with dietary antioxidant phytochemicals on recovery from eccentric exercise-induced muscle damage. The performance of physical activities that involve unaccustomed eccentric muscle actions-such as lowering a weight or downhill walking-can result in muscle damage, oxidative stress, and inflammation. These events may be accompanied by muscle weakness and delayed-onset muscle soreness. According to the current evidences, supplementation with dietary antioxidant phytochemicals appears to have the potential to attenuate symptoms associated with eccentric exercise-induced muscle damage. However, there are inconsistencies regarding the relationship between muscle damage and blood markers of oxidative stress and inflammation. Furthermore, the effectiveness of strategies appear to depend on a number of aspects inherent to phytochemical compounds as well as its food matrix. Methodological issues also may interfere with the proper interpretation of supplementation effects. Thus, the study may contribute to updating professionals involved in sport nutrition as well as highlighting the interest of scientists in new perspectives that can widen dietary strategies applied to training. Copyright © 2015 Elsevier Inc. All rights reserved.

QUADRICEPS LOW FREQUENCY FATIGUE AND MUSCLE PAIN ARE CONTRACTION TYPE DEPENDENT

PubMed Central

Iguchi, Masaki; Shields, Richard K.

2010-01-01

Introduction Eccentric contractions are thought to induce greater low frequency fatigue (LFF) and delayed onset muscle soreness (DOMS) than concentric contractions. This study induced a similar amount of eccentric quadriceps muscle fatigue during either a concentric or eccentric fatigue task to compare LFF and DOMS. Methods Subjects (n=22) performed concentric or eccentric fatigue tasks using 75% of the pre-fatigue maximal voluntary contraction (MVC) torque, and both tasks ended when the MVC eccentric torque decreased by 25% pre-fatigue. Results When subjects reached the failure criterion during the eccentric and concentric tasks, the concentric MVC was 78 ± 9.8% and 64 ± 8.4% of initial, respectively. LFF was greater after the concentric than the eccentric protocols (22 ± 12.4% and 15 ± 7.6% increase, respectively; p < 0.01). DOMS was over 100% greater for the eccentric protocol. Discussion These results indicate that DOMS is not dependent on the events that contribute to LFF. PMID:20544933

Effect of aerobic recovery intensity on delayed-onset muscle soreness and strength.

PubMed

Tufano, James J; Brown, Lee E; Coburn, Jared W; Tsang, Kavin K W; Cazas, Vanessa L; LaPorta, Joe W

2012-10-01

Because of the performance decrements associated with delayed-onset muscle soreness (DOMS), a treatment to alleviate its symptoms is of great interest. The purpose of this study was to investigate the effect of low vs. moderate-intensity aerobic recovery on DOMS and strength. Twenty-six women (22.11 ± 2.49 years; 60.33 ± 8.37 kg; and 163.83 ± 7.29 cm) were split into 3 different groups and performed a DOMS-inducing protocol of 60 eccentric actions of the knee extensors followed by 1 of three 20-minute recovery interventions: moderate-intensity cycling (n = 10), low-intensity cycling (LIC; n = 10), or seated rest (CON; n = 6) after the eccentric protocol. Pain scale (PS), isometric strength (ISO), and dynamic strength (PT) were recorded before (PRE), immediately post (IP), 24- (24h), 48- (48h), 72- (72h), and 96- (96h) hours after exercise. For PT, PRE, 48h, 72h, and 96h were significantly (p < 0.05) greater than IP values but not different from 24h. For PS, IP (4.83 ± 0.36) was greater than that for all other time periods, whereas 24h (2.91 ± 0.42), 48h (2.62 ± 0.53), and 72h (1.97 ± 0.49) were all greater than PRE (0.44 ± 0.19) values. Also, 24h and 48h were not different but were both greater than 72h and 96h (1.13 ± 0.32), whereas 72h was >96h. For ISO, neither CON nor LIC showed any significant difference across time. Moderate-intensity cycling showed no difference between PRE (189.88 ± 40.68), IP (193.75 ± 47.24), 24h (186.52 ± 53.55), or 48h (195.36 ± 55.06), but 72h (210.05 ± 53.57) and 96h (207.78 ± 59.99) were significantly >24h. The 72h was also greater than IP. Therefore, moderate-intensity aerobic recovery may be suggested after eccentric muscle actions.

The Effect of Gender and Menstrual Phase on Serum Creatine Kinase Activity and Muscle Soreness Following Downhill Running

PubMed Central

Oosthuyse, Tanja; Bosch, Andrew N.

2017-01-01

Serum creatine kinase (CK) activity reflects muscle membrane disruption. Oestrogen has antioxidant and membrane stabilising properties, yet no study has compared the CK and muscle soreness (DOMS) response to unaccustomed exercise between genders when all menstrual phases are represented in women. Fifteen eumenorrhoeic women (early follicular, EF (n = 5); late follicular, LF (n = 5); mid-luteal, ML (n = 5) phase) and six men performed 20 min of downhill running (−10% gradient) at 9 km/h. Serum CK activity and visual analogue scale rating of perceived muscle soreness were measured before, immediately, 24-h, 48-h and 72-h after exercise. The 24-h peak CK response (relative to pre-exercise) was similar between women and men (mean change (95% confidence interval): 58.5 (25.2 to 91.7) IU/L; 68.8 (31.3 to 106.3) IU/L, respectively). However, serum CK activity was restored to pre-exercise levels quicker in women (regardless of menstrual phase) than men; after 48-h post exercise in women (16.3 (−4.4 to 37.0) IU/L; 56.3 (37.0 to 75.6) IU/L, respectively) but only after 72-h in men (14.9 (−14.8 to 44.6) IU/L). Parallel to the CK response, muscle soreness recovered by 72-h in men. Conversely, the women still reported muscle soreness at 72-h despite CK levels being restored by 48-h; delayed recovery of muscle soreness appeared mainly in EF and LF. The CK and DOMS response to downhill running is gender-specific. The CK response recovers quicker in women than men. The CK and DOMS response occur in concert in men but not in women. The DOMS response in women is prolonged and may be influenced by menstrual phase. PMID:28241459

Ultrasound and magnetic resonance imaging in sports-related muscle injuries.

PubMed

Megliola, A; Eutropi, F; Scorzelli, A; Gambacorta, D; De Marchi, A; De Filippo, M; Faletti, C; Ferrari, F S

2006-09-01

The objective of this study was to evaluate the role of magnetic resonance imaging (MRI) and ultrasonography (US) in the diagnosis of traumatic muscle injuries. From June 2003 to June 2004, 81 football players with a history of traumatic muscle injuries to the lower limbs were examined. US was performed shortly after the trauma (from 6 to 72 h afterwards) and MRI within a maximum of 5 days. MRI revealed 26 minor and 55 major traumas. MRI and US showed complete concordance in 71 patients (site, type and extent of injury). US produced ten false negative results, including six minor lesions and four major lesions. US had a sensitivity of 87.65% in the correct identification of muscle injuries; its sensitivity was 92.72% for major lesions and 76.92% for minor lesions, 57% for delayed-onset muscle soreness (DOMS), 80% for lengthenings, 83% for contractures, 84% for strains, 87.5% for mild contusions and 100% for severe contusions. US is the first-line technique for examination of muscle injuries. MRI is able to reveal lesions that may be missed at US and provide a more accurate assessment of site and extent of injury.

Photobiomodulation in human muscle tissue: an advantage in sports performance?

PubMed Central

Ferraresi, Cleber; Huang, Ying-Ying; Hamblin, Michael R.

2016-01-01

Photobiomodulation (PBM) describes the use of red or near-infrared (NIR) light to vstimulate, heal, and regenerate damaged tissue. Both pre-conditioning (light delivered to muscles before exercise) and PBM applied after exercise can increase sports performance in athletes. This review covers the effects of PBM on human muscle tissue in clinical trials in volunteers related to sports performance and in athletes. The parameters used were categorized into those with positive effects or no effects on muscle performance and recovery. Randomized controlled trials and case-control studies in both healthy trained and untrained participants, and elite athletes were retrieved from MEDLINE up to 2016. Performance metrics included fatigue, number of repetitions, torque, hypertrophy; measures of muscle damage and recovery such as creatine kinase and delayed onset muscle soreness. Searches retrieved 533 studies, of which 46 were included in the review (n=1045 participants). Studies used single laser probes, cluster of laser-diodes, LED-clusters, mixed clusters (lasers and LEDs), and flexible LED arrays. Both red, NIR, and red/NIR mixtures were used. PBM can increase muscle mass gained after training, and decrease inflammation and oxidative stress in muscle biopsies. We raise the question of whether PBM should be permitted in athletic competition by international regulatory authorities. PMID:27874264

Antioxidants for preventing and reducing muscle soreness after exercise.

PubMed

Ranchordas, Mayur K; Rogerson, David; Soltani, Hora; Costello, Joseph T

2017-12-14

Muscle soreness typically occurs after intense exercise, unaccustomed exercise or actions that involve eccentric contractions where the muscle lengthens while under tension. It peaks between 24 and 72 hours after the initial bout of exercise. Many people take antioxidant supplements or antioxidant-enriched foods before and after exercise in the belief that these will prevent or reduce muscle soreness after exercise. To assess the effects (benefits and harms) of antioxidant supplements and antioxidant-enriched foods for preventing and reducing the severity and duration of delayed onset muscle soreness following exercise. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, SPORTDiscus, trial registers, reference lists of articles and conference proceedings up to February 2017. We included randomised and quasi-randomised controlled trials investigating the effects of all forms of antioxidant supplementation including specific antioxidant supplements (e.g. tablets, powders, concentrates) and antioxidant-enriched foods or diets on preventing or reducing delayed onset muscle soreness (DOMS). We excluded studies where antioxidant supplementation was combined with another supplement. Two review authors independently screened search results, assessed risk of bias and extracted data from included trials using a pre-piloted form. Where appropriate, we pooled results of comparable trials, generally using the random-effects model. The outcomes selected for presentation in the 'Summary of findings' table were muscle soreness, collected at times up to 6 hours, 24, 48, 72 and 96 hours post-exercise, subjective recovery and adverse effects. We assessed the quality of the evidence using GRADE. Fifty randomised, placebo-controlled trials were included, 12 of which used a cross-over design. Of the 1089 participants, 961 (88.2%) were male and 128 (11.8%) were female. The age range for participants was between 16 and 55 years and training status varied from sedentary to moderately trained. The trials were heterogeneous, including the timing (pre-exercise or post-exercise), frequency, dose, duration and type of antioxidant supplementation, and the type of preceding exercise. All studies used an antioxidant dosage higher than the recommended daily amount. The majority of trials (47) had design features that carried a high risk of bias due to selective reporting and poorly described allocation concealment, potentially limiting the reliability of their findings.We tested only one comparison: antioxidant supplements versus control (placebo). No studies compared high-dose versus low-dose, where the low-dose supplementation was within normal or recommended levels for the antioxidant involved.Pooled results for muscle soreness indicated a small difference in favour of antioxidant supplementation after DOMS-inducing exercise at all main follow-ups: up to 6 hours (standardised mean difference (SMD) -0.30, 95% confidence interval (CI) -0.56 to -0.04; 525 participants, 21 studies; low-quality evidence); at 24 hours (SMD -0.13, 95% CI -0.27 to 0.00; 936 participants, 41 studies; moderate-quality evidence); at 48 hours (SMD -0.24, 95% CI -0.42 to -0.07; 1047 participants, 45 studies; low-quality evidence); at 72 hours (SMD -0.19, 95% CI -0.38 to -0.00; 657 participants, 28 studies; moderate-quality evidence), and little difference at 96 hours (SMD -0.05, 95% CI -0.29 to 0.19; 436 participants, 17 studies; low-quality evidence). When we rescaled to a 0 to 10 cm scale in order to quantify the actual difference between groups, we found that the 95% CIs for all five follow-up times were all well below the minimal important difference of 1.4 cm: up to 6 hours (MD -0.52, 95% CI -0.95 to -0.08); at 24 hours (MD -0.17, 95% CI -0.42 to 0.07); at 48 hours (MD -0.41, 95% CI -0.69 to -0.12); at 72 hours (MD -0.29, 95% CI -0.59 to 0.02); and at 96 hours (MD -0.03, 95% CI -0.43 to 0.37). Thus, the effect sizes suggesting less muscle soreness with antioxidant supplementation were very unlikely to equate to meaningful or important differences in practice. Neither of our subgroup analyses to examine for differences in effect according to type of DOMS-inducing exercise (mechanical versus whole body aerobic) or according to funding source confirmed subgroup differences. Sensitivity analyses excluding cross-over trials showed that their inclusion had no important impact on results.None of the 50 included trials measured subjective recovery (return to previous activities without signs or symptoms).There is very little evidence regarding the potential adverse effects of taking antioxidant supplements as this outcome was reported in only nine trials (216 participants). From the studies that did report adverse effects, two of the nine trials found adverse effects. All six participants in the antioxidant group of one trial had diarrhoea and four of these also had mild indigestion; these are well-known side effects of the particular antioxidant used in this trial. One of 26 participants in a second trial had mild gastrointestinal distress. There is moderate to low-quality evidence that high dose antioxidant supplementation does not result in a clinically relevant reduction of muscle soreness after exercise at up to 6 hours or at 24, 48, 72 and 96 hours after exercise. There is no evidence available on subjective recovery and only limited evidence on the adverse effects of taking antioxidant supplements. The findings of, and messages from, this review provide an opportunity for researchers and other stakeholders to come together and consider what are the priorities, and underlying justifications, for future research in this area.

Immunological changes in human skeletal muscle and blood after eccentric exercise and multiple biopsies

PubMed Central

Malm, Christer; Nyberg, Pernilla; Engström, Marianne; Sjödin, Bertil; Lenkei, Rodica; Ekblom, Björn; Lundberg, Ingrid

2000-01-01

A role of the immune system in muscular adaptation to physical exercise has been suggested but data from controlled human studies are scarce. The present study investigated immunological events in human blood and skeletal muscle by immunohistochemistry and flow cytometry after eccentric cycling exercise and multiple biopsies. Immunohistochemical detection of neutrophil- (CD11b, CD15), macrophage- (CD163), satellite cell- (CD56) and IL-1β-specific antigens increased similarly in human skeletal muscle after eccentric cycling exercise together with multiple muscle biopsies, or multiple biopsies only. Changes in immunological variables in blood and muscle were related, and monocytes and natural killer (NK) cells appeared to have governing functions over immunological events in human skeletal muscle. Delayed onset muscle soreness, serum creatine kinase activity and C-reactive protein concentration were not related to leukocyte infiltration in human skeletal muscle. Eccentric cycling and/or muscle biopsies did not result in T cell infiltration in human skeletal muscle. Modes of stress other than eccentric cycling should therefore be evaluated as a myositis model in human. Based on results from the present study, and in the light of previously published data, it appears plausible that muscular adaptation to physical exercise occurs without preceding muscle inflammation. Nevertheless, leukocytes seem important for repair, regeneration and adaptation of human skeletal muscle. PMID:11080266

Soreness-related changes in three-dimensional running biomechanics following eccentric knee extensor exercise.

PubMed

Paquette, Max R; Peel, Shelby A; Schilling, Brian K; Melcher, Dan A; Bloomer, Richard J

2017-06-01

Runners often experience delayed onset muscle soreness (DOMS), especially of the knee extensors, following prolonged running. Sagittal knee joint biomechanics are altered in the presence of knee extensor DOMS but it is unclear how muscle soreness affects lower limb biomechanics in other planes of motion. The purpose of this study was to assess the effects of knee extensor DOMS on three-dimensional (3D) lower limb biomechanics during running. Thirty-three healthy men (25.8 ± 6.8 years; 84.1 ± 9.2 kg; 1.77 ± 0.07 m) completed an isolated eccentric knee extensor damaging protocol to elicit DOMS. Biomechanics of over-ground running at a set speed of 3.35 m s -1 ±5% were measured before eccentric exercise (baseline) and, 24 h and 48 h following exercise in the presence of knee extensor DOMS. Knee flexion ROM was reduced at 48 h (P = 0.01; d = 0.26), and peak knee extensor moment was reduced at 24 h (P = 0.001; d = 0.49) and 48 h (P < 0.001; d = 0.68) compared to baseline. Frontal and transverse plane biomechanics were unaffected by the presence of DOMS (P > 0.05). Peak positive ankle and knee joint powers and, peak negative knee joint power were all reduced from baseline to 24 h and 48 h (P < 0.05). These findings suggest that knee extensor DOMS greatly influences sagittal knee joint angular kinetics and, reduces sagittal power production at the ankle joint. However, knee extensor DOMS does not affect frontal and transverse plane lower limb joint biomechanics during running.

The physiological response to cold-water immersion following a mixed martial arts training session.

PubMed

Lindsay, Angus; Carr, Sam; Cross, Sean; Petersen, Carl; Lewis, John G; Gieseg, Steven P

2017-05-01

Combative sport is one of the most physically intense forms of exercise, yet the effect of recovery interventions has been largely unexplored. We investigated the effect of cold-water immersion on structural, inflammatory, and physiological stress biomarkers following a mixed martial arts (MMA) contest preparation training session in comparison with passive recovery. Semiprofessional MMA competitors (n = 15) were randomly assigned to a cold-water immersion (15 min at 10 °C) or passive recovery protocol (ambient air) completed immediately following a contest preparation training session. Markers of muscle damage (urinary myoglobin), inflammation/oxidative stress (urinary neopterin + total neopterin (neopterin + 7,8-dihydroneopterin)), and hypothalamic-pituitary axis (HPA) activation (saliva cortisol) were determined before, immediately after, and 1, 2, and 24 h postsession. Ratings of perceived soreness and fatigue, counter movement jump, and gastrointestinal temperature were also measured. Concentrations of all biomarkers increased significantly (p < 0.05) postsession. Cold water immersion attenuated increases in urinary neopterin (p < 0.05, d = 0.58), total neopterin (p < 0.05, d = 0.89), and saliva cortisol after 2 h (p < 0.05, d = 0.68) and urinary neopterin again at 24 h (p < 0.01, d = 0.57) in comparison with passive recovery. Perceived soreness, fatigue, and gastrointestinal temperatures were also lower for the cold-water immersion group at several time points postsession whilst counter movement jump did not differ. Combative sport athletes who are subjected to impact-induced stress may benefit from immediate cold-water immersion as a simple recovery intervention that reduces delayed onset muscle soreness as well as macrophage and HPA activation whilst not impairing functional performance.

To Compare the Effect of Vibration Therapy and Massage in Prevention of Delayed Onset Muscle Soreness (DOMS).

PubMed

Imtiyaz, Shagufta; Veqar, Zubia; Shareef, M Y

2014-01-01

To compare the effects of vibration therapy and massage in prevention of DOMS. Pre-test and Post-test Control-Group Design was used, 45 healthy female non athletic Subjects were recruited and randomly distributed to the three groups (15 subject in each group). After the subject's initial status was measured experimental groups received vibration therapy (50 Hz vibration for five minutes) or massage therapy (15 minutes) intervention and control group received no treatment, just prior to the eccentric exercise. Subjects were undergoing the following measurements to evaluate the changes in the muscle condition: muscle soreness (pain perception), Range of Motion (ROM), Maximum Isometric Force (MIF), Repetition maximum (RM), Lactate dehydrogenase (LDH) and Cretain Kinase (CK) level. All the parameters except LDH, CK and 1RM were measured before, immediately post intervention, immediately post exercise, 24 hours post exercise, 48 hours post exercise and 72 hours post exercise. LDH, CK and 1 RM were measured before and 48 hours post exercise. Muscle soreness was reported to be significantly less for experimental (vibration and massage) group (p=0.000) as compared to control group at 24, 48, and 72 hours of post-exercise. Experimental and control group did not show any significant difference in MIF immediate (p=0.2898), 24 hours (p=0.4173), 48 hours (p=0.752) and 72 hours (p=0.5297) of post-exercise. Range of motion demonstrated significant recovery in experimental groups in 48 hours (p=0.0016) and 72 hours (p=0.0463). Massage therapy showed significant recovery in 1RM (p=0.000) compared to control group and vibration therapy shows significantly less LDH level (p=0.000) 48 hours of post exercise compare to control group. CK at 48 hours of post exercise in vibration group (p=0.000) and massage group showed (p=0.002) significant difference as compared to control group. Vibration therapy and massage are equally effective in prevention of DOMS. Massage is effective in restoration of concentric strength (1 RM). Yet vibration therapy shows clinically early reduction of pain and is effective in decreasing the level of LDH in 48 hours post exercise periods.

The effect of contrast water therapy on symptoms of delayed onset muscle soreness.

PubMed

Vaile, Joanna M; Gill, Nicholas D; Blazevich, Anthony J

2007-08-01

This study examined the effect of contrast water therapy (CWT) on the physiological and functional symptoms of delayed onset muscle soreness (DOMS) following DOMS-inducing leg press exercise. Thirteen recreational athletes performed 2 experimental trials separated by 6 weeks in a randomized crossover design. On each occasion, subjects performed a DOMS-inducing leg press protocol consisting of 5 x 10 eccentric contractions (180 seconds recovery between sets) at 140% of 1 repetition maximum (1RM). This was followed by a 15-minute recovery period incorporating either CWT or no intervention, passive recovery (PAS). Creatine kinase concentration (CK), perceived pain, thigh volume, isometric squat strength, and weighted jump squat performance were measured prior to the eccentric exercise, immediately post recovery, and 24, 48, and 72 hours post recovery. Isometric force production was not reduced below baseline measures throughout the 72-hour data collection period following CWT ( approximately 4-10%). However, following PAS, isometric force production (mean +/- SD) was 14.8 +/- 11.4% below baseline immediately post recovery (p < 0.05), 20.8 +/- 15.6% 24 hours post recovery (p < 0.05), and 22.5 +/- 12.3% 48 hours post recovery (p < 0.05). Peak power produced during the jump squat was significantly reduced (p < 0.05) following both PAS (20.9 +/- 13.4%) and CWT (12.8 +/- 8.0%), with the mean reduction in power for PAS being marginally (not significantly) greater than for CWT (effect size = 0.76). Thigh volume measured immediately following CWT was significantly less than PAS. No significant differences in the changes in CK were found; in addition, there were no significant (p > 0.01) differences in perceived pain between treatments. Contrast water therapy was associated with a smaller reduction, and faster restoration, of strength and power measured by isometric force and jump squat production following DOMS-inducing leg press exercise when compared to PAS. Therefore, CWT seems to be effective in reducing and improving the recovery of functional deficiencies that result from DOMS, as opposed to passive recovery.

Effect of volume of milk consumed on the attenuation of exercise-induced muscle damage.

PubMed

Cockburn, Emma; Robson-Ansley, Paula; Hayes, Philip R; Stevenson, Emma

2012-09-01

Exercise-induced muscle damage (EIMD) leads to decrements in muscle performance, increases in intramuscular proteins and delayed-onset of muscle soreness (DOMS). Previous research demonstrated that one litre of milk-based protein-carbohydrate (CHO) consumed immediately following muscle damaging exercise can limit changes in markers of EIMD possibly due to attenuating protein degradation and/or increasing protein synthesis. If the attenuation of EIMD is derived from changes in protein metabolism then it can be hypothesised that consuming a smaller volume of CHO and protein will elicit similar effects. Three independent matched groups of 8 males consumed 500 mL of milk, 1,000 mL of milk or a placebo immediately following muscle damaging exercise. Passive and active DOMS, isokinetic muscle performance, creatine kinase (CK), myoglobin and interleukin-6 were assessed immediately before and 24, 48 and 72 h after EIMD. After 72 h 1,000 mL of milk had a likely benefit for limiting decrements in peak torque compared to the placebo. After 48 h, 1,000 mL of milk had a very likely benefit of limiting increases in CK in comparison to the placebo. There were no differences between consuming 500 or 1,000 mL of milk for changes in peak torque and CK. In conclusion, decrements in isokinetic muscle performance and increases in CK can be limited with the consumption of 500 mL of milk.

Eccentric resistance training intensity may affect the severity of exercise induced muscle damage.

PubMed

Hasenoehrl, Timothy; Wessner, Barbara; Tschan, Harald; Vidotto, Claudia; Crevenna, Richard; Csapo, Robert

2017-09-01

The aim of the present study was to assess the role of eccentric exercise intensity in the development of and recovery from delayed onset muscle soreness (DOMS). Using a cross-over study design, 15 healthy, male college students were tested on two occasions. The training stimulus consisted of an exhaustive series of eccentric muscle contractions of the elbow flexors at either 100% (high intensity) or 50% (low intensity) of the individual concentric one-repetition maximum. Blood samples were taken at baseline as well as 24, 48, 72 and 96 hours postexercise, and analyzed for creatine kinase, myoglobin, interleukin-6 and prostaglandin-2. Additionally, upper arm circumference (CIRC) and DOMS-related sensation of pain (PAIN) were measured. Following high intensity training, CIRC was significantly greater (P=0.007). Further, creatine kinase, myoglobin and interleukin-6 tended to be higher, although the main effect of the factor "intensity" just failed to reach significance (creatine kinase: P=0.056, myoglobin: P=0.064, interleukin-6: P=0.091). No differences were found for prostaglandin-2 (P=0.783) and PAIN (P=0.147). When performed at greater intensity, fatiguing eccentric resistance exercise of the elbow flexors leads to greater muscle swelling and, potentially, increases in serum markers reflecting lesions in the muscle's cellular membrane.

Season-long increases in perceived muscle soreness in professional rugby league players: role of player position, match characteristics and playing surface.

PubMed

Fletcher, Ben D; Twist, Craig; Haigh, Julian D; Brewer, Clive; Morton, James P; Close, Graeme L

2016-01-01

Rugby League (RL) is a high-impact collision sport characterised by repeated sprints and numerous high-speed impacts and consequently players often report immediate and prolonged muscle soreness in the days after a match. We examined muscle soreness after matches during a full season to understand the extent to which match characteristics influence soreness. Thirty-one elite Super League players provided daily measures of muscle soreness after each of the 26 competitive fixtures of the 2012 season. Playing position, phase of the season, playing surface and match characteristics were recorded from each match. Muscle soreness peaked at day 1 and was still apparent at day 4 post-game with no attenuation in the magnitude of muscle soreness over the course of the season. Neither playing position, phase of season or playing surface had any effects on the extent of muscle soreness. Playing time and total number of collisions were significantly correlated with higher ratings of muscle soreness, especially in the forwards. These data indicate the absence "contact adaptations" in elite rugby players with soreness present throughout the entire season. Strategies must now be implemented to deal with the physical and psychological consequences of prolonged feeling of pain.

The effects of topical Arnica on performance, pain and muscle damage after intense eccentric exercise.

PubMed

Pumpa, Kate L; Fallon, Kieran E; Bensoussan, Alan; Papalia, Shona

2014-01-01

The aim of the study was to determine if topical Arnica is effective in reducing pain, indicators of inflammation and muscle damage, and in turn improve performance in well-trained males experiencing delayed onset muscle soreness (DOMS). Twenty well-trained males matched by maximal oxygen uptake (V̇O2 Max) completed a double-blind, randomised placebo-controlled trial. Topical Arnica was applied to the skin superficial to the quadriceps and gastrocnemius muscles immediately after a downhill running protocol designed to induce DOMS. Topical Arnica was reapplied every 4 waking hours for the duration of the study. Performance measures (peak torque, countermovement and squat jump), pain assessments (visual analogue scale (VAS) and muscle tenderness) and blood analysis (interleukin-1 beta, interleukin-6, tumour necrosis factor-alpha, C-reactive protein, myoglobin and creatine kinase) were assessed at seven time points over five days (pre-, post-, 4, 24, 48, 72 and 96 hours after the downhill run). Participants in the topical Arnica group reported less pain as assessed through muscle tenderness and VAS 72 hours post-exercise. The application of topical Arnica did not affect any performance assessments or markers of muscle damage or inflammation. Topical Arnica used immediately after intense eccentric exercise and for the following 96 hours did not have an effect on performance or blood markers. It did however demonstrate the possibility of providing pain relief three days post-eccentric exercise.

Exercise-induced rhabdomyolysis from stationary biking: a case report.

PubMed

Inklebarger, J; Galanis, N; Kirkos, J; Kapetanos, G

2010-10-01

There are several reports concerning exercise and rabdomyolysis. There has been no report in the English literature of exercise induced rabdomyolisis from a stationary bike.A 63-year-old female recreational athlete presented to our hospital seeking treatment for lower back, leg pain and stiffness after exercising on a stationary bicycle one day prior. Blood work showed a raised CK of 38,120 U/L, a myoglobin of 5330 and an AST 495 U/L with normal urea and electrolytes. Urinalysis remained negative. She was admitted for oral and intravenous hydration and fluid balance monitoringThis is a very rare case of rhabdomyolysis due to exercise. This study highlights the difficulties faced by accident and emergency teams in distinguishing delayed onset muscle soreness (DOMS) from exercise-induced rhabdomyolysis, and reinforces the concept that rhabdomyolysis can occur at any level of exercise intensity.

Influence of fatigue, stress, muscle soreness and sleep on perceived exertion during submaximal effort.

PubMed

Haddad, Monoem; Chaouachi, Anis; Wong, Del P; Castagna, Carlo; Hambli, Mourad; Hue, Olivier; Chamari, Karim

2013-07-02

The aim of this study was to assess the effects of the Hooper's Index variations (i.e., self-ratings of fatigue, stress, delayed onset muscle soreness (DOMS), and sleep) on rating of perceived exertion during a 10 min submaximal exercise training session (RPE-10 min) and then check the stability and the internal consistency of RPE-10 min. Seventeen junior soccer players took part in this study. The individual Hooper's indices taken before each training session were correlated with RPE-10 min during a constant intensity and duration effort (10 min) using Pearson product moment correlation. Intraclass correlation (ICC) was used to assess the internal consistency of the RPE-10 min. All individual correlations between RPE-10 min and quality of sleep and quantity of fatigue, stress, and DOMS were non-significant (p>0.05). No significant correlations were resulted between RPE-10 min and Hooper's Index in all athletes. The ICC of RPE-10 min was 0.77 thus demonstrating internal consistency. The results of the present study demonstrated the objectivity and utility of RPE as a psychological tool for monitoring training during traditional soccer training. Therefore, the results of the present study suggest that fatigue, stress, DOMS and sleep are not major contributors of perceived exertion during traditional soccer training without excessive training loads. It seems that psychobiological factors other than fatigue, stress, DOMS and sleep may have mediated the 10 min exercise perceptual intensity. © 2013.

Neurodynamic mobilization and foam rolling improved delayed-onset muscle soreness in a healthy adult population: a randomized controlled clinical trial.

PubMed

Romero-Moraleda, Blanca; La Touche, Roy; Lerma-Lara, Sergio; Ferrer-Peña, Raúl; Paredes, Víctor; Peinado, Ana Belén; Muñoz-García, Daniel

2017-01-01

Compare the immediate effects of a Neurodynamic Mobilization (NM) treatment or foam roller (FR) treatment after DOMS. Double blind randomised clinical trial. The participants performed 100 drop jumps (5 sets of 20 repetitions, separated by 2 min rests) from a 0.5-m high box in a University biomechanics laboratory to induce muscle soreness. The participants were randomly assigned in a counter-balanced fashion to either a FR or NM treatment group. Thirty-two healthy subjects (21 males and 11 females, mean age 22.6 ± 2.2 years) were randomly assigned into the NM group ( n  = 16) or the FR group ( n  = 16). The numeric pain rating scale (NPRS; 0-10), isometric leg strength with dynamometry, surface electromyography at maximum voluntary isometric contraction (MVIC) and muscle peak activation (MPA) upon landing after a test jump were measured at baseline, 48 h after baseline before treatment, and immediately after treatment. Both groups showed significant reduction in NPRS scores after treatment (NM: 59%, p  < .01; FR: 45%, p  < .01), but no difference was found between them ( p  > .05). The percentage change improvement in the MVIC for the rectus femoris was the only significant difference between the groups ( p  < 0.05) at post-treatment. After treatment, only the FR group had a statistically significant improvement ( p  < 0.01) in strength compared to pre-treatment. Our results illustrate that both treatments are effective in reducing pain perception after DOMS whereas only FR application showed differences for the MVIC in the rectus femoris and strength.

Effect of BCAA supplement timing on exercise-induced muscle soreness and damage: a pilot placebo-controlled double-blind study.

PubMed

Ra, Song-Gyu; Miyazaki, Teruo; Kojima, Ryo; Komine, Shoichi; Ishikura, Keisuke; Kawanaka, Kentaro; Honda, Akira; Matsuzaki, Yasushi; Ohmori, Hajime

2017-09-22

The aim of present study was to compare the effects of branched-chain amino acid (BCAA) supplementation taken before or after exercise on delayed onset muscle soreness (DOMS) and exercise-induced muscle damage (EIMD). Fifteen young men (aged 21.5 ± 0.4 years) were given either BCAA (9.6 g·day-1) or placebo before and after exercise (and for 3 days prior to and following the exercise day) in three independent groups: the Control group (placebo before and after exercise), the PRE group (BCAA before exercise and placebo after exercise), and the POST group (placebo before exercise and BCAA after exercise). Participants performed 30 repetitions of eccentric exercise with the non-dominant arm. DOMS, upper arm circumference (CIR), elbow range of motion (ROM), serum creatine kinase (CK), lactate dehydrogenase (LDH), and aldolase, BCAA, and Beta-hydroxy-Beta-methylbutyrate (3HMB) were measured immediately before and after the exercise and on the following 4 days. Serum BCAA and 3HMB concentrations increased significantly in the PRE group immediately after the exercise, recovering to baseline over the following days. In the days following the exercise day, DOMS, CIR, and ROM were significantly improved in the PRE group compared to the Control group, with weaker effects in the POST group. Serum activities of CK, LDH, and aldolase in the days following the exercise day were significantly suppressed in the PRE group compared to Control group. Present study confirmed that repeated BCAA supplementation before exercise had a more beneficial effect in attenuating DOMS and EIMD induced by eccentric exercise than repeated supplementation after exercise.

The magnitude of muscle strain does not influence serial sarcomere number adaptations following eccentric exercise.

PubMed

Butterfield, Timothy A; Herzog, Walter

2006-02-01

It is generally accepted that eccentric exercise, when performed by a muscle that is unaccustomed to that type of contraction, results in a delayed onset of muscle soreness (DOMS). A prolonged exposure to eccentric exercise leads to the disappearance of the signs and symptoms associated with DOMS, which has been referred to as the repeated bout effect (RBE). Although the mechanisms underlying the RBE remain unclear, several mechanisms have been proposed, including the serial sarcomere number addition following exercise induced muscle damage. In the traditional DOMS and RBE protocols, muscle injury has been treated as a global parameter, with muscle force and strain assumed to be uniform throughout the muscle. To assess the effects of muscle-tendon unit strain, fiber strain, torque and injury on serial sarcomere number adaptations, three groups of New Zealand White (NZW) rabbits were subjected to chronic repetitive eccentric exercise bouts of the ankle dorsiflexors for 6 weeks. These eccentric exercise protocols consisted of identical muscle tendon unit (MTU) strain, but other mechanical factors were systematically altered. Following chronic eccentric exercise, serial sarcomere number adaptations were not identical between the three eccentric exercise protocols, and serial sarcomere number adaptations were not uniform across all regions of the muscle. Peak torque and relaxation fiber strain were the best predictors of serial sarcomere number across all three protocols. Therefore, MTU strain does not appear to be the primary cause for sarcomerogenesis, and differential adaptations within the muscle may be explained by the nonuniform architecture of the muscle, resulting in differential local fiber strains.

Methods of Muscle Activation Onset Timing Recorded During Spinal Manipulation.

PubMed

Currie, Stuart J; Myers, Casey A; Krishnamurthy, Ashok; Enebo, Brian A; Davidson, Bradley S

2016-05-01

The purpose of this study was to determine electromyographic threshold parameters that most reliably characterize the muscular response to spinal manipulation and compare 2 methods that detect muscle activity onset delay: the double-threshold method and cross-correlation method. Surface and indwelling electromyography were recorded during lumbar side-lying manipulations in 17 asymptomatic participants. Muscle activity onset delays in relation to the thrusting force were compared across methods and muscles using a generalized linear model. The threshold combinations that resulted in the lowest Detection Failures were the "8 SD-0 milliseconds" threshold (Detection Failures = 8) and the "8 SD-10 milliseconds" threshold (Detection Failures = 9). The average muscle activity onset delay for the double-threshold method across all participants was 149 ± 152 milliseconds for the multifidus and 252 ± 204 milliseconds for the erector spinae. The average onset delay for the cross-correlation method was 26 ± 101 for the multifidus and 67 ± 116 for the erector spinae. There were no statistical interactions, and a main effect of method demonstrated that the delays were higher when using the double-threshold method compared with cross-correlation. The threshold parameters that best characterized activity onset delays were an 8-SD amplitude and a 10-millisecond duration threshold. The double-threshold method correlated well with visual supervision of muscle activity. The cross-correlation method provides several advantages in signal processing; however, supervision was required for some results, negating this advantage. These results help standardize methods when recording neuromuscular responses of spinal manipulation and improve comparisons within and across investigations. Copyright © 2016 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

A Comparison of Exercise-Induced Muscle Damage Following Maximal Eccentric Contractions in Men and Boys.

PubMed

Deli, Chariklia K; Fatouros, Ioannis G; Paschalis, Vassilis; Georgakouli, Kalliopi; Zalavras, Athanasios; Avloniti, Alexandra; Koutedakis, Yiannis; Jamurtas, Athanasios Z

2017-08-01

Research regarding exercise-induced muscle-damage mainly focuses on adults. The present study examined exercise-induced muscle-damage responses in adults compared with children. Eleven healthy boys (10-12 y) and 15 healthy men (18-45 y) performed 5 sets of 15 maximal eccentric contractions of the knee extensors. Range of motion (ROM), delayed onset muscle soreness (DOMS) during squat and walking, and peak isometric, concentric and eccentric torque were assessed before, post, 24, 48, 72, and 96 hr postexercise. Creatine kinase (CK) activity was assessed before and 72 hr postexercise. Eccentric exercise resulted in DOMS during squat that persisted for up to 96h in men, and 48 hr in boys (p < .05), and DOMS during walking that persisted for up to 72 hr in men, and 48 hr in boys (p < .01). The ROM was lower in both age groups 48 hr postexercise (p < .001). Isometric (p < .001), concentric (p < .01) and eccentric (p < .01) force decreased post, and up to 48 hr postexercise in men. Except for a reduction in isometric force immediately after exercise, no other changes occurred in boys' isokinetic force. CK activity increased in men at 72 hr postexercise compared with pre exercise levels (p = .05). Our data provide further confirmation that children are less susceptible to exercise-induced muscle damage compared with adults.

An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis

PubMed Central

Dupuy, Olivier; Douzi, Wafa; Theurot, Dimitri; Bosquet, Laurent; Dugué, Benoit

2018-01-01

Introduction: The aim of the present work was to perform a meta-analysis evaluating the impact of recovery techniques on delayed onset muscle soreness (DOMS), perceived fatigue, muscle damage, and inflammatory markers after physical exercise. Method: Three databases including PubMed, Embase, and Web-of-Science were searched using the following terms: (“recovery” or “active recovery” or “cooling” or “massage” or “compression garment” or “electrostimulation” or “stretching” or “immersion” or “cryotherapy”) and (“DOMS” or “perceived fatigue” or “CK” or “CRP” or “IL-6”) and (“after exercise” or “post-exercise”) for randomized controlled trials, crossover trials, and repeated-measure studies. Overall, 99 studies were included. Results: Active recovery, massage, compression garments, immersion, contrast water therapy, and cryotherapy induced a small to large decrease (−2.26 < g < −0.40) in the magnitude of DOMS, while there was no change for the other methods. Massage was found to be the most powerful technique for recovering from DOMS and fatigue. In terms of muscle damage and inflammatory markers, we observed an overall moderate decrease in creatine kinase [SMD (95% CI) = −0.37 (−0.58 to −0.16), I2 = 40.15%] and overall small decreases in interleukin-6 [SMD (95% CI) = −0.36 (−0.60 to −0.12), I2 = 0%] and C-reactive protein [SMD (95% CI) = −0.38 (−0.59 to−0.14), I2 = 39%]. The most powerful techniques for reducing inflammation were massage and cold exposure. Conclusion: Massage seems to be the most effective method for reducing DOMS and perceived fatigue. Perceived fatigue can be effectively managed using compression techniques, such as compression garments, massage, or water immersion. PMID:29755363

Dosages of cold-water immersion post exercise on functional and clinical responses: a randomized controlled trial.

PubMed

Machado, A F; Almeida, A C; Micheletti, J K; Vanderlei, F M; Tribst, M F; Netto Junior, J; Pastre, C M

2017-11-01

Cold-water immersion (CWI) is one of the recovery techniques commonly used by athletes for post-exercise recovery. Nevertheless, the effects of CWI using different temperatures and the dose-response relationship of this technique have not yet been investigated. The aims of this study were to compare the effects of two strategies of CWI, using different water temperatures with passive recovery post exercise in the management of some markers of muscle damage, and to observe whether any of the techniques used caused deleterious effects on performance. Sixty healthy male participants performed an eccentric protocol to induce muscle damage and were then randomized to one of three groups (CWI1: 15 min at 9 °C; CWI2: 15 min at 14 °C; CG: control group). Levels of creatine kinase, muscle soreness, pain threshold, perception of recovery, and maximal voluntary isometric contraction were monitored up to 96 h post exercise. A large effect for time for all outcomes was observed [P < 0.001; CK (ES = 0.516), muscle soreness (ES = 0.368); pain threshold (ES = 0.184); perception of recovery (ES = 0.565); MVIC (ES = 0.273)]. CWI groups presented an earlier recovery for muscle soreness with lower ratings immediately post recovery. For delayed effects, the application of CWI2 (15 min at 14 °C) presented earlier recovery compared with CWI1 and control condition for maximal voluntary isometric contraction (P < 0.05). There were no significant group and interaction (Group × Time) effects. CWI groups acted more efficiently for muscle soreness and performance considering the time of recovery was observed. No evidence was found to suggest dose-response relationship and deleterious effects. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Influence of Passive Muscle Tension on Electromechanical Delay in Humans

PubMed Central

Lacourpaille, Lilian; Hug, François; Nordez, Antoine

2013-01-01

Background Electromechanical delay is the time lag between onsets of muscle activation and muscle force production and reflects both electro-chemical processes and mechanical processes. The aims of the present study were two-fold: to experimentally determine the slack length of each head of the biceps brachii using elastography and to determine the influence of the length of biceps brachii on electromechanical delay and its electro-chemical/mechanical processes using very high frame rate ultrasound. Methods/Results First, 12 participants performed two passive stretches to evaluate the change in passive tension for each head of the biceps brachii. Then, they underwent two electrically evoked contractions from 120 to 20° of elbow flexion (0°: full extension), with the echographic probe maintained over the muscle belly and the myotendinous junction of biceps brachii. The slack length was found to occur at 95.5 ± 6.3° and 95.3 ± 8.2° of the elbow joint angle for the long and short heads of the biceps brachii, respectively. The electromechanical delay was significantly longer at 120° (16.9 ± 3.1 ms; p<0.001), 110° (15.0 ± 3.1 ms; p<0.001) and 100° (12.7 ± 2.5 ms; p = 0.01) of elbow joint angle compared to 90° (11.1 ± 1.7 ms). However, the delay between the onset of electrical stimulation and the onset of both muscle fascicles (3.9 ± 0.2 ms) and myotendinous junction (3.7 ± 0.3 ms) motion was not significantly affected by the joint angle (p>0.95). Conclusion In contrast to previous observations on gastrocnemius medialis, the onset of muscle motion and the onset of myotendinous junction motion occurred simultaneously regardless of the length of the biceps brachii. That suggests that the between-muscles differences reported in the literature cannot be explained by different muscle passive tension but instead may be attributable to muscle architectural differences. PMID:23308153

Neuromuscular dysfunction that may predict ACL injury risk: a case report.

PubMed

Saunders, Natalie; McLean, Scott G; Fox, Aaron S; Otago, Leonie

2014-06-01

This case report examined the neuromuscular function of a competitive female netball player six days prior to an incident where she sustained an acute anterior cruciate ligament injury during normal sports activity. Electromyography was used to examine activation onsets of four lower limb muscles (rectus femoris, biceps femoris, medial hamstrings and gluteus medius) relative to initial contact (IC) during netball-specific landings of varying complexity. The results of the injured participant were compared to the remaining participants in the study (n=8), and the injured participant's injured limb was compared to the contralateral limb. The injured participant was the only player to record delayed pre-injury muscle onsets after IC for all muscles tested in the injured limb, while her non-injured limb was comparable to the other participants tested. Furthermore, delayed muscle onset after IC occurred more frequently as landing complexity increased. This case report suggests that delayed muscle activity onset after IC during landing may be an important risk factor for ACL injury. Copyright © 2014 Elsevier B.V. All rights reserved.

Supplementation with beta-hydroxy-beta-methylbutyrate (HMB) and alpha-ketoisocaproic acid (KIC) reduces signs and symptoms of exercise-induced muscle damage in man.

PubMed

van Someren, Ken A; Edwards, Adam J; Howatson, Glyn

2005-08-01

This study examined the effects of beta-hydroxyl-beta-methylbutyrate (HMB) and alpha-ketoisocaproic acid (KIC) supplementation on signs and symptoms of exercise-induced muscle damage following a single bout of eccentrically biased resistance exercise. Six non-resistance trained male subjects performed an exercise protocol designed to induce muscle damage on two separate occasions, performed on the dominant or non-dominant arm in a counter-balanced crossover design. Subjects were assigned to an HMB/KIC (3 g HMB and 0.3 g alpha-ketoisocaproic acid, daily) or placebo treatment for 14 d prior to exercise in the counter-balanced crossover design. One repetition maximum (1RM), plasma creatine kinase activity (CK), delayed onset muscle soreness (DOMS), limb girth, and range of motion (ROM) were determined pre-exercise, at 1h, 24 h, 48 h, and 72 h post-exercise. DOMS and the percentage changes in 1RM, limb girth, and ROM all changed over the 72 h period (P < 0.05). HMB//IC supplementation attenuated the CK response, the percentage decrement in 1RM, and the percentage increase in limb girth (P < 0.05). In addition, DOMS was reduced at 24 h post-exercise (P < 0.05) in the HMB/KIC treatment. In conclusion, 14 d of HMB and KIC supplementation reduced signs and symptoms of exercise-induced muscle damage in non-resistance trained males following a single bout of eccentrically biased resistance exercise.

Differentiation of original and regenerated skeletal muscle fibres in mdx dystrophic muscles.

PubMed

Earnshaw, John C; Kyprianou, Phillip; Krishan, Kewal; Dhoot, Gurtej K

2002-07-01

The differentiation of both original muscle fibres and the regenerated muscle fibres following necrosis in mdx muscles was investigated using immunoblotting and immunocytochemical procedures. Before the onset of necrosis, postnatal skeletal muscles in mdx mouse differentiated well with only a slight delay in differentiation indicated by the level of developmental isoforms of troponin T. Prior to the onset of apparent myopathic change, both fast and slow skeletal muscle fibre types in mdx leg muscles also differentiated well when investigated by analysis of specific myosin heavy chain expression pattern. While the original muscle fibres in mdx leg muscles developed well, the differentiation of regenerated myotubes into both slow and distinct fast muscle fibre types, however, was markedly delayed or inhibited as indicated by several clusters of homogeneously staining fibres even at 14 weeks of age. The number of slow myosin heavy chain-positive myotubes amongst the regenerated muscle clusters was quite small even in soleus. This study thus established that while muscle fibres initially develop normally with only a slight delay in the differentiation process, the differentiation of regenerated myotubes in mdx muscles is markedly compromised and consequently delayed.

Effects of acute postexercise chocolate milk consumption during intensive judo training on the recovery of salivary hormones, salivary SIgA, mood state, muscle soreness, and judo-related performance.

PubMed

Papacosta, Elena; Nassis, George P; Gleeson, Michael

2015-11-01

This study examined the effects of postexercise chocolate milk (CM) or water (W) consumption during 5 days of intensive judo training with concomitant weight loss on salivary cortisol and testosterone, salivary secretory immunoglobulin A (SIgA), delayed-onset muscle soreness (DOMS), and judo-related performance. Twelve trained male judo athletes engaged in 5 days of intensive judo training followed by a simulated judo competition, on 2 separate training weeks 14 days apart. The athletes consumed 1000 mL of W (week 1) or CM (week 2) immediately post-training. During both weeks, athletes were instructed to "make weight" for the upcoming competition. Performance in timed push-ups and the Special Judo Fitness Test improved by 14.6% and 6.8%, respectively, at the end of the training week with CM consumption (both p < 0.001). Decreased salivary cortisol (p < 0.01) and a trend for an increased salivary testosterone/cortisol ratio (p = 0.07) were also observed midweek in the CM condition. Saliva flow rate was higher during the week with CM intake compared with W intake (p < 0.001). DOMS (p < 0.001) and mood disturbance (p < 0.0001) increased after the first day of training in the W condition but not in the CM condition. Salivary testosterone and SIgA responses were similar between treatments (p > 0.05). Body mass decreased by 1.9% in the W condition and by 1.1% in the CM condition, with no significant difference between treatments. This study indicates that postexercise CM consumption during short-term intensive judo training enhances aspects of recovery without affecting intentional weight loss.

Evaluation of hydrotherapy, using passive tests and power tests, for recovery across a cyclic week of competitive rugby union.

PubMed

Higgins, Trevor R; Climstein, Mike; Cameron, Melainie

2013-04-01

In team sports, a cycle of training, competition, and recovery occurs weekly during the competitive season. In this research, we evaluated hydrotherapy for recovery from a simulated game of rugby union tracked over a week of training. Twenty-four experienced male rugby union players (mean ± SD age 19.46 ± 0.82 years, weight 82.38 ± 11.12 kg, height 178.54 ± 5.75 cm) were randomly divided into 3 groups: cold water immersion (n = 8), contrast bath therapy (n = 8), and a control group (n = 8). The 2 forms of hydrotherapy were administered immediately after a simulated rugby game. Testing was conducted 1 hour before the game and at 5 intervals postgame: 1, 48, 72, 96, and 144 hours. Dependent variables included countermovement jump, 10- and 40-m sprints, sessional rating of perceived exertion (RPE), flexibility, thigh circumference, and self-reported delayed onset muscle soreness (DOMS). Significant differences in DOMS were found between the cold water immersion and contrast bath groups at 48 hours post intervention (p = 0.02), and between the control and contrast bath groups at 72 (p = 0.03) and 96 (p = 0.04) hours post intervention. Cold water immersion and contrast bath groups reported significantly different RPE at 72 hours (p = ?) and 96 hours post (p = 0.05) intervention. Athletes' perceptions of muscle soreness and sessional RPE scores for training were greater in the contrast bath group (20%) after the simulated game and throughout the training week. Although results from passive and power tests were inconclusive in determining whether cold water immersion or passive recovery was more effective in attenuating fatigue, results indicated contrast baths had little benefit in enhancing recovery during a cyclic week of rugby union.

Influence of cold-water immersion on recovery of elite triathletes following the ironman world championship.

PubMed

Stearns, Rebecca L; Nolan, Julie K; Huggins, Robert A; Maresh, Carl M; Munõz, Colleen X; Pagnotta, Kelly D; Volk, Brittanie M; Casa, Douglas J

2018-01-31

Cold water immersion (CWI) has been widely used for enhancing athlete recovery though its use following an Ironman triathlon has never been examined. The purpose of this paper is to determine the influence of CWI immediately following an Ironman triathlon on markers of muscle damage, inflammation and muscle soreness. Prospective cohort study. Thirty three (22 male, 11 female), triathletes participating in the Ironman World Championships volunteered to participate (mean±SD: age=40±11years; height=174.5±9.1cm; body mass=70±11.8kg; percent body fat=11.4±4.1%, finish time=11:03.00±01:25.08). Post race, participants were randomly assigned to a 10-min bout of 10°C CWI or no-intervention control group. Data collection occurred pre-intervention (PRE), post-intervention (POST), 16h (16POST) and 40h (40POST) following the race. Linear mixed model ANOVA with Bonferroni corrections were performed to examine group by time differences for delayed onset muscle soreness (DOMS), hydration indices, myoglobin, creatine kinase (CK), cortisol, C-reactive protein (CRP), IL-6 and percent body mass loss (%BML). Pearson's bivariate correlations were used for comparisons with finishing time. Alpha level was set a priori at 0.05. No significant group by time interactions occurred. Significant differences occurred for POST BML (-1.7±0.9kg) vs. 16POST, and 40POST BML (0.9±1.4, -0.1±1.2kg, respectively; p<0.001). Compared to PRE, myoglobin, CRP and CK remained significantly elevated at 40POST. Cortisol returned to PRE values by 16POST and IL-6 returned to PRE values by 40POST. A single bout of CWI did not provide any physiological benefit during recovery from a triathlon within 40h post race. Effect of CWI beyond this time is unknown. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Effects of air-pulsed cryotherapy on neuromuscular recovery subsequent to exercise-induced muscle damage.

PubMed

Guilhem, Gaël; Hug, François; Couturier, Antoine; Regnault, Stéphanie; Bournat, Laure; Filliard, Jean-Robert; Dorel, Sylvain

2013-08-01

Localized cooling has been proposed as an effective strategy to limit the deleterious effects of exercise-induced muscle damage on neuromuscular function. However, the literature reports conflicting results. This randomized controlled trial aimed to determine the effects of a new treatment, localized air-pulsed cryotherapy (-30°C), on the recovery time-course of neuromuscular function following a strenuous eccentric exercise. Controlled laboratory study. A total of 24 participants were included in either a control group (CONT) or a cryotherapy group (CRYO). Immediately after 3 sets of 20 maximal isokinetic eccentric contractions of elbow flexors, and then 1, 2, and 3 days after exercise, the CRYO group received a cryotherapy treatment (3 × 4 minutes at -30°C separated by 1 minute). The day before and 1, 2, 3, 7, and 14 days after exercise, several parameters were quantified: maximal isometric torque and its associated maximal electromyographic activity recorded by a 64-channel electrode, delayed-onset muscle soreness (DOMS), biceps brachii transverse relaxation time (T2) measured using magnetic resonance imaging, creatine kinase activity, interleukin-6, and C-reactive protein. Maximal isometric torque decreased similarly for the CONT (-33% ± 4%) and CRYO groups (-31% ± 6%). No intergroup differences were found for DOMS, electromyographic activity, creatine kinase activity, and T2 level averaged across the whole biceps brachii. C-reactive protein significantly increased for CONT (+93% at 72 hours, P < .05) but not for CRYO. Spatial analysis showed that cryotherapy delayed the significant increase of T2 and the decrease of electromyographic activity level for CRYO compared with CONT (between day 1 and day 3) in the medio-distal part of the biceps brachii. Although some indicators of muscle damage after severe eccentric exercise were delayed (ie, local formation of edema and decrease of muscle activity) by repeated air-pulsed cryotherapy, we provide evidence that this cooling procedure failed to improve long-term recovery of muscle performance. Four applications of air-pulsed cryotherapy in the 3 days after a strenuous eccentric exercise are ineffective overall in promoting long-term muscle recovery. Further studies taking into account the amount of exercise-induced muscle damage would allow investigators to make stronger conclusions regarding the inefficiency of this recovery modality.

Can postoperative deltoid weakness after cervical laminoplasty be prevented by using intraoperative neurophysiological monitoring?

PubMed

Ando, Muneharu; Tamaki, Tetsuya; Matsumoto, Takuji; Maio, Kazuhiro; Teraguchi, Masatoshi; Takiguchi, Noboru; Iwahashi, Hiroki; Onishi, Makiko; Nakagawa, Yukihiro; Iwasaki, Hiroshi; Tsutsui, Shunji; Takami, Masanari; Yamada, Hiroshi

2018-04-17

Laminoplasty, frequently performed in patients with cervical myelopathy, is safe and provides relatively good results. However, motor palsy of the upper extremities, which occurs after decompression surgery for cervical myelopathy, often reduces muscle strength of the deltoid muscle, mainly in the C5 myotome. The aim of this study was to investigate prospectively whether postoperative deltoid weakness (DW) can be predicted by performing intraoperative neurophysiological monitoring (IONM) during cervical laminoplasty and to clarify whether it is possible to prevent palsy using IONM. We evaluated the 278 consecutive patients (175 males and 103 females) who underwent French-door cervical laminoplasty for cervical myelopathy under IONM between November 2008 and December 2016 at our hospital. IONM was performed using muscle evoked potential after electrical stimulation to the brain [Br(E)-MsEP] from the deltoid muscle. Seven patients (2.5%) developed DW after surgery (2 with acute and 5 with delayed onset). In all patients, deltoid muscle strength recovered to ≥ 4 on manual muscle testing 3-6 months after surgery. Persistent IONM alerts occurred in 2 patients with acute-onset DW. To predict the acute onset of DW, Br(E)-MsEP alerts in the deltoid muscle had both a sensitivity and specificity of 100%. The PPV of persistent Br(E)-MsEP alerts had both a sensitivity and specificity of 100% for acute-onset DW. There was no change in Br(E)-MsEP in patients with delayed-onset palsy. The incidence of deltoid palsy was relatively low. Persistent Br(E)-MsEP alerts of the deltoid muscle had a 100% sensitivity and specificity for predicting a postoperative acute deficit. IONM was unable to predict delayed-onset DW. In only 1 patient were we able to prevent postoperative DW by performing a foraminotomy.

Effect of the Abdominal Hollowing and Bracing Maneuvers on Activity Pattern of the Lumbopelvic Muscles During Prone Hip Extension in Subjects With or Without Chronic Low Back Pain: A Preliminary Study.

PubMed

Kahlaee, Amir H; Ghamkhar, Leila; Arab, Amir M

2017-02-01

The purpose of this study was to compare the effect of abdominal hollowing (AH) and abdominal bracing (AB) maneuvers on the activity pattern of lumbopelvic muscles during prone hip extension (PHE) in participants with or without nonspecific chronic low back pain (CLBP). Twenty women with or without CLBP participated in this cross-sectional observational study. The electromyographic activity (amplitude and onset time) of the contralateral erector spinae (CES), ipsilateral erector spinae (IES), gluteus maximus, and biceps femoris muscles was measured during PHE with and without abdominal maneuvers. A 3-way mixed model analysis of variance and post hoc tests were used for statistical analysis. Between-group comparisons showed that the CES onset delay during PHE alone was greater (P = .03) and the activity level of IES, CES, and biceps femoris in all maneuvers (P < .05) was higher in patients with CLBP than in asymptomatic participants. In asymptomatic participants, PHE + AH significantly decreased the signal amplitude (AMP) of IES (P = .01) and CES (P = .02) muscles. In participants with CLBP, IES muscle AMP was lower during PHE + AH compared with PHE + AB and PHE alone. With regard to onset delay, the results also showed no significant difference between maneuvers within either of the 2 groups (P > .05). Performance of the AH maneuver decreased the erector spinae muscle AMP in both groups, and neither maneuver altered the onset delay of any of the muscles in either group. The low back pain group showed higher levels of activity in all muscles (not statistically significant in gluteus maximus during all maneuvers). The groups were similar according to the onset delay of any of the muscles during either maneuver. Copyright © 2016. Published by Elsevier Inc.

Minocycline Prevents Muscular Pain Hypersensitivity and Cutaneous Allodynia Produced by Repeated Intramuscular Injections of Hypertonic Saline in Healthy Human Participants.

PubMed

Samour, Mohamad Samir; Nagi, Saad Saulat; Shortland, Peter John; Mahns, David Anthony

2017-08-01

Minocycline, a glial suppressor, prevents behavioral hypersensitivities in animal models of peripheral nerve injury. However, clinical trials of minocycline in human studies have produced mixed results. This study addressed 2 questions: can repeated injections of hypertonic saline (HS) in humans induce persistent hypersensitivity? Can pretreatment with minocycline, a tetracycline antibiotic with microglial inhibitory effects, prevent the onset of hypersensitivity? Twenty-seven healthy participants took part in this double-blind, placebo-controlled study, consisting of 6 test sessions across 2 weeks. At the beginning of every session, pressure-pain thresholds of the anterior muscle compartment of both legs were measured to determine the region distribution and intensity of muscle soreness. To measure changes in thermal sensitivity in the skin overlying the anterior muscle compartment of both legs, quantitative sensory testing was used to measure the cutaneous thermal thresholds (cold sensation, cold pain, warm sensation, and heat pain) and a mild cooling stimulus was applied to assess the presence of cold allodynia. To induce ongoing hypersensitivity, repeated injections of HS were administered into the right tibialis anterior muscle at 48-hour intervals. In the final 2 sessions (days 9 and 14), only sensory assessments were done to plot the recovery after cessation of HS administrations and drug washout. By day 9, nontreated participants experienced a significant bilateral increase in muscle soreness (P < .0001), accompanied by the emergence of bilateral cold allodynia in 44% of participants, thus confirming the effectiveness of the model. Placebo-treated participants experienced a bilateral 35% alleviation in muscle soreness (P < .0001), with no changes to the prevalence of cold allodynia. In contrast, minocycline-treated participants experienced a bilateral 70% alleviation in muscle soreness (P < .0001), additionally, only 10% of minocycline-treated participants showed cold allodynia. This study showed that repeated injections of HS can induce a hypersensitivity that outlasts the acute response, and the development of this hypersensitivity can be reliably attenuated with minocycline pretreatment. Four repeated injections of HS at 48-hour intervals induce a state of persistent hypersensitivity in healthy human participants. This hypersensitivity was characterized by bilateral muscular hyperalgesia and cutaneous cold allodynia, symptoms commonly reported in many chronic pain conditions. Minocycline pretreatment abolished the development of this state. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

BounceBack capsules for reduction of DOMS after eccentric exercise: a randomized, double-blind, placebo-controlled, crossover pilot study.

PubMed

Udani, Jay K; Singh, Betsy B; Singh, Vijay J; Sandoval, Elizabeth

2009-06-05

Delayed onset muscle soreness (DOMS) is muscle pain and discomfort experienced approximately one to three days after exercise. DOMS is thought to be a result of microscopic muscle fiber tears that occur more commonly after eccentric exercise rather than concentric exercise. This study sought to test the efficacy of a proprietary dietary supplement, BounceBack, to alleviate the severity of DOMS after standardized eccentric exercise. The study was a randomized, double-blind, placebo-controlled, crossover study. Ten healthy community-dwelling untrained subjects, ranging in age from 18-45 years, were enrolled. Mean differences within and between groups were assessed inferentially at each data collection time-point using t-tests for all outcome measures. In this controlled pilot study, intake of BounceBack capsules for 30 days resulted in a significant reduction in standardized measures of pain and tenderness post-eccentric exercise compared to the placebo group. There were trends towards reductions in plasma indicators of inflammation (high sensitivity C-reactive protein) and muscle damage (creatine phosphokinase and myoglobin). BounceBack capsules were able to significantly reduce standardized measures of pain and tenderness at several post-eccentric exercise time points in comparison to placebo. The differences in the serological markers of DOMS, while not statistically significant, appear to support the clinical findings. The product appears to have a good safety profile and further study with a larger sample size is warranted based on the current results.

BounceBack™ capsules for reduction of DOMS after eccentric exercise: a randomized, double-blind, placebo-controlled, crossover pilot study

PubMed Central

Udani, Jay K; Singh, Betsy B; Singh, Vijay J; Sandoval, Elizabeth

2009-01-01

Background Delayed onset muscle soreness (DOMS) is muscle pain and discomfort experienced approximately one to three days after exercise. DOMS is thought to be a result of microscopic muscle fiber tears that occur more commonly after eccentric exercise rather than concentric exercise. This study sought to test the efficacy of a proprietary dietary supplement, BounceBack™, to alleviate the severity of DOMS after standardized eccentric exercise. Methods The study was a randomized, double-blind, placebo-controlled, crossover study. Ten healthy community-dwelling untrained subjects, ranging in age from 18–45 years, were enrolled. Mean differences within and between groups were assessed inferentially at each data collection time-point using t-tests for all outcome measures. Results In this controlled pilot study, intake of BounceBack™ capsules for 30 days resulted in a significant reduction in standardized measures of pain and tenderness post-eccentric exercise compared to the placebo group. There were trends towards reductions in plasma indicators of inflammation (high sensitivity C-reactive protein) and muscle damage (creatine phosphokinase and myoglobin). Conclusion BounceBack™ capsules were able to significantly reduce standardized measures of pain and tenderness at several post-eccentric exercise time points in comparison to placebo. The differences in the serological markers of DOMS, while not statistically significant, appear to support the clinical findings. The product appears to have a good safety profile and further study with a larger sample size is warranted based on the current results. PMID:19500355

Gender differences in muscle inflammation after eccentric exercise.

PubMed

Stupka, N; Lowther, S; Chorneyko, K; Bourgeois, J M; Hogben, C; Tarnopolsky, M A

2000-12-01

Unaccustomed exercise is followed by delayed-onset muscle soreness and morphological changes in skeletal muscle. Animal studies have demonstrated that women have an attenuated response to muscle damage. We studied the effect of eccentric exercise in untrained male (n = 8) and female (n = 8) subjects using a unilateral exercise design [exercise (Ex) and control (Con) legs]. Plasma granulocyte counts [before (Pre) and 48 h after exercise (+48h)] and creatine kinase activity [Pre, 24 h after exercise (+24h), +48h, and 6 days after exercise (+6d)] were determined before (Pre) and after (+24h, +48h, +6d) exercise, with biopsies taken from the vastus lateralis of each leg at +48h for determination of muscle damage and/or inflammation. Plasma granulocyte counts increased for men and decreased for women at +48h (P < 0.05), and creatine kinase activity increased for both genders at +48h and +6d (P < 0.01). There were significantly greater areas of both focal (P < 0.001) and extensive (P < 0.01) damage in the Ex vs. Con leg for both genders, which was assessed by using toluidine blue staining. The number of leukocyte common antigen-positive cells/mm(2) tissue increased with exercise (P < 0.05), and men tended to show more in their Ex vs. Con leg compared with women (P = 0.052). Men had a greater total (Ex and Con legs) number of bcl-2-positive cells/mm(2) tissue vs. women (P < 0.05). Atrophic fibers with homogeneous bcl-2-positive staining were seen only in men (n = 3). We conclude that muscle damage is similar between genders, yet the inflammatory response is attenuated in women vs. men. Finally, exercise may stimulate the expression of proteins involved in apoptosis in skeletal muscle.

Docosahexaenoic acid affects markers of inflammation and muscle damage after eccentric exercise.

PubMed

DiLorenzo, Frank M; Drager, Christopher J; Rankin, Janet W

2014-10-01

The effect of docosahexaenoic acid (DHA) on inflammatory and muscle damage response to acute eccentric exercise and to the subsequent initiation of a resistance training program was studied in 41 untrained men. Subjects consumed either 2 g·d of either DHA or placebo (PL) for 28 days before a 17-day exercise phase (day 1 to day 17) that began with an eccentric exercise bout of the elbow flexors (day 1). For analysis, the exercise period was further divided into an acute response phase (day 1-4). Isometric muscle strength (STR), range of motion (ROM), and delayed onset muscle soreness (DOMS) were measured on days 1, 2, 3, 4, 7, 12, and 17. Fasted blood was measured for interleukin 6 (IL-6), interleukin 1 receptor antagonist, C-reactive protein (CRP), and creatine kinase (CK) on days 1, 2, and 4. Serum CK and CRP were also measured in blood collected on days 7, 12, and 17. In the acute phase, DHA significantly reduced the serum CK (12.5%) and the IL-6 response (32%) but did not affect STR or DOMS. Over the entire 17-day resistance exercise period, DOMS area under the curve was 183.2 ± 96.2 for DHA and 203.2 ± 120.9 for PL (p = 0.054) and the CK response was numerically lower for DHA (p = 0.093). Docosahexaenoic acid supplementation reduced some but not all indicators of muscle damage and inflammation in the 4 days after an acute eccentric exercise bout but did not significantly affect the response to initiation of resistance exercise.

Individuals with chronic low back pain demonstrate delayed onset of the back muscle activity during prone hip extension.

PubMed

Suehiro, Tadanobu; Mizutani, Masatoshi; Ishida, Hiroshi; Kobara, Kenichi; Osaka, Hiroshi; Watanabe, Susumu

2015-08-01

Prone hip extension (PHE) is commonly used in the evaluation of the stability of the lumbopelvic region. There is little evidence of difference in muscle activity onset timing between healthy individuals and individuals with chronic low back pain (CLBP) during PHE. The purpose of this study was to determine if individuals with and without CLBP differ in the onset time of the trunk and hip extensor muscles activity during PHE. The participants were 20 patients with CLBP and 20 healthy individuals. Electromyography data of the erector spinae, multifidus, gluteus maximus, and semitendinosus were collected during PHE using a surface electromyograph. Relative differences in the onset times between each muscle and the prime mover (i.e., the semitendinosus) were calculated. The onsets of the bilateral multifidus and contralateral erector spinae were significantly delayed in the CLBP group compared with the healthy group (p<0.001), despite the onset timings of leg movement not being significantly different between the groups. The onset times of the gluteus maximus and ipsilateral erector spinae showed no significant differences between the groups. These results suggest that individuals with CLBP use an altered, and possibly inadequate, trunk muscle recruitment pattern. Copyright © 2015 Elsevier Ltd. All rights reserved.

Treatment of ischial pressure sores with both profunda femoris artery perforator flaps and muscle flaps.

PubMed

Kim, Chae Min; Yun, In Sik; Lee, Dong Won; Lew, Dae Hyun; Rah, Dong Kyun; Lee, Won Jai

2014-07-01

Reconstruction of ischial pressure sore defects is challenging due to extensive bursas and high recurrence rates. In this study, we simultaneously applied a muscle flap that covered the exposed ischium and large bursa with sufficient muscular volume and a profunda femoris artery perforator fasciocutaneous flap for the management of ischial pressure sores. We retrospectively analyzed data from 14 patients (16 ischial sores) whose ischial defects had been reconstructed using both a profunda femoris artery perforator flap and a muscle flap between January 2006 and February 2014. We compared patient characteristics, operative procedure, and clinical course. All flaps survived the entire follow-up period. Seven patients (50%) had a history of surgery at the site of the ischial pressure sore. The mean age of the patients included was 52.8 years (range, 18-85 years). The mean follow-up period was 27.9 months (range, 3-57 months). In two patients, a biceps femoris muscle flap was used, while a gracilis muscle flap was used in the remaining patients. In four cases (25%), wound dehiscence occurred, but healed without further complication after resuturing. Additionally, congestion occurred in one case (6%), but resolved with conservative treatment. Among 16 cases, there was only one (6%) recurrence at 34 months. The combination of a profunda femoris artery perforator fasciocutaneous flap and muscle flap for the treatment of ischial pressure sores provided pliability, adequate bulkiness and few long-term complications. Therefore, this may be used as an alternative treatment method for ischial pressure sores.

Treatment of Ischial Pressure Sores with Both Profunda Femoris Artery Perforator Flaps and Muscle Flaps

PubMed Central

Kim, Chae Min; Yun, In Sik; Lee, Dong Won; Lew, Dae Hyun; Rah, Dong Kyun

2014-01-01

Background Reconstruction of ischial pressure sore defects is challenging due to extensive bursas and high recurrence rates. In this study, we simultaneously applied a muscle flap that covered the exposed ischium and large bursa with sufficient muscular volume and a profunda femoris artery perforator fasciocutaneous flap for the management of ischial pressure sores. Methods We retrospectively analyzed data from 14 patients (16 ischial sores) whose ischial defects had been reconstructed using both a profunda femoris artery perforator flap and a muscle flap between January 2006 and February 2014. We compared patient characteristics, operative procedure, and clinical course. Results All flaps survived the entire follow-up period. Seven patients (50%) had a history of surgery at the site of the ischial pressure sore. The mean age of the patients included was 52.8 years (range, 18-85 years). The mean follow-up period was 27.9 months (range, 3-57 months). In two patients, a biceps femoris muscle flap was used, while a gracilis muscle flap was used in the remaining patients. In four cases (25%), wound dehiscence occurred, but healed without further complication after resuturing. Additionally, congestion occurred in one case (6%), but resolved with conservative treatment. Among 16 cases, there was only one (6%) recurrence at 34 months. Conclusions The combination of a profunda femoris artery perforator fasciocutaneous flap and muscle flap for the treatment of ischial pressure sores provided pliability, adequate bulkiness and few long-term complications. Therefore, this may be used as an alternative treatment method for ischial pressure sores. PMID:25075362

Postneedling soreness after deep dry needling of a latent myofascial trigger point in the upper trapezius muscle: Characteristics, sex differences and associated factors.

PubMed

Martín-Pintado-Zugasti, Aitor; Rodríguez-Fernández, Ángel Luis; Fernandez-Carnero, Josue

2016-04-27

Postneedling soreness is considered the most frequent secondary effect associated to dry needling. A detailed description of postneedling soreness characteristics has not been previously reported. (1) to assess the intensity and duration of postneedling soreness and tenderness after deep dry needling of a trapezius latent myofascial trigger point (MTrP), (2) to evaluate the possible differences in postneedling soreness between sexes and (3) to analyze the influence on postneedling soreness of factors involved in the dry needling process. Sixty healthy subjects (30 men, 30 women) with latent MTrPs in the upper trapezius muscle received a dry needling intervention in the MTrP. Pain and pressure pain threshold (PPT) were assessed during a 72 hours follow-up period. Repeated measures analysis of covariance showed a significant effect for time in pain and in PPT. An interaction between sex and time in pain was obtained: women exhibited higher intensity in postneedling pain than men. The pain during needling and the number of needle insertions significantly correlated with postneedling soreness. Soreness and hyperalgesia are present in all subjects after dry needling of a latent MTrP in the upper trapezius muscle. Women exhibited higher intensity of postneedling soreness than men.

Change in skeletal muscle stiffness after running competition is dependent on both running distance and recovery time: a pilot study.

PubMed

Sadeghi, Seyedali; Newman, Cassidy; Cortes, Daniel H

2018-01-01

Long-distance running competitions impose a large amount of mechanical loading and strain leading to muscle edema and delayed onset muscle soreness (DOMS). Damage to various muscle fibers, metabolic impairments and fatigue have been linked to explain how DOMS impairs muscle function. Disruptions of muscle fiber during DOMS exacerbated by exercise have been shown to change muscle mechanical properties. The objective of this study is to quantify changes in mechanical properties of different muscles in the thigh and lower leg as function of running distance and time after competition. A custom implementation of Focused Comb-Push Ultrasound Shear Elastography (F-CUSE) method was used to evaluate shear modulus in runners before and after a race. Twenty-two healthy individuals (age: 23 ± 5 years) were recruited using convenience sampling and split into three race categories: short distance (nine subjects, 3-5 miles), middle distance (10 subjects, 10-13 miles), and long distance (three subjects, 26+ miles). Shear Wave Elastography (SWE) measurements were taken on both legs of each subject on the rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), soleus, lateral gastrocnemius (LG), medial gastrocnemius (MG), biceps femoris (BF) and semitendinosus (ST) muscles. For statistical analyses, a linear mixed model was used, with recovery time and running distance as fixed variables, while shear modulus was used as the dependent variable. Recovery time had a significant effect on the soleus ( p  = 0.05), while running distance had considerable effect on the biceps femoris ( p  = 0.02), vastus lateralis ( p  < 0.01) and semitendinosus muscles ( p  = 0.02). Sixty-seven percent of muscles exhibited a decreasing stiffness trend from before competition to immediately after competition. The preliminary results suggest that SWE could potentially be used to quantify changes of muscle mechanical properties as a way for measuring recovery procedures for runners.

Effects of intensity on muscle-specific voluntary electromechanical delay and relaxation electromechanical delay.

PubMed

Smith, Cory M; Housh, Terry J; Hill, Ethan C; Keller, Josh L; Johnson, Glen O; Schmidt, Richard J

2018-06-01

The purposes of this study were to examine: 1) the potential muscle-specific differences in voluntary electromechanical delay (EMD) and relaxation electromechanical delay (R-EMD), and 2) the effects of intensity on EMD and R-EMD during step incremental isometric muscle actions from 10 to 100% maximal voluntary isometric contraction (MVIC). EMD and R-EMD measures were calculated from the simultaneous assessments of electromyography, mechanomyography, and force production from the vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF) during step isometric muscle actions. There were no differences between the VL, VM, and RF for the voluntary EMD E-M (onsets of the electromyographic to mechanomyographic signals), EMD M-F (onsets the mechanomyographic to force production), or EMD E-F (onsets of the electromyographic signal to force production) as well as R-EMD E-M (cessation of electromyographic to mechanomyographic signal), R-EMD M-F (cessation of mechanomyographic signal to force cessation), or R-EMD E-F (cessation of electromyorgraphic signal to force cessation) at any intensity. There were decreases in all EMD and R-EMD measures with increases in intensity. The relative contributions from EMD E-M and EMD M-F to EMD E-F as well as R-EMD E-M and R-EMD M-F to R-EMD E-F remained similar across all intensities. The superficial muscles of the quadriceps femoris shared similar EMD and R-EMD measurements.

Reliability and discriminative validity of sudden ankle inversion measurements in patients with chronic ankle instability.

PubMed

Eechaute, Christophe; Vaes, Peter; Duquet, William; Van Gheluwe, Bart

2009-07-01

Studies investigating peroneal muscle reaction times in chronically unstable ankle joints present conflicting results. The degree of reliability and accuracy of these measurements is unknown in patients with chronic ankle instability (CAI). 40 patients with CAI and 30 healthy subjects were tested using a sudden ankle inversion of 50 degrees while standing on a trapdoor device. Sudden ankle inversion measurements were registered using electromyography, accelerometry and electrogoniometry. For reliability testing, intra-class coefficients (ICCs; model 3,1) and standard errors of measurements of the latency time, motor response time and electromechanical delay of the peroneus longus muscle, the time and angular position of onset of decelerations, the mean and maximum inversion speed and the total inversion time were calculated in 15 patients with CAI. To assess between-group differences, t-tests for independent samples (p<.05) were used. ICCs ranged from .20 (angular position of onset of the second deceleration) to .98 (electromechanical delay of the peroneus longus muscle). Significant between-group differences were observed in only 2 of the 12 variables (for the electromechanical delay of the peroneus longus muscle, p=.001; time of onset of the second deceleration, p=.040). The latency time and motor response time of the peroneus longus muscle, the total inversion time and the mean inversion speed demonstrate acceptable reliability in healthy subjects and patients. The latency time and motor response time of the peroneus longus muscle are not delayed in patients with CAI. Ankle inversion measurements are not discriminative for CAI.

Perforator-based island flap with a peripheral muscle patch for coverage of sacral sores.

PubMed

Chang, Jung Woo; Lee, Jang Hyun; Choi, Matthew Seung Suk

2016-06-01

Despite numerous therapeutic advances, the treatment of pressure sores remains a challenge. The increased use of perforator flaps enables surgeons to minimize donor-site morbidity by sparing the underlying muscle. In the presence of focal deep spaces, however, the inclusion of muscle would be beneficial. The goal of this study was to introduce a method for including a muscle patch at the periphery of a perforator-based island flap for coverage of sacral pressure sores. Between March 2010 and February 2015, 26 patients with stage IV sacral sores underwent perforator-based island flap reconstruction with a peripheral muscle patch. Patient characteristics, including sex, age, defect size, and postoperative complications, were recorded. All flaps survived without major complications. No flap necrosis was noted. The present study shows that a muscle patch incorporated into the periphery of a perforator-based flap can be transferred safely. This can be a good surgical option in cases where infection control or more volume is needed. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

The role of massage in sports performance and rehabilitation: current evidence and future direction.

PubMed

Brummitt, Jason

2008-02-01

Massage is a popular treatment choice of athletes, coaches, and sports physical therapists. Despite its purported benefits and frequent use, evidence demonstrating its efficacy is scarce. To identify current literature relating to sports massage and its role in effecting an athlete's psychological readiness, in enhancing sports performance, in recovery from exercise and competition, and in the treatment of sports related musculoskeletal injuries. Electronic databases were used to identify papers relevant to this review. The following keywords were searched: massage, sports injuries, athletic injuries, physical therapy, rehabilitation, delayed onset muscle soreness, sports psychology, sports performance, sports massage, sports recovery, soft tissue mobilization, deep transverse friction massage, pre-event, and post exercise. RESEARCH STUDIES PERTAINING TO THE FOLLOWING GENERAL CATEGORIES WERE IDENTIFIED AND REVIEWED: pre-event (physiological and psychological variables), sports performance, recovery, and rehabilitation. Despite the fact clinical research has been performed, a poor appreciation exists for the appropriate clinical use of sports massage. Additional studies examining the physiological and psychological effects of sports massage are necessary in order to assist the sports physical therapist in developing and implementing clinically significant evidence based programs or treatments.

Dissociated time course between peak torque and total work recovery following bench press training in resistance trained men.

PubMed

Ferreira, Diogo V; Gentil, Paulo; Ferreira-Junior, João B; Soares, Saulo R S; Brown, Lee E; Bottaro, Martim

2017-10-01

To evaluate the time course of peak torque and total work recovery after a resistance training session involving the bench press exercise. Repeated measures with a within subject design. Twenty-six resistance-trained men (age: 23.7±3.7years; height: 176.0±5.7cm; mass: 79.65±7.61kg) performed one session involving eight sets of the bench press exercise performed to momentary muscle failure with 2-min rest between sets. Shoulder horizontal adductors peak torque (PT), total work (TW), delayed onset muscle soreness (DOMS) and subjective physical fitness were measured pre, immediately post, 24, 48, 72 and 96h following exercise. The exercise protocol resulted in significant pectoralis major DOMS that lasted for 72h. Immediately after exercise, the reduction in shoulder horizontal adductors TW (25%) was greater than PT (17%). TW, as a percentage of baseline values, was also less than PT at 24, 48 and 96h after exercise. Additionally, PT returned to baseline at 96h, while TW did not. Resistance trained men presented dissimilar PT and TW recovery following free weight bench press exercise. This indicates that recovery of maximal voluntary contraction does not reflect the capability to perform multiple contractions. Strength and conditioning professionals should be cautious when evaluating muscle recovery by peak torque, since it can lead to the repetition of a training session sooner than recommended. Copyright © 2017. Published by Elsevier Inc.

Dietary Supplements for Health, Adaptation, and Recovery in Athletes.

PubMed

Rawson, Eric S; Miles, Mary P; Larson-Meyer, D Enette

2018-03-01

Some dietary supplements are recommended to athletes based on data that supports improved exercise performance. Other dietary supplements are not ergogenic per se, but may improve health, adaptation to exercise, or recovery from injury, and so could help athletes to train and/or compete more effectively. In this review, we describe several dietary supplements that may improve health, exercise adaptation, or recovery. Creatine monohydrate may improve recovery from and adaptation to intense training, recovery from periods of injury with extreme inactivity, cognitive processing, and reduce severity of or enhance recovery from mild traumatic brain injury (mTBI). Omega 3-fatty acid supplementation may also reduce severity of or enhance recovery from mTBI. Replenishment of vitamin D insufficiency or deficiency will likely improve some aspects of immune, bone, and muscle health. Probiotic supplementation can reduce the incidence, duration, and severity of upper respiratory tract infection, which may indirectly improve training or competitive performance. Preliminary data show that gelatin and/or collagen may improve connective tissue health. Some anti-inflammatory supplements, such as curcumin or tart cherry juice, may reduce inflammation and possibly delayed onset muscle soreness (DOMS). Beta-hydroxy beta-methylbutyrate (HMB) does not consistently increase strength and/or lean mass or reduce markers of muscle damage, but more research on recovery from injury that includes periods of extreme inactivity is needed. Several dietary supplements, including creatine monohydrate, omega 3-fatty acids, vitamin D, probiotics, gelatin, and curcumin/tart cherry juice could help athletes train and/or compete more effectively.

Increased xanthine oxidase-related ROS production and TRPV1 synthesis preceding DOMS post-eccentric exercise in rats.

PubMed

Retamoso, Leandro T; Silveira, Mauro E P; Lima, Frederico D; Busanello, Guilherme L; Bresciani, Guilherme; Ribeiro, Leandro R; Chagas, Pietro M; Nogueira, Cristina W; Braga, Ana Claudia M; Furian, Ana Flávia; Oliveira, Mauro S; Fighera, Michele R; Royes, Luiz Fernando F

2016-05-01

It is well-known that unaccustomed exercise, especially eccentric exercise, is associated to delayed onset muscle soreness (DOMS). Whether DOMS is associated with reactive oxygen species (ROS) and the transient receptor potential vanilloid 1 (TRPV1) is still an open question. Thus, the aim of this study was to investigate the association between TRPV1 and xanthine oxidase-related ROS production in muscle and DOMS after a bout of eccentric exercise. Male Wistar rats performed a downhill running exercise on a treadmill at a -16° tilt and a constant speed for 90min (5min/bout separated by 2min of rest). Mechanical allodynia and grip force tests were performed before and 1, 3, 6, 9, 12, 24, 48 and 72h after the downhill running. Biochemical assays probing oxidative stress, purine degradation, xanthine oxidase activity, Ca(2+) ATPase activity and TRPV1 protein content were performed in gastrocnemius muscle at 12, 24, and 48h after the downhill running. Our statistical analysis showed an increase in mechanical allodynia and a loss of strength after the downhill running. Similarly, an increase in carbonyl, xanthine oxidase activity, uric acid levels and TRPV1 immunoreactivity were found 12h post-exercise. On the other hand, Ca(2+) ATPase activity decreased in all analyzed times. Our results suggest that a possible relationship between xanthine oxidase-related ROS and TRPV1 may exist during the events preceding eccentric exercise-related DOMS. Copyright © 2016 Elsevier Inc. All rights reserved.

Velocity-specific strength recovery after a second bout of eccentric exercise.

PubMed

Barss, Trevor S; Magnus, Charlene R A; Clarke, Nick; Lanovaz, Joel L; Chilibeck, Philip D; Kontulainen, Saija A; Arnold, Bart E; Farthing, Jonathan P

2014-02-01

A bout of eccentric exercise (ECC) has the protective effect of reducing muscle damage during a subsequent bout of ECC known as the "repeated bout effect" (RBE). The purpose of this study was to determine if the RBE is greater when both bouts of ECC are performed using the same vs. different velocity of contraction. Thirty-one right-handed participants were randomly assigned to perform an initial bout of either fast (3.14 rad·s [180°·s]) or slow (0.52 rad·s [30°·s]) maximal isokinetic ECCs of the elbow flexors. Three weeks later, the participants completed another bout of ECC at the same velocity (n = 16), or at a different velocity (n = 15). Indirect muscle damage markers were measured before, immediately after, and at 24, 48, and 72 hours postexercise. Measures included maximal voluntary isometric contraction (MVC) strength (dynamometer), muscle thickness (MT; ultrasound), delayed onset muscle soreness (DOMS; visual analog scale), biceps and triceps muscle activation amplitude (electromyography), voluntary activation (interpolated twitch), and twitch torque. After the repeated bout, MVC strength recovered faster compared with the same time points after the initial bout for only the same velocity group (p = 0.017), with no differences for all the other variables. Irrespective of velocity, MT and DOMS were reduced after the repeated bout compared with that of the initial bout at 24, 48, and 72 hours with a corresponding increase in TT at 72 hours (p < 0.05). Faster recovery of isometric strength associated with a repeated bout of ECC was evident when the velocity was matched between bouts, suggesting that specificity effects contribute to the RBE. The current findings support the idea of multiple mechanisms contributing to the RBE.

Chest Press Exercises With Different Stability Requirements Result in Similar Muscle Damage Recovery in Resistance-Trained Men.

PubMed

Ferreira, Diogo V; Ferreira-Júnior, João B; Soares, Saulo R S; Cadore, Eduardo L; Izquierdo, Mikel; Brown, Lee E; Bottaro, Martim

2017-01-01

Ferreira, DV, Ferreira-Júnior, JB, Soares, SRS, Cadore, EL, Izquierdo, M, Brown, LE, and Bottaro, M. Chest press exercises with different stability requirements result in similar muscle damage recovery in resistance trained men. J Strength Cond Res 31(1): 71-79, 2017-This study investigated the time course of 96 hours of muscle recovery after 3 different chest press exercises with different stability requirements in resistance-trained men. Twenty-seven men (23.5 ± 3.8 years) were randomly assigned to one of the 3 groups: (a) Smith machine bench press; (b) barbell bench press; or (c) dumbbell bench press. Participants performed 8 sets of 10 repetition maximum with 2 minutes rest between sets. Muscle thickness, peak torque (PT), and soreness were measured pre, post, 24, 48, 72, and 96 hours after exercise. There were no differences in the time course of PT or muscle thickness values of the pectoralis major (p = 0.98 and p = 0.91, respectively) or elbow extensors (p = 0.07 and p = 0.86, respectively) between groups. Muscle soreness of the pectoralis major was also not different between groups (p > 0.05). However, the Smith machine and barbell groups recovered from triceps brachii muscle soreness by 72 hours after exercise (p > 0.05), whereas the dumbbell group did not present any triceps brachii muscle soreness after exercise (p > 0.05). In conclusion, resistance-trained men experience similar muscle damage recovery after Smith machine, barbell, and dumbbell chest press exercise. However, muscle soreness of the elbow extensors takes a longer time to recover after using a barbell chest press exercise.

Effect of bilberry juice on indices of muscle damage and inflammation in runners completing a half-marathon: a randomised, placebo-controlled trial.

PubMed

Lynn, Anthony; Garner, Samantha; Nelson, Nichola; Simper, Trevor N; Hall, Anna C; Ranchordas, Mayur K

2018-01-01

Emerging evidence indicates that fruits rich in polyphenols may attenuate exercise-induced muscle damage and associated markers of inflammation and soreness. This study was conducted to determine whether bilberry juice (BJ), which is particularly rich in polyphenols, reduces markers of muscle damage in runners completing a half marathon. A total of 21 recreationally trained runners (age 30.9 ± 10.4 y; mass 71.6 ± 11.0 kg; M = 16; F = 5) were recruited to a single blind, randomised, placebo-controlled, parallel study. Participants were block randomised to consume 2 × 200 ml of BJ or energy-matched control drink (PLA) for 5 d before the Sheffield Half Marathon, on race day, and for 2 days post-race. Measurements of delayed onset muscle soreness (DOMS), muscle damage (creatine kinase; CK) and inflammation (c-reactive protein; CRP) were taken at baseline, pre-race, post-race, 24 h post-race and 48 h post-race. The effect of treatment on outcome measures was analysed using magnitude-based inferences based on data from 19 participants; 2 participants were excluded from the analyses because they did not provide samples for all time points. The half marathon caused elevations in DOMS, CRP and CK. BJ had a possibly harmful effect on DOMS from pre-race to immediately post-race (11.6%, 90% CI ± 14.7%), a likely harmful effect on CRP from pre-race to 24 h post-race (mean difference ES 0.56, 90% CI ± 0.72) and a possibly harmful effect on CRP from pre-race to 48 h post-race (ES 0.12, 90% CI ± 0.69). At other time points, the differences between the BJ and PLA groups in DOMS and CRP were unclear, possibly trivial or likely trivial . Differences in the changes in CK between BJ and PLA were unclear at every time point other than from baseline to pre-race, where BJ had a possibly harmful effect on reducing muscle damage (ES 0.23, 90% CI ± 0.57). Despite being a rich source of antioxidant and anti-inflammatory phytochemicals, BJ evoked small to moderate increases in exercise-induced DOMS and CRP. Further larger studies are required to confirm these unexpected preliminary results.

Evaluating skeletal muscle electromechanical delay with intramuscular pressure.

PubMed

Go, Shanette A; Litchy, William J; Evertz, Loribeth Q; Kaufman, Kenton R

2018-06-08

Intramuscular pressure (IMP) is the fluid pressure generated within skeletal muscle and directly reflects individual muscle tension. The purpose of this study was to assess the development of force, IMP, and electromyography (EMG) in the tibialis anterior (TA) muscle during ramped isometric contractions and evaluate electromechanical delay (EMD). Force, EMG, and IMP were simultaneously measured during ramped isometric contractions in eight young, healthy human subjects. The EMD between the onset of force and EMG activity (Δt-EMG force) and the onset of IMP and EMG activity (Δt EMG-IMP) were calculated. A statistically significant difference (p < 0.05) was found between the mean force-EMG EMD (36 ± 31 ms) and the mean IMP-EMG EMD (3 ± 21 ms). IMP reflects changes in muscle tension due to the contractile muscle elements. Copyright © 2018 Elsevier Ltd. All rights reserved.

Flap surgery for pressure sores: should the underlying muscle be transferred or not?

PubMed

Thiessen, Filip E; Andrades, Patricio; Blondeel, Philip N; Hamdi, Moustapha; Roche, Nathalie; Stillaert, Filip; Van Landuyt, Koenraad; Monstrey, Stan

2011-01-01

Musculocutaneous flaps have become the first choice in the surgical repair of pressure sores, but the indication for including muscle in the transferred flaps still remains poorly defined. This study compares outcomes after muscle and non-muscle flap coverage of pressure sores to investigate whether it is still necessary to incorporate muscle tissue as part of the surgical treatment of these ulcers. A retrospective revision of 94 consecutive patients with ischial or sacral pressure sores operated between 1996 and 2002 was performed. Depending on the inclusion of muscle into the flap, the patients were divided in two groups: musculocutaneous flap group and fasciocutaneous flap group. Charts were reviewed for patient characteristics, ulcer features and reconstructive information. Data between groups were compared with emphasis on early (haematoma or seroma, dehiscence, infections, necrosis and secondary procedures) and late (recurrence) postoperative complications. A total of 37 wounds were covered with muscle and 57 wounds covered without muscle tissue. The groups were comparable in relation to age, gender, ulcer characteristics and timing for surgery. There were no significant differences in early complications between the study groups. The mean follow-up period was 3.10 ± 1.8 years (range: 0.5 to 6.7). There were no statistical differences in ulcer recurrence between the groups. The type of flap used was not associated with postoperative morbidity or recurrence in the univariate and multivariate analyses. The findings of this clinical study indicate that the musculocutaneous flaps are as good as fasciocutaneous flaps in the reconstruction of pressure sores, and they question the long-standing dogma that muscle is needed in the repair of these ulcers. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Walking delays anticipatory postural adjustments but not reaction times in a choice reaction task.

PubMed

Haridas, C; Gordon, I T; Misiaszek, J E

2005-06-01

During standing, anticipatory postural adjustments (APAs) and focal movements are delayed while performing a choice reaction task, compared with a simple reaction task. We hypothesized that APAs and focal movements of a choice reaction task would be similarly delayed during walking. Furthermore, reaction times are delayed during walking compared with standing. We further hypothesized that APAs and focal movements would be delayed during walking, compared with standing, for both simple and choice reaction tasks. Subjects either walked or stood on a treadmill while holding on to stable handles. They were asked to push or pull on the handles in response to a visual cue. Muscle activity was recorded from muscles of the leg (APA) and arm (RT). Our results were in agreement with previous work showing APA onset was delayed in the choice reaction task compared with the simple reaction task. In addition, the interval between the onset of APA and focal movement activity increased with choice reaction tasks. The task of walking did not delay the onset of focal movement for either the simple or choice reaction tasks. Walking did delay the onset of the APA, but only during choice reaction tasks. The results suggest the added demand of walking does not significantly modify the control of focal arm movements. However, additional attentional demands while walking may compromise anticipatory postural control.

Effects of protein supplements on muscle damage, soreness and recovery of muscle function and physical performance: a systematic review.

PubMed

Pasiakos, Stefan M; Lieberman, Harris R; McLellan, Tom M

2014-05-01

Protein supplements are frequently consumed by athletes and recreationally-active individuals, although the decision to purchase and consume protein supplements is often based on marketing claims rather than evidence-based research. To provide a systematic and comprehensive analysis of literature examining the hypothesis that protein supplements enhance recovery of muscle function and physical performance by attenuating muscle damage and soreness following a previous bout of exercise. English language articles were searched with PubMed and Google Scholar using protein and supplements together with performance, exercise, competition and muscle, alone or in combination as keywords. Inclusion criteria required studies to recruit healthy adults less than 50 years of age and to evaluate the effects of protein supplements alone or in combination with carbohydrate on performance metrics including time-to-exhaustion, time-trial or isometric or isokinetic muscle strength and markers of muscle damage and soreness. Twenty-seven articles were identified of which 18 dealt exclusively with ingestion of protein supplements to reduce muscle damage and soreness and improve recovery of muscle function following exercise, whereas the remaining 9 articles assessed muscle damage as well as performance metrics during single or repeat bouts of exercise. Papers were evaluated based on experimental design and examined for confounders that explain discrepancies between studies such as dietary control, training state of participants, sample size, direct or surrogate measures of muscle damage, and sensitivity of the performance metric. High quality and consistent data demonstrated there is no apparent relationship between recovery of muscle function and ratings of muscle soreness and surrogate markers of muscle damage when protein supplements are consumed prior to, during or after a bout of endurance or resistance exercise. There also appears to be insufficient experimental data demonstrating ingestion of a protein supplement following a bout of exercise attenuates muscle soreness and/or lowers markers of muscle damage. However, beneficial effects such as reduced muscle soreness and markers of muscle damage become more evident when supplemental protein is consumed after daily training sessions. Furthermore, the data suggest potential ergogenic effects associated with protein supplementation are greatest if participants are in negative nitrogen and/or energy balance. Small sample numbers and lack of dietary control limited the effectiveness of several investigations. In addition, studies did not measure the effects of protein supplementation on direct indices of muscle damage such as myofibrillar disruption and various measures of protein signaling indicative of a change in rates of protein synthesis and degradation. As a result, the interpretation of the data was often limited. Overwhelmingly, studies have consistently demonstrated the acute benefits of protein supplementation on post-exercise muscle anabolism, which, in theory, may facilitate the recovery of muscle function and performance. However, to date, when protein supplements are provided, acute changes in post-exercise protein synthesis and anabolic intracellular signaling have not resulted in measureable reductions in muscle damage and enhanced recovery of muscle function. Limitations in study designs together with the large variability in surrogate markers of muscle damage reduced the strength of the evidence-base.

Muscle damage and adaptation after the second bout of eccentric exercise of the knee extensors.

PubMed

Hassan, E S

2014-10-01

This study examined the muscles ability to adapt to eccentric exercise by the changes in serum myoglobin (Mb), creatine kinase (CK) activity and muscle soreness. The study involved 54 healthy young men from the 23± 2yr age group. These were distributed as subjects for three types of experiments with 18 men in each. Subjects performed 300 maximal eccentric exercises. In experiment I, after performing the first bout of exercise, they were split into three subgroups to perform the second bout after a period of 4, 6, and 8 weeks (WK), respectively. In experiment II, performed the second exercise after a period of 2, 3, and 5 wk, respectively. In experiment III, they performed four exercise bouts spaced 1 wk apart. in experiment II a significant (P<0.05) decrease in muscle soreness, serum Mb and CK was found on exercise bout 2. In experiment III, serum CK, Mb and muscle soreness responses were highest following bout 1. It was concluded that performance of a single exercise bout had a prophylactic effect on muscle soreness and serum protein responses that lasts approximately 2 wk, with the greatest adaptation occurring after one bout.

Detection of the electromechanical delay and its components during voluntary isometric contraction of the quadriceps femoris muscle.

PubMed

Begovic, Haris; Zhou, Guang-Quan; Li, Tianjie; Wang, Yi; Zheng, Yong-Ping

2014-01-01

Electromechanical delay (EMD) was described as a time elapsed between first trigger and force output. Various results have been reported based on the measurement method with observed inconsistent results when the trigger is elicited by voluntary contraction. However, mechanomyographic (MMG) sensor placed far away on the skin from the contracting muscle was used to detect muscle fiber motion and excitation-contraction (EC) coupling which may give unreliable results. On this basis, the purpose of this study was to detect EMD during active muscle contraction whilst introducing an ultrafast ultrasound (US) method to detect muscle fiber motion from a certain depth of the muscle. Time delays between onsets of EMG-MMG, EMG-US, MMG-FORCE, US-FORCE, and EMG-FORCE were calculated as 20.5 ± 4.73, 28.63 ± 6.31, 19.21 ± 6.79, 30.52 ± 8.85, and 49.73 ± 6.99 ms, respectively. Intrarater correlation coefficient (ICC) was higher than MMG when ultrafast US was used for detecton of the Δt EMG-US and Δt US-FORCE, ICC values of 0.75 and 0.70, respectively. Synchronization of the ultrafast ultrasound with EMG and FORCE sensors can reveal reliable and clinically useful results related to the EMD and its components when muscle is voluntarily contracted. With ultrafast US, we detect onset from the certain depth of the muscle excluding the tissues above the muscle acting as a low-pass filter which can lead to inaccurate time detection about the onset of the contracting muscle fibers. With this non-invasive technique, understanding of the muscle dynamics can be facilitated.

Effect of Arnica D30 in marathon runners. Pooled results from two double-blind placebo controlled studies.

PubMed

Tveiten, D; Bruset, S

2003-10-01

To examine whether the homeopathic medicine Arnica D30 has an effect on muscle soreness and cell damage after marathon running. The subjects were 82 marathon runners from two separate randomised double-blind placebo controlled trials participating in the Oslo Marathon in 1990 and 1995. Five pills of Arnica D30 or placebo were given morning and evening. Treatment started on the evening before the marathon and continued on day of the race and the three following days. The runners assessed muscular soreness on a visual analogue scale. Muscle enzymes, electrolytes and creatinine were measured before and after the marathon. Muscle soreness immediately after the marathon run was lower in the Arnica group than in the placebo group (P = 0.04). Cell damage measured by enzymes was similar in the Arnica and the placebo group. These pooled results suggest that Arnica D30 has a positive effect on muscle soreness after marathon running, but not on cell damage measured by enzymes.

Assessment of Fatigue and Recovery in Male and Female Athletes After 6 Days of Intensified Strength Training.

PubMed

Raeder, Christian; Wiewelhove, Thimo; Simola, Rauno Álvaro De Paula; Kellmann, Michael; Meyer, Tim; Pfeiffer, Mark; Ferrauti, Alexander

2016-12-01

Raeder, C, Wiewelhove, T, Simola, RÁDP, Kellmann, M, Meyer, T, Pfeiffer, M, and Ferrauti, A. Assessment of fatigue and recovery in male and female athletes after 6 days of intensified strength training. J Strength Cond Res 30(12): 3412-3427, 2016-This study aimed to analyze changes of neuromuscular, physiological, and perceptual markers for routine assessment of fatigue and recovery in high-resistance strength training. Fourteen male and 9 female athletes participated in a 6-day intensified strength training microcycle (STM) designed to purposefully overreach. Maximal dynamic strength (estimated 1 repetition maximum [1RMest]; criterion measure of fatigue and recovery); maximal voluntary isometric strength (MVIC); countermovement jump (CMJ) height; multiple rebound jump (MRJ) height; jump efficiency (reactive strength index, RSI); muscle contractile properties using tensiomyography including muscle displacement (Dm), delay time (Td), contraction time (Tc), and contraction velocity (V90); serum concentration of creatine kinase (CK); perceived muscle soreness (delayed-onset muscle soreness, DOMS) and perceived recovery (physical performance capability, PPC); and stress (MS) were measured before and after the STM and after 3 days of recovery. After completing the STM, there were significant (p ≤ 0.05) performance decreases in 1RMest (%[INCREMENT] ± 90% confidence limits, ES = effect size; -7.5 ± 3.5, ES = -0.21), MVIC (-8.2 ± 4.9, ES = -0.24), CMJ (-6.4 ± 2.1, ES = -0.34), MRJ (-10.5 ± 3.3, ES = -0.66), and RSI (-11.2 ± 3.8, ES = -0.73), as well as significantly reduced muscle contractile properties (Dm, -14.5 ± 5.3, ES = -0.60; V90, -15.5 ± 4.9, ES = -0.62). After days of recovery, a significant return to baseline values could be observed in 1RMest (4.3 ± 2.8, ES = 0.12), CMJ (5.2 ± 2.2, ES = 0.28), and MRJ (4.9 ± 3.8, ES = 0.32), whereas RSI (-7.9 ± 4.5, ES = -0.50), Dm (-14.7 ± 4.8, ES = -0.61), and V90 (-15.3 ± 4.7, ES = -0.66) remained significantly reduced. The STM also induced significant changes of large practical relevance in CK, DOMS, PPC, and MS before to after training and after the recovery period. The markers Td and Tc remained unaffected throughout the STM. Moreover, the accuracy of selected markers for assessment of fatigue and recovery in relation to 1RMest derived from a contingency table was inadequate. Correlational analyses also revealed no significant relationships between changes in 1RMest and all analyzed markers. In conclusion, mean changes of performance markers and CK, DOMS, PPC, and MS may be attributed to STM-induced fatigue and subsequent recovery. However, given the insufficient accuracy of markers for differentiation between fatigue and recovery, their potential applicability needs to be confirmed at the individual level.

Supraspinal control of automatic postural responses in people with multiple sclerosis.

PubMed

Peterson, D S; Gera, G; Horak, F B; Fling, B W

2016-06-01

The neural underpinnings of delayed automatic postural responses in people with multiple sclerosis (PwMS) are unclear. We assessed whether white matter pathways of two supraspinal regions (the cortical proprioceptive Broadman's Area-3; and the balance/locomotor-related pedunculopontine nucleus) were related to delayed postural muscle response latencies in response to external perturbations. 19 PwMS (48.8±11.4years; EDSS=3.5 (range: 2-4)) and 12 healthy adults (51.7±12.2years) underwent 20 discrete, backward translations of a support surface. Onset latency of agonist (medial-gastrocnemius) and antagonist (tibialis anterior) muscles were assessed. Diffusion tensor imaging assessed white-matter integrity (i.e. radial diffusivity) of cortical proprioceptive and balance/locomotor-related tracts. Latency of the tibialis anterior, but not medial gastrocnemius was larger in PwMS than control subjects (p=0.012 and 0.071, respectively). Radial diffusivity of balance/locomotor tracts was higher (worse) in PwMS than control subjects (p=0.004), and was significantly correlated with tibialis (p=0.002), but not gastrocnemius (p=0.06) onset latency. Diffusivity of cortical proprioceptive tracts was not correlated with muscle onset. Lesions in supraspinal structures including the pedunculopontine nucleus balance/locomotor network may contribute to delayed onset of postural muscle activity in PwMS, contributing to balance deficits in PwMS. Published by Elsevier B.V.

Muscle fascicle behavior during eccentric cycling and its relation to muscle soreness.

PubMed

Peñailillo, Luis; Blazevich, Anthony J; Nosaka, Kazunori

2015-04-01

A single bout of eccentric exercise confers a protective effect against muscle damage and soreness in subsequent eccentric exercise bouts, but the mechanisms underpinning this effect are unclear. This study compared vastus lateralis (VL) muscle-tendon behavior between two eccentric cycling bouts to test the hypothesis that muscle-tendon behavior would be different between bouts and would be associated with the protective effect. Eleven untrained men (27.1 ± 7.0 yr) performed two bouts of eccentric cycling (ECC1 and ECC2) separated by 2 wk for 10 min at 65% of maximal concentric workload (191.9 ± 44.2 W) each. Muscle soreness (by visual analog scale) and maximal voluntary isometric contraction (MVC) torque of the knee extensors were assessed before and 1-2 d after exercise. Using ultrasonography, VL fascicle length and angle changes during cycling were assessed, and tendinous tissue (TT) length changes were estimated. VL EMG amplitude, crank torque, and knee joint angles were measured during cycling. Soreness was greater (P < 0.0001) after ECC1 than ECC2, although MVC changes were not different between bouts (P = 0.47). No significant differences in peak EMG amplitude (normalized to EMG during MVC), crank peak torque, or knee angles were evident between bouts. However, fascicle elongation was 16% less during ECC2 than ECC1 (P < 0.01), indicating less fascicle strain in ECC2. Maximum TT length occurred at a smaller knee joint angle during ECC2 than ECC1 (P = 0.055). These results suggest that a lesser fascicle elongation and earlier TT elongation were associated with reduced muscle soreness after ECC2 than ECC1; thus, changes in muscle-tendon behavior may be an important mechanism underpinning the protective effect.

Clinical score and rapid antigen detection test to guide antibiotic use for sore throats: randomised controlled trial of PRISM (primary care streptococcal management).

PubMed

Little, Paul; Hobbs, F D Richard; Moore, Michael; Mant, David; Williamson, Ian; McNulty, Cliodna; Cheng, Ying Edith; Leydon, Geraldine; McManus, Richard; Kelly, Joanne; Barnett, Jane; Glasziou, Paul; Mullee, Mark

2013-10-10

To determine the effect of clinical scores that predict streptococcal infection or rapid streptococcal antigen detection tests compared with delayed antibiotic prescribing. Open adaptive pragmatic parallel group randomised controlled trial. Primary care in United Kingdom. Patients aged ≥ 3 with acute sore throat. An internet programme randomised patients to targeted antibiotic use according to: delayed antibiotics (the comparator group for analyses), clinical score, or antigen test used according to clinical score. During the trial a preliminary streptococcal score (score 1, n=1129) was replaced by a more consistent score (score 2, n=631; features: fever during previous 24 hours; purulence; attends rapidly (within three days after onset of symptoms); inflamed tonsils; no cough/coryza (acronym FeverPAIN). Symptom severity reported by patients on a 7 point Likert scale (mean severity of sore throat/difficulty swallowing for days two to four after the consultation (primary outcome)), duration of symptoms, use of antibiotics. For score 1 there were no significant differences between groups. For score 2, symptom severity was documented in 80% (168/207 (81%) in delayed antibiotics group; 168/211 (80%) in clinical score group; 166/213 (78%) in antigen test group). Reported severity of symptoms was lower in the clinical score group (-0.33, 95% confidence interval -0.64 to -0.02; P=0.04), equivalent to one in three rating sore throat a slight versus moderate problem, with a similar reduction for the antigen test group (-0.30, -0.61 to -0.00; P=0.05). Symptoms rated moderately bad or worse resolved significantly faster in the clinical score group (hazard ratio 1.30, 95% confidence interval 1.03 to 1.63) but not the antigen test group (1.11, 0.88 to 1.40). In the delayed antibiotics group, 75/164 (46%) used antibiotics. Use of antibiotics in the clinical score group (60/161) was 29% lower (adjusted risk ratio 0.71, 95% confidence interval 0.50 to 0.95; P=0.02) and in the antigen test group (58/164) was 27% lower (0.73, 0.52 to 0.98; P=0.03). There were no significant differences in complications or reconsultations. Targeted use of antibiotics for acute sore throat with a clinical score improves reported symptoms and reduces antibiotic use. Antigen tests used according to a clinical score provide similar benefits but with no clear advantages over a clinical score alone. ISRCTN32027234.

Comparison of between-training-sessions recovery strategies for world-class BMX pilots.

PubMed

Marquet, Laurie-Anne; Hausswirth, Christophe; Hays, Arnaud; Vettoretti, Fabrice; Brisswalter, Jeanick

2015-03-01

To assess the impact of between-training-sessions recovery strategies (passive [PAS], active [ACT], cold-water immersion [CWI], and ingestion of a recovery drink [NUTR]) on maximal cycling performance, perceptions of delayed-onset muscle soreness (DOMS), and fatigue in world-class BMX riders. Eleven elite BMX athletes, members of the French national team (top country in the 2011 international ranking, 4 medals at the 2012 World Championships, top European country), participated in the study, which involved standardized training periods. Athletes performed 3 maximal-sprint power tests: the first day of the week before the training session and before and after training on the third day of the week (D3). The recovery strategy was randomly assigned to each participant on day 2 immediately after the last training period of the day. Perceptions of DOMS and general fatigue were recorded on D3. After training on D3, the decrease in maximal-sprint power (Pmax) was significantly greater for PAS than with CWI (P=.02) and NUTR (P=.018). Similar results were found with ACT (vs CWI P=.044, and vs NUTR P=.042). Self-reported DOMS and fatigue were significantly greater after PAS than after other strategies. For elite BMX riders, between training days, nutritional and/or CWI recovery strategies appear to be best for reducing muscle fatigue and increasing the capacity to withstand the training schedule.

The effects of grounding (earthing) on inflammation, the immune response, wound healing, and prevention and treatment of chronic inflammatory and autoimmune diseases

PubMed Central

Oschman, James L; Chevalier, Gaétan; Brown, Richard

2015-01-01

Multi-disciplinary research has revealed that electrically conductive contact of the human body with the surface of the Earth (grounding or earthing) produces intriguing effects on physiology and health. Such effects relate to inflammation, immune responses, wound healing, and prevention and treatment of chronic inflammatory and autoimmune diseases. The purpose of this report is two-fold: to 1) inform researchers about what appears to be a new perspective to the study of inflammation, and 2) alert researchers that the length of time and degree (resistance to ground) of grounding of experimental animals is an important but usually overlooked factor that can influence outcomes of studies of inflammation, wound healing, and tumorigenesis. Specifically, grounding an organism produces measurable differences in the concentrations of white blood cells, cytokines, and other molecules involved in the inflammatory response. We present several hypotheses to explain observed effects, based on current research results and our understanding of the electronic aspects of cell and tissue physiology, cell biology, biophysics, and biochemistry. An experimental injury to muscles, known as delayed onset muscle soreness, has been used to monitor the immune response under grounded versus ungrounded conditions. Grounding reduces pain and alters the numbers of circulating neutrophils and lymphocytes, and also affects various circulating chemical factors related to inflammation. PMID:25848315

Moderate Load Eccentric Exercise; A Distinct Novel Training Modality

PubMed Central

Hoppeler, Hans

2016-01-01

Over the last 20 years a number of studies have been published using progressive eccentric exercise protocols on motorized ergometers or similar devices that allow for controlled application of eccentric loads. Exercise protocols ramp eccentric loads over an initial 3 weeks period in order to prevent muscle damage and delayed onset muscle soreness. Final training loads reach 400–500 W in rehabilitative settings and over 1200 W in elite athletes. Training is typically carried out three times per week for durations of 20–30 min. This type of training has been characterizes as moderate load eccentric exercise. It has also been denoted RENEW (Resistance Exercise via Negative Eccentric Work by LaStayo et al., 2014). It is distinct from plyometric exercises (i.e., drop jumps) that impose muscle loads of several thousand Watts on muscles and tendons. It is also distinct from eccentric overload training whereby loads in a conventional strength training setting are increased in the eccentric phase of the movement to match concentric loads. Moderate load eccentric exercise (or RENEW) has been shown to be similarly effective as conventional strength training in increasing muscle strength and muscle volume. However, as carried out at higher angular velocities of joint movement, it reduces joint loads. A hallmark of moderate load eccentric exercise is the fact that the energy requirements are typically 4-fold smaller than in concentric exercise of the same load. This makes moderate load eccentric exercise training the tool of choice in medical conditions with limitations in muscle energy supply. The use and effectiveness of moderate load eccentric exercise has been demonstrated mostly in small scale studies for cardiorespiratory conditions, sarcopenia of old age, cancer, diabetes type 2, and neurological conditions. It has also been used effectively in the prevention and rehabilitation of injuries of the locomotor system in particular the rehabilitation after anterior cruciate ligament surgery. PMID:27899894

Vascular delay of the latissimus dorsi muscle: an essential component of cardiomyoplasty.

PubMed

Carroll, S M; Carroll, C M; Stremel, R W; Heilman, S J; Tobin, G R; Barker, J H

1997-04-01

Cardiomyoplasty (CMP) uses the latissimus dorsi muscle (LDM) to assist the heart in cases of cardiac failure. Distal ischemia and necrosis of the LDM is a recognized complication of CMP that can reduce distal muscle function and the mechanical effectiveness of CMP. Canine (n = 9) LDMs were subjected to a 10-day period of vascular delay followed by a simulated CMP. Two weeks after simulated CMP (corresponding to the healing delay between CMP and the onset of LDM stimulation used in the clinical setting), LDM perfusion was measured in the distal, middle, and proximal segments of the muscle, and circumferential (distal and middle squeezing muscle function) and longitudinal (proximal pulling muscle function) force generation and fatigue rates were measured. The results were compared with the contralateral nondelayed simulated CMP. Muscle perfusion was significantly (p < 0.05) greater in the distal and middle segments of vascular-delayed LDMs. Circumferential muscle force generation and fatigue rates were significantly (p < 0.05) improved in the vascular-delayed LDMs. Vascular delay can significantly improve LDM perfusion and function in a model that closely reflects clinical CMP, and the use of vascular delay may improve clinical outcomes in CMP.

Pressure sores and hip fractures.

PubMed

Haleem, S; Heinert, G; Parker, M J

2008-02-01

Development of pressure sores during hospital admission causes morbidity and distress to the patient, increases strain on nursing resources, delaying discharge and possibly increasing mortality. A hip fracture in elderly patients is a known high-risk factor for development of pressure sores. We aimed to determine the current incidence of pressure sores and identify those factors which were associated with an increased risk of pressure sores. We retrospectively analysed prospectively collected data of 4654 consecutive patients admitted to a single unit. One hundred and seventy-eight (3.8%) of our patients developed pressure sores. Patient factors that increased the risk of pressure sores were increased age, diabetes mellitus, a lower mental test score, a lower mobility score, a higher ASA score, lower admission haemoglobin and an intra-operative drop in blood pressure. The risk was higher in patients with an extracapsular neck of femur fracture and patients with an increased time interval between admission to hospital and surgery. Our studies indicate that while co-morbidities constitute a substantial risk in an elderly population, the increase in incidence of pressure sores can be reduced by minimising delays to surgery.

Neuromotor control of gluteal muscles in runners with achilles tendinopathy.

PubMed

Franettovich Smith, Melinda M; Honeywill, Conor; Wyndow, Narelle; Crossley, Kay M; Creaby, Mark W

2014-03-01

The purpose of this study was to compare the neuromotor control of the gluteus medius (GMED) and gluteus maximus (GMAX) muscles in runners with Achilles tendinopathy to that of healthy controls. Fourteen male runners with Achilles tendinopathy and 19 healthy male runners (control) ran overground while EMG of GMED and GMAX was recorded. Three temporal variables were identified via visual inspection of EMG data: (i) onset of muscle activity (onset), (ii) offset of muscle activity (offset), and (iii) duration of muscle activity (duration). A multivariate analysis of covariance with between-subject factor of group (Achilles tendinopathy, control) and variables of onset, offset, and duration was performed for each muscle. Age, weight, and height were included as covariates, and α level was set at 0.05. The Achilles tendinopathy group demonstrated a delay in the activation of the GMED relative to heel strike (P < 0.001) and a shorter duration of activation (P < 0.001) compared to that of the control group. GMED offset time relative to heel strike was not different between the groups (P = 0.063). For GMAX, the Achilles tendinopathy group demonstrated a delay in its onset (P = 0.008), a shorter duration of activation (P = 0.002), and earlier offset (P < 0.001) compared to the control group. This study provides preliminary evidence of altered neuromotor control of the GMED and GMAX muscles in male runners with Achilles tendinopathy. Although further prospective studies are required to discern the causal nature of this relationship, this study highlights the importance of considering neuromotor control of the gluteal muscles in the assessment and management of patients with Achilles tendinopathy.

The Role of Massage in Sports Performance and Rehabilitation: Current Evidence and Future Direction

PubMed Central

2008-01-01

Background Massage is a popular treatment choice of athletes, coaches, and sports physical therapists. Despite its purported benefits and frequent use, evidence demonstrating its efficacy is scarce. Purpose To identify current literature relating to sports massage and its role in effecting an athlete's psychological readiness, in enhancing sports performance, in recovery from exercise and competition, and in the treatment of sports related musculoskeletal injuries. Methods Electronic databases were used to identify papers relevant to this review. The following keywords were searched: massage, sports injuries, athletic injuries, physical therapy, rehabilitation, delayed onset muscle soreness, sports psychology, sports performance, sports massage, sports recovery, soft tissue mobilization, deep transverse friction massage, pre-event, and post exercise. Results Research studies pertaining to the following general categories were identified and reviewed: pre-event (physiological and psychological variables), sports performance, recovery, and rehabilitation. Discussion Despite the fact clinical research has been performed, a poor appreciation exists for the appropriate clinical use of sports massage. Conclusion Additional studies examining the physiological and psychological effects of sports massage are necessary in order to assist the sports physical therapist in developing and implementing clinically significant evidence based programs or treatments. PMID:21509135

Evaluating the influence of massage on leg strength, swelling, and pain following a half-marathon.

PubMed

Dawson, Lance G; Dawson, Kimberley A; Tiidus, Peter M

2004-11-01

Massage therapy is commonly used following endurance running races with the expectation that it will enhance post-run recovery of muscle function and reduce soreness. A limited number of studies have reported little or no influence of massage therapy on post-exercise muscle recovery. However, no studies have been conducted in a field setting to assess the potential for massage to influence muscle recovery following an actual endurance running race. To evaluate the potential for repeated massage therapy interventions to influence recovery of quadriceps and hamstring muscle soreness, recovery of quadriceps and hamstring muscle strength and reduction of upper leg muscle swelling over a two week recovery period following an actual road running race. Twelve adult recreational runners (8 male, 4 female) completed a half marathon (21.1 km) road race. On days 1,4, 8, and 11 post-race, subjects received 30 minutes of standardized massage therapy performed by a registered massage therapist on a randomly assigned massage treatment leg, while the other (control) leg received no massage treatment. Two days prior to the race (baseline) and preceding the treatments on post-race days 1, 4, 8, and 11 the following measures were conducted on each of the massage and control legs: strength of quadriceps and hamstring muscles, leg swelling, and soreness perception. At day 1, post-race quadriceps peak torque was significantly reduced (p < 0.05), and soreness and leg circumference significantly elevated (p < 0.05) relative to pre-race values with no difference between legs. This suggested that exercise-induced muscle disruption did occur. Comparing the rate of return to baseline measures between the massaged and control legs, revealed no significant differences (p > 0.05). All measures had returned to baseline at day 11. Massage did not affect the recovery of muscles in terms of physiological measures of strength, swelling, or soreness. However, questionnaires revealed that 7 of the 12 participants perceived that the massaged leg felt better upon recovery. Key PointsMassage does not appear to affect physiological indices of muscle recovery post exercise.Massage does appear to positively influence perceptions of recovery.More research needs to be completed on the purported benefits of massage.

A randomised trial comparing the efficacy and safety of topical ketoprofen in Transfersome(®) gel (IDEA-033) with oral ketoprofen and drug-free ultra-deformable Sequessome™ vesicles (TDT 064) for the treatment of muscle soreness following exercise.

PubMed

Seidel, Egbert J; Rother, Matthias; Regenspurger, Katja; Rother, Ilka

2016-01-01

We compared the effectiveness of topical ketoprofen in Transfersome(®) gel (IDEA-033) with oral ketoprofen and drug-free Sequessome™ vesicles (FLEXISEQ(®) Sport; TDT 064) in reducing calf muscle soreness. One hundred and sixty eight healthy individuals with a pain score ≥ 3 (10-point scale) 12-16 h post-exercise (walking down stairs with an altitude of 300-400 m) were randomised to receive IDEA-033 plus oral placebo (two dose groups), oral ketoprofen plus TDT 064, or TDT 064 plus oral placebo. The primary endpoint was muscle soreness reduction from pre-dosing to Day 7. Higher pain scores were recorded with oral ketoprofen plus TDT 064 (mean ± s 462.4 ± 160.4) versus IDEA-033 plus oral placebo (434.7 ± 190.8; P = 0.2931) or TDT 064 plus oral placebo (376.2 ± 159.1; P = 0.0240) in the 7 days post-exercise. Recovery from muscle soreness was longer with oral ketoprofen plus TDT 064 (mean 91.0 ± 19.5 h) versus IDEA-033 plus placebo (mean 81.4 ± 22.9 h; P = 0.5964) or TDT 064 plus placebo (mean 78.9 ± 22.8 h; P = 0.0262). In conclusion, ultradeformable phospholipid vesicles ± ketoprofen did not retard recovery from muscle soreness. TDT 064 improves osteoarthritis-related pain and could be of interest as a treatment for joint pain during and post-exercise.

The effect of kinesio taping versus stretching techniques on muscle soreness, and flexibility during recovery from nordic hamstring exercise.

PubMed

Ozmen, Tarik; Yagmur Gunes, Gokce; Dogan, Hanife; Ucar, Ilyas; Willems, Mark

2017-01-01

The purpose of this study was to examine the effects of static stretching, proprioceptive neuromuscular facilitation (PNF) stretching, or kinesio taping (KT) on muscle soreness and flexibility during recovery from exercise. Sixty-five females were randomly assigned to four groups: PNF stretching (n = 15), static stretching (n = 16), KT (n = 17), and control (n = 17). All participants performed nordic hamstring exercise (5 sets of 8 repetitions). In all groups, hamstring flexibility at 24 h and 48 h was not changed from baseline (p > .05). The muscle soreness was measured higher at 48 h post-exercise compared with baseline in the control group (p = .04) and at 24 h post-exercise compared with baseline in the PNF group (p < .01). No significant differences were found for intervention groups compared with control group in all measurements (p > .05). The KT application and pre-exercise stretching have no contribute to flexibility at 24 h and 48 h after exercise, but may attenuate muscle soreness. Copyright © 2016 Elsevier Ltd. All rights reserved.

Vibration Therapy Is No More Effective Than the Standard Practice of Massage and Stretching for Promoting Recovery From Muscle Damage After Eccentric Exercise.

PubMed

Fuller, Joel T; Thomson, Rebecca L; Howe, Peter R C; Buckley, Jonathan D

2015-07-01

The purpose of this study was to determine if vibration therapy is more effective than the standard treatment of stretching and massage for improving recovery of muscle strength and reducing muscle soreness after muscle damage induced by eccentric exercise. A randomized, single-blinded parallel intervention trial design was used. Research laboratory. Fifty untrained men aged 18 to 30 years completed the study. Participants performed 100 maximal eccentric muscle actions (ECCmax) of the right knee extensor muscles. For the next 7 days, 25 participants applied cycloidal vibration therapy to the knee extensors twice daily and 25 participants performed stretching and sports massage (SSM) twice daily. Changes in markers of muscle damage [peak isometric torque (PIT), serum creatine kinase (CK), and serum myoglobin (Mb)], muscle soreness (visual analog scale), and inflammation [serum C-reactive protein (CRP)] were assessed. After ECCmax, there was no difference in recovery of PIT and muscle soreness or serum CK, Mb, and CRP levels between vibration and SSM groups (P > 0.28). Cycloidal vibration therapy is no more effective than the standard practice of stretching and massage to promote muscle recovery after the performance of muscle-damaging exercise. Prescription of vibration therapy after maximal exercise involving eccentric muscle damage did not alleviate signs and symptoms of muscle damage faster than the standard prescription of stretching and massage.

Changes in the electromechanical delay components during a fatiguing stimulation in human skeletal muscle: an EMG, MMG and force combined approach.

PubMed

Cè, Emiliano; Rampichini, Susanna; Monti, Elena; Venturelli, Massimo; Limonta, Eloisa; Esposito, Fabio

2017-01-01

Peripheral fatigue involves electrochemical and mechanical mechanisms. An electromyographic, mechanomyographic and force combined approach may permit a kinetic evaluation of the changes at the synaptic, skeletal muscle fiber, and muscle-tendon unit level during a fatiguing stimulation. Surface electromyogram, mechanomyogram, force and stimulation current were detected from the gastrocnemius medialis muscle in twenty male participants during a fatiguing stimulation (twelve blocks of 35 Hz stimulations, duty cycle 9 s on/1 s off, duration 120 s). The total electromechanical delay and its three components (between stimulation current and electromyogram, synaptic component; between electromyogram and mechanomyogram signal onset, muscle fiber electrochemical component, and between mechanomyogram and force signal onset, mechanical component) were calculated. Interday reliability and sensitivity were determined. After fatigue, peak force decreased by 48% (P < 0.05) and the total electromechanical delay and its synaptic, electrochemical and mechanical components lengthened from 25.8 ± 0.9, 1.47 ± 0.04, 11.2 ± 0.6, and 13.1 ± 1.3 ms to 29.0 ± 1.6, 1.56 ± 0.05, 12.4 ± 0.9, and 17.2 ± 0.6 ms, respectively (P < 0.05). During fatigue, the total electromechanical delay and the mechanical component increased significantly after the 40th second, and then remained stable. The synaptic and electrochemical components lengthened significantly after the 20th and 30th second, respectively. Interday reliability was high to very high, with an adequate level of sensitivity. The kinetic evaluation of the delays during the fatiguing stimulation highlighted different onsets and kinetics, with the events at synaptic level being the first to reveal a significant elongation, followed by those at the intra-fiber level. The mechanical events, which were the most affected by fatigue, were the last to lengthen.

What is the ideal dose and power output of low-level laser therapy (810 nm) on muscle performance and post-exercise recovery? Study protocol for a double-blind, randomized, placebo-controlled trial.

PubMed

de Oliveira, Adriano Rodrigues; Vanin, Adriane Aver; De Marchi, Thiago; Antonialli, Fernanda Colella; Grandinetti, Vanessa dos Santos; de Paiva, Paulo Roberto Vicente; Albuquerque Pontes, Gianna Móes; Santos, Larissa Aline; Aleixo Junior, Ivo de Oliveira; de Carvalho, Paulo de Tarso Camillo; Bjordal, Jan Magnus; Leal-Junior, Ernesto Cesar Pinto

2014-02-27

Recent studies involving phototherapy applied prior to exercise have demonstrated positive results regarding the attenuation of muscle fatigue and the expression of biochemical markers associated with recovery. However, a number of factors remain unknown, such as the ideal dose and application parameters, mechanisms of action and long-term effects on muscle recovery. The aims of the proposed project are to evaluate the long-term effects of low-level laser therapy on post-exercise musculoskeletal recovery and identify the best dose andapplication power/irradiation time. A double-blind, randomized, placebo-controlled clinical trial with be conducted. After fulfilling the eligibility criteria, 28 high-performance athletes will be allocated to four groups of seven volunteers each. In phase 1, the laser power will be 200 mW and different doses will be tested: Group A (2 J), Group B (6 J), Group C (10 J) and Group D (0 J). In phase 2, the best dose obtained in phase 1 will be used with the same distribution of the volunteers, but with different powers: Group A (100 mW), Group B (200 mW), Group C (400 mW) and Group D (0 mW). The isokinetic test will be performed based on maximum voluntary contraction prior to the application of the laser and after the eccentric contraction protocol, which will also be performed using the isokinetic dynamometer. The following variables related to physical performance will be analyzed: peak torque/maximum voluntary contraction, delayed onset muscle soreness (algometer), biochemical markers of muscle damage, inflammation and oxidative stress. Our intention, is to determine optimal laser therapy application parameters capable of slowing down the physiological muscle fatigue process, reducing injuries or micro-injuries in skeletal muscle stemming from physical exertion and accelerating post-exercise muscle recovery. We believe that, unlike drug therapy, LLLT has a biphasic dose-response pattern. The protocol for this study is registered with the Protocol Registry System, ClinicalTrials.gov identifier NCT01844271.

The Influence of Oral L-Glutamine Supplementation on Muscle Strength Recovery and Soreness Following Unilateral Knee Extension Eccentric Exercise.

PubMed

Legault, Zachary; Bagnall, Nicholas; Kimmerly, Derek S

2015-10-01

The study aimed to examine the effects that L-glutamine supplementation has on quadriceps muscle strength and soreness ratings following eccentric exercise. It was hypothesized that glutamine ingestion would quicken the recovery rate of peak force production and decrease muscle soreness ratings over a 72-hr recovery period. Sixteen healthy participants (8♀/8♂; 22 ± 4 years) volunteered in a double-blind, randomized, placebo-controlled crossover study. Supplement conditions consisted of isoenergetic placebo (maltodextrin, 0.6 g·kg-1·day-1) and L-glutamine (0.3 g·kg-1·day-1 + 0.3 g·kg-1·day-1 maltodextrin) ingestion once per day over 72 hr. Knee extensor peak torque at 0°, 30°, and 180° per second and muscle soreness were measured before, immediately following, 24, 48, and 72 hr posteccentric exercise. Eccentric exercise consisted of 8 sets (10 repetitions/set) of unilateral knee extension at 125% maximum concentric force with 2-min rest intervals. L-glutamine resulted in greater relative peak torque at 180°/sec both immediately after (71 ± 8% vs. 66 ± 9%), and 72 hr (91 ± 8% vs. 86 ± 7%) postexercise (all, p < .01). In men, L-glutamine produced greater (p < .01) peak torques at 30°/ sec postexercise. Men also produced greater normalized peak torques at 30°/sec (Nm/kg) in the L-glutamine condition than women (all, p < .05). In the entire sample, L-glutamine resulted in lower soreness ratings at 24 (2.8 ± 1.2 vs. 3.4 ± 1.2), 48 (2.6 ± 1.4 vs. 3.9 ± 1.2), and 72 (1.7 ± 1.2 vs. 2.9 ± 1.3) hr postexercise (p < .01). The L-glutamine supplementation resulted in faster recovery of peak torque and diminished muscle soreness following eccentric exercise. The effect of L-glutamine on muscle force recovery may be greater in men than women.

Muscle damage and repeated bout effect induced by enhanced eccentric squats.

PubMed

Coratella, Giuseppe; Chemello, Alessandro; Schena, Federico

2016-12-01

Muscle damage and repeated bout effect have been studied after pure eccentric-only exercise. The aim of this study was to evaluate muscle damage and repeated bout effect induced by enhanced eccentric squat exercise using flywheel device. Thirteen healthy males volunteered for this study. Creatine kinase blood activity (CK), quadriceps isometric peak torque and muscle soreness were used as markers of muscle damage. The dependent parameters were measured at baseline, immediately after and each day up to 96 hours after the exercise session. The intervention consisted of 100 repetitions of enhanced eccentric squat exercise using flywheel device. The same protocol was repeated after 4 weeks. After the first bout, CK and muscle soreness were significantly greater (P<0.05) than baseline respectively up to 72 and 96 hours. Isometric peak torque was significantly lower (P<0.05) up to 72 hours. After the second bout, CK showed no significant increase (P>0.05), while isometric peak torque and muscle soreness returned to values similar to baseline after respectively 48 and 72 hours. All muscle damage markers were significantly lower after second compared to first bout. The enhanced eccentric exercise induced symptoms of muscle damage up to 96 hours. However, it provided muscle protection after the second bout, performed four weeks later. Although it was not eccentric-only exercise, the enhancement of eccentric phase provided muscle protection.

Static stretching does not enhance recovery in elite youth soccer players

PubMed Central

Pooley, Sam; Spendiff, Owen; Allen, Matt; Moir, Hannah J

2017-01-01

Background Static stretching (SS) is a recovery intervention used for the reduction of muscle soreness postexercise. The effects of SS on elite young footballers have received little attention, and therefore the aim of this study was to assess the effects of SS on muscle recovery following competitive soccer matches in elite young footballers. Methods Ten male participants (16±1 years) were recruited from an English Premier League professional soccer academy. Using a controlled crossover design, participants followed one of two recovery interventions (SS or passive recovery (PR)) immediately following completion of competitive soccer matches. Muscle oedema, creatine kinase (CK), countermovement jump with arms (CMJA) performance and perceived muscle soreness were assessed before, immediately after and 48 hours postmatch. Results Competitive soccer matches significantly induced muscle damage, with time intervals of perceived soreness and CK showing significant increases (p<0.05), and CMJA showing significant decreases between prematch, postmatch and 48 hours postmatch for both SS and PR (p<0.05). Comparisons of the absolute effects of SS with PR only revealed significant decreases for CK 48 hours postmatch (p<0.05) as a result of SS intervention. Conclusion The current study demonstrated competitive soccer matches induced muscle damage, which may have detrimental effects on future performance within 24–48 hours postmatch. Furthermore, there was limited evidence to suggest SS would assist in the reduction of muscle soreness postexercise. Therefore, it can be argued that SS is not a beneficial recovery option for elite youth soccer players. PMID:28761702

The natural history of community-acquired common colds symptoms assessed over 4-years.

PubMed

Witek, Theodore J; Ramsey, David L; Carr, Andrew N; Riker, Donald K

2015-03-01

The common cold is the most frequently experienced infection among humans, but limited data exist to characterize the onset, duration, severity and intersection of symptoms in community-acquired colds. A more complete understanding of the symptom frequency and burden in naturally occurring colds is needed. We characterized common cold symptoms from 226 cold episodes experienced by 104 male or female subjects. Subjects were enrolled in the work environment in an attempt to start symptom evaluation (frequency and severity) at the earliest sign of their cold. We also assessed the symptom that had the greatest impact on the subject by asking them to identify their single most bothersome symptom. Symptom reporting started within 24 hours of cold onset for most subjects. Sore throat was a harbinger of the illness but was accompanied by multiple symptoms, including nasal congestion, runny nose and headache. Cough was not usually the most frequent symptom, but was present throughout the cold, becoming most bothersome later in the cold. Nasal congestion, pain (eg, sore throat, headache, muscle pains) or feverishness and secretory symptoms (eg, runny nose, sneezing), and even cough, were simultaneously experienced with high incidence over the first 4 days of illness. The single most bothersome symptom was sore throat on day 1, followed by nasal congestion on days 2-5 and cough on days 6 and 7. There is substantial overlap in the appearance of common cold symptoms over the first several days of the common cold. Nasal congestion, secretory and pain symptoms frequently occur together, with cough being somewhat less prominent, but quite bothersome when present. These data establish the typical symptomatology of a common cold and provide a foundation for the rational treatment of cold symptoms typically experienced by cold sufferers.

Prolonged Reduction in Shoulder Strength after Transcutaneous Electrical Nerve Stimulation Treatment of Exercise-Induced Acute Muscle Pain.

PubMed

Butera, Katie A; George, Steven Z; Borsa, Paul A; Dover, Geoffrey C

2018-03-05

Transcutaneous electrical nerve stimulation (TENS) is commonly used for reducing musculoskeletal pain to improve function. However, peripheral nerve stimulation using TENS can alter muscle motor output. Few studies examine motor outcomes following TENS in a human pain model. Therefore, this study investigated the influence of TENS sensory stimulation primarily on motor output (strength) and secondarily on pain and disability following exercise-induced delayed-onset muscle soreness (DOMS). Thirty-six participants were randomized to a TENS treatment, TENS placebo, or control group after completing a standardized DOMS protocol. Measures included shoulder strength, pain, mechanical pain sensitivity, and disability. TENS treatment and TENS placebo groups received 90 minutes of active or sham treatment 24, 48, and 72 hours post-DOMS. All participants were assessed daily. A repeated measures analysis of variance and post-hoc analysis indicated that, compared to the control group, strength remained reduced in the TENS treatment group (48 hours post-DOMS, P < 0.05) and TENS placebo group (48 hours post-DOMS, P < 0.05; 72 hours post-DOMS, P < 0.05). A mixed-linear modeling analysis was conducted to examine the strength (motor) change. Randomization group explained 5.6% of between-subject strength variance (P < 0.05). Independent of randomization group, pain explained 8.9% of within-subject strength variance and disability explained 3.3% of between-subject strength variance (both P < 0.05). While active and placebo TENS resulted in prolonged strength inhibition, the results were nonsignificant for pain. Results indicated that higher pain and higher disability were independently related to decreased strength. Regardless of the impact on pain, TENS, or even the perception of TENS, may act as a nocebo for motor output. © 2018 World Institute of Pain.

Using recovery modalities between training sessions in elite athletes: does it help?

PubMed

Barnett, Anthony

2006-01-01

Achieving an appropriate balance between training and competition stresses and recovery is important in maximising the performance of athletes. A wide range of recovery modalities are now used as integral parts of the training programmes of elite athletes to help attain this balance. This review examined the evidence available as to the efficacy of these recovery modalities in enhancing between-training session recovery in elite athletes. Recovery modalities have largely been investigated with regard to their ability to enhance the rate of blood lactate removal following high-intensity exercise or to reduce the severity and duration of exercise-induced muscle injury and delayed onset muscle soreness (DOMS). Neither of these reflects the circumstances of between-training session recovery in elite athletes. After high-intensity exercise, rest alone will return blood lactate to baseline levels well within the normal time period between the training sessions of athletes. The majority of studies examining exercise-induced muscle injury and DOMS have used untrained subjects undertaking large amounts of unfamiliar eccentric exercise. This model is unlikely to closely reflect the circumstances of elite athletes. Even without considering the above limitations, there is no substantial scientific evidence to support the use of the recovery modalities reviewed to enhance the between-training session recovery of elite athletes. Modalities reviewed were massage, active recovery, cryotherapy, contrast temperature water immersion therapy, hyperbaric oxygen therapy, nonsteroidal anti-inflammatory drugs, compression garments, stretching, electromyostimulation and combination modalities. Experimental models designed to reflect the circumstances of elite athletes are needed to further investigate the efficacy of various recovery modalities for elite athletes. Other potentially important factors associated with recovery, such as the rate of post-exercise glycogen synthesis and the role of inflammation in the recovery and adaptation process, also need to be considered in this future assessment.

Matching initial torque with different stimulation parameters influences skeletal muscle fatigue.

PubMed

Bickel, C Scott; Gregory, Chris M; Azuero, Andres

2012-01-01

A fundamental barrier to using electrical stimulation in the clinical setting is an inability to maintain torque production secondary to muscle fatigue. Electrical stimulation parameters are manipulated to influence muscle torque production, and they may also influence fatigability during repetitive stimulation. Our purpose was to determine the response of the quadriceps femoris to three different fatigue protocols using the same initial torque obtained by altering stimulator parameter settings. Participants underwent fatigue protocols in which either pulse frequency (lowHz), pulse duration (lowPD), or voltage (lowV) was manipulated to obtain an initial torque that equaled 25% of maximum voluntary isometric contraction. Muscle soreness was reported on a visual analog scale 48 h after each fatigue test. The lowHz protocol resulted in the least fatigue (25% +/- 14%); the lowPD (50% +/- 13%) and lowV (48% +/- 14%) protocols had similar levels of fatigue. The lowHz protocol resulted in significantly less muscle soreness than the higher frequency protocols. Stimulation protocols that use a lower frequency coupled with long pulse durations and high voltages result in lesser amounts of muscle fatigue and perceived soreness. The identification of optimal stimulation patterns to maximize muscle performance will reduce the effect of muscle fatigue and potentially improve clinical efficacy.

CHANGES IN MUSCLE DAMAGE MARKERS IN FEMALE BASKETBALL PLAYERS

PubMed Central

Moreira, A.; Nosaka, K.; Nunes, J.A.; Viveiros, L.; Jamurtas, A.Z.

2014-01-01

The aim of the present study was to investigate changes in muscle soreness, blood muscle damage markers, muscle strength and agility following an official basketball match. Eleven elite female professional basketball players (27.4 ± 4.8 years, 179.5 ± 5.5 cm, 72.0 ± 7.8 kg) of a team participated in this study. The official match was the seventh match of the season in the first phase of the Brazilian National Female Basketball Championship. Muscle soreness, plasma creatine kinase activity (CK), and myoglobin concentration (Mb) were determined before and after the match (post-match, 24 and 48 hours after the match). The 1RM strength for bench press and leg press, and the agility T test were assessed before and at 24 and 48 hours after the match. Significant increases in muscle soreness, CK and Mb were observed at 24 and 48 hours post-match (p<0.05). No significant changes in the 1RM strength and T test were detected during recovery (24 and 48 hours after the match). These results suggest that a basketball match induced limited muscle damage with minimal effect on performance during recovery. The small increase in muscle damage markers following a basketball match did not affect strength and agility performance. PMID:24917683

Changes in muscle damage markers in female basketball players.

PubMed

Moreira, A; Nosaka, K; Nunes, J A; Viveiros, L; Jamurtas, A Z; Aoki, M S

2014-03-01

The aim of the present study was to investigate changes in muscle soreness, blood muscle damage markers, muscle strength and agility following an official basketball match. Eleven elite female professional basketball players (27.4 ± 4.8 years, 179.5 ± 5.5 cm, 72.0 ± 7.8 kg) of a team participated in this study. The official match was the seventh match of the season in the first phase of the Brazilian National Female Basketball Championship. Muscle soreness, plasma creatine kinase activity (CK), and myoglobin concentration (Mb) were determined before and after the match (post-match, 24 and 48 hours after the match). The 1RM strength for bench press and leg press, and the agility T test were assessed before and at 24 and 48 hours after the match. Significant increases in muscle soreness, CK and Mb were observed at 24 and 48 hours post-match (p<0.05). No significant changes in the 1RM strength and T test were detected during recovery (24 and 48 hours after the match). These results suggest that a basketball match induced limited muscle damage with minimal effect on performance during recovery. The small increase in muscle damage markers following a basketball match did not affect strength and agility performance.

MRS evidence of adequate O2 supply in human skeletal muscle at the onset of exercise

PubMed Central

Richardson, Russell S.; Wary, Claire; Wray, D. Walter; Hoff, Jan; Rossiter, Harry; Layec, Gwenael; Carlier, Pierre G.

2015-01-01

Purpose At exercise onset, intramuscular oxidative energy production responds relatively slowly in comparison to the change in ATP demand. To determine if the slow kinetics of oxidative ATP production is due to inadequate O2 supply or metabolic inertia we studied the kinetics of intramyocellular deoxygenation (deoxy-myoglobin, Mb) and metabolism (phosphocreatine, PCr), using proton (1H) and phosphorus (31P) magnetic resonance spectroscopy (MRS) in 6 healthy subjects (33 ± 5 yrs). Methods Specifically, utilizing dynamic plantar flexion exercise, rest to exercise and recovery was assessed at both 60% of maximum work rate (WRmax) (moderate intensity) and 80% of WRmax (heavy intensity). Results At exercise onset [PCr] fell without delay and with a similar time constant (τ) at both exercise intensities (~33 s). In contrast, the increase in deoxy-Mb was delayed at exercise onset by 5–7 s, after which it increased with kinetics (moderate τ = 37 ± 9 s, and heavy τ = 29 ± 6 s) that were not different from τPCr (p > 0.05). At cessation, deoxy-Mb recovered without a time delay and more rapidly (τ ~20 s) than PCr (τ ~33 s) (p < 0.05). Conclusion using a unique combination of in vivo MRS techniques with high time-resolution, this study revealed a delay in intramuscular de-oxygenation at the onset of exercise, and rapid re-oxygenation kinetics upon cessation. Together these data imply that intramuscular substrate-enzyme interactions, and not O2 availability, determine the exercise onset kinetics of oxidative metabolism in healthy human skeletal muscle. PMID:25830362

Bell palsy

MedlinePlus

... in the face Other symptoms that may occur: Dry eye, which may lead to eye sores or infections ... Complications may include: Eye surface becoming dry, leading to eye sores, infections, and vision loss Swelling in the muscles due to loss of nerve function

The effects PCSO-524®, a patented marine oil lipid and omega-3 PUFA blend derived from the New Zealand green lipped mussel (Perna canaliculus), on indirect markers of muscle damage and inflammation after muscle damaging exercise in untrained men: a randomized, placebo controlled trial.

PubMed

Mickleborough, Timothy D; Sinex, Jacob A; Platt, David; Chapman, Robert F; Hirt, Molly

2015-01-01

The purpose of the present study was to evaluate the effects of PCSO-524®, a marine oil lipid and n-3 LC PUFA blend, derived from New Zealand green- lipped mussel (Perna canaliculus), on markers of muscle damage and inflammation following muscle damaging exercise in untrained men. Thirty two untrained male subjects were randomly assigned to consume 1200 mg/d of PCSO- 524® (a green-lipped mussel oil blend) or placebo for 26 d prior to muscle damaging exercise (downhill running), and continued for 96 h following the muscle damaging exercise bout. Blood markers of muscle damage (skeletal muscle slow troponin I, sTnI; myoglobin, Mb; creatine kinase, CK), and inflammation (tumor necrosis factor, TNF-α), and functional measures of muscle damage (delayed onset muscle soreness, DOMS; pressure pain threshold, PPT; knee extensor joint range of motion, ROM; isometric torque, MVC) were assessed pre- supplementation (baseline), and multiple time points post-supplementation (before and after muscle damaging exercise). At baseline and 24 h following muscle damaging exercise peripheral fatigue was assessed via changes in potentiated quadriceps twitch force (∆Qtw,pot) from pre- to post-exhaustive cycling ergometer test in response to supra-maximal femoral nerve stimulation. Compared to placebo, supplementation with the green-lipped mussel oil blend significantly attenuated (p < 0.05) sTnI and TNF-α at 2, 24, 48, 72 and 96 h., Mb at 24, 48, 72, 96 h., and CK-MM at all-time points following muscle damaging exercise, significantly reduced (p < 0.05) DOMS at 72 and 96 h post-muscle damaging exercise, and resulted in significantly less strength loss (MVC) and provided a protective effect against joint ROM loss at 96 h post- muscle damaging exercise. At 24 h after muscle damaging exercise perceived pain was significantly greater (p < 0.05) compared to baseline in the placebo group only. Following muscle damaging exercise ∆Qtw,pot was significantly less (p < 0.05) on the green-lipped mussel oil blend compared to placebo. Supplementation with a marine oil lipid and n-3 LC PUFA blend (PCSO-524®), derived from the New Zealand green lipped mussel, may represent a useful therapeutic agent for attenuating muscle damage and inflammation following muscle damaging exercise.

Watermelon juice: potential functional drink for sore muscle relief in athletes.

PubMed

Tarazona-Díaz, Martha P; Alacid, Fernando; Carrasco, María; Martínez, Ignacio; Aguayo, Encarna

2013-08-07

l-Citrulline is an excellent candidate to reduce muscle soreness, and watermelon is a fruit rich in this amino acid. This study investigated the potential of watermelon juice as a functional drink for athletes. An in vitro study of intestinal absorption of l-citrulline in Caco-2 cells was performed using unpasteurized (NW), pasteurized (80 °C for 40 s) watermelon juice (PW) and, as control, a standard of l-citrulline. l-citrulline bioavailability was greater when it was contained in a matrix of watermelon and when no heat treatment was applied. In the in vivo experiment (maximum effort test in a cycloergometer), seven athletes were supplied with 500 mL of natural watermelon juice (1.17 g of l-citrulline), enriched watermelon juice (4.83 g of l-citrulline plus 1.17 g from watermelon), and placebo. Both watermelon juices helped to reduce the recovery heart rate and muscle soreness after 24 h.

Pomegranate Supplementation Accelerates Recovery of Muscle Damage and Soreness and Inflammatory Markers after a Weightlifting Training Session

PubMed Central

Ammar, Achraf; Turki, Mouna; Chtourou, Hamdi; Hammouda, Omar; Trabelsi, Khaled; Kallel, Choumous; Abdelkarim, Osama; Hoekelmann, Anita; Bouaziz, Mohamed; Ayadi, Fatma; Driss, Tarak; Souissi, Nizar

2016-01-01

Purpose The aim of this study was to investigate the effect of natural Pomegranate juice supplementation on performance and acute and delayed responses of muscle soreness and biomarkers of muscle damage after a weightlifting training session. Methods Nine elite weightlifters (21±0.5 years) performed two Olympic-Weightlifting-sessions after either placebo (PLA) or natural pomegranate juice (POMj) supplementations. Heart rate, blood pressure and blood samples (hematological parameters, muscle damage and C-reactive protein (CRP)) were collected at rest, 3min and 48h after each session. Weightlifting performance, RPE, and DOMS were also assessed after each training session. Results T-test showed higher performance (+8.30%) and lower RPE values (-4.37%) using POMj supplementation (p<0.05) in comparison with PLA. For the DOMS values, a significant improvement (13.4%) was shown only for the knee extensors (p<0.01) using the POMj. Compared to PLA condition, POMj attenuated the acute (i.e., 3min) increase of systolic blood pressure (SBP), HR, CK and LDH (p<0.05; -4.46%, -1.81%, -8.75%, -1.64%, respectively) and blunted the significant increase of ASAT, PAL and CRP (p>0.05). Additionally, during the 48h following the training session, POMj improved the recovery kinetic of SBP (p<0.01, 7.97%), CK (p<0.001, 11.34%), LDH (p<0.05, 7.30%) and ASAT (p<0.05, 6.77%). Indeed, the present study showed that 48h of recovery associated to natural POMj supplementation was sufficient to reach the resting values of the selected muscle damage markers after intensive training session. Conclusion Natural POMj seems to ameliorate the capacity to adhere to an intensive training program. Therefore, elite weightlifters are advised to use natural POMj during intensive training program and competition to accelerate muscle recovery. Trial Registration ClinicalTrials.gov NCT02697903 PMID:27764091

Pomegranate Supplementation Accelerates Recovery of Muscle Damage and Soreness and Inflammatory Markers after a Weightlifting Training Session.

PubMed

Ammar, Achraf; Turki, Mouna; Chtourou, Hamdi; Hammouda, Omar; Trabelsi, Khaled; Kallel, Choumous; Abdelkarim, Osama; Hoekelmann, Anita; Bouaziz, Mohamed; Ayadi, Fatma; Driss, Tarak; Souissi, Nizar

2016-01-01

The aim of this study was to investigate the effect of natural Pomegranate juice supplementation on performance and acute and delayed responses of muscle soreness and biomarkers of muscle damage after a weightlifting training session. Nine elite weightlifters (21±0.5 years) performed two Olympic-Weightlifting-sessions after either placebo (PLA) or natural pomegranate juice (POMj) supplementations. Heart rate, blood pressure and blood samples (hematological parameters, muscle damage and C-reactive protein (CRP)) were collected at rest, 3min and 48h after each session. Weightlifting performance, RPE, and DOMS were also assessed after each training session. T-test showed higher performance (+8.30%) and lower RPE values (-4.37%) using POMj supplementation (p<0.05) in comparison with PLA. For the DOMS values, a significant improvement (13.4%) was shown only for the knee extensors (p<0.01) using the POMj. Compared to PLA condition, POMj attenuated the acute (i.e., 3min) increase of systolic blood pressure (SBP), HR, CK and LDH (p<0.05; -4.46%, -1.81%, -8.75%, -1.64%, respectively) and blunted the significant increase of ASAT, PAL and CRP (p>0.05). Additionally, during the 48h following the training session, POMj improved the recovery kinetic of SBP (p<0.01, 7.97%), CK (p<0.001, 11.34%), LDH (p<0.05, 7.30%) and ASAT (p<0.05, 6.77%). Indeed, the present study showed that 48h of recovery associated to natural POMj supplementation was sufficient to reach the resting values of the selected muscle damage markers after intensive training session. Natural POMj seems to ameliorate the capacity to adhere to an intensive training program. Therefore, elite weightlifters are advised to use natural POMj during intensive training program and competition to accelerate muscle recovery. ClinicalTrials.gov NCT02697903.

Functional characterization of muscle fibres from patients with chronic fatigue syndrome: case-control study.

PubMed

Pietrangelo, T; Toniolo, L; Paoli, A; Fulle, S; Puglielli, C; Fanò, G; Reggiani, C

2009-01-01

Chronic fatigue syndrome (CFS) is a disabling condition characterized by unexplained chronic fatigue that impairs normal activities. Although immunological and psychological aspects are present, symptoms related to skeletal muscles, such as muscle soreness, fatigability and increased lactate accumulation, are prominent in CFS patients. In this case-control study, the phenotype of the same biopsy samples was analyzed by determining i) fibre-type proportion using myosin isoforms as fibre type molecular marker and gel electrophoresis as a tool to separate and quantify myosin isoforms, and ii) contractile properties of manually dissected, chemically made permeable and calcium-activated single muscle fibres. The results showed that fibre-type proportion was significantly altered in CSF samples, which showed a shift from the slow- to the fast-twitch phenotype. Cross sectional area, force, maximum shortening velocity and calcium sensitivity were not significantly changed in single muscle fibres from CSF samples. Thus, the contractile properties of muscle fibres were preserved but their proportion was changed, with an increase in the more fatigue-prone, energetically expensive fast fibre type. Taken together, these results support the view that muscle tissue is directly involved in the pathogenesis of CSF and it might contribute to the early onset of fatigue typical of the skeletal muscles of CFS patients.

No Differences Between Alter G-Trainer and Active and Passive Recovery Strategies on Isokinetic Strength, Systemic Oxidative Stress and Perceived Muscle Soreness After Exercise-Induced Muscle Damage.

PubMed

Cooke, Matthew B; Nix, Carrie M; Greenwood, Lori D; Greenwood, Mike C

2018-03-01

Cooke, MB, Nix, C, Greenwood, L, and Greenwood, M. No Differences Between Alter G-Trainer and Active and Passive Recovery Strategies on Isokinetic Strength, Systemic Oxidative Stress and Perceived Muscle Soreness After Exercise-Induced Muscle Damage. J Strength Cond Res 32(3): 736-747, 2018-The incidence of muscle injuries is prevalent in elite sport athletes and weekend warriors and strategies that safely and effectively hasten recovery are highly desirable. The purpose of this study was to examine the differences between 3 recovery methods after eliciting muscle damage in recreationally active men relative to maximal isokinetic contractions, perceived muscle soreness, and psychological mood states. Twenty-five recreationally active men (22.15 ± 3.53 years, 75.75 ± 11.91 kg, 180.52 ± 7.3 cm) were randomly matched by V[Combining Dot Above]O2 peak (53.86 ± 6.65 ml·kg·min) and assigned to one of 3 recovery methods: anti-gravity treadmill (G-Trainer) (N = 8), conventional treadmill (N = 8) or static stretching (N = 9). Recovery methods were performed 30 minutes, 24, 48, and 72 hours after a 45-minute downhill run. Following eccentrically biased running, no significant differences were noted in isokinetic knee flexion and extension peak torque, systemic markers of muscle damage, oxidative stress and lipid peroxidation such as serum creatine kinase (CK), superoxide dismutase (SOD), and malondialdehyde (MDA), respectively, and subjective ratings of perceived muscle soreness between recovery methods. The G-Trainer group did however display a higher mood state as indicated by the Profile of Mood State global scores at 24 hours postexercise when compared to the conventional treadmill recovery group (p = 0.035). The improved mood state after the use of the anti-gravity treadmill may provide clinical relevance to other populations.

Combined V-Y Fasciocutaneous Advancement and Gluteus Maximus Muscle Rotational Flaps for Treating Sacral Sores

PubMed Central

Choi, Eun Jeong; Moon, Suk Ho; Lee, Yoon Jae

2016-01-01

The sacral area is the most common site of pressure sore in bed-ridden patients. Though many treatment methods have been proposed, a musculocutaneous flap using the gluteus muscles or a fasciocutaneous flap is the most popular surgical option. Here, we propose a new method that combines the benefits of these 2 methods: combined V-Y fasciocutaneous advancement and gluteus maximus muscle rotational flaps. A retrospective review was performed for 13 patients who underwent this new procedure from March 2011 to December 2013. Patients' age, sex, accompanying diseases, follow-up duration, surgical details, complications, and recurrence were documented. Computed tomography was performed postoperatively at 2 to 4 weeks and again at 4 to 6 months to identify the thickness and volume of the rotational muscle portion. After surgery, all patients healed within 1 month; 3 patients experienced minor complications. The average follow-up period was 13.6 months, during which time 1 patient had a recurrence (recurrence rate, 7.7%). Average thickness of the rotated muscle was 9.43 mm at 2 to 4 weeks postoperatively and 9.22 mm at 4 to 6 months postoperatively (p = 0.087). Muscle thickness had not decreased, and muscle volume was relatively maintained. This modified method is relatively simple and easy for reconstructing sacral sores, provides sufficient padding, and has little muscle donor-site morbidity. PMID:27366755

Photobiomodulation therapy (PBMT) and/or cryotherapy in skeletal muscle restitution, what is better? A randomized, double-blinded, placebo-controlled clinical trial.

PubMed

de Paiva, Paulo Roberto Vicente; Tomazoni, Shaiane Silva; Johnson, Douglas Scott; Vanin, Adriane Aver; Albuquerque-Pontes, Gianna Móes; Machado, Caroline Dos Santos Monteiro; Casalechi, Heliodora Leão; de Carvalho, Paulo de Tarso Camillo; Leal-Junior, Ernesto Cesar Pinto

2016-12-01

Cryotherapy for post-exercise recovery remains widely used despite the lack of quality evidence. Photobiomodulation therapy (PBMT) studies (with both low-level laser therapy and light-emitting diode therapy) have demonstrated positive scientific evidence to suggest its use. The study aims to evaluate PBMT and cryotherapy as a single or combined treatment on skeletal muscle recovery after eccentric contractions of knee extensors. Fifty healthy male volunteers were recruited and randomized into five groups (PBMT, cryotherapy, cryotherapy + PBMT, PMBT + cryotherapy, or placebo) for a randomized, double-blinded, placebo-controlled trial that evaluated exercise performance (maximum voluntary contraction (MVC)), delayed onset muscle soreness (DOMS), and muscle damage (creatine kinase (CK)). Assessments were performed at baseline; immediately after; and at 1, 24, 48, 72, and 96 h. Comparator treatments was performed 3 min after exercise and repeated at 24, 48, and 72 h. PBMT was applied employing a cordless, portable GameDay ™ device (combination of 905 nm super-pulsed laser and 875- and 640-nm light-emitting diodes (LEDs); manufactured by Multi Radiance Medical ™ , Solon - OH, USA), and cryotherapy by flexible rubber ice packs. PBMT alone was optimal for post-exercise recovery with improved MVC, decreased DOMS, and CK activity (p < 0.05) from 24 to 96 h compared to placebo, cryotherapy, and cryotherapy + PBMT. In the PBMT + cryotherapy group, the effect of PBMT was decreased (p > 0.05) but demonstrated significant improvement in MVC, decreased DOMS, and CK activity (p < 0.05). Cryotherapy as single treatment and cryotherapy + PBMT were similar to placebo (p > 0.05). We conclude that PBMT used as single treatment is the best modality for enhancement of post-exercise restitution, leading to complete recovery to baseline levels from 24 h after high-intensity eccentric contractions.

Differences in feedforward trunk muscle activity in subgroups of patients with mechanical low back pain.

PubMed

Silfies, Sheri P; Mehta, Rupal; Smith, Sue S; Karduna, Andrew R

2009-07-01

To investigate alterations in trunk muscle timing patterns in subgroups of patients with mechanical low back pain (MLBP). Our hypothesis was that subjects with MLBP would demonstrate delayed muscle onset and have fewer muscles functioning in a feedforward manner than the control group. We further hypothesized that we would find differences between subgroups of our patients with MLBP, grouped according to diagnosis (segmental instability and noninstability). Case-control. Laboratory. Forty-three patients with chronic MLBP (25 instability, 18 noninstability) and 39 asymptomatic controls. Not applicable. Surface electromyography was used to measure onset time of 10 trunk muscles during a self-perturbation task. Trunk muscle onset latency relative to the anterior deltoid was calculated and the number of muscles functioning in feedforward determined. Activation timing patterns (P<.01; eta=.50; 1-beta=.99) and number of muscles functioning in feedforward (P=.02; eta=.30; 1-beta=.83) were statistically different between patients with MLBP and controls. The control group activated the external oblique, lumbar multifidus, and erector spinae muscles in a feedforward manner. The heterogeneous MLBP group did not activate the trunk musculature in feedforward, but responded with significantly delayed activations. MLBP subgroups demonstrated significantly different timing patterns. The noninstability MLBP subgroup activated trunk extensors in a feedforward manner, similar to the control group, but significantly earlier than the instability subgroup. Lack of feedforward activation of selected trunk musculature in patients with MLBP may result in a period of inefficient muscular stabilization. Activation timing was more impaired in the instability than the noninstability MLBP subgroup. Training specifically for recruitment timing may be an important component of the rehabilitation program.

Onset in abdominal muscles recorded simultaneously by ultrasound imaging and intramuscular electromyography.

PubMed

Vasseljen, Ottar; Fladmark, Anne M; Westad, Christian; Torp, Hans G

2009-04-01

Delayed onset of muscle activity in abdominal muscles has been related to low back pain. To investigate this in larger clinical trials it would be beneficial if non-invasive and less cumbersome alternatives to intramuscular electromyography (EMG) were available. This study was designed to compare onset of muscle activity recorded by intramuscular EMG to onset of muscle deformations by ultrasound imaging. Muscle deformations were recorded by two ultrasound imaging modes at high time resolution (m-mode and tissue velocity) in separate sessions and compared to simultaneously recorded intramuscular EMG in three abdominal muscles. Tissue velocity imaging was converted to strain rate which measures deformation velocity gradients within small regions, giving information about the rate of local tissue shortening or lengthening along the beam axis. Onsets in transversus abdominis (TrA), obliquus internus abdominis (OI) and obliquus externus abdominis (OE) were recorded during rapid arm flexions in ten healthy subjects. During ultrasound m-mode recordings, the results showed that mean onsets by EMG were detected 7 ms (95% CI of mean difference; +/-4 ms) and 2 ms (95% CI of mean difference; +/-6 ms) before concurrent ultrasound m-mode detected onsets in TrA and OI, respectively. In contrast, OE onset was recorded 54 ms (95% CI of bias; +/-16 ms) later by EMG compared to ultrasound m-mode. The discrepancy of ultrasound m-mode to accurately record onset in OE was practically corrected in the ultrasound-based strain rate recordings. However, this could only be applied on half of the subjects due to the angle dependency between the ultrasound beam and the direction of the contraction in strain rate recordings. The angle dependency needs to be further explored.

An exploratory study of voice change associated with healthy speakers after transcutaneous electrical stimulation to laryngeal muscles.

PubMed

Fowler, Linda P; Gorham-Rowan, Mary; Hapner, Edie R

2011-01-01

The purpose of this study was to determine if measurable changes in fundamental frequency (F(0)) and relative sound level (RSL) occurred in healthy speakers after transcutaneous electrical stimulation (TES) as applied via VitalStim (Chattanooga Group, Chattanooga, TN). A prospective, repeated-measures design. Ten healthy female and 10 healthy male speakers, 20-53 years of age, participated in the study. All participants were nonsmokers and reported negative history for voice disorders. Participants received 1 hour of TES while engaged in eating, drinking, and conversation to simulate a typical dysphagia therapy protocol. Voice recordings were obtained before and immediately after TES. The voice samples consisted of a sustained vowel task and reading of the Rainbow Passage. Measurements of F(0) and RSL were obtained using TF32 (Milenkovic, 2005, University of Wisconsin). The participants also reported any sensations 5 minutes and 24 hours after TES. Measurable changes in F(0) and RSL were found for both tasks but were variable in direction and magnitude. These changes were not statistically significant. Subjective comments ranged from reports of a vocal warm-up feeling to delayed onset muscle soreness. These findings demonstrate that application of TES produces measurable changes in F(0) and RSL. However, the direction and magnitude of these changes are highly variable. Further research is needed to determine factors that may affect the extent to which TES contributes to significant changes in voice. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

The accordion gracilis muscle flap: a new design for coverage of recurrent and complicated ischeal pressure sores.

PubMed

El-Sabbagh, Ahmed H

2011-10-01

Management of patients with large or recurrent pressure ulcerations can be complicated by the lack of available local flap, whether already used or because adjacent lesions make such flap insufficient for complete coverage. In this article, the gracilis muscle was modified to cover large defects without help from its cutaneous territory. Twelve ischeal pressure sores were treated between August 2007 and 2009 with the modified gracilis muscle flap in a single-staged procedure. Five ulcers were recurrent and seven patients have associated pressure ulcers. All reconstructions were successful. Mean patient age was 35 years and nearly all patients had multiple significant comorbidities, including associated ulcers, diabetes and urethrocutaneous fistula. All flaps and donor sites healed uneventfully. There was one complication presented as cellulites at the donor site. Follow-up in some cases extend up to 1·5 years. No recurrence was observed. The accordion gracilis muscle flap is a handy, safe and fast flap for reconstruction of recurrent, difficult ischeal pressure sores. © 2011 The Author. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

IGF-II gene region polymorphisms related to exertional muscle damage.

PubMed

Devaney, Joseph M; Hoffman, Eric P; Gordish-Dressman, Heather; Kearns, Amy; Zambraski, Edward; Clarkson, Priscilla M

2007-05-01

We examined the association of a novel single-nucleotide polymorphism (SNP) in IGF-I (IGF-I -C1245T located in the promoter) and eight SNPs in the IGF-II gene region with indicators of muscle damage [strength loss, muscle soreness, and increases in circulating levels of creatine kinase (CK) and myoglobin] after eccentric exercise. We also examined two SNPs in the IGF binding protein-3 (IGFBP-3). The age, height, and body mass of the 151 subjects studied were 24.1 +/- 5.2 yr, 170.8 +/- 9.9 cm, and 73.3 +/- 17.0 kg, respectively. There were no significant associations of phenotypes with IGF-I. IGF-II SNP (G12655A, rs3213216) and IGFBP-3 SNP (A8618T, rs6670) were not significantly associated with any variable. The most significant finding in this study was that for men, IGF-II (C13790G, rs3213221), IGF-II (ApaI, G17200A, rs680), IGF-II antisense (IGF2AS) (G11711T, rs7924316), and IGFBP-3 (-C1592A, rs2132570) were significantly associated with muscle damage indicators. We found that men who were 1) homozygous for the rare IGF-II C13790G allele and rare allele for the ApaI (G17200A) SNP demonstrated the greatest strength loss immediately after exercise, greatest soreness, and highest postexercise serum CK activity; 2) homozygous wild type for IGF2AS (G11711T, rs7924316) had the greatest strength loss and most muscle soreness; and 3) homozygous wild type for the IGF2AS G11711T SNP showed the greatest strength loss, highest muscle soreness, and greater CK and myoglobin response to exercise. In women, fewer significant associations appeared.

Efficacy of intraoperative monitoring of transcranial electrical stimulation-induced motor evoked potentials and spontaneous electromyography activity to identify acute-versus delayed-onset C-5 nerve root palsy during cervical spine surgery: clinical article.

PubMed

Bhalodia, Vidya M; Schwartz, Daniel M; Sestokas, Anthony K; Bloomgarden, Gary; Arkins, Thomas; Tomak, Patrick; Gorelick, Judith; Wijesekera, Shirvinda; Beiner, John; Goodrich, Isaac

2013-10-01

Deltoid muscle weakness due to C-5 nerve root injury following cervical spine surgery is an uncommon but potentially debilitating complication. Symptoms can manifest upon emergence from anesthesia or days to weeks following surgery. There is conflicting evidence regarding the efficacy of spontaneous electromyography (spEMG) monitoring in detecting evolving C-5 nerve root compromise. By contrast, transcranial electrical stimulation-induced motor evoked potential (tceMEP) monitoring has been shown to be highly sensitive and specific in identifying impending C-5 injury. In this study the authors sought to 1) determine the frequency of immediate versus delayed-onset C-5 nerve root injury following cervical spine surgery, 2) identify risk factors associated with the development of C-5 palsies, and 3) determine whether tceMEP and spEMG neuromonitoring can help to identify acutely evolving C-5 injury as well as predict delayed-onset deltoid muscle paresis. The authors retrospectively reviewed the neuromonitoring and surgical records of all patients who had undergone cervical spine surgery involving the C-4 and/or C-5 level in the period from 2006 to 2008. Real-time tceMEP and spEMG monitoring from the deltoid muscle was performed as part of a multimodal neuromonitoring protocol during all surgeries. Charts were reviewed to identify patients who had experienced significant changes in tceMEPs and/or episodes of neurotonic spEMG activity during surgery, as well as those who had shown new-onset deltoid weakness either immediately upon emergence from the anesthesia or in a delayed fashion. Two hundred twenty-nine patients undergoing 235 cervical spine surgeries involving the C4-5 level served as the study cohort. The overall incidence of perioperative C-5 nerve root injury was 5.1%. The incidence was greatest (50%) in cases with dual corpectomies at the C-4 and C-5 spinal levels. All patients who emerged from anesthesia with deltoid weakness had significant and unresolved changes in tceMEPs during surgery, whereas only 1 had remarkable spEMG activity. Sensitivity and specificity of tceMEP monitoring for identifying acute-onset deltoid weakness were 100% and 99%, respectively. By contrast, sensitivity and specificity for spEMG were only 20% and 92%, respectively. Neither modality was effective in identifying patients who demonstrated delayed-onset deltoid weakness. The risk of new-onset deltoid muscle weakness following cervical spine surgery is greatest for patients undergoing 2-level corpectomies involving C-4 and C-5. Transcranial electrical stimulation-induced MEP monitoring is a highly sensitive and specific technique for detecting C-5 radiculopathy that manifests immediately upon waking from anesthesia. While the absence of sustained spEMG activity does not rule out nerve root irritation, the presence of excessive neurotonic discharges serves both to alert the surgeon of such potentially injurious events and to prompt neuromonitoring personnel about the need for additional tceMEP testing. Delayed-onset C-5 nerve root injury cannot be predicted by intraoperative neuromonitoring via either modality.

Effects of whole-body cryotherapy (-110 °C) on proprioception and indices of muscle damage.

PubMed

Costello, J T; Algar, L A; Donnelly, A E

2012-04-01

The purpose of this study was to investigate the effects of whole-body cryotherapy (WBC) on proprioceptive function, muscle force recovery following eccentric muscle contractions and tympanic temperature (T(TY) ). Thirty-six subjects were randomly assigned to a group receiving two 3-min treatments of -110 ± 3 °C or 15 ± 3 °C. Knee joint position sense (JPS), maximal voluntary isometric contraction (MVIC) of the knee extensors, force proprioception and T(TY) were recorded before, immediately after the exposure and again 15 min later. A convenience sample of 18 subjects also underwent an eccentric exercise protocol on their contralateral left leg 24 h before exposure. MVIC (left knee), peak power output (PPO) during a repeated sprint on a cycle ergometer and muscles soreness were measured pre-, 24, 48 and 72h post-treatment. WBC reduced T(TY) , by 0.3 °C, when compared with the control group (P<0.001). However, JPS, MVIC or force proprioception was not affected. Similarly, WBC did not effect MVIC, PPO or muscle soreness following eccentric exercise. WBC, administered 24 h after eccentric exercise, is ineffective in alleviating muscle soreness or enhancing muscle force recovery. The results of this study also indicate no increased risk of proprioceptive-related injury following WBC. © 2011 John Wiley & Sons A/S.

Organophosphate-induced intermediate syndrome: aetiology and relationships with myopathy.

PubMed

Karalliedde, Lakshman; Baker, David; Marrs, Timothy C

2006-01-01

The intermediate syndrome (IMS) following organophosphorus (OP) insecticide poisoning was first described in the mid-1980s. The syndrome described comprised characteristic symptoms and signs occurring after apparent recovery from the acute cholinergic syndrome. As the syndrome occurred after the acute cholinergic syndrome but before organophosphate-induced delayed polyneuropathy, the syndrome was called 'intermediate syndrome'. The IMS occurs in approximately 20% of patients following oral exposure to OP pesticides, with no clear association between the particular OP pesticide involved and the development of the syndrome. It usually becomes established 2-4 days after exposure when the symptoms and signs of the acute cholinergic syndrome (e.g. muscle fasciculations, muscarinic signs) are no longer obvious. The characteristic features of the IMS are weakness of the muscles of respiration (diaphragm, intercostal muscles and accessory muscles including neck muscles) and of proximal limb muscles. Accompanying features often include weakness of muscles innervated by some cranial nerves. It is now emerging that the degree and extent of muscle weakness may vary following the onset of the IMS. Thus, some patients may only have weakness of neck muscles whilst others may have weakness of neck muscles and proximal limb muscles. These patients may not require ventilatory care but close observation and monitoring of respiratory function is mandatory. Management is essentially that of rapidly developing respiratory distress and respiratory failure. Delays in instituting ventilatory care will result in death. Initiation of ventilatory care and maintenance of ventilatory care often requires minimal doses of non-depolarising muscle relaxants. The use of depolarising muscle relaxants such as suxamethonium is contraindicated in OP poisoning. The duration of ventilatory care required by patients may differ considerably and it is usual for patients to need ventilatory support for 7-15 days and even up to 21 days. Weaning from ventilatory care is best carried out in stages, with provision of continuous positive airway pressure prior to complete weaning. Continuous and close monitoring of respiratory function (arterial oxygen saturation, partial pressure of oxygen in arterial blood, partial pressure of carbon dioxide in arterial blood) and acid-base status are an absolute necessity. Prophylactic antibiotics are usually not required unless there has been evidence of aspiration of material into the lungs. Close monitoring of fluid and electrolyte balance is mandatory in view of the profuse offensive diarrhoea that most patients develop. Maintenance of nutrition, physiotherapy, prevention of bed sores and other routine measures to minimise discomfort during ventilatory care are necessary. Recovery from the intermediate syndrome is normally complete and without any sequelae. The usefulness of oximes during the IMS remains uncertain. In animal experiments, very early administration of oximes has prevented the occurrence of myopathy. There are reports from developed countries where administration of oximes at recommended doses and within 2 hours of ingestion of OP insecticide did not prevent the onset of the IMS. Controlled randomised clinical studies are necessary to evaluate the efficacy of oximes in combating the IMS. Electrophysiological studies following OP poisoning have revealed three characteristic phenomena: (i) repetitive firing following a single stimulus; (ii) gradual reduction in twitch height or compound muscle action potential followed by an increase with repetitive stimulation (the 'decrement-increment response'); and (iii) continued reduction in twitch height or compound muscle action potential with repetitive simulation ('decrementing response'). Of these, the decrementing response is the most frequent finding during the IMS, whilst repetitive firing is observed during the acute cholinergic syndrome. The distribution of the weakness in human cases of the IMS, in general, parallels the distribution of the myopathy observed in a number of studies in experimental animals. This has led to speculation that myopathy is involved in the causation of the IMS. However, while myopathy and the IMS have a common origin in acetylcholine accumulation, they are not causally related to one another.

[Repair of pressure sores over ischial tuberosity with long head of biceps femoris muscle flap combined with semi-V posterior thigh fasciocutaneous flap].

PubMed

Hai, Heng-lin; Shen, Chuan-an; Chai, Jia-ke; Li, Hua-tao

2012-02-01

To explore the clinical effect of transplantation of the long head of biceps femoris muscle flap in combination with semi-V posterior thigh fasciocutaneous flap for repair of pressure sores over ischial tuberosity. Eight patients with 10 deep pressure sores over ischial tuberosity were admitted to the First Affiliated Hospital to the PLA General Hospital and the 98th Hospital of PLA from April 2004 to June 2010. The wounds measured from 2 cm × 2 cm to 6 cm × 4 cm were covered with the long head of biceps femoris muscle flap and semi-V posterior thigh fasciocutaneous flap (ranged from 10 cm × 6 cm to 13 cm × 8 cm). The condition of flaps was observed and followed up for a long time. All flaps survived. Nine wounds healed by first intention. Subcutaneous accumulation of fluids occurred in one wound with formation of a sinus at drainage site, and it healed after dressing change for 25 days. Patients were followed up for 7 to 34 months. Sore recurred in one patient 9 months after surgery, and it was successfully repaired with the same flap for the second time. Flaps in the other 7 patients appeared satisfactory with soft texture and without ulceration. This combined flap is easy in formation and transfer, and it causes little side injury with good resistance against pressure. It is a new method for repair of pressure sore over sacral region.

The effects of acute post exercise consumption of two cocoa-based beverages with varying flavanol content on indices of muscle recovery following downhill treadmill running.

PubMed

Peschek, Katelyn; Pritchett, Robert; Bergman, Ethan; Pritchett, Kelly

2013-12-20

Dietary flavanols have been associated with reduced oxidative stress, however their efficacy in promoting recovery after exercise induced muscle damage is unclear. This study examined the effectiveness of acute consumption of cocoa-flavanols on indices of muscle recovery including: subsequent exercise performance, creatine kinase, muscle tenderness, force, and self-perceived muscle soreness. Eight endurance-trained athletes (VO2max 64.4±7.6 mL/kg/min) completed a downhill running protocol to induce muscle soreness, and 48-h later completed a 5-K (kilometer) time trial. Muscle recovery measurements were taken at PRE, 24 h-POST, 48 h-POST, and POST-5K. Participants consumed 1.0 g of carbohydrate per kilogram of body weight of a randomly assigned beverage (CHOC: 0 mg flavanols vs. CocoaCHOC: 350 mg flavanols per serving) immediately after the downhill run and again 2 h later. The same protocol was repeated three weeks later with the other beverage. An ANOVA revealed no significant difference (p=0.97) between trials for 5 K completion time (CHOC 1198.3±160.6 s, CocoaCHOC 1195.5±148.8 s). No significant difference was found for creatine kinase (CK) levels (p=0.31), or muscle soreness (p=0.21) between groups over time. These findings suggest that the acute addition of cocoa flavanols to low-fat chocolate milk offer no additional recovery benefits.

The Effects of Acute Post Exercise Consumption of Two Cocoa-Based Beverages with Varying Flavanol Content on Indices of Muscle Recovery Following Downhill Treadmill Running

PubMed Central

Peschek, Katelyn; Pritchett, Robert; Bergman, Ethan; Pritchett, Kelly

2013-01-01

Dietary flavanols have been associated with reduced oxidative stress, however their efficacy in promoting recovery after exercise induced muscle damage is unclear. This study examined the effectiveness of acute consumption of cocoa-flavanols on indices of muscle recovery including: subsequent exercise performance, creatine kinase, muscle tenderness, force, and self-perceived muscle soreness. Eight endurance-trained athletes (VO2max 64.4 ± 7.6 mL/kg/min) completed a downhill running protocol to induce muscle soreness, and 48-h later completed a 5-K (kilometer) time trial. Muscle recovery measurements were taken at PRE, 24 h-POST, 48 h-POST, and POST-5K. Participants consumed 1.0 g of carbohydrate per kilogram of body weight of a randomly assigned beverage (CHOC: 0 mg flavanols vs. CocoaCHOC: 350 mg flavanols per serving) immediately after the downhill run and again 2 h later. The same protocol was repeated three weeks later with the other beverage. An ANOVA revealed no significant difference (p = 0.97) between trials for 5 K completion time (CHOC 1198.3 ± 160.6 s, CocoaCHOC 1195.5 ± 148.8 s). No significant difference was found for creatine kinase (CK) levels (p = 0.31), or muscle soreness (p = 0.21) between groups over time. These findings suggest that the acute addition of cocoa flavanols to low-fat chocolate milk offer no additional recovery benefits. PMID:24362706

Older adults utilize less efficient postural control when performing pushing task

PubMed Central

Lee, Yun-Ju; Chen, Bing; Aruin, Alexander S.

2015-01-01

The ability to maintain balance deteriorates with increasing age. The aim was to investigate the role of age in generation of anticipatory (APA) and compensatory (CPA) postural adjustments during pushing an object. Older (68.8 ± 1.0 years) and young adults (30.1 ± 1.4 years) participated in the experiment involving pushing an object (a pendulum attached to the ceiling) using both hands. Electrical activity of six leg and trunk muscles and displacements of the center of pressure (COP) were recorded and analyzed during the APA and CPA phases. The onset time, integrals of muscle activity, and COP displacements were determined. In addition, the indexes of co-activation and reciprocal activation of muscles for the shank, thigh, and trunk segments were calculated. Older adults, compared to young adults, showed less efficient postural control seen as delayed anticipatory muscle onset times and delayed COP displacements. Moreover, older adults used co-activation of muscles during the CPA phase while younger subjects utilized reciprocal activation of muscles. The observed diminished efficiency of postural control during both anticipatory and compensatory postural adjustments observed in older adults might predispose them to falls while performing tasks involving pushing. The outcome provides a background for future studies focused on the optimization of the daily activities of older adults. PMID:26403099

Recovery of lower limb function following 6 weeks of non-weight bearing

NASA Astrophysics Data System (ADS)

MacIntyre, Donna L.; Eng, Janice J.; Allen, Trevor J.

2005-05-01

Skeletal muscle weakness and atrophy occur following an extended period of decreased use, including space flight and limb unloading. It is also likely that affected muscles will be susceptible to a re-loading injury when they begin return to earth or weight bearing. However, there is a paucity of literature evaluating the response of human unloaded muscle to exercise and return to activity. The purpose of this pilot study was to evaluate the soreness, function and strength response of muscle to re-loading in seven patients who were non-weight bearing for 6 weeks, compared to five healthy subjects. Function improved significantly over time for the patients but was still less than the healthy subjects over 12 weeks of physiotherapy. Concentric quadriceps muscle strength increased significantly over time for the patients. There was considerable variability in the patients' reports of muscle soreness but there were no significant changes over time or between groups.

The Effects of Different Passive Static Stretching Intensities on Recovery from Unaccustomed Eccentric Exercise - A Randomized Controlled Trial.

PubMed

Apostolopoulos, Nikos C; Lahart, Ian M; Plyley, Michael J; Taunton, Jack; Nevill, Alan M; Koutedakis, Yiannis; Wyon, Matthew; Metsios, George S

2018-03-12

Effects of passive static stretching intensity on recovery from unaccustomed eccentric exercise of right knee extensors was investigated in 30 recreationally active males randomly allocated into three groups: high-intensity (70-80% maximum perceived stretch), low-intensity (30-40% maximum perceived stretch), and control. Both stretching groups performed 3 sets of passive static stretching exercises of 60s each for hamstrings, hip flexors, and quadriceps, over 3 consecutive days, post-unaccustomed eccentric exercise. Muscle function (eccentric and isometric peak torque) and blood biomarkers (CK and CRP) were measured before (baseline) and after (24, 48, and 72h) unaccustomed eccentric exercise. Perceived muscle soreness scores were collected immediately (time 0), and after 24, 48, and 72h post-exercise. Statistical time x condition interactions observed only for eccentric peak torque (p=.008). Magnitude-based inference analyses revealed low-intensity stretching had most likely, very likely, or likely beneficial effects on perceived muscle soreness (48-72h and 0-72h) and eccentric peak torque (baseline-24h and baseline-72h), compared with high-intensity stretching. Compared with control, low-intensity stretching had very likely or likely beneficial effects on perceived muscle soreness (0-24h and 0-72h), eccentric peak torque (baseline-48h and baseline-72h), and isometric peak torque (baseline-72h). High-intensity stretching had likely beneficial effects on eccentric peak torque (baseline-48h), but likely harmful effects eccentric peak torque (baseline-24h) and CK (baseline-48h and baseline-72h), compared with control. Therefore, low-intensity stretching is likely to result in small-to-moderate beneficial effects on perceived muscle soreness and recovery of muscle function post-unaccustomed eccentric exercise, but not markers of muscle damage and inflammation, compared with high-intensity or no stretching.

Elderly Onset of Weakness in Facioscapulohumeral Muscular Dystrophy

PubMed Central

Fee, Dominic B.

2012-01-01

A 77-year-old male is presented. He had onset of proximal weakness 10 years earlier. His course was slowly progressive. Despite having phenotypic features of facioscapulohumeral muscular dystrophy (FSH), genetic testing for this was delayed because of his age of onset, lack of family history, and benign appearing muscle biopsy. This case is one of the oldest onset of weakness in genetically confirmed FSH and highlights the recognized expansion in phenotype that has occurred since the advent of genetic testing. PMID:23024867

Elderly onset of weakness in facioscapulohumeral muscular dystrophy.

PubMed

Fee, Dominic B

2012-01-01

A 77-year-old male is presented. He had onset of proximal weakness 10 years earlier. His course was slowly progressive. Despite having phenotypic features of facioscapulohumeral muscular dystrophy (FSH), genetic testing for this was delayed because of his age of onset, lack of family history, and benign appearing muscle biopsy. This case is one of the oldest onset of weakness in genetically confirmed FSH and highlights the recognized expansion in phenotype that has occurred since the advent of genetic testing.

Effects of powdered Montmorency tart cherry supplementation on an acute bout of intense lower body strength exercise in resistance trained males.

PubMed

Levers, Kyle; Dalton, Ryan; Galvan, Elfego; Goodenough, Chelsea; O'Connor, Abigail; Simbo, Sunday; Barringer, Nicholas; Mertens-Talcott, Susanne U; Rasmussen, Christopher; Greenwood, Mike; Riechman, Steven; Crouse, Stephen; Kreider, Richard B

2015-01-01

The purpose of this study was to examine whether short-term ingestion of a powdered tart cherry supplement prior to and following intense resistance-exercise attenuates muscle soreness and recovery strength loss, while reducing markers of muscle damage, inflammation, and oxidative stress. Twenty-three healthy, resistance-trained men (20.9 ± 2.6 yr, 14.2 ± 5.4% body fat, 63.9 ± 8.6 kg FFM) were matched based on relative maximal back squat strength, age, body weight, and fat free mass. Subjects were randomly assigned to ingest, in a double blind manner, capsules containing a placebo (P, n = 12) or powdered tart cherries [CherryPURE(®)] (TC, n = 11). Participants supplemented one time daily (480 mg/d) for 10-d including day of exercise up to 48-h post-exercise. Subjects performed ten sets of ten repetitions at 70% of a 1-RM back squat exercise. Fasting blood samples, isokinetic MVCs, and quadriceps muscle soreness ratings were taken pre-lift, 60-min, 24-h, and 48-h post-lift and analyzed by MANOVA with repeated measures. Muscle soreness perception in the vastus medialis (¼) (p = 0.10) and the vastus lateralis (¼) (p = 0.024) was lower in TC over time compared to P. Compared to pre-lift, TC vastus medialis (¼) soreness was significantly attenuated up to 48-h post-lift with vastus lateralis (¼) soreness significantly lower at 24-h post-lift compared to P. TC changes in serum creatinine (p = 0.03, delta p = 0.024) and total protein (p = 0.018, delta p = 0.006) were lower over time and smaller from pre-lift levels over time compared to P Significant TC group reductions from pre-lift levels were found for AST and creatinine 48-h post-lift, bilirubin and ALT 60-min and 48-h post-lift. No significant supplementation effects were observed for serum inflammatory or anti-inflammatory markers. None of the free radical production, lipid peroxidation, or antioxidant capacity markers (NT, TBARS, TAS, SOD) demonstrated significant changes with supplementation. Changes in TC whole blood lymphocyte counts (p = 0.013) from pre-lift were greater compared to P, but TC lymphocyte counts returned to pre-lift values quicker than P. Short-term supplementation of Montmorency powdered tart cherries surrounding a single bout of resistance exercise, appears to be an effective dietary supplement to attenuate muscle soreness, strength decrement during recovery, and markers of muscle catabolism in resistance trained individuals.

Delayed onset of transversus abdominus in long-standing groin pain.

PubMed

Cowan, Sallie M; Schache, Anthony G; Brukner, Peter; Bennell, Kim L; Hodges, Paul W; Coburn, Paul; Crossley, Kay M

2004-12-01

Long-standing groin pain is a persistent problem that is commonly difficult to rehabilitate. Theoretical rationale indicates a relationship between the motor control of the pelvis and long-standing groin pain; however, this link has not been investigated. The current experiment aimed to evaluate motor control of the abdominal muscles in a group of Australian football players with and without long-standing groin pain. Ten participants with long-standing groin pain and 12 asymptomatic controls were recruited for the study. Participants were elite or subelite Australian football players. Fine-wire and surface electromyography electrodes were used to record the activity of the selected abdominal and leg muscles during a visual choice reaction-time task (active straight leg raising). When the asymptomatic controls completed the active straight leg raise (ASLR) task, the transversus abdominus contracted in a feed-forward manner. However, when individuals with long-standing groin pain completed the ASLR task, the onset of transversus abdominus was delayed (P < 0.05) compared with the control group. There were no differences between groups for the onset of activity of internal oblique, external oblique, and rectus abdominus (all P > 0.05). The finding that the onset of transversus abdominus is delayed in individuals with long-standing groin pain is important, as it demonstrates an association between long-standing groin pain and transversus abdominus activation.

Is There Evidence that Runners can Benefit from Wearing Compression Clothing?

PubMed

Engel, Florian Azad; Holmberg, Hans-Christer; Sperlich, Billy

2016-12-01

Runners at various levels of performance and specializing in different events (from 800 m to marathons) wear compression socks, sleeves, shorts, and/or tights in attempt to improve their performance and facilitate recovery. Recently, a number of publications reporting contradictory results with regard to the influence of compression garments in this context have appeared. To assess original research on the effects of compression clothing (socks, calf sleeves, shorts, and tights) on running performance and recovery. A computerized research of the electronic databases PubMed, MEDLINE, SPORTDiscus, and Web of Science was performed in September of 2015, and the relevant articles published in peer-reviewed journals were thus identified rated using the Physiotherapy Evidence Database (PEDro) Scale. Studies examining effects on physiological, psychological, and/or biomechanical parameters during or after running were included, and means and measures of variability for the outcome employed to calculate Hedges'g effect size and associated 95 % confidence intervals for comparison of experimental (compression) and control (non-compression) trials. Compression garments exerted no statistically significant mean effects on running performance (times for a (half) marathon, 15-km trail running, 5- and 10-km runs, and 400-m sprint), maximal and submaximal oxygen uptake, blood lactate concentrations, blood gas kinetics, cardiac parameters (including heart rate, cardiac output, cardiac index, and stroke volume), body and perceived temperature, or the performance of strength-related tasks after running. Small positive effect sizes were calculated for the time to exhaustion (in incremental or step tests), running economy (including biomechanical variables), clearance of blood lactate, perceived exertion, maximal voluntary isometric contraction and peak leg muscle power immediately after running, and markers of muscle damage and inflammation. The body core temperature was moderately affected by compression, while the effect size values for post-exercise leg soreness and the delay in onset of muscle fatigue indicated large positive effects. Our present findings suggest that by wearing compression clothing, runners may improve variables related to endurance performance (i.e., time to exhaustion) slightly, due to improvements in running economy, biomechanical variables, perception, and muscle temperature. They should also benefit from reduced muscle pain, damage, and inflammation.

A new method for the noninvasive determination of abdominal muscle feedforward activity based on tissue velocity information from tissue Doppler imaging.

PubMed

Mannion, A F; Pulkovski, N; Schenk, P; Hodges, P W; Gerber, H; Loupas, T; Gorelick, M; Sprott, H

2008-04-01

Rapid arm movements elicit anticipatory activation of the deep-lying abdominal muscles; this appears modified in back pain, but the invasive technique used for its assessment [fine-wire electromyography (EMG)] has precluded its widespread investigation. We examined whether tissue-velocity changes recorded with ultrasound (M-mode) tissue Doppler imaging (TDI) provided a viable noninvasive alternative. Fourteen healthy subjects rapidly flexed, extended, and abducted the shoulder; recordings were made of medial deltoid (MD) surface EMG and of fine-wire EMG and TDI tissue-velocity changes of the contralateral transversus abdominis, obliquus internus, and obliquus externus. Muscle onsets were determined by blinded visual analysis of EMG and TDI data. TDI could not distinguish between the relative activation of the three muscles, so in subsequent analyses only the onset of the earliest abdominal muscle activity was used. The latter occurred <50 ms after the onset of medial deltoid EMG (i.e., was feedforward) and correlated with the corresponding EMG onsets (r = 0.47, P < 0.0001). The mean difference between methods was 20 ms and was likely explained by electromechanical delay; limits of agreement were wide (-40 to +80 ms) but no greater than those typical of repeated measurements using either technique. The between-day standard error of measurement of the TDI onsets (examined in 16 further subjects) was 16 ms. TDI yielded reliable and valid measures of the earliest onset of feedforward activity within the anterolateral abdominal muscle group. The method can be used to assess muscle dysfunction in large groups of back-pain patients and may also be suitable for the noninvasive analysis of other deep-lying or small/thin muscles.

[A variant of island flaps for the covering of pressure sores: the hatchet flap. Apropos of 31 cases].

PubMed

Quillot, M; Lodde, J P; Pegorier, O; Reynaud, J P; Cormerais, A

1994-08-01

The authors propose a modification of the classical design of island flaps for cover of pressure sores, applied to gluteus maximus and tensor fascia lata muscles: the hatchet flap. 31 flaps have been used including 13 gluteus maximus superior flaps for sacral pressure sores, 9 gluteal inferior flaps for ischial pressure sores and 9 tensor fascia lata flaps for trochanteric pressure sores. A small partial necrosis and two cases of sepsis were observed in this series, but did not require surgical revision. The authors emphasize the value of this modification of the classical flap design, which preserves an even better musculocutaneous capital in these patients, who are often already multi-operated. The very rapid recovery of patients supports the authors' application of hatchet flaps to the surgery of pressure sores, and suggests the extension to other musculocutaneous flaps in the future.

Definition of healthcare-associated influenza: A review and results from an international survey.

PubMed

Munier-Marion, Elodie; Bénet, Thomas; Vanhems, Philippe

2017-09-01

To describe definitions of healthcare-associated influenza (HAI) in recent literature and in hospitals participating in a survey of Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN) members. A review with PubMed search was undertaken to retrieve articles published between 2008 and 2016, focusing on the subject headings "influenza, human" and "cross infection." Definitions of clinical influenza-like illness (ILI) and HAI were identified. An invitation to participate in the survey was sent to 218 SRN members via email. Of 75 articles on HAI included in the review, 30 presented a standardized definition of clinical ILI based on fever (100%), cough (80%), and sore throat (70%). Forty studies (53%) contained a standardized HAI definition, grounded on threshold delay from admission in 29 of them, this delay ranging from 48 to 196 hour (median: 72 hour). Fifty-five SRN members responded to the survey, with a standardized definition of HAI adopted by 76% of them. This definition was based on clinical features for 24%, virological features for 31%, and both for 45%. Fever (mean threshold: 38.0°C) was part of the definition for 82%. The features required most frequently in the clinical definition were cough (46%) and sore throat (26%). Median threshold delay between admission and symptoms onset adopted for HAI definition was 48 hour (range: 24-96 hour). This work underlined the heterogeneity of HAI definitions in different countries. A standardized definition would be helpful to evaluate HAI spread, outcomes in patients and healthcare systems, and the impact of prevention measures, including vaccination. © 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Muscle enzyme release does not predict muscle function impairment after triathlon.

PubMed

Margaritis, I; Tessier, F; Verdera, F; Bermon, S; Marconnet, P

1999-06-01

We sought to determine the effects of a long distance triathlon (4 km swim, 120 km bike-ride, and 30 km run) on the four-day kinetics of the biochemical markers of muscle damage, and whether they were quantitatively linked with muscle function impairment and soreness. Data were collected from 2 days before until 4 days after the completion of the race. Twelve triathletes performed the triathlon and five did not. Maximal voluntary contraction (MVC), muscle soreness (DOMS) and total serum CK, CK-MB, LDH, AST and ALT activities were assessed. Significant changes after triathlon completion were found for all muscle damage indirect markers over time (p < 0.0001). MVC of the knee extensor and flexor muscles decreased over time (p < 0.05). There is disparity in the time point at which peak values where reached for DOMS, MVC and enzyme leakage. There is no correlation between serum enzyme leakage, DOMS and MVC impairment which occur after triathlon. Long distance triathlon race caused muscle damage, but extent, as well as muscle recovery cannot be evaluated by the magnitude of changes in serum enzyme activities. Muscle enzyme release cannot be used to predict the magnitude of the muscle function impairment caused by muscle damage.

Older adults utilize less efficient postural control when performing pushing task.

PubMed

Lee, Yun-Ju; Chen, Bing; Aruin, Alexander S

2015-12-01

The ability to maintain balance deteriorates with increasing age. The aim was to investigate the role of age in generation of anticipatory (APA) and compensatory (CPA) postural adjustments during pushing an object. Older (68.8 ± 1.0 years) and young adults (30.1 ± 1.4 years) participated in the experiment involving pushing an object (a pendulum attached to the ceiling) using both hands. Electrical activity of six leg and trunk muscles and displacements of the center of pressure (COP) were recorded and analyzed during the APA and CPA phases. The onset time, integrals of muscle activity, and COP displacements were determined. In addition, the indexes of co-activation and reciprocal activation of muscles for the shank, thigh, and trunk segments were calculated. Older adults, compared to young adults, showed less efficient postural control seen as delayed anticipatory muscle onset times and delayed COP displacements. Moreover, older adults used co-activation of muscles during the CPA phase while younger subjects utilized reciprocal activation of muscles. The observed diminished efficiency of postural control during both anticipatory and compensatory postural adjustments observed in older adults might predispose them to falls while performing tasks involving pushing. The outcome provides a background for future studies focused on the optimization of the daily activities of older adults. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effects of an Elastic Hamstring Assistance Device During Downhill Running

PubMed Central

Aldret, Randy L; Trahan, Brittany A; Davis, Greggory; Campbell, Brian; Bellar, David M

2017-01-01

Abstract The purpose of this study was to determine the appropriateness of using an elastic hamstring assistance device to reduce perceived levels of soreness, increase isometric strength, increase passive range of motion, and decrease biomarkers of muscle damage after eccentric exercise, specifically, downhill running This study was conducted in a university exercise physiology laboratory placing sixteen apparently healthy males (X = 21.6 ± 2.5 years) into two groups using a pre-test/post-test design. Pre-intervention measures taken included participants’ body height, body mass, body fat, capillary blood samples, VO2max, isometric hamstring strength at 45 and 90 degrees of flexion and passive hamstring range of motion. Post-intervention measures included blood biomarkers, passive range of motion, the perceived level of soreness and isometric strength. An analysis of normality of data was initially conducted followed by multivariate analysis of variance (MANOVA) of hamstring strength at 45 and 90 degrees of flexion, blood myoglobin and passive range of motion of the hamstrings. Statistically significant changes were noted in subject-perceived muscle soreness and isometric strength at 90 degrees at the 24-hour post-exercise trial measure between the two groups. Results would suggest the findings could be explained by the decrease in muscle soreness from utilizing the device during the exercise trial. Further research should be conducted to address sample size issues and to determine if the results are comparable on different surfaces. PMID:28713460

Cardiac Autonomic and Blood Pressure Responses to an Acute Foam Rolling Session.

PubMed

Lastova, Kevin; Nordvall, Michael; Walters-Edwards, Michelle; Allnutt, Amy; Wong, Alexei

2018-03-22

Foam Rolling (FR) is a self-myofascial release method that has become extremely popular among athletes and fitness enthusiasts for its ability to improve flexibility and range of motion and alleviate delayed onset muscle soreness. However, the cardiac autonomic modulation and blood pressure (BP) responses induced by an acute FR session are currently unknown. The present study evaluated the effects of an acute session of FR exercise on heart rate variability (HRV) and BP responses in healthy individuals. Fifteen (M=8, F=7) healthy subjects completed either a FR or non-exercise control trial in randomized order. HRV and BP measurements were collected at baseline, 10 and 30 min after each trial. There were significant increases (P < 0.01) in markers of vagal tone (nHF) for 30 min after the FR trial, while no changes from baseline were observed following control. There were also significant decreases (P < 0.05) in markers of sympathetic activity (nLF), sympathovagal balance (nLF/nHF), systolic BP and diastolic BP at 10 and 30 min after the trial KB trial while no changes from baseline were observed after the control trial. Our findings indicate that FR decreases sympathovagal balance for 30 min post-intervention which is concurrent with an important hypotensive effect. Further research is warranted to evaluate the potential cardiovascular protective effects of FR in diverse populations.

The repeated bout effect of typical lower body strength training sessions on sub-maximal running performance and hormonal response.

PubMed

Doma, Kenji; Schumann, Moritz; Sinclair, Wade H; Leicht, Anthony S; Deakin, Glen B; Häkkinen, Keijo

2015-08-01

This study examined the effects of two typical strength training sessions performed 1 week apart (i.e. repeated bout effect) on sub-maximal running performance and hormonal. Fourteen resistance-untrained men (age 24.0 ± 3.9 years; height 1.83 ± 0.11 m; body mass 77.4 ± 14.0 kg; VOpeak 48.1 ± 6.1 M kg(-1) min(-1)) undertook two bouts of high-intensity strength training sessions (i.e. six-repetition maximum). Creatine kinase (CK), delayed-onset muscle soreness (DOMS), counter-movement jump (CMJ) as well as concentrations of serum testosterone, cortisol and testosterone/cortisol ratio (T/C) were examined prior to and immediately post, 24 (T24) and 48 (T48) h post each strength training bout. Sub-maximal running performance was also conducted at T24 and T48 of each bout. When measures were compared between bouts at T48, the degree of elevation in CK (-58.4 ± 55.6 %) and DOMS (-31.43 ± 42.9 %) and acute reduction in CMJ measures (4.1 ± 5.4 %) were attenuated (p < 0.05) following the second bout. Cortisol was increased until T24 (p < 0.05) although there were no differences between bouts and no differences were found for testosterone and T/C ratio (p > 0.05). Sub-maximal running performance was impaired until T24, although changes were not attenuated following the second bout. The initial bout appeared to provide protection against a number of muscle damage indicators suggesting a greater need for recovery following the initial session of typical lower body resistance exercises in resistance-untrained men although sub-maximal running should be avoided following the first two sessions.

Oxygen exchange profile in rat muscles of contrasting fibre types.

PubMed

Behnke, Brad J; McDonough, Paul; Padilla, Danielle J; Musch, Timothy I; Poole, David C

2003-06-01

To determine whether fibre type affects the O2 exchange characteristics of skeletal muscle at the microcirculatory level we tested the hypothesis that, following the onset of contractions, muscle comprising predominately type I fibres (soleus, Sol, 86 % type I) would, based on demonstrated blood flow responses, exhibit a blunted microvascular PO2 (PO2,m, which is determined by the O2 delivery (QO2) to O2 uptake (VO2) ratio) profile (assessed via phosphorescence quenching) compared to muscle of primarily type II fibres (peroneal, Per, 84 % type II). PO2,m was measured at rest, and following the rest-contractions (twitch, 1 Hz, 2-4 V for 120 s) transition in Sol (n = 6) and Per (n = 6) muscles of Sprague-Dawley rats. Both muscles exhibited a delay followed by a mono-exponential decrease in PO2,m to the steady state. However, compared with Sol, Per demonstrated (1) a larger change in baseline minus steady state contracting PO2,m (DeltaPO2,m) (Per, 13.4 +/- 1.7 mmHg; Sol, 8.6 +/- 0.9 mmHg, P < 0.05); (2) a faster mean response time (i.e. time delay (TD) plus time constant (tau); Per, 23.8 +/- 1.5 s; Sol, 39.6 +/- 4.3 s, P < 0.05); and therefore (3) a greater rate of PO2,m decline (DeltaPO2,m/tau; Per, 0.92 +/- 0.08 mmHg s-1; Sol, 0.42 +/- 0.05 mmHg s-1, P < 0.05). These data demonstrate an increased microvascular pressure head of O2 at any given point after the initial time delay for Sol versus Per following the onset of contractions that is probably due to faster QO2 dynamics relative to those of VO2.

Utility of multi-channel surface electromyography in assessment of focal hand dystonia.

PubMed

Sivadasan, Ajith; Sanjay, M; Alexander, Mathew; Devasahayam, Suresh R; Srinivasa, Babu K

2013-09-01

Surface electromyography (SEMG) allows objective assessment and guides selection of appropriate treatment in focal hand dystonia (FHD). Sixteen-channel SEMG obtained during different phases of a writing task was used to study timing, activation patterns, and spread of muscle contractions in FHD compared with normal controls. Customized software was developed to acquire and analyze EMG signals. SEMG of FHD subjects (20) showed "early onset" during motor imagery, rapid proximal muscle recruitment, agonist-antagonist co-contraction involving proximal muscle groups, "delayed offset" after stopping writing, higher rectified mean amplitudes, and mirror activity in contralateral limb compared with controls (16). Muscle activation latencies were heterogenous in FHD. Anticipation, delayed relaxation, and mirror EMG activation were noted in FHD. A clear pattern of muscle activation cannot be ascertained. Multi-channel SEMG can aid in objective assessment of temporal-spatial distribution of activity and can refine targeted therapies like chemodenervation and biofeedback. Copyright © 2013 Wiley Periodicals, Inc.

Rosiglitazone delayed weight loss and anorexia while attenuating adipose depletion in mice with cancer cachexia.

PubMed

Asp, Michelle L; Tian, Min; Kliewer, Kara L; Belury, Martha A

2011-12-01

Cachexia is characterized by severe weight loss, including adipose and muscle wasting, and occurs in a large percentage of cancer patients. Insulin resistance contributes to dysregulated metabolism in cachexia and occurs prior to weight loss in mice with colon-26 tumor-induced cachexia. Therefore, we hypothesized that the insulin sensitizer, rosiglitazone, would attenuate the loss of adipose and muscle to result in improved outcomes for mice with late-stage cachexia. Male CD2F1 mice were inoculated with colon-26 adenocarcinoma cells or vehicle. Treatments included vehicle, rosiglitazone (10 mg/kg body weight/day) or rosiglitazone plus pair-feeding to food intake of vehicle-treated mice with tumors. Rosiglitazone delayed weight loss onset by 2 d over the 16 d duration of this aggressive tumor model. This finding was associated, in part, with increased food intake. In addition, adipose mass, adipocyte cross-sectional area and inflammation were improved with rosiglitazone. However, at the time of necropsy 16 d after tumor inoculation rosiglitazone had no effect on retention of muscle mass, strength or proteolysis in late-stage cachexia. We did not measure stamina or endurance in this study. In early-stage cachexia, rosiglitazone normalized PDK4 and PPAR-delta mRNA in quadriceps muscle and rescued the decrease in insulin-stimulated glucose disappearance in mice with tumors. Rosiglitazone may delay weight loss onset by decreasing tumor-induced markers of metabolic change in early-stage cachexia. These changes predict for modest improvement in adipose, but no improvement in muscle strength in late-stage cachexia.

Rosiglitazone delayed weight loss and anorexia while attenuating adipose depletion in mice with cancer cachexia

PubMed Central

Asp, Michelle L.; Tian, Min; Kliewer, Kara L.

2011-01-01

Cachexia is characterized by severe weight loss, including adipose and muscle wasting, and occurs in a large percentage of cancer patients. Insulin resistance contributes to dysregulated metabolism in cachexia and occurs prior to weight loss in mice with colon-26 tumor-induced cachexia. Therefore, we hypothesized that the insulin sensitizer, rosiglitazone, would attenuate the loss of adipose and muscle to result in improved outcomes for mice with late-stage cachexia. Male CD2F1 mice were inoculated with colon-26 adenocarcinoma cells or vehicle. Treatments included vehicle, rosiglitazone (10 mg/kg body weight/day) or rosiglitazone plus pair-feeding to food intake of vehicle-treated mice with tumors. Rosiglitazone delayed weight loss onset by 2 d over the 16 d duration of this aggressive tumor model. This finding was associated, in part, with increased food intake. In addition, adipose mass, adipocyte cross-sectional area and inflammation were improved with rosiglitazone. However, at the time of necropsy 16 d after tumor inoculation rosiglitazone had no effect on retention of muscle mass, strength or proteolysis in late-stage cachexia. We did not measure stamina or endurance in this study. In early-stage cachexia, rosiglitazone normalized PDK4 and PPAR-delta mRNA in quadriceps muscle and rescued the decrease in insulin-stimulated glucose disappearance in mice with tumors. Rosiglitazone may delay weight loss onset by decreasing tumor-induced markers of metabolic change in early-stage cachexia. These changes predict for modest improvement in adipose, but no improvement in muscle strength in late-stage cachexia. PMID:22104958

Age-related changes in physical and perceptual markers of recovery following high-intensity interval cycle exercise.

PubMed

Borges, Nattai R; Reaburn, Peter R; Doering, Thomas M; Argus, Christos K; Driller, Matthew W

2018-05-29

The purpose of this study was to compare physical performance, perceptual and haematological markers of recovery in well-trained masters and young cyclists across 48 h following a bout of repeated high-intensity interval exercise. Nine masters (mean ± SD; age = 55.6 ± 5.0 years) and eight young (age = 25.9 ± 3.0 years) cyclists performed a high-intensity interval exercise session consisting of 6 × 30 s intervals at 175% peak power output with 4.5 min rest between efforts. Maximal voluntary contraction (MVC), 10 s sprint (10SST), 30-min time trial (30TT) performance, creatine kinase concentration (CK) and perceptual measures of motivation, total recovery, fatigue and muscle soreness were collected at baseline and at standardised time points across the 48 h recovery period. No significant group-time interactions were observed for performance of MVC, 10SST, 30TT and CK (P > 0.05). A significant reduction in 10SST peak power was found in both masters (P = 0.002) and young (P = 0.003) cyclists at 1 h post exercise, however, both groups physically recovered at similar rates. Neither group showed significant (P > 0.05) or practically meaningful increases in CK (%∆ < 10%). A significant age-related difference was found for perceptual fatigue (P = 0.01) and analysis of effect size (ES) showed that perceptual recovery was delayed with masters cyclists reporting lower motivation (ES ±90%CI = 0.69 ± 0.77, moderate), greater fatigue (ES = 0.75 ± 0.93, moderate) and muscle soreness (ES = 0.61 ± 0.70, moderate) after 48 h of recovery. The delay in perceived recovery may have negative effects on long-term participation to systematic training.

Dynamic versus isometric electromechanical delay in non-fatigued and fatigued muscle: A combined electromyographic, mechanomyographic, and force approach.

PubMed

Smith, Cory M; Housh, Terry J; Hill, Ethan C; Johnson, Glen O; Schmidt, Richard J

2017-04-01

This study used a combined electromyographic, mechanomyographic, and force approach to identify electromechanical delay (EMD) from the onsets of the electromyographic to force signals (EMD E-F ), onsets of the electromyographic to mechanomyogrpahic signals (EMD E-M ), and onsets of mechanomyographic to force signals (EMD M-F ). The purposes of the current study were to examine: (1) the differences in EMD E-F , EMD E-M , and EMD M-F from the vastus lateralis during maximal, voluntary dynamic (1 repetition maximum [1-RM]) and isometric (maximal voluntary isometric contraction [MVIC]) muscle actions; and (2) the effects of fatigue on EMD E-F , EMD M-F , and EMD E-M . Ten men performed pretest and posttest 1-RM and MVIC leg extension muscle actions. The fatiguing workbout consisted of 70% 1-RM dynamic constant external resistance leg extension muscle actions to failure. The results indicated that there were no significant differences between 1-RM and MVIC EMD E-F , EMD E-M , or EMD M-F. There were, however, significant fatigue-induced increases in EMD E-F (94% and 63%), EMD E-M (107%), and EMD M-F (63%) for both the 1-RM and MVIC measurements. Therefore, these findings demonstrated the effects of fatigue on EMD measures and supported comparisons among studies which examined dynamic or isometric EMD measures from the vastus lateralis using a combined electromyographic, mechanomyographic, and force approach. Copyright © 2017 Elsevier Ltd. All rights reserved.

The relative efficacy of three recovery modalities after professional rugby league matches.

PubMed

Webb, Nicholas P; Harris, Nigel K; Cronin, John B; Walker, Craig

2013-09-01

This study investigated the relative efficacy of postgame recovery modalities on jump height performance and subjective ratings of muscle soreness and muscle damage at 1, 18, and 42 hours after professional rugby league competition games. Twenty-one professional rugby league players performed 3 different postmatch recovery modalities: cold water immersion (CWI), contrast water therapy (CWT), and active recovery (ACT). The effects of the recovery treatments were analyzed with mixed modeling including a covariate (fatigue score) to adjust for changes in the intensity of each match on the postmatch values of the dependent variables of interest. Standardization of effects was used to make magnitude-based inferences, presented as mean with ±90% confidence limits. Cold water immersion and CWT clearly recovered jump height performance (CWI 2.3 ± 3.7%; CWT 3.5 ± 4.1%), reduced muscle soreness (CWI -0.95 ± 0.37; CWT -0.55 ± 0.37), and decreased creatine kinase (CWI -11.0 ± 15.1%; CWT 18.2 ± 20.1%) by 42 hours postgame compared with ACT. Contrast water therapy was however clearly more effective compared with CWI on the recovery of muscle soreness and creatine kinase by 42 hours postgame. Based on these findings, CWT recovery is recommended postmatch for team rugby sports.

Does a SLAP lesion affect shoulder muscle recruitment as measured by EMG activity during a rugby tackle?

PubMed Central

2010-01-01

Background The study objective was to assess the influence of a SLAP lesion on onset of EMG activity in shoulder muscles during a front on rugby football tackle within professional rugby players. Methods Mixed cross-sectional study evaluating between and within group differences in EMG onset times. Testing was carried out within the physiotherapy department of a university sports medicine clinic. The test group consisted of 7 players with clinically diagnosed SLAP lesions, later verified on arthroscopy. The reference group consisted of 15 uninjured and full time professional rugby players from within the same playing squad. Controlled tackles were performed against a tackle dummy. Onset of EMG activity was assessed from surface EMG of Pectorialis Major, Biceps Brachii, Latissimus Dorsi, Serratus Anterior and Infraspinatus muscles relative to time of impact. Analysis of differences in activation timing between muscles and limbs (injured versus non-injured side and non injured side versus matched reference group). Results Serratus Anterior was activated prior to all other muscles in all (P = 0.001-0.03) subjects. In the SLAP injured shoulder Biceps was activated later than in the non-injured side. Onset times of all muscles of the non-injured shoulder in the injured player were consistently earlier compared with the reference group. Whereas, within the injured shoulder, all muscle activation timings were later than in the reference group. Conclusions This study shows that in shoulders with a SLAP lesion there is a trend towards delay in activation time of Biceps and other muscles with the exception of an associated earlier onset of activation of Serratus anterior, possibly due to a coping strategy to protect glenohumeral stability and thoraco-scapular stability. This trend was not statistically significant in all cases PMID:20184752

Whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults.

PubMed

Costello, Joseph T; Baker, Philip R A; Minett, Geoffrey M; Bieuzen, Francois; Stewart, Ian B; Bleakley, Chris

2015-09-18

Recovery strategies are often used with the intention of preventing or minimising muscle soreness after exercise. Whole-body cryotherapy, which involves a single or repeated exposure(s) to extremely cold dry air (below -100 °C) in a specialised chamber or cabin for two to four minutes per exposure, is currently being advocated as an effective intervention to reduce muscle soreness after exercise. To assess the effects (benefits and harms) of whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, the British Nursing Index and the Physiotherapy Evidence Database. We also searched the reference lists of articles, trial registers and conference proceedings, handsearched journals and contacted experts.The searches were run in August 2015. We aimed to include randomised and quasi-randomised trials that compared the use of whole-body cryotherapy (WBC) versus a passive or control intervention (rest, no treatment or placebo treatment) or active interventions including cold or contrast water immersion, active recovery and infrared therapy for preventing or treating muscle soreness after exercise in adults. We also aimed to include randomised trials that compared different durations or dosages of WBC. Our prespecified primary outcomes were muscle soreness, subjective recovery (e.g. tiredness, well-being) and adverse effects. Two review authors independently screened search results, selected studies, assessed risk of bias and extracted and cross-checked data. Where appropriate, we pooled results of comparable trials. The random-effects model was used for pooling where there was substantial heterogeneity. We assessed the quality of the evidence using GRADE. Four laboratory-based randomised controlled trials were included. These reported results for 64 physically active predominantly young adults (mean age 23 years). All but four participants were male. Two trials were parallel group trials (44 participants) and two were cross-over trials (20 participants). The trials were heterogeneous, including the type, temperature, duration and frequency of WBC, and the type of preceding exercise. None of the trials reported active surveillance of predefined adverse events. All four trials had design features that carried a high risk of bias, potentially limiting the reliability of their findings. The evidence for all outcomes was classified as 'very low' quality based on the GRADE criteria.Two comparisons were tested: WBC versus control (rest or no WBC), tested in four studies; and WBC versus far-infrared therapy, also tested in one study. No studies compared WBC with other active interventions, such as cold water immersion, or different types and applications of WBC.All four trials compared WBC with rest or no WBC. There was very low quality evidence for lower self-reported muscle soreness (pain at rest) scores after WBC at 1 hour (standardised mean difference (SMD) -0.77, 95% confidence interval (CI) -1.42 to -0.12; 20 participants, 2 cross-over trials); 24 hours (SMD -0.57, 95% CI -1.48 to 0.33) and 48 hours (SMD -0.58, 95% CI -1.37 to 0.21), both with 38 participants, 2 cross-over studies, 1 parallel group study; and 72 hours (SMD -0.65, 95% CI -2.54 to 1.24; 29 participants, 1 cross-over study, 1 parallel group study). Of note is that the 95% CIs also included either no between-group differences or a benefit in favour of the control group. One small cross-over trial (9 participants) found no difference in tiredness but better well-being after WBC at 24 hours post exercise. There was no report of adverse events.One small cross-over trial involving nine well-trained runners provided very low quality evidence of lower levels of muscle soreness after WBC, when compared with infrared therapy, at 1 hour follow-up, but not at 24 or 48 hours. The same trial found no difference in well-being but less tiredness after WBC at 24 hours post exercise. There was no report of adverse events. There is insufficient evidence to determine whether whole-body cryotherapy (WBC) reduces self-reported muscle soreness, or improves subjective recovery, after exercise compared with passive rest or no WBC in physically active young adult males. There is no evidence on the use of this intervention in females or elite athletes. The lack of evidence on adverse events is important given that the exposure to extreme temperature presents a potential hazard. Further high-quality, well-reported research in this area is required and must provide detailed reporting of adverse events.

Throat infections are associated with exacerbation in a substantial proportion of patients with chronic plaque psoriasis

PubMed Central

Thorleifsdottir, Ragna H.; Eysteinsdottir, Jenna H.; Olafsson, Jon H.; Sigurdsson, Martin I.; Johnston, Andrew; Valdimarsson, Helgi; Sigurgeirsson, Bardur

2016-01-01

Streptococcal throat infections are known to trigger or exacerbate psoriasis, and several studies support the benefit of tonsillectomy. To evaluate the potential of tonsillectomy as a treatment, we used a retrospective study-specific questionnaire to assess the proportion of psoriasis patients with sore throat-associated psoriasis exacerbations. Our survey sampled 275 psoriasis patients. 42% of patients with plaque psoriasis reported sore throat-associated psoriasis exacerbations, and 72% of patients with confirmed streptococcal infections reported aggravation. Notably, women and early onset psoriasis patients were more likely to report psoriasis exacerbation after a sore throat (p<0.001, p=0.046 respectively). Other psoriasis aggravation factors were more common in patients with sore throat-associated exacerbations (p<0.01). 49% of tonsillectomized patients reported subsequent improvement and had more frequent sore throat-associated aggravation of psoriasis than patients who did not improve after tonsillectomy (p=0.015). These findings suggest a closer association between sore throats, streptococcal throat infections and plaque psoriasis than previously reported. PMID:26984718

Throat Infections are Associated with Exacerbation in a Substantial Proportion of Patients with Chronic Plaque Psoriasis.

PubMed

Thorleifsdottir, Ragna H; Eysteinsdóttir, Jenna H; Olafsson, Jón H; Sigurdsson, Martin I; Johnston, Andrew; Valdimarsson, Helgi; Sigurgeirsson, Bardur

2016-08-23

Streptococcal throat infections are known to trigger or exacerbate psoriasis, and several studies support the benefit of tonsillectomy. To evaluate the potential of tonsillectomy as a treatment, we used a retrospective study-specific questionnaire to assess the proportion of psoriasis patients with sore throat-associated psoriasis exacerbations. Our survey sampled 275 psoriasis patients. Of patients with plaque psoriasis, 42% reported sore throat-associated psoriasis exacerbations, and of patients with confirmed streptococcal infections, 72% reported aggravation. Notably, women and patients with early onset psoriasis were more likely to report psoriasis exacerbation after a sore throat (p < 0.001, p = 0.046, respectively). Other psoriasis aggravation factors were more common in patients with sore throat-associated exacerbations (p < 0.01). Of tonsillectomized patients, 49% reported subsequent improvement and had more frequent sore throat-associated aggravation of psoriasis than patients who did not improve after tonsillectomy (p = 0.015). These findings suggest a closer association between sore throats, streptococcal throat infections and plaque psoriasis than reported previously.

Onset of action of a lozenge containing flurbiprofen 8.75 mg: a randomized, double-blind, placebo-controlled trial with a new method for measuring onset of analgesic activity.

PubMed

Schachtel, Bernard; Aspley, Sue; Shephard, Adrian; Shea, Timothy; Smith, Gary; Sanner, Kathleen; Savino, Laurie; Rezuke, Jeanne; Schachtel, Emily

2014-02-01

A new onset-of-action model was utilized to distinguish the pharmacologic activity of flurbiprofen 8.75mg delivered in a lozenge from the demulcent effect of the lozenge base. In a randomized, double-blind, placebo-controlled trial, patients with sore throat rated pain on a Sore Throat Pain Intensity Scale before taking one flurbiprofen or placebo lozenge and at frequent (2-minute) intervals over the first hour after treatment. Further ratings of the Sore Throat Pain Intensity Scale and other patient-reported outcomes (difficulty swallowing, swollen throat, pain relief) were obtained at varying intervals over 6 hours. Onset of pharmacologic activity was defined as the median time of first perceived pain reduction if a patient reported clinically meaningful (at least moderate) relief. The conventional method of comparing mean treatment responses at each time point was also implemented. Demulcent action was detected at the first 2-minute assessment. By the new method, 102 flurbiprofen-treated patients were identified as first perceiving pain relief at 12 minutes, compared with >120 minutes by 102 patients using placebo (P<0.001). By the conventional method, mean percentage pain reduction for flurbiprofen 8.75 mg was first significantly differentiated from placebo at 26 minutes (P<0.05). Efficacy of flurbiprofen lozenge was demonstrated for 3.5-4hours on the 4 patient-reported outcomes (all P<0.05 compared with placebo). There were no serious adverse events. This patient-centered onset-of-action model identifies the initiation of pain relief in patients who are definite drug responders, here demonstrating that a flurbiprofen 8.75-mg lozenge provides early relief of sore throat. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

The effect of topical thiocolchicoside in preventing and reducing the increase of muscle tone, stiffness, and soreness: A real-life study on top-level road cyclists during stage competition.

PubMed

Gervasi, Marco; Sisti, Davide; Benelli, Piero; Fernández-Peña, Eneko; Calcabrini, Cinzia; Rocchi, Marco B L; Lanata, Luigi; Bagnasco, Michela; Tonti, Andrea; Vilberto, Stocchi; Sestili, Piero

2017-07-01

In professional road cyclists, the majority of overuse injuries affect the lower limbs and are mostly represented by contractures or muscle shortening, characterized by an increase of tone and stiffness and a variation of elasticity. Treatment and prevention of these specific conditions may include physical, supplementary, and pharmacologic support. The aim of this real-life study was to determine: first, the alterations of tone, stiffness, elasticity, and soreness of rectus femoris (RF) and biceps femoris (BF) in top class cyclists engaged in 3 multistage races, and second, whether any variable in the management of the athletes may affect the prevention and/or reduction of such alterations.Twenty-three professional cyclists competing in 3 international, cycling stage races were assessed. Athletes could receive, upon the approval of the medical staff, physical, dietary, and/or pharmacological management which could include treatments with topical over-the-counter myorelaxants to prevent and/or reduce muscle contractures. MyotonPro was used to daily measure tone, stiffness, and elasticity in RF and BF in relaxed and contracted state after every stage. In parallel, BF and RF soreness was also assessed with a Likert scale.All athletes received the same general massage management; none of them received dietary supplements; some of the athletes were treated with a topical myorelaxant thiocolchicoside (TCC 0.25%) foam 3 times daily. TCC was identified as the only variable able to affect these muscle parameters in the cyclists. Tone, stiffness (regardless of the state), and soreness significantly increased over time either in BF or RF in all athletes. In the group of athletes that used TCC (n = 11; TCC+) the increase in tone, stiffness, and soreness was significantly lower than in the group not receiving TCC (n = 12; No-TCC). Elasticity varied coherently with tone and stiffness.A very intense and protracted sport activity increases muscular tone, stiffness, and soreness over time. Topical TCC foam significantly attenuates these alterations and might represent an efficient strategy both to prevent and manage contractures and their consequences in professional cyclists as well in athletes from other disciplines involving similar workloads.

[Sacral pressure sores and their treatment].

PubMed

Bielecki, Marek; Skowroński, Rafał; Skowroński, Jan

2006-01-01

Sacral bed sores still present a serious problem in most surgery departments. They occur mainly in elderly patients of limited mobility. The treatment of such sores extends over long periods of time and therefore involves considerable costs. The material consisted of 11 sacral pressure ulcers treated surgically. The sores occurred in 4 severely disabled patients suffering from proximal third femur fractures, 4 patients with traumatic brain injury (treated in the Intensive Care Unit), and 3 patients suffering from bed sores after spinal cord injury. In 6 patients a fasciocutaneous flap was applied to the sores and in 5 cases a pedicled musculocutaneous gluteus maximus flap. The end results were assessed using Seiler's criteria. Complications of the "seroma" type were observed in 3 patients, and in 2 marginal necrosis. In all our patients complete healing was achieved within 2-4 weeks. On analysing our experience to date in surgical treatment of bed sores we are of the opinion that even extensive sacral sores can be covered with unilateral pedicled flaps provided that they are appropriately planned. Deep sores of the 4th degree sometimes with concomitant osteomyelitis require pedicled muscle flaps or in some cases musculocutaneous flaps to improve local circulation. The preparation of the patient for reconstruction surgery is just as important as the operation itself and therefore such preparation should never be neglected.

Comparison of three types of full‐body compression garments on throwing and repeat‐sprint performance in cricket players

PubMed Central

Duffield, Rob; Portus, Marc

2007-01-01

Objective To compare the effects of three types of full‐body compression garments (Skins, Adidas and Under Armour) on repeat‐sprint and throwing performance in cricket players. Methods Following familiarisation, 10 male cricket players performed four randomised exercise sessions (3 garments and a control). Each session involved a 30 min repeat‐sprint exercise protocol comprising 20 m sprints every minute, separated by submaximal exercise. Throwing tests included a pre‐exercise and a postexercise maximal distance test and accuracy throwing tests. During each session, measures of heart rate, skin temperature, change in body mass, rate of perceived exertion and perceived muscle soreness were recorded. Capillary blood samples were analysed before and after exercise for lactate, pH, O2 saturation and O2 partial pressure, and 24 h after exercise for creatine kinase (CK). Ratings of perceived muscle soreness were also obtained 24 h after exercise. Results No significant differences (p>0.05) were evident in repeat‐sprint performance (10 m, 20 m time or total submaximal distance covered) or throwing performance (maximum distance or accuracy). No significant differences (p>0.05) were observed in heart rate, body mass change or blood measures during exercise. Significant differences (p<0.05) were observed by way of higher mean skin temperature, lower 24 h postexercise CK values and lower 24 h postexercise ratings of muscle soreness when wearing compression garments. Analysis between respective brands of compression garments revealed no statistical differences (p>0.05). Conclusions No benefit was noted when wearing compression garments for repeat‐sprint or throwing performance; however, the use of the garments as a recovery tool, when worn after exercise, may be beneficial to reduce postexercise trauma and perceived muscle soreness. PMID:17341589

Effects of winter military training on energy balance, whole-body protein balance, muscle damage, soreness, and physical performance.

PubMed

Margolis, Lee M; Murphy, Nancy E; Martini, Svein; Spitz, Marissa G; Thrane, Ingjerd; McGraw, Susan M; Blatny, Janet-Martha; Castellani, John W; Rood, Jennifer C; Young, Andrew J; Montain, Scott J; Gundersen, Yngvar; Pasiakos, Stefan M

2014-12-01

Physiological consequences of winter military operations are not well described. This study examined Norwegian soldiers (n = 21 males) participating in a physically demanding winter training program to evaluate whether short-term military training alters energy and whole-body protein balance, muscle damage, soreness, and performance. Energy expenditure (D2(18)O) and intake were measured daily, and postabsorptive whole-body protein turnover ([(15)N]-glycine), muscle damage, soreness, and performance (vertical jump) were assessed at baseline, following a 4-day, military task training phase (MTT) and after a 3-day, 54-km ski march (SKI). Energy intake (kcal·day(-1)) increased (P < 0.01) from (mean ± SD (95% confidence interval)) 3098 ± 236 (2985, 3212) during MTT to 3461 ± 586 (3178, 3743) during SKI, while protein (g·kg(-1)·day(-1)) intake remained constant (MTT, 1.59 ± 0.33 (1.51, 1.66); and SKI, 1.71 ± 0.55 (1.58, 1.85)). Energy expenditure increased (P < 0.05) during SKI (6851 ± 562 (6580, 7122)) compared with MTT (5480 ± 389 (5293, 5668)) and exceeded energy intake. Protein flux, synthesis, and breakdown were all increased (P < 0.05) 24%, 18%, and 27%, respectively, during SKI compared with baseline and MTT. Whole-body protein balance was lower (P < 0.05) during SKI (-1.41 ± 1.11 (-1.98, -0.84) g·kg(-1)·10 h) than MTT and baseline. Muscle damage and soreness increased and performance decreased progressively (P < 0.05). The physiological consequences observed during short-term winter military training provide the basis for future studies to evaluate nutritional strategies that attenuate protein loss and sustain performance during severe energy deficits.

Citrulline malate enhances athletic anaerobic performance and relieves muscle soreness.

PubMed

Pérez-Guisado, Joaquín; Jakeman, Philip M

2010-05-01

The purpose of the present study was to determine the effects of a single dose of citrulline malate (CM) on the performance of flat barbell bench presses as an anaerobic exercise and in terms of decreasing muscle soreness after exercise. Forty-one men performed 2 consecutive pectoral training session protocols (16 sets). The study was performed as a randomized, double-blind, 2-period crossover design. Eight grams of CM was used in 1 of the 2 training sessions, and a placebo was used in the other. The subjects' resistance was tested using the repetitions to fatigue test, at 80% of their predetermined 1 repetition maximum (RM), in the 8 sets of flat barbell bench presses during the pectoral training session (S1-4 and S1'-4'). The p-value was 0.05. The number of repetitions showed a significant increase from placebo treatment to CM treatment from the third set evaluated (p <0.0001). This increase was positively correlated with the number of sets, achieving 52.92% more repetitions and the 100% of response in the last set (S4'). A significant decrease of 40% in muscle soreness at 24 hours and 48 hours after the pectoral training session and a higher percentage response than 90% was achieved with CM supplementation. The only side effect reported was a feeling of stomach discomfort in 14.63% of the subjects. We conclude that the use of CM might be useful to increase athletic performance in high-intensity anaerobic exercises with short rest times and to relieve postexercise muscle soreness. Thus, athletes undergoing intensive preparation involving a high level of training or in competitive events might profit from CM.

Comparison of three types of full-body compression garments on throwing and repeat-sprint performance in cricket players.

PubMed

Duffield, Rob; Portus, Marc

2007-07-01

To compare the effects of three types of full-body compression garments (Skins, Adidas and Under Armour) on repeat-sprint and throwing performance in cricket players. Following familiarisation, 10 male cricket players performed four randomised exercise sessions (3 garments and a control). Each session involved a 30 min repeat-sprint exercise protocol comprising 20 m sprints every minute, separated by submaximal exercise. Throwing tests included a pre-exercise and a postexercise maximal distance test and accuracy throwing tests. During each session, measures of heart rate, skin temperature, change in body mass, rate of perceived exertion and perceived muscle soreness were recorded. Capillary blood samples were analysed before and after exercise for lactate, pH, O(2) saturation and O(2) partial pressure, and 24 h after exercise for creatine kinase (CK). Ratings of perceived muscle soreness were also obtained 24 h after exercise. No significant differences (p>0.05) were evident in repeat-sprint performance (10 m, 20 m time or total submaximal distance covered) or throwing performance (maximum distance or accuracy). No significant differences (p>0.05) were observed in heart rate, body mass change or blood measures during exercise. Significant differences (p<0.05) were observed by way of higher mean skin temperature, lower 24 h postexercise CK values and lower 24 h postexercise ratings of muscle soreness when wearing compression garments. Analysis between respective brands of compression garments revealed no statistical differences (p>0.05). No benefit was noted when wearing compression garments for repeat-sprint or throwing performance; however, the use of the garments as a recovery tool, when worn after exercise, may be beneficial to reduce postexercise trauma and perceived muscle soreness.

Phototherapy in skeletal muscle performance and recovery after exercise: effect of combination of super-pulsed laser and light-emitting diodes.

PubMed

Antonialli, Fernanda Colella; De Marchi, Thiago; Tomazoni, Shaiane Silva; Vanin, Adriane Aver; dos Santos Grandinetti, Vanessa; de Paiva, Paulo Roberto Vicente; Pinto, Henrique Dantas; Miranda, Eduardo Foschini; de Tarso Camillo de Carvalho, Paulo; Leal-Junior, Ernesto Cesar Pinto

2014-11-01

Recent studies with phototherapy have shown positive results in enhancement of performance and improvement of recovery when applied before exercise. However, several factors still remain unknown such as therapeutic windows, optimal treatment parameters, and effects of combination of different light sources (laser and LEDs). The aim of this study was to evaluate the effects of phototherapy with the combination of different light sources on skeletal muscle performance and post-exercise recovery, and to establish the optimal energy dose. A randomized, double-blinded, placebo-controlled trial with participation of 40 male healthy untrained volunteers was performed. A single phototherapy intervention was performed immediately after pre-exercise (baseline) maximum voluntary contraction (MVC) with a cluster of 12 diodes (4 of 905 nm lasers-0.3125 mW each, 4 of 875 nm LEDs-17.5 mW each, and 4 of 670 nm LEDs-15 mW each- manufactured by Multi Radiance Medical™) and dose of 10, 30, and 50 J or placebo in six sites of quadriceps. MVC, delayed onset muscle soreness (DOMS), and creatine kinase (CK) activity were analyzed. Assessments were performed before, 1 min, 1, 24, 48, 72, and 96 h after eccentric exercise protocol employed to induce fatigue. Phototherapy increased (p < 0.05) MVC was compared to placebo from immediately after to 96 h after exercise with 10 or 30 J doses (better results with 30 J dose). DOMS was significantly decreased compared to placebo (p < 0.05) with 30 J dose from 24 to 96 h after exercise, and with 50 J dose from immediately after to 96 h after exercise. CK activity was significantly decreased (p < 0.05) compared to placebo with all phototherapy doses from 1 to 96 h after exercise (except for 50 J dose at 96 h). Pre-exercise phototherapy with combination of low-level laser and LEDs, mainly with 30 J dose, significantly increases performance, decreases DOMS, and improves biochemical marker related to skeletal muscle damage.

Neuromuscular electrical stimulation via the peroneal nerve is superior to graduated compression socks in reducing perceived muscle soreness following intense intermittent endurance exercise.

PubMed

Ferguson, Richard A; Dodd, Matthew J; Paley, Victoria R

2014-10-01

A novel technique of neuromuscular electrical stimulation (NMES) via the peroneal nerve has been shown to augment limb blood flow which could enhance recovery following exercise. The present study examined the effects of NMES, compared to graduated compression socks on muscle soreness, strength, and markers of muscle damage and inflammation following intense intermittent exercise. Twenty-one (age 21 ± 1 years, height 179 ± 7 cm, body mass 76 ± 9 kg,) healthy males performed a 90-min intermittent shuttle running test on three occasions. Following exercise, the following interventions were applied: passive recovery (CON), graduated compression socks (GCS) or NMES. Perceived muscle soreness (PMS) and muscle strength (isometric maximal voluntary contraction of knee extensors and flexors) were measured and a venous blood sample taken pre-exercise and 0, 1, 24, 48 and 72 h following exercise for measurement of creatine kinase (CK) and Lactate dehydrogenase (LDH) activity and IL-6 and CRP concentrations. PMS increased in all conditions immediately, 1 and 24 h post-exercise. At 24 h PMS was lower in NMES compared to GCS and CON (2.0 ± 1.6, 3.2 ± 2.1, 4.6 ± 2.0, respectively). At 48 h PMS was lower in NMES compared to CON (1.3 ± 1.5 and 3.1 ± 1.8, respectively). There were no differences between treatments for muscle strength, CK and LDH activity, IL-6 and CRP concentrations. The novel NMES technique is superior to GCS in reducing PMS following intense intermittent endurance exercise.

Effects of Volitional Spine Stabilization and Lower-Extremity Fatigue on the Knee and Ankle During Landing Performance in a Population With Recurrent Low Back Pain.

PubMed

Haddas, Ram; Sawyer, Steven F; Sizer, Phillip S; Brooks, Toby; Chyu, Ming-Chien; James, C Roger

2017-09-01

Recurrent lower back pain (rLBP) and neuromuscular fatigue are independently thought to increase the risk of lower extremity (LE) injury. Volitional preemptive abdominal contraction (VPAC) is thought to improve lumbar spine and pelvis control in individuals with rLBP. The effects of VPAC on fatigued landing performance in individuals with rLBP are unknown. To determine the effects of VPAC and LE fatigue on landing performance in a rLBP population. Cross-sectional pretest-posttest cohort control design. A clinical biomechanics laboratory. 32 rLBP (age 21.2 ± 2.7 y) but without current symptoms and 33 healthy (age 20.9 ± 2.3 y) subjects. (i) Volitional preemptive abdominal contraction using abdominal bracing and (ii) fatigue using submaximal free-weight squat protocol with 15% body weight until task failure was achieved. Knee and ankle angles, moments, electromyographic measurements from semitendinosus and vastus medialis muscles, and ground reaction force (GRF) were collected during 0.30 m drop-jump landings. The VPAC resulted in significantly earlier muscle onsets across all muscles with and without fatigue in both groups (mean ± SD, 0.063 ± 0.016 s earlier; P ≤ .001). Fatigue significantly delayed semitendinosus muscle onsets (0.033 ± 0.024 s later; P ≤ .001), decreased GRF (P ≤ .001), and altered landing kinematics in a variety of ways. The rLBP group exhibited delayed semitendinosus and vastus medialis muscle onsets (0.031 ± 0.028 s later; P ≤ .001) and 1.8° less knee flexion at initial contact (P ≤ .008). The VPAC decreases some of the detrimental effects of fatigue on landing biomechanics and thus may reduce LE injury risk in a rLBP population.

The creatine kinase response to eccentric exercise with atorvastatin 10 mg or 80 mg.

PubMed

Kearns, Amy K; Bilbie, Cherie L; Clarkson, Priscilla M; White, C Michael; Sewright, Kim A; O'Fallon, Kevin S; Gadarla, Mamatha; Thompson, Paul D

2008-09-01

Hydroxy-methyl-glutaryl co-enzyme A (HMG-CoA) reductase inhibitors or statins are well tolerated by most patients, but can produce a variety of skeletal muscle problems including myalgia, creatine kinase (CK) elevations and clinically important rhabdomyolysis. We have previously demonstrated that the CK response to downhill walking is greater in statin compared to placebo treated subjects. This study examined the CK response to downhill walking in subjects treated with low and high dose of atorvastatin. 79 subjects with LDL cholesterol>100mg/dL were randomly assigned to atorvastatin 10mg (N=42) or 80 mg (N=37) for 5 weeks. Subjects performed a downhill walking exercise during the fifth week of treatment. Leg muscle soreness, plasma CK and CK-MB levels were measured daily for 4 days following the exercise. CK, CK-MB and muscle soreness increased above pre-exercise levels in all subjects after the exercise. There were no differences in the CK, CK-MB or soreness response between the high and low dose treatment groups at any time point. The downhill walking model of muscle injury does not distinguish between high and low dose atorvastatin therapy either because this test is insensitive to differences among statin doses or because there is no difference in muscle injury between these two drug doses with this statin. Clinicians should be aware, however, that exercise can increase CK levels with even low dose statin therapy.

Effect of intermittent eccentric contractions on symptoms of muscle microinjury.

PubMed

Teague, B N; Schwane, J A

1995-10-01

The purpose was to determine whether varying the duration of rest between contractions affects selected symptoms of eccentric contraction-induced skeletal muscle microinjury. Thirty-three women were assigned to three groups (N = 11). Each performed one bout of exercise with each arm involving 10 eccentric contractions of the elbow flexor muscles, lowering a load equaling 60% of maximal static force. One arm exercised continuously; the other exercised with rest periods of 15 s, 5 min, or 10 min between contractions, depending on the group. Preexercise and 0, 24, and 48 h postexercise, symptoms of microinjury in the elbow flexor muscles were assessed: soreness and changes in strength, resting elbow angle ("musculotendinous stiffness"), and arm girth ("swelling"). For all groups combined, 10 continuous contractions caused changes (P < 0.05) in all variables at every measurement time. For example, soreness ratings (0-10 scale) were 4.3 +/- 2.0 (24 h) and 4.3 +/- 2.1 (48 h) and strength was reduced 18% 0 h postexercise. Responses were similar with 15 s of rest between contractions. Although they were moderated, symptoms occurred even with 5 and 10 min of rest. With 10 min between contractions, soreness occurred (e.g., 2.4 +/- 1.5 [24 h]) and strength was 17% reduced 0 h postexercise. Results are most consistent with a mechanical cause of eccentric contraction-induced muscle microinjury, rather than a metabolic or other factor with a short recovery time, although involvement of the latter cannot be ruled out.

Muscle Mitochondrial Uncoupling Dismantles Neuromuscular Junction and Triggers Distal Degeneration of Motor Neurons

PubMed Central

Dupuis, Luc; Gonzalez de Aguilar, Jose-Luis; Echaniz-Laguna, Andoni; Eschbach, Judith; Rene, Frédérique; Oudart, Hugues; Halter, Benoit; Huze, Caroline; Schaeffer, Laurent; Bouillaud, Frédéric; Loeffler, Jean-Philippe

2009-01-01

Background Amyotrophic lateral sclerosis (ALS), the most frequent adult onset motor neuron disease, is associated with hypermetabolism linked to defects in muscle mitochondrial energy metabolism such as ATP depletion and increased oxygen consumption. It remains unknown whether muscle abnormalities in energy metabolism are causally involved in the destruction of neuromuscular junction (NMJ) and subsequent motor neuron degeneration during ALS. Methodology/Principal Findings We studied transgenic mice with muscular overexpression of uncoupling protein 1 (UCP1), a potent mitochondrial uncoupler, as a model of muscle restricted hypermetabolism. These animals displayed age-dependent deterioration of the NMJ that correlated with progressive signs of denervation and a mild late-onset motor neuron pathology. NMJ regeneration and functional recovery were profoundly delayed following injury of the sciatic nerve and muscle mitochondrial uncoupling exacerbated the pathology of an ALS animal model. Conclusions/Significance These findings provide the proof of principle that a muscle restricted mitochondrial defect is sufficient to generate motor neuron degeneration and suggest that therapeutic strategies targeted at muscle metabolism might prove useful for motor neuron diseases. PMID:19404401

Blunted Myoglobin and Quadriceps Soreness after Electrical Stimulation during the Luteal Phase or Oral Contraception

ERIC Educational Resources Information Center

Anderson, Lindsey J.; Baker, Lucinda L.; Schroeder, E. Todd

2017-01-01

Purpose: Acute muscle damage after exercise triggers subsequent regeneration, leading to hypertrophy and increased strength after repeated exercise. It has been debated whether acute exercise-induced muscle damage is altered under various premenopausal estrogen conditions. Acute contraction-induced muscle damage was compared during exogenous (oral…

Biochemical, physiological, and performance response of a functional watermelon juice enriched in L-citrulline during a half-marathon race

PubMed Central

Martínez-Sánchez, Ascensión; Ramos-Campo, Domingo J.; Fernández-Lobato, Bárbara; Rubio-Arias, Jacobo A.; Alacid, Fernando; Aguayo, Encarna

2017-01-01

ABSTRACT Background: Watermelon is a rich natural source of l-citrulline. This non-essential amino acid increases exercise performance. Objective: Evaluate the effect of Fashion watermelon juice enriched in l-citrulline (CWJ) (3.45 g per 500 mL) in physical performance and biochemical markers after a half-marathon race. Design: A randomised, double blind, crossover design where 2 h after drinking 500 mL of CWJ or placebo (PLA, beverage without l-citrulline) amateur male runners performed two half-marathon races. Jump height, heart rate and rating of perceived exertion were evaluated before and after the races. Moreover, muscle soreness and plasma markers of muscle damage and metabolism were evaluated for 72 h after the races. Results: Muscle soreness perception was significantly lower from 24 to 72 h after the race with CWJ beverage. Immediately after the races, runners under CWJ condition showed plasma lactate and glucose concentrations significantly lower and higher lactate dehydrogenase and l-arginine concentration than runners under PLA. A maintenance of jump heights after the races under CWJ supplementation was found, decreasing significantly with PLA. Conclusion: A single Fashion watermelon juice enriched in l-citrulline dose diminished muscle soreness perception from 24 to 72 h after the race and maintained lower concentrations of plasma lactate after an exhausting exercise. PMID:28659740

Flurbiprofen microgranules for relief of sore throat: a randomised, double-blind trial

PubMed Central

Russo, Marc; Bloch, Mark; de Looze, Fred; Morris, Christopher; Shephard, Adrian

2013-01-01

Background Many people with sore throat seek, and are often inappropriately prescribed, antibiotics. Aim The objective of this study was to determine the analgesic efficacy of flurbiprofen 8.75 mg microgranules versus placebo. These microgranules are a possible alternative treatment for patients with sore throat due to upper respiratory tract infection (URTI). Design and setting Randomised, double-blind, placebo-controlled, multiple-dose study conducted at eight primary care sites in Australia. Method Participants with sore throat of onset within the past 4 days received either flurbiprofen 8.75 mg microgranules or non-medicated placebo microgranules. Throat soreness, difficulty in swallowing, sore throat pain intensity, sore throat relief, oral temperature, and treatment benefits were all assessed at regular intervals. Result Of 373 patients from eight centres, 186 received flurbiprofen 8.75 mg microgranules and 187 received placebo microgranules (intent-to-treat population). Throat soreness was significantly reduced over the first 2 hours after the first dose. Reductions in difficulty in swallowing were observed at all time points from 5 to 360 minutes after the first dose, after taking flurbiprofen microgranules versus placebo. Sore throat relief was also evident at 1 minute and lasted for at least 6 hours. The multiple-dose efficacy results showed reduction of difficulty in swallowing at the end of days 1–3 and sore throat relief at the end of day 1. Conclusion Microgranules containing flurbiprofen 8.75 mg provided fast and effective relief from sore throat due to URTI and represent an alternative treatment option to antibiotic therapy. PMID:23561694

What Are the Symptoms of Puberty, Precocious Puberty, and Delayed Puberty?

MedlinePlus

... puberty include: Growth of pubic and other body hair Growth spurt Breast development Onset of menstruation (after puberty ... of pubic hair, other body hair, and facial hair Enlargement of testicles and penis Muscle growth Growth spurt Acne Deepening of the voice Precocious ...

Muscle damage and inflammation during recovery from exercise.

PubMed

Peake, Jonathan M; Neubauer, Oliver; Della Gatta, Paul A; Nosaka, Kazunori

2017-03-01

Unaccustomed exercise consisting of eccentric (i.e., lengthening) muscle contractions often results in muscle damage characterized by ultrastructural alterations in muscle tissue, clinical signs, and symptoms (e.g., reduced muscle strength and range of motion, increased muscle soreness and swelling, efflux of myocellular proteins). The time course of recovery following exercise-induced muscle damage depends on the extent of initial muscle damage, which in turn is influenced by the intensity and duration of exercise, joint angle/muscle length, and muscle groups used during exercise. The effects of these factors on muscle strength, soreness, and swelling are well characterized. By contrast, much less is known about how they affect intramuscular inflammation and molecular aspects of muscle adaptation/remodeling. Although inflammation has historically been viewed as detrimental for recovery from exercise, it is now generally accepted that inflammatory responses, if tightly regulated, are integral to muscle repair and regeneration. Animal studies have revealed that various cell types, including neutrophils, macrophages, mast cells, eosinophils, CD8 and T-regulatory lymphocytes, fibro-adipogenic progenitors, and pericytes help to facilitate muscle tissue regeneration. However, more research is required to determine whether these cells respond to exercise-induced muscle damage. A large body of research has investigated the efficacy of physicotherapeutic, pharmacological, and nutritional interventions for reducing the signs and symptoms of exercise-induced muscle damage, with mixed results. More research is needed to examine if/how these treatments influence inflammation and muscle remodeling during recovery from exercise. Copyright © 2017 the American Physiological Society.

Increased technetium uptake is not equivalent to muscle necrosis: scintigraphic, morphological and intramuscular pressure analyses of sore muscles after exercise

NASA Technical Reports Server (NTRS)

Crenshaw, A. G.; Friden, J.; Hargens, A. R.; Lang, G. H.; Thornell, L. E.

1993-01-01

A scintigraphic technique employing technetium pyrophosphate uptake was used to identify the area of skeletal muscle damage in the lower leg of four runners 24 h after an ultramarathon footrace (160 km). Most of the race had been run downhill which incorporated an extensive amount of eccentric work. Soreness was diffuse throughout the posterior region of the lower leg. In order to interpret what increased technetium uptake reflects and to express extreme endurance related damages, a biopsy was taken from the 3-D position of abnormal uptake. In addition, intramuscular pressures were determined in the deep posterior compartment. Scintigraphs revealed increased technetium pyrophosphate uptake in the medial portion of the gastrocnemius muscle. For 3698 fibres analysed, 33 fibres (1%) were necrotic, while a few other fibres were either atrophic or irregular shaped. A cluster of necrotic fibres occurred at the fascicular periphery for one subject and fibre type grouping occurred for another. Ultrastructural analysis revealed Z-line streaming near many capillaries and variously altered subsarcolemmal mitochondria including some with paracrystalline inclusions. The majority of the capillaries included thickened and irregular shaped endothelial cells. Intramuscular pressures of the deep posterior compartment were slightly elevated (12-15 mmHg) for three of the four subjects. Increased technetium uptake following extreme endurance running does not just reflect muscle necrosis but also subtle fibre abnormalities. Collectively, these pathological findings are attributed to relative ischaemia occurring during the race and during pre-race training, whereas, intramuscular pressure elevations associated with muscle soreness are attributed to mechanical stress caused by extensive eccentric work during the race.

Effects of combined β-hydroxy-β-methylbutyrate (HMB) and whey protein ingestion on symptoms of eccentric exercise-induced muscle damage.

PubMed

Shirato, Minayuki; Tsuchiya, Yosuke; Sato, Teruyuki; Hamano, Saki; Gushiken, Takeshi; Kimura, Naoto; Ochi, Eisuke

2016-01-01

The purpose of this study was to examine the effects of combined β-hydroxy-β-methylbutyrate (HMB) and whey protein ingestion on muscle strength and damage following a single bout of eccentric exercise. Eighteen untrained male subjects were assigned to HMB and Whey protein (HMB + Whey; 3 g/day HMB and 36.6 g/day whey protein, n = 6), HMB (3 g/day, n = 6), or whey protein (36.6 g/day, n = 6) groups. Ingestion commenced 7 days before non-dominant elbow flexor eccentric exercise (30 deg/sec, 6 reps × 7 sets) and continued until 4 days post-exercise. The maximal isometric strength, muscle soreness, plasma creatine kinase (CK), lactate dehydrogenase (LDH) were assessed pre-exercise, and at 1, 2, 3, and 5 days after exercise. The change scores of maximal isometric strength significantly decreased at day 1, 2, and 5 in the whey protein group compared to pre value and that in HMB + Whey protein and HMB groups decreased at day 1 and 5. The muscle soreness significantly increased in the whey and HMB + Whey protein groups at day 3 compared to pre value (p < 0.05). CK and LDH significantly increased (time effect: p < 0.05) after exercise. However, all data were not significant difference among the groups. These results suggest that ingestion of combined HMB and whey protein does not have a role to inhibit muscle strength loss and soreness, and decrease in muscle damage markers after eccentric exercise in comparison with HMB and whey protein alone.

A New Option for the Reconstruction of Primary or Recurrent Ischial Pressure Sores: Hamstring-Adductor Magnus Muscle Advancement Flap and Direct Closure.

PubMed

Burm, Jin Sik; Hwang, Jungil; Lee, Yung Ki

2018-04-01

Owing to the high recurrence rates of ischial pressure sores, surgeons should consider the possibility of future secondary flap surgery during flap selection. The purpose of this article is to present a new surgical option for the reconstruction of primary or recurrent ischial pressure sores using a simple hamstring-adductor magnus advancement flap and direct closure. After horizontal fusiform skin excision, complete bursa excision and ischiectomy were performed. The tenomuscular origin of the adductor magnus and the conjoined tenomuscular origin of the biceps femoris long head and semitendinosus were isolated and completely detached from the inferior border of the ischial tuberosity. They were then advanced in a cephalad direction without detachment of the distal tendon or muscle and securely affixed to the sacrotuberous ligament. The wound was directly closed without further incision or dissection. Twelve ischial pressure sores (6 primary and 6 recurrent; 12 patients) were surgically corrected. The follow-up period was 12 to 65 months. All patients healed successfully without early postoperative complications, such as hematoma, seroma, infection, wound dehiscence, or partial necrosis. Late complications included wound disruption 5 weeks after surgery that spontaneously healed in 1 case and recurrence 3 years later in another case. The new surgical option presented herein, which involves hamstring-adductor magnus advancement flap and direct closure, is a simple and reliable method for providing sufficient muscle bulk to fill the dead space and proper padding to the bone stump while preserving the main vascular perforators and pedicles as well as future surgical options.

Takotsubo cardiomyopathy with involvement of delayed-onset rhabdomyolysis and acute kidney injury after rosuvastatin treatment.

PubMed

Kamada, Tomohito; Hayashi, Mutsuharu; Yokoi, Hiroatsu; Fujiwara, Wakaya; Yoshikawa, Daiji; Mukaide, Daisuke; Sugishita, Yoshinori; Yoshinaga, Masataka; Ito, Takehiro; Ozaki, Yukio; Izawa, Hideo

2015-01-01

Takotsubo cardiomyopathy is a disorder characterized by left ventricular apical ballooning with preceding emotional and/or physical stressors. This condition is also an important differential diagnosis of acute coronary syndrome. We herein describe a case of Takotsubo cardiomyopathy, a significant clinical phenomenon, triggered by delayed-onset rhabdomyolysis following the administration of long-term statin treatment, without any preceding stressors or changes in the patient's medical condition, in association with complaints of non-specific muscle-related symptoms. Although an electrocardiogram showed remarkable ST-segment elevation, a careful reading of the electrocardiogram findings revealed the features of Takotsubo cardiomyopathy. Withdrawing the statin therapy improved the patient's cardiac function.

A critical overview of homeopathy.

PubMed

Jonas, Wayne B; Kaptchuk, Ted J; Linde, Klaus

2003-03-04

Homeopathy is a 200-year-old therapeutic system that uses small doses of various substances to stimulate autoregulatory and self-healing processes. Homeopathy selects substances by matching a patient's symptoms with symptoms produced by these substances in healthy individuals. Medicines are prepared by serial dilution and shaking, which proponents claim imprints information into water. Although many conventional physicians find such notions implausible, homeopathy had a prominent place in 19th-century health care and has recently undergone a worldwide revival. In the United States, patients who seek homeopathic care are more affluent and younger and more often seek treatment for subjective symptoms than those who seek conventional care. Homeopathic remedies were allowed by the 1939 Pure Food and Drug Act and are available over the counter. Some data--both from randomized, controlled trials and laboratory research--show effects from homeopathic remedies that contradict the contemporary rational basis of medicine. Three independent systematic reviews of placebo-controlled trials on homeopathy reported that its effects seem to be more than placebo, and one review found its effects consistent with placebo. There is also evidence from randomized, controlled trials that homeopathy may be effective for the treatment of influenza, allergies, postoperative ileus, and childhood diarrhea. Evidence suggests that homeopathy is ineffective for migraine, delayed-onset muscle soreness, and influenza prevention. There is a lack of conclusive evidence on the effectiveness of homeopathy for most conditions. Homeopathy deserves an open-minded opportunity to demonstrate its value by using evidence-based principles, but it should not be substituted for proven therapies.

EFFECTS OF 2,4-DITHIOBIURET ON SENSORY AND MOTOR FUNCTION

EPA Science Inventory

2,4-Dithiobiuret exposure causes a delayed onset muscle weakness in rats that has been attributed to depressed neuromuscular transmission. he present study compares the effects of DTB on sensory and motor function in rats. dult male Long-Evans hooded rats were exposed to saline, ...

Protein Supplementation During or Following a Marathon Run Influences Post-Exercise Recovery

PubMed Central

Saunders, Michael J.; Luden, Nicholas D.; DeWitt, Cash R.; Gross, Melinda C.; Dillon Rios, Amanda

2018-01-01

The effects of protein supplementation on the ratings of energy/fatigue, muscle soreness [ascending (A) and descending (D) stairs], and serum creatine kinase levels following a marathon run were examined. Variables were compared between recreational male and female runners ingesting carbohydrate + protein (CP) during the run (CPDuring, n = 8) versus those that were consuming carbohydrate (CHODuring, n = 8). In a second study, outcomes were compared between subjects who consumed CP or CHO immediately following exercise [CPPost (n = 4) versus CHOPost (n = 4)]. Magnitude-based inferences revealed no meaningful differences between treatments 24 h post-marathon. At 72 h, recovery [Δ(72 hr-Pre)] was likely improved with CPDuring versus CHODuring, respectively, for Physical Energy (+14 ± 64 vs −74 ± 70 mm), Mental Fatigue (−52 ± 59 vs +1 ± 11 mm), and Soreness-D (+15 ± 9 vs +21 ± 70 mm). In addition, recovery at 72 h was likely-very likely improved with CPPost versus CHOPost for Physical Fatigue, Mental Energy, and Soreness-A. Thus, protein supplementation did not meaningfully alter recovery during the initial 24 h following a marathon. However, ratings of energy/fatigue and muscle soreness were improved over 72 h when CP was consumed during exercise, or immediately following the marathon. PMID:29534444

Efficacy of massage on muscle soreness, perceived recovery, physiological restoration and physical performance in male bodybuilders.

PubMed

Kargarfard, Mehdi; Lam, Eddie T C; Shariat, Ardalan; Shaw, Ina; Shaw, Brandon S; Tamrin, Shamsul B M

2016-01-01

It is believed that sport massage after intensive exercise might improve power and perceptual recovery in athletes. However, few studies have been done in this area. This study aimed to examine the effect of massage on the performance of bodybuilders. Thirty experienced male bodybuilders were randomly assigned to either a massage group (n = 15) or a control group (n = 15). Both groups performed five repetition sets at 75-77% of 1RM of knee extensor and flexor muscle groups. The massage group then received a 30-min massage after the exercise protocol while the control group maintained their normal passive recovery. Criteria under investigation included: plasma creatine kinase (CK) level, agility test, vertical jump test, isometric torque test, and perception of soreness. All variables were measured over 6 time periods: baseline, immediately after the DOMS inducing protocol, right after the massage, and 24, 48, and 72 h after the massage. Both groups showed significant (P < .001) decreases in jumping, agility performance, and isometric torque, but significant (P < .001) increases in CK and muscle soreness levels. The massage group in general demonstrated a better recovery rate. As such, a post-exercise massage session can improve the exercise performance and recovery rate in male bodybuilders after intensive exercise.

Leukemia inhibitory factor influences the timing of programmed synapses withdrawal from neonatal muscles.

PubMed

Kwon, Y W; Abbondanzo, S J; Stewart, C L; Gurney, M E

1995-09-01

We show that leukemia inhibitory factor (LIF) plays a physiological role in the programmed withdrawal of synapses from neonatal muscles. First, LIF mRNA is present in embryonic skeletal muscle and is developmentally regulated. We detect high levels of LIF mRNA at embryonic day 17 (E17) in mouse hind leg muscles. The content of LIF mRNA falls 10-fold between E17 and birth and then remains low in the neonate and adult. The decrease in LIF mRNA in skeletal muscle coincides with the end of secondary myogenesis and the completion of the adult number of myofibers. Second, treatment of the mouse tensor fascia latae (TFL), a superficial muscle of the hind leg, with LIF from birth (100 ng/day), transiently delays the withdrawal of excess inputs from polyneuronally innervated myofibers by approximately 3 days. The midpoint of the process is shifted from 7.5 +/- 10.2 +/- 0.6 days of age. LIF treatment delays synapse withdrawal by altering its timing without an appreciable effect on its rate. Third, in mice homozygous for a disruption of the LIF gene, the midpoint in the reduction of multiply innervated TFL myofibers occurs 1 day earlier, at 6.5 +/- 0.5 days of age. Muscle fiber number is unchanged in LIF null mice. Treatment with LIF does not alter the rate of neonatal growth, the number of muscle fibers in the TFL, or the reappearance of inputs that have been eliminated. Instead, LIF appears to delay maturation of the motor unit by transiently delaying the onset of synapse withdrawal. We hypothesize that this is a necessary component of a selective process that will operate simultaneously and equally on multiple, competing motor units.

Rotator cuff tendinopathy alters the muscle activity onset and kinematics of scapula.

PubMed

Leong, Hio Teng; Ng, Gabriel Yin-Fat; Chan, Shing Chung; Fu, Siu Ngor

2017-08-01

Athletes with rotator cuff (RC) tendinopathy demonstrate an aberrant pattern of scapular motion which might relate to deficits in the scapular muscles. This study aimed to determine whether alteration in scapular kinematics is associated with deficits in the activity onset of scapular muscles. Forty-three male volleyball players (17 asymptomatic and 26 with RC tendinopathy) joined the study. Three-dimensional scapular kinematics was quantified using an acromial marker cluster method. The activity onset of the upper (UT), middle (MT), and lower trapezius (LT), and serratus anterior (SA) during arm abduction was assessed with electromyography. Athletes with RC tendinopathy demonstrated less scapular upward rotation (6.6±2.3 vs. 8.2±1.1°, p=0.021) in the early phase of shoulder abduction from 0° to 30° when compared to asymptomatic athletes. The tendinopathy group had delayed activity onset of LT (14.1±31.4ms vs. 74.4±45.1ms, p<0.001) and SA (-44.9±26.0ms vs. 23.0±25.2ms, p<0.001) relative to UT when compared to the asymptomatic group. In asymptomatic athletes, earlier activity onset of MT and LT relative to UT was associated with more scapular upward rotation during 0-30° of abduction (r=0.665, p=0.021) and 30-60° of abduction (r=0.680, p=0.015), respectively. Our findings showed the control of the scapular upward rotation is related to the activity onset of the scapular muscles in athletes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Onset and maximum values of electromyographic amplitude during prone hip extension after neurodynamic technique in patients with lumbosciatic pain: A pilot study.

PubMed

Horment-Lara, Giselle; Cruz-Montecinos, Carlos; Núñez-Cortés, Rodrigo; Letelier-Horta, Pablo; Henriquez-Fuentes, Luis

2016-04-01

The mechanisms underlying the effects of neurodynamic techniques are still unknown. Therefore, the aim of this study was to provide a starting point for future research on explaining why neurodynamic techniques affect muscular activities in patients with sciatic pain. A double-blind trial was conducted in 12 patients with lumbosciatica. Surface electromyography activity was assessed for different muscles during prone hip extension. Pre- and post-intervention values for muscle activity onset and maximal amplitude signals were determined. There was a significant reduction in the surface electromyography activity of maximal amplitude in the erector spinae and contralateral erector spinae (p < 0.05). Additionally, gluteus maximus (p < 0.05) activity onset was delayed post-intervention. Self-neurodynamic sliding techniques modify muscular activity and onset during prone hip extension, possibly reducing unnecessary adaptations for protecting injured components. Future work will analyze the effects of self-neurodynamic sliding techniques during other physical tasks. Copyright © 2015 Elsevier Ltd. All rights reserved.

Deficits in Lower Limb Muscle Reflex Contraction Latency and Peak Force Are Associated With Impairments in Postural Control and Gross Motor Skills of Children With Developmental Coordination Disorder: A Cross-Sectional Study.

PubMed

Fong, Shirley S M; Ng, Shamay S M; Guo, X; Wang, Yuling; Chung, Raymond C K; Stat, Grad; Ki, W Y; Macfarlane, Duncan J

2015-10-01

This cross-sectional, exploratory study aimed to compare neuromuscular performance, balance and motor skills proficiencies of typically developing children and those with developmental coordination disorder (DCD) and to determine associations of these neuromuscular factors with balance and motor skills performances in children with DCD.One hundred thirty children with DCD and 117 typically developing children participated in the study. Medial hamstring and gastrocnemius muscle activation onset latencies in response to an unexpected posterior-to-anterior trunk perturbation were assessed by electromyography and accelerometer. Hamstring and gastrocnemius muscle peak force and time to peak force were quantified by dynamometer, and balance and motor skills performances were evaluated with the Movement Assessment Battery for Children (MABC).Independent t tests revealed that children with DCD had longer hamstring and gastrocnemius muscle activation onset latencies (P < 0.001) and lower isometric peak forces (P < 0.001), but not times to peak forces (P > 0.025), than the controls. Multiple regression analysis accounting for basic demographics showed that gastrocnemius peak force was independently associated with the MABC balance subscore and ball skills subscore, accounting for 5.7% (P = 0.003) and 8.5% (P = 0.001) of the variance, respectively. Gastrocnemius muscle activation onset latency also explained 11.4% (P < 0.001) of the variance in the MABC ball skills subscore.Children with DCD had delayed leg muscle activation onset times and lower isometric peak forces. Gastrocnemius peak force was associated with balance and ball skills performances, whereas timing of gastrocnemius muscle activation was a determinant of ball skill performance in the DCD population.

Altered trunk muscle recruitment patterns during lifting in individuals in remission from recurrent low back pain.

PubMed

Suehiro, Tadanobu; Ishida, Hiroshi; Kobara, Kenichi; Osaka, Hiroshi; Watanabe, Susumu

2018-04-01

Changes in the recruitment pattern of trunk muscles may contribute to the development of recurrent or chronic symptoms in people with low back pain (LBP). However, the recruitment pattern of trunk muscles during lifting tasks associated with a high risk of LBP has not been clearly determined in recurrent LBP. The present study aimed to investigate potential differences in trunk muscles recruitment patterns between individuals with recurrent LBP and asymptomatic individuals during lifting. The subjects were 25 individuals with recurrent LBP and 20 asymptomatic individuals. Electromyography (EMG) was used to measure onset time, EMG amplitude, overall activity of abdominal muscles, and overall activity of back muscles during a lifting task. The onsets of the transversus abdominis/internal abdominal oblique and multifidus were delayed in the recurrent LBP group despite remission from symptoms. Additionally, the EMG amplitudes of the erector spinae, as well as the overall activity of abdominal muscles or back muscles, were greater in the recurrent LBP group. No differences in EMG amplitude of the external oblique, transversus abdominis/internal abdominal oblique, and multifidus were found between the groups. Our findings indicate the presence of an altered trunk muscle recruitment pattern in individuals with recurrent LBP during lifting. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effects of a combined protein and antioxidant supplement on recovery of muscle function and soreness following eccentric exercise.

PubMed

Ives, Stephen J; Bloom, Samuel; Matias, Alexs; Morrow, Noelle; Martins, Natalya; Roh, Yookee; Ebenstein, Daniel; O'Brien, Gabriel; Escudero, Daniela; Brito, Kevin; Glickman, Leah; Connelly, Scott; Arciero, Paul J

2017-01-01

An acute bout of eccentric contractions (ECC) cause muscle fiber damage, inflammation, impaired muscle function (MF) and muscle soreness (MS). Individually, protein (PRO) and antioxidant (AO) supplementation may improve some aspects of recovery from ECC, though have yet to be combined. We sought to determine if combined PRO and AO supplementation (PRO + AO) improves MS and MF following damaging ECC over PRO alone. Sixty sedentary college-aged males participated in a randomized, single-blind, parallel design study of peak isometric torque (PIMT), peak isokinetic torque (PIKT), thigh circumference (TC), and muscle soreness (MS) of knee extensor muscles measured at baseline, immediately after and 1, 2, 6, and 24 h after completion of 100 maximal ECC. Immediately, 6 h, and 22 h post-ECC, participants consumed either: carbohydrate control (CHO; n  = 14), PRO ( n  = 16), or PRO + AO ( n  = 17). At baseline MS, TC, MF, macro- and micro-nutrient intakes, and total work during the ECC were not different between groups ( p  > 0.05). PIMT and PIKT (both -25%∆), TC (~1%∆) and MS (~35%∆) all changed with time ( p  < 0.05). We observed a group by time effect for PIKT (PRO + AO and PRO > CHO, p  < 0.05). At 24 h post ECC, there was a trend towards improved relative PIMT (~11%) and PIKT (~17%) for PRO + AO (~17%) and PRO (~11%) compared to CHO. An interaction indicated PRO + AO had lowest MS over time (PRO + AO > PRO & CHO, p  < 0.05). Our results suggest PRO facilitates recovery of muscle function within 24 h following ECC, and addition of AO ameliorates MS more than PRO or CHO alone.

Flurbiprofen 8.75 mg lozenges for treating sore throat symptoms: a randomized, double-blind, placebo-controlled study.

PubMed

Schachtel, Bernard P; Shephard, Adrian; Shea, Timothy; Sanner, Kathleen; Savino, Laurie; Rezuke, Jeanne; Schachtel, Emily; Aspley, Sue

2016-11-01

This study assessed multiple doses of flurbiprofen 8.75 mg lozenges for the relief of three prominent symptoms of acute pharyngitis: pain intensity (primary end point), difficulty swallowing and swollen throat. A total of 204 patients (102 in each group) with confirmed pharyngitis (onset ≤4 days) were randomly assigned to take up to five flurbiprofen or placebo lozenges every 3-6 h, for 7 days. Using validated rating scales (sore throat pain intensity, difficulty swallowing and swollen throat) patients rated their symptoms for the duration of the study. Over the first 24 h, patients treated with flurbiprofen lozenges reported significantly greater reductions in sore throat pain (47%) as well as difficulty swallowing (66%) and swollen throat (40%) compared with placebo (all p < 0.05). Multiple doses of flurbiprofen lozenges provide effective relief of sore throat pain intensity as well as difficulty swallowing and swollen throat.

[Adverse muscle effects of a podofyllotoxin-containing cytotoxic drug product with simvastatin].

PubMed

Kaipiainen-Seppänen, Oili; Savolainen, Elina; Elfving, Pia; Kononoff, Aulikki

2009-01-01

With the ageing population, drug interactions pose an increasing challenge to health professionals. We describe four patients, for whom concurrent administration of a podofyllotoxin-containing cytotoxic drug product and simvastatin caused severe adverse effects on muscles, including muscle pain, soreness or fatigue or weakness, and in some patients also disintegration of muscle tissue, i.e. rhabdomyolysis. The metabolism of both drugs proceeds via the common CYP3A4 enzyme pathway.

Early-Onset LMNA-Associated Muscular Dystrophy with Later Involvement of Contracture.

PubMed

Lee, Younggun; Lee, Jung Hwan; Park, Hyung Jun; Choi, Young Chul

2017-10-01

The early diagnosis of LMNA-associated muscular dystrophy is important for preventing sudden arrest related to cardiac conduction block. However, diagnosing early-onset Emery-Dreifuss muscular dystrophy (EDMD) with later involvement of contracture and limb-girdle muscular dystrophy type 1B is often delayed due to heterogeneous clinical presentations. We aimed to determine the clinical features that contribute to a delayed diagnosis. We reviewed four patients who were recently diagnosed with LMNA-associated muscular dystrophy by targeted exome sequencing and who were initially diagnosed with nonspecific or other types of muscular dystrophy. Certain clinical features such as delayed contracture involvement and calf hypertrophy were found to contribute to a delayed diagnosis. Muscle biopsies were not informative for the diagnosis in these patients. Genetic testing of single or multiple genes is useful for confirming a diagnosis of LMNA-associated muscular dystrophy. Even EDMD patients could experience the later involvement of contracture, so clinicians should consider early genetic testing for patients with undiagnosed muscular dystrophy or laminopathy. Copyright © 2017 Korean Neurological Association

Assessment of eccentric exercise-induced muscle damage of the elbow flexors by tensiomyography.

PubMed

Hunter, Angus M; Galloway, Stuart D R; Smith, Iain J; Tallent, Jamie; Ditroilo, Massimiliano; Fairweather, Malcolm M; Howatson, Glyn

2012-06-01

Exercise induced muscle damage (EIMD) impairs maximal torque production which can cause a decline in athletic performance and/or mobility. EIMD is commonly assessed by using maximal voluntary contraction (MVC), creatine kinase (CK) and muscle soreness. We propose as an additional technique, tensiomyography (TMG), recently introduced to measure mechanical and muscle contractile characteristics. The purpose of this study was to determine the validity of TMG in detecting changes in maximal torque following EIMD. Nineteen participants performed eccentric elbow flexions to achieve EIMD on the non- dominant arm and used the dominant elbow flexor as a control. TMG parameters, MVC and rate of torque development (RTD) were measured prior to EIMD and repeated for another six consecutive days. Creatine kinase, muscle soreness and limb girth were also measured during this period. Twenty four hours after inducing EIMD, MVC torque, RTD and TMG maximal displacement had significantly (p<0.01) declined by 37%, 44% and 31%, respectively. By day 6 MVC, RTD and TMG recovered to 12%, 24% and 17% of respective pre-EIMD values. In conclusion, as hypothesised TMG maximal displacement significantly followed other standard EIMD responses. This could therefore be useful in detecting muscle damage from impaired muscle function and its recovery following EIMD. Copyright © 2012 Elsevier Ltd. All rights reserved.

Development of Temporomandibular Disorders is associated with greater bodily pain experience

PubMed Central

Lim, Pei Feng; Smith, Shad; Bhalang, Kanokporn; Slade, Gary D.; Maixner, William

2009-01-01

Objectives The aim of this study is to examine the difference in the report of bodily pain experienced by subjects who develop temporomandibular disorders (TMD) and by those who do not develop TMD over a 3 year observation period. Methods This is a 3 year prospective study of 266 females aged 18–34 years initially free of TMD pain. All subjects completed the Symptom Report Questionnaire (SRQ) at baseline and yearly intervals, and at the time they developed TMD (if applicable). The SRQ is a self-report instrument evaluating the extent and location of pain experienced in the prior 6 months. Statistical analysis was carried out using repeated measures ANOVA. Results Over the 3 year period, 16 subjects developed TMD based on the Research Diagnostic Criteria for TMD. Subjects who developed TMD reported more headaches (P=0.0089), muscle soreness or pain (P=0.005), joint soreness or pain (P=0.0012), back pain (P=0.0001), chest pain (P=0.0004), abdominal pain (P=0.0021), and menstrual pain (P=0.0036) than subjects who did not develop TMD at both the baseline and final visits. Subjects who developed TMD also reported significantly more headache (P=0.0006), muscle soreness or pain (P=0.0059), and other pains (P=0.0188) when they were diagnosed with TMD compared to the baseline visit. Discussion The development of TMD was accompanied by increases in headaches, muscle soreness or pain, and other pains that were not observed in the subjects who did not develop TMD. Subjects who developed TMD also report higher experience of joint, back, chest and menstrual pain at baseline. PMID:20090437

The efficacy of protein supplementation during recovery from muscle-damaging concurrent exercise.

PubMed

Eddens, Lee; Browne, Sarah; Stevenson, Emma J; Sanderson, Brad; van Someren, Ken; Howatson, Glyn

2017-07-01

This study investigated the effect of protein supplementation on recovery following muscle-damaging exercise, which was induced with a concurrent exercise design. Twenty-four well-trained male cyclists were randomised to 3 independent groups receiving 20 g protein hydrolysate, iso-caloric carbohydrate, or low-calorific placebo supplementation, per serve. Supplement serves were provided twice daily, from the onset of the muscle-damaging exercise, for a total of 4 days and in addition to a controlled diet (6 g·kg -1 ·day -1 carbohydrate, 1.2 g·kg -1 ·day -1 protein, remainder from fat). Following the concurrent exercise session at time-point 0 h, comprising a simulated high-intensity road cycling trial and 100 drop-jumps, recovery of outcome measures was assessed at 24, 48, and 72 h. The concurrent exercise protocol was deemed to have caused exercise-induced muscle damage (EIMD), owing to time effects (p < 0.001), confirming decrements in maximal voluntary contraction (peaking at 15% ± 10%) and countermovement jump performance (peaking at 8% ± 7%), along with increased muscle soreness, creatine kinase, and C-reactive protein concentrations. No group or interaction effects (p > 0.05) were observed for any of the outcome measures. The present results indicate that protein supplementation does not attenuate any of the indirect indices of EIMD imposed by concurrent exercise, when employing great rigour around the provision of a quality habitual diet and the provision of appropriate supplemental controls.

Does a foamy-block mattress system prevent pressure sores ? A prospective randomised clinical trial in 1729 patients.

PubMed

Berthe, J V; Bustillo, A; Mélot, C; de Fontaine, S

2007-01-01

Pressure ulcers are a frequent complication of bed rest. The development of an efficient and low cost pressure relieving system for the prevention of bed-sores would be of considerable hospital health and economic interest. Our study was designed to determine the effectiveness in pressure-sore prevention of an interface pressure-decreasing mattress, the Kliniplot mattress, used in our institution since 1978. In a prospective randomised controlled 7-month clinical trial we compared the Kliniplot mattress with our standard hospital mattress in 1729 patients admitted to medical and surgical departments (neurology, cardiology, oncology-haematology, neurosurgery, thoracic surgery and orthopaedic surgery). Two groups (Klinipot mattress and standard hospital mattress) were monitored for the prevention of pressure sores. The patients were evaluated on a daily basis from their admission until the eventual occurrence of a bed-sore. Patients' characteristics and pressure-sore risk factors were similar at the baseline in both groups. Patients presenting with a pressure sore at the time of admission were excluded. Forty-two of the 1729 patients (2.4%) who entered the study developed at least one pressure sore. Twenty-one of the 657 patients (3.2%) nursed on the Kliniplot mattress, and 21 of the 1072 patients (1.9%) on the standard mattress developed bed-sores (p = 0.154). The median time for the occurrence of pressure sores was 31 days (range 6-87) with the Kliniplot mattress and 18 days (range 2 to 38) with the standard mattress (p < 0.001). The risk categories for developing bed-sores using the modified Ek's scale were no different at the baseline between both groups (p = 0.764). The severity of the pressure sores was no different between both groups (p = 0.918). Our results show that the occurrence of pressure sores is not reduced but is delayed when patients are nursed on a Kliniplot pressure-decreasing mattress.

Effects of Combined Rocuronium and Cisatracurium in Laparoscopic Cholecystectomy.

PubMed

Park, Woo Young; Lee, Kwang Ho; Lee, Young Bok; Kim, Myeong Hoon; Lim, Hyun Kyo; Choi, Jong Bum

2017-01-01

Laparoscopic upper abdominal surgery can cause spontaneous respiration due to diaphragmatic stimulation and intra-abdominal CO 2 inflation. Therefore, sufficient muscle relaxation is necessary for a safe surgical environment. We investigated if the combination of rocuronium and cisatracurium can counteract the delayed onset of cisatracurium's action and delayed recovery of muscle relaxation and whether the dosage of rocuronium, which is metabolized hepatically, can be reduced. A total of 75 patients scheduled for laparoscopic cholecystectomy with an American Society of Anesthesiology physical status I-II, in the age range of 20-60 years, and with a 20-30 kg/m 2 body mass index were included in the study. The patients were divided into the following groups: combination group (Group RC, rocuronium 0.3 mg/kg and cisatracurium 0.05 mg/kg), rocuronium group (Group R, rocuronium 0.6 mg/kg), and cisatracurium group (Group C, cisatracurium 0.1 mg/kg), and the onset, 25% duration, recovery index, and addition/time ratio were measured. Patients in Group RC exhibited a significantly different addition/time ratio compared with patients in the other two groups (p = 0.003). During laparoscopic cholecystectomy, the 95% effective dose of rocuronium in combination with cisatracurium is expected to provide a sufficient muscle relaxant effect.

The superior gluteal artery perforator flap for reconstruction of sacral sores

PubMed Central

Chen, Weijian; Jiang, Bo; Zhao, Jiaju; Wang, Peiji

2016-01-01

This report describes our experiences using the superior gluteal artery perforator (SGAP) flaps for reconstruction of 2 sacral sore cases. A 47-year-old female patient and a 38-year-old man with sacral sores were treated in our unit. The size of the defects were approximately 5×6 cm2 and 8×9 cm2, the defects were repaired by SGAP flaps. The size of designed was SGAP flaps varied from 7×20 to 9×16 cm2. All flaps survived and healed primary, the texture, functions, and appearance of flaps were satisfactory, and also without region dysfunction of donor and recipient sites. The SGAP flap, which has reliable blood supply, preserves the gluteus maximus muscle and could be transferred simply and safely, is an ideal and reusable method to reconstruct sacral sores with low rate of postoperative recurrence and satisfactory appearance. PMID:27652367

The use of thermal imaging to assess the effectiveness of ice massage and cold-water immersion as methods for supporting post-exercise recovery.

PubMed

Adamczyk, Jakub Grzegorz; Krasowska, Ilona; Boguszewski, Dariusz; Reaburn, Peter

2016-08-01

Cold water immersion (CWI) and ice massage (IM) are commonly used treatments to prevent the delay onset of muscle soreness (DOMS); however, little is known on their relative benefits and effectiveness to lower tissue temperature. This study was designed to evaluate the effectiveness of IM and CMI on tissue temperature and potential benefit to preventing DOMS. The research encompassed 36 subjects divided into three groups of twelve depending on the form of recovery: ice massage (IM), cold-water immersion (CWI), or passive recovery (PAS). All the participants were asked to jump as high as possible from a full squat for one minute. Thermal imaging was conducted at rest, immediately following the exercise, immediately after the trial, following the recovery treatment, and after 30min of rest. Their pain levels were assessed using the Visual Analogue Scale (VAS). After applying the selected method for supporting recovery, the LA level decreased by 4.25mmol/L in the IM group, and by 4.96mmol/L in the CWI group (IM vs. CWI p>0.05). The 2.75mmol/L decrease in lactate concentration in the PAS group was significantly lower than in the other groups (IM vs. PAS p<0.05/ CWI vs. PAS p<0.01). In both groups, Tsk after 30min was significantly lower (ΔTsk~0.5°C) than at rest (p<0.05). In turn, Tsk in the PAS group returned to the resting values (p>0.05). Seventy-two hours after the exercise, a clear decrease in discomfort was observed in the IM and CWI groups compared to the PAS group. The two applied treatments have proven to be effective both in utilizing lactate and preventing DOMS. Depending on training requirements, we recommend the use of IM when athletes experience localized muscle fatigue. One the other hand, CWI is recommended in situations of global or generalized muscle injury or fatigue. Copyright © 2016 Elsevier Ltd. All rights reserved.

Estrogen-related receptor-α (ERRα) deficiency in skeletal muscle impairs regeneration in response to injury

PubMed Central

LaBarge, Samuel; McDonald, Marisa; Smith-Powell, Leslie; Auwerx, Johan; Huss, Janice M.

2014-01-01

The estrogen-related receptor-α (ERRα) regulates mitochondrial biogenesis and glucose and fatty acid oxidation during differentiation in skeletal myocytes. However, whether ERRα controls metabolic remodeling during skeletal muscle regeneration in vivo is unknown. We characterized the time course of skeletal muscle regeneration in wild-type (M-ERRαWT) and muscle-specific ERRα−/− (M-ERRα−/−) mice after injury by intramuscular cardiotoxin injection. M-ERRα−/− mice exhibited impaired regeneration characterized by smaller myofibers with increased centrally localized nuclei and reduced mitochondrial density and cytochrome oxidase and citrate synthase activities relative to M-ERRαWT. Transcript levels of mitochondrial transcription factor A, nuclear respiratory factor-2a, and peroxisome proliferator-activated receptor (PPAR)-γ coactivator (PGC)-1β, were downregulated in the M-ERRα−/− muscles at the onset of myogenesis. Furthermore, coincident with delayed myofiber recovery, we observed reduced muscle ATP content (−45% vs. M-ERRαWT) and enhanced AMP-activated protein kinase (AMPK) activation in M-ERRα−/− muscle. We subsequently demonstrated that pharmacologic postinjury AMPK activation was sufficient to delay muscle regeneration in WT mice. AMPK activation induced ERRα transcript expression in M-ERRαWT muscle and in C2C12 myotubes through induction of the Esrra promoter, indicating that ERRα may control gene regulation downstream of the AMPK pathway. Collectively, these results suggest that ERRα deficiency during muscle regeneration impairs recovery of mitochondrial energetic capacity and perturbs AMPK activity, resulting in delayed myofiber repair.—LaBarge, S., McDonald, M., Smith-Powell, L., Auwerx, J., Huss, J. M. Estrogen-related receptor-α (ERRα) deficiency in skeletal muscle impairs regeneration in response to injury. PMID:24277576

Magnesium sulfate accelerates the onset of low-dose rocuronium in patients undergoing laryngeal microsurgery.

PubMed

Choi, Eun-Su; Jeong, Woo-Jin; Ahn, Soon-Hyun; Oh, Ah-Young; Jeon, Young-Tae; Do, Sang-Hwan

2017-02-01

We evaluated the effect of magnesium sulfate-an enhancer of neuromuscular blockade-on onset and duration of low dose of rocuronium, and on operating conditions during laryngeal microsurgery. Randomized, prospective, double-blinded study. Eighty-four patients scheduled for elective laryngeal microsurgery. Patients were randomly allocated to receive different doses of rocuronium: 0.6 mg/kg (group C, n=28), 0.45 mg/kg (group LR, n=28), or 0.45 mg/kg plus magnesium sulfate 30 mg/kg (group LM, n=28). We measured the onset time and duration of action of rocuronium, and evaluated the surgeon's satisfaction with the operating conditions. Group LR showed significantly delayed onset time (group C: 87±22 seconds, group LR: 127±47 seconds, and group LM: 89±32 seconds; P=.001) and maximal suppression than did other groups (group C: 102±30 seconds, group LR: 155±66 seconds, and group LM: 105±36 seconds; P=.002). Duration of action of rocuronium was significantly longer in group C than in other groups (group C: 39±7 minutes, group LR: 28±8 minutes, group LRM: 31±8 minutes; P<.001). Laryngoscope placement score (P=.002), surgeon's satisfaction (P=.005), and sore throat (P=.035) were significantly worse in group LR. Magnesium sulfate 30 mg/kg accelerated the onset and improved operating conditions of low-dose rocuronium without prolongation of action. Copyright © 2016 Elsevier Inc. All rights reserved.

Triheptanoin Protects Motor Neurons and Delays the Onset of Motor Symptoms in a Mouse Model of Amyotrophic Lateral Sclerosis

PubMed Central

Barkl-Luke, Mallory E.; Ngo, Shyuan T.; Thomas, Nicola K.; McDonald, Tanya S.; Borges, Karin

2016-01-01

There is increasing evidence that energy metabolism is disturbed in Amyotrophic Lateral Sclerosis (ALS) patients and animal models. Treatment with triheptanoin, the triglyceride of heptanoate, is a promising approach to provide alternative fuel to improve oxidative phosphorylation and aid ATP generation. Heptanoate can be metabolized to propionyl-CoA, which after carboxylation can produce succinyl-CoA and thereby re-fill the tricarboxylic acid (TCA) cycle (anaplerosis). Here we tested the hypothesis that treatment with triheptanoin prevents motor neuron loss and delays the onset of disease symptoms in female mice overexpressing the mutant human SOD1G93A (hSOD1G93A) gene. When oral triheptanoin (35% of caloric content) was initiated at P35, motor neuron loss at 70 days of age was attenuated by 33%. In untreated hSOD1G93A mice, the loss of hind limb grip strength began at 16.7 weeks. Triheptanoin maintained hind limb grip strength for 2.8 weeks longer (p<0.01). Loss of balance on the rotarod and reduction of body weight were delayed by 13 and 11 days respectively (both p<0.01). Improved motor function occurred in parallel with alterations in the expression of genes associated with muscle metabolism. In gastrocnemius muscles, the mRNA levels of pyruvate, 2-oxoglutarate and succinate dehydrogenases and methyl-malonyl mutase were reduced by 24–33% in 10 week old hSOD1G93A mice when compared to wild-type mice, suggesting that TCA cycling in skeletal muscle may be slowed in this ALS mouse model at a stage when muscle strength is still normal. At 25 weeks of age, mRNA levels of succinate dehydrogenases, glutamic pyruvic transaminase 2 and the propionyl carboxylase β subunit were reduced by 69–84% in control, but not in triheptanoin treated hSOD1G93A animals. Taken together, our results suggest that triheptanoin slows motor neuron loss and the onset of motor symptoms in ALS mice by improving TCA cycling. PMID:27564703

Pycnogenol

MedlinePlus

... SLE in some patients. Ringing in the ears (tinnitus). Early research suggests that taking 100-150 mg of pycnogenol daily for 34 days reduces tinnitus symptoms. Stroke prevention. Muscle soreness. Other conditions. More ...

Effects of far infrared rays emitting clothing on recovery after an intense plyometric exercise bout applied to elite soccer players: a randomized double-blind placebo-controlled trial

PubMed Central

Loturco, I; Abad, CCC; Nakamura, FY; Ramos, SP; Kobal, R; Gil, S; Pereira, LA; Burini, FHP; Roschel, H; Ugrinowitsch, C; Tricoli, V

2016-01-01

The aim was to investigate the effects of far infrared (FIR) ray emitting clothes on indirect markers of exercise-induced muscle damage and physical performance recovery after a plyometric bout applied to soccer players. Twenty-one male players (18.9±0.6 years; 70.8±5.01 kg; 178.3±0.06 cm) performed 100 drop-jumps. Six hours after the bout, athletes put on FIR clothes (FIR) (density of 225 g·m-2, 88% far infrared rays emitting polyamide 66 Emana yarn (PA66) fibre, 12% Spandex, emissivity of 0.88 and power emitted of 341 W/m2µm at 37°C in the 5-20 µm wavelength range, patent WO 2009/077834 A2) (N = 10) or placebo clothes (PLA) (N = 11). Mid-thigh circumferences, creatine kinase (CK), and delayed-onset muscle soreness (DOMS) were assessed before, immediately after and 24, 48, and 72 h after the bout. Squat (SJ) and countermovement jump (CMJ) heights were measured before and at 24, 48, and 72 h after, while 1RM leg press (maximum strength) was measured before and at 72 h after the plyometrics. No differences between groups were found in mid-thigh circumferences, SJ, CMJ or 1RM. CK increased significantly 24 h after the plyometrics in comparison to before (p < 0.05) in both groups. PLA showed significant DOMS increases at 24, 48, and 72 h, while FIR showed significant increases at 24 and 48 h (p < 0.05). DOMS effect sizes were greater in FIR (moderate at 48 h, ES = 0.737 and large at 72 h, ES = 0.844), suggesting that FIR clothes may reduce perceived DOMS after an intense plyometric session performed by soccer players. PMID:27601783

Activation of the gluteus maximus and hamstring muscles during prone hip extension with knee flexion in three hip abduction positions.

PubMed

Kang, Sun-Young; Jeon, Hye-Seon; Kwon, Ohyun; Cynn, Heon-Seock; Choi, Boram

2013-08-01

The direction of fiber alignment within a muscle is known to influence the effectiveness of muscle contraction. However, most of the commonly used clinical gluteus maximus (GM) exercises do not consider the direction of fiber alignment within the muscle. Therefore, the purpose of this study was to investigate the influence of hip abduction position on the EMG (electromyography) amplitude and onset time of the GM and hamstrings (HAM) during prone hip extension with knee flexion (PHEKF) exercise. Surface EMG signals were recorded from the GM and HAM during PHEKF exercise in three hip abduction positions: 0°, 15°, and 30°. Thirty healthy subjects voluntarily participated in this study. The results show that GM EMG amplitude was greatest in the 30° hip abduction position, followed by 15° and then 0° hip abduction during PHEKF exercise. On the other hand, the HAM EMG amplitude at 0° hip abduction was significantly greater than at 15° and 30° hip abduction. Additionally, GM EMG onset firing was delayed relative to that of the HAM at 0° hip abduction. On the contrary, the GM EMG onset occurred earlier than the HAM in the 15° and 30° hip abduction positions. These findings indicate that performing PHEKF exercise in the 30° hip abduction position may be recommended as an effective way to facilitate the GM muscle activity and advance the firing time of the GM muscle in asymptomatic individuals. This finding provides preliminary evidence that GM EMG amplitude and onset time can be modified by the degree of hip abduction. Copyright © 2012 Elsevier Ltd. All rights reserved.

Arterial stiffness results from eccentrically biased downhill running exercise.

PubMed

Burr, J F; Boulter, M; Beck, K

2015-03-01

There is increasing evidence that select forms of exercise are associated with vascular changes that are in opposition to the well-accepted beneficial effects of moderate intensity aerobic exercise. To determine if alterations in arterial stiffness occur following eccentrically accentuated aerobic exercise, and if changes are associated with measures of muscle soreness. Repeated measures experimental cohort. Twelve (m=8/f=4) moderately trained (VO₂max=52.2 ± 7.4 ml kg(-1)min(-1)) participants performed a downhill run at -12° grade using a speed that elicited 60% VO₂max for 40 min. Cardiovascular and muscle soreness measures were collected at baseline and up to 72 h post-running. Muscle soreness peaked at 48 h (p=<0.001). Arterial stiffness similarly peaked at 48 h (p=0.04) and remained significantly elevated above baseline through 72 h. Eccentrically accentuated downhill running is associated with arterial stiffening in the absence of an extremely prolonged duration or fast pace. The timing of alterations coincides with the well-documented inflammatory response that occurs from the muscular insult of downhill running, but whether the observed changes are a result of either systemic or local inflammation is yet unclear. These findings may help to explain evidence of arterial stiffening in long-term runners and following prolonged duration races wherein cumulative eccentric loading is high. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

A startling acoustic stimulus facilitates voluntary lower extremity movements and automatic postural responses in people with chronic stroke.

PubMed

Coppens, Milou J M; Roelofs, Jolanda M B; Donkers, Nicole A J; Nonnekes, Jorik; Geurts, Alexander C H; Weerdesteyn, Vivian

2018-05-14

A startling acoustic stimulus (SAS) involuntary releases prepared movements at accelerated latencies, known as the StartReact effect. Previous work has demonstrated intact StartReact in paretic upper extremity movements in people after stroke, suggesting preserved motor preparation. The question remains whether motor preparation of lower extremity movements is also unaffected after stroke. Here, we investigated StartReact effects on ballistic lower extremity movements and on automatic postural responses (APRs) following perturbations to standing balance. These APRs are particularly interesting as they are critical to prevent a fall following balance perturbations, but show substantial delays and poor muscle coordination after stroke. Twelve chronic stroke patients and 12 healthy controls performed voluntary ankle dorsiflexion movements in response to a visual stimulus, and responded to backward balance perturbations evoking APRs. Twenty-five percent of all trials contained a SAS (120 dB) simultaneously with the visual stimulus or balance perturbation. As expected, in the absence of a SAS muscle and movement onset latencies at the paretic side were delayed compared to the non-paretic leg and to controls. The SAS accelerated ankle dorsiflexion onsets in both the legs of the stroke subjects and in controls. Following perturbations, the SAS accelerated bilateral APR onsets not only in controls, but for the first time, we also demonstrated this effect in people after stroke. Moreover, APR inter- and intra-limb muscle coordination was rather weak in our stroke subjects, but substantially improved when the SAS was applied. These findings show preserved movement preparation, suggesting that there is residual (subcortical) capacity for motor recovery.

Contrasting roles for MyoD in organizing myogenic promoter structures during embryonic skeletal muscle development.

PubMed

Cho, Ok Hyun; Mallappa, Chandrashekara; Hernández-Hernández, J Manuel; Rivera-Pérez, Jaime A; Imbalzano, Anthony N

2015-01-01

Among the complexities of skeletal muscle differentiation is a temporal distinction in the onset of expression of different lineage-specific genes. The lineage-determining factor MyoD is bound to myogenic genes at the onset of differentiation whether gene activation is immediate or delayed. How temporal regulation of differentiation-specific genes is established remains unclear. Using embryonic tissue, we addressed the molecular differences in the organization of the myogenin and muscle creatine kinase (MCK) gene promoters by examining regulatory factor binding as a function of both time and spatial organization during somitogenesis. At the myogenin promoter, binding of the homeodomain factor Pbx1 coincided with H3 hyperacetylation and was followed by binding of co-activators that modulate chromatin structure. MyoD and myogenin binding occurred subsequently, demonstrating that Pbx1 facilitates chromatin remodeling and modification before myogenic regulatory factor binding. At the same time, the MCK promoter was bound by HDAC2 and MyoD, and activating histone marks were largely absent. The association of HDAC2 and MyoD was confirmed by co-immunoprecipitation, proximity ligation assay (PLA), and sequential ChIP. MyoD differentially promotes activated and repressed chromatin structures at myogenic genes early after the onset of skeletal muscle differentiation in the developing mouse embryo. © 2014 Wiley Periodicals, Inc.

Effects of lymphatic drainage and cryotherapy on indirect markers of muscle damage.

PubMed

Behringer, Michael; Jedlicka, Diana; Mester, Joachim

2018-06-01

Muscle enzymes are cleared from the extracellular space by the lymphatic system, while smaller proteins enter the bloodstream directly. We investigated if manual lymphatic drainage (MLD), local cryotherapy (CRY), and rest (RST) differently affect the time course of creatine kinase (CK, 84 kDa) and heart-type fatty acid binding protein (h-FABP, 15 kDa) in the blood. Randomized controlled trial. After 4x20 unilateral, eccentric accentuated knee extensions (with one-third of the maximal isometric force) 30 sports students randomly received either a 30 min MLD, CRY or they rested (RST) for the same amount of time. CK, h-FABP, neutrophil granulocytes, and the perceived muscle soreness were assessed before, immediately after, and 1 hour, 4 hours, and 24 hours after the exercise. All measures increased significantly (P<0.001) after the protocol indicating that muscle damage was induced. However, the responses did not differ between the treatments. Large and small damage markers were not affected differently by MLD, CRY, or RST, when applied for 30 min and no beneficial effects on inflammation or muscle soreness could be found for MLD and CRY when compared to RST. This information is particularly important for those sports physicians and conditioning specialists who use biochemical muscle damage markers to adjust the training load and volume of athletes.

Full Range of Motion Induces Greater Muscle Damage Than Partial Range of Motion in Elbow Flexion Exercise With Free Weights.

PubMed

Baroni, Bruno M; Pompermayer, Marcelo G; Cini, Anelize; Peruzzolo, Amanda S; Radaelli, Régis; Brusco, Clarissa M; Pinto, Ronei S

2017-08-01

Baroni, BM, Pompermayer, MG, Cini, A, Peruzzolo, AS, Radaelli, R, Brusco, CM, and Pinto, RS. Full range of motion induces greater muscle damage than partial range of motion in elbow flexion exercise with free weights. J Strength Cond Res 31(8): 2223-2230, 2017-Load and range of motion (ROM) applied in resistance training (RT) affect the muscle damage magnitude and the recovery time-course. Because exercises performed with partial ROM allow a higher load compared with those with full ROM, this study investigated the acute effect of a traditional RT exercise using full ROM or partial ROM on muscle damage markers. Fourteen healthy men performed 4 sets of 10 concentric-eccentric repetitions of unilateral elbow flexion on the Scott bench. Arms were randomly assigned to partial-ROM (50-100°) and full-ROM (0-130°) conditions, and load was determined as 80% of 1 repetition maximum (1RM) in the full- and partial-ROM tests. Muscle damage markers were assessed preexercise, immediately, and 24, 48, and 72 hours after exercise. Primary outcomes were peak torque, muscle soreness during palpation and elbow extension, arm circumference, and joint ROM. The load lifted in the partial-ROM condition (1RM = 19.1 ± 3.0 kg) was 40 ± 18% higher compared with the full-ROM condition (1RM = 13.7 ± 2.2 kg). Seventy-two hours after exercise, the full-ROM condition led to significant higher soreness sensation during elbow extension (1.3-4.1 cm vs. 1.0-1.9 cm) and smaller ROM values (97.5-106.1° vs. 103.6-115.7°). Peak torque, soreness from palpation, and arm circumference were statistically similar between conditions, although mean values in all time points of these outcomes have suggested more expressive muscle damage for the full-ROM condition. In conclusion, elbow flexion exercise with full ROM seems to induce greater muscle damage than partial-ROM exercises, even though higher absolute load was achieved with partial ROM.

The prevention and treatment of exercise-induced muscle damage.

PubMed

Howatson, Glyn; van Someren, Ken A

2008-01-01

Exercise-induced muscle damage (EIMD) can be caused by novel or unaccustomed exercise and results in a temporary decrease in muscle force production, a rise in passive tension, increased muscle soreness and swelling, and an increase in intramuscular proteins in blood. Consequently, EIMD can have a profound effect on the ability to perform subsequent bouts of exercise and therefore adhere to an exercise training programme. A variety of interventions have been used prophylactically and/or therapeutically in an attempt to reduce the negative effects associated with EIMD. This article focuses on some of the most commonly used strategies, including nutritional and pharmacological strategies, electrical and manual therapies and exercise. Long-term supplementation with antioxidants or beta-hydroxy-beta-methylbutyrate appears to provide a prophylactic effect in reducing EIMD, as does the ingestion of protein before and following exercise. Although the administration of high-dose NSAIDs may reduce EIMD and muscle soreness, it also attenuates the adaptive processes and should therefore not be prescribed for long-term treatment of EIMD. Whilst there is some evidence that stretching and massage may reduce muscle soreness, there is little evidence indicating any performance benefits. Electrical therapies and cryotherapy offer limited effect in the treatment of EIMD; however, inconsistencies in the dose and frequency of these and other interventions may account for the lack of consensus regarding their efficacy. Both as a cause and a consequence of this, there are very few evidence-based guidelines for the application of many of these interventions. Conversely, there is unequivocal evidence that prior bouts of eccentric exercise provide a protective effect against subsequent bouts of potentially damaging exercise. Further research is warranted to elucidate the most appropriate dose and frequency of interventions to attenuate EIMD and if these interventions attenuate the adaptation process. This will both clarify the efficacy of such strategies and provide guidelines for evidence-based practice.

Patients with sacroiliac joint dysfunction exhibit altered movement strategies when performing a sit-to-stand task.

PubMed

Capobianco, Robyn A; Feeney, Daniel F; Jeffers, Jana R; Nelson-Wong, Erika; Morreale, Joseph; Grabowski, Alena M; Enoka, Roger M

2018-04-03

The ability to rise from a chair is a basic functional task that is frequently compromised in individuals diagnosed with orthopedic disorders in the low back and hip. There is no published literature that describes how this task is altered by sacroiliac joint dysfunction (SIJD). The objective of this study was to compare lower extremity biomechanics and the onset of muscle activity when rising from a chair in subjects with SIJD and in healthy persons. Six women with unilateral SIJD and six age-matched healthy controls performed a sit-to-stand task while we measured kinematics, kinetics, and muscle activity. Subjects stood up at a preferred speed from a seated position on an armless and backless adjustable stool. We measured kinematics with a 10-camera motion capture system, ground reaction forces for each leg with force plates, and muscle activity with surface electromyography. Joint angles and torques were calculated using inverse dynamics. Leg-loading rate was quantified as the average slope of vertical ground reaction (VGRF) force during the 500-millisecond interval preceding maximal knee extension. Between-leg differences in loading rates and peak VGRFs were significantly greater for the SIJD group than for the control group. Maximal hip angles were significantly less for the SIJD group (p=.001). Peak hip moment in the SIJD group was significantly greater in the unaffected leg (0.75±0.22 N⋅m/kg) than in the affected leg (0.47±0.29 N⋅m/kg, p=.005). There were no between-leg or between-group differences for peak knee or ankle moments. The onset of activity in the latissimus dorsi muscle on the affected side was delayed and the erector spinae muscles were activated earlier in the SIJD group than in the control group. Subjects with SIJD have a greater VGRF on the unaffected leg, generate a greater peak hip moment in the unaffected leg, use a smaller range of motion at the hip joint of the affected leg, and delay the onset of a key muscle on the affected side when rising from a seated position. Copyright © 2018 Elsevier Inc. All rights reserved.

Giant trochanteric pressure sore: Use of a pedicled chimeric perforator flap for cover

PubMed Central

Mehrotra, Sandeep

2009-01-01

Pressure sores are increasing in frequency commensurate with an ageing population with multi-system disorders and trauma. Numerous classic options are described for providing stable wound cover. With the burgeoning knowledge on perforator anatomy, recent approaches focus on the use of perforator-based flaps in bedsore surgery. A giant neglected trochanteric pressure sore in a paraplegic is presented. Since conventional options of reconstruction appeared remote, the massive ulcer was successfully managed by a chimeric perforator-based flap. The combined muscle and fasciocutaneous flaps were raised as separate paddles based on the anterolateral thigh perforator branches and provided stable cover without complications. Perforators allow versatility in managing complex wounds without compromising on established principles. PMID:19881035

Muscle Damage following Maximal Eccentric Knee Extensions in Males and Females

PubMed Central

2016-01-01

Aim To investigate whether there is a sex difference in exercise induced muscle damage. Materials and Method Vastus Lateralis and patella tendon properties were measured in males and females using ultrasonography. During maximal voluntary eccentric knee extensions (12 reps x 6 sets), Vastus Lateralis fascicle lengthening and maximal voluntary eccentric knee extensions torque were recorded every 10° of knee joint angle (20–90°). Isometric torque, Creatine Kinase and muscle soreness were measured pre, post, 48, 96 and 168 hours post damage as markers of exercise induced muscle damage. Results Patella tendon stiffness and Vastus Lateralis fascicle lengthening were significantly higher in males compared to females (p<0.05). There was no sex difference in isometric torque loss and muscle soreness post exercise induced muscle damage (p>0.05). Creatine Kinase levels post exercise induced muscle damage were higher in males compared to females (p<0.05), and remained higher when maximal voluntary eccentric knee extension torque, relative to estimated quadriceps anatomical cross sectional area, was taken as a covariate (p<0.05). Conclusion Based on isometric torque loss, there is no sex difference in exercise induced muscle damage. The higher Creatine Kinase in males could not be explained by differences in maximal voluntary eccentric knee extension torque, Vastus Lateralis fascicle lengthening and patella tendon stiffness. Further research is required to understand the significant sex differences in Creatine Kinase levels following exercise induced muscle damage. PMID:26986066

[Indication of sclerotherapy in the treatment of ischiatic pressure sore: about 13 cases].

PubMed

Bahé, L; Prud'homme, A; Penaud, A; Formé, N; Zakine, G

2012-12-01

Ischiatic pressure sore is a common pathology of the paraplegic patient. Usually treated after medical therapy, with fasciocutaneous or musculocutaneous local flaps, despite this treatment the recurrence rate is high. Sclerotherapy, injection of pure ethanol in the cavity of the pressure sore could be an interesting solution in the armentarium of the plastic surgeon in some indications. Sclerotherapy was used for 13 patients in the plastic surgery department to treat ischiatic pressure sores with a cavity, beneath the defect. The mean length of stay was 24 days. The ischiatic pressure sore was completely healed with no skin defect or cavity for nine patients (65%). For two patients, there was a delay of healing of the skin defect but no cavity beneath. There were two early recurrences of the pressure sore. They were treated by sclerotherapy with a complete recovery in 2 months with simple hydrocolloid dressings. The mean post op follow-up was 14,6 months (4 to 24). Only one recurrence was observed after 12 months. The injection of pure ethanol in the cavity of specifics ischiatics pressure sores is a simple, fast and effective technique with a good and stable long term wound healing. The mean length of stay is shorter and the recurrence rate is equivalent to other techniques. Copyright © 2009 Elsevier Masson SAS. All rights reserved.

Effect of aqua exercise on recovery of lower limb muscles after downhill running.

PubMed

Takahashi, Junichiro; Ishihara, Keiji; Aoki, Junichiro

2006-08-01

The aim of the present study was to examine how the recovery of physiological functioning of the leg muscles after high-intensity eccentric exercise such as downhill running could be promoted by aqua exercise for a period until the damaged muscle had recovered almost completely. Ten male long-distance runners were divided equally into an aqua exercise group and a control group. From the first day (Day 0) to the fourth day (Day 3), the participants completed a questionnaire on muscle soreness, and serum creatine kinase activity, muscle power, flexibility, whole-body reaction time and muscle stiffness were measured. After measurements on Day 0, the participants performed downhill running (three 5 min runs with a 5 min rest interval at -10%, 335.7 +/- 6.1 m . min-1). The aqua exercise group performed walking, jogging and jumping in water on three successive days following the downhill running on Day 0 for 30 min each day. Muscle power was reduced on Day 1 in the control group (P < 0.05). Muscle soreness in the calf on Day 3 was greater in the control group than that in the aqua exercise group (P < 0.05). In the aqua exercise group, muscle stiffness in the calf was less than that in the control group over 4 days (time main effect: P < 0.05; group x time interaction: P < 0.05). We conclude that aqua exercise promoted physiological functioning of the muscles in the legs after high-intensity downhill running for a period until the damaged muscles had recovered almost completely.

SRT2104 extends survival of male mice on a standard diet and preserves bone and muscle mass

PubMed Central

Mercken, Evi M; Mitchell, Sarah J; Martin-Montalvo, Alejandro; Minor, Robin K; Almeida, Maria; Gomes, Ana P; Scheibye-Knudsen, Morten; Palacios, Hector H; Licata, Jordan J; Zhang, Yongqing; Becker, Kevin G; Khraiwesh, Husam; González-Reyes, José A; Villalba, José M; Baur, Joseph A; Elliott, Peter; Westphal, Christoph; Vlasuk, George P; Ellis, James L; Sinclair, David A; Bernier, Michel; de Cabo, Rafael

2014-01-01

Increased expression of SIRT1 extends the lifespan of lower organisms and delays the onset of age-related diseases in mammals. Here, we show that SRT2104, a synthetic small molecule activator of SIRT1, extends both mean and maximal lifespan of mice fed a standard diet. This is accompanied by improvements in health, including enhanced motor coordination, performance, bone mineral density, and insulin sensitivity associated with higher mitochondrial content and decreased inflammation. Short-term SRT2104 treatment preserves bone and muscle mass in an experimental model of atrophy. These results demonstrate it is possible to design a small molecule that can slow aging and delay multiple age-related diseases in mammals, supporting the therapeutic potential of SIRT1 activators in humans. PMID:24931715

The effect of local cryotherapy on subjective and objective recovery characteristics following an exhaustive jump protocol

PubMed Central

Hohenauer, Erich; Clarys, Peter; Baeyens, Jean-Pierre; Clijsen, Ron

2016-01-01

The purpose of this controlled trial was to investigate the effects of a single local cryotherapy session on the recovery characteristics over a period of 72 hours. Twenty-two young and healthy female (n=17; mean age: 21.9±1.1 years) and male (n=5;mean age: 25.4±2.8 years) adults participated in this study. Following an exhaustive jump protocol (3×30 countermovement jumps), half of the participants received either a single local cryotherapy application (+8°C) or a single local thermoneutral application (+32°C) of 20-minute duration using two thigh cuffs. Subjective measures of recovery (delayed-onset muscle soreness and ratings of perceived exertion) and objective measures of recovery (vertical jump performance and peak power output) were assessed immediately following the postexercise applications (0 hours) and at 24 hours, 48 hours, and 72 hours after the jump protocol. Local cryotherapy failed to significantly affect any subjective recovery variable during the 72-hour recovery period (P>0.05). After 72 hours, the ratings of perceived exertion were significantly lower in the thermoneutral group compared to that in the cryotherapy group (P=0.002). No significant differences were observed between the cryotherapy and the thermoneutral groups with respect to any of the objective recovery variables. In this experimental study, a 20-minute cryotherapy cuff application failed to demonstrate a positive effect on any objective measures of recovery. The effects of local thermoneutral application on subjective recovery characteristics were superior when compared to the effects of local cryotherapy application at 72 hours postapplication. PMID:27579000

The Effect of Post-Exercise Cryotherapy on Recovery Characteristics: A Systematic Review and Meta-Analysis.

PubMed

Hohenauer, Erich; Taeymans, Jan; Baeyens, Jean-Pierre; Clarys, Peter; Clijsen, Ron

2015-01-01

The aim of this review and meta-analysis was to critically determine the possible effects of different cooling applications, compared to non-cooling, passive post-exercise strategies, on recovery characteristics after various, exhaustive exercise protocols up to 96 hours (hrs). A total of n = 36 articles were processed in this study. To establish the research question, the PICO-model, according to the PRISMA guidelines was used. The Cochrane's risk of bias tool, which was used for the quality assessment, demonstrated a high risk of performance bias and detection bias. Meta-analyses of subjective characteristics, such as delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE) and objective characteristics like blood plasma markers and blood plasma cytokines, were performed. Pooled data from 27 articles revealed, that cooling and especially cold water immersions affected the symptoms of DOMS significantly, compared to the control conditions after 24 hrs recovery, with a standardized mean difference (Hedges' g) of -0.75 with a 95% confidence interval (CI) of -1.20 to -0.30. This effect remained significant after 48 hrs (Hedges' g: -0.73, 95% CI: -1.20 to -0.26) and 96 hrs (Hedges' g: -0.71, 95% CI: -1.10 to -0.33). A significant difference in lowering the symptoms of RPE could only be observed after 24 hrs of recovery, favouring cooling compared to the control conditions (Hedges' g: -0.95, 95% CI: -1.89 to -0.00). There was no evidence, that cooling affects any objective recovery variable in a significant way during a 96 hrs recovery period.

The Effect of Post-Exercise Cryotherapy on Recovery Characteristics: A Systematic Review and Meta-Analysis

PubMed Central

Hohenauer, Erich

2015-01-01

The aim of this review and meta-analysis was to critically determine the possible effects of different cooling applications, compared to non-cooling, passive post-exercise strategies, on recovery characteristics after various, exhaustive exercise protocols up to 96 hours (hrs). A total of n = 36 articles were processed in this study. To establish the research question, the PICO-model, according to the PRISMA guidelines was used. The Cochrane’s risk of bias tool, which was used for the quality assessment, demonstrated a high risk of performance bias and detection bias. Meta-analyses of subjective characteristics, such as delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE) and objective characteristics like blood plasma markers and blood plasma cytokines, were performed. Pooled data from 27 articles revealed, that cooling and especially cold water immersions affected the symptoms of DOMS significantly, compared to the control conditions after 24 hrs recovery, with a standardized mean difference (Hedges’ g) of -0.75 with a 95% confidence interval (CI) of -1.20 to -0.30. This effect remained significant after 48 hrs (Hedges’ g: -0.73, 95% CI: -1.20 to -0.26) and 96 hrs (Hedges’ g: -0.71, 95% CI: -1.10 to -0.33). A significant difference in lowering the symptoms of RPE could only be observed after 24 hrs of recovery, favouring cooling compared to the control conditions (Hedges’ g: -0.95, 95% CI: -1.89 to -0.00). There was no evidence, that cooling affects any objective recovery variable in a significant way during a 96 hrs recovery period. PMID:26413718

The effect of local cryotherapy on subjective and objective recovery characteristics following an exhaustive jump protocol.

PubMed

Hohenauer, Erich; Clarys, Peter; Baeyens, Jean-Pierre; Clijsen, Ron

2016-01-01

The purpose of this controlled trial was to investigate the effects of a single local cryotherapy session on the recovery characteristics over a period of 72 hours. Twenty-two young and healthy female (n=17; mean age: 21.9±1.1 years) and male (n=5;mean age: 25.4±2.8 years) adults participated in this study. Following an exhaustive jump protocol (3×30 countermovement jumps), half of the participants received either a single local cryotherapy application (+8°C) or a single local thermoneutral application (+32°C) of 20-minute duration using two thigh cuffs. Subjective measures of recovery (delayed-onset muscle soreness and ratings of perceived exertion) and objective measures of recovery (vertical jump performance and peak power output) were assessed immediately following the postexercise applications (0 hours) and at 24 hours, 48 hours, and 72 hours after the jump protocol. Local cryotherapy failed to significantly affect any subjective recovery variable during the 72-hour recovery period (P>0.05). After 72 hours, the ratings of perceived exertion were significantly lower in the thermoneutral group compared to that in the cryotherapy group (P=0.002). No significant differences were observed between the cryotherapy and the thermoneutral groups with respect to any of the objective recovery variables. In this experimental study, a 20-minute cryotherapy cuff application failed to demonstrate a positive effect on any objective measures of recovery. The effects of local thermoneutral application on subjective recovery characteristics were superior when compared to the effects of local cryotherapy application at 72 hours postapplication.

Dysphagia in amyotrophic lateral sclerosis: prevalence and clinical findings.

PubMed

Ruoppolo, G; Schettino, I; Frasca, V; Giacomelli, E; Prosperini, L; Cambieri, C; Roma, R; Greco, A; Mancini, P; De Vincentiis, M; Silani, V; Inghilleri, M

2013-12-01

To characterize swallowing deficits in amyotrophic lateral sclerosis (ALS); investigate the delay in dysphagia onset; estimate correlations between dysphagia severity and patients' functional status; identify the symptom(s) most likely to predict dysphagia. A group of 49 consecutive patients with ALS, 14 with bulbar onset and 35 with spinal onset, underwent swallowing evaluation including bedside and fiberoptic endoscopic examination to detect dysphagia. Patients with dysphagia were more likely than those without to have bulbar onset ALS (P = 0.02); more severely impaired chewing (P = 0.01); and tongue muscle deficits (P = 0.001). The only variable measured at first examination significantly associated with dysphagia was a more than mild tongue muscle deficit. The only variable useful in predicting dysphagia was a chewing deficit. In 10 of the 49 patients studied, swallowing evaluation disclosed an impaired cough reflex. Dysphagia in patients with ALS correlates significantly with bulbar onset and with oral swallowing impairment. Fiberoptic swallowing evaluation is a useful tool for detecting swallowing deficits and laryngeal sensitivity in patients with ALS. An impaired cough reflex is an unexpected finding in many patients with ALS. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Mometasone Nasal Spray

MedlinePlus

... nausea, or vomiting nosebleeds headache sore throat increased menstrual pain muscle or joint pain sinus pain weakness diarrhea ... weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and ...

[Pressure sores in geriatric medicine: the role of nutrition].

PubMed

Fontaine, Juliette; Raynaud-Simon, Agathe

2008-01-01

Malnutrition is frequent in geriatric patients: it affects 30 to 60% of elderly residents of institutions and 30 to 70% of patients admitted for short-term hospitalization. Malnutrition is a risk factor for developing pressure sores, and patients with them are more often and more severely malnourished than patients without them. In elderly subjects, multiple and interlinked factors may trigger or aggravate malnutrition; they may be physical, psychological or social and may be worsened by drugs and some diets. Malnutrition has been recognized as a risk factor for the onset and perpetuation of pressure sores. Of the dietary factors, protein intake seems most important. A low body mass index (BMI), low serum albumin, and weight loss are associated with an increased risk of pressure sores. A physician observing pressure sores must conduct a nutritional assessment, using clinical and laboratory screening tools. The criteria for malnutrition in elderly subjects are weight loss > or =5% in 3 months or > or =10% in 6 months, BMI<21 kg/m(2), serum albumin<35 g/L or a MNA (Mini Nutritional Assessment) score<17. Any one of these criteria is a sufficient basis for a diagnosis of malnutrition. Nutritional management is part of the prevention and treatment of pressure sores in geriatric medicine. It must be adapted for each patient. The recommended calorie intake in malnourished patients at risk of or with pressure sores is 30-40 kcal/kg/d, with 1.2-1.5 g of proteins/kg/d.

One session of partial-body cryotherapy (-110 °C) improves muscle damage recovery.

PubMed

Ferreira-Junior, J B; Bottaro, M; Vieira, A; Siqueira, A F; Vieira, C A; Durigan, J L Q; Cadore, E L; Coelho, L G M; Simões, H G; Bemben, M G

2015-10-01

To evaluate the effects of a single session of partial-body cryotherapy (PBC) on muscle recovery, 26 young men performed a muscle-damaging protocol that consisted of five sets of 20 drop jumps with 2-min rest intervals between sets. After the exercise, the PBC group (n = 13) was exposed to 3 min of PBC at -110 °C, and the control group (n = 13) was exposed to 3 min at 21 °C. Anterior thigh muscle thickness, isometric peak torque, and muscle soreness of knee extensors were measured pre, post, 24, 48, 72, and 96 h following exercise. Peak torque did not return to baseline in control group (P < 0.05), whereas the PBC group recovered peak torques 96 h post exercise (P > 0.05). Peak torque was also higher after PBC at 72 and 96 h compared with control group (P < 0.05). Muscle thickness increased after 24 h in the control group (P < 0.05) and was significantly higher compared with the PBC group at 24 and 96 h (P < 0.05). Muscle soreness returned to baseline for the PBC group at 72 h compared with 96 h for controls. These results indicate that PBC after strenuous exercise may enhance recovery from muscle damage. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Absence of Nrf2 or Its Selective Overexpression in Neurons and Muscle Does Not Affect Survival in ALS-Linked Mutant hSOD1 Mouse Models

PubMed Central

Vargas, Marcelo R.; Burton, Neal C.; Gan, Li; Johnson, Delinda A.; Schäfer, Matthias; Werner, Sabine; Johnson, Jeffrey A.

2013-01-01

The nuclear factor erythroid 2-related factor 2 (Nrf2) governs the expression of antioxidant and phase II detoxifying enzymes. Nrf2 activation can prevent or reduce cellular damage associated with several types of injury in many different tissues and organs. Dominant mutations in Cu/Zn-superoxide dismutase (SOD1) cause familial forms of amyotrophic lateral sclerosis (ALS), a fatal disorder characterized by the progressive loss of motor neurons and subsequent muscular atrophy. We have previously shown that Nrf2 activation in astrocytes delays neurodegeneration in ALS mouse models. To further investigate the role of Nrf2 in ALS we determined the effect of absence of Nrf2 or its restricted overexpression in neurons or type II skeletal muscle fibers on symptoms onset and survival in mutant hSOD1 expressing mice. We did not observe any detrimental effect associated with the lack of Nrf2 in two different mutant hSOD1 animal models of ALS. However, restricted Nrf2 overexpression in neurons or type II skeletal muscle fibers delayed disease onset but failed to extend survival in hSOD1G93A mice. These results highlight the concept that not only the pharmacological target but also the cell type targeted may be relevant when considering a Nrf2-mediated therapeutic approach for ALS. PMID:23418589

Absence of Nrf2 or its selective overexpression in neurons and muscle does not affect survival in ALS-linked mutant hSOD1 mouse models.

PubMed

Vargas, Marcelo R; Burton, Neal C; Kutzke, Jennifer; Gan, Li; Johnson, Delinda A; Schäfer, Matthias; Werner, Sabine; Johnson, Jeffrey A

2013-01-01

The nuclear factor erythroid 2-related factor 2 (Nrf2) governs the expression of antioxidant and phase II detoxifying enzymes. Nrf2 activation can prevent or reduce cellular damage associated with several types of injury in many different tissues and organs. Dominant mutations in Cu/Zn-superoxide dismutase (SOD1) cause familial forms of amyotrophic lateral sclerosis (ALS), a fatal disorder characterized by the progressive loss of motor neurons and subsequent muscular atrophy. We have previously shown that Nrf2 activation in astrocytes delays neurodegeneration in ALS mouse models. To further investigate the role of Nrf2 in ALS we determined the effect of absence of Nrf2 or its restricted overexpression in neurons or type II skeletal muscle fibers on symptoms onset and survival in mutant hSOD1 expressing mice. We did not observe any detrimental effect associated with the lack of Nrf2 in two different mutant hSOD1 animal models of ALS. However, restricted Nrf2 overexpression in neurons or type II skeletal muscle fibers delayed disease onset but failed to extend survival in hSOD1(G93A) mice. These results highlight the concept that not only the pharmacological target but also the cell type targeted may be relevant when considering a Nrf2-mediated therapeutic approach for ALS.

Use of polyurethane foam inside plaster casts to prevent the onset of heel sores in the population at risk. A controlled clinical study.

PubMed

Forni, Cristiana; Loro, Loretta; Tremosini, Morena; Mini, Sandra; Pignotti, Elettra; Bigoni, Ombretta; Guzzo, Giuseppe; Bellini, Laura; Trofa, Carmela; Di Cataldo, Anna M; Guzzi, Marilena

2011-03-01

The aim of this study was to test the effectiveness of polyurethane foam in contact with the heel inside a plaster cast to decrease the rate of pressure sores in the population at most risk. The rate of pressure sores caused by the plaster cast is reported to be 14-15% in the paediatric population, 33.3% in patients having undergone chemotherapy for bone tumours and 43% in orthopaedic patients who already have sore skin when the cast is applied (grade 1 lesion) to the heel. Controlled clinical trial. From November 2007-January 2009, all consecutive subjects requiring lower limb casts having undergone chemotherapy and/or presenting heel soreness received polyurethane foam in contact with the skin of the heel before applying the cast. The results were compared with those of patients with the same risk factors but were not administered the foam and were enrolled from May 2005-August 2006. In total, 156 patients were enrolled, 85 in the control group and 71 in the experimental group. In the experimental group, 2 of the 56 patients (3.6%) with sore skin developed a pressure sore compared with 21 of 49 (42.9%) in the control group without polyurethane foam (p < 0.0005). In the experimental group, one of the 24 patients (4.2%) patients undergoing chemotherapy developed a pressure sore compared with 18 of 54 (33.3%) in the control group (p = 0.005). Placing polyurethane foam in contact with the skin of the heel inside a plaster cast prevents the formation of pressure sores. This study provides evidence that using polyurethane foam to prevent sores even inside plaster casts in populations at most risk is a simple and cost-effective strategy and decreases the discomfort, pain and risks in these patients. © 2011 Blackwell Publishing Ltd.

Tensiomyographic Markers Are Not Sensitive for Monitoring Muscle Fatigue in Elite Youth Athletes: A Pilot Study.

PubMed

Wiewelhove, Thimo; Raeder, Christian; de Paula Simola, Rauno Alvaro; Schneider, Christoph; Döweling, Alexander; Ferrauti, Alexander

2017-01-01

Objective: Tensiomyography (TMG) is an indirect measure of a muscle's contractile properties and has the potential as a technique for detecting exercise-induced skeletal muscle fatigue. Therefore, the aim of this study was to assess the sensitivity of tensiomyographic markers to identify reduced muscular performance in elite youth athletes. Methods: Fourteen male junior tennis players (age: 14.9 ± 1.2 years) with an international (International Tennis Federation) ranking position participated in this pre-post single group trial. They completed a 4-day high-intensity interval training (HIT) microcycle, which was composed of seven training sessions. TMG markers; countermovement jump (CMJ) performance (criterion measure of fatigue); delayed onset muscle soreness; and perceived recovery and stress were measured 24 h before and after the training program. The TMG measures included maximal radial deformation of the rectus femoris muscle belly (Dm), contraction time between 10 and 90% Dm (Tc) and the rate of deformation until 10% (V10) and 90% Dm (V90), respectively. Diagnostic characteristics were assessed with a receiver-operating curve (ROC) analysis and a contingency table, in which the area under the curve (AUC), Youden's index, sensitivity, specificity, and the diagnostic effectiveness (DE) of TMG measures were reported. A minimum AUC of 0.70 and a lower confidence interval (CI) >0.50 classified "good" diagnostic markers to assess performance changes. Results: Twenty-four hours after the microcycle, CMJ performance was observed to be significantly ( p < 0.001) reduced (Effect Size [ES] = -0.68), and DOMS (ES = 3.62) as well as perceived stress were significantly ( p < 0.001) increased. In contrast, Dm (ES = -0.35), Tc (ES = 0.04), V10 (ES = -0.32), and V90 (ES = -0.33) remained unchanged ( p > 0.05) throughout the study. ROC analysis and the data derived from the contingency table revealed that none of the tensiomyographic markers were effective diagnostic tools for detecting impaired muscular performance in elite youth athletes (AUC, 95% CI, DE%; Dm: 0.46, 0.15-0.77, 35.7%; Tc: 0.29, 0.03-0.59, 35.7%; V10: 0.71, 0.27-1.00, 35.7%; V90: 0.37, 0.10-0.65, 35.7%). Conclusion: The tensiomyographic parameters that were assessed in this study were not sensitive enough to detect muscular performance changes in elite youth athletes.However, due to the preliminary nature of the study, further research is needed to investigate the sensitivity of TMG in this population.

Tensiomyographic Markers Are Not Sensitive for Monitoring Muscle Fatigue in Elite Youth Athletes: A Pilot Study

PubMed Central

Wiewelhove, Thimo; Raeder, Christian; de Paula Simola, Rauno Alvaro; Schneider, Christoph; Döweling, Alexander; Ferrauti, Alexander

2017-01-01

Objective: Tensiomyography (TMG) is an indirect measure of a muscle's contractile properties and has the potential as a technique for detecting exercise-induced skeletal muscle fatigue. Therefore, the aim of this study was to assess the sensitivity of tensiomyographic markers to identify reduced muscular performance in elite youth athletes. Methods: Fourteen male junior tennis players (age: 14.9 ± 1.2 years) with an international (International Tennis Federation) ranking position participated in this pre-post single group trial. They completed a 4-day high-intensity interval training (HIT) microcycle, which was composed of seven training sessions. TMG markers; countermovement jump (CMJ) performance (criterion measure of fatigue); delayed onset muscle soreness; and perceived recovery and stress were measured 24 h before and after the training program. The TMG measures included maximal radial deformation of the rectus femoris muscle belly (Dm), contraction time between 10 and 90% Dm (Tc) and the rate of deformation until 10% (V10) and 90% Dm (V90), respectively. Diagnostic characteristics were assessed with a receiver-operating curve (ROC) analysis and a contingency table, in which the area under the curve (AUC), Youden's index, sensitivity, specificity, and the diagnostic effectiveness (DE) of TMG measures were reported. A minimum AUC of 0.70 and a lower confidence interval (CI) >0.50 classified “good” diagnostic markers to assess performance changes. Results: Twenty-four hours after the microcycle, CMJ performance was observed to be significantly (p < 0.001) reduced (Effect Size [ES] = −0.68), and DOMS (ES = 3.62) as well as perceived stress were significantly (p < 0.001) increased. In contrast, Dm (ES = −0.35), Tc (ES = 0.04), V10 (ES = −0.32), and V90 (ES = −0.33) remained unchanged (p > 0.05) throughout the study. ROC analysis and the data derived from the contingency table revealed that none of the tensiomyographic markers were effective diagnostic tools for detecting impaired muscular performance in elite youth athletes (AUC, 95% CI, DE%; Dm: 0.46, 0.15–0.77, 35.7%; Tc: 0.29, 0.03–0.59, 35.7%; V10: 0.71, 0.27–1.00, 35.7%; V90: 0.37, 0.10–0.65, 35.7%). Conclusion: The tensiomyographic parameters that were assessed in this study were not sensitive enough to detect muscular performance changes in elite youth athletes.However, due to the preliminary nature of the study, further research is needed to investigate the sensitivity of TMG in this population. PMID:28670284

Asymmetric pelvic bracing and altered kinematics in patients with posterior pelvic pain who present with postural muscle delay.

PubMed

Bussey, Melanie D; Milosavljevic, Stephan

2015-01-01

The purpose of the study was to examine the muscle activity and hip-spine kinematics in a group of individuals diagnosed with posterior pelvic girdle pain and confirmed postural muscle delay during a repeated fast hip flexion task. Twenty-four (12 pain and 12 control) age and sex matched participants performed a repeated fast hip flexion task to auditory signal. Surface EMG activity in the external and internal oblique, the multifidus, the gluteus maximus and biceps femoris in the stance-limb was examined for onset timing and EMG integral. Sagittal plane hip (swing limb) and spine kinematics were examined for group and side differences over the repeated trials. While the pain group lacked significant feedforward muscle activity they displayed higher muscle activity at movement onset in the biceps femoris bilaterally (p<0.05) as well as the external oblique (p<0.05) during motion of the symptomatic side. Furthermore, the pain group experienced asymmetrical spinal range of motion with increased motion on the contralateral side (p<0.001) and reduced flexion velocity on the symptomatic side (p<0.001). The findings support previous hypotheses regarding the effect of increased biceps activity on pelvic control during lumbo-pelvic rotation. Further, there appears to be a symptom led strategy for bracing the innominate through opposing tension in the biceps and external oblique during movement of the painful side. Such asymmetrical pelvic girdle bracing may be a strategy to increase the stability of the pelvis in light of the failed load transfer mechanism. Putatively, this strategy may increase the mechanical stress on the sacroiliac joint exacerbating pain complaints. Copyright © 2014 Elsevier Ltd. All rights reserved.

Muscle activities used by young and old adults when stepping to regain balance during a forward fall.

PubMed

Thelen, D G; Muriuki, M; James, J; Schultz, A B; Ashton-Miller, J A; Alexander, N B

2000-04-01

The current study was undertaken to determine if age-related differences in muscle activities might relate to older adults being significantly less able than young adults to recover balance during a forward fall. Fourteen young and twelve older healthy males were released from forward leans of various magnitudes and asked to regain standing balance by taking a single forward step. Myoelectric signals were recorded from 12 lower extremity muscles and processed to compare the muscle activation patterns of young and older adults. Young adults successfully recovered from significantly larger leans than older adults using a single step (32.2 degrees vs. 23.5 degrees ). Muscular latency times, the time between release and activity onset, ranged from 73 to 114 ms with no significant age-related differences in the shortest muscular latency times. The overall response muscular activation patterns were similar for young and older adults. However older adults were slower to deactivate three stance leg muscles and also demonstrated delays in activating the step leg hip flexors and knee extensors prior to and during the swing phase. In the forward fall paradigm studied, age-differences in balance recovery performance do not seem due to slowness in response onset but may relate to differences in muscle activation timing during the stepping movement.

Acute and timing effects of beta-hydroxy-beta-methylbutyrate (HMB) on indirect markers of skeletal muscle damage.

PubMed

Wilson, Jacob M; Kim, Jeong-Su; Lee, Sang-Rok; Rathmacher, John A; Dalmau, Brett; Kingsley, J Derek; Koch, Heather; Manninen, Anssi H; Saadat, Raz; Panton, Lynn B

2009-02-04

While chronic β-Hydroxy β-Methylbutyrate (HMB) supplementation (≥ 2 wk) lowers exercise induced muscle damage, its acute or timing effects have not been examined. The purpose of this study was to investigate the acute and timing effects of oral HMB supplementation on serum creatine kinase (CK), lactate dehydrogenase (LDH), muscle soreness, and maximal voluntary contraction (MVC). Sixteen non-resistance trained men (22 ± 2 yrs) were assigned to HMB-Pre or HMB-Post groups. In a crossover design, all subjects performed 55 maximal eccentric knee extension/flexion contractions on 2 occasions on either the right or left leg. HMB-Pre (N = 8) randomly received 3 grams of either a placebo or HMB before and a placebo after exercise. HMB-Post (N = 8) received a placebo before and either 3 grams of HMB or a placebo after exercise. Muscle damage tests were recorded before, at 8, 24, 48, and 72 hrs post exercise. There was a reduction in MVC and an increase in soreness in the quadriceps and hamstrings following exercise (p < 0.001). Although HMB-Pre approached significance in attenuating soreness for the quadriceps (p = 0.07), there was no time x group effect. Serum indices of damage increased, peaking at 48 hrs for CK (773%) (p < 0.001) and 72 hrs for LDH (180%) (p < 0.001). While there were no time x group effects of HMB on CK and LDH, post hoc analysis revealed that only HMB-Pre showed no significant increase in LDH levels following exercise. Our findings suggest no clear acute or timing effects of HMB supplementation. However, consuming HMB before exercise appeared to prevent increases in LDH.

Acute and timing effects of beta-hydroxy-beta-methylbutyrate (HMB) on indirect markers of skeletal muscle damage

PubMed Central

Wilson, Jacob M; Kim, Jeong-su; Lee, Sang-rok; Rathmacher, John A; Dalmau, Brett; Kingsley, J Derek; Koch, Heather; Manninen, Anssi H; Saadat, Raz; Panton, Lynn B

2009-01-01

Background While chronic β-Hydroxy β-Methylbutyrate (HMB) supplementation (≥ 2 wk) lowers exercise induced muscle damage, its acute or timing effects have not been examined. The purpose of this study was to investigate the acute and timing effects of oral HMB supplementation on serum creatine kinase (CK), lactate dehydrogenase (LDH), muscle soreness, and maximal voluntary contraction (MVC). Methods Sixteen non-resistance trained men (22 ± 2 yrs) were assigned to HMB-Pre or HMB-Post groups. In a crossover design, all subjects performed 55 maximal eccentric knee extension/flexion contractions on 2 occasions on either the right or left leg. HMB-Pre (N = 8) randomly received 3 grams of either a placebo or HMB before and a placebo after exercise. HMB-Post (N = 8) received a placebo before and either 3 grams of HMB or a placebo after exercise. Muscle damage tests were recorded before, at 8, 24, 48, and 72 hrs post exercise. Results There was a reduction in MVC and an increase in soreness in the quadriceps and hamstrings following exercise (p < 0.001). Although HMB-Pre approached significance in attenuating soreness for the quadriceps (p = 0.07), there was no time × group effect. Serum indices of damage increased, peaking at 48 hrs for CK (773%) (p < 0.001) and 72 hrs for LDH (180%) (p < 0.001). While there were no time × group effects of HMB on CK and LDH, post hoc analysis revealed that only HMB-Pre showed no significant increase in LDH levels following exercise. Conclusion Our findings suggest no clear acute or timing effects of HMB supplementation. However, consuming HMB before exercise appeared to prevent increases in LDH. PMID:19193206

Flexibility training and the repeated-bout effect: priming interventions prior to eccentric training of the knee flexors.

PubMed

Leslie, Andrew W; Lanovaz, Joel L; Andrushko, Justin W; Farthing, Jonathan P

2017-10-01

Both the repeated-bout effect and increased flexibility have been linked to reduced muscle damage, fatigue, and strength loss after intense eccentric exercise. Our purpose was to compare the eccentric-training (ECC) response after first priming the muscles with either static flexibility training or a single intense bout of eccentric exercise. Twenty-five participants were randomly assigned to flexibility training (n = 8; 3×/week; 30 min/day), a single bout of intense eccentric exercise (n = 9), or no intervention (control; n = 8) during a 4-week priming phase, prior to completing a subsequent 4-week period of eccentric training of the knee flexors. Testing was completed prior to the priming phase, before ECC, during acute ECC (0 h, 24 h, and 48 h after bouts 1 and 4), and after ECC. Measures included muscle thickness (MT; via ultrasound); isometric, concentric, and eccentric strength; muscle power (dynamometer); electromyography; range of motion; optimal angle of peak torque; and soreness (visual analog scale). Flexibility training and single-bout groups had 47% less soreness at 48 h after the first bout of ECC compared with control (p < 0.05). The flexibility training group had 10% less soreness at 48 h after the fourth ECC bout compared with both the single-bout and control groups (p < 0.05). Isometric strength loss was attenuated for the flexibility training group (-9%) after the fourth ECC bout compared with control (-19%; p < 0.05). All groups had similar increases in strength, MT, and power after ECC (p < 0.05). Prior flexibility training may be more effective than a single session of eccentric exercise in reducing adverse symptoms during the acute stages of eccentric training; however, these benefits did not translate into greater performance after training.

Eicosapentaenoic and docosahexaenoic acids-rich fish oil supplementation attenuates strength loss and limited joint range of motion after eccentric contractions: a randomized, double-blind, placebo-controlled, parallel-group trial.

PubMed

Tsuchiya, Yosuke; Yanagimoto, Kenichi; Nakazato, Koichi; Hayamizu, Kohsuke; Ochi, Eisuke

2016-06-01

This study investigated the effect of eicosapentaenoic and docosahexaenoic acids-rich fish oil (EPA + DHA) supplementation on eccentric contraction-induced muscle damage. Twenty-four healthy men were randomly assigned to consume the EPA + DHA supplement (EPA, n = 12) or placebo (PL, n = 12) by the double-blind method. Participants consumed EPA + DHA or placebo supplement for 8 weeks prior to exercise and continued it until 5 days after exercise. The EPA group consumed EPA + DHA-rich fish oil containing 600 mg EPA and 260 mg DHA per day. Subjects performed five sets of six maximal eccentric elbow flexion exercises. Changes in the maximal voluntary contraction (MVC) torque, range of motion (ROM), upper arm circumference, muscle soreness as well as serum creatine kinase, myoglobin, IL-6, and TNF-α levels in blood were assessed before, immediately after, and 1, 2, 3, and 5 days after exercise. MVC was significantly higher in the EPA group than in the PL group at 2-5 days after exercise (p < 0.05). ROM was also significantly greater in the EPA group than in the PL group at 1-5 days after exercise (p < 0.05). At only 3 days after exercise, muscle soreness of the brachialis was significantly greater in the PL group than in the EPA group (p < 0.05), with a concomitant increase in serum IL-6 levels in the PL group. Eight-week EPA + DHA supplementation attenuates strength loss and limited ROM after exercise. The supplementation also attenuates muscle soreness and elevates cytokine level, but the effect is limited.

Post-Game High Protein Intake May Improve Recovery of Football-Specific Performance during a Congested Game Fixture: Results from the PRO-FOOTBALL Study

PubMed Central

Mohr, Magni; Sovatzidis, Apostolos; Nakopoulou, Theofano; Ermidis, Georgios; Koulouris, Agisilaos; Tsimeas, Panagiotis; Chatzinikolaou, Athanasios; Karagounis, Leonidas G.; Batsilas, Dimitrios; Krustrup, Peter; Jamurtas, Athanasios Z.

2018-01-01

The effects of protein supplementation on performance recovery and inflammatory responses during a simulated one-week in-season microcycle with two games (G1, G2) performed three days apart were examined. Twenty football players participated in two trials, receiving either milk protein concentrate (1.15 and 0.26 g/kg on game and training days, respectively) (PRO) or an energy-matched placebo (1.37 and 0.31 g/kg of carbohydrate on game and training days, respectively) (PLA) according to a randomized, repeated-measures, crossover, double-blind design. Each trial included two games and four daily practices. Speed, jump height, isokinetic peak torque, and muscle soreness of knee flexors (KF) and extensors (KE) were measured before G1 and daily thereafter for six days. Blood was drawn before G1 and daily thereafter. Football-specific locomotor activity and heart rate were monitored using GPS technology during games and practices. The two games resulted in reduced speed (by 3–17%), strength of knee flexors (by 12–23%), and jumping performance (by 3–10%) throughout recovery, in both trials. Average heart rate and total distance covered during games remained unchanged in PRO but not in PLA. Moreover, PRO resulted in a change of smaller magnitude in high-intensity running at the end of G2 (75–90 min vs. 0–15 min) compared to PLA (P = 0.012). KE concentric strength demonstrated a more prolonged decline in PLA (days 1 and 2 after G1, P = 0.014–0.018; days 1, 2 and 3 after G2, P = 0.016–0.037) compared to PRO (days 1 after G1, P = 0.013; days 1 and 2 after G2, P = 0.014–0.033) following both games. KF eccentric strength decreased throughout recovery after G1 (PLA: P=0.001–0.047—PRO: P =0.004–0.22) in both trials, whereas after G2 it declined throughout recovery in PLA (P = 0.000–0.013) but only during the first two days (P = 0.000–0.014) in PRO. No treatment effect was observed for delayed onset of muscle soreness, leukocyte counts, and creatine kinase activity. PRO resulted in a faster recovery of protein and lipid peroxidation markers after both games. Reduced glutathione demonstrated a more short-lived reduction after G2 in PRO compared to PLA. In summary, these results provide evidence that protein feeding may more efficiently restore football-specific performance and strength and provide antioxidant protection during a congested game fixture. PMID:29659539

Reconstruction of pressure sores with perforator-based propeller flaps.

PubMed

Jakubietz, Rafael G; Jakubietz, Danni F; Zahn, Robert; Schmidt, Karsten; Meffert, Rainer H; Jakubietz, Michael G

2011-03-01

Perforator flaps have been successfully used for reconstruction of pressure sores. Although V-Y advancement flaps approximate debrided wound edges, perforator-based propeller flaps allow rotation of healthy tissue into the defect. Perforator-based propeller flaps were planned in 13 patients. Seven pressure sores were over the sacrum, five over the ischial tuberosity, and one on the tip of the scapula. Three patients were paraplegic, six were bedridden, and five were ambulatory. In three patients, no perforators were found. In 10 patients, propeller flaps were transferred. In two patients, total flap necrosis occurred, which was reconstructed with local advancement flaps. In two cases, a wound dehiscence occurred and had to be revised. One hematoma required evacuation. No further complications were noted. No recurrence at the flap site occurred. Local perforator flaps allow closure of pressure sores without harvesting muscle. The propeller version has the added benefit of transferring tissue from a distant site, avoiding reapproximation of original wound edges. Twisting of the pedicle may cause torsion and venous obstruction. This can be avoided by dissecting a pedicle of at least 3 cm. Propeller flaps are a safe option for soft tissue reconstruction of pressure sores. © Thieme Medical Publishers.

Recovery From Exercise-Induced Muscle Damage: Cold-Water Immersion Versus Whole-Body Cryotherapy.

PubMed

Abaïdia, Abd-Elbasset; Lamblin, Julien; Delecroix, Barthélémy; Leduc, Cédric; McCall, Alan; Nédélec, Mathieu; Dawson, Brian; Baquet, Georges; Dupont, Grégory

2017-03-01

To compare the effects of cold-water immersion (CWI) and whole-body cryotherapy (WBC) on recovery kinetics after exercise-induced muscle damage. Ten physically active men performed single-leg hamstring eccentric exercise comprising 5 sets of 15 repetitions. Immediately postexercise, subjects were exposed in a randomized crossover design to CWI (10 min at 10°C) or WBC (3 min at -110°C) recovery. Creatine kinase concentrations, knee-flexor eccentric (60°/s) and posterior lower-limb isometric (60°) strength, single-leg and 2-leg countermovement jumps, muscle soreness, and perception of recovery were measured. The tests were performed before and immediately, 24, 48, and 72 h after exercise. Results showed a very likely moderate effect in favor of CWI for single-leg (effect size [ES] = 0.63; 90% confidence interval [CI] = -0.13 to 1.38) and 2-leg countermovement jump (ES = 0.68; 90% CI = -0.08 to 1.43) 72 h after exercise. Soreness was moderately lower 48 h after exercise after CWI (ES = -0.68; 90% CI = -1.44 to 0.07). Perception of recovery was moderately enhanced 24 h after exercise for CWI (ES = -0.62; 90% CI = -1.38 to 0.13). Trivial and small effects of condition were found for the other outcomes. CWI was more effective than WBC in accelerating recovery kinetics for countermovement-jump performance at 72 h postexercise. CWI also demonstrated lower soreness and higher perceived recovery levels across 24-48 h postexercise.

Post-match Perceived Exertion, Feeling and Wellness in Professional Soccer Players.

PubMed

Fessi, Mohamed Saifeddin; Moalla, Wassim

2018-01-18

The aim of this study was to assess post-match perceived exertion, feeling and wellness according to the match outcome (winning, drawing or losing) in professional soccer players. Twelve outfield players were followed during 52 official matches where the outcomes (win, draw or lose) were noted. Following each match players completed both a 10-point scale rating of perceived exertion (RPE) and an 11-point scale rating of perceived feeling. Rating of perceived sleep quality, stress, fatigue and muscle soreness were collected separately on a 7-point scale the day following each match. Player RPE was higher by a very largely magnitude following a loss compared to a draw or a win and higher by a small magnitude after a draw compared to a win. Players felt more pleasure after a win compared to a draw or loss and more displeasure after a loss compared to draw. The players reported a largely and moderately better-perceived sleep quality, less stress and fatigue following a win compared to draw or a loss, and a moderately bad-perceived sleep quality, higher stress and fatigue following a draw compared to a loss. In contrast, only a trivial-small change was observed in perceived muscle soreness between all outcomes. Matches outcomes moderately to largely affect RPE, perceived feeling, sleep quality, stress and fatigue whereas perceived muscle soreness remains high regardless of the match outcome. However, winning a match decreases the strain and improves both pleasure and wellness in professional soccer players.

Effect of dehydroepiandrosterone administration on recovery from mix-type exercise training-induced muscle damage.

PubMed

Liao, Yi-Hung; Liao, Kun-Fu; Kao, Chung-Lan; Chen, Chung-Yu; Huang, Chih-Yang; Chang, Wei-Hsiang; Ivy, John L; Bernard, Jeffrey R; Lee, Shin-Da; Kuo, Chia-Hua

2013-01-01

This study aimed to determine the role of DHEA-S in coping against the exercise training mixing aerobic and resistance components. During 5-day successive exercise training, 16 young male participants (19.2 ± 1.2 years) received either a placebo (flour capsule) or DHEA (100 mg/day) in a double-blinded and placebo-controlled design. Oral DHEA supplementation significantly increased circulating DHEA-S by 2.5-fold, but a protracted drop (~35 %) was observed from Day 3 during training. In the Placebo group, only a minimal DHEA-S reduction (~17 %) was observed. Changes in testosterone followed a similar pattern as DHEA-S. Muscle soreness was elevated significantly on Day 2 for both groups to a similar extent. Lower muscle soreness was observed in the DHEA-supplemented group on Day 3 and Day 6. In the Placebo group, training increased circulating creatine kinase (CK) levels by approximately ninefold, while only a threefold increase was observed in the DHEA-supplemented group. This mix-type exercise training improved glucose tolerance in both groups, while lowering the insulin response to the glucose challenge, but no difference between treatments was observed. Our results suggest that DHEA-S may play a role in protecting skeletal muscle from exercise training-induced muscle damage.

Task-specificity of bilateral anticipatory activation of the deep abdominal muscles in healthy and chronic low back pain populations.

PubMed

Massé-Alarie, Hugo; Beaulieu, Louis-David; Preuss, Richard; Schneider, Cyril

2015-02-01

Cross-sectional study of lumbopelvic muscle activation during rapid limb movements in chronic low back pain (CLBP) patients and healthy controls. Controversy exists over whether bilateral anticipatory activation of the deep abdominal muscles represents a normal motor control strategy prior to all rapid limb movements, or if this is simply a task-specific strategy appropriate for only certain movement conditions. To assess the onset timing of the transversus abdominis/internal oblique muscles (TrA/IO) during two rapid limb movement tasks with different postural demands - bilateral shoulder flexion in standing, unilateral hip extension in prone lying - as well as differences between CLBP and controls. Twelve CLBP and 13 controls performed the two tasks in response to an auditory cue. Surface EMG was acquired bilaterally from five muscles, including TrA/IO. In both groups, 50% of bilateral shoulder flexion trials showed bilateral anticipatory TrA/IO activation. This was rare, however, in unilateral hip extension for which only the TrA/IO contralateral to the moving leg showed anticipatory activation. The only significant difference in lumbo-pelvic muscle onset timing between CLBP and controls was a delay in semitendinosus activation during bilateral shoulder flexion in standing. Our data suggest that bilateral anticipatory TrA/IO activation is a task-specific motor control strategy, appropriate for only certain rapid limb movement conditions. Furthermore, the presence of altered semitendinosus onset timing in the CLBP group during bilateral shoulder flexion may be reflective of other possible lumbo-pelvic motor control alterations among this population. Copyright © 2014 Elsevier B.V. All rights reserved.

Scheduling of eccentric lower limb injury prevention exercises during the soccer micro-cycle: Which day of the week?

PubMed

Lovell, R; Whalan, M; Marshall, P W M; Sampson, J A; Siegler, J C; Buchheit, M

2018-05-24

Scheduling eccentric-based injury prevention programs (IPP) during the common 6-day micro-cycle in soccer is challenged by recovery and tapering phases. This study profiled muscle damage, neuromuscular performance, and perceptual responses to a lower limb eccentric-based IPP administered 1 (MD+1) vs 3 days (MD+3) postmatch. A total of 18 semi-professional players were monitored daily during 3 in-season 6-day micro-cycles, including weekly competitive fixtures. Capillary creatine kinase concentration (CK), posterior lower limb isometric peak force (PF), counter-movement jump (CMJ) performance, and muscle soreness were assessed 24 hours prior to match-day (baseline), and every 24 hours up to 120 hours postmatch. The IPP consisted of lunges, single stiff leg dead-lifts, single leg-squats, and Nordic hamstring exercises. Performing the IPP on MD+1 attenuated the decline in CK normally observed following match play (CON: 142%; MD+3: 166%; small differences). When IPP was delivered on MD+3, CK was higher vs CON and MD+1 trials on both MD+4 (MD+3: 260%; CON: 146%; MD+1: 151%; moderate differences) and MD+5 (MD+3: 209%; CON: 125%; MD+1: 127%; small differences). Soreness ratings were not exacerbated when the IPP was delivered on MD+1, but when prescribed on MD+3, hamstring soreness ratings remained higher on MD+4 and MD+5 (small differences). No between-trial differences were observed for PF and CMJ. Administering the IPP in the middle of the micro-cycle (MD+3) increased measures of muscle damage and soreness, which remained elevated on the day prior to the next match (MD+5). Accordingly, IPP should be scheduled early in the micro-cycle, to avoid compromising preparation for the following match. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Inferior gluteal artery perforator flap: a viable alternative for ischial pressure sores.

PubMed

Kim, Young Seok; Lew, Dae Hyun; Roh, Tai Suk; Yoo, Won Min; Lee, Won Jai; Tark, Kwan Chul

2009-10-01

The ischial area is by far the most common site for pressure sores in wheelchair-bound paraplegic patients, because most of the pressure of the body is exerted on this area in the seated position. Even after a series of successful pressure sore treatments, the site is very prone to relapse from the simplest everyday tasks. Therefore, it is crucial to preserve the main pedicle during primary surgery. Several surgical procedures, such as myocutaneous flap and perforator flap, have been introduced for the treatment of pressure sores. During a 4-year time period at our institute, we found favourable clinical results using the inferior gluteal artery perforator (IGAP) procedure for ischial sore treatment. A total of 23 patients (20 males and three females) received IGAP flap surgery in our hospital from January 2003 to January 2007. Surgery was performed on the same site again in 10 (43%) patients who had originally relapsed after undergoing the conventional method of pressure sore surgery. The average age of patients was 47.4 years (range 26-71 years). Most of the patients were paraplegic (16 cases, 70%) and others were either quadriplegic (four cases, 17%) or ambulatory (three cases, 13%). Based on hospital records and clinical photographs, we attempted to assess the feasibility and practicability of the IGAP flap procedure through comparative analysis of several parameters including the size of the defective area, treatment modalities, relapses, complications, and postoperative treatments. The average follow-up duration for 23 subjects was 25.4 months (range 5-42 months). All flaps survived without major complications. Partial flap necrosis developed in one case but secondary healing was achieved and the final outcome was not impaired. Most of the cases healed well during the follow-up period. Postoperative complications such as wound dehiscence and fistula developed in some subjects, but all healed well with a secondary treatment. A total of five cases relapsed after surgery due to tissue deficit and these were treated with bursectomy and muscle transposition flap to fill the dead space. We propose that the IGAP flap should be considered a viable alternative to other methods of ischial pressure sore surgery owing to its many advantages, which include the ability to preserve peripheral muscle tissue, the variability of flap designs, relatively good durability, and the low donor site morbidity rate.

Core muscle recruitment pattern during voluntary heel raises is different between patients with patellofemoral pain and healthy individuals.

PubMed

Biabanimoghadam, Mana; Motealleh, Alireza; Cowan, Sallie Melissa

2016-06-01

Recent studies suggest that the inconsistent outcomes of patellofemoral pain (PFP) treatment may result from the unclear understanding of changes in the structures remote from the knee joint. Due to the crucial influence of core stability on the knee function, this study aimed to evaluate the recruitment pattern of core muscles in individuals with and without PFP. Sixty women aged 18 to 40years, including 30 subjects diagnosed with PFP and 30 healthy controls rose on to their toes as quickly and strongly as possible in response to a sound alarm in standing position. Electromyographic onsets of the transversus abdominis (TrA)/internal oblique (IO), erector spinae (ES), and gluteus medius (GM) muscles were expressed relative to the electromyographic onset of the prime mover (i.e. soleus). Independent t-tests were performed to compare the onsets of each muscle between the groups. The nonparametric Friedman test and the post-hoc of Wilcoxon signed-rank test were used to describe the muscle activation pattern within the groups. The results revealed different recruitment patterns of the core muscles between the groups. In the healthy group the GM and TrA/IO contracted, almost simultaneously, in anticipation of the prime mover contraction (sol). However, in PFP subjects a significant delay in the contraction of TrA/IO changed the pattern of muscle activation. The findings demonstrate that muscular stabilization of spine is altered in the presence of PFP and suggest that treatment techniques aimed at improving core stability could be appropriate in the management of PFP. Copyright © 2016 Elsevier B.V. All rights reserved.

Effects of lemon verbena extract (Recoverben®) supplementation on muscle strength and recovery after exhaustive exercise: a randomized, placebo-controlled trial.

PubMed

Buchwald-Werner, Sybille; Naka, Ioanna; Wilhelm, Manfred; Schütz, Elivra; Schoen, Christiane; Reule, Claudia

2018-01-01

Exhaustive exercise causes muscle damage accompanied by oxidative stress and inflammation leading to muscle fatigue and muscle soreness. Lemon verbena leaves, commonly used as tea and refreshing beverage, demonstrated antioxidant and anti-inflammatory properties. The aim of this study was to investigate the effects of a proprietary lemon verbena extract (Recoverben®) on muscle strength and recovery after exhaustive exercise in comparison to a placebo product. The study was performed as a randomized, placebo-controlled, double-blind study with parallel design. Forty-four healthy males and females, which were 22-50 years old and active in sports, were randomized to 400 mg lemon verbena extract once daily or placebo. The 15 days intervention was divided into 10 days supplementation prior to the exhaustive exercise day (intensive jump-protocol), one day during the test and four days after. Muscle strength (MVC), muscle damage (CK), oxidative stress (GPx), inflammation (IL6) and volunteer-reported muscle soreness intensity were assessed pre and post exercise. Participants in the lemon verbena group benefited from less muscle damage as well as faster and full recovery. Compared to placebo, lemon verbena extract receiving participants had significantly less exercise-related loss of muscle strength ( p  = 0.0311) over all timepoints, improved glutathione peroxidase activity by trend ( p  = 0.0681) and less movement induced pain ( p  = 0.0788) by trend. Creatine kinase and IL-6 didn't show significant discrimmination between groups. Lemon verbena extract (Recoverben®) has been shown to be a safe and well-tolerated natural sports ingredient, by reducing muscle damage after exhaustive exercise. The trial was registered in the clinical trials registry (clinical trial.gov NCT02923102). Registered 28 September 2016.

Post-traumatic delayed onset pectoralis myospasm secondary to α-γ dysfunction

PubMed Central

Barnett, Dennis L; McGhee, Klinton; Bungee, Paul

2013-01-01

A restrained motor vehicle accident victim suffered from delayed onset left pectoralis myospasms refractory to multiple treatments: behavioural, conservative, physical therapy, opiate, muscle relaxer and incomplete response to invasive pain management spinal blocks. After conduction of a literature review, several authors had noted the mechanism of α-γ loop dysfunction resulting in myospams, and also case studies which described painful postsurgical myospasms that were treated with neurectomy and/or botulinum toxin A with successful results. The patient in this case underwent an initial lidocaine injection to observe response to treatment, followed by two treatments with botulinum toxin A treatment with subsequent resolution of symptoms. Successful therapy and previous research supports that botulinum toxin A can be an effective treatment for myospasms secondary to trauma-induced α-γ dysfunction, as suggested by the cellular pathophysiology. PMID:23814192

Contributions of Central Command and Muscle Feedback to Sympathetic Nerve Activity in Contracting Human Skeletal Muscle.

PubMed

Boulton, Daniel; Taylor, Chloe E; Macefield, Vaughan G; Green, Simon

2016-01-01

During voluntary contractions, muscle sympathetic nerve activity (MSNA) to contracting muscles increases in proportion to force but the underlying mechanisms are not clear. To shed light on these mechanisms, particularly the influences of central command and muscle afferent feedback, the present study tested the hypothesis that MSNA is greater during voluntary compared with electrically-evoked contractions. Seven male subjects performed a series of 1-min isometric dorsiflexion contractions (left leg) separated by 2-min rest periods, alternating between voluntary and electrically-evoked contractions at similar forces (5-10% of maximum). MSNA was recorded continuously (microneurography) from the left peroneal nerve and quantified from cardiac-synchronized, negative-going spikes in the neurogram. Compared with pre-contraction values, MSNA increased by 51 ± 34% (P < 0.01) during voluntary contractions but did not change significantly during electrically-evoked contractions (-8 ± 12%, P > 0.05). MSNA analyzed at 15-s intervals revealed that this effect of voluntary contraction appeared 15-30 s after contraction onset (P < 0.01), remained elevated until the end of contraction, and disappeared within 15 s after contraction. These findings suggest that central command, and not feedback from contracting muscle, is the primary mechanism responsible for the increase in MSNA to contracting muscle. The time-course of MSNA suggests that there is a longer delay in the onset of this effect compared with its cessation after contraction.

Test-retest reliability of sudden ankle inversion measurements in subjects with healthy ankle joints.

PubMed

Eechaute, Christophe; Vaes, Peter; Duquet, William; Van Gheluwe, Bart

2007-01-01

Sudden ankle inversion tests have been used to investigate whether the onset of peroneal muscle activity is delayed in patients with chronically unstable ankle joints. Before interpreting test results of latency times in patients with chronic ankle instability and healthy subjects, the reliability of these measures must be first demonstrated. To investigate the test-retest reliability of variables measured during a sudden ankle inversion movement in standing subjects with healthy ankle joints. Validation study. Research laboratory. 15 subjects with healthy ankle joints (30 ankles). Subjects stood on an ankle inversion platform with both feet tightly fixed to independently moveable trapdoors. An unexpected sudden ankle inversion of 50 degrees was imposed. We measured latency and motor response times and electromechanical delay of the peroneus longus muscle, along with the time and angular position of the first and second decelerating moments, the mean and maximum inversion speed, and the total inversion time. Correlation coefficients and standard error of measurements were calculated. Intraclass correlation coefficients ranged from 0.17 for the electromechanical delay of the peroneus longus muscle (standard error of measurement = 2.7 milliseconds) to 0.89 for the maximum inversion speed (standard error of measurement = 34.8 milliseconds). The reliability of the latency and motor response times of the peroneus longus muscle, the time of the first and second decelerating moments, and the mean and maximum inversion speed was acceptable in subjects with healthy ankle joints and supports the investigation of the reliability of these measures in subjects with chronic ankle instability. The lower reliability of the electromechanical delay of the peroneus longus muscle and the angular positions of both decelerating moments calls the use of these variables into question.

[Blunt force injuries due to martial arts in children--a diagnostic problem? Delayed diagnosis of an infected hematoma].

PubMed

Kruppa, C; Goericke, S L; Matheney, T; Ozokyay, L; Schildhauer, T A; Muhr, G; Dudda, M

2010-10-01

Blunt force injuries in martial arts occur frequently but isolated hematoma of muscles in the extremities is rare. Even minor trauma of the lower extremities due to throwing techniques in judo and other forms of Asian martial arts can lead to major pathologies. A 9-year-old girl presented with an unclear swelling and soreness of the calf muscle. The patient could not remember an obvious traumatic event. She was admitted 4 days later because of increased swelling, pain and erythema. The parents reported a minor trauma at judo training 1 week ago. Further investigation was performed with MRI and confirmed a massive hematoma much greater than previously shown by sonography. Histologic and microbiologic evaluation demonstrated florid inflammation and proof of Staphylococcus aureus was found intra-operatively. The diagnosis of blunt force injuries due to martial arts is difficult in childhood because often children do not remember a traumatic event. Therefore, it is important to obtain a thorough history from caregivers. Because sonography depends highly on the experience of the investigator MRI is considered to be a better diagnostic modality to diagnose and guide treatment in this age group.

Local injections of corticotropin releasing factor reduce doxorubicin-induced acute inflammation in the eyelid.

PubMed

McLoon, L K; Wirtschafter, J

1997-04-01

Doxorubicin chemomyectomy is an effective alternative treatment option for patients with blepharospasm and hemifacial spasm. One side effect of the use of doxorubicin in localized injections is the development of acute inflammation and skin injury at the injection site. Corticotropin releasing factor (CRF) was reported to reduce inflammation after acute inflammatory injuries due to other causes and at other sites. This study was performed to assess the potential of CRF to prevent the development of skin injury and eyelid soreness after local doxorubicin injection. Rabbits received lower eyelid injections of either 75 or 150 micrograms CRF followed by injection of either 0.5, 1, or 2 mg doxorubicin or doxorubicin alone. Eyelids were assessed for changes in acute inflammation by immunohistochemical localization of macrophages and monocytes using anti-CD11, an antibody specific for these cell types. Short-term alterations in vascular permeability were assessed using an Evans blue assay. Additional eyelids were followed daily for changes in the skin over the injection site to determine day of onset of skin injury and the total duration of skin injury. After 1 month, the eyelids were processed histologically for morphometric analysis of muscle fiber loss. Monkey eyelids also were examined for the effect of CRF and doxorubicin injections. Doxorubicin alone produced an acute inflammatory reaction in the treated eyelids, with a large influx of macrophages and monocytes throughout the connective tissue at 1 and 2 days. Corticotropin releasing factor pretreatment significantly reduced this influx of inflammatory cells into the connective tissue. Doxorubicin produced a large increase in vascular permeability in the treated eyelids, with resultant edema. Corticotropin releasing factor did not alter this change in vascular permeability, indicating that CRF appears to have a specific effect on migration of inflammatory cells rather than just a generalized effect on vascular permeability. Corticotropin releasing factor and doxorubicin cotreatments delayed the onset of skin injury and decreased the total duration of injury to the skin compared to doxorubicin alone. The effectiveness of doxorubicin chemomyectomy was maintained; muscle loss was significant at all doses of CRF combined with doxorubicin. Corticotropin releasing factor dramatically decreased the acute inflammatory reaction that results in the eyelid from local doxorubicin injections. Not only did CRF reduce the acute influx of monocytes and macrophages, but it protected the skin overlying the injection site, substantially reducing the extent of skin injury. The efficacy of doxorubicin-induced muscle toxicity was maintained. A treatment protocol that combines myotoxicity with antiinflammatory activity in the treated eyelids may lead to a more effective patient treatment by increasing patient acceptance. The potential should be explored that CRF may be of clinical use in limiting tissue injury when administered immediately after extravasation during cancer chemotherapy.

Isokinetic exercise: A review of the literature

NASA Technical Reports Server (NTRS)

Olree, H. D.; Corbin, B.; Smith, C.

1978-01-01

Isokinetic muscle training has all the advantages of isometrics and isotonics while minimizing their deficiencies. By holding the speed of movement constant throughout the full range of motion, isokinetic training devices respond with increased resistance rather than acceleration when the power output of the muscle is increased. Isokinetic training is superior to isometric and isotonic training with respect to increases in strength, specificity of training, desirable changes in motor performance tasks, lack of muscle soreness, and decreases in relative body fat.

Elevated PGC-1α activity sustains mitochondrial biogenesis and muscle function without extending survival in a mouse model of inherited ALS.

PubMed

Da Cruz, Sandrine; Parone, Philippe A; Lopes, Vanda S; Lillo, Concepción; McAlonis-Downes, Melissa; Lee, Sandra K; Vetto, Anne P; Petrosyan, Susanna; Marsala, Martin; Murphy, Anne N; Williams, David S; Spiegelman, Bruce M; Cleveland, Don W

2012-05-02

The transcriptional coactivator PGC-1α induces multiple effects on muscle, including increased mitochondrial mass and activity. Amyotrophic lateral sclerosis (ALS) is a progressive, fatal, adult-onset neurodegenerative disorder characterized by selective loss of motor neurons and skeletal muscle degeneration. An early event is thought to be denervation-induced muscle atrophy accompanied by alterations in mitochondrial activity and morphology within muscle. We now report that elevation of PGC-1α levels in muscles of mice that develop fatal paralysis from an ALS-causing SOD1 mutant elevates PGC-1α-dependent pathways throughout disease course. Mitochondrial biogenesis and activity are maintained through end-stage disease, accompanied by retention of muscle function, delayed muscle atrophy, and significantly improved muscle endurance even at late disease stages. However, survival was not extended. Therefore, muscle is not a primary target of mutant SOD1-mediated toxicity, but drugs increasing PGC-1α activity in muscle represent an attractive therapy for maintaining muscle function during progression of ALS. Copyright © 2012 Elsevier Inc. All rights reserved.

The time course of short-term hypertrophy in the absence of eccentric muscle damage.

PubMed

Stock, Matt S; Mota, Jacob A; DeFranco, Ryan N; Grue, Katherine A; Jacobo, A Unique; Chung, Eunhee; Moon, Jordan R; DeFreitas, Jason M; Beck, Travis W

2017-05-01

It has been proposed that the increase in skeletal muscle mass observed during the initial weeks of initiating a resistance training program is concomitant with eccentric muscle damage and edema. We examined the time course of muscle hypertrophy during 4 weeks of concentric-only resistance training. Thirteen untrained men performed unilateral concentric-only dumbbell curls and shoulder presses twice per week for 4 weeks. Sets of 8-12 repetitions were performed to failure, and training loads were increased during each session. Subjects consumed 500 ml of whole milk during training. Assessments of soreness, lean mass, echo intensity, muscle thickness, relaxed and flexed arm circumference, and isokinetic strength were performed every 72 or 96 h. Soreness, echo intensity, relaxed circumference, and peak torque data did not significantly change. Significant increases in lean mass, muscle thickness, and flexed circumference were observed within seven training sessions. Lean mass was elevated at tests #7 (+109.3 g, p = .002) and #8 (+116.1 g, p = .035), with eight different subjects showing changes above the minimal difference of 139.1 g. Muscle thickness was elevated at tests #6 (+0.23 cm, p = .004), #7 (+0.31 cm, p < .001), and #8 (+0.27 cm, p < .001), with ten subjects exceeding the minimal difference of 0.24 cm. There were no changes for the control arm. In individuals beginning a resistance training program, small but detectable increases in hypertrophy may occur in the absence of eccentric muscle damage within seven training sessions.

Attenuation of muscle damage by preconditioning with muscle hyperthermia 1-day prior to eccentric exercise.

PubMed

Nosaka, K; Muthalib, M; Lavender, A; Laursen, P B

2007-01-01

This study investigated the hypothesis that muscle damage would be attenuated in muscles subjected to passive hyperthermia 1 day prior to exercise. Fifteen male students performed 24 maximal eccentric actions of the elbow flexors with one arm; the opposite arm performed the same exercise 2-4 weeks later. The elbow flexors of one arm received a microwave diathermy treatment that increased muscle temperature to over 40 degrees C, 16-20 h prior to the exercise. The contralateral arm acted as an untreated control. Maximal voluntary isometric contraction strength (MVC), range of motion (ROM), upper arm circumference, muscle soreness, plasma creatine kinase activity and myoglobin concentration were measured 1 day prior to exercise, immediately before and after exercise, and daily for 4 days following exercise. Changes in the criterion measures were compared between conditions (treatment vs. control) using a two-way repeated measures ANOVA with a significance level of P < 0.05. All measures changed significantly following exercise, but the treatment arm showed a significantly faster recovery of MVC, a smaller change in ROM, and less muscle soreness compared with the control arm. However, the protective effect conferred by the diathermy treatment was significantly less effective compared with that seen in the second bout performed 4-6 weeks after the initial bout by a subgroup of the subjects (n = 11) using the control arm. These results suggest that passive hyperthermia treatment 1 day prior to eccentric exercise-induced muscle damage has a prophylactic effect, but the effect is not as strong as the repeated bout effect.

The Effects of Local Vibration on Balance, Power, and Self-Reported Pain After Exercise.

PubMed

Custer, Lisa; Peer, Kimberly S; Miller, Lauren

2017-05-01

Muscle fatigue and acute muscle soreness occur after exercise. Application of a local vibration intervention may reduce the consequences of fatigue and soreness. To examine the effects of a local vibration intervention after a bout of exercise on balance, power, and self-reported pain. Single-blind crossover study. Laboratory. 19 healthy, moderately active subjects. After a 30-min bout of full-body exercise, subjects received either an active or a sham vibration intervention. The active vibration intervention was performed bilaterally over the muscle bellies of the triceps surae, quadriceps, hamstrings, and gluteals. At least 1 wk later, subjects repeated the bout, receiving the other vibration intervention. Static balance, dynamic balance, power, and self-reported pain were measured at baseline, after the vibration intervention, and 24 h postexercise. After the bout of exercise, subjects had reduced static and dynamic balance and increased self-reported pain regardless of vibration intervention. There were no differences between outcome measures between the active and sham vibration conditions. The local vibration intervention did not affect balance, power, or self-reported pain.

Sarcomere Length and Tension Changes in Tetanized Frog Muscle Fibers after Quick Stretches and Releases

NASA Astrophysics Data System (ADS)

Sugi, Haruo; Kobayashi, Takakazu

1983-10-01

The sarcomere length changes in tetanized frog muscle fibers in response to quick fiber length changes were examined along the fiber length with a high-sensitivity laser diffraction technique. The experiments were only performed with muscle fibers in which the uniform orientation and sarcomere length of the component myofibrils were well preserved during a tetanus. When the sarcomere length changes were recorded near the fixed fiber end, the delay of the onset of sarcomere length change in response to the applied fiber length change tended to be longer than that of the onset of tension changes recorded at the fixed fiber end. The magnitude of sarcomere length changes was larger near the moving fiber end than near the fixed fiber end. In the case of quick releases, the resulting sarcomere shortening tended to outlast the fiber shortening, so that the quick tension recovery started during the sarcomere shortening. These results indicate (i) that the tension changes in response to quick fiber length changes may not give direct information about the cross-bridge properties and (ii) that the viscoelastic multisegmental nature of muscle fibers should be taken into consideration in interpreting the tension responses to quick length changes.

Graves' disease associated with infectious mononucleosis due to primary Epstein-Barr virus infection: report of 3 cases.

PubMed

Akahori, Hiroshi; Takeshita, Yumie; Saito, Reina; Kaneko, Shuichi; Takamura, Toshinari

2010-01-01

Although the etiology of Graves' disease is still not clear, it is generally suggested that environmental factors such as infections contribute to the development of Graves' disease. We report here three cases of Graves' disease which presented simultaneously with infectious mononucleosis due to primary EBV infection. Acute EBV infection might play an important role in the onset of Graves' disease. These three women complained of a sore throat or neck pain, resembling subacute thyroiditis. In the case of thyrotoxicosis accompanied by sore throat or neck pain, Graves' disease must be distinguished from subacute thyroiditis.

Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain

PubMed Central

León-Hernández, Jose V.; Martín-Pintado-Zugasti, Aitor; Frutos, Laura G.; Alguacil-Diego, Isabel M.; de la Llave-Rincón, Ana I.; Fernandez-Carnero, Josue

2016-01-01

ABSTRACT Background Dry needling (DN) and percutaneous electrical nerve stimulation (PENS) are widely used techniques in the treatment of myofascial pain. Objective To investigate the immediate and short-term effects of the combination of DN and PENS compared to DN alone on the upper trapezius muscle. Method This is a 72-hour follow-up single-blinded randomized controlled trial. Sixty-two volunteer patients with chronic myofascial neck pain with active Myofascial Trigger Points (MTrPs) in the upper trapezius muscle were recruited. Randomization was performed, and 31 patients received DN treatment (DN group) and 31 received DN and PENS (DN+PENS group). The primary outcomes were neck disability index (NDI) and visual analog scale for pain for both post-needling soreness (PNS) and neck pain intensity (NPI). Pressure pain threshold (PPT) and cervical range of motion (CROM) were the secondary outcomes. Results We detected between-group differences in NPI and PNS in favor of the DN+PENS group immediately after treatment. No between-group differences in NDI were observed. Conclusion PENS application after dry needling treatment is more effective than dry needling alone for decreasing soreness in the short term and improving neck pain intensity immediately in patients with myofascial chronic neck pain. PMID:27410163

Reconstruction of trochanteric pressure sores with pedicled anterolateral thigh myocutaneous flaps.

PubMed

Wang, Chih-Hsin; Chen, Shih-Yi; Fu, Ju-Peng; Dai, Niann-Tzyy; Chen, Shao-Liang; Chen, Tim-Mo; Chen, Shyi-Gen

2011-05-01

To provide an alternative choice for covering trochanteric pressure sores, we report on a modified pedicle anterolateral thigh (ALT) myocutaneous flap based on the descending branch of the lateral circumflex femoral artery. From August 2007 to January 2010, 20 consecutive patients (10 men and 10 women) underwent 21 pedicled ALT myocutaneous flaps for reconstruction of trochanteric pressure sores. The flap was designed and elevated, resembling the ALT perforator flap including part of the vastus lateralis muscle but without skeletonisation of the perforators. The mean age of patients was 79.4 years (range: 46-103). The mean follow-up period was 13.9 months (range: 3-32). The flaps were 8-21 cm long and 5-11 cm wide. All flaps healed without major complications. All donor sites were closed primarily without skin grafting and showed good aesthetic results. No recurrence was observed. This modified design of pedicled ALT myocutaneous flap without skeletonisation of perforators is a reliable and easily harvested flap for reconstruction of trochanteric pressure sores with limited morbidity. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

Neuromuscular changes and the rapid adaptation following a bout of damaging eccentric exercise.

PubMed

Goodall, S; Thomas, K; Barwood, M; Keane, K; Gonzalez, J T; St Clair Gibson, A; Howatson, G

2017-08-01

An initial bout of eccentric exercise is known to protect against muscle damage following a repeated bout of the same exercise; however, the neuromuscular adaptations owing to this phenomenon are unknown. To determine whether neuromuscular disturbances are modulated following a repeated bout of eccentric exercise. Following eccentric exercise performed with the elbow flexors, we measured maximal voluntary force, resting twitch force, muscle soreness, creatine kinase (CK) and voluntary activation (VA) using motor point and motor cortex stimulation at baseline, immediately post-exercise and at 1, 2, 3, 4 and 7 days post-exercise on two occasions, separated by 3 weeks. Significant muscle damage and fatigue were evident following the first exercise bout; maximal voluntary contraction (MVC) was reduced immediately by 35% and remained depressed at 7 days post-exercise. Soreness and CK release peaked at 3 and 4 days post-exercise respectively. Resting twitch force remained significantly reduced at 7 days (-48%), whilst VA measured with motor point and motor cortex stimulation was reduced until 2 and 3 days respectively. A repeated bout effect (RBE) was observed with attenuated soreness and CK release and a quicker recovery of MVC and resting twitch force. A similar decrement in VA was observed following both bouts; however, following the repeated bout there was a significantly smaller reduction in, and a faster recovery of, VA measured using motor cortical stimulation. Our data suggest that the RBE may be explained, partly, by a modification in motor corticospinal drive. © 2016 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

Neurosteroids and self-reported pain in veterans who served in the U.S. Military after September 11, 2001.

PubMed

Kilts, Jason D; Tupler, Larry A; Keefe, Francis J; Payne, Victoria M; Hamer, Robert M; Naylor, Jennifer C; Calnaido, Rohana P; Morey, Rajendra A; Strauss, Jennifer L; Parke, Gillian; Massing, Mark W; Youssef, Nagy A; Shampine, Lawrence J; Marx, Christine E

2010-10-01

Nearly half of Operation Enduring Freedom/Operation Iraqi Freedom veterans experience continued pain post-deployment. Several investigations report analgesic effects of allopregnanolone and other neurosteroids in animal models, but few data are currently available focusing on neurosteroids in clinical populations. Allopregnanolone positively modulates GABA(A) receptors and demonstrates pronounced analgesic and anxiolytic effects in rodents, yet studies examining the relationship between pain and allopregnanolone in humans are limited. We thus hypothesized that endogenous allopregnanolone and other neurosteroid levels may be negatively correlated with self-reported pain symptoms in humans. We determined serum neurosteroid levels by gas chromatography/mass spectrometry (allopregnanolone, pregnenolone) or radioimmunoassay (dehydroepiandrosterone [DHEA], progesterone, DHEA sulfate [DHEAS]) in 90 male veterans who served in the U.S. military after September 11, 2001. Self-reported pain symptoms were assessed in four areas (low back pain, chest pain, muscle soreness, headache). Stepwise linear regression analyses were conducted to investigate the relationship between pain assessments and neurosteroids, with the inclusion of smoking, alcohol use, age, and history of traumatic brain injury as covariates. Durham VA Medical Center. Allopregnanolone levels were inversely associated with low back pain (P=0.044) and chest pain (P=0.013), and DHEA levels were inversely associated with muscle soreness (P=0.024). DHEAS levels were positively associated with chest pain (P=0.001). Additionally, there was a positive association between traumatic brain injury and muscle soreness (P=0.002). Neurosteroids may be relevant to the pathophysiology of self-reported pain symptoms in this veteran cohort, and could represent future pharmacological targets for pain disorders. Wiley Periodicals, Inc.

Surface-distributed low-frequency asynchronous stimulation delays fatigue of stimulated muscles.

PubMed

Maneski, Lana Z Popović; Malešević, Nebojša M; Savić, Andrej M; Keller, Thierry; Popović, Dejan B

2013-12-01

One important reason why functional electrical stimulation (FES) has not gained widespread clinical use is the limitation imposed by rapid muscle fatigue due to non-physiological activation of the stimulated muscles. We aimed to show that asynchronous low-pulse-rate (LPR) electrical stimulation applied by multipad surface electrodes greatly postpones the occurrence of muscle fatigue compared with conventional stimulation (high pulse rate, HPR). We compared the produced force vs. time of the forearm muscles responsible for finger flexion in 2 stimulation protocols, LPR (fL = 10 Hz) and HPR (fH = 40 Hz). Surface-distributed low-frequency asynchronous stimulation (sDLFAS) doubles the time interval before the onset of fatigue (104 ± 80%) compared with conventional synchronous stimulation. Combining the performance of multipad electrodes (increased selectivity and facilitated positioning) with sDLFAS (decreased fatigue) can improve many FES applications in both the lower and upper extremities. Copyright © 2013 Wiley Periodicals, Inc.

Comparison in muscle damage between maximal voluntary and electrically evoked isometric contractions of the elbow flexors.

PubMed

Jubeau, Marc; Muthalib, Makii; Millet, Guillaume Y; Maffiuletti, Nicola A; Nosaka, Kazunori

2012-02-01

This study compared between maximal voluntary (VOL) and electrically stimulated (ES) isometric contractions of the elbow flexors for changes in indirect markers of muscle damage to investigate whether ES would induce greater muscle damage than VOL. Twelve non-resistance-trained men (23-39 years) performed VOL with one arm and ES with the contralateral arm separated by 2 weeks in a randomised, counterbalanced order. Both VOL and ES (frequency 75 Hz, pulse duration 250 μs, maximally tolerated intensity) exercises consisted of 50 maximal isometric contractions (4-s on, 15-s off) of the elbow flexors at a long muscle length (160°). Changes in maximal voluntary isometric contraction torque (MVC), range of motion, muscle soreness, pressure pain threshold and serum creatine kinase (CK) activity were measured before, immediately after and 1, 24, 48, 72 and 96 h following exercise. The average peak torque over the 50 isometric contractions was greater (P < 0.05) for VOL (32.9 ± 9.8 N m) than ES (16.9 ± 6.3 N m). MVC decreased greater and recovered slower (P < 0.05) after ES (15% lower than baseline at 96 h) than VOL (full recovery). Serum CK activity increased (P < 0.05) only after ES, and the muscles became more sore and tender after ES than VOL (P < 0.05). These results showed that ES induced greater muscle damage than VOL despite the lower torque output during ES. It seems likely that higher mechanical stress imposed on the activated muscle fibres, due to the specificity of motor unit recruitment in ES, resulted in greater muscle damage.

SRT2104 extends survival of male mice on a standard diet and preserves bone and muscle mass.

PubMed

Mercken, Evi M; Mitchell, Sarah J; Martin-Montalvo, Alejandro; Minor, Robin K; Almeida, Maria; Gomes, Ana P; Scheibye-Knudsen, Morten; Palacios, Hector H; Licata, Jordan J; Zhang, Yongqing; Becker, Kevin G; Khraiwesh, Husam; González-Reyes, José A; Villalba, José M; Baur, Joseph A; Elliott, Peter; Westphal, Christoph; Vlasuk, George P; Ellis, James L; Sinclair, David A; Bernier, Michel; de Cabo, Rafael

2014-10-01

Increased expression of SIRT1 extends the lifespan of lower organisms and delays the onset of age-related diseases in mammals. Here, we show that SRT2104, a synthetic small molecule activator of SIRT1, extends both mean and maximal lifespan of mice fed a standard diet. This is accompanied by improvements in health, including enhanced motor coordination, performance, bone mineral density, and insulin sensitivity associated with higher mitochondrial content and decreased inflammation. Short-term SRT2104 treatment preserves bone and muscle mass in an experimental model of atrophy. These results demonstrate it is possible to design a small molecule that can slow aging and delay multiple age-related diseases in mammals, supporting the therapeutic potential of SIRT1 activators in humans. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

Effect of Repeated Active Recovery During a High-Intensity Interval-Training Shock Microcycle on Markers of Fatigue.

PubMed

Wiewelhove, Thimo; Raeder, Christian; Meyer, Tim; Kellmann, Michael; Pfeiffer, Mark; Ferrauti, Alexander

2016-11-01

To investigate the effect of repeated use of active recovery during a 4-d shock microcycle with 7 high-intensity interval-training (HIT) sessions on markers of fatigue. Eight elite male junior tennis players (age 15.1 ± 1.4 y) with an international ranking between 59 and 907 (International Tennis Federation) participated in this study. After each training session, they completed 15 min of either moderate jogging (active recovery [ACT]) or passive recovery (PAS) with a crossover design, which was interrupted by a 4-mo washout period. Countermovement-jump (CMJ) height, serum concentration of creatine kinase (CK), delayed-onset muscle soreness (DOMS), and perceived recovery and stress (Short Recovery and Stress Scale) were measured 24 h before and 24 h after the training program. The HIT shock microcycle induced a large decrease in CMJ performance (ACT: effect size [ES] = -1.39, P < .05; PAS: ES = -1.42, P < .05) and perceived recovery (ACT: ES = -1.79, P < .05; PAS: ES = -2.39, P < .05), as well as a moderate to large increase in CK levels (ACT: ES = 0.76, P > .05; PAS: ES = 0.81, P >.05), DOMS (ACT: ES = 2.02, P < .05; PAS: ES = 2.17, P < .05), and perceived stress (ACT: ES = 1.98, P < .05; PAS: ES = 3.06, P < .05), compared with the values before the intervention. However, no significant recovery intervention × time interactions or meaningful differences in changes were noted in any of the markers between ACT and PAS. Repeated use of individualized ACT, consisting of 15 min of moderate jogging, after finishing each training session during an HIT shock microcycle did not affect exercise-induced fatigue.

The effects of acute leucine or leucine-glutamine co-ingestion on recovery from eccentrically biased exercise.

PubMed

Waldron, Mark; Ralph, Cameron; Jeffries, Owen; Tallent, Jamie; Theis, Nicola; Patterson, Stephen David

2018-05-16

This study investigated the effects of leucine or leucine + glutamine supplementation on recovery from eccentric exercise. In a double-blind independent groups design, 23 men were randomly assigned to a leucine (0.087 g/kg; n = 8), leucine + glutamine (0.087 g/kg + glutamine 0.3 g/kg; n = 8) or placebo (0.3 g/kg maltodextrin; n = 7) group. Participants performed 5 sets of drop jumps, with each set comprising 20 repetitions. Isometric knee-extensor strength, counter-movement jump (CMJ) height, delayed-onset muscle soreness (DOMS) and creatine kinase (CK) were measured at baseline, 1, 24, 48 h and 72 h post-exercise. There was a time × group interaction for isometric strength, CMJ and CK (P < 0.05), with differences between the leucine + glutamine and placebo group at 48 h and 72 h for strength (P = 0.013; d = 1.43 and P < 0.001; d = 2.06), CMJ (P = 0.008; d = 0.87 and P = 0.019; d = 1.17) and CK at 24 h (P = 0.012; d = 0.54) and 48 h (P = 0.010; d = 1.37). The leucine group produced higher strength at 72 h compared to placebo (P = 0.007; d = 1.65) and lower CK at 24 h (P = 0.039; d = 0.63) and 48 h (P = 0.022; d = 1.03). Oral leucine or leucine + glutamine increased the rate of recovery compared to placebo after eccentric exercise. These findings highlight potential benefits of co-ingesting these amino acids to ameliorate recovery.

Non-invasive Assessments of Subjective and Objective Recovery Characteristics Following an Exhaustive Jump Protocol

PubMed Central

Hohenauer, Erich; Clarys, Peter; Baeyens, Jean-Pierre; Clijsen, Ron

2017-01-01

Fast recovery after strenuous exercise is important in sports and is often studied via cryotherapy applications. Cryotherapy has a significant vasoconstrictive effect, which seems to be the leading factor in its effectiveness. The resulting enhanced recovery can be measured by using both objective and subjective parameters. Two commonly measured subjective characteristics of recovery are delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE). Two important objective recovery characteristics are countermovement jump (CMJ) performance and peak power output (PPO). Here, we provide a detailed protocol to induce muscular exhaustion of the frontal thighs with a self-paced, 3 x 30 countermovement jump protocol (30-s rest between each set). This randomized controlled trial protocol explains how to perform local cryotherapy cuff application (+ 8 °C for 20 min) and thermoneutral cuff application (+ 32 °C for 20 min) on both thighs as two possible post-exercise recovery modalities. Finally, we provide a non-invasive protocol to measure the effects of these two recovery modalities on subjective (i.e., DOMS of both frontal thighs and RPE) and objective recovery (i.e., CMJ and PPO) characteristics 24, 48, and 72 h post-application. The advantage of this method is that it provides a tool for researchers or coaches to induce muscular exhaustion, without using any expensive devices; to implement local cooling strategies; and to measure both subjective and objective recovery, without using invasive methods. Limitations of this protocol are that the 30 s rest period between sets is very short, and the cardiovascular demand is very high. Future studies may find the assessment of maximum voluntary contractions to be a more sensitive assessment of muscular exhaustion compared to CMJs. PMID:28654037

A clinical tool for predicting survival in ALS.

PubMed

Knibb, Jonathan A; Keren, Noa; Kulka, Anna; Leigh, P Nigel; Martin, Sarah; Shaw, Christopher E; Tsuda, Miho; Al-Chalabi, Ammar

2016-12-01

Amyotrophic lateral sclerosis (ALS) is a progressive and usually fatal neurodegenerative disease. Survival from diagnosis varies considerably. Several prognostic factors are known, including site of onset (bulbar or limb), age at symptom onset, delay from onset to diagnosis and the use of riluzole and non-invasive ventilation (NIV). Clinicians and patients would benefit from a practical way of using these factors to provide an individualised prognosis. 575 consecutive patients with incident ALS from a population-based registry in South-East England register for ALS (SEALS) were studied. Their survival was modelled as a two-step process: the time from diagnosis to respiratory muscle involvement, followed by the time from respiratory involvement to death. The effects of predictor variables were assessed separately for each time interval. Younger age at symptom onset, longer delay from onset to diagnosis and riluzole use were associated with slower progression to respiratory involvement, and NIV use was associated with lower mortality after respiratory involvement, each with a clinically significant effect size. Riluzole may have a greater effect in younger patients and those with longer delay to diagnosis. A patient's survival time has a roughly 50% chance of falling between half and twice the predicted median. A simple and clinically applicable graphical method of predicting an individual patient's survival from diagnosis is presented. The model should be validated in an independent cohort, and extended to include other important prognostic factors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Muscle activity pattern dependent pain development and alleviation.

PubMed

Sjøgaard, Gisela; Søgaard, Karen

2014-12-01

Muscle activity is for decades considered to provide health benefits irrespectively of the muscle activity pattern performed and whether it is during e.g. sports, transportation, or occupational work tasks. Accordingly, the international recommendations for public health-promoting physical activity do not distinguish between occupational and leisure time physical activity. However, in this body of literature, attention has not been paid to the extensive documentation on occupational physical activity imposing a risk of impairment of health - in particular musculoskeletal health in terms of muscle pain. Focusing on muscle activity patterns and musculoskeletal health it is pertinent to elucidate the more specific aspects regarding exposure profiles and body regional pain. Static sustained muscle contraction for prolonged periods often occurs in the neck/shoulder area during occupational tasks and may underlie muscle pain development in spite of rather low relative muscle load. Causal mechanisms include a stereotype recruitment of low threshold motor units (activating type 1 muscle fibers) characterized by a lack of temporal as well as spatial variation in recruitment. In contrast during physical activities at leisure and sport the motor recruitment patterns are more dynamic including regularly relatively high muscle forces - also activating type 2 muscles fibers - as well as periods of full relaxation even of the type 1 muscle fibers. Such activity is unrelated to muscle pain development if adequate recovery is granted. However, delayed muscle soreness may develop following intensive eccentric muscle activity (e.g. down-hill skiing) with peak pain levels in thigh muscles 1-2 days after the exercise bout and a total recovery within 1 week. This acute pain profile is in contrast to the chronic muscle pain profile related to repetitive monotonous work tasks. The painful muscles show adverse functional, morphological, hormonal, as well as metabolic characteristics. Of note is that intensive muscle strength training actually may rehabilitate painful muscles, which has recently been repeatedly proven in randomized controlled trials. With training the maximal muscle activation and strength can be shown to recover, and consequently allow for decreased relative muscle load during occupational repetitive work tasks. Exercise training induces adaptation of metabolic and stress-related mRNA and protein responses in the painful muscles, which is in contrast to the responses evoked during repetitive work tasks per se. Copyright © 2014 Elsevier Ltd. All rights reserved.

Flu facts. What is influenza?

PubMed

2002-02-01

Influenza, commonly called 'the flu', is an illness caused by the influenza virus. The virus is passed form person to person by sneezing or coughing. Typical symptoms of influenza include fever, cough, sore throat, fatigue, muscle aches, headaches, runny nose and watery eyes.

Neurovascular and Autonomic Dysfunction Associated with Gulf War Illness Pain

DTIC Science & Technology

2017-10-01

pesticides with human cholinesterases." Chem Biol Interact 190(2-3): 79-83. Wilson, B. W., J. D. Henderson, E. M. Coatney, P. S. Nieberg and P. S...Keywords: pain, autonomic, nociceptor, blood flow, pesticides , pyridostigmine bromide, DEET, Gulf War Illness 3. Accomplishments The SOW is...delayed onset joint, muscle and other deep tissue pain. The Research Advisory Committee on Gulf War Illness (GWI) has determined that pesticides may

Activation of lower back muscles via FES for pressure sores prevention in paraplegia: a case study.

PubMed

Vanoncini, M; Holderbaum, W; Andrews, B J

2010-04-01

The aim of this paper is to show the feasibility of the use of functional electrical stimulation (FES) applied to the lower back muscles for pressure sores prevention in paraplegia. The hypothesis under study is that FES induces a change in the pressure distribution on the contact area during sitting. Tests were conducted on a paraplegic subject (T5), sitting on a standard wheelchair and cushion. Trunk extensors (mainly the erector spinae) were stimulated using surface electrodes placed on the skin. A pressure mapping system was used to measure the pressure on the sitting surface in four situations: (a) no stimulation; (b) stimulation on one side of the spine only; (c) stimulation on both sides, at different levels; and (d) stimulation at the same level on both sides, during pressure-relief manoeuvres. A session of prolonged stimulation was also conducted. The experimental results show that the stimulation of the erector spinae on one side of the spine can induce a trunk rotation on the sagittal plane, which causes a change in the pressure distribution. A decrease of pressure on the side opposite to the stimulation was recorded. The phenomenon is intensified when different levels of stimulation are applied to the two sides, and such change can be sustained for a considerable time (around 5 minutes). The stimulation did not induce changes during pressure-relief manoeuvres. Finally, from this research we can conclude that the stimulation of the trunk extensors can be a useful tool for pressure sores prevention, and can potentially be used in a routine for pressure sores prevention based on periodical weight shifts.

Loss of the Inducible Hsp70 Delays the Inflammatory Response to Skeletal Muscle Injury and Severely Impairs Muscle Regeneration

PubMed Central

Howard, Travis M.; Ahn, Bumsoo; Ferreira, Leonardo F.

2013-01-01

Skeletal muscle regeneration following injury is a highly coordinated process that involves transient muscle inflammation, removal of necrotic cellular debris and subsequent replacement of damaged myofibers through secondary myogenesis. However, the molecular mechanisms which coordinate these events are only beginning to be defined. In the current study we demonstrate that Heat shock protein 70 (Hsp70) is increased following muscle injury, and is necessary for the normal sequence of events following severe injury induced by cardiotoxin, and physiological injury induced by modified muscle use. Indeed, Hsp70 ablated mice showed a significantly delayed inflammatory response to muscle injury induced by cardiotoxin, with nearly undetected levels of both neutrophil and macrophage markers 24 hours post-injury. At later time points, Hsp70 ablated mice showed sustained muscle inflammation and necrosis, calcium deposition and impaired fiber regeneration that persisted several weeks post-injury. Through rescue experiments reintroducing Hsp70 intracellular expression plasmids into muscles of Hsp70 ablated mice either prior to injury or post-injury, we confirm that Hsp70 optimally promotes muscle regeneration when expressed during both the inflammatory phase that predominates in the first four days following severe injury and the regenerative phase that predominates thereafter. Additional rescue experiments reintroducing Hsp70 protein into the extracellular microenvironment of injured muscles at the onset of injury provides further evidence that Hsp70 released from damaged muscle may drive the early inflammatory response to injury. Importantly, following induction of physiological injury through muscle reloading following a period of muscle disuse, reduced inflammation in 3-day reloaded muscles of Hsp70 ablated mice was associated with preservation of myofibers, and increased muscle force production at later time points compared to WT. Collectively our findings indicate that depending on the nature and severity of muscle injury, therapeutics which differentially target both intracellular and extracellular localized Hsp70 may optimally preserve muscle tissue and promote muscle functional recovery. PMID:23626847

A Cystine-Rich Whey Supplement (Immunocal®) Delays Disease Onset and Prevents Spinal Cord Glutathione Depletion in the hSOD1G93A Mouse Model of Amyotrophic Lateral Sclerosis

PubMed Central

Ross, Erika K.; Winter, Aimee N.; Wilkins, Heather M.; Sumner, Whitney A.; Duval, Nathan; Patterson, David; Linseman, Daniel A.

2014-01-01

Depletion of the endogenous antioxidant, glutathione (GSH), underlies progression of the devastating neurodegenerative disease, amyotrophic lateral sclerosis (ALS). Thus, strategies aimed at elevating GSH may yield new therapeutics for ALS. Here, we investigated the effects of a unique non-denatured whey protein supplement, Immunocal®, in the transgenic Gly position 93 to Ala (G93A) mutant hSOD1 (hSOD1G93A) mouse model of ALS. Immunocal® is rich in the GSH precursor, cystine, and is therefore capable of bolstering GSH content. Transgenic hSOD1G93A mice receiving Immunocal® displayed a significant delay in disease onset compared to untreated hSOD1G93A controls. Additionally, Immunocal® treatment significantly decreased the rate of decline in grip strength and prevented disease-associated reductions in whole blood and spinal cord tissue GSH levels in end-stage hSOD1G93A mice. However, Immunocal® did not extend survival, likely due to its inability to preserve the mitochondrial GSH pool in spinal cord. Combination treatment with Immunocal® and the anti-glutamatergic compound, riluzole, delayed disease onset and extended survival in hSOD1G93A mice. These findings demonstrate that sustaining tissue GSH with Immunocal® only modestly delays disease onset and slows the loss of skeletal muscle strength in hSOD1G93A mice. Moreover, the inability of Immunocal® to rescue mitochondrial GSH in spinal cord provides a possible mechanism for its lack of effect on survival and is a limiting factor in the potential utility of this supplement as a therapeutic for ALS. PMID:26785244

The effect of milk on recovery from repeat-sprint cycling in female team-sport athletes.

PubMed

Rankin, Paula; Lawlor, Michael J; Hills, Frank A; Bell, Phillip G; Stevenson, Emma J; Cockburn, Emma

2018-02-01

The consumption of milk following eccentric exercise attenuates the effects of muscle damage in team-sport athletes. However, participation in team sport involves both concentric-eccentric loading and metabolic stress. Therefore, the aim of this study was to investigate the effects of postexercise milk consumption on recovery from a cycling protocol designed to simulate the metabolic demands of team sport. Ten female team-sport athletes participated in a randomised crossover investigation. Upon completion of the protocol participants consumed 500 mL of milk (MILK) or 500 mL of an energy-matched carbohydrate (CHO) drink. Muscle function (peak torque, rate of force development, countermovement jump, 20-m sprint), muscle soreness and tiredness, serum creatine kinase, high-sensitivity C-reactive protein, and measures of oxidative stress (protein carbonyls and reduced glutathione/oxidized glutathione (GSH/GSSG) ratio) were determined at pre-exercise and 24 h, 48 h, and 72 h postexercise. MILK had a possible beneficial effect in attenuating losses in peak torque (180°/s) from baseline to 24 h (3.2% ± 7.8% vs. -6.2% ± 7.5%, MILK vs. CHO) and a possible beneficial effect in minimising soreness (baseline-48 h; baseline-72 h) and tiredness (baseline-24 h; baseline-72 h). There was no change in oxidative stress following the exercise protocol, though a likely benefit of milk was observed for GSH/GSSG ratio at baseline-24 h (0.369 ×/÷ 1.89, 1.103 ×/÷ 3.96, MILK vs. CHO). MILK had an unclear effect on all other variables. Consumption of 500 mL of milk after repeat sprint cycling had little to no benefit in minimising losses in peak torque or minimising increases in soreness and tiredness and had no effect on serum markers of muscle damage and inflammation.

Benefits of Compression Garments Worn During Handball-Specific Circuit on Short-Term Fatigue in Professional Players.

PubMed

Ravier, Gilles; Bouzigon, Romain; Beliard, Samuel; Tordi, Nicolas; Grappe, Frederic

2018-04-04

Ravier, G, Bouzigon, R, Beliard, S, Tordi, N, and Grappe, F. Benefits of compression garments worn during handball-specific circuit on short-term fatigue in professional players. J Strength Cond Res XX(X): 000-000, 2016-The purpose of this study was to investigate the benefits of full-leg length compression garments (CGs) worn during a handball-specific circuit exercises on athletic performance and acute fatigue-induced changes in strength and muscle soreness in professional handball players. Eighteen men (mean ± SD: age 23.22 ± 4.97 years; body mass: 82.06 ± 9.69 kg; height: 184.61 ± 4.78 cm) completed 2 identical sessions either wearing regular gym short or CGs in a randomized crossover design. Exercise circuits of explosive activities included 3 periods of 12 minutes of sprints, jumps, and agility drills every 25 seconds. Before, immediately after and 24 hours postexercise, maximal voluntary knee extension (maximal voluntary contraction, MVC), rate of force development (RFD), and muscle soreness were assessed. During the handball-specific circuit sprint and jump performances were unchanged in both conditions. Immediately after performing the circuit exercises MVC, RFD, and PPT decreased significantly compared with preexercise with CGs and noncompression clothes. Decrement was similar in both conditions for RFD (effect size, ES = 0.40) and PPT for the soleus (ES = 0.86). However, wearing CGs attenuated decrement in MVC (p < 0.001) with a smaller decrease (ES = 1.53) in CGs compared with regular gym shorts condition (-5.4 vs. -18.7%, respectively). Full recovery was observed 24 hours postexercise in both conditions for muscle soreness, MVC, and RFD. These findings suggest that wearing CGs during a handball-specific circuit provides benefits on the impairment of the maximal muscle force characteristics and is likely to be worthwhile for handball players involved in activities such as tackles.

Phototherapy for Improvement of Performance and Exercise Recovery: Comparison of 3 Commercially Available Devices.

PubMed

De Marchi, Thiago; Schmitt, Vinicius Mazzochi; Danúbia da Silva Fabro, Carla; da Silva, Larissa Lopes; Sene, Juliane; Tairova, Olga; Salvador, Mirian

2017-05-01

  Recent studies suggest the prophylactic use of low-powered laser/light has ergogenic effects on athletic performance and postactivity recovery. Manufacturers of high-powered lasers/light devices claim that these can produce the same clinical benefits with increased power and decreased irradiation time; however, research with high-powered lasers is lacking.   To evaluate the magnitude of observed phototherapeutic effects with 3 commercially available devices.   Randomized double-blind placebo-controlled study.   Laboratory.   Forty healthy untrained male participants.   Participants were randomized into 4 groups: placebo, high-powered continuous laser/light, low-powered continuous laser/light, or low-powered pulsed laser/light (comprising both lasers and light-emitting diodes). A single dose of 180 J or placebo was applied to the quadriceps.   Maximum voluntary contraction, delayed-onset muscle soreness (DOMS), and creatine kinase (CK) activity from baseline to 96 hours after the eccentric exercise protocol.   Maximum voluntary contraction was maintained in the low-powered pulsed laser/light group compared with placebo and high-powered continuous laser/light groups in all time points (P < .05). Low-powered pulsed laser/light demonstrated less DOMS than all groups at all time points (P < .05). High-powered continuous laser/light did not demonstrate any positive effects on maximum voluntary contraction, CK activity, or DOMS compared with any group at any time point. Creatine kinase activity was decreased in low-powered pulsed laser/light compared with placebo (P < .05) and high-powered continuous laser/light (P < .05) at all time points. High-powered continuous laser/light resulted in increased CK activity compared with placebo from 1 to 24 hours (P < .05).   Low-powered pulsed laser/light demonstrated better results than either low-powered continuous laser/light or high-powered continuous laser/light in all outcome measures when compared with placebo. The increase in CK activity using the high-powered continuous laser/light compared with placebo warrants further research to investigate its effect on other factors related to muscle damage.

Neuromuscular responses differ between slip-induced falls and recoveries in older adults

PubMed Central

Pai, Yi-Chung (Clive); Bhatt, Tanvi; Ting, Lena H.

2016-01-01

How does the robust control of walking and balance break down during a fall? Here, as a first step in identifying the neuromuscular determinants of falls, we tested the hypothesis that falls and recoveries are characterized by differences in neuromuscular responses. Using muscle synergy analysis, conventional onset latencies, and peak activity, we identified differences in muscle coordination between older adults who fell and those who recovered from a laboratory-induced slip. We found that subjects who fell recruited fewer muscle synergies than those who recovered, suggesting a smaller motor repertoire. During slip trials, compared with subjects who recovered, subjects who fell had delayed knee flexor and extensor onset times in the leading/slip leg, as well as different muscle synergy structure involving those muscles. Therefore, the ability to coordinate muscle activity around the knee in a timely manner may be critical to avoiding falls from slips. Unique to subjects who fell during slip trials were greater bilateral (interlimb) muscle activation and the recruitment of a muscle synergy with excessive coactivation. These differences in muscle coordination between subjects who fell and those who recovered could not be explained by differences in gait-related variables at slip onset (i.e., initial motion state) or variations in slip difficulty, suggesting that differences in muscle coordination may reflect differences in neural control of movement rather than biomechanical constraints imposed by perturbation or initial walking mechanics. These results are the first step in determining the causation of falls from the perspective of muscle coordination. They suggest that there may be a neuromuscular basis for falls that could provide new insights into treatment and prevention. Further research comparing the muscle coordination and mechanics of falls and recoveries within subjects is necessary to establish the neuromuscular causation of falls. NEW & NOTEWORTHY A central question relevant to the prevention of falls is: How does the robust control of walking and balance break down during a fall? Previous work has focused on muscle coordination during successful balance recoveries or the kinematics and kinetics of falls. Here, for the first time, we identified differences in the spatial and temporal coordination of muscles among older adults who fell and those who recovered from an unexpected slip. PMID:27832608

Neuromuscular responses differ between slip-induced falls and recoveries in older adults.

PubMed

Sawers, Andrew; Pai, Yi-Chung Clive; Bhatt, Tanvi; Ting, Lena H

2017-02-01

How does the robust control of walking and balance break down during a fall? Here, as a first step in identifying the neuromuscular determinants of falls, we tested the hypothesis that falls and recoveries are characterized by differences in neuromuscular responses. Using muscle synergy analysis, conventional onset latencies, and peak activity, we identified differences in muscle coordination between older adults who fell and those who recovered from a laboratory-induced slip. We found that subjects who fell recruited fewer muscle synergies than those who recovered, suggesting a smaller motor repertoire. During slip trials, compared with subjects who recovered, subjects who fell had delayed knee flexor and extensor onset times in the leading/slip leg, as well as different muscle synergy structure involving those muscles. Therefore, the ability to coordinate muscle activity around the knee in a timely manner may be critical to avoiding falls from slips. Unique to subjects who fell during slip trials were greater bilateral (interlimb) muscle activation and the recruitment of a muscle synergy with excessive coactivation. These differences in muscle coordination between subjects who fell and those who recovered could not be explained by differences in gait-related variables at slip onset (i.e., initial motion state) or variations in slip difficulty, suggesting that differences in muscle coordination may reflect differences in neural control of movement rather than biomechanical constraints imposed by perturbation or initial walking mechanics. These results are the first step in determining the causation of falls from the perspective of muscle coordination. They suggest that there may be a neuromuscular basis for falls that could provide new insights into treatment and prevention. Further research comparing the muscle coordination and mechanics of falls and recoveries within subjects is necessary to establish the neuromuscular causation of falls. A central question relevant to the prevention of falls is: How does the robust control of walking and balance break down during a fall? Previous work has focused on muscle coordination during successful balance recoveries or the kinematics and kinetics of falls. Here, for the first time, we identified differences in the spatial and temporal coordination of muscles among older adults who fell and those who recovered from an unexpected slip. Copyright © 2017 the American Physiological Society.

Salivary hormones, IgA, and performance during intense training and tapering in judo athletes.

PubMed

Papacosta, Elena; Gleeson, Michael; Nassis, George P

2013-09-01

The aims of this study were to identify the time course of change of salivary testosterone (sT), cortisol (sC), and IgA (SIgA); mood state; and performance capacity during a 2-week taper in judo athletes and to examine the diurnal variation in these salivary markers. Eleven male judo athletes completed 5 weeks of training: 1 week of normal training (NORM), 2 weeks of intensified training (INT), and 2 weeks of exponential tapering (TAPER). Once per week subjects completed vertical and horizontal countermovement jump tests, a grip strength test, a Special Judo Fitness Test, a multistage aerobic fitness test, a 3 × 300-m run test, and anthropometric measurement. Subjects also completed questionnaires to assess mood state and muscle soreness. Two daily saliva samples (at 0700 and 1900) were collected at the end of each week during NORM and INT and every day during TAPER. Increased morning sT, decreased evening sC, lower muscle soreness, and enhanced mood state (p < 0.05) were evident by the early phases of TAPER. A significant 7.0% improvement in 3 × 300-m performance time, a 6.9% improvement in the vertical jump (p < 0.05), and increased morning and evening SIgA secretion rate (p < 0.01) were observed during the middle-late phases of TAPER. The higher values of salivary variables were observed in the morning. This study indicates that salivary hormones display diurnal variation. Furthermore, changes in hormonal responses, mood state, and muscle soreness precede enhancements in performance and mucosal immunity, suggesting that judo athletes taper for at least a week before competition.

Physiological effects of wearing graduated compression stockings during running.

PubMed

Ali, Ajmol; Creasy, Robert H; Edge, Johann A

2010-08-01

This study examined the effect of wearing different grades of graduated compression stockings (GCS) on physiological and perceptual measures during and following treadmill running in competitive runners. Nine males and one female performed three 40-min treadmill runs (80 +/- 5% maximal oxygen uptake) wearing either control (0 mmHg; CON), low (12-15 mmHg; LO-GCS), or high (23-32 mmHg; HI-GCS) grade GCS in a double-blind counterbalanced order. Oxygen uptake, heart rate and blood lactate were measured. Perceptual scales were used pre- and post-run to assess comfort, tightness and any pain associated with wearing GCS. Changes in muscle function, soreness and damage were determined pre-run, immediately after running and 24 and 48 h post-run by measuring creatine kinase and myoglobin, counter-movement jump height, perceived soreness diagrams, and pressure sensitivity. There were no significant differences between trials for oxygen uptake, heart rate or blood lactate during exercise. HI-GCS was perceived as tighter (P < 0.05) and more pain-inducing (P < 0.05) than the other interventions; CON and LO-GCS were rated more comfortable than HI-GCS (P < 0.05). Creatine kinase (P < 0.05), myoglobin (P < 0.05) and jump height (P < 0.05) were higher and pressure sensitivity was more pronounced (P < 0.05) immediately after running but not after 24 and 48 h. Only four participants reported muscle soreness during recovery from running and there were no differences in muscle function between trials. In conclusion, healthy runners wearing GCS did not experience any physiological benefits during or following treadmill running. However, athletes felt more comfortable wearing low-grade GCS whilst running.

Neurosteroids and Self-Reported Pain in Veterans Who Served in the U.S. Military After September 11, 2001

PubMed Central

Kilts, Jason D; Tupler, Larry A; Keefe, Francis J; Payne, Victoria M; Hamer, Robert M; Naylor, Jennifer C; Calnaido, Rohana P; Morey, Rajendra A; Strauss, Jennifer L; Parke, Gillian; Massing, Mark W; Youssef, Nagy A; Shampine, Lawrence J; Marx, Christine E

2010-01-01

Objective Nearly half of Operation Enduring Freedom / Operation Iraqi Freedom (OEF/OIF) veterans experience continued pain post-deployment. Several investigations report analgesic effects of allopregnanolone and other neurosteroids in animal models, but few data are currently available focusing on neurosteroids in clinical populations. Allopregnanolone positively modulates GABAA receptors and demonstrates pronounced analgesic and anxiolytic effects in rodents, yet studies examining the relationship between pain and allopregnanolone in humans are limited. We thus hypothesized that endogenous allopregnanolone and other neurosteroid levels may be negatively correlated with self-reported pain symptoms in humans. Design We determined serum neurosteroid levels by gas chromatography / mass spectrometry (allopregnanolone, pregnenolone) or radioimmunoassay (dehydroepiandrosterone [DHEA], progesterone, DHEA sulfate [DHEAS]) in 90 male veterans who served in the U.S. military after September 11, 2001. Self-reported pain symptoms were assessed in four areas (low back pain, chest pain, muscle soreness, headache). Stepwise linear regression analyses were conducted to investigate the relationship between pain assessments and neurosteroids, with the inclusion of smoking, alcohol use, age, and history of traumatic brain injury as covariates. Setting Durham VA Medical Center. Results Allopregnanolone levels were inversely associated with low back pain (p=0.044) and chest pain (p=0.013), and DHEA levels were inversely associated with muscle soreness (p=0.024). DHEAS levels were positively associated with chest pain (p=0.001). Additionally, there was a positive association between traumatic brain injury and muscle soreness (p=0.002). Conclusions Neurosteroids may be relevant to the pathophysiology of self-reported pain symptoms in this veteran cohort, and could represent future pharmacological targets for pain disorders. PMID:20735755

The effects of compression garments on intermittent exercise performance and recovery on consecutive days.

PubMed

Duffield, Rob; Edge, Johann; Merrells, Robert; Hawke, Emma; Barnes, Matt; Simcock, David; Gill, Nicholas

2008-12-01

The aim of this study was to determine whether compression garments improve intermittent-sprint performance and aid performance or self-reported recovery from high-intensity efforts on consecutive days. Following familiarization, 14 male rugby players performed two randomized testing conditions (with or without garments) involving consecutive days of a simulated team sport exercise protocol, separated by 24 h of recovery within each condition and 2 weeks between conditions. Each day involved an 80-min high-intensity exercise circuit, with exercise performance determined by repeated 20-m sprints and peak power on a cart dynamometer (single-man scrum machine). Measures of nude mass, heart rate, skin and tympanic temperature, and blood lactate (La-) were recorded throughout each day; also, creatine kinase (CK) and muscle soreness were recorded each day and 48 h following exercise. No differences (P=.20 to 0.40) were present between conditions on either day of the exercise protocol for repeated 20-m sprint efforts or peak power on a cart dynamometer. Heart rate, tympanic temperature, and body mass did not significantly differ between conditions; however, skin temperature was higher under the compression garments. Although no differences (P=.50) in La- or CK were present, participants felt reduced levels of perceived muscle soreness in the ensuing 48 h postexercise when wearing the garments (2.5+/-1.7 vs 3.5+/-2.1 for garment and control; P=.01). The use of compression garments did not improve or hamper simulated team-sport activity on consecutive days. Despite benefits of reduced self-reported muscle soreness when wearing garments during and following exercise each day, no improvements in performance or recovery were apparent.

The effectiveness of chocolate milk as a post-climbing recovery aid.

PubMed

Potter, J; Fuller, B

2015-12-01

Recovery is essential to effective performance in climbing competitions which often involve repeated bouts, and sport climbing where climbers may work a route over a number of days prior to a complete ascent. This study employed a cross-over design to compare water with chocolate milk as recovery aids following an exhaustive bout of high intensity endurance climbing. Ten male climbers (age: 22±1 years; height: 178.5±7.9 cm; mass: 74.7±11.3 kg) climbed a Tredwall (Brewer Ledge M6) until volitional exhaustion. The participants consumed either water or chocolate milk 20 minutes after the climb and then again with their evening meal. The exercise protocol was repeated 24 hours after the original climb. The second condition was completed 7 days later. Workload indicators of heart rate, rate of perceived exertion (RPE), blood lactate and muscle soreness scores were recorded alongside climbing performance measures of duration and distance of the climb. A improved performance was found after the consumption of chocolate milk, with both a greater distance climbed (F(1,9)=11.704, P=0.008) and duration (F(1,9) =10.922, P=0.009), there were no differences in end of climb heart rate or RPE. Muscle soreness scores were lower three days after exercise following chocolate milk (t(8)=3.773, P=0.005). Chocolate milk as a recovery drink resulted in further sustained climbing, a decrease in muscle soreness, compared to water. It may be pertinent for climbers to consider its use as a recovery aid during repeated climbing bouts. Chocolate milk is a relatively unexplored recovery aid and warrants further attention.

Research in human performance related to space: A compilation of three projects/proposals

NASA Technical Reports Server (NTRS)

Hasson, Scott M.

1989-01-01

Scientific projects were developed in order to maximize performance in space and assure physiological homeostatis upon return. Three projects that are related to this common goal were either initiated or formulated during the Faculty Fellowship Summer Program. The projects were entitled: (1) Effect of simulated weightlessness (bed rest) on muscle performance and morphology; (2) Effect of submaximal eccentric muscle contractions on muscle injury, soreness and performance: A grant proposal; and (3) Correlation between isolated joint dynamic muscle strength to end-effector strength of the push and pull extravehicular activity (EVA) ratchet maneuver. The purpose is to describe each of these studies in greater detail.

Chronic phase advance alters circadian physiological rhythms and peripheral molecular clocks

PubMed Central

Wolff, Gretchen; Duncan, Marilyn J.

2013-01-01

Shifting the onset of light, acutely or chronically, can profoundly affect responses to infection, tumor progression, development of metabolic disease, and mortality in mammals. To date, the majority of phase-shifting studies have focused on acute exposure to a shift in the timing of the light cycle, whereas the consequences of chronic phase shifts alone on molecular rhythms in peripheral tissues such as skeletal muscle have not been studied. In this study, we tested the effect of chronic phase advance on the molecular clock mechanism in two phenotypically different skeletal muscles. The phase advance protocol (CPA) involved 6-h phase advances (earlier light onset) every 4 days for 8 wk. Analysis of the molecular clock, via bioluminescence recording, in the soleus and flexor digitorum brevis (FDB) muscles and lung demonstrated that CPA advanced the phase of the rhythm when studied immediately after CPA. However, if the mice were placed into free-running conditions (DD) for 2 wk after CPA, the molecular clock was not phase shifted in the two muscles but was still shifted in the lung. Wheel running behavior remained rhythmic in CPA mice; however, the endogenous period length of the free-running rhythm was significantly shorter than that of control mice. Core body temperature, cage activity, and heart rate remained rhythmic throughout the experiment, although the onset of the rhythms was significantly delayed with CPA. These results provide clues that lifestyles associated with chronic environmental desynchrony, such as shift work, can have disruptive effects on the molecular clock mechanism in peripheral tissues, including both types of skeletal muscle. Whether this can contribute, long term, to increased incidence of insulin resistance/metabolic disease requires further study. PMID:23703115

Effects of Motor Control Exercise Vs Muscle Stretching Exercise on Reducing Compensatory Lumbopelvic Motions and Low Back Pain: A Randomized Trial.

PubMed

Park, Kyue-Nam; Kwon, Oh-Yun; Yi, Chung-Hwi; Cynn, Heon-Seock; Weon, Jong-Hyuck; Kim, Tae-Ho; Choi, Houng-Sik

2016-10-01

The purpose of this study was to investigate the effectiveness of a 6-week motor control exercise (MCE) vs stretching exercise (SE) on reducing compensatory pelvic motion during active prone knee flexion (APKF) and intensity of low back pain. Thirty-six people in the lumbar-rotation-extension subgroup were randomly assigned equally into 2 exercise groups (18 people in each an MCE or SE group). A 3-dimensional motion-analysis system was used to measure the range and onset time of pelvic motion and knee flexion during APKF. Surface electromyography was used to measure the muscle activity and onset time of the erector spinae and the hamstrings during APKF. The level of subjective low back pain was measured using a visual analog scale. The MCE group had more significant decreases in and delay of anterior pelvic tilt, pelvic rotation, and erector spinae muscle activity during APKF, as well as reduced intensity of low back pain compared with the SE group (P < .05). For rehabilitation in patients in the lumbar-rotation-extension subgroup, MCE was more effective than SE in reducing compensatory pelvic motion and muscle activity during APKF and minimizing low back pain. Copyright © 2016. Published by Elsevier Inc.

Profunda Femoris Artery Perforator Propeller Flap: A Valid Method to Cover Complicated Ischiatic Pressure Sores.

PubMed

Scalise, Alessandro; Tartaglione, Caterina; Bolletta, Elisa; Pierangeli, Marina; Di Benedetto, Giovanni

2015-08-01

We report the case of a 50-year-old paraplegic man with a complicated grade III/IV ischiatic pressure sore treated with a propeller flap based on the first perforator of the profunda femoris artery. Our aim was to surgically reconstruct an ischiatic pressure sore in a patient with ankylosis using a fasciocutaneous perforator propeller flap obtained from the posterior region of the thigh. Our decision to perform a profunda femoris artery perforator propeller flap reconstruction was mainly due to the anatomical contiguity of the flap with the site of the lesion and the good quality of the skin harvested from the posterior region of the thigh. The use of the perforator fasciocutaneous flap represents a muscle-sparing technique, providing a better long-term result in surgical reconstruction. The choice of the 180-degree propeller flap was due to its ability to provide a good repair of the pressure ulcer and to pass over the ischiatic prominence in the patient in the forced decubitus position. The operatory course did not present any kind of complication. Using this reconstructive treatment, we have obtained complete coverage of the ischiatic pressure sore.

Pentostatin Injection

MedlinePlus

... pain constipation sores in the mouth and throat flatulence or large amounts of gas in the intestines or bowels hair loss muscle, back, or joint pain headache sweating difficulty falling asleep or staying asleep dry skin itching loss of strength or energy Some side effects can be serious. If you ...

Citrulline Malate Does Not Improve Muscle Recovery after Resistance Exercise in Untrained Young Adult Men

PubMed Central

da Silva, Douglas K.; Jacinto, Jeferson L.; de Andrade, Walquiria B.; Roveratti, Mirela C.; Estoche, José M.; Balvedi, Mario C. W.; de Oliveira, Douglas B.; da Silva, Rubens A.; Aguiar, Andreo F.

2017-01-01

The effects of citrulline malate (CM) on muscle recovery from resistance exercise remains unknown. We aimed to determine if citrulline malate supplementation improves muscle recovery after a single session of high-intensity resistance exercise (RE) in untrained young adult men. Nine young adult men (24.0 ± 3.3 years) participated in a double-blind crossover study in which they received 6 g of CM and placebo (PL) on two occasions, separated by a seven-day washout period. Each occasion consisted of a single session of high-intensity RE (0 h) and three subsequent fatigue tests sessions (at 24, 48, and 72 h) to assess the time course of muscle recovery. During the tests sessions, we assessed the following variables: number of maximum repetitions, electromyographic signal (i.e., root mean square (RMS) and median frequency (MF)), muscle soreness and perceived exertion, as well as blood levels of creatine kinase (CK), lactate, insulin, and testosterone:cortisol ratio. CK levels increased at 24 h post-exercise and remained elevate at 48 and 72 h, with no difference between CM and PL conditions. Muscle soreness increased at 24 h post-exercise, which progressively returned to baseline at 72 h in both conditions. Lactate levels increased immediately post-exercise and remained elevated at 24, 48, and 72 h in both conditions. No significant treatment × time interaction was found for all dependents variables (maximum repetitions, perceived exertion, CK, lactate, RMS, MF, and testosterone:cortisol ratio) during the recovery period. In conclusion, our data indicate that CM supplementation (single 6 g dose pre-workout) does not improve the muscle recovery process following a high-intensity RE session in untrained young adult men. PMID:29057836

Citrulline Malate Does Not Improve Muscle Recovery after Resistance Exercise in Untrained Young Adult Men.

PubMed

da Silva, Douglas K; Jacinto, Jeferson L; de Andrade, Walquiria B; Roveratti, Mirela C; Estoche, José M; Balvedi, Mario C W; de Oliveira, Douglas B; da Silva, Rubens A; Aguiar, Andreo F

2017-10-18

The effects of citrulline malate (CM) on muscle recovery from resistance exercise remains unknown. We aimed to determine if citrulline malate supplementation improves muscle recovery after a single session of high-intensity resistance exercise (RE) in untrained young adult men. Nine young adult men (24.0 ± 3.3 years) participated in a double-blind crossover study in which they received 6 g of CM and placebo (PL) on two occasions, separated by a seven-day washout period. Each occasion consisted of a single session of high-intensity RE (0 h) and three subsequent fatigue tests sessions (at 24, 48, and 72 h) to assess the time course of muscle recovery. During the tests sessions, we assessed the following variables: number of maximum repetitions, electromyographic signal (i.e., root mean square (RMS) and median frequency (MF)), muscle soreness and perceived exertion, as well as blood levels of creatine kinase (CK), lactate, insulin, and testosterone:cortisol ratio. CK levels increased at 24 h post-exercise and remained elevate at 48 and 72 h, with no difference between CM and PL conditions. Muscle soreness increased at 24 h post-exercise, which progressively returned to baseline at 72 h in both conditions. Lactate levels increased immediately post-exercise and remained elevated at 24, 48, and 72 h in both conditions. No significant treatment × time interaction was found for all dependents variables (maximum repetitions, perceived exertion, CK, lactate, RMS, MF, and testosterone:cortisol ratio) during the recovery period. In conclusion, our data indicate that CM supplementation (single 6 g dose pre-workout) does not improve the muscle recovery process following a high-intensity RE session in untrained young adult men.

A randomized controlled trial of manual therapy and pneumatic compression for recovery from prolonged running - an extended study.

PubMed

Heapy, Amanda M; Hoffman, Martin D; Verhagen, Heidie H; Thompson, Samuel W; Dhamija, Pavitra; Sandford, Fiona J; Cooper, Mary C

2018-03-07

Manual therapy (MT) and intermittent pneumatic compression (IPC) are recovery methods used by endurance athletes with little evidence supporting effectiveness. This randomized controlled trial evaluated effectiveness of four daily post-race treatments of a specific MT protocol and IPC compared with supine rest on recovery following an ultramarathon among 56 ultramarathoners. Groups were comparable across all characteristics examined, including post-race plasma creatine kinase concentration. Subject completed timed 400 m runs before the race and on days three, five, seven and 14 post- race, and also provided muscle pain and soreness ratings and fatigue scores immediately before and after treatments, and during the 14 days post- race. Daily subjective measures and 400 m run times were not improved by either treatment, but both treatments reduced (p < .05) muscular fatigue scores acutely after treatment following the race and on post-race day 1, and MT improved (p < .05) muscle pain and soreness acutely following the race.

Adding Fish Oil to Whey Protein, Leucine, and Carbohydrate Over a Six-Week Supplementation Period Attenuates Muscle Soreness Following Eccentric Exercise in Competitive Soccer Players.

PubMed

Philpott, Jordan D; Donnelly, Chris; Walshe, Ian H; MacKinley, Elizabeth E; Dick, James; Galloway, Stuart D R; Tipton, Kevin D; Witard, Oliver C

2018-01-01

Soccer players often experience eccentric exercise-induced muscle damage given the physical demands of soccer match-play. Since long chain n-3 polyunsaturated fatty acids (n-3PUFA) enhance muscle sensitivity to protein supplementation, dietary supplementation with a combination of fish oil-derived n-3PUFA, protein, and carbohydrate may promote exercise recovery. This study examined the influence of adding n-3PUFA to a whey protein, leucine, and carbohydrate containing beverage over a six-week supplementation period on physiological markers of recovery measured over three days following eccentric exercise. Competitive soccer players were assigned to one of three conditions (2 × 200 mL): a fish oil supplement beverage (FO; n = 10) that contained n-3PUFA (1100 mg DHA/EPA-approximately 550 mg DHA, 550 mg EPA), whey protein (15 g), leucine (1.8 g), and carbohydrate (20 g); a protein supplement beverage (PRO; n = 10) that contained whey protein (15 g), leucine (1.8 g), and carbohydrate (20 g); and a carbohydrate supplement beverage (CHO; n = 10) that contained carbohydrate (24 g). Eccentric exercise consisted of unilateral knee extension/flexion contractions on both legs separately. Maximal force production was impaired by 22% during the 72-hour recovery period following eccentric exercise (p < 0.05). Muscle soreness, expressed as area under the curve (AUC) during 72-hour recovery, was less in FO (1948 ± 1091 mm × 72 h) than PRO (4640 ± 2654 mm × 72 h, p < 0.05) and CHO (4495 ± 1853 mm × 72 h, p = 0.10). Blood concentrations of creatine kinase, expressed as AUC, were ~60% lower in FO compared to CHO (p < 0.05) and tended to be lower (~39%, p = 0.07) than PRO. No differences in muscle function, soccer performance, or blood c-reactive protein concentrations were observed between groups. In conclusion, the addition of n-3PUFA to a beverage containing whey protein, leucine, and carbohydrate ameliorates the increase in muscle soreness and blood concentrations of creatine kinase following eccentric exercise in competitive soccer players.

Effect on Laryngeal Adductor Function of Vincristine Block of Posterior Cricoarytenoid Muscle 3-5 Months After Recurrent Laryngeal Nerve Injury

PubMed Central

Paniello, Randal C.; Park, Andrea

2015-01-01

Objectives It has been shown, in a canine model, that a single injection of vincristine into the PCA muscle at the time of recurrent laryngeal nerve (RLN) injury effectively blocks its reinnervation and results in improved adductor strength. But clinically, such injuries are usually diagnosed weeks or months after onset. Vincristine injection does not affect a muscle that is already innervated; thus, there is a limited time frame following RLN injury during which a vincristine injection could effectively improve ultimate laryngeal adductor functional recovery. A series of delayed injections were performed in a canine model and results assessed. Study Design Animal (canine) experiment. Methods The RLN was transected and repaired, and vincristine (0.4 mg) was injected into the PCA muscle at the time of injury (n=12), or at 3, 4, and 5 months later (n=8 each study group). Six months after RLN injury, laryngeal adductor function was measured. Results of vincristine injection without RLN injury (n=6), and longer-term (12 months) follow-up for time zero injections (n=4), are also reported. Results The animals injected at time zero had better adductor function than non-injected controls, as reported previously, and this result was further increased at 12 months. The 3-month delay gave results similar to the time zero group. The 5-month delay group showed no vincristine benefit, and the 4-month delay group gave an intermediate result. Vincristine to the PCA had no effect on adductor function when the RLN was left intact. Plasma levels showed 19% of injected vincristine reached systemic circulation, which was cleared within 69 hours. Conclusions Vincristine injection of the PCA muscle after RLN injury, which blocks this functional recovery. The window of opportunity to apply this treatment closes by four months after RLN injury in the canine model. Human RLN recovery follows a similar time course and can reasonably be expected to have a similar therapeutic window. PMID:25595140

The Effects of Eccentric Contraction Duration on Muscle Strength, Power Production, Vertical Jump, and Soreness.

PubMed

Mike, Jonathan N; Cole, Nathan; Herrera, Chris; VanDusseldorp, Trisha; Kravitz, Len; Kerksick, Chad M

2017-03-01

Mike, JN, Cole, N, Herrera, C, VanDusseldorp, T, Kravitz, L, and Kerksick, CM. The effects of eccentric contraction duration on muscle strength, power production, vertical jump, and soreness. J Strength Cond Res 31(3): 773-786, 2017-Previous research has investigated the effects of either eccentric-only training or comparing eccentric and concentric exercise on changes related to strength and power expression, but no research to date has investigated the impact of altering the duration of either the concentric or the eccentric component on these parameters. Therefore, the purpose of this study was to assess the duration of eccentric (i.e., 2-second, 4-second vs. 6-second) muscle contractions and their effect on muscle strength, power production, vertical jump, and soreness using a plate-loaded barbell Smith squat exercise. Thirty college-aged men (23 ± 3.5 years, 178 ± 6.8 cm, 82 ± 12 kg, and 11.6 ± 5.1% fat) with 3.0 ± 1.0 years of resistance training experience and training frequency of 4.3 ± 0.9 days per week were randomized and assigned to 1 of 3 eccentric training groups that incorporated different patterns of contraction. For every repetition, all 3 groups used 2-second concentric contractions and paused for 1 second between the concentric and eccentric phases. The control group (2S) used 2-second eccentric contractions, whereas the 4S group performed 4-second eccentric contractions and the 6S group performed 6-second eccentric contractions. All repetitions were completed using the barbell Smith squat exercise. All participants completed a 4-week training protocol that required them to complete 2 workouts per week using their prescribed contraction routine for 4 sets of 6 repetitions at an intensity of 80-85% one repetition maximum (1RM). For all performance data, significant group × time (G × T) interaction effects were found for average power production across all 3 sets of a squat jump protocol (p = 0.04) while vertical jump did not reach significance but there was a trend toward a difference (G × T, p = 0.07). No other significant (p > 0.05) G × T interaction effects were found for the performance variables. All groups showed significant main effects for time in 1RM (p < 0.001), vertical jump (p = 0.004), peak power (p < 0.001), and average power (p < 0.001). Peak velocity data indicated that the 6S group experienced a significant reduction in peak velocity during the squat jump protocol as a result of the 4-week training program (p = 0.03). Soreness data revealed significant increases across time in all groups at both week 0 and week 4. Paired sample t-tests revealed greater differences in soreness values across time in the 2S group. The results provide further evidence that resistance training with eccentrically dominated movement patterns can be an effective method to acutely increase maximal strength and power expression in trained college age men. Furthermore, longer eccentric contractions may negatively impact explosive movements such as the vertical jump, whereas shorter eccentric contractions may instigate greater amounts of soreness. These are important considerations for the strength and conditioning professional to more fully understand that expressions of strength and power through eccentric training and varying durations of eccentric activity can have a significant impact for populations ranging from athletes desiring peak performance.

The effect of aging on anticipatory postural control

PubMed Central

Kanekar, Neeta; Aruin, Alexander S.

2014-01-01

The aim of the study was to investigate the differences in anticipatory (APAs) postural adjustments between young and older adults and its effect on subsequent control of posture. Ten healthy older adults and thirteen healthy young adults were exposed to predictable external perturbations using the pendulum-impact paradigm. EMG activity of the trunk and leg muscles, the center of pressure (COP), and center of mass (COM) displacements in the anterior-posterior (AP) direction were recorded and analyzed during the anticipatory and compensatory (CPAs) phases of postural control. The effect of aging was seen as delayed anticipatory muscle activity and larger compensatory muscle responses in older adults as compared to young adults. Moreover, in spite of such larger reactive responses, older adults were still more unstable, exhibiting larger COP and COM peak displacements after the perturbation than young adults when exposed to similar postural disturbances. Nonetheless, while APAs are impaired in older adults, the ability to recruit muscles anticipatorily is largely preserved, however, due to their smaller magnitudes and delayed onsets, it is likely that their effectiveness in reducing the magnitude of CPAs is smaller. The outcome of the study lends support towards investigating the ways of improving anticipatory postural control in people with balance impairments due to aging or neurological disorders. PMID:24449006

Is recovery driven by central or peripheral factors? A role for the brain in recovery following intermittent-sprint exercise

PubMed Central

Minett, Geoffrey M.; Duffield, Rob

2013-01-01

Prolonged intermittent-sprint exercise (i.e., team sports) induce disturbances in skeletal muscle structure and function that are associated with reduced contractile function, a cascade of inflammatory responses, perceptual soreness, and a delayed return to optimal physical performance. In this context, recovery from exercise-induced fatigue is traditionally treated from a peripheral viewpoint, with the regeneration of muscle physiology and other peripheral factors the target of recovery strategies. The direction of this research narrative on post-exercise recovery differs to the increasing emphasis on the complex interaction between both central and peripheral factors regulating exercise intensity during exercise performance. Given the role of the central nervous system (CNS) in motor-unit recruitment during exercise, it too may have an integral role in post-exercise recovery. Indeed, this hypothesis is indirectly supported by an apparent disconnect in time-course changes in physiological and biochemical markers resultant from exercise and the ensuing recovery of exercise performance. Equally, improvements in perceptual recovery, even withstanding the physiological state of recovery, may interact with both feed-forward/feed-back mechanisms to influence subsequent efforts. Considering the research interest afforded to recovery methodologies designed to hasten the return of homeostasis within the muscle, the limited focus on contributors to post-exercise recovery from CNS origins is somewhat surprising. Based on this context, the current review aims to outline the potential contributions of the brain to performance recovery after strenuous exercise. PMID:24550837

Air University Athletic Programs and Related Sport Injuries: What You Should Know

DTIC Science & Technology

1984-04-01

runners most frequently sustain shin splints , knee pain, muscle soreness, hamstring strain and low back pain. More experienced * runners, along with long...failed. SHIN SPLINTS p.. Definition An overuse syndrome affecting the muscles, tendons and bone covering of the front, lower two-thirds of the leg(s...These tissues become inflamed and swollen producing pain along the inner lower two-thirds of the leg(s). Causes Four primary causes of shin splints

Effects of spinal cord injury-induced changes in muscle activation on foot drag in a computational rat ankle model

PubMed Central

Hillen, Brian K.; Jindrich, Devin L.; Abbas, James J.; Yamaguchi, Gary T.

2015-01-01

Spinal cord injury (SCI) can lead to changes in muscle activation patterns and atrophy of affected muscles. Moderate levels of SCI are typically associated with foot drag during the swing phase of locomotion. Foot drag is often used to assess locomotor recovery, but the causes remain unclear. We hypothesized that foot drag results from inappropriate muscle coordination preventing flexion at the stance-to-swing transition. To test this hypothesis and to assess the relative contributions of neural and muscular changes on foot drag, we developed a two-dimensional, one degree of freedom ankle musculoskeletal model with gastrocnemius and tibialis anterior muscles. Anatomical data collected from sham-injured and incomplete SCI (iSCI) female Long-Evans rats as well as physiological data from the literature were used to implement an open-loop muscle dynamics model. Muscle insertion point motion was calculated with imposed ankle trajectories from kinematic analysis of treadmill walking in sham-injured and iSCI animals. Relative gastrocnemius deactivation and tibialis anterior activation onset times were varied within physiologically relevant ranges based on simplified locomotor electromyogram profiles. No-atrophy and moderate muscle atrophy as well as normal and injured muscle activation profiles were also simulated. Positive moments coinciding with the transition from stance to swing phase were defined as foot swing and negative moments as foot drag. Whereas decreases in activation delay caused by delayed gastrocnemius deactivation promote foot drag, all other changes associated with iSCI facilitate foot swing. Our results suggest that even small changes in the ability to precisely deactivate the gastrocnemius could result in foot drag after iSCI. PMID:25673734

Effects of spinal cord injury-induced changes in muscle activation on foot drag in a computational rat ankle model.

PubMed

Hillen, Brian K; Jindrich, Devin L; Abbas, James J; Yamaguchi, Gary T; Jung, Ranu

2015-04-01

Spinal cord injury (SCI) can lead to changes in muscle activation patterns and atrophy of affected muscles. Moderate levels of SCI are typically associated with foot drag during the swing phase of locomotion. Foot drag is often used to assess locomotor recovery, but the causes remain unclear. We hypothesized that foot drag results from inappropriate muscle coordination preventing flexion at the stance-to-swing transition. To test this hypothesis and to assess the relative contributions of neural and muscular changes on foot drag, we developed a two-dimensional, one degree of freedom ankle musculoskeletal model with gastrocnemius and tibialis anterior muscles. Anatomical data collected from sham-injured and incomplete SCI (iSCI) female Long-Evans rats as well as physiological data from the literature were used to implement an open-loop muscle dynamics model. Muscle insertion point motion was calculated with imposed ankle trajectories from kinematic analysis of treadmill walking in sham-injured and iSCI animals. Relative gastrocnemius deactivation and tibialis anterior activation onset times were varied within physiologically relevant ranges based on simplified locomotor electromyogram profiles. No-atrophy and moderate muscle atrophy as well as normal and injured muscle activation profiles were also simulated. Positive moments coinciding with the transition from stance to swing phase were defined as foot swing and negative moments as foot drag. Whereas decreases in activation delay caused by delayed gastrocnemius deactivation promote foot drag, all other changes associated with iSCI facilitate foot swing. Our results suggest that even small changes in the ability to precisely deactivate the gastrocnemius could result in foot drag after iSCI. Copyright © 2015 the American Physiological Society.

ATF3 expression improves motor function in the ALS mouse model by promoting motor neuron survival and retaining muscle innervation.

PubMed

Seijffers, Rhona; Zhang, Jiangwen; Matthews, Jonathan C; Chen, Adam; Tamrazian, Eric; Babaniyi, Olusegun; Selig, Martin; Hynynen, Meri; Woolf, Clifford J; Brown, Robert H

2014-01-28

ALS is a fatal neurodegenerative disease characterized by a progressive loss of motor neurons and atrophy of distal axon terminals in muscle, resulting in loss of motor function. Motor end plates denervated by axonal retraction of dying motor neurons are partially reinnervated by remaining viable motor neurons; however, this axonal sprouting is insufficient to compensate for motor neuron loss. Activating transcription factor 3 (ATF3) promotes neuronal survival and axonal growth. Here, we reveal that forced expression of ATF3 in motor neurons of transgenic SOD1(G93A) ALS mice delays neuromuscular junction denervation by inducing axonal sprouting and enhancing motor neuron viability. Maintenance of neuromuscular junction innervation during the course of the disease in ATF3/SOD1(G93A) mice is associated with a substantial delay in muscle atrophy and improved motor performance. Although disease onset and mortality are delayed, disease duration is not affected. This study shows that adaptive axonal growth-promoting mechanisms can substantially improve motor function in ALS and importantly, that augmenting viability of the motor neuron soma and maintaining functional neuromuscular junction connections are both essential elements in therapy for motor neuron disease in the SOD1(G93A) mice. Accordingly, effective protection of optimal motor neuron function requires restitution of multiple dysregulated cellular pathways.

Effect of immediate and delayed cold water immersion after a high intensity exercise session on subsequent run performance.

PubMed

Brophy-Williams, Ned; Landers, Grant; Wallman, Karen

2011-01-01

The purpose of the study was to determine the effects of cold water immersion (CWI) performed immediately or 3 h after a high intensity interval exercise session (HIIS) on next-day exercise performance. Eight male athletes performed three HIIS at 90%VO2max velocity followed by either a passive recovery (CON), CWI performed immediately post-exercise (CWI(0)) or CWI performed 3 h post-exercise (CWI(3)). Recovery trials were performed in a counter balanced manner. Participants then returned 24 h later and completed a muscle soreness and a totally quality recovery perception (TQRP) questionnaire, which was then followed by the Yoyo Intermittent Recovery Test [level 1] (YRT). Venous blood samples were collected pre-HIIS and pre-YRT to determine C-Reactive Protein (CRP) levels. Significantly more shuttles were performed during the YRT following CWI(0) compared to the CON trial (p=0.017, ES = 0. 8), while differences between the CWI(3) and the CON trials approached significance (p = 0.058, ES = 0.5). Performance on the YRT between the CWI(0) and CWI(3) trials were similar (p = 0.147, ES = 0. 3). Qualitative analyses demonstrated a 98% and 92% likely beneficial effect of CWI(0) and CWI(3) on next day performance, compared to CON, respectively, while CWI(0) resulted in a 79% likely benefit when compared to CWI(3). CRP values were significantly lower pre-YRT, compared to baseline, following CWI(0) (p = 0.0.36) and CWI(3) (p = 0.045), but were similar for CON (p = 0.157). Muscle soreness scores were similar between trials (p = 1.10), while TQRP scores were significantly lower for CON compared to CWI(0) (p = 0.002 ) and CWI(3) (p = 0.024). Immediate CWI resulted in superior next-day YRT performance compared to CON, while delayed (3 h) CWI was also likely to be beneficial. Qualitative analyses suggested that CWI(0) resulted in better performance than CWI(3). These results are important for athletes who do not have immediate access to CWI following exercise. Key pointsPerformance of cold water immersion as a recovery procedure following exercise is better than performing no recovery procedureAthletes, coaches and sport trainers should implement cold water immersion post-exercise irrespective of the time of administration.Where possible, cold water immersion should be performed immediately post-exercise to gain maximal recovery benefits.

The SIRT1 activator SRT1720 extends lifespan and improves health of mice fed a standard diet

PubMed Central

Mitchell, Sarah J.; Martin-Montalvo, Alejandro; Mercken, Evi M.; Palacios, Hector H.; Ward, Theresa M.; Abulwerdi, Gelareh; Minor, Robin K.; Vlasuk, George P.; Ellis, James L.; Sinclair, David A.; Dawson, John; Allison, David B.; Zhang, Yongqing; Becker, Kevin G.; Bernier, Michel; de Cabo, Rafael

2014-01-01

The prevention or delay of the onset of age-related diseases prolongs survival and improves quality of life while reducing the burden on the health care system. Activation of sirtuin 1 (SIRT1), an NAD+ deacetylase, improves metabolism and confers protection against physiological and cognitive disturbances in old age. SRT1720 is a specific SIRT1 activator that has health and lifespan benefits in adult mice fed a high-fat diet. We found extension in lifespan, delayed onset of age-related metabolic diseases, and improved general health in mice fed a standard diet after SRT1720 supplementation. Inhibition of pro-inflammatory gene expression both in the liver and muscle of SRT1720-treated animals was noted. SRT1720 lowered phosphorylation of NF-κB pathway regulators in vitro only when SIRT1 was functionally present. Combined with our previous work, the current study further supports the beneficial effects of SRT1720 on health across the lifespan in mice. PMID:24582957

Hereditary myopathies with early respiratory insufficiency in adults.

PubMed

Naddaf, Elie; Milone, Margherita

2017-11-01

Hereditary myopathies with early respiratory insufficiency as a predominant feature of the clinical phenotype are uncommon and underestimated in adults. We reviewed the clinical and laboratory data of patients with hereditary myopathies who demonstrated early respiratory insufficiency before the need for ambulatory assistance. Only patients with disease-causing mutations or a specific histopathological diagnosis were included. Patients with cardiomyopathy were excluded. We identified 22 patients; half had isolated respiratory symptoms at onset. The diagnosis of the myopathy was often delayed, resulting in delayed ventilatory support. The most common myopathies were adult-onset Pompe disease, myofibrillar myopathy, multi-minicore disease, and myotonic dystrophy type 1. Single cases of laminopathy, MELAS (mitochondrial encephalomyopathy with lactic acidosis and strokelike events), centronuclear myopathy, and cytoplasmic body myopathy were identified. We highlighted the most common hereditary myopathies associated with early respiratory insufficiency as the predominant clinical feature, and underscored the importance of a timely diagnosis for patient care. Muscle Nerve 56: 881-886, 2017. © 2017 Wiley Periodicals, Inc.

Statin Therapy Negatively Impacts Skeletal Muscle Regeneration and Cutaneous Wound Repair in Type 1 Diabetic Mice.

PubMed

Rebalka, Irena A; Cao, Andrew W; Raleigh, Matthew J; Henriksbo, Brandyn D; Coleman, Samantha K; Schertzer, Jonathan D; Hawke, Thomas J

2017-01-01

Those with diabetes invariably develop complications including cardiovascular disease (CVD). To reduce their CVD risk, diabetics are generally prescribed cholesterol-lowering 3-hydroxy-methylglutaryl coenzyme A reductase inhibitors (i.e., statins). Statins inhibit cholesterol biosynthesis, but also reduce the synthesis of a number of mevalonate pathway intermediates, leading to several cholesterol-independent effects. One of the pleiotropic effects of statins is the reduction of the anti-fibrinolytic hormone plasminogen activator inhibitor-1 (PAI-1). We have previously demonstrated that a PAI-1 specific inhibitor alleviated diabetes-induced delays in skin and muscle repair. Here we tested if statin administration, through its pleiotropic effects on PAI-1, could improve skin and muscle repair in a diabetic rodent model. Six weeks after diabetes onset, adult male streptozotocin-induced diabetic (STZ), and WT mice were assigned to receive control chow or a diet enriched with 600 mg/kg Fluvastatin. Tibialis anterior muscles were injured via Cardiotoxin injection to induce skeletal muscle injury. Punch biopsies were administered on the dorsal scapular region to induce injury of skin. Twenty-four days after the onset of statin therapy (10 days post-injury), tissues were harvested and analyzed. PAI-1 levels were attenuated in statin-treated diabetic tissue when compared to control-treated tissue, however no differences were observed in non-diabetic tissue as a result of treatment. Muscle and skin repair were significantly attenuated in Fluvastatin-treated STZ-diabetic mice as demonstrated by larger wound areas, less mature granulation tissue, and an increased presence of smaller regenerating muscle fibers. Despite attenuating PAI-1 levels in diabetic tissue, Fluvastatin treatment impaired cutaneous healing and skeletal muscle repair in STZ-diabetic mice.

Effect on laryngeal adductor function of vincristine block of posterior cricoarytenoid muscle 3 to 5 months after recurrent laryngeal nerve injury.

PubMed

Paniello, Randal C; Park, Andrea

2015-06-01

It has been shown in a canine model that a single injection of vincristine into the posterior cricoarytenoid (PCA) muscle at the time of recurrent laryngeal nerve (RLN) injury effectively blocks its reinnervation and results in improved adductor strength. But clinically, such injuries are usually diagnosed weeks or months after onset. Vincristine injection does not affect a muscle that is already innervated; thus, there is a limited time frame following RLN injury during which a vincristine injection could effectively improve ultimate laryngeal adductor functional recovery. A series of delayed injections was performed in a canine model and results assessed. Animal (canine) experiment. The RLN was transected and repaired, and vincristine (0.4 mg) was injected into the PCA muscle at the time of injury (n=12) or 3, 4, and 5 months later (n=8 each study group). Six months after RLN injury, laryngeal adductor function was measured. Results of vincristine injection without RLN injury (n=6) and longer-term (12 months) follow-up for time zero injections (n=4) are also reported. The animals injected at time zero had better adductor function than non-injected controls, as reported previously, and this result was further increased at 12 months. The 3-month delay gave results similar to the time zero group. The 5-month delay group showed no vincristine benefit, and the 4-month delay group gave an intermediate result. Vincristine to the PCA had no effect on adductor function when the RLN was left intact. Plasma levels showed 19% of injected vincristine reached systemic circulation, which was cleared within 69 hours. Vincristine injection of the PCA muscle after RLN injury, which blocks this antagonist muscle from synkinetic reinnervation, leads to improved laryngeal adductor functional recovery. The window of opportunity to apply this treatment closes by 4 months after RLN injury in the canine model. Human RLN recovery follows a similar time course and can reasonably be expected to have a similar therapeutic window. © The Author(s) 2015.

An atypical case of SCN9A mutation presenting with global motor delay and a severe pain disorder.

PubMed

Meijer, Inge Anita; Vanasse, Michel; Nizard, Sonia; Robitaille, Yves; Rossignol, Elsa

2014-01-01

Erythromelalgia due to heterozygous gain-of-function SCN9A mutations usually presents as a pure sensory-autonomic disorder characterized by recurrent episodes of burning pain and redness of the extremities. We describe a patient with an unusual phenotypic presentation of gross motor delay, childhood-onset erythromelalgia, extreme visceral pain episodes, hypesthesia, and self-mutilation. The investigation of the patient's motor delay included various biochemical analyses, a comparative genomic hybridization array (CGH), electromyogram (EMG), and muscle biopsy. Once erythromelalgia was suspected clinically, the SCN9A gene was sequenced. The EMG, CGH, and biochemical tests were negative. The biopsy showed an axonal neuropathy and neurogenic atrophy. Sequencing of SCN9A revealed a heterozygous missense mutation in exon 7; p.I234T. This is a case of global motor delay and erythromelalgia associated with SCN9A. The motor delay may be attributed to the extreme pain episodes or to a developmental perturbation of proprioceptive inputs. Copyright © 2013 Wiley Periodicals, Inc.

Antibiotic prescription strategies for acute sore throat: a prospective observational cohort study.

PubMed

Little, Paul; Stuart, Beth; Hobbs, F D Richard; Butler, Chris C; Hay, Alastair D; Delaney, Brendan; Campbell, John; Broomfield, Sue; Barratt, Paula; Hood, Kerenza; Everitt, Hazel; Mullee, Mark; Williamson, Ian; Mant, David; Moore, Michael

2014-03-01

Data from trials suggest that antibiotics reduce the risk of complications of sore throat by at least 50%, but few trials for complications have been done in modern settings, and datasets of delayed antibiotic prescription are underpowered. Observational evidence is important in view of poor compliance with antibiotic treatment outside trials, but no prospective observational cohort studies have been done to date. We generated a large prospective cohort from the DESCARTE study, and the PRISM component of DESCARTE, of 12,829 adults presenting with sore throat (≤ 2 weeks duration) in primary care. Our follow-up of the cohort was based on a detailed and structured review of routine medical records, and analysis of the comparison of three antibiotic prescription strategies (no antibiotic prescription, immediate antibiotic prescription, and delayed antibiotic prescription) to control for the propensity to prescribe antibiotics. Information about antibiotic prescription was recorded in 12,677 individuals (4805 prescribed no antibiotics, 6088 prescribed antibiotics immediately, and 1784 prescribed delayed antibiotics). We documented by review of patients' notes (n=11,950) the development of suppurative complications (eg, quinsy, impetigo and cellulitis, otitis media, and sinusitis) or reconsultation with new or non-resolving symptoms). We used multivariate analysis to control for variables significantly related to the propensity to prescribe antibiotics and for clustering by general practitioner. 164 (1.4%) of the 11,950 patients with information available developed complications; otitis media and sinusitis were the most common complications (101 patients [62%]). Compared with no antibiotic prescription, immediate antibiotic prescription was associated with fewer complications (adjusted risk ratio [RR] 0.62, 95% CI 0.43-0.91, estimated number needed to treat [NNT 193) as was delayed prescription of antibiotics (0.58, 0.34-0.98; NNT 174). 1787 of the 11,950 patients (15%) reconsulted with new or non-resolving symptoms; the risk of reconsultation was also reduced by immediate (0.83, 0.73-0.94; NNT 40) or delayed antibiotics (0.61, 0.50-0.74; NNT 18). Suppurative complications are not common in primary care and most are not serious. The risks of suppurative complications or reconsultation in adults are reduced by antibiotics, but not as much as the trial evidence suggests. In most cases, no antibiotic is needed, but a delayed prescription strategy is likely to provide similar benefits to an immediate antibiotic prescription. Copyright © 2014 Elsevier Ltd. All rights reserved.

Vascular delay improves latissimus dorsi muscle perfusion and muscle function for use in cardiomyoplasty.

PubMed

Carroll, S M; Heilman, S J; Stremel, R W; Tobin, G R; Barker, J H

1997-04-01

Ischemia of the distal portion of the latissimus dorsi muscle occurs in muscle transfer for cardiomyoplasty and reduces distal muscle contractility and thus the mechanical effectiveness of cardiomyoplasty. We hypothesized that muscle function would be improved by a vascular delay procedure that increases distal muscle perfusion of the latissimus dorsi muscle. The latissimus dorsi muscles of 10 adult mongrel dogs were subjected to a vascular delay procedure on one side and a sham procedure on the other. Following 10 days of vascular delay, muscle perfusion was measured with a laser-Doppler perfusion imager before and after elevation of the muscles as flaps based only on their thoracodorsal neurovascular pedicles. The muscles were wrapped and sutured around silicone chambers (simulating cardiomyoplasty), a stimulating electrode was placed around each thoracodorsal nerve, and the muscles were stimulated to contract in both rhythmic and tetanic fashion. Circumferential (distal and middle latissimus dorsi muscle function) force generation and fatigue rates were measured independently. Circumferential muscle force, circumferential and longitudinal fatigue rate, and distal, middle, and overall perfusion were significantly (p < 0.05) improved in delayed muscle compared with nondelayed muscle. We found that a vascular delay procedure and a 10-day delay adaptation period significantly improve latissimus dorsi muscle flap perfusion and function, particularly in the distal and middle portions of the muscle. Delay should be considered as a means of improving the clinical outcome in cardiomyoplasty.

Prevalence of delayed-onset posttraumatic stress disorder in military personnel: is there evidence for this disorder?: Results of a prospective UK cohort study.

PubMed

Goodwin, Laura; Jones, Margaret; Rona, Roberto J; Sundin, Josefin; Wessely, Simon; Fear, Nicola T

2012-05-01

Delayed-onset posttraumatic stress disorder (PTSD) is defined as onset at least 6 months after a traumatic event. This study investigates the prevalence of delayed-onset PTSD in 1397 participants from a two-phase prospective cohort study of UK military personnel. Delayed-onset PTSD was categorized as participants who did not meet the criteria for probable PTSD (assessed using the PTSD Checklist Civilian version) at phase 1 but met the criteria by phase 2. Of the participants, 3.5% met the criteria for delayed-onset PTSD. Subthreshold PTSD, common mental disorder (CMD), poor/fair self-reported health, and multiple physical symptoms at phase 1 and the onset of alcohol misuse or CMD between phases 1 and 2 were associated with delayed-onset PTSD. Delayed-onset PTSD exists in this UK military sample. Military personnel who developed delayed-onset PTSD were more likely to have psychological ill-health at an earlier assessment, and clinicians should be aware of the potential comorbidity in these individuals, including alcohol misuse. Leaving the military or experiencing relationship breakdown was not associated.

Oxidative stress response in trained men following repeated squats or sprints.

PubMed

Bloomer, Richard J; Falvo, Michael J; Fry, Andrew C; Schilling, Brian K; Smith, Webb A; Moore, Christopher A

2006-08-01

The purpose of this investigation was to measure the oxidative stress response to similarly matched work bouts of squat and sprint exercise. Twelve anaerobically trained men performed six 10-s sprints and, on a separate occasion, repeated barbell squats to approximately equal the amount of work performed during the sprints. Blood lactate, heart rate, and perceived exertion was measured before and following each exercise bout. Muscle soreness, muscle force, and creatine kinase activity was determined preexercise and through 48 h of recovery. Desmin cytoskeletal protein was determined via muscle biopsy of the vastus lateralis before and at 24 h following each exercise. Plasma protein carbonyls (PC) and malondialdehyde (MDA) were measured as biomarkers of oxidative stress. Heart rate and perceived exertion was not different between exercise sessions (P > 0.05), although lactate was higher following sprinting compared with squatting (P = 0.002). Muscle soreness was greater for squatting than sprinting (P = 0.003) and reached a peak immediately postexercise for both sessions (P = 0.0003). Muscle force was unaffected by either exercise session (P > 0.05), and creatine kinase activity was elevated to a similar extent following both sessions. Desmin-negative fibers were virtually nonexistent after either exercise bout, indicating no loss of this cytoskeletal protein. Neither PC nor MDA was affected by the exercise (P > 0.05). These results suggest that in anaerobically trained men, the oxidative stress and muscle injury response to similarly matched anaerobic exercise bouts is minimal, and not different between exercise modes. Furthermore, when compared with previous literature on untrained subjects, the response is significantly attenuated, possibly because of adaptations occurring as a result of chronic, strenuous anaerobic training.

Lower-volume muscle-damaging exercise protects against high-volume muscle-damaging exercise and the detrimental effects on endurance performance.

PubMed

Burt, Dean; Lamb, Kevin; Nicholas, Ceri; Twist, Craig

2015-07-01

This study examined whether lower-volume exercise-induced muscle damage (EIMD) performed 2 weeks before high-volume muscle-damaging exercise protects against its detrimental effect on running performance. Sixteen male participants were randomly assigned to a lower-volume (five sets of ten squats, n = 8) or high-volume (ten sets of ten squats, n = 8) EIMD group and completed baseline measurements for muscle soreness, knee extensor torque, creatine kinase (CK), a 5-min fixed-intensity running bout and a 3-km running time-trial. Measurements were repeated 24 and 48 h after EIMD, and the running time-trial after 48 h. Two weeks later, both groups repeated the baseline measurements, ten sets of ten squats and the same follow-up testing (Bout 2). Data analysis revealed increases in muscle soreness and CK and decreases in knee extensor torque 24-48 h after the initial bouts of EIMD. Increases in oxygen uptake [Formula: see text], minute ventilation [Formula: see text] and rating of perceived exertion were observed during fixed-intensity running 24-48 h after EIMD Bout 1. Likewise, time increased and speed and [Formula: see text] decreased during a 3-km running time-trial 48 h after EIMD. Symptoms of EIMD, responses during fixed-intensity and running time-trial were attenuated in the days after the repeated bout of high-volume EIMD performed 2 weeks after the initial bout. This study demonstrates that the protective effect of lower-volume EIMD on subsequent high-volume EIMD is transferable to endurance running. Furthermore, time-trial performance was found to be preserved after a repeated bout of EIMD.

Effects of low-level laser therapy applied before or after plyometric exercise on muscle damage markers: randomized, double-blind, placebo-controlled trial.

PubMed

Fritsch, Carolina Gassen; Dornelles, Maurício Pinto; Severo-Silveira, Lucas; Marques, Vanessa Bernardes; Rosso, Isabele de Albuquerque; Baroni, Bruno Manfredini

2016-12-01

Promising effects of phototherapy on markers of exercise-induced muscle damage has been already demonstrated in constant load or isokinetic protocols. However, its effects on more functional situations, such as plyometric exercises, and when is the best moment to apply this treatment (pre- or post-exercise) remain unclear. Therefore, the purpose of this study was to investigate the effect of low-level laser therapy (LLLT) before or after plyometric exercise on quadriceps muscle damage markers. A randomized, double-blinded, placebo-controlled trial was conducted with 24 healthy men, 12 at pre-exercise treatment group and 12 at post-exercise treatment group. Placebo and LLLT (810 nm, 200 mW per diode, 6 J per diode, 240 J per leg) were randomly applied on right/left knee extensor muscles of each volunteer before/after a plyometric exercise protocol. Muscular echo intensity (ultrasonography images), soreness (visual analogue scale - VAS), and strength impairment (maximal voluntary contraction - MVC) were assessed at baseline, 24, 48, and 72 h post-exercise. Legs treated with LLLT before or after exercise presented significantly smaller increments of echo intensity (values up to 1 %) compared to placebo treatments (increased up to ∼7 %). No significant treatment effect was found for VAS and MVC, although a trend toward better results on LLLT legs have been found for VAS (mean values up to 30 % lesser than placebo leg). In conclusion, LLLT applied before or after plyometric exercise reduces the muscle echo intensity response and possibly attenuates the muscle soreness. However, these positive results were not observed on strength impairment.

Probiotic Streptococcus thermophilus FP4 and Bifidobacterium breve BR03 Supplementation Attenuates Performance and Range-of-Motion Decrements Following Muscle Damaging Exercise.

PubMed

Jäger, Ralf; Purpura, Martin; Stone, Jason D; Turner, Stephanie M; Anzalone, Anthony J; Eimerbrink, Micah J; Pane, Marco; Amoruso, Angela; Rowlands, David S; Oliver, Jonathan M

2016-10-14

Probiotics have immunomodulatory effects. However, little is known about the potential benefit of probiotics on the inflammation subsequent to strenuous exercise. In a double-blind, randomized, placebo controlled, crossover design separated by a 21-day washout, 15 healthy resistance-trained men ingested an encapsulated probiotic Streptococcus ( S. ) thermophilus FP4 and Bifidobacterium ( B. ) breve BR03 at 5 bn live cells (AFU) concentration each, or a placebo, daily for 3 weeks prior to muscle-damaging exercise (ClinicalTrials.gov NCT02520583). Isometric strength, muscle soreness, range of motion and girth, and blood interleukin-6 (IL-6) and creatine kinase (CK) concentrations were measured from pre- to 72 h post-exercise. Statistical analysis was via mixed models and magnitude-based inference to the standardized difference. Probiotic supplementation resulted in an overall decrease in circulating IL-6, which was sustained to 48 h post-exercise. In addition, probiotic supplementation likely enhanced isometric average peak torque production at 24 to 72 h into the recovery period following exercise (probiotic-placebo point effect ±90% CI: 24 h, 11% ± 7%; 48 h, 12% ± 18%; 72 h, 8% ± 8%). Probiotics also likely moderately increased resting arm angle at 24 h (2.4% ± 2.0%) and 48 h (1.9% ± 1.9%) following exercise, but effects on soreness and flexed arm angle and CK were unclear. These data suggest that dietary supplementation with probiotic strains S. thermophilus FP4 and B. breve BR03 attenuates performance decrements and muscle tension in the days following muscle-damaging exercise.

Recovery following a marathon: a comparison of cold water immersion, whole body cryotherapy and a placebo control.

PubMed

Wilson, Laura J; Cockburn, Emma; Paice, Katherine; Sinclair, Scott; Faki, Tanwir; Hills, Frank A; Gondek, Marcela B; Wood, Alyssa; Dimitriou, Lygeri

2018-01-01

Cryotherapy is an increasingly popular recovery strategy used in an attempt to attenuate the negative impact of strenuous physical activity on subsequent exercise. Therefore, this study aimed to assess the effects of whole body cryotherapy (WBC) and cold water immersion (CWI) on markers of recovery following a marathon. Thirty-one endurance trained males completed a marathon. Participants were randomly assigned to a CWI, WBC or placebo group. Perceptions of muscle soreness, training stress and markers of muscle function were recorded before the marathon and at 24 and 48 h post exercise. Blood samples were taken at baseline, post intervention and 24 and 48 h post intervention to assess inflammation and muscle damage. WBC had a harmful effect on muscle function compared to CWI post marathon. WBC positively influenced perceptions of training stress compared to CWI. With the exception of C-reactive protein (CRP) at 24 and 48 h, neither cryotherapy intervention positively influenced blood borne markers of inflammation or structural damage compared to placebo. The findings show WBC has a negative impact on muscle function, perceptions of soreness and a number of blood parameters compared to CWI, contradicting the suggestion that WBC may be a superior recovery strategy. Further, cryotherapy is no more effective than a placebo intervention at improving functional recovery or perceptions of training stress following a marathon. These findings lend further evidence to suggest that treatment belief and the placebo effect may be largely responsible for the beneficial effects of cryotherapy on recovery following a marathon.

A metabolic switch toward lipid use in glycolytic muscle is an early pathologic event in a mouse model of amyotrophic lateral sclerosis

PubMed Central

Palamiuc, Lavinia; Schlagowski, Anna; Ngo, Shyuan T; Vernay, Aurelia; Dirrig-Grosch, Sylvie; Henriques, Alexandre; Boutillier, Anne-Laurence; Zoll, Joffrey; Echaniz-Laguna, Andoni; Loeffler, Jean-Philippe; René, Frédérique

2015-01-01

Amyotrophic lateral sclerosis (ALS) is the most common fatal motor neuron disease in adults. Numerous studies indicate that ALS is a systemic disease that affects whole body physiology and metabolic homeostasis. Using a mouse model of the disease (SOD1G86R), we investigated muscle physiology and motor behavior with respect to muscle metabolic capacity. We found that at 65 days of age, an age described as asymptomatic, SOD1G86R mice presented with improved endurance capacity associated with an early inhibition in the capacity for glycolytic muscle to use glucose as a source of energy and a switch in fuel preference toward lipids. Indeed, in glycolytic muscles we showed progressive induction of pyruvate dehydrogenase kinase 4 expression. Phosphofructokinase 1 was inhibited, and the expression of lipid handling molecules was increased. This mechanism represents a chronic pathologic alteration in muscle metabolism that is exacerbated with disease progression. Further, inhibition of pyruvate dehydrogenase kinase 4 activity with dichloroacetate delayed symptom onset while improving mitochondrial dysfunction and ameliorating muscle denervation. In this study, we provide the first molecular basis for the particular sensitivity of glycolytic muscles to ALS pathology. PMID:25820275

Influences of adult-onset diabetes on orofacial pain and related health behaviors.

PubMed

Rahim-Williams, Bridgett; Tomar, Scott; Blanchard, Shirley; Riley, Joseph L

2010-01-01

This study tested the hypothesis that persons with orofacial pain and comorbid adult-onset diabetes will experience greater functional and emotional impact than persons experiencing orofacial pain without diabetes. A random-digit dialing sampling procedure was used for a disproportionate probability sample of 10,341 persons who were screened for orofacial pain in the past 6 months and diabetes. This paper reports on 1,767 individuals reporting toothache pain and 877 reporting painful oral sores. A structured telephone interview assessed diabetes history, orofacial pain characteristics, oral health-care behaviors, and emotional and functional impacts of orofacial pain. The 6-month point prevalence was 16.8 percent for toothache pain, 8.9 percent for painful oral sores, and 9.6 percent for adult-onset diabetes. Individuals with comorbid orofacial pain and adult-onset diabetes differed significantly on many of the pain characteristics and health behaviors compared with nondiabetic sufferers of orofacial pain. Diabetics were more likely than nondiabetics to have pain every day, to suffer negative emotions associated with pain, to experience disruption of daily activities and sleep, to make an emergency room visit for orofacial pain, and to report the current need for a pain-related health-care visit. Although diabetes is well known to be associated with neuropathic pain, these results indicate that the experience of nociceptive pain is exacerbated by diabetes. Findings have significance for the subjective experience of oral pain, dental-care outcomes, and health-related quality of life associated with oral-health outcomes among individuals with diabetes.

Delayed recovery of the affected finger extensors at chronic stage in a stroke patient: A case report.

PubMed

Jang, Sung Ho; Lee, Han Do

2017-10-01

A 33-year-old male presented with complete weakness of the right extremities due to corona radiata infarct. The main concerns of the patient is recovery of hand function especially related to finger extension. Right corona radiata infarct. He underwent physical therapy and occupational therapy at the outpatient clinic of the rehabilitation department of the same university hospital until 2 years after onset. In addition, he underwent neuromuscular electrical stimulation for the right finger extensors continuously until 4 years after onset. At 6 months after onset, the weakness of his right side recovered to subnormal state except for the right finger extensors which were completely weak. At 1.5 years after onset, the right finger extensors began to show slow and continuous recovery. At 4 years after onset, the patient showed motor recovery in the right finger extensors to the extent that he was able to move against gravity. Discontinuation of the left corticospinal tract was observed on 2-month diffusion tensor tractography (DTT); however, the integrity of this discontinuation had recovered to the primary motor cortex on 4-year DTT. On 2-month transcranial magnetic stimulation (TMS), no motor-evoked potential was evoked; in contrast, motor-evoked potentials were obtained at the right-hand muscle on 4-year TMS study. We demonstrated unusual delayed and long-term recovery of the affected finger extensors in a patient with corona radiata infarct using DTT and TMS.

Modulation of plantar pressure and gastrocnemius activity during gait using electrical stimulation of the tibialis anterior in healthy adults

PubMed Central

Ueno, Mizuki; Yoshikawa, Yoshiyuki; Terashi, Hiroto; Fujino, Hidemi

2018-01-01

High plantar flexor moment during the stance phase is known to cause high plantar pressure under the forefoot; however, the effects on plantar pressure due to a change of gastrocnemius medialis (GM) activity during gait, have not been investigated to date. Reciprocal inhibition is one of the effects of electrical stimulation (ES), and is the automatic antagonist alpha motor neuron inhibition which is evoked by excitation of the agonist muscle. The aim of this study was to investigate the influences of ES of the tibialis anterior (TA) on plantar pressure and the GM activity during gait in healthy adults. ES was applied to the TAs of twenty healthy male adults for 30 minutes at the level of intensity that causes a full range of dorsiflexion in the ankle (frequency; 50 Hz, on-time; 10 sec, off-time; 10 sec). Subjects walked 10 meters before and after ES, and we measured the peak plantar pressure (PP), pressure time integral (PTI), and gait parameters by using an F-scan system. The percentage of integrated electromyogram (%IEMG), active time, onset time, peak time, and cessation time of TA and GM were calculated. PP and PTI under the forefoot, rear foot, and total plantar surface significantly decreased after the application of ES. Meanwhile, changes of gait parameters were not observed. %IEMG and the active time of both muscles did not change; however, onset time and peak time of GM became significantly delayed. ES application to the TA delayed the timing of onset and peak in the GM, and caused the decrease of plantar pressure during gait. The present results suggest that ES to the TA could become a new method for the control of plantar pressure via modulation of GM activity during gait. PMID:29746498

Probiotic Bacillus coagulans GBI-30, 6086 reduces exercise-induced muscle damage and increases recovery

PubMed Central

Jäger, Ralf; Shields, Kevin A.; Lowery, Ryan P.; De Souza, Eduardo O.; Partl, Jeremy M.; Hollmer, Chase; Purpura, Martin

2016-01-01

Objective. Probiotics have been reported to support healthy digestive and immune function, aid in protein absorption, and decrease inflammation. Further, a trend to increase vertical jump power has been observed following co-administration of protein and probiotics in resistance-trained subjects. However, to date the potential beneficial effect of probiotics on recovery from high intensity resistance exercise have yet to be explored. Therefore, this study examined the effect of co-administration of protein and probiotics on muscle damage, recovery and performance following a damaging exercise bout. Design. Twenty nine (n = 29) recreationally-trained males (mean ± SD; 21.5 ± 2.8 years; 89.7 ± 28.2 kg; 177.4 ± 8.0 cm) were assigned to consume either 20 g of casein (PRO) or 20 g of casein plus probiotic (1 billion CFU Bacillus coagulans GBI-30, 6086, PROBC) in a crossover, diet-controlled design. After two weeks of supplementation, perceptional measures, athletic performance, and muscle damage were analyzed following a damaging exercise bout. Results. The damaging exercise bout significantly increased muscle soreness, and reduced perceived recovery; however, PROBC significantly increased recovery at 24 and 72 h, and decreased soreness at 72 h post exercise in comparison to PRO. Perceptual measures were confirmed by increases in CK (PRO: +266.8%, p = 0.0002; PROBC: +137.7%, p = 0.01), with PROBC showing a trend towards reduced muscle damage (p = 0.08). The muscle-damaging exercise resulted in significantly increased muscle swelling and Blood Urea Nitrogen levels in both conditions with no difference between groups. The strenuous exercise significantly reduced athletic performance in PRO (Wingate Peak Power; PRO: (−39.8 watts, −5.3%, p = 0.03)), whereas PROBC maintained performance (+10.1 watts, +1.7%). Conclusions. The results provide evidence that probiotic supplementation in combination with protein tended to reduce indices of muscle damage, improves recovery, and maintains physical performance subsequent to damaging exercise. PMID:27547577

Perceived demands and postexercise physical dysfunction in CrossFit® compared to an ACSM based training session.

PubMed

Drum, Scott N; Bellovary, Bryanne N; Jensen, Randall L; Moore, Maggy T; Donath, Lars

2017-05-01

CrossFit® is considered an intense and extreme conditioning program (ECP) that can cause overtraining and injury. Exertional Rhabdomyolysis (ER) - breakdown of muscle tissue - after ECP has been reported in CrossFit® and might be linked to comparatively high rates of subjectively perceived exertion levels. Therefore, the present study aimed at recording symptoms of postexercise physical dysfunction (e.g., excessive muscle soreness, shortness of breath) following CrossFit® and ratings of perceived exertion (RPE) during CrossFit® compared with training according to the American College of Sports Medicine (ACSM) guidelines. A validated questionnaire was completed by 101 CrossFit® (age: 35±8 years; weight: 79±16 kg) and 56 ACSM (age: 35±10 years; weight: 75±27 kg) participants. CrossFit® and ACSM groups, respectively, reported significantly different RPE levels of 7.3±1.7 and 5.5±1.4 (P≤0.001) and amounts of hard days per week of 4.0±1.1 and 3.5±1.4 (P=0.04). The five most frequent and hardest ECP workouts of the day (WODs) were Fran (47), Murph (27), Fight Gone Bad (10), Helen (9) and Filthy 50 (9). Presence of severe post-exercise symptoms was notably higher in CrossFit® for excessive fatigue (42 vs. 8; P<0.001), muscle soreness (96 vs. 48; P=0.04), muscle swelling (19 vs. 4; P=0.048), shortness of breath (13 vs. 1; P=0.02), muscle pain to touch (31 vs. 4; P=0.001), and limited muscle movement during workout (37 vs. 9; P=0.007). CrossFit® leads to "very hard" perceived exertion causing detrimental post-exercise effects on muscle and ventilatory function in experienced athletes. Improved training progression with adequate recovery schedules are needed to prevent severe muscle injury, such as ER.

Protein supplementation for military personnel: a review of the mechanisms and performance outcomes.

PubMed

McLellan, Tom M

2013-11-01

Protein supplement use is common among athletes, active adults, and military personnel. This review provides a summary of the evidence base that either supports or refutes the ergogenic effects associated with different mechanisms that have been proposed to support protein supplementation. It was clear that if carbohydrate delivery was optimal either during or after an acute bout of exercise that additional protein will not increase exercise capacity. Evidence was also weak to substantiate use of protein supplements to slow the increase in brain serotonin and onset of central fatigue. It was also evident that additional research is warranted to test whether the benefits of protein supplements for enhancing recovery of fluid balance after exercise will affect subsequent work in the heat. In contrast, with repeated exercise, use of protein supplementation was associated with reductions in muscle soreness and often a faster recovery of muscle function due to reductions in protein degradation. There was also good supportive evidence for long-term benefits of protein supplementation for gains in muscle mass and strength through accelerated rates of protein synthesis, as long as the training stimulus was of sufficient intensity, frequency, and duration. However, studies have not examined the impact of protein supplements under the combined stress of a military environment that includes repeated bouts of exercise with little opportunity for feeding and recovery, lack of sleep, and exposure to extreme environments. Both additional laboratory and field research is warranted to help provide evidence-based guidance for the choice of protein supplements to enhance soldier performance.

Intramuscular Pressure of Tibialis Anterior Reflects Ankle Torque but Does Not Follow Joint Angle-Torque Relationship.

PubMed

Ateş, Filiz; Davies, Brenda L; Chopra, Swati; Coleman-Wood, Krista; Litchy, William J; Kaufman, Kenton R

2018-01-01

Intramuscular pressure (IMP) is the hydrostatic fluid pressure that is directly related to muscle force production. Electromechanical delay (EMD) provides a link between mechanical and electrophysiological quantities and IMP has potential to detect local electromechanical changes. The goal of this study was to assess the relationship of IMP with the mechanical and electrical characteristics of the tibialis anterior muscle (TA) activity at different ankle positions. We hypothesized that (1) the TA IMP and the surface EMG (sEMG) and fine-wire EMG (fwEMG) correlate to ankle joint torque, (2) the isometric force of TA increases at increased muscle lengths, which were imposed by a change in ankle angle and IMP follows the length-tension relationship characteristics, and (3) the electromechanical delay (EMD) is greater than the EMD of IMP during isometric contractions. Fourteen healthy adults [7 female; mean ( SD ) age = 26.9 (4.2) years old with 25.9 (5.5) kg/m 2 body mass index] performed (i) three isometric dorsiflexion (DF) maximum voluntary contraction (MVC) and (ii) three isometric DF ramp contractions from 0 to 80% MVC at rate of 15% MVC/second at DF, Neutral, and plantarflexion (PF) positions. Ankle torque, IMP, TA fwEMG, and TA sEMG were measured simultaneously. The IMP, fwEMG, and sEMG were significantly correlated to the ankle torque during ramp contractions at each ankle position tested. This suggests that IMP captures in vivo mechanical properties of active muscles. The ankle torque changed significantly at different ankle positions however, the IMP did not reflect the change. This is explained with the opposing effects of higher compartmental pressure at DF in contrast to the increased force at PF position. Additionally, the onset of IMP activity is found to be significantly earlier than the onset of force which indicates that IMP can be designed to detect muscular changes in the course of neuromuscular diseases impairing electromechanical transmission.

Carbohydrate Nutrition and Team Sport Performance.

PubMed

Williams, Clyde; Rollo, Ian

2015-11-01

The common pattern of play in 'team sports' is 'stop and go', i.e. where players perform repeated bouts of brief high-intensity exercise punctuated by lower intensity activity. Sprints are generally 2-4 s long and recovery between sprints is of variable length. Energy production during brief sprints is derived from the degradation of intra-muscular phosphocreatine and glycogen (anaerobic metabolism). Prolonged periods of multiple sprints drain muscle glycogen stores, leading to a decrease in power output and a reduction in general work rate during training and competition. The impact of dietary carbohydrate interventions on team sport performance have been typically assessed using intermittent variable-speed shuttle running over a distance of 20 m. This method has evolved to include specific work to rest ratios and skills specific to team sports such as soccer, rugby and basketball. Increasing liver and muscle carbohydrate stores before sports helps delay the onset of fatigue during prolonged intermittent variable-speed running. Carbohydrate intake during exercise, typically ingested as carbohydrate-electrolyte solutions, is also associated with improved performance. The mechanisms responsible are likely to be the availability of carbohydrate as a substrate for central and peripheral functions. Variable-speed running in hot environments is limited by the degree of hyperthermia before muscle glycogen availability becomes a significant contributor to the onset of fatigue. Finally, ingesting carbohydrate immediately after training and competition will rapidly recover liver and muscle glycogen stores.

Royal Sun Culinary-Medicinal Mushroom, Agaricus brasiliensis (Agaricomycetes), Supplement in Training Capacity Improvement Parameters.

PubMed

Silva, Flávio F; de Oliveira, Guilherme A C; Costa, Hugo C Martins; Regis, Wiliam C B

2017-01-01

People seek a greater quality of life and healthy aging that culminates in improved self-esteem and vitality in the performance of daily activities; this is generating a growing number of people enrolled in gyms in search of quick results. However, this training can result in physical and metabolic damage. During physical exercise, under conditions of oxidative stress, changes take place that lead to the onset of fatigue. The Agaricus brasiliensis mushroom is native to Brazil and has therapeutic potential, with widely studied antioxidant and immunomodulatory capabilities. However, little is known about its potential benefits regarding muscular strength. Therefore, this study evaluated the possible effects of supplementation with this mushroom with respect to strength performance before and after a resistance training session. A blinded randomized trial was performed with male volunteers (n = 5) randomly divided into 2 groups (placebo and treatment with A. brasiliensis). Perceptions of muscle soreness and performance were assessed before and after high-intensity resistance training sessions. The study was executed over a 24-day period. Promising results were found related to intrasession rapid strength, most likely a result of antioxidant action and redox balance. The bioactive compounds in A. brasiliensis revealed the potential to improve conditions of muscle fatigue without altering other parameters. Thus, this mushroom has become a target of great expectations in the fields of fitness and athletics.

Sex differences in response to maximal eccentric exercise.

PubMed

Sewright, Kimberly A; Hubal, Monica J; Kearns, Amy; Holbrook, Mariko T; Clarkson, Priscilla M

2008-02-01

This study examined sex differences in strength loss, muscle soreness, and serum creatine kinase (CK) and myoglobin (Mb) after high-intensity eccentric exercise of the elbow flexors in a large group of men and women. One hundred participants (58 women, 42 men) performed 50 maximal eccentric contractions of the elbow flexor muscles of their nondominant arm. Maximum isometric voluntary contraction (MVC) was recorded at baseline, immediately after exercise, and at 0.5 (12-14 h), 3, 4, 7, and 10 d after exercise. Blood samples for serum CK activity and Mb were taken at baseline and at 4, 7, and 10 d after exercise. Soreness was evaluated at baseline and at 0.5, 3, 4, 7, and 10 d after exercise. Women experienced significantly greater relative strength loss immediately after exercise (-57.8% +/- 19.1) than men (-50.4% +/- 16.9%) (independent t-test; P < or = 0.05), and a greater percentage of women experienced more than 70% strength loss immediately after exercise compared with men (34.4% of women; 7.1% of men). Men exhibited a larger CK response compared with women (ANCOVA; P < or = 0.05), partly because there were more men who were high responders. There were no significant differences between the sexes for serum Mb or soreness measures. Generally, stronger relationships among CK, soreness, and strength-loss measures were found in men compared with women (r = 0.55-0.59 for men; r = 0.12-0.49 for women). In response to eccentric exercise, women experienced greater immediate strength loss than men and were more likely to be high responders for immediate strength loss; men experienced greater serum CK activity than women and were more likely to be high responders for increased serum CK. Although the explanation for high responders to eccentric exercise remains unknown, we have shown that there are sex-specific differences in CK and strength-loss response after eccentric exercise.

Slow-onset and fast-onset symptom presentations in acute coronary syndrome (ACS): new perspectives on prehospital delay in patients with ACS.

PubMed

O'Donnell, Sharon; McKee, Gabrielle; Mooney, Mary; O'Brien, Frances; Moser, Debra K

2014-04-01

Patient decision delay is the main reason why many patients fail to receive timely medical intervention for symptoms of acute coronary syndrome (ACS). This study examines the validity of slow-onset and fast-onset ACS presentations and their influence on ACS prehospital delay times. A fast-onset ACS presentation is characterized by sudden, continuous, and severe chest pain, and slow-onset ACS pertains to all other ACS presentations. Baseline data pertaining to medical profiles, prehospital delay times, and ACS symptoms were recorded for all ACS patients who participated in a large multisite randomized control trial (RCT) in Dublin, Ireland. Patients were interviewed 2-4 days after their ACS event, and data were gathered using the ACS Response to Symptom Index. Only baseline data from the RCT, N = 893 patients, were analyzed. A total of 65% (n = 577) of patients experienced slow-onset ACS presentation, whereas 35% (n = 316) experienced fast-onset ACS. Patients who experienced slow-onset ACS were significantly more likely to have longer prehospital delays than patients with fast-onset ACS (3.5 h vs. 2.0 h, respectively, t = -5.63, df 890, p < 0.001). A multivariate analysis of delay revealed that, in the presence of other known delay factors, the only independent predictors of delay were slow-onset and fast-onset ACS (β = -.096, p < 0.002) and other factors associated with patient behavior. Slow-onset ACS and fast-onset ACS presentations are associated with distinct behavioral patterns that significantly influence prehospital time frames. As such, slow-onset ACS and fast-onset ACS are legitimate ACS presentation phenomena that should be seriously considered when examining the factors associated with prehospital delay. Copyright © 2014 Elsevier Inc. All rights reserved.

Effect of whole-body vibration therapy on performance recovery.

PubMed

Manimmanakorn, Nuttaset; Ross, Jenny J; Manimmanakorn, Apiwan; Lucas, Samuel J; Hamlin, Michael J

2015-04-01

To compare whole-body vibration (WBV) with traditional recovery protocols after a high-intensity training bout. In a randomized crossover study, 16 athletes performed 6 × 30-s Wingate sprints before completing either an active recovery (10 min of cycling and stretching) or WBV for 10 min in a series of exercises on a vibration platform. Muscle hemodynamics (assessed via near-infrared spectroscopy) were measured before and during exercise and into the 10-min recovery period. Blood lactate concentration, vertical jump, quadriceps strength, flexibility, rating of perceived exertion (RPE), muscle soreness, and performance during a single 30-s Wingate test were assessed at baseline and 30 and 60 min postexercise. A subset of participants (n = 6) completed a 3rd identical trial (1 wk later) using a passive 10-min recovery period (sitting). There were no clear effects between the recovery protocols for blood lactate concentration, quadriceps strength, jump height, flexibility, RPE, muscle soreness, or single Wingate performance across all measured recovery time points. However, the WBV recovery protocol substantially increased the tissue-oxygenation index compared with the active (11.2% ± 2.4% [mean ± 95% CI], effect size [ES] = 3.1, and -7.3% ± 4.1%, ES = -2.1 for the 10 min postexercise and postrecovery, respectively) and passive recovery conditions (4.1% ± 2.2%, ES = 1.3, 10 min postexercise only). Although WBV during recovery increased muscle oxygenation, it had little effect in improving subsequent performance compared with a normal active recovery.

Behavioral deficits during early stages of aging in Caenorhabditis elegans result from locomotory deficits possibly linked to muscle frailty.

PubMed Central

Glenn, Charles F.; Chow, David K.; Gami, Minaxi S.; Iser, Wendy B.; Hanselman, Keaton B.; Wolkow, Catherine A.; David, Lawrence; Goldberg, Ilya G.; Cooke, Carol A.

2005-01-01

Many behavioral responses require the coordination of sensory inputs with motor outputs. Aging is associated with progressive declines in both motor function and muscle structure. However, the consequences of age-related motor deficits upon behavior have not been clearly defined. Here, we examined the effects of aging on behavior in the nematode, Caenorhabditis elegans. As animals aged, mild locomotory deficits appeared that were sufficient to impair behavioral responses to sensory cues. In contrast, sensory ability appeared well-maintained during aging. Age-related behavioral declines were delayed in animals with mutations in the daf-2/insulin-like pathway governing longevity. A decline in muscle tissue integrity was correlated with the onset of age-related behavioral deficits, although significant muscle deterioration did not. Treatment with a muscarinic agonist significantly improved locomotory behavior in aged animals, indicating that improved neuromuscular signaling may be one strategy for reducing the severity of age-related behavioral impairments. PMID:15699524

Phenotype variability of infantile-onset multisystem neurologic, endocrine, and pancreatic disease IMNEPD.

PubMed

Picker-Minh, Sylvie; Mignot, Cyril; Doummar, Diane; Hashem, Mais; Faqeih, Eissa; Josset, Patrice; Dubern, Béatrice; Alkuraya, Fowzan S; Kraemer, Nadine; Kaindl, Angela M

2016-04-29

Infantile-onset multisystem neurologic, endocrine, and pancreatic disease (IMNEPD) has been recently linked to biallelic mutation of the peptidyl-tRNA hydrolase 2 gene PTRH2. Two index patients with IMNEPD in the original report had multiple neurological symptoms such as postnatal microcephaly, intellectual disability, developmental delay, sensorineural deafness, cerebellar atrophy, ataxia, and peripheral neuropathy. In addition, distal muscle weakness and abnormalities of thyroid, pancreas, and liver were found. Here, we report five further IMNEPD patients with a different homozygous PTRH2 mutation, broaden the phenotypic spectrum of the disease and differentiate common symptoms and interindividual variability in IMNEPD associated with a unique mutation. We thereby hope to better define IMNEPD and promote recognition and diagnosis of this novel disease entity.

Creatine, L-Carnitine, and ω3 Polyunsaturated Fatty Acid Supplementation from Healthy to Diseased Skeletal Muscle

PubMed Central

D'Antona, Giuseppe; Nabavi, Seyed Mohammad; Micheletti, Piero; Aquilani, Roberto; Nisoli, Enzo; Rondanelli, Mariangela; Daglia, Maria

2014-01-01

Myopathies are chronic degenerative pathologies that induce the deterioration of the structure and function of skeletal muscle. So far a definitive therapy has not yet been developed and the main aim of myopathy treatment is to slow the progression of the disease. Current nonpharmacological therapies include rehabilitation, ventilator assistance, and nutritional supplements, all of which aim to delay the onset of the disease and relieve its symptoms. Besides an adequate diet, nutritional supplements could play an important role in the treatment of myopathic patients. Here we review the most recent in vitro and in vivo studies investigating the role supplementation with creatine, L-carnitine, and ω3 PUFAs plays in myopathy treatment. Our results suggest that these dietary supplements could have beneficial effects; nevertheless continued studies are required before they could be recommended as a routine treatment in muscle diseases. PMID:25243159

Carbohydrate Strategies for Injury Prevention

PubMed Central

Schlabach, Gretchen

1994-01-01

Prevention of injury involves identifying risk factors that would predispose one to injury and developing strategies to attenuate or eliminate their presence. Because muscle glycogen depletion is associated with fatigue and injury, it should be treated as a possible risk factor. Muscle glycogen stores are derived almost entirely from carbohydrate intake. Because there is a limited capacity to store muscle glycogen, and because muscle glycogen is the predominant fuel in exercise of moderate to severe intensity, the nutritional focus should be on carbohydrate consumption. Easy-to-follow nutritional strategies should be employed that will maximize muscle glycogen stores and delay the onset of fatigue. Individuals involved in activities lasting less than 60 minutes need to consume an adequate amount of carbohydrate daily and a pre-event meal before the start of the activity. However, individuals participating in activities longer than 60 minutes or participating in activities requiring repeated bouts of high intensity exercise need to: 1) consume an adequate amount of carbohydrate daily, 2) practice carbohydrate loading, 3) consume the pre-event meal, and 4) ingest carbohydrates immediately before, during, and after the activity. PMID:16558287

Concentrically trained cyclists are not more susceptible to eccentric exercise-induced muscle damage than are stretch-shortening exercise-trained runners.

PubMed

Snieckus, Audrius; Kamandulis, Sigitas; Venckūnas, Tomas; Brazaitis, Marius; Volungevičius, Gintautas; Skurvydas, Albertas

2013-03-01

Here, we test the hypothesis that continuous concentric exercise training renders skeletal muscles more susceptible to damage in response to eccentric exercise. Elite road cyclists (CYC; n = 10, training experience 8.1 ± 2.0 years, age 22.9 ± 3.7 years), long-distance runners (LDR; n = 10, 9.9 ± 2.3 years, 24.4 ± 2.5 years), and healthy untrained (UT) men (n = 10; 22.4 ± 1.7 years) performed 100 submaximal eccentric contractions at constant angular velocity of 60° s(-1). Concentric isokinetic peak torque, isometric maximal voluntary contraction (MVC), and electrically induced knee extension torque were measured at baseline and immediately and 48 h after an eccentric exercise bout. Muscle soreness was assessed and plasma creatine kinase (CK) activity was measured at baseline and 48 h after exercise. Voluntary and electrically stimulated knee extension torque reduction were significantly greater (p < 0.05) in UT than in LDR and CYC. Immediately and 48 h after exercise, MVC decreased by 32 % and 20 % in UT, 20 % and 5 % in LDR, and 25 % and 6 % in CYC. Electrically induced 20 Hz torque decreased at the same times by 61 and 29 % in UT, 40 and 17 % in LDR, and 26 and 14 % in CYC. Muscle soreness and plasma CK activity 48 h after exercise did not differ significantly between athletes and UT subjects. In conclusion, even though elite endurance athletes are more resistant to eccentric exercise-induced muscle damage than are UT people, stretch-shortening exercise-trained LDR have no advantage over concentrically trained CYC.

A contralateral repeated bout effect attenuates induction of NF-κB DNA binding following eccentric exercise.

PubMed

Xin, Ling; Hyldahl, Robert D; Chipkin, Stuart R; Clarkson, Priscilla M

2014-06-01

We investigated the existence of contralateral repeated bout effect and tested if the attenuation of nuclear factor-kappa B (NF-κB; an important regulator of muscle inflammation) induction following eccentric exercise is a potential mechanism. Thirty-one healthy men performed two bouts of knee extension eccentric exercise, initially with one leg and then with the opposite leg 4 wk later. Vastus lateralis muscle biopsies of both exercised and control legs were taken 3 h postexercise. Knee extension isometric and isokinetic strength (60°/sec and 180°/sec) were measured at baseline, pre-exercise, immediately postexercise, and 1/day for 5 days postexercise. Serum creatine kinase (CK) activity and muscle soreness were assessed at baseline and 1/day for 5 days postexercise. NF-κB (p65) DNA-binding activity was measured in the muscle biopsies. Isometric strength loss was lower in bout 2 than in bout 1 at 24, 72, and 96 h postexercise (P < 0.05). Isokinetic strength (60°/s and 180°/s) was reduced less in bout 2 than in bout 1 at 72 h postexercise (P < 0.01). There were no significant differences between bouts for postexercise CK activity or muscle soreness. p65 DNA-binding activity was increased following eccentric exercise (compared with the control leg) in bout 1 (122.9% ± 2.6%; P < 0.001) and bout 2 (109.1% ± 3.0%; P < 0.05). Compared with bout 1, the increase in NF-κB DNA-binding activity postexercise was attenuated after bout 2 (P = 0.0008). Repeated eccentric exercise results in a contralateral repeated bout effect, which could be due to the attenuated increase in NF-κB activity postexercise. Copyright © 2014 the American Physiological Society.

Relationship Between Pretraining Subjective Wellness Measures, Player Load, and Rating-of-Perceived-Exertion Training Load in American College Football.

PubMed

Govus, Andrew D; Coutts, Aaron; Duffield, Rob; Murray, Andrew; Fullagar, Hugh

2018-01-01

The relationship between pretraining subjective wellness and external and internal training load in American college football is unclear. To examine the relationship of pretraining subjective wellness (sleep quality, muscle soreness, energy, wellness Z score) with player load and session rating of perceived exertion (s-RPE-TL) in American college football players. Subjective wellness (measured using 5-point, Likert-scale questionnaires), external load (derived from GPS and accelerometry), and s-RPE-TL were collected during 3 typical training sessions per week for the second half of an American college football season (8 wk). The relationship of pretraining subjective wellness with player load and s-RPE training load was analyzed using linear mixed models with a random intercept for athlete and a random slope for training session. Standardized mean differences (SMDs) denote the effect magnitude. A 1-unit increase in wellness Z score and energy was associated with trivial 2.3% (90% confidence interval [CI] 0.5, 4.2; SMD 0.12) and 2.6% (90% CI 0.1, 5.2; SMD 0.13) increases in player load, respectively. A 1-unit increase in muscle soreness (players felt less sore) corresponded to a trivial 4.4% (90% CI -8.4, -0.3; SMD -0.05) decrease in s-RPE training load. Measuring pretraining subjective wellness may provide information about players' capacity to perform in a training session and could be a key determinant of their response to the imposed training demands American college football. Hence, monitoring subjective wellness may aid in the individualization of training prescription in American college football players.

Parasacral Perforator Flaps for Reconstruction of Sacral Pressure Sores.

PubMed

Lin, Chin-Ta; Chen, Shih-Yi; Chen, Shyi-Gen; Tzeng, Yuan-Sheng; Chang, Shun-Cheng

2015-07-01

Despite advances in reconstruction techniques, pressure sores continue to present a challenge to the plastic surgeon. The parasacral perforator flap is a reliable flap that preserves the entire contralateral side as a future donor site. On the ipsilateral side, the gluteal muscle itself is preserved and all flaps based on the inferior gluteal artery are still possible. We present our experience of using parasacral perforator flaps in reconstructing sacral defects. Between August 2004 and January 2013, 19 patients with sacral defects were included in this study. All the patients had undergone surgical reconstruction of sacral defects with a parasacral perforator flap. The patients' sex, age, cause of sacral defect, flap size, flap type, numbers of perforators used, rotation angle, postoperative complications, and hospital stay were recorded. There were 19 parasacral perforator flaps in this series. All flaps survived uneventfully except for 1 parasacral perforator flap, which failed because of methicillin-resistant Staphylococcus aureus infection. The overall flap survival rate was 95% (18/19). The mean follow-up period was 17.3 months (range, 2-24 months). The average length of hospital stay was 20.7 days (range, 9-48 days). No flap surgery-related mortality was found. Also, there was no recurrence of sacral pressure sores or infected pilonidal cysts during the follow-up period. Perforator-based flaps have become popular in modern reconstructive surgery because of low donor-site morbidity and good preservation of muscle. Parasacral perforator flaps are durable and reliable in reconstructing sacral defects. We recommend the parasacral perforator flap as a good choice for reconstructing sacral defects.

Know and Share the Facts about Flu Vaccination

ERIC Educational Resources Information Center

Grohskopf, Lisa

2012-01-01

Flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs. It can cause mild to severe illness, and sometimes can lead to death. Symptoms of flu can include fever or a feverish feeling, cough, sore throat, runny or stuffy nose, muscle or body aches, headache, fatigue, vomiting, and diarrhea. Flu…

Does Citrulline Malate Enhance Physical Performance

DTIC Science & Technology

2010-10-01

Jakeman, P.M. (2010). Citrulline malate enhances athletic anaerobic performance and relieves muscle soreness. Journal of Strength and Conditioning...returned for their third and final VO2 max test. VO2max, lactate threshold , maximum watts reached, ratings of perceived exertion and pre- and post...7 Figure 7. Lactate threshold (as % of VO2max) for all three conditions

A2 Milk Enhances Dynamic Muscle Function Following Repeated Sprint Exercise, a Possible Ergogenic Aid for A1-Protein Intolerant Athletes?

PubMed

Kirk, Ben; Mitchell, Jade; Jackson, Matthew; Amirabdollahian, Farzad; Alizadehkhaiyat, Omid; Clifford, Tom

2017-01-28

Hyperaminoacidemia following ingestion of cows-milk may stimulate muscle anabolism and attenuate exercise-induced muscle damage (EIMD). However, as dairy-intolerant athletes do not obtain the reported benefits from milk-based products, A2 milk may offer a suitable alternative as it lacks the A1-protein. This study aimed to determine the effect of A2 milk on recovery from a sports-specific muscle damage model. Twenty-one male team sport players were allocated to three independent groups: A2 milk ( n = 7), regular milk ( n = 7), and placebo (PLA) ( n = 7). Immediately following muscle-damaging exercise, participants consumed either A2 milk, regular milk or PLA (500 mL each). Visual analogue scale (muscle soreness), maximal voluntary isometric contraction (MVIC), countermovement jump (CMJ) and 20-m sprint were measured prior to and 24, 48, and 72 h post EIMD. At 48 h post-EIMD, CMJ and 20-m sprint recovered quicker in A2 (33.4 ± 6.6 and 3.3 ± 0.1, respectively) and regular milk (33.1 ± 7.1 and 3.3 ± 0.3, respectively) vs. PLA (29.2 ± 3.6 and 3.6 ± 0.3, respectively) ( p < 0.05). Relative to baseline, decrements in 48 h CMJ and 20-m sprint were minimised in A2 (by 7.2 and 5.1%, respectively) and regular milk (by 6.3 and 5.2%, respectively) vs. PLA. There was a trend for milk treatments to attenuate decrements in MVIC, however statistical significance was not reached ( p = 0.069). Milk treatments had no apparent effect on muscle soreness ( p = 0.152). Following muscle-damaging exercise, ingestion of 500 mL of A2 or regular milk can limit decrements in dynamic muscle function in male athletes, thus hastening recovery and improving subsequent performance. The findings propose A2 milk as an ergogenic aid following EIMD, and may offer an alternative to athletes intolerant to the A1 protein.

The SIRT1 activator SRT1720 extends lifespan and improves health of mice fed a standard diet.

PubMed

Mitchell, Sarah J; Martin-Montalvo, Alejandro; Mercken, Evi M; Palacios, Hector H; Ward, Theresa M; Abulwerdi, Gelareh; Minor, Robin K; Vlasuk, George P; Ellis, James L; Sinclair, David A; Dawson, John; Allison, David B; Zhang, Yongqing; Becker, Kevin G; Bernier, Michel; de Cabo, Rafael

2014-03-13

The prevention or delay of the onset of age-related diseases prolongs survival and improves quality of life while reducing the burden on the health care system. Activation of sirtuin 1 (SIRT1), an NAD(+)-dependent deacetylase, improves metabolism and confers protection against physiological and cognitive disturbances in old age. SRT1720 is a specific SIRT1 activator that has health and lifespan benefits in adult mice fed a high-fat diet. We found extension in lifespan, delayed onset of age-related metabolic diseases, and improved general health in mice fed a standard diet after SRT1720 supplementation. Inhibition of proinflammatory gene expression in both liver and muscle of SRT1720-treated animals was noted. SRT1720 lowered the phosphorylation of NF-κB pathway regulators in vitro only when SIRT1 was functionally present. Combined with our previous work, the current study further supports the beneficial effects of SRT1720 on health across the lifespan in mice. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

The Effects of Compression-Garment Pressure on Recovery After Strenuous Exercise.

PubMed

Hill, Jessica; Howatson, Glyn; van Someren, Ken; Gaze, David; Legg, Hayley; Lineham, Jack; Pedlar, Charles

2017-09-01

Compression garments are frequently used to facilitate recovery from strenuous exercise. To identify the effects of 2 different grades of compression garment on recovery indices after strenuous exercise. Forty-five recreationally active participants (n = 26 male and n = 19 female) completed an eccentric-exercise protocol consisting of 100 drop jumps, after which they were matched for body mass and randomly but equally assigned to a high-compression pressure (HI) group, a low-compression pressure (LOW) group, or a sham ultrasound group (SHAM). Participants in the HI and LOW groups wore the garments for 72 h postexercise; participants in the SHAM group received a single treatment of 10-min sham ultrasound. Measures of perceived muscle soreness, maximal voluntary contraction (MVC), countermovement-jump height (CMJ), creatine kinase (CK), C-reactive protein (CRP), and myoglobin (Mb) were assessed before the exercise protocol and again at 1, 24, 48, and 72 h postexercise. Data were analyzed using a repeated-measures ANOVA. Recovery of MVC and CMJ was significantly improved with the HI compression garment (P < .05). A significant time-by-treatment interaction was also observed for jump height at 24 h postexercise (P < .05). No significant differences were observed for parameters of soreness and plasma CK, CRP, and Mb. The pressures exerted by a compression garment affect recovery after exercise-induced muscle damage, with higher pressure improving recovery of muscle function.

The Effects of Montmorency Tart Cherry Concentrate Supplementation on Recovery Following Prolonged, Intermittent Exercise.

PubMed

Bell, Phillip G; Stevenson, Emma; Davison, Gareth W; Howatson, Glyn

2016-07-22

This study investigated Montmorency tart cherry concentrate (MC) supplementation on markers of recovery following prolonged, intermittent sprint activity. Sixteen semi-professional, male soccer players, who had dietary restrictions imposed for the duration of the study, were divided into two equal groups and consumed either MC or placebo (PLA) supplementation for eight consecutive days (30 mL twice per day). On day 5, participants completed an adapted version of the Loughborough Intermittent Shuttle Test (LISTADAPT). Maximal voluntary isometric contraction (MVIC), 20 m Sprint, counter movement jump (CMJ), agility and muscle soreness (DOMS) were assessed at baseline, and 24, 48 and 72 h post-exercise. Measures of inflammation (IL-1-β, IL-6, IL-8, TNF-α, hsCRP), muscle damage (CK) and oxidative stress (LOOH) were analysed at baseline and 1, 3, 5, 24, 48 and 72 h post-exercise. Performance indices (MVIC, CMJ and agility) recovered faster and muscle soreness (DOMS) ratings were lower in the MC group (p < 0.05). Additionally, the acute inflammatory response (IL-6) was attenuated in the MC group. There were no effects for LOOH and CK. These findings suggest MC is efficacious in accelerating recovery following prolonged, repeat sprint activity, such as soccer and rugby, and lends further evidence that polyphenol-rich foods like MC are effective in accelerating recovery following various types of strenuous exercise.

Impact of Ramadan intermittent fasting on cognitive function in trained cyclists: a pilot study.

PubMed

Chamari, K; Briki, W; Farooq, A; Patrick, T; Belfekih, T; Herrera, C P

2016-03-01

This study assessed selected measures of cognitive function in trained cyclists who observed daylight fasting during Ramadan. Eleven cyclists volunteered to participate (age: 21.6±4.8 years, VO2max: 57.7±5.6 ml kg(-1)·min(-1)) and were followed for 2 months. Cognitive function (Cambridge Neuropsychological Test Automated Battery (CANTAB), Reaction Time index (RTI) and Rapid Visual Information Processing (RVP) tests) and sleep architecture (ambulatory EEG) were assessed: before Ramadan (BR), in the 1st week (RA1) and 4th week of Ramadan (RA4), and 2 weeks post-Ramadan (PR). Both cognitive tests were performed twice per day: before and after Ramadan at 8-10 a.m. and 4-6 p.m., and during Ramadan at 4-6 p.m. and 0-2 a.m., respectively. Training load (TL) by the rating of perceived exertion (RPE) method and wellness (Hooper index) were measured daily. If the TL increased over the study period, this variable was stable during Ramadan. The perceived fatigue and delayed onset muscle soreness (DOMS) increased at RA4. Sleep patterns and architecture showed clear disturbances, with significant increases in the number of awakenings and light sleep durations during Ramadan (RA1 and RA4), together with decreased durations of deep and REM sleep stages at PR. RTI (simple and multiple reaction index) reaction and movement times did not vary over the study period. The RVP test showed reduced false alarms during Ramadan, suggesting reduced impulsivity. Overall accuracy significantly increased at RA1, RA4 and PR compared to baseline. At RA4, the accuracy was higher at 0-2 a.m. compared to 4-6 p.m. Despite the observed disturbances in sleep architecture, Ramadan fasting did not negatively impact the cognitive performance of trained cyclists from the Middle East.

Impact of Ramadan intermittent fasting on cognitive function in trained cyclists: a pilot study

PubMed Central

Briki, W; Farooq, A; Patrick, T; Belfekih, T; Herrera, CP

2015-01-01

This study assessed selected measures of cognitive function in trained cyclists who observed daylight fasting during Ramadan. Eleven cyclists volunteered to participate (age: 21.6±4.8 years, VO2max: 57.7±5.6 ml kg−1·min−1) and were followed for 2 months. Cognitive function (Cambridge Neuropsychological Test Automated Battery (CANTAB), Reaction Time index (RTI) and Rapid Visual Information Processing (RVP) tests) and sleep architecture (ambulatory EEG) were assessed: before Ramadan (BR), in the 1st week (RA1) and 4th week of Ramadan (RA4), and 2 weeks post-Ramadan (PR). Both cognitive tests were performed twice per day: before and after Ramadan at 8-10 a.m. and 4-6 p.m., and during Ramadan at 4-6 p.m. and 0-2 a.m., respectively. Training load (TL) by the rating of perceived exertion (RPE) method and wellness (Hooper index) were measured daily. If the TL increased over the study period, this variable was stable during Ramadan. The perceived fatigue and delayed onset muscle soreness (DOMS) increased at RA4. Sleep patterns and architecture showed clear disturbances, with significant increases in the number of awakenings and light sleep durations during Ramadan (RA1 and RA4), together with decreased durations of deep and REM sleep stages at PR. RTI (simple and multiple reaction index) reaction and movement times did not vary over the study period. The RVP test showed reduced false alarms during Ramadan, suggesting reduced impulsivity. Overall accuracy significantly increased at RA1, RA4 and PR compared to baseline. At RA4, the accuracy was higher at 0-2 a.m. compared to 4-6 p.m. Despite the observed disturbances in sleep architecture, Ramadan fasting did not negatively impact the cognitive performance of trained cyclists from the Middle East. PMID:26985134

Acute response to hydrotherapy after a simulated game of rugby.

PubMed

Higgins, Trevor R; Cameron, Melainie L; Climstein, Mike

2013-10-01

Despite lacking clear scientific evidence, hydrotherapies (water treatments) are accepted techniques to help team sport athletes recover from the physical effects of games. The purpose of this study was to assess the comparative effectiveness of cold water immersions (CWIs) and hot-and-cold contrast baths on athletes' recovery after a simulated game of rugby union. Twenty-four experienced, well-trained, male rugby union players were divided into 3 groups to receive recovery interventions: CWI for 1 group, contrast baths for a second group, and passive recovery for a third (control) group. Pregame and postgame measurements included a countermovement jump (normalized as a ratio to body weight), a sit-and-stretch flexibility test (centimeters), thigh circumference (to detect swelling; centimeters), and participants' perception of delayed-onset muscular soreness (DOMS, 100-mm visual analog scale). Statistical analysis included analysis of variance, and the calculation of omnibus effect sizes for each group ((Equation is included in full-text article.)) and the magnitudes of change within and between groups (Cohen's d). The participants in the contrast bath group reported statistically significantly greater measures of DOMS than participants in the control group did at 1 hour postintervention (p = 0.05, control group: d = 1.80; contrast bath: d = 4.75), and than participants in the CWI group did at 48 hours postintervention (p = 0.02, CWI: d = 1.17; contrast bath: d = 1.97). These findings provide modest evidence that contrast baths are a less effective strategy for recovery from rugby union than are CWI or passive recovery. Specifically, 2 × 5-minute CWI is superior to both contrasts baths and passive recovery in alleviating DOMS after exercise-induced muscle damage. Our recommendation for rugby union players aiming to attenuate the effects of DOMS postgames is to take 2 × 5-minute CWIs baths immediately after the game.

The stretch-shortening cycle : a model to study naturally occurring neuromuscular fatigue.

PubMed

Nicol, Caroline; Avela, Janne; Komi, Paavo V

2006-01-01

Neuromuscular fatigue has traditionally been examined using isolated forms of either isometric, concentric or eccentric actions. However, none of these actions are naturally occurring in human (or animal) ground locomotion. The basic muscle function is defined as the stretch-shortening cycle (SSC), where the preactivated muscle is first stretched (eccentric action) and then followed by the shortening (concentric) action. As the SSC taxes the skeletal muscles very strongly mechanically, its influence on the reflex activation becomes apparent and very different from the isolated forms of muscle actions mentioned above. The ground contact phases of running, jumping and hopping etc. are examples of the SSC for leg extensor muscles; similar phases can also be found for the upper-body activities. Consequently, it is normal and expected that the fatigue phenomena should be explored during SSC activities. The fatigue responses of repeated SSC actions are very versatile and complex because the fatigue does not depend only on the metabolic loading, which is reportedly different among muscle actions. The complexity of SSC fatigue is well reflected by the recovery patterns of many neuromechanical parameters. The basic pattern of SSC fatigue response (e.g. when using the complete exhaustion model of hopping or jumping) is the bimodality showing an immediate reduction in performance during exercise, quick recovery within 1-2 hours, followed by a secondary reduction, which may often show the lowest values on the second day post-exercise when the symptoms of muscle soreness/damage are also greatest. The full recovery may take 4-8 days depending on the parameter and on the severity of exercise. Each subject may have their own time-dependent bimodality curve. Based on the reviewed literature, it is recommended that the fatigue protocol is 'completely' exhaustive to reduce the important influence of inter-subject variability in the fatigue responses. The bimodality concept is especially apparent for stretch reflex responses, measured either in passive or active conditions. Interestingly, the reflex responses follow parallel changes with some of the pure mechanical parameters, such as yielding of the braking force during an initial ground contact of running or hopping. The mechanism of SSC fatigue and especially the bimodal response of performance deterioration and its recovery are often difficult to explain. The immediate post-exercise reduction in most of the measured parameters and their partial recovery 1-2 hours post-exercise can be explained primarily to be due to metabolic fatigue induced by exercise. The secondary reduction in these parameters takes place when the muscle soreness is highest. The literature gives several suggestions including the possible structural damage of not only the extrafusal muscle fibres, but also the intrafusal ones. Temporary changes in structural proteins and muscle-tendon interaction may be related to the fatigue-induced force reduction. Neural adjustments in the supraspinal level could naturally be operative, although many studies quoted in this article emphasise more the influences of exhaustive SSC fatigue on the fusimotor-muscle spindle system. It is, however, still puzzling why the functional recovery lasts several days after the disappearance of muscle soreness. Unfortunately, this and many other possible mechanisms need more thorough testing in animal models provided that the SSC actions can be truly performed as they appear in normal human locomotion.

Exercise-induced muscle damage and the repeated bout effect: evidence for cross transfer.

PubMed

Starbuck, Chelsea; Eston, Roger G

2012-03-01

We examined whether a prior bout of eccentric exercise in the elbow flexors provided protection against exercise-induced muscle damage in the contralateral arm. Fifteen males (age 22.7 ± 2.1 years; height 178.6 ± 6.8 cm, mass 75.8 ± 9.3 kg) were randomly assigned to two groups who performed two bouts of 60 eccentric contractions (30°/s) separated by 2 weeks: ipsilateral (n = 7, both bouts performed in the same arm), contralateral (n = 8, one bout performed in each arm). Strength, muscle soreness and resting arm angle (RAA) were measured at baseline and at 1, 24 and 48 h post exercise. Surface electromyography was recorded during both bouts of exercise. The degree of strength loss was attenuated (p < 0.05) in the ipsilateral group after the second bout of eccentric exercise (-22 cf. -3% for bout 1 and 2 at 24 h, respectively). Strength loss following eccentric exercise was also attenuated (p < 0.05) at 24 h in the contralateral group (-30 cf. 13% for bout 1 and 2, respectively). Muscle soreness (≈34 cf 19 mm) and change in RAA (≈5 cf. 3%) were also lower following the second bout of eccentric exercise (p < 0.05), although there was no difference in the overall change in these values between groups. Median frequency (MF) was decreased by 31% between bouts, with no difference between groups. Data support observations that the repeated bout effect transfers to the opposite (untrained) limb. The similar reduction in MF between bouts for the two groups provides evidence for a centrally mediated, neural adaptation.

Plasma Actin, Gelsolin and Orosomucoid Levels after Eccentric Exercise.

PubMed

Tékus, Éva; Váczi, Márk; Horváth-Szalai, Zoltán; Ludány, Andrea; Kőszegi, Tamás; Wilhelm, Márta

2017-02-01

The present study investigated the acute effect of eccentric exercise on blood plasma actin, gelsolin (GSN) and orosomucoid (AGP) levels in untrained and moderately trained individuals, and their correlation with exercise induced muscle damage (EIMD) markers (CK, intensity of muscle soreness and maximal voluntary contraction torque deficit). Healthy physical education students (6 untrained, 12 moderately trained) participated in this research. Actin, GSN, AGP and CK levels were measured in blood plasma at baseline, immediately, 1 h, 6 h and 24 h post-exercise comprising 90 eccentric quadriceps contractions performed on a dynamometer. There was significant time main effect for GSN, AGP, CK and significant difference was found between baseline and the lowest value of post-exercise GSN (p < 0.05), as well as baseline and the highest value of post-exercise AGP (p < 0.05). Relationships were found between GSN levels and other indirect EIMD markers (between all GSN levels at post-exercise and CK activity at 6 h, p < 0.05; GSNMIN and muscle soreness at post-exercise, p < 0.04), GSN and AGP; however, actin did not correlate at any time points with GSN. Actin, GSN, AGP and CK responses after eccentric exercise do not seem sensitive to training status. The plasma actin level is used as an indicator of injury, however, our results suggest that it is not an accurate marker of EIMD, while plasma GSN concentrations show a better relationship with EIMD and the post-exercise inflammatory process. The elevated plasma AGP and the correlation between GSN and AGP seem to be promising for assessment of exercise-induced muscle injury.

Plasma Actin, Gelsolin and Orosomucoid Levels after Eccentric Exercise

PubMed Central

Váczi, Márk; Horváth-Szalai, Zoltán; Ludány, Andrea; Kőszegi, Tamás; Wilhelm, Márta

2017-01-01

Abstract The present study investigated the acute effect of eccentric exercise on blood plasma actin, gelsolin (GSN) and orosomucoid (AGP) levels in untrained and moderately trained individuals, and their correlation with exercise induced muscle damage (EIMD) markers (CK, intensity of muscle soreness and maximal voluntary contraction torque deficit). Healthy physical education students (6 untrained, 12 moderately trained) participated in this research. Actin, GSN, AGP and CK levels were measured in blood plasma at baseline, immediately, 1 h, 6 h and 24 h post-exercise comprising 90 eccentric quadriceps contractions performed on a dynamometer. There was significant time main effect for GSN, AGP, CK and significant difference was found between baseline and the lowest value of post-exercise GSN (p < 0.05), as well as baseline and the highest value of post-exercise AGP (p < 0.05). Relationships were found between GSN levels and other indirect EIMD markers (between all GSN levels at post-exercise and CK activity at 6 h, p < 0.05; GSNMIN and muscle soreness at post-exercise, p < 0.04), GSN and AGP; however, actin did not correlate at any time points with GSN. Actin, GSN, AGP and CK responses after eccentric exercise do not seem sensitive to training status. The plasma actin level is used as an indicator of injury, however, our results suggest that it is not an accurate marker of EIMD, while plasma GSN concentrations show a better relationship with EIMD and the post-exercise inflammatory process. The elevated plasma AGP and the correlation between GSN and AGP seem to be promising for assessment of exercise-induced muscle injury. PMID:28469748

Optimal timing of pulse onset for language mapping with navigated repetitive transcranial magnetic stimulation.

PubMed

Krieg, Sandro M; Tarapore, Phiroz E; Picht, Thomas; Tanigawa, Noriko; Houde, John; Sollmann, Nico; Meyer, Bernhard; Vajkoczy, Peter; Berger, Mitchel S; Ringel, Florian; Nagarajan, Srikantan

2014-10-15

Within the primary motor cortex, navigated transcranial magnetic stimulation (nTMS) has been shown to yield maps strongly correlated with those generated by direct cortical stimulation (DCS). However, the stimulation parameters for repetitive nTMS (rTMS)-based language mapping are still being refined. For this purpose, the present study compares two rTMS protocols, which differ in the timing of pulse train onset relative to picture presentation onset during object naming. Results were the correlated with DCS language mapping during awake surgery. Thirty-two patients with left-sided perisylvian tumors were examined by rTMS prior to awake surgery. Twenty patients underwent rTMS pulse trains starting at 300 ms after picture presentation onset (delayed TMS), whereas another 12 patients received rTMS pulse trains starting at the picture presentation onset (ONSET TMS). These rTMS results were then evaluated for correlation with intraoperative DCS results as gold standard in terms of differential consistencies in receiver operating characteristics (ROC) statistics. Logistic regression analysis by protocols and brain regions were conducted. Within and around Broca's area, there was no difference in sensitivity (onset TMS: 100%, delayed TMS: 100%), negative predictive value (NPV) (onset TMS: 100%, delayed TMS: 100%), and positive predictive value (PPV) (onset TMS: 55%, delayed TMS: 54%) between the two protocols compared to DCS. However, specificity differed significantly (onset TMS: 67%, delayed TMS: 28%). In contrast, for posterior language regions, such as supramarginal gyrus, angular gyrus, and posterior superior temporal gyrus, early pulse train onset stimulation showed greater specificity (onset TMS: 92%, delayed TMS: 20%), NPV (onset TMS: 92%, delayed TMS: 57%) and PPV (onset TMS: 75%, delayed TMS: 30%) with comparable sensitivity (onset TMS: 75%, delayed TMS: 70%). Logistic regression analysis also confirmed the greater fit of the predictions by rTMS that had the pulse train onset coincident with the picture presentation onset when compared to the delayed stimulation. Analyses of differential disruption patterns of mapped cortical regions were further able to distinguish clusters of cortical regions standardly associated with semantic and pre-vocalization phonological networks proposed in various models of word production. Repetitive nTMS predictions by both protocols correlate well with DCS outcomes especially in Broca's region, particularly with regard to TMS negative predictions. With this study, we have demonstrated that rTMS stimulation onset coincident with picture presentation onset improves the accuracy of preoperative language maps, particularly within posterior language areas. Moreover, immediate and delayed pulse train onsets may have complementary disruption patterns that could differentially capture cortical regions causally necessary for semantic and pre-vocalization phonological networks. Published by Elsevier Inc.

The Pacman Perforator-Based V-Y Advancement Flap for Reconstruction of Pressure Sores at Different Locations.

PubMed

Bonomi, Stefano; Salval, André; Brenta, Federica; Rapisarda, Vincenzo; Settembrini, Fernanda

2016-09-01

Many procedures have been proposed for the treatment of pressure sores, and V-Y advancement flaps are widely used to repair a defect. Unfortunately, the degree of mobility of a V-Y advancement flap is dependent on the laxity of the underlying subcutaneous tissue. This is an important disadvantage of traditional V-Y advancement flap and limits its use.We used V-Y advancement flaps as perforator-based to overcome mobility restriction problem, with a further modification (Pacman-like shape) to improve the covering surface area of the flap. Between January 2012 and December 2014, the authors used 37 V-Y Pacman perforator-based flaps in 33 consecutive patients for coverage of defects located at sacral (n = 21), ischial (n = 13), trochanter (n = 1) regions. There were 27 male and 6 female patients with a mean age of 49.9 years (range, 15-74 years). All flaps survived completely (92.3%) except 3 in which one of them had undergone total necrosis due to hematoma and the other 2 had partial necrosis. No venous congestion was observed. The mean follow-up period was 14.9 months (range, 2-38 months). No flap surgery-related mortality or recurrence of pressure sores was noted. The V-Y Pacman perforator-based advancement flaps are safe and very effective for reconstruction of pressure sores at various regions. The advantage of our modification procedure include shorter operative time, lesser pedicle dissection, low donor site morbidity, good preservation of muscle, and offers remarkable excursion to the V-Y flap, which make the V-Y Pacman perforator-based flaps an excellent choice for large pressure sore coverage.

Arousal mechanisms related to posture and locomotion: 1. Descending modulation.

PubMed

Garcia-Rill, Edgar; Homma, Yutaka; Skinner, Robert D

2004-01-01

Much of the controversy surrounding the induction of locomotion following stimulation of mesopontine sites, including the pedunculopontine nucleus (PPN), appears based on procedural differences, including stimulus onset, delay preceding stepping, and frequency of stimuli. The results reviewed in this chapter address these issues and provide novel information suggesting that descending projections from the PPN may exert a frequency-dependent effect. Stimulation at approximately 60 Hz (which induces prolonged tonic firing) may exercise a "push" towards locomotion (activation of pontine interneurons) as well as a "pull" away from decreased muscle tone (inhibiting giant pontine reticulospinal cells). Higher frequencies of stimulation (> 100 Hz, which induces phasic burst-like activity) may "push" towards decreases in muscle tone, including the atonia of rapid eye movement sleep (activating giant pontine reticulospinal cells).

MR elastography measurement of the effect of passive warmup prior to eccentric exercise on thigh muscle mechanical properties

PubMed Central

Kennedy, Paul; Macgregor, Lewis J.; Barnhill, Eric; Johnson, Curtis L.; Perrins, Michael; Hunter, Angus; Brown, Colin; van Beek, Edwin J.R.

2017-01-01

Purpose To investigate the effect of warmup by application of the thermal agent Deep Heat (DH) on muscle mechanical properties using magnetic resonance elastography (MRE) at 3T before and after exercise‐induced muscle damage (EIMD). Materials and Methods Twenty male participants performed an individualized protocol designed to induce EIMD in the quadriceps. DH was applied to the thigh in 50% of the participants before exercise. MRE, T 2‐weighted MRI, maximal voluntary contraction (MVC), creatine kinase (CK) concentration, and muscle soreness were measured before and after the protocol to assess EIMD effects. Five participants were excluded: four having not experienced EIMD and one due to incidental findings. Results Total workload performed during the EIMD protocol was greater in the DH group than the control group (P < 0.03), despite no significant differences in baseline MVC (P = 0.23). Shear stiffness |G*| increased in the rectus femoris (RF) muscle in both groups (P < 0.03); however, DH was not a significant between‐group factor (P =  0.15). MVC values returned to baseline faster in the DH group (5 days) than the control group (7 days). Participants who displayed hyperintensity on T 2‐weighted images had a greater stiffness increase following damage than those without: RF; 0.61 kPa vs. 0.15 kPa, P < 0.006, vastus intermedius; 0.34 kPa vs. 0.03 kPa, P = 0.06. Conclusion EIMD produces increased muscle stiffness as measured by MRE, with the change in |G*| significantly increased when T 2 hyperintensity was present. DH did not affect CK concentration or soreness; however, DH participants produced greater workload during the EIMD protocol and exhibited accelerated MVC recovery. Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1115–1127. PMID:28218814

Direct muscle delivery of GDNF with human mesenchymal stem cells improves motor neuron survival and function in a rat model of familial ALS

PubMed Central

Suzuki, Masatoshi; McHugh, Jacalyn; Tork, Craig; Shelley, Brandon; Hayes, Antonio; Bellantuono, Ilaria; Aebischer, Patrick; Svendsen, Clive N.

2008-01-01

Amyotrophic Lateral Sclerosis (ALS) is a fatal neurodegenerative disease in which there is a progressive loss of motor neurons and their connections to muscle leading to paralysis. To maintain muscle connections in a rat model of familial ALS, we performed intramuscular transplantation with human mesenchymal stem cells (hMSC) as “Trojan horses” to deliver growth factors to the terminals of motor neurons as well as the skeletal muscles. hMSC engineered to secrete glial cell line derived neurotrophic factor (hMSC-GDNF) were transplanted bilaterally into three muscle groups. The cells survived within the muscle, released GDNF, and significantly increased the number of neuromuscular connections and motor neuron cell bodies in the spinal cord at mid stages of the disease. Furthermore, intramuscular transplantation with hMSC-GDNF could ameliorate motor neuron loss within the spinal cord which connected to the limb muscles with transplants. While disease onset was similar in all animals, hMSC-GDNF significantly delayed disease progression, increasing overall lifespan by up to 28 days, which is one of the longest effects on survival noted for this rat model of familial ALS. This pre-clinical data provides a novel and practical approach towards ex vivo gene therapy for ALS. PMID:18797452

Direct muscle delivery of GDNF with human mesenchymal stem cells improves motor neuron survival and function in a rat model of familial ALS.

PubMed

Suzuki, Masatoshi; McHugh, Jacalyn; Tork, Craig; Shelley, Brandon; Hayes, Antonio; Bellantuono, Ilaria; Aebischer, Patrick; Svendsen, Clive N

2008-12-01

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease in which there is a progressive loss of motor neurons and their connections to muscle, leading to paralysis. In order to maintain muscle connections in a rat model of familial ALS (FALS), we performed intramuscular transplantation with human mesenchymal stem cells (hMSCs) used as "Trojan horses" to deliver growth factors to the terminals of motor neurons and to the skeletal muscles. hMSCs engineered to secrete glial cell line-derived neurotrophic factor (hMSC-GDNF) were transplanted bilaterally into three muscle groups. The cells survived within the muscle, released GDNF, and significantly increased the number of neuromuscular connections and motor neuron cell bodies in the spinal cord at mid-stages of the disease. Further, intramuscular transplantation with hMSC-GDNF was found to ameliorate motor neuron loss within the spinal cord where it connects with the limb muscles receiving transplants. While disease onset was similar in all the animals, hMSC-GDNF significantly delayed disease progression, increasing overall lifespan by up to 28 days, which is one of the largest effects on survival noted for this rat model of FALS. This preclinical data provides a novel and practical approach toward ex vivo gene therapy for ALS.

Evaluation of clinical measures and different criteria for diagnosis of adult-onset Still's disease in a Chinese population.

PubMed

Jiang, Lindi; Wang, Zhen; Dai, Xiaomin; Jin, Xuejuan

2011-04-01

To determine the value of clinical measures in diagnosis of adult-onset Still's disease (AOSD), and to identify the optimal set of proposed classification criteria, in a Chinese population. A total of 70 patients with AOSD and 140 non-AOSD inpatients with fever were retrospectively identified at Zhongshan Hospital, Shanghai, from January 2003 to December 2009. Clinical measures and 4 sets of diagnostic criteria (Yamaguchi, Calabro, Cush, and Reginato) were evaluated by sensitivity, specificity, positive/negative predictive value (PPV, NPV), and positive/negative likelihood ratio (PLR, NLR) for diagnosis of AOSD. In our series, higher sensitivity included hyperpyrexia (temperature ≥ 39°C, 94.29%), arthralgia (80.0%), polymorphonuclear neutrophils (PMN) ≥ 75% (84.29%), serum ferritin ≥ 2-fold the upper normal value (90.0%), negative antinuclear antibodies (85.29%), and rheumatoid factor (84.38%); while higher specificity included transient erythema (98.57%), sore throat (85.0%), leukocytes ≥ 15,000/mm(3) (87.86%), and PMN ≥ 85% (85.0%). Rash, arthralgia, and sore throat were found to have better sensitivity and specificity (PLR 3.29-4.86). Leukocytes ≥ 10,000/mm(3), PMN ≥ 80%, and serum ferritin ≥ 5-fold the upper normal limit were set as critical points. The Reginato criteria set had the highest specificity, 99.29%. The Yamaguchi set had the highest sensitivity, 78.57%, with a better accuracy of 87.14%. The Yamaguchi diagnostic criteria had better accuracy in Chinese patients. Indicators such as rash, arthralgia, sore throat, leukocytes ≥ 10,000/mm(3), PMN ≥ 80%, and serum ferritin ≥ 5-fold the upper normal limit were helpful for diagnosis of AOSD. We recommend using these indicators in combination instead of alone.

Effect of cryotherapy on muscle recovery and inflammation following a bout of damaging exercise.

PubMed

Crystal, Naomi J; Townson, David H; Cook, Summer B; LaRoche, Dain P

2013-10-01

The purpose of this study was to determine the effect of cryotherapy on the inflammatory response to muscle-damaging exercise using a randomized trial. Twenty recreationally active males completed a 40-min run at a -10 % grade to induce muscle damage. Ten of the subjects were immersed in a 5 °C ice bath for 20 min and the other ten served as controls. Knee extensor peak torque, soreness rating, and thigh circumference were obtained pre- and post-run, and 1, 6, 24, 48, and 72 h post-run. Blood samples were obtained pre- and post-run, and 1, 6 and 24 h post-run for assay of plasma chemokine ligand 2 (CCL2). Peak torque decreased from 270 ± 57 Nm at baseline to 253 ± 65 Nm post-run and increased to 295 ± 68 Nm by 72 h post-run with no differences between groups (p = 0.491). Soreness rating increased from 3.6 ± 6.0 mm out of 100 mm at baseline to 47.4 ± 28.2 mm post-run and remained elevated at all time points with no differences between groups (p = 0.696). CCL2 concentrations increased from 116 ± 31 pg mL(-1) at baseline to 293 ± 109 pg mL(-1) at 6 h post-run (control) and from 100 ± 27 pg mL(-1) at baseline to 208 ± 71 pg mL(-1) at 6 h post-run (cryotherapy). The difference between groups was not significant (p = 0.116), but there was a trend for lower CCL2 in the cryotherapy group at 6 h (p = 0.102), though this measure was highly variable. In conclusion, 20 min of cryotherapy was ineffective in attenuating the strength decrement and soreness seen after muscle-damaging exercise, but may have mitigated the rise in plasma CCL2 concentration. These results do not support the use of cryotherapy during recovery.

Correlation between stiffness and electromechanical delay components during muscle contraction and relaxation before and after static stretching.

PubMed

Longo, Stefano; Cè, Emiliano; Rampichini, Susanna; Devoto, Michela; Venturelli, Massimo; Limonta, Eloisa; Esposito, Fabio

2017-04-01

The study was aimed at assessing possible correlations of the electromechanical delay components during muscle contraction (Delay TOT ) and relaxation (R-Delay TOT ), with muscle-tendon unit (MTU), muscle, and tendon stiffness before and after static stretching (SS). Plantarflexor muscles' maximum voluntary torque (T max ) was measured in 18 male participants (age 24±3yrs; body mass 76.4±8.9kg; stature 1.78±0.09m; mean±SD). During T max , surface electromyogram (EMG), mechanomyogram, and force signals were detected. Delay TOT and R-Delay TOT with their electrochemical and mechanical components were calculated. Passive torque and myotendinous junction displacement were assessed at 0°, 10° and 20° of dorsiflexion to determine MTU, muscle and tendon stiffness. The same protocol was repeated after SS. Delay TOT , R-Delay TOT and their mainly mechanical components correlated with MTU, muscle and tendon stiffness, both before (R 2 from 0.562 to 0.894; p<0.001) and after SS (R 2 from 0.726 to 0.955; p<0.001). SS decreased T max (-14%; p<0.001) and lengthened almost all the Delay TOT and R-Delay TOT components (from +5.9% to +30.5%; p<0.05). Correlations were found only between stiffness and the mechanical components of Delay TOT and R-Delay TOT . Correlations persisted after SS but delays increased to a higher extent than stiffness, indicating a complexity of the relationship between stiffness and delays that will be discussed in the manuscript. Copyright © 2017 Elsevier Ltd. All rights reserved.

RESPIRATORY MODULATION OF LINGUAL MUSCLE ACTIVITY ACROSS SLEEP-WAKE STATES IN RATS

PubMed Central

Stettner, Georg M.; Rukhadze, Irma; Mann, Graziella L.; Lei, Yanlin; Kubin, Leszek

2013-01-01

In obstructive sleep apnea (OSA) patients, inspiratory activation (IA) of lingual muscles protects the upper airway from collapse. We aimed to determine when rats’ lingual muscles exhibit IA. In 5 Sprague-Dawley and 3 Wistar rats, we monitored cortical EEG and lingual, diaphragmatic and nuchal electromyograms (EMGs), and identified segments of records when lingual EMG exhibited IA. Individual segments lasted 2.4–269 s (median: 14.5 s), most (89%) occurred during slow-wave sleep (SWS), and they collectively occupied 0.3–6.1% of the total recording time. IA usually started to increase with a delay after SWS onset and ended with an arousal, or declined prior to rapid eye movement sleep. IA of lingual EMG was not accompanied by increased diaphragmatic activity or respiratory rate changes, but occurred when cortical EEG power was particularly low in a low beta-1 frequency range (12.5–16.4 Hz). A deep SWS-related activation of upper airway muscles may be an endogenous phenomenon designed to protect the upper airway against collapse. PMID:23732510

Health hazard evaluation report HETA 84-419-1697, USGS Laboratory, Doraville, Georgia. [Benzene, methylene chloride, hexane, and acetone

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rondinelli, R.; Wilcox, T.; Roper, P.

1986-05-01

The U.S. Geological Survey National Water Quality Laboratory, Doraville, Georgia requested an evaluation of physical complaints reported by employees to determine possible work related causes. Laboratory workers, in general, complained of physical symptoms which were irritative (rash, sore throat, nose or sinus irritation), neurological (numbness, muscle weakness) and nonspecific (dizziness, headache, emotional swings, insomnia, muscle aching, fatigue). Reported exposure to solvents such as benzene, methylene chloride, hexane and acetone were positively related with light headedness or dizziness, numbness, unexplained muscle weakness and muscle aching. Air sampling did not reveal any remarkable exposure to chemical contaminants. The authors conclude that nomore » relationship could be established between chemical exposures and antinuclear antibody positivity. Exposure to chemicals measured by air sampling were below occupational health exposure limits.« less

Remodeling of the neuromuscular junction precedes sarcopenia related alterations in myofibers.

PubMed

Deschenes, Michael R; Roby, Mackenzie A; Eason, Margaret K; Harris, M Brennan

2010-05-01

Several mechanisms contributing to the etiology of sarcopenia (age-related loss of muscle size) have been postulated. One of these attributes the loss of muscle mass to a preceding age-related denervation of myofibers. The aim of this study was to determine if signs of denervation were apparent at the neuromuscular junction (NMJ) before fiber atrophy, or fiber type conversion could be documented, and to reveal if a muscle's activity level impacts its sensitivity to age-related denervation. Plantaris and soleus muscles were obtained from young adult (10 months) and early aged (21 months) rats. Pre- and post-synaptic NMJ morphology was quantified with cytofluorescent staining of nerve terminal branches and endplate regions, respectively. Myofiber profiles (fiber size and fiber type composition) were assessed with histochemical procedures. Results show that in the lightly recruited plantaris, significant (P<0.05) signs of denervation were noted in aged rats, while the same muscles displayed no change in myofiber profile. In the heavily recruited soleus, however, there was little evidence of denervation, and again no alterations in myofiber profile. These results indicate that age-related denervation occurs before myofiber atrophy, and that high amounts of neuromuscular activity may delay the onset of age-related denervation and sarcopenia.

The Next Step in Understanding Impaired Reactive Balance Control in People With Stroke: The Role of Defective Early Automatic Postural Responses.

PubMed

de Kam, Digna; Roelofs, Jolanda M B; Bruijnes, Amber K B D; Geurts, Alexander C H; Weerdesteyn, Vivian

2017-08-01

Postural muscle responses are often impaired after stroke. We aimed to identify the contribution of deficits in very early postural responses to poorer reactive balance capacity, with a particular focus on reactive stepping as a key strategy for avoiding falls. A total of 34 chronic stroke survivors and 17 controls were subjected to translational balance perturbations in 4 directions. We identified the highest perturbation intensity that could be recovered without stepping (single stepping threshold [SST]) and with maximally 1 step (multiple stepping threshold [MST]). We determined onset latencies and response amplitudes of 7 leg muscles bilaterally and identified associations with balance capacity. People with stroke had a lower MST than controls in all directions. Side steps resulted in a higher lateral MST than crossover steps but were less common toward the paretic side. Postural responses were delayed and smaller in amplitude on the paretic side only. We observed the strongest associations between gluteus medius (GLUT) onset and amplitude and MST toward the paretic side ( R 2 = 0.33). Electromyographic variables were rather weakly associated with forward and backward MSTs ( R 2 = 0.10-0.22) and with SSTs ( R 2 = 0.08-0.15). Delayed and reduced paretic postural responses are associated with impaired reactive stepping after stroke. Particularly, fast and vigorous activity of the GLUT is imperative for overcoming large sideways perturbations, presumably because it facilitates the effective use of side steps. Because people with stroke often fall toward the paretic side, this finding indicates an important target for training.

Antinociceptive reflex alteration in acute posttraumatic headache following whiplash injury.

PubMed

Keidel, M; Rieschke, P; Stude, P; Eisentraut, R; van Schayck, R; Diener, H

2001-06-01

Brainstem-mediated antinociceptive inhibitory reflexes of the temporalis muscle were investigated in 82 patients (47 F, 35 M, mean age 28.3 years, SD 9.4) with acute posttraumatic headache (PH) following whiplash injury but without neurological deficits, bone injury of the cervical spine or a combined direct head trauma on average 5 days after the acceleration trauma. Latencies and durations of the early and late exteroceptive suppression (ES1 and ES2) and the interposed EMG burst (IE) of the EMG of the voluntarily contracted right temporalis muscle evoked by ipsilateral stimulation of the second and third branches of the trigeminal nerve were analyzed and compared to a cohort of 82 normal subjects (43 F, 39 M, mean age 27.7 years, SD 7.1). Highly significant reflex alterations were found in patients with PH with a shortening of ES2 duration with delayed onset and premature ending as the primary parameter of this study, a moderate prolongation of ES1 and IE duration and a delayed onset of IE. The latency of ES1 was not significantly changed. These findings indicate that acute PH in whiplash injury is accompanied by abnormal antinociceptive brainstem reflexes. We conclude that the abnormality of the trigeminal inhibitory temporalis reflex is based on a transient dysfunction of the brainstem-mediated reflex circuit mainly of the late polysynaptic pathways. The reflex abnormalities are considered as a neurophysiological correlate of the posttraumatic (cervico)-cephalic pain syndrome. They point to an altered central pain control in acute PH due to whiplash injury.

Prolonged survival and improved glycemia in BioBreeding diabetic rats after early sustained exposure to glucagon-like peptide 1.

PubMed

Yanay, Ofer; Moralejo, Daniel; Kernan, Kelly; Brzezinski, Margaret; Fuller, Jessica M; Barton, Randall W; Lernmark, Ake; Osborne, William R

2010-06-01

Type 1 diabetes (T1D) in both humans and BioBreeding (BB) rats is an autoimmune disease that results in complete destruction of islets and insulin dependency for life. Glucagon-like peptide 1 (GLP-1) promotes beta cell proliferation and neogenesis and has a potent insulinotropic effect. We hypothesized that the expression of GLP-1 before disease onset would increase islet mass, delay diabetes and prolong survival of BB rats. Vascular smooth muscle cells retrovirally transduced to secrete GLP-1 were seeded into TheraCyte encapsulation devices, implanted subcutaneously, and rats were monitored for diabetes. In untreated control rats, plasma GLP-1 levels were 34.5-39.5 pmol/l, whereas, in treated rats, plasma levels were elevated, in the range 90-250.4 pmol/l. Hypoglycemia was not detected and this was anticipated from the glucose-regulated action of GLP-1. Diabetes onset (mean + or - SEM) in untreated rats occurred at 56.5 + or - 0.6 days (n = 6) and, in GLP-1-treated rats, was delayed until 76.4 + or - 3.3 days (n = 5) (p < 0.001). After disease onset, untreated control rats showed a rapid weight loss and elevated blood glucose (>650 mg/dl) and did not survive beyond 11 days. At 5 days after diabetes onset, insulin-secreting islets were absent in untreated rats. By contrast, treated rats maintained weight for up to 143 days of age and showed insulin-secreting beta cells. Sustained GLP-1 expression delivered by encapsulated cells before diabetes onset in BB rats showed an improved clinical outcome, suggesting the potential for treating patients using long lasting GLP-1 analogs.

Perturbation to Cholesterol at the Neuromuscular Junction Confers Botulinum Neurotoxin A Sensitivity to Neonatal Mice.

PubMed

Thyagarajan, Baskaran; Potian, Joseph G; McArdle, Joseph J; Baskaran, Padmamalini

2017-09-01

Botulinum neurotoxin A (BoNT/A) cleaves SNAP25 at the motor nerve terminals and inhibits stimulus evoked acetylcholine release. This causes skeletal muscle paralysis. However, younger neonatal mice (P7) mice. However, neonatal mice younger than 7 days-age remained unaffected by BoNT/A injection. Also, BoNT/A inhibited stimulus evoked acetylcholine release and stimulus-evoked twitch tension of diaphragm nerve muscle preparations (NMPs) of adult mouse and >P7 neonates but not that of P7. However, cholesterol depletion using methyl-β-cyclodextrin (MβCD) sensitized

Sarcopenia and nutrition.

PubMed

Laviano, Alessandro; Gori, Chiara; Rianda, Serena

2014-01-01

Preserving or restoring adequate nutritional status is a key factor to delay the onset of chronic diseases and to accelerate recovery from acute illnesses. In particular, consistent and robust data show the loss of muscle mass, that is, sarcopenia, is clinically relevant since it is closely related to increased morbidity and mortality in healthy individuals and patients. Sarcopenia is defined as the age-related loss of muscle mass and function. International study groups have recently proposed separate definitions and diagnostic criteria for sarcopenia. Unfortunately, the rate of agreement in assessing the prevalence of sarcopenia is just fair, which highlights the need for a common effort to harmonize definitions and diagnostic criteria. Sarcopenia should be distinct from myopenia, which is the disease-associated loss of muscle mass, although in clinical practice it may be impossible to separate them (i.e., in old cancer patients). The pathogenesis of sarcopenia is complex and multifactorial. Consequently, its treatment should target the different factors involved, including quantitatively and qualitatively inappropriate food intake and reduced physical activity. © 2014 Elsevier Inc. All rights reserved.

Differential Roles for the Thyroarytenoid and Lateral Cricoarytenoid Muscles in Phonation

PubMed Central

Chhetri, Dinesh K.; Neubauer, Juergen

2015-01-01

Objective Laryngeal adductor muscle dysfunction is common cause of voice disorders. Reconstitution of adductor muscle function is often the target of therapy, but the effects of these muscles on voice production remain to be fully understood. This study investigated the differential roles of thyroarytenoid (TA) and lateral cricoarytenoid (LCA) muscles on voice production. Study Design Basic science study using an in vivo canine model of phonation. Methods The TA and LCA muscle nerve branches were stimulated to obtain 7 graded levels of muscle activation, from threshold to maximal contraction. The effects of LCA activation alone, TA activation alone, and combined TA and LCA activation on phonation onset parameters were investigated. Phonatory posture, phonation onset type, fundamental frequency (F0), phonation onset pressure, and airflow were evaluated. Results LCA activation closed the posterior glottis but mid-membranous gap remained. TA activation closed the membranous glottis but posterior gap remained. Complete glottal closure was obtained only with combined TA and LCA activation. Phonation onset with LCAs alone was characterized by multiple modes (soft, aperiodic, periodic), while with TAs alone was abrupt and periodic but had significant baseline noise. Combined muscle activation led to elimination of baseline noise with stable abrupt periodic onset of phonation. Combined muscle activation was also necessary for F0 variation. LCA assisted the TA in increasing subglottal pressure while concurrently reducing phonation onset airflow. Conclusion TA is necessary for F0 variation, stable onset phonation, and increased subglottal pressure but needs LCA for optimal effectiveness and to reduce airflow requirements with increased activation. PMID:26198167

Efficacy of flurbiprofen 8.75 mg delivered as a spray or lozenge in patients with sore throat due to upper respiratory tract infection: a randomized, non-inferiority trial in the Russian Federation

PubMed Central

Radkova, Eugenia; Burova, Natalia; Bychkova, Valeria; DeVito, Robert

2017-01-01

Objective To assess the efficacy of flurbiprofen 8.75 mg delivered as a spray or lozenge in patients with sore throat due to upper respiratory tract infection (URTI). Materials and methods This multicenter, double-blind, double-dummy, non-inferiority study randomized 440 adults with recent-onset, moderate-to-severe sore throat due to URTI to a single dose of either flurbiprofen 8.75 mg spray (n=218) or flurbiprofen 8.75 mg lozenge (n=222). The presence or absence of beta-hemolytic streptococci (A or C) was confirmed by culture tests (throat swab). The primary efficacy end point was the difference from baseline to 2 hours post-dose in sore throat pain intensity scale (STPIS pain intensity difference [PID] 2h), a validated 100 mm visual analog scale (from 0=“no pain” to 100=“severe pain”), with a non-inferiority margin of −6 mm. Secondary end points included STPIS PID at 1 hour (STPIS PID 1h) and over 2 hours (STPIS sum of sore throat pain intensity differences [SPID]0–2h) and ratings of patient satisfaction and investigator assessment of drug efficacy at 2 hours. Safety (adverse events [AEs]) was also assessed. Results Reductions in sore throat pain intensity at 2 hours (STPIS PID 2h) were similar for spray (least square mean −40.51) and lozenge (−40.10) (difference: 0.41, 95% confidence interval [95% CI] −3.20, 4.01), with non-inferiority demonstrated. Subgroup analyses showed similar efficacy (STPIS PID 2h) for patients testing positive or negative for Strep A or C. There was no significant difference between spray and lozenge in STPIS PID 1h or STPIS SPID0–2h, and patient satisfaction and investigators’ assessment of efficacy at 2 hours were similar for both groups. There were no significant differences in AEs between the two groups, with 17 drug-related events across both groups, all being mild and none being serious. Conclusion Both formulations demonstrated comparable efficacy and safety profiles and provide patients with two different treatment formats to choose from for effective symptomatic relief of sore throat, depending on their preference. PMID:28740426

Efficacy of flurbiprofen 8.75 mg delivered as a spray or lozenge in patients with sore throat due to upper respiratory tract infection: a randomized, non-inferiority trial in the Russian Federation.

PubMed

Radkova, Eugenia; Burova, Natalia; Bychkova, Valeria; DeVito, Robert

2017-01-01

To assess the efficacy of flurbiprofen 8.75 mg delivered as a spray or lozenge in patients with sore throat due to upper respiratory tract infection (URTI). This multicenter, double-blind, double-dummy, non-inferiority study randomized 440 adults with recent-onset, moderate-to-severe sore throat due to URTI to a single dose of either flurbiprofen 8.75 mg spray (n=218) or flurbiprofen 8.75 mg lozenge (n=222). The presence or absence of beta-hemolytic streptococci (A or C) was confirmed by culture tests (throat swab). The primary efficacy end point was the difference from baseline to 2 hours post-dose in sore throat pain intensity scale (STPIS pain intensity difference [PID] 2h), a validated 100 mm visual analog scale (from 0="no pain" to 100="severe pain"), with a non-inferiority margin of -6 mm. Secondary end points included STPIS PID at 1 hour (STPIS PID 1h) and over 2 hours (STPIS sum of sore throat pain intensity differences [SPID] 0-2h ) and ratings of patient satisfaction and investigator assessment of drug efficacy at 2 hours. Safety (adverse events [AEs]) was also assessed. Reductions in sore throat pain intensity at 2 hours (STPIS PID 2h) were similar for spray (least square mean -40.51) and lozenge (-40.10) (difference: 0.41, 95% confidence interval [95% CI] -3.20, 4.01), with non-inferiority demonstrated. Subgroup analyses showed similar efficacy (STPIS PID 2h) for patients testing positive or negative for Strep A or C. There was no significant difference between spray and lozenge in STPIS PID 1h or STPIS SPID 0-2h , and patient satisfaction and investigators' assessment of efficacy at 2 hours were similar for both groups. There were no significant differences in AEs between the two groups, with 17 drug-related events across both groups, all being mild and none being serious. Both formulations demonstrated comparable efficacy and safety profiles and provide patients with two different treatment formats to choose from for effective symptomatic relief of sore throat, depending on their preference.

Effect of Compression Garments on Physiological Responses After Uphill Running.

PubMed

Struhár, Ivan; Kumstát, Michal; Králová, Dagmar Moc

2018-03-01

Limited practical recommendations related to wearing compression garments for athletes can be drawn from the literature at the present time. We aimed to identify the effects of compression garments on physiological and perceptual measures of performance and recovery after uphill running with different pressure and distributions of applied compression. In a random, double blinded study, 10 trained male runners undertook three 8 km treadmill runs at a 6% elevation rate, with the intensity of 75% VO2max while wearing low, medium grade compression garments and high reverse grade compression. In all the trials, compression garments were worn during 4 hours post run. Creatine kinase, measurements of muscle soreness, ankle strength of plantar/dorsal flexors and mean performance time were then measured. The best mean performance time was observed in the medium grade compression garments with the time difference being: medium grade compression garments vs. high reverse grade compression garments. A positive trend in increasing peak torque of plantar flexion (60º·s-1, 120º·s-1) was found in the medium grade compression garments: a difference between 24 and 48 hours post run. The highest pain tolerance shift in the gastrocnemius muscle was the medium grade compression garments, 24 hour post run, with the shift being +11.37% for the lateral head and 6.63% for the medial head. In conclusion, a beneficial trend in the promotion of running performance and decreasing muscle soreness within 24 hour post exercise was apparent in medium grade compression garments.

Investigating the Effects of Typical Rowing Strength Training Practices on Strength and Power Development and 2,000 m Rowing Performance

PubMed Central

Caplan, Nicholas; Christian Gibbon, Karl; Howatson, Glyn; Grant Thompson, Kevin

2016-01-01

Abstract This study aimed to determine the effects of a short-term, strength training intervention, typically undertaken by club-standard rowers, on 2,000 m rowing performance and strength and power development. Twenty-eight male rowers were randomly assigned to intervention or control groups. All participants performed baseline testing involving assessments of muscle soreness, creatine kinase activity (CK), maximal voluntary contraction (leg-extensors) (MVC), static-squat jumps (SSJ), counter-movement jumps (CMJ), maximal rowing power strokes (PS) and a 2,000 m rowing ergometer time-trial (2,000 m) with accompanying respiratory-exchange and electromyography (EMG) analysis. Intervention group participants subsequently performed three identical strength training (ST) sessions, in the space of five days, repeating all assessments 24 h following the final ST. The control group completed the same testing procedure but with no ST. Following ST, the intervention group experienced significant elevations in soreness and CK activity, and decrements in MVC, SSJ, CMJ and PS (p < 0.01). However, 2,000 m rowing performance, pacing strategy and gas exchange were unchanged across trials in either condition. Following ST, significant increases occurred for EMG (p < 0.05), and there were non-significant trends for decreased blood lactate and anaerobic energy liberation (p = 0.063 – 0.086). In summary, club-standard rowers, following an intensive period of strength training, maintained their 2,000 m rowing performance despite suffering symptoms of muscle damage and disruption to muscle function. This disruption likely reflected the presence of acute residual fatigue, potentially in type II muscle fibres as strength and power development were affected. PMID:28149354

The repeated bout effect of traditional resistance exercises on running performance across 3 bouts.

PubMed

Doma, Kenji; Schumann, Moritz; Leicht, Anthony Scott; Heilbronn, Brian Edward; Damas, Felipe; Burt, Dean

2017-09-01

This study investigated the repeated bout effect of 3 typical lower body resistance-training sessions on maximal and submaximal effort running performance. Twelve resistance-untrained men (age, 24 ± 4 years; height, 1.81 ± 0.10 m; body mass, 79.3 ± 10.9 kg; peak oxygen uptake, 48.2 ± 6.5 mL·kg -1 ·min -1 ; 6-repetition maximum squat, 71.7 ± 12.2 kg) undertook 3 bouts of resistance-training sessions at 6-repetitions maximum. Countermovement jump (CMJ), lower-body range of motion (ROM), muscle soreness, and creatine kinase (CK) were examined prior to and immediately, 24 h (T24), and 48 h (T48) after each resistance-training bout. Submaximal (i.e., below anaerobic threshold (AT)) and maximal (i.e., above AT) running performances were also conducted at T24 and T48. Most indirect muscle damage markers (i.e., CMJ, ROM, and muscle soreness) and submaximal running performance were significantly improved (P < 0.05; 1.9%) following the third resistance-training bout compared with the second bout. Whilst maximal running performance was also improved following the third bout (P < 0.05; 9.8%) compared with other bouts, the measures were still reduced by 12%-20% versus baseline. However, the increase in CK was attenuated following the second bout (P < 0.05) with no further protection following the third bout (P > 0.05). In conclusion, the initial bout induced the greatest change in CK; however, at least 2 bouts were required to produce protective effects on other indirect muscle damage markers and submaximal running performance measures. This suggests that submaximal running sessions should be avoided for at least 48 h after resistance training until the third bout, although a greater recovery period may be required for maximal running sessions.

The Effect of Water Temperature during Cold-Water Immersion on Recovery from Exercise-Induced Muscle Damage.

PubMed

Vieira, A; Siqueira, A F; Ferreira-Junior, J B; do Carmo, J; Durigan, J L Q; Blazevich, A; Bottaro, M

2016-11-01

This study investigated the effects of 5 and 15°C cold-water immersion on recovery from exercise resulting in exercise-induced muscle damage. 42 college-aged men performed 5×20 drop-jumps and were randomly allocated into one of 3 groups: (1) 5°C; (2) 15°C; or (3) control. After exercise, individuals from the cold-water immersion groups had their lower limbs immerged in iced water for 20 min. Isometric knee extensor torque, countermovement jump, muscle soreness, and creatine kinase were measured before, immediately after, 24, 48, 72, 96 and 168 h post-exercise. There was no between-group difference in isometric strength recovery (p=0.73). However, countermovement jump recovered quicker in cold-water immersion groups compared to control group (p<0.05). Countermovement jump returned to baseline after 72 h in 15°C, 5°C group recovered after 96 h and control did not recovered at any time point measured. Also, creatine kinase returned to baseline at 72 h and remained stable for all remaining measurements for 15°C group, whereas remained elevated past 168 h in both 5°C and control groups. There was a trend toward lower muscle soreness (p=0.06) in 15°C group compared to control at 24 h post-exercise. The result suggests that cold-water immersion promote recovery of stretch-shortening cycle performance, but not influence the recovery of maximal contractile force. Immersion at warmer temperature may be more effective than colder temperatures promoting recovery from strenuous exercise. © Georg Thieme Verlag KG Stuttgart · New York.

Exogenous lipoid pneumonia due to inhalation of spray lubricant (WD-40 lung).

PubMed

Glynn, K P; Gale, N A

1990-05-01

An elderly woman developed lipoid pneumonia due to the inhalation of mist from a spray lubricant that she was using as a liniment for sore back and neck muscles. This unusual practice is reported to be common among older people bothered by rheumatism. The potential for this complication to occur in other patients leads us to present this case report.

Combined Carbohydrate and Protein Ingestion During Australian Rules Football Matches and Training Sessions Does Not Reduce Fatigue or Accelerate Recovery Throughout a Weeklong Junior Tournament.

PubMed

Lee, Nathan A; Fell, James W; Pitchford, Nathan W; Hall, Andrew H; Leveritt, Michael D; Kitic, Cecilia M

2018-02-01

Lee, NA, Fell, JW, Pitchford, NW, Hall, AH, Leveritt, MD, and Kitic, CM. Combined carbohydrate and protein ingestion during Australian rules football matches and training sessions does not reduce fatigue or accelerate recovery throughout a weeklong junior tournament. J Strength Cond Res 32(2): 344-355, 2018-Australian rules football (ARF) is a physically demanding sport that can induce high levels of fatigue. Fatigue may be intensified during periods where multiple matches are played with limited recovery time. Combined carbohydrate and protein (CHO + PRO) intake during physical activity may provide performance and recovery benefits. The aim of this study was to investigate whether CHO + PRO ingestion during ARF matches and training sessions throughout a tournament would enhance performance or recovery in comparison with CHO-only ingestion. Australian rules football players (n = 21) competing in a 7-day national tournament participated in this randomized and double-blinded study. Beverages containing either CHO (n = 10) or CHO + PRO (n = 11) were provided during matches (day 1, day 4, and day 7) and training sessions (day 2 and day 3). Countermovement jumps (CMJs), ratings of muscle soreness, and autonomic function were assessed throughout the tournament. Gastrointestinal tract (GI) discomfort was measured after matches. Countermovement jump peak velocity increased in the CHO + PRO group (p = 0.01) but not in the CHO group. There were no differences in the other CMJ variables. In both groups, muscle soreness increased from days 0 and 1 to day 2 (p ≤ 0.05) but did not remain elevated. R-R intervals (time elapsed between successive peaks in QRS complexes) increased in both groups from day 1 to day 7 (mean difference = 59.85 ms, p < 0.01). Postmatch GI discomfort was not different (p > 0.05) between groups. When daily dietary protein is adequate (>1.8 g·kg·d), the ingestion of CHO + PRO during matches and training sessions throughout a tournament does not reduce muscle soreness nor have clear benefits for neuromuscular recovery or modulate autonomic function in junior ARF athletes, compared with that of CHO alone.

Asymmetry of neck motion and activation of the cervical paraspinal muscles during prone neck extension in subjects with unilateral posterior neck pain.

PubMed

Park, Kyue-Nam; Kwon, Oh-Yun; Kim, Su-Jung; Kim, Si-Hyun

2017-01-01

Although unilateral posterior neck pain (UPNP) is more prevalent than central neck pain, little is known about how UPNP affects neck motion and the muscle activation pattern during prone neck extension. To investigate whether deviation in neck motion and asymmetry of activation of the bilateral cervical paraspinal muscles occur during prone neck extension in subjects with UPNP compared to subjects without UPNP. This study recruited 20 subjects with UPNP and 20 age- and sex-matched control subjects without such pain. Neck motion and muscle onset time during prone neck extension were measured using a three-dimensional motion-analysis system and surface electromyography. The deviation during prone neck extension was greater in the UPNP group than in the controls (p < 0.05). Compared with the controls, cervical extensor muscle activation in the UPNP group was significantly delayed on the painful side during prone neck extension (p < 0.05). Subjects with UPNP showed greater asymmetry of neck motion and muscle activation during prone neck extension compared with the controls. This suggests that UPNP has specific effects on neck motion asymmetry and the functions of the cervical extensors, triggering a need for specific evaluation and exercises in the management of patients with UPNP.

Cystic Fibrosis Transmembrane Conductance Regulator in Sarcoplasmic Reticulum of Airway Smooth Muscle. Implications for Airway Contractility

PubMed Central

Cook, Daniel P.; Rector, Michael V.; Bouzek, Drake C.; Michalski, Andrew S.; Gansemer, Nicholas D.; Reznikov, Leah R.; Li, Xiaopeng; Stroik, Mallory R.; Ostedgaard, Lynda S.; Abou Alaiwa, Mahmoud H.; Thompson, Michael A.; Prakash, Y. S.; Krishnan, Ramaswamy; Meyerholz, David K.; Seow, Chun Y.

2016-01-01

Rationale: An asthma-like airway phenotype has been described in people with cystic fibrosis (CF). Whether these findings are directly caused by loss of CF transmembrane conductance regulator (CFTR) function or secondary to chronic airway infection and/or inflammation has been difficult to determine. Objectives: Airway contractility is primarily determined by airway smooth muscle. We tested the hypothesis that CFTR is expressed in airway smooth muscle and directly affects airway smooth muscle contractility. Methods: Newborn pigs, both wild type and with CF (before the onset of airway infection and inflammation), were used in this study. High-resolution immunofluorescence was used to identify the subcellular localization of CFTR in airway smooth muscle. Airway smooth muscle function was determined with tissue myography, intracellular calcium measurements, and regulatory myosin light chain phosphorylation status. Precision-cut lung slices were used to investigate the therapeutic potential of CFTR modulation on airway reactivity. Measurements and Main Results: We found that CFTR localizes to the sarcoplasmic reticulum compartment of airway smooth muscle and regulates airway smooth muscle tone. Loss of CFTR function led to delayed calcium reuptake following cholinergic stimulation and increased myosin light chain phosphorylation. CFTR potentiation with ivacaftor decreased airway reactivity in precision-cut lung slices following cholinergic stimulation. Conclusions: Loss of CFTR alters porcine airway smooth muscle function and may contribute to the airflow obstruction phenotype observed in human CF. Airway smooth muscle CFTR may represent a therapeutic target in CF and other diseases of airway narrowing. PMID:26488271

Myasthenia Gravis: Unusual Presentations and Diagnostic Pitfalls.

PubMed

Rodolico, Carmelo; Parisi, Daniela; Portaro, Simona; Biasini, Fiammetta; Sinicropi, Stefano; Ciranni, Annamaria; Toscano, Antonio; Messina, Sonia; Musumeci, Olimpia; Vita, Giuseppe; Girlanda, Paolo

2016-08-30

Myasthenia gravis (MG) is an autoimmune disorder presenting with fluctuating, fatigable muscle weakness. Initial symptoms classically involve ocular and proximal limb muscles. Rarely, MG may onset with unusual features, so it can be misdiagnosed with other neuromuscular diseases. To describe unusual and atypical presentations of MG in a large cohort of patients, considering and discussing diagnostic difficulties and pitfalls. We report on 21 out of 508 MG patients, coming to our department in the last 27 years and presenting with atypical or unusual features. The diagnosis was achieved performing a careful clinical examination, a proper neurophysiological assessment, the neostigmine test, the AChR and MuSK antibodies assay and chest CT-scan. Patients with atypical/unusual MG onset were the 4.4% of all MG patients population. We describe seven different clinical categories: asymmetric distal upper limbs weakness, foot drop, isolated triceps brachii weakness and foot drop, post exertional axial weakness with dropped head, acute facial dyplegia, limb-girdle MG and MG with sudden lower limbs weakness and recurrent falls. Atypical and unusual presentations may increase the risk to misdiagnose or delay MG diagnosis. Isolated limb-girdle presentation is the most frequent atypical form in our series.

Late-onset childhood neuronal ceroid lipofuscinosis: Early clinical and electroencephalographic markers.

PubMed

Beltrán, Lucas; Valenzuela, Gabriela Reyes; Loos, Mariana; Vargas, Rodrigo; Lizama, Rafael; Spinsanti, Pablo; Caraballo, Roberto

2018-05-15

The objective of the study was to describe the initial clinical and electroencephalographic findings in children with late-infantile neuronal ceroid lipofuscinosis (LINCL). The clinical charts of 35 patients seen between 1990 and 2016 were reviewed. The patients were divided into two groups: Group 1 (G1) consisting of 12 patients with NCL type 2 (CLN2) disease confirmed by enzymatic activity in dried blood spots on filter paper and/or genetic studies, and Group 2 (G2) consisting of 23 patients with a diagnosis of LINCL based on pathology studies by muscle biopsy. Mean age at symptom onset was 3 years in G1 and 3.4 years in G2. Symptoms at onset were epilepsy in 58%, language delay in 34%, and gait disturbances in 8% of patients in G1 and epilepsy in 52.1%, language delay in 26%, gait disturbances in 17.4%, and loss of visual acuity in 4.5% in G2. The most common seizure types in G1 patients were myoclonic in 3/7, generalized tonic-clonic in 2/7, focal motor in 1/7, and febrile seizures in 1/7; in G2 patients they were myoclonic in 5/12, generalized tonic-clonic in 3/12, myoclonic-atonic in 2/12, and febrile seizures in 2/12. A photoparoxysmal response to intermittent photic stimulation (IPS) was found in the initial EEG in 9/12 patients in G1 (mean age 3.8 years) and in 10/13 patients in G2 (mean age 3.9 years). There were no significant differences between both groups. Seizures, especially myoclonic, are the most common symptom at onset followed by language delay and gait disturbances. Low-frequency IPS is a useful study that may help facilitate the diagnosis of the disease. Copyright © 2018 Elsevier B.V. All rights reserved.

Abdominal muscle activity during a standing long jump.

PubMed

Okubo, Yu; Kaneoka, Koji; Shiina, Itsuo; Tatsumura, Masaki; Miyakawa, Shumpei

2013-08-01

Experimental laboratory study. To measure the activation patterns (onset and magnitude) of the abdominal muscles during a standing long jump using wire and surface electromyography. Activation patterns of the abdominal muscles, especially the deep muscles such as the transversus abdominis (TrA), have yet to be examined during full-body movements such as jumping. Thirteen healthy men participated. Wire electrodes were inserted into the TrA with the guidance of ultrasonography, and surface electrodes were attached to the skin overlying the rectus abdominis (RA) and external oblique (EO). Electromyographic signals and video images were recorded while each subject performed a standing long jump. The jump task was divided into 3 phases: preparation, push-off, and float. For each muscle, activation onset relative to the onset of the RA and normalized muscle activation levels (percent maximum voluntary contraction) were analyzed during each phase. Comparisons between muscles and phases were assessed using 2-way analyses of variance. The onset times of the TrA and EO relative to the onset of the RA were -0.13 ? 0.17 seconds and -0.02 ? 0.07 seconds, respectively. Onset of TrA activation was earlier than that of the EO. The activation levels of all 3 muscles were significantly greater during the push-off phase than during the preparation and float phases. Consistent with previously published trunk-perturbation studies in healthy persons, the TrA was activated prior to the RA and EO. Additionally, the highest muscle activation levels were observed during the push-off phase.

Current and emerging treatment strategies for Duchenne muscular dystrophy

PubMed Central

Mah, Jean K

2016-01-01

Duchenne muscular dystrophy (DMD) is the most common form of muscular dystrophy in childhood. It is caused by mutations of the DMD gene, leading to progressive muscle weakness, loss of independent ambulation by early teens, and premature death due to cardiorespiratory complications. The diagnosis can usually be made after careful review of the history and examination of affected boys presenting with developmental delay, proximal weakness, and elevated serum creatine kinase, plus confirmation by muscle biopsy or genetic testing. Precise characterization of the DMD mutation is important for genetic counseling and individualized treatment. Current standard of care includes the use of corticosteroids to prolong ambulation and to delay the onset of secondary complications. Early use of cardioprotective agents, noninvasive positive pressure ventilation, and other supportive strategies has improved the life expectancy and health-related quality of life for many young adults with DMD. New emerging treatment includes viral-mediated microdystrophin gene replacement, exon skipping to restore the reading frame, and nonsense suppression therapy to allow translation and production of a modified dystrophin protein. Other potential therapeutic targets involve upregulation of compensatory proteins, reduction of the inflammatory cascade, and enhancement of muscle regeneration. So far, data from DMD clinical trials have shown limited success in delaying disease progression; unforeseen obstacles included immune response against the generated mini-dystrophin, inconsistent evidence of dystrophin production in muscle biopsies, and failure to demonstrate a significant improvement in the primary outcome measure, as defined by the 6-minute walk test in some studies. The long-term safety and efficacy of emerging treatments will depend on the selection of appropriate clinical end points and sensitive biomarkers to detect meaningful changes in disease progression. Correction of the underlying mutations using new gene-editing technologies and corticosteroid analogs with better safety profiles offers renewed hope for many individuals with DMD and their families. PMID:27524897

Reflexes in cat ankle muscles after landing from falls.

PubMed Central

Prochazka, A; Schofield, P; Westerman, R A; Ziccone, S P

1977-01-01

1. Electrical activity and length of ankle muscles were recorded by telemetry during free fall and landing in cats. 2. After foot contact, there was a delay in onset of stretch of ankle extensors of between 8 and 11 ms. High-speed cinematography showed the delay to be associated with rapid initial dorsiflexion of the toes. 3. Electromyograms (e.m.g.) from lateral gastrocnemius increased in amplitude prior to landing. An early depression of lateral gastrocnemius e.m.g. commenced at 8 ms after foot contact, and was followed by a large peak of activity commencing some 8 ms after the first increase in lateral gastrocnemius length. 4. Local anaesthesia of the plantar cushion did not alter this pattern of response. 5. The early inhibition of lateral gastrocnemius was attributed to the action on lateral gastrocnemius motoneurones of non-cutaneous afferents responding to the initial toe dorsiflexion. Additional autogenetic inhibition may also have contributed. 6. The subsequent peak of e.m.g. was at a latenty consistent with a rapid stretch reflex, and occurred soon enough for the resulting active tension to contribute significantly to the extensor force during body deceleration. PMID:592210

Gastroschisis in the rat model is associated with a delayed maturation of intestinal pacemaker cells and smooth muscle cells.

PubMed

Midrio, P; Faussone-Pellegrini, M S; Vannucchi, M G; Flake, A W

2004-10-01

A pacemaker system is required for peristalsis generation. The interstitial cells of Cajal (ICC) are considered the intestinal pacemaker, and are identified by expression of the c-kit gene--encoded protein. Gastroschisis is characterized by a severe gastrointestinal dysmotility in newborns. In spite of this clinical picture, few studies have focused on smooth muscle cells (SMC) morphology and none on ICC. Therefore, their morphology has been studied in fetuses at term in the rat model of gastroschisis. At 18.5 day's gestation (E18.5), 10 rat fetuses were killed, 10 underwent surgical creation of gastroschisis, and 10 underwent manipulation only. The small intestine of the latter 2 groups was harvested at E21.5. Specimens were processed for H&E, c-kit and actin (alpha smooth muscle antibody [alpha-SMA]) immunohistochemistry, and transmission electron microscopy (TEM). In the controls, SMC were c-kit+ and alpha-SMA+, with labeling intensity increasing by age. At E21.5, some cells around the Auerbach's plexus were more intensely c-kit+, and differentiating ICC were seen under TEM at this level. Gastroschisis fetuses had no c-kit+ cells referable to ICC. In the more damaged loops, SMC were very faintly c-kit+ and alpha-SMA+. Under TEM, there were few differentiated SMC and no presumptive ICC. In the less-damaged loops, SMC were faintly c-kit+ and alpha-SMA+ and had ultrastructural features intermediate between those of E18.5 and E21.5 controls; ICC were very immature. ICC and SMC differentiation is delayed in gastroschisis with the most damaged loops showing the most incomplete picture. These findings might help in understanding the delayed onset of peristalsis and the variable time-course of the recover seen in babies affected by gastroschisis.

Comparison of reversal with neostigmine of low-dose rocuronium vs. reversal with sugammadex of high-dose rocuronium for a short procedure.

PubMed

Choi, E S; Oh, A Y; Koo, B W; Hwang, J W; Han, J W; Seo, K S; Ahn, S H; Jeong, W J

2017-10-01

Some short procedures require deep neuromuscular blockade, which needs to be reversed at the end of the procedure. Forty-four patients undergoing elective laryngeal micro-surgery were randomly allocated into two groups: rocuronium 0.45 mg.kg -1 with neostigmine (50 μg.kg -1 with glycopyrrolate 10 μg.kg -1 ) reversal (moderate block group) vs. rocuronium 0.90 mg.kg -1 with sugammadex (4 mg.kg -1 ) reversal (deep block group). The primary outcome was the intubating conditions during laryngoscopy secondary outcomes included recovery of neuromuscular block; conditions for tracheal intubation; satisfaction score as determined by the surgeon; onset of neuromuscular block; and postoperative sore throat. The onset of neuromuscular block was more rapid, and intubation conditions and ease of intra-operative laryngoscopy were more favourable, and the satisfaction score was lower in the moderate block group compared with the deep block group. No difference was found in the incidence of postoperative sore throat. In laryngeal micro-surgery, the use of rocuronium 0.9 mg.kg -1 with sugammadex for reversal was associated with better surgical conditions and a shorter recovery time than rocuronium 0.45 mg.kg -1 with neostigmine. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

Delayed-onset dementia after stroke or transient ischemic attack.

PubMed

Mok, Vincent C T; Lam, Bonnie Y K; Wang, Zhaolu; Liu, Wenyan; Au, Lisa; Leung, Eric Y L; Chen, Sirong; Yang, Jie; Chu, Winnie C W; Lau, Alexander Y L; Chan, Anne Y Y; Shi, Lin; Fan, Florence; Ma, Sze H; Ip, Vincent; Soo, Yannie O Y; Leung, Thomas W H; Kwok, Timothy C Y; Ho, Chi L; Wong, Lawrence K S; Wong, Adrian

2016-11-01

Patients surviving stroke without immediate dementia are at high risk of delayed-onset dementia. Mechanisms underlying delayed-onset dementia are complex and may involve vascular and/or neurodegenerative diseases. Dementia-free patients with stroke and/or transient ischemic attack (TIA; n = 919) were studied for 3 years prospectively, excluding those who developed dementia 3 to 6 months after stroke and/or TIA. Forty subjects (4.4%) developed dementia during the study period. Imaging markers of severe small vessel disease (SVD), namely presence of ≥3 lacunes and confluent white matter changes; history of hypertension and diabetes mellitus independently predicted delayed-onset dementia after adjustment for age, gender, and education. Only 6 of 31 (19.4%) subjects with delayed cognitive decline harbored Alzheimer's disease-like Pittsburg compound B (PiB) retention. Most PiB cases (16/25, 64%) had evidence of severe SVD. Severe SVD contributes importantly to delayed-onset dementia after stroke and/or TIA. Future clinical trials aiming to prevent delayed-onset dementia after stroke and/or TIA should target this high-risk group. Copyright © 2016 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

[Acute tonsillopharyngitis: the effectiveness of topical therapy].

PubMed

Nosulya, E V; Kim, I A; Chernykh, N M; Karnoukhova, O A

2015-01-01

The objective of the present study was to evaluate the clinical effectiveness of a furasol sore throat gargle solution for the treatment of acute tonsillopharyngitis. Forty patients presenting with acute tonsillopharyngitis were allocated to two groups, 20 subjects in each, by means of independent sequential randomization. Prior to the onset of the treatment, all the patients were examined for determining the species composition of pharyngeal microflora with the use of an «AutoScan4 System» analyzer («Siemens», USA) and estimating the resistance to antibacterial preparations (by the disk diffusion method). All the participants of the study were prescribed antibacterial therapy. In the patients of group 1 (study group), the antibacterial treatment of acute tonsillopharyngitis was supplemented by a furasol sore throat gargle solution whereas those of group 2 (controls) were treated without topical therapy. The quantitative evaluation of the severity of manifestations of the disease before and after the treatment was based on a 5-point visual-analog scale. It was shown that systemic antibacterial therapy resulted in the consistent decrease of the frequency of occurrence of pathogenic and potentially pathogenic microflora in the patients comprising both groups. Treatment with a furasol sore throat gargle solution did not lead to the appearance of bacterial species alien to the oropharynx, nor was it accompanied by the impairment of resistance of its mucous membrane to the colonization by microorganisms. The results of the study give evidence of the well apparent regression of the subjective signs of tonsillopharyngitis and the inflammatory changes in the mucous membrane of the pharynx in the patients given the topical treatment in the form of a furasol sore throat gargle solution in addition to antibacterial therapy. It is concluded that a furasol sore throat gargle solution can be recommended for the introduction into the combined treatment of the patients presenting with acute tonsillopharyngitis.

Muscle damage and repeated bout effect following blood flow restricted exercise.

PubMed

Sieljacks, Peter; Matzon, Andreas; Wernbom, Mathias; Ringgaard, Steffen; Vissing, Kristian; Overgaard, Kristian

2016-03-01

Blood-flow restricted resistance exercise training (BFRE) is suggested to be effective in rehabilitation training, but more knowledge is required about its potential muscle damaging effects. Therefore, we investigated muscle-damaging effects of BFRE performed to failure and possible protective effects of previous bouts of BFRE or maximal eccentric exercise (ECC). Seventeen healthy young men were allocated into two groups completing two exercise bouts separated by 14 days. One group performed BFRE in both exercise bouts (BB). The other group performed ECC in the first and BFRE in the second bout. BFRE was performed to failure. Indicators of muscle damage were evaluated before and after exercise. The first bout in the BB group led to decrements in maximum isometric torque, and increases in muscle soreness, muscle water retention, and serum muscle protein concentrations after exercise. These changes were comparable in magnitude and time course to what was observed after first bout ECC. An attenuated response was observed in the repeated exercise bout in both groups. We conclude that unaccustomed single-bout BFRE performed to failure induces significant muscle damage. Additionally, both ECC and BFRE can precondition against muscle damage induced by a subsequent bout of BFRE.

Barx2 is Expressed in Satellite Cells and is Required for Normal Muscle Growth and Regeneration

PubMed Central

Meech, Robyn; Gonzalez, Katie N.; Barro, Marietta; Gromova, Anastasia; Zhuang, Lizhe; Hulin, Julie-Ann; Makarenkova, Helen P.

2015-01-01

Muscle growth and regeneration are regulated through a series of spatiotemporally dependent signaling and transcriptional cascades. Although the transcriptional program controlling myogenesis has been extensively investigated, the full repertoire of transcriptional regulators involved in this process is far from defined. Various homeodomain transcription factors have been shown to play important roles in both muscle development and muscle satellite cell-dependent repair. Here, we show that the homeodomain factor Barx2 is a new marker for embryonic and adult myoblasts and is required for normal postnatal muscle growth and repair. Barx2 is coexpressed with Pax7, which is the canonical marker of satellite cells, and is upregulated in satellite cells after muscle injury. Mice lacking the Barx2 gene show reduced postnatal muscle growth, muscle atrophy, and defective muscle repair. Moreover, loss of Barx2 delays the expression of genes that control proliferation and differentiation in regenerating muscle. Consistent with the in vivo observations, satellite cell-derived myoblasts cultured from Barx2−/− mice show decreased proliferation and ability to differentiate relative to those from wild-type or Barx2+/− mice. Barx2−/− myoblasts show reduced expression of the differentiation-associated factor myogenin as well as cell adhesion and matrix molecules. Finally, we find that mice lacking both Barx2 and dystrophin gene expression have severe early onset myopathy. Together, these data indicate that Barx2 is an important regulator of muscle growth and repair that acts via the control of satellite cell proliferation and differentiation. PMID:22076929

Controlling the fluoride dosage in a patient with compromised salivary function.

PubMed

Eichmiller, Frederick C; Eidelman, Naomi; Carey, Clifton M

2005-01-01

High-concentration topical fluorides are used commonly to with compromised salivary function due to irradiation and chemotherapy. The authors describe a 50-year-old man with previously treated cancer who was using tray-applied topical fluoride gel. He complained of gastric symptoms, difficulty in swallowing, leg muscle soreness and knee joint soreness. A computed tomographic scan revealed thickening of the esophageal walls. An upper endoscopy revealed abnormal motility. The motility test indicated high-amplitude peristalsis and hypertensive lower esophageal sphincter, and urine testing indicated high levels of systemic fluoride. The patient's fluoride regimen was altered, and within a short period his urinary fluoride levels returned to normal and his symptoms resolved. Clinicians prescribing home-applied high-concentration fluorides need to be cognizant of the symptoms of fluoride toxicity, carefully monitor the patient's compliance with the treatment regimen, and adjust the dosage or mode of application to control the total ingested dose of fluoride.

Temporomandibular pain caused by sleep disorders: a review and case report.

PubMed

Babiec, Daniel F

2017-01-01

Patients who present to the general dentist's office with complaints of temporomandibular joint pain may exhibit signs and symptoms such as muscle soreness, bruxism, joint soreness, limited range of movement, altered movement, and facial pain as well as tooth chipping or tooth movement. After examinations, radiographic evaluations, and a review of medical history, dentists may have a bias toward regarding these symptoms as oral or dental in origin. After a diagnosis of a temporomandibular disorder (TMD), bruxism, or muscular spasms due to occlusal instabilities is established, the treatment protocol often includes an oral appliance (such as a nightguard), exercises, and pharmacologic agents. However, patients with sleep-disordered breathing (SDB) can exhibit the same signs and symptoms as patients with TMDs, and these symptoms can be misinterpreted as being dental in origin. Dental treatment can actually worsen these medical conditions, putting patients at further risk for untreated and aggravated SDB along with its medical sequelae.

Practical Recommendations for Diagnosis and Management of Respiratory Muscle Weakness in Late-Onset Pompe Disease

PubMed Central

Boentert, Matthias; Prigent, Hélène; Várdi, Katalin; Jones, Harrison N.; Mellies, Uwe; Simonds, Anita K.; Wenninger, Stephan; Barrot Cortés, Emilia; Confalonieri, Marco

2016-01-01

Pompe disease is an autosomal-recessive lysosomal storage disorder characterized by progressive myopathy with proximal muscle weakness, respiratory muscle dysfunction, and cardiomyopathy (in infants only). In patients with juvenile or adult disease onset, respiratory muscle weakness may decline more rapidly than overall neurological disability. Sleep-disordered breathing, daytime hypercapnia, and the need for nocturnal ventilation eventually evolve in most patients. Additionally, respiratory muscle weakness leads to decreased cough and impaired airway clearance, increasing the risk of acute respiratory illness. Progressive respiratory muscle weakness is a major cause of morbidity and mortality in late-onset Pompe disease even if enzyme replacement therapy has been established. Practical knowledge of how to detect, monitor and manage respiratory muscle involvement is crucial for optimal patient care. A multidisciplinary approach combining the expertise of neurologists, pulmonologists, and intensive care specialists is needed. Based on the authors’ own experience in over 200 patients, this article conveys expert recommendations for the diagnosis and management of respiratory muscle weakness and its sequelae in late-onset Pompe disease. PMID:27763517

Fatigue-induced early onset of anticipatory postural adjustments in non-fatigued muscles: support for a centrally mediated adaptation.

PubMed

Strang, Adam J; Berg, William P; Hieronymus, Mathias

2009-08-01

Muscle fatigue has been shown to result in early onset of anticipatory postural adjustments (APAs) relative to those produced in a non-fatigued state. This adaptation is thought to reflect an attempt to preserve postural stability during a focal movement performed in a fatigued state. It remains unclear, however, whether this adaptation is of central (e.g., central nervous system motor command) or peripheral (e.g., muscle contractile properties), origin. One way to confirm that this adaptation is centrally driven is to identify fatigued-induced early APA onsets in non-fatigued muscles. In this study, APAs were obtained using a rapid bilateral reaching maneuver and recorded via surface electromyography before and after conditions of rest (n = 25) or fatigue (n = 25). Fatigue was generated using isokinetic exercise of the right leg. Results showed that fatigue-induced early APA onsets occurred in fatigued and non-fatigued muscles, confirming that fatigue-induced early APA onset is a centrally mediated adaptation.

Silencing neuronal mutant androgen receptor in a mouse model of spinal and bulbar muscular atrophy.

PubMed

Sahashi, Kentaro; Katsuno, Masahisa; Hung, Gene; Adachi, Hiroaki; Kondo, Naohide; Nakatsuji, Hideaki; Tohnai, Genki; Iida, Madoka; Bennett, C Frank; Sobue, Gen

2015-11-01

Spinal and bulbar muscular atrophy (SBMA), an adult-onset neurodegenerative disease that affects males, results from a CAG triplet repeat/polyglutamine expansions in the androgen receptor (AR) gene. Patients develop progressive muscular weakness and atrophy, and no effective therapy is currently available. The tissue-specific pathogenesis, especially relative pathological contributions between degenerative motor neurons and muscles, remains inconclusive. Though peripheral pathology in skeletal muscle caused by toxic AR protein has been recently reported to play a pivotal role in the pathogenesis of SBMA using mouse models, the role of motor neuron degeneration in SBMA has not been rigorously investigated. Here, we exploited synthetic antisense oligonucleotides to inhibit the RNA levels of mutant AR in the central nervous system (CNS) and explore its therapeutic effects in our SBMA mouse model that harbors a mutant AR gene with 97 CAG expansions and characteristic SBMA-like neurogenic phenotypes. A single intracerebroventricular administration of the antisense oligonucleotides in the presymptomatic phase efficiently suppressed the mutant gene expression in the CNS, and delayed the onset and progression of motor dysfunction, improved body weight gain and survival with the amelioration of neuronal histopathology in motor units such as spinal motor neurons, neuromuscular junctions and skeletal muscle. These findings highlight the importance of the neurotoxicity of mutant AR protein in motor neurons as a therapeutic target. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Lack of short-wavelength light during the school day delays dim light melatonin onset (DLMO) in middle school students.

PubMed

Figueiro, Mariana G; Rea, Mark S

2010-01-01

Circadian timing affects sleep onset. Delayed sleep onset can reduce sleep duration in adolescents required to awake early for a fixed school schedule. The absence of short-wavelength ("blue") morning light, which helps entrain the circadian system, can hypothetically delay sleep onset and decrease sleep duration in adolescents. The goal of this study was to investigate whether removal of short-wavelength light during the morning hours delayed the onset of melatonin in young adults. Dim light melatonin onset (DLMO) was measured in eleven 8th-grade students before and after wearing orange glasses, which removed short-wavelength light, for a five-day school week. DLMO was significantly delayed (30 minutes) after the five-day intervention, demonstrating that short-wavelength light exposure during the day can be important for advancing circadian rhythms in students. Lack of short-wavelength light in the morning has been shown to delay the circadian clock in controlled laboratory conditions. The results presented here are the first to show, outside laboratory conditions, that removal of short-wavelength light in the morning hours can delay DLMO in 8th-grade students. These field data, consistent with results from controlled laboratory studies, are directly relevant to lighting practice in schools.

Carbohydrate Dependence During Prolonged, Intense Endurance Exercise.

PubMed

Hawley, John A; Leckey, Jill J

2015-11-01

A major goal of training to improve the performance of prolonged, continuous, endurance events lasting up to 3 h is to promote a range of physiological and metabolic adaptations that permit an athlete to work at both higher absolute and relative power outputs/speeds and delay the onset of fatigue (i.e., a decline in exercise intensity). To meet these goals, competitive endurance athletes undertake a prodigious volume of training, with a large proportion performed at intensities that are close to or faster than race pace and highly dependent on carbohydrate (CHO)-based fuels to sustain rates of muscle energy production [i.e., match rates of adenosine triphosphate (ATP) hydrolysis with rates of resynthesis]. Consequently, to sustain muscle energy reserves and meet the daily demands of training sessions, competitive athletes freely select CHO-rich diets. Despite renewed interest in high-fat, low-CHO diets for endurance sport, fat-rich diets do not improve training capacity or performance, but directly impair rates of muscle glycogenolysis and energy flux, limiting high-intensity ATP production. When highly trained athletes compete in endurance events lasting up to 3 h, CHO-, not fat-based fuels are the predominant fuel for the working muscles and CHO, not fat, availability becomes rate limiting for performance.

Modulation of GH/IGF-1 axis: potential strategies to counteract sarcopenia in older adults.

PubMed

Giovannini, Silvia; Marzetti, Emanuele; Borst, Stephen E; Leeuwenburgh, Christiaan

2008-10-01

Aging is associated with progressive decline of skeletal muscle mass and function. This condition, termed sarcopenia, is associated with several adverse outcomes, including loss of autonomy and mortality. Due to the high prevalence of sarcopenia, a deeper understanding of its pathophysiology and possible remedies represents a high public health priority. Evidence suggests the existence of a relationship between declining growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels and age-related changes in body composition and physical function. Therefore, the age-dependent decline of GH and IGF-1 serum levels may promote frailty by contributing to the loss of muscle mass and strength. Preclinical studies showed that infusion of angiotensin II produced a marked reduction in body weight, accompanied by decreased serum and muscle levels of IGF-1. Conversely, overexpression of muscle-specific isoform of IGF-1 mitigates angiotensin II-induced muscle loss. Moreover, IGF-1 serum levels have been shown to increase following angiotensin converting enzyme inhibitors (ACEIs) treatment. Here we will review the most recent evidence regarding age-related changes of the GH/IGF-1 axis and its modulation by several interventions, including ACEIs which might represent a potential novel strategy to delay the onset and impede the progression of sarcopenia.

Prone Hip Extension Muscle Recruitment is Associated with Hamstring Injury Risk in Amateur Soccer.

PubMed

Schuermans, Joke; Van Tiggelen, Damien; Witvrouw, Erik

2017-09-01

'Core stability' is considered essential in rehabilitation and prevention. Particularly with respect to hamstring injury prevention, assessment and training of lumbo-pelvic control is thought to be key. However, supporting scientific evidence is lacking. To explore the importance of proximal neuromuscular function with regard to hamstring injury susceptibility, this study investigated the association between the Prone Hip Extension (PHE) muscle activation pattern and hamstring injury incidence in amateur soccer players. 60 healthy male soccer players underwent a comprehensive clinical examination, comprising a range of motion assessments and the investigation of the posterior chain muscle activation pattern during PHE. Subsequently, hamstring injury incidence was recorded prospectively throughout a 1.5-season monitoring period. Players who were injured presented a PHE activation pattern that differed significantly from those who did not. Contrary to the controls, hamstring activity onset was significantly delayed (p=0.018), resulting in a shifted activation sequence. Players were 8 times more likely to get injured if the hamstring muscles were activated after the lumbar erector spinae instead of vice versa (p=0.009). Assessment of muscle recruitment during PHE demonstrated to be useful in injury prediction, suggesting that neuromuscular coordination in the posterior chain influences hamstring injury vulnerability. © Georg Thieme Verlag KG Stuttgart · New York.

Effects of respiratory alkalosis on human skeletal muscle metabolism at the onset of submaximal exercise.

PubMed

LeBlanc, P J; Parolin, M L; Jones, N L; Heigenhauser, G J F

2002-10-01

The purpose of this study was to examine the effects of respiratory alkalosis on human skeletal muscle metabolism at rest and during submaximal exercise. Subjects exercised on two occasions for 15 min at 55 % of their maximal oxygen uptake while either hyperventilating (R-Alk) or breathing normally (Con). Muscle biopsies were taken at rest and after 1 and 15 min of exercise. At rest, no effects on muscle metabolism were observed in response to R-Alk. In the first minute of exercise, there was a delayed activation of pyruvate dehydrogenase (PDH) in R-Alk compared with Con, resulting in a reduced rate of pyruvate oxidation. Also, glycogenolysis was higher in R-Alk compared with Con, which was attributed to a higher availability of the monoprotonated form of inorganic phosphate (P(i)), resulting in an elevated rate of pyruvate production. The mismatch between pyruvate production and its oxidation resulted in net lactate accumulation. These effects were not seen after 15 min of exercise, with no further differences in muscle metabolism between conditions. The results from the present study suggest that respiratory alkalosis may play an important role in lactate accumulation during the transition from rest to exercise in acute hypoxic conditions, but that other factors mediate lactate accumulation during steady-state exercise.

Effects of respiratory alkalosis on human skeletal muscle metabolism at the onset of submaximal exercise

PubMed Central

LeBlanc, P J; Parolin, M L; Jones, N L; Heigenhauser, G J F

2002-01-01

The purpose of this study was to examine the effects of respiratory alkalosis on human skeletal muscle metabolism at rest and during submaximal exercise. Subjects exercised on two occasions for 15 min at 55 % of their maximal oxygen uptake while either hyperventilating (R-Alk) or breathing normally (Con). Muscle biopsies were taken at rest and after 1 and 15 min of exercise. At rest, no effects on muscle metabolism were observed in response to R-Alk. In the first minute of exercise, there was a delayed activation of pyruvate dehydrogenase (PDH) in R-Alk compared with Con, resulting in a reduced rate of pyruvate oxidation. Also, glycogenolysis was higher in R-Alk compared with Con, which was attributed to a higher availability of the monoprotonated form of inorganic phosphate (Pi), resulting in an elevated rate of pyruvate production. The mismatch between pyruvate production and its oxidation resulted in net lactate accumulation. These effects were not seen after 15 min of exercise, with no further differences in muscle metabolism between conditions. The results from the present study suggest that respiratory alkalosis may play an important role in lactate accumulation during the transition from rest to exercise in acute hypoxic conditions, but that other factors mediate lactate accumulation during steady-state exercise. PMID:12356901

The changes of lumbar muscle flexion-relaxation phenomenon due to antero-posteriorly slanted ground surfaces.

PubMed

Hu, Boyi; Ning, Xiaopeng; Dai, Fei; Almuhaidib, Ibrahim

2016-09-01

Uneven ground surface is a common occupational injury risk factor in industries such as agriculture, fishing, transportation and construction. Studies have shown that antero-posteriorly slanted ground surfaces could reduce spinal stability and increase the risk of falling. In this study, the influence of antero-posteriorly slanted ground surfaces on lumbar flexion-relaxation responses was investigated. Fourteen healthy participants performed sagittally symmetric and asymmetric trunk bending motions on one flat and two antero-posteriorly slanted surfaces (-15° (uphill facing) and 15° (downhill facing)), while lumbar muscle electromyography and trunk kinematics were recorded. Results showed that standing on a downhill facing slanted surface delays the onset of lumbar muscle flexion-relaxation phenomenon (FRP), while standing on an uphill facing ground causes lumbar muscle FRP to occur earlier. In addition, compared to symmetric bending, when performing asymmetric bending, FRP occurred earlier on the contralateral side of lumbar muscles and significantly smaller maximum lumbar flexion and trunk inclination angles were observed. Practitioner Summary: Uneven ground surface is a common risk factor among a number of industries. In this study, we investigated the influence of antero-posteriorly slanted ground surface on trunk biomechanics during trunk bending. Results showed the slanted surface alters the lumbar tissue load-sharing mechanism in both sagittally symmetric and asymmetric bending.

Production of Potent Fully Human Polyclonal Antibodies Against Zaire Ebola Virus in Transchromosomal Cattle

DTIC Science & Technology

2016-07-01

both humans and non-human primates (NHP) causing severe hemorrhagic fevers with symptoms of disease including sudden onset of fever , chills, headache...and anorexia followed by sore throat, vomiting, diarrhea, hemorrhaging, and the appearance of a petechial rash1-3. Filoviruses are categorized as...hemorrhagic fever . Clinics in laboratory medicine 30, 161-177 (2010). 6. Parren, P.W., et al., Pre- and postexposure prophylaxis of Ebola virus

Administration of the non-steroidal anti-inflammatory drug ibuprofen increases macrophage concentrations but reduces necrosis during modified muscle use

NASA Technical Reports Server (NTRS)

Cheung, E. V.; Tidball, J. G.

2003-01-01

OBJECTIVE: To test the hypothesis that ibuprofen administration during modified muscle use reduces muscle necrosis and invasion by select myeloid cell populations. METHODS: Rats were subjected to hindlimb unloading for 10 days, after which they experienced muscle reloading by normal weight-bearing to induce muscle inflammation and necrosis. Some animals received ibuprofen by intraperitoneal injection 8 h prior to the onset of muscle reloading, and then again at 8 and 16 h following the onset of reloading. Other animals received buffer injection at 8 h prior to reloading and then ibuprofen at 8 and 16 h following the onset of reloading. Control animals received buffer only at each time point. Quantitative immunohistochemical analysis was used to assess the presence of necrotic muscle fibers, total inflammatory infiltrate, neutrophils, ED1+ macrophages and ED2+ macrophages at 24 h following the onset of reloading. RESULT: Administration of ibuprofen beginning 8 h prior to reloading caused significant reduction in the concentration of necrotic fibers, but increased the concentration of inflammatory cells in muscle. The increase in inflammatory cells was attributable to a 2.6-fold increase in the concentration of ED2+ macrophages. Animals treated with ibuprofen 8 h following the onset of reloading showed no decrease in muscle necrosis or increase in ED2+ macrophage concentrations. CONCLUSION: Administration of ibuprofen prior to increased muscle loading reduces muscle damage, but increases the concentration of macrophages that express the ED2 antigen. The increase in ED2+ macrophage concentration and decrease in necrosis may be mechanistically related because ED2+ macrophages have been associated with muscle regeneration and repair.

l-Carnitine Supplementation in Recovery after Exercise.

PubMed

Fielding, Roger; Riede, Linda; Lugo, James P; Bellamine, Aouatef

2018-03-13

Given its pivotal role in fatty acid oxidation and energy metabolism, l-carnitine has been investigated as ergogenic aid for enhancing exercise capacity in the healthy athletic population. Early research indicates its beneficial effects on acute physical performance, such as increased maximum oxygen consumption and higher power output. Later studies point to the positive impact of dietary supplementation with l-carnitine on the recovery process after exercise. It is demonstrated that l-carnitine alleviates muscle injury and reduces markers of cellular damage and free radical formation accompanied by attenuation of muscle soreness. The supplementation-based increase in serum and muscle l-carnitine contents is suggested to enhance blood flow and oxygen supply to the muscle tissue via improved endothelial function thereby reducing hypoxia-induced cellular and biochemical disruptions. Studies in older adults further showed that l-carnitine intake can lead to increased muscle mass accompanied by a decrease in body weight and reduced physical and mental fatigue. Based on current animal studies, a role of l-carnitine in the prevention of age-associated muscle protein degradation and regulation of mitochondrial homeostasis is suggested.

l-Carnitine Supplementation in Recovery after Exercise

PubMed Central

Fielding, Roger; Riede, Linda; Lugo, James P.; Bellamine, Aouatef

2018-01-01

Given its pivotal role in fatty acid oxidation and energy metabolism, l-carnitine has been investigated as ergogenic aid for enhancing exercise capacity in the healthy athletic population. Early research indicates its beneficial effects on acute physical performance, such as increased maximum oxygen consumption and higher power output. Later studies point to the positive impact of dietary supplementation with l-carnitine on the recovery process after exercise. It is demonstrated that l-carnitine alleviates muscle injury and reduces markers of cellular damage and free radical formation accompanied by attenuation of muscle soreness. The supplementation-based increase in serum and muscle l-carnitine contents is suggested to enhance blood flow and oxygen supply to the muscle tissue via improved endothelial function thereby reducing hypoxia-induced cellular and biochemical disruptions. Studies in older adults further showed that l-carnitine intake can lead to increased muscle mass accompanied by a decrease in body weight and reduced physical and mental fatigue. Based on current animal studies, a role of l-carnitine in the prevention of age-associated muscle protein degradation and regulation of mitochondrial homeostasis is suggested. PMID:29534031

Four-week rapamycin treatment improves muscular dystrophy in a fukutin-deficient mouse model of dystroglycanopathy.

PubMed

Foltz, Steven J; Luan, Junna; Call, Jarrod A; Patel, Ankit; Peissig, Kristen B; Fortunato, Marisa J; Beedle, Aaron M

2016-01-01

Secondary dystroglycanopathies are a subset of muscular dystrophy caused by abnormal glycosylation of α-dystroglycan (αDG). Loss of αDG functional glycosylation prevents it from binding to laminin and other extracellular matrix receptors, causing muscular dystrophy. Mutations in a number of genes, including FKTN (fukutin), disrupt αDG glycosylation. We analyzed conditional Fktn knockout (Fktn KO) muscle for levels of mTOR signaling pathway proteins by Western blot. Two cohorts of Myf5-cre/Fktn KO mice were treated with the mammalian target of rapamycin (mTOR) inhibitor rapamycin (RAPA) for 4 weeks and evaluated for changes in functional and histopathological features. Muscle from 17- to 25-week-old fukutin-deficient mice has activated mTOR signaling. However, in tamoxifen-inducible Fktn KO mice, factors related to Akt/mTOR signaling were unchanged before the onset of dystrophic pathology, suggesting that Akt/mTOR signaling pathway abnormalities occur after the onset of disease pathology and are not causative in early dystroglycanopathy development. To determine any pharmacological benefit of targeting mTOR signaling, we administered RAPA daily for 4 weeks to Myf5/Fktn KO mice to inhibit mTORC1. RAPA treatment reduced fibrosis, inflammation, activity-induced damage, and central nucleation, and increased muscle fiber size in Myf5/Fktn KO mice compared to controls. RAPA-treated KO mice also produced significantly higher torque at the conclusion of dosing. These findings validate a misregulation of mTOR signaling in dystrophic dystroglycanopathy skeletal muscle and suggest that such signaling molecules may be relevant targets to delay and/or reduce disease burden in dystrophic patients.

Slow-onset myocardial infarction and its influence on help-seeking behaviors.

PubMed

O'Donnell, Sharon; Moser, Debra K

2012-01-01

Patient decision delay continues to be a major factor of delay along the pathway of care for patients with myocardial infarction (MI). Although potentially modifiable, efforts to reduce these delays through educational and media interventions have been relatively unsuccessful. This failure has been due, in part, to the lack of understanding about the complex sociopsychological and clinical dimensions associated with the phenomenon of help-seeking behavior. The aims of this study were to (1) perform an in-depth analysis of patients' MI symptom experiences and (2) describe their help-seeking behavior in response to these symptom experiences. In-depth interviews were used to examine the symptom experiences and help-seeking behavior of men and women with MI. Participants (n = 42) were interviewed 2 to 4 days after their admission to 1 of 2 hospitals in Dublin, Ireland. Two new discrete MI categories emerged from the findings-slow-onset MI and fast-onset MI. Slow-onset MI is characterized by the gradual onset of mild symptoms, whereas fast-onset MI describes the sudden onset of severe chest pain. Most participants (n = 27) experienced slow-onset MI but expected the symptom presentation associated with fast-onset MI. The mismatch of expected and experienced symptoms for participants with slow-onset MI led to the mislabeling of symptoms to a noncardiac cause and protracted help-seeking delays. Participants with fast-onset MI (n = 15) quickly attributed their symptoms to a cardiac cause, which expedited appropriate help-seeking behaviors. Definitions of MI and the educational information provided to the public need to be reviewed. Slow-onset MI and fast-onset MI provide plausible definition alternatives and, possibly, a more authentic version of real MI events than what is currently used. They also provide a unique "delay" perspective, which may inform future educational initiatives targeted at decision delay reduction.

Acute Cellular Rejection in ABO-Incompatible Renal Transplant Recipients Receiving Rituximab Is Associated with Delayed-Onset Neutropenia.

PubMed

Uchida, Junji; Iwai, Tomoaki; Nishide, Shunji; Kabei, Kazuya; Kuwabara, Nobuyuki; Yamasaki, Takeshi; Naganuma, Toshihide; Kumada, Norihiko; Takemoto, Yoshiaki; Nakatani, Tatsuya

2017-07-25

BACKGROUND Rituximab induces long-lasting B cell depletion in the peripheral blood and increases the levels of proinflammatory cytokines associated with regulatory B cell depletion. Previous reports showed that B cell-related cytokine release after administration of rituximab may induce acute cellular rejection (ACR) and delayed-onset neutropenia. The present study was conducted to investigate the correlation between acute rejection and delayed-onset neutropenia in ABO-incompatible renal transplant recipients who underwent administration of rituximab for 1 year after transplantation. MATERIAL AND METHODS From June 2006 to July 2015, 47 patients with chronic renal failure received ABO-incompatible renal transplant with rituximab induction at Osaka City University Hospital. All 47 patients underwent plasmapheresis due to removal of anti-A/B antibodies and administration of rituximab, and their transplants were carried out successfully. We investigated the correlation between ACR and delayed-onset neutropenia in ABO-incompatible renal transplant recipients who underwent administration of rituximab for 1 year after transplantation. RESULTS Fourteen patients (29.8%) experienced ACR (group A), and 33 recipients did not develop ACR (group B). The frequency of delayed-onset neutropenia was higher in group A than in group B (p=0.0503). Multivariate logistic regression analysis revealed that the frequency of ACR correlated significantly with the prevalence of delayed-onset neutropenia. CONCLUSIONS Our results indicated that ACR in ABO-incompatible renal transplant recipients receiving rituximab was associated with delayed-onset neutropenia.

PubMed Central

MEOLA, GIOVANNI

2013-01-01

Myotonic dystrophy (DM) is the most common adult muscular dystrophy, characterized by autosomal dominant progressive myopathy, myotonia and multiorgan involvement. To date two distinct forms caused by similar mutations have been identified. Myotonic dystrophy type 1 (DM1, Steinert's disease) was described more than 100 years ago and is caused by a (CTG)n expansion in DMPK, while myotonic dystrophy type 2 (DM2) was identified only 18 years ago and is caused by a (CCTG)n expansion in ZNF9/CNBP. When transcribed into CUG/CCUG-containing RNA, mutant transcripts aggregate as nuclear foci that sequester RNA-binding proteins, resulting in spliceopathy of downstream effector genes. Despite clinical and genetic similarities, DM1 and DM2 are distinct disorders requiring different diagnostic and management strategies. DM1 may present in four different forms: congenital, early childhood, adult onset and late-onset oligosymptomatic DM1. Congenital DM1 is the most severe form of DM characterized by extreme muscle weakness and mental retardation. In DM2 the clinical phenotype is extremely variable and there are no distinct clinical subgroups. Congenital and childhood-onset forms are not present in DM2 and, in contrast to DM1, myotonia may be absent even on EMG. Due to the lack of awareness of the disease among clinicians, DM2 remains largely underdiagnosed. The delay in receiving the correct diagnosis after onset of first symptoms is very long in DM: on average more than 5 years for DM1 and more than 14 years for DM2 patients. The long delay in the diagnosis of DM causes unnecessary problems for the patients to manage their lives and anguish with uncertainty of prognosis and treatment. PMID:24803843

Dietary aspartyl-phenylalanine-1-methyl ester delays osteoarthritis and prevents associated bone loss in STR/ORT mice

PubMed Central

Manion, Carl V.; Hochgeschwender, Ute; Edmundson, Allen B.; Hugli, Tony E.

2011-01-01

Objective. STR/ORT mice provide a well-known model for murine idiopathic OA, with histological joint lesions resembling those of human OA. This model was used to investigate protective effects of the dipeptide aspartyl-phenylalanine-1-methyl ester (Asp-Phe-OMe or aspartame) via the oral route vs a regular diet. Methods. STR/ORT mice were housed individually and fed diets with or without Asp-Phe-OMe (4 mg/kg), after weaning at the age of 3 weeks, until 15 months of age (average of 20 animals per group). The study groups were kept blinded to the investigators, who measured food consumption and body weight and performed gait mobility tests. Radiographic scans were also performed at regular time intervals to evaluate differential radiographic anomalies associated with progress of OA in response to oral Asp-Phe-OMe therapy. Results. The Asp-Phe-OMe-fed animals presented a pattern of significantly delayed disease onset. In addition, their muscle and bone mass were highly preserved, even at later time points after OA was established. Moreover, control animals presented a higher variability in gait motility in comparison with the Asp-Phe-OMe-fed animals, suggesting a protective effect from movement limitations associated with advanced OA. Conclusion. Asp-Phe-OMe, given orally, delays OA in the spontaneous STR/ORT model, improves bone cortical density and muscle mass, and may contribute to a better quality of life for these diseased animals. PMID:21372000

Does this case hold the answer to one of the worse types of pain in medicine--that of loin pain haematuria syndrome (LPHS).

PubMed

Russell, Alan; Chatterjee, Suman; Seed, Michael

2015-04-26

A patient with loin pain haematuria syndrome suffering chronic throbbing pulsing pain overlaid with prolonged periods of incapacitating colic and overnight vomiting was presented 10 months following diagnosis. Ultrasound was normal. No renal or ureteral stones, or filling defects were seen on CT. At cytoscopy, bladder and urethra were normal, and bloody urine effluxed from the left ureteric orifice. The ureters were normal at diagnosis, and developed new abutting non-penetrating calcifications by 8 months. Pain episodes of complete incapacitating intensity of 2-4 h duration were reduced to 10 min with 5 mg crushed tadalafil administered at onset. If tadalafil was delayed to after onset, the original course of agony resulted. Daily tadalafil reduced loin pain intensity, but not the exacerbations. Tadalafil efficacy may indicate that the pain exacerbations are due to spasm of ureter smooth muscle. 5 mg tadalafil taken at onset alleviated severe loin pain exacerbations in this case of loin pain haematuria syndrome. 2015 BMJ Publishing Group Ltd.

Respiratory Infections and Antibiotic Usage in Common Variable Immunodeficiency.

PubMed

Sperlich, Johannes M; Grimbacher, Bodo; Workman, Sarita; Haque, Tanzina; Seneviratne, Suranjith L; Burns, Siobhan O; Reiser, Veronika; Vach, Werner; Hurst, John R; Lowe, David M

Patients with common variable immunodeficiency (CVID) suffer frequent respiratory tract infections despite immunoglobulin replacement and are prescribed significant quantities of antibiotics. The clinical and microbiological nature of these exacerbations, the symptomatic triggers to take antibiotics, and the response to treatment have not been previously investigated. To describe the nature, frequency, treatment, and clinical course of respiratory tract exacerbations in patients with CVID and to describe pathogens isolated during respiratory tract exacerbations. We performed a prospective diary card exercise in 69 patients with CVID recruited from a primary immunodeficiency clinic in the United Kingdom, generating 6210 days of symptom data. We collected microbiology (sputum microscopy and culture, atypical bacterial PCR, and mycobacterial culture) and virology (nasopharyngeal swab multiplex PCR) samples from symptomatic patients with CVID. There were 170 symptomatic exacerbations and 76 exacerbations treated by antibiotics. The strongest symptomatic predictors for commencing antibiotics were cough, shortness of breath, and purulent sputum. There was a median delay of 5 days from the onset of symptoms to commencing antibiotics. Episodes characterized by purulent sputum responded more quickly to antibiotics, whereas sore throat and upper respiratory tract symptoms responded less quickly. A pathogenic virus was isolated in 56% of respiratory exacerbations and a potentially pathogenic bacteria in 33%. Patients with CVID delay and avoid treatment of symptomatic respiratory exacerbations, which could result in structural lung damage. However, viruses are commonly represented and illnesses dominated by upper respiratory tract symptoms respond poorly to antibiotics, suggesting that antibiotic usage could be better targeted. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

Effects of fetal hypothyroidism on uterine smooth muscle contraction and structure of offspring rats.

PubMed

Bagheripuor, Fatemeh; Ghanbari, Mahboubeh; Piryaei, Abbas; Ghasemi, Asghar

2018-05-01

What is the central question of this study? Does fetal hypothyroidism in rats alter uterine contractions and structure in the adult offspring? What is the main finding and its importance? Our study indicated that maternal hypothyroidism during pregnancy increased gestational length and decreased litter size. In addition, maternal hypothyroidism caused delayed puberty onset, irregular uterine contractions and histological changes in the uterus in the female offspring. This model might contribute to a better understanding of the cellular and molecular mechanisms involved in uterine contractions in fetal hypothyroidism, studies which are not possible in humans, and might help to establish therapeutic methods for these disorders observed in uterine contractions. Thyroid hormones play an essential role in fetal growth. Hypothyroidism impairs reproductive function in both humans and animals. The aim of this study was to assess the effects of fetal hypothyroidism on uterine smooth muscle contraction and structure in the adult offspring. The control group of female Wistar rats consumed tap water, whereas the hypothyroid group received water containing 0.025% of 6-propyl-2-thiouracial throughout gestation from mating until delivery. Isometric contractility and histological changes in uterine tissue were evaluated in the adult female offspring. We tested the effects of carbachol (10 -10 -10 -3  m) and oxytocin (10 -13 -10 -8  m) on uterine smooth muscle contraction in the fetal hypothyroid (FH) and control groups. Compared with control uteri, carbachol induced contractions with lower amplitude in the FH group (area under the curve: 1820.0 ± 250.0 versus 1370.0 ± 125.0 a.u., control versus FH group, respectively, P < 0.001) and frequency (86.4 ± 7.3 versus 37.0 ± 6.1 a.u., P < 0.001). Likewise, after exposure to oxytocin the amplitude (6614.0 ± 492.2 versus 4793.0 ± 735.2 a.u., P < 0.001) and frequency (367.4 ± 32.0 versus 167.0 ± 39.0 a.u., P < 0.001) of uterine contractions in the FH group were significantly lower than in the control group. In addition, the thickness of the endometrium and smooth muscle layer and the cross-sectional area of the uterus were also significantly lower in the FH group. Gestational length was longer and litter size smaller in FH rats compared with control animals; FH offspring also had delayed puberty. In conclusion, thyroid hormone deficiency during pregnancy increased gestational length and decreased litter size; in the offspring, it delayed puberty onset, reduced uterine rhythmic contractions and resulted in uterine structural changes. © 2018 The Authors. Experimental Physiology © 2018 The Physiological Society.

Streptococcal throat infections and exacerbation of chronic plaque psoriasis: a prospective study.

PubMed

Gudjonsson, J E; Thorarinsson, A M; Sigurgeirsson, B; Kristinsson, K G; Valdimarsson, H

2003-09-01

Guttate psoriasis has a well-known association with streptococcal throat infections but the effects of these infections in patients with chronic psoriasis remains to be evaluated in a prospective study. To determine whether streptococcal throat infections are more common in and can cause exacerbation in patients with chronic psoriasis. Two hundred and eight patients with chronic plaque psoriasis and 116 unrelated age-matched household controls were followed for 1 year. At recruitment all patients were examined, their disease severity scored and throat swabs taken. Patients and corresponding controls were then re-examined and tested for streptococcal colonization whenever they reported sore throat or exacerbation of their psoriasis during the study period. The psoriasis patients reported sore throat significantly more often than controls (61 of 208 vs. three of 116, P < 0.0001), and beta-haemolytic streptococci of Lancefield groups A, C and G (M protein-positive streptococci) were more often cultured from the patients than the controls (19 of 208 vs. one of 116, P = 0.003). A significant exacerbation of psoriasis (P = 0.004) was observed only if streptococci were isolated and the patients were assessed 4 days or later after the onset of sore throat. No difference was observed between groups A, C or G streptococci in this respect. This study confirms anecdotal and retrospective reports that streptococcal throat infections can cause exacerbation of chronic plaque psoriasis. It is concluded that psoriasis patients should be encouraged to report sore throat to their physician and that early treatment of streptococcal throat infections might be beneficial in psoriasis. A controlled trial for assessing potential benefits of tonsillectomy in patients with severe psoriasis should also be considered.

Early-progressive dilated cardiomyopathy in a family with Becker muscular dystrophy related to a novel frameshift mutation in the dystrophin gene exon 27.

PubMed

Tsuda, Takeshi; Fitzgerald, Kristi; Scavena, Mena; Gidding, Samuel; Cox, Mary O; Marks, Harold; Flanigan, Kevin M; Moore, Steven A

2015-03-01

We report a family in which two male siblings with Becker muscular dystrophy (BMD) developed severe dilated cardiomyopathy (DCM) and progressive heart failure (HF) at age 11 years; one died at age 14 years while awaiting heart transplant and the other underwent left ventricular assist device implantation at the same age. Genetic analysis of one sibling showed a novel frameshift mutation in exon 27 of Duchenne muscular dystrophy (DMD) gene (c.3779_3785delCTTTGGAinsGG), in which seven base pairs are deleted and two are inserted. Although this predicts an amino-acid substitution and premature termination (p.Thr1260Argfs*8), muscle biopsy dystrophin immunostaining instead indicates that the mutation is more likely to alter splicing. Despite relatively preserved skeletal muscular performance, both the siblings developed progressive HF secondary to early-onset DCM. In addition, their 7-year-old nephew with delayed gross motor development, mild proximal muscle weakness and markedly elevated serum creatine kinase level (>13 000 IU l(-1)) at 16 months was recently demonstrated to have the familial DMD mutation. Here, we report a novel genotype of BMD with early-onset DCM and progressive lethal HF during early adolescence.

Delayed-onset PTSD among war veterans: the role of life events throughout the life cycle.

PubMed

Horesh, Danny; Solomon, Z; Zerach, G; Ein-Dor, T

2011-09-01

The underlying mechanisms of delayed-onset PTSD are yet to be understood. This study examines the role of stressful life events throughout the life cycle in delayed-onset PTSD following combat. 675 Israeli veterans from the 1982 Lebanon War, 369 with antecedent combat stress reaction (CSR) and 306 without CSR were assessed prospectively, 1, 2 and 20 years after the war. Veterans were divided into four groups, according to the time of first PTSD onset (first onset at 1983, 1984, and 2002 and no PTSD onset). They were assessed for post-, peri- and pre-traumatic life events, as well as military and socio-demographic characteristics. Our findings indicate that shorter delays in PTSD onset were associated with a higher risk for CSR, a higher number of pre- and post-war life events, more severe subjective battle exposure, greater perceived danger during combat and a more stressful military position. CSR was found to be the most powerful predictor of PTSD onset. A recency effect was also found, with more recent life events proving to be stronger predictors of PTSD onset. First, our findings validate the existence of delayed-onset PTSD, as it was found among a substantial number of participants (16.5%). Second, post-, peri- and pre-traumatic life events are associated with the time of PTSD onset. Thus, practitioners and researchers are encouraged to examine not only the original trauma, but also the stressful experiences throughout the survivors' life cycle. In particular, identification of antecedent CSR may help mental help professionals in targeting high-risk populations.

Exertional muscle injury: evaluation of concentric versus eccentric actions with serial MR imaging.

PubMed

Shellock, F G; Fukunaga, T; Mink, J H; Edgerton, V R

1991-06-01

Eccentric muscular actions involve the forced lengthening or stretching of muscles and tend to produce exertional injuries. This study used magnetic resonance (MR) imaging to serially evaluate muscles in five healthy, untrained subjects who performed exhaustive biceps exercise by doing isolated eccentric and concentric actions with a dumbbell. Symptoms were assessed, and T2-weighted images of the arms were obtained before exercise and 1, 3, 5, 10, 25, 40, 50, 60, and 80 days after exercise. Statistically significant increases in T2 relaxation times indicative of muscle injury occurred on each day of MR imaging evaluation in muscles performing eccentric actions, peaking on day 3 in two subjects; day 5, two subjects; and day 10, one subject. The pattern and extent of the abnormalities on MR images were variable. Pain, soreness, and joint stiffness were present on days 1, 3, and 5 in muscles that performed eccentric actions. MR imaging showed subclinical abnormalities that lasted as long as 75 days after the disappearance of symptoms (two subjects). Muscles that performed concentric actions had no changes in T2 relaxation times and were asymptomatic throughout the study.

ALS-related misfolded protein management in motor neurons and muscle cells.

PubMed

Galbiati, Mariarita; Crippa, Valeria; Rusmini, Paola; Cristofani, Riccardo; Cicardi, Maria Elena; Giorgetti, Elisa; Onesto, Elisa; Messi, Elio; Poletti, Angelo

2014-12-01

Amyotrophic Lateral Sclerosis (ALS) is the most common form of adult-onset motor neuron disease. It is now considered a multi-factorial and multi-systemic disorder in which alterations of the crosstalk between neuronal and non-neuronal cell types might influence the course of the disease. In this review, we will provide evidence that dysfunctions of affected muscle cells are not only a marginal consequence of denervation associated to motor neurons loss, but a direct consequence of cell muscle toxicity of mutant SOD1. In muscle, the misfolded state of mutant SOD1 protein, unlike in motor neurons, does not appear to have direct effects on protein aggregation and mitochondrial functionality. Muscle cells are, in fact, more capable than motor neurons to handle misfolded proteins, suggesting that mutant SOD1 toxicity in muscle is not mediated by classical mechanisms of intracellular misfolded proteins accumulation. Several recent works indicate that a higher activation of molecular chaperones and degradative systems is present in muscle cells, which for this reason are possibly able to better manage misfolded mutant SOD1. However, several alterations in gene expression and regenerative potential of skeletal muscles have also been reported as a consequence of the expression of mutant SOD1 in muscle. Whether these changes in muscle cells are causative of ALS or a consequence of motor neuron alterations is not yet clear, but their elucidation is very important, since the understanding of the mechanisms involved in mutant SOD1 toxicity in muscle may facilitate the design of treatments directed toward this specific tissue to treat ALS or at least to delay disease progression. Copyright © 2014 Elsevier Ltd. All rights reserved.

Serial neurophysiological and neurophysiological examinations for delayed facial nerve palsy in a patient with Fisher syndrome.

PubMed

Umekawa, Motoyuki; Hatano, Keiko; Matsumoto, Hideyuki; Shimizu, Takahiro; Hashida, Hideji

2017-05-27

The patient was a 47-year-old man who presented with diplopia and gait instability with a gradual onset over the course of three days. Neurological examinations showed ophthalmoplegia, diminished tendon reflexes, and truncal ataxia. Tests for anti-GQ1b antibodies and several other antibodies to ganglioside complex were positive. We made a diagnosis of Fisher syndrome. After administration of intravenous immunoglobulin, the patient's symptoms gradually improved. However, bilateral facial palsy appeared during the recovery phase. Brain MRI showed intensive contrast enhancement of bilateral facial nerves. During the onset phase of facial palsy, the amplitude of the compound muscle action potential (CMAP) in the facial nerves was preserved. During the peak phase, the facial CMAP amplitude was within the lower limit of normal values, or mildly decreased. During the recovery phase, the CMAP amplitude was normalized, and the R1 and R2 responses of the blink reflex were prolonged. The delayed facial nerve palsy improved spontaneously, and the enhancement on brain MRI disappeared. Serial neurophysiological and neuroradiological examinations suggested that the main lesions existed in the proximal part of the facial nerves and the mild lesions existed in the facial nerve terminals, probably due to reversible conduction failure.

Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study

PubMed Central

Little, Paul; Hobbs, FD Richard; Mant, David; McNulty, Cliodna AM; Mullee, Mark

2012-01-01

Background Management of pharyngitis is commonly based on features which are thought to be associated with Lancefield group A beta-haemolytic streptococci (GABHS) but it is debatable which features best predict GABHS. Non-group A strains share major virulence factors with group A, but it is unclear how commonly they present and whether their presentation differs. Aim To assess the incidence and clinical variables associated with streptococcal infections. Design and setting Prospective diagnostic cohort study in UK primary care. Method The presence of pathogenic streptococci from throat swabs was assessed among patients aged ≥5 years presenting with acute sore throat. Results Pathogenic streptococci were found in 204/597 patients (34%, 95% CI = 31 to 38%): 33% (68/204) were non-group A streptococci, mostly C (n = 29), G (n = 18) and B (n = 17); rarely D (n = 3) and Streptococcus pneumoniae (n = 1). Patients presented with similar features whether the streptococci were group A or non-group A. The features best predicting A, C or G beta-haemolytic streptococci were patient’s assessment of severity (odds ratio [OR] for a bad sore throat 3.31, 95% CI = 1.24 to 8.83); doctors’ assessment of severity (severely inflamed tonsils OR 2.28, 95% CI = 1.39 to 3.74); absence of a bad cough (OR 2.73, 95% CI = 1.56 to 4.76), absence of a coryza (OR 1.54, 95% CI = 0.99 to 2.41); and moderately bad or worse muscle aches (OR 2.20, 95% CI = 1.41 to 3.42). Conclusion Non-group A strains commonly cause streptococcal sore throats, and present with similar symptomatic clinical features to group A streptococci. The best features to predict streptococcal sore throat presenting in primary care deserve revisiting. PMID:23211183

Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study.

PubMed

Little, Paul; Hobbs, F D Richard; Mant, David; McNulty, Cliodna A M; Mullee, Mark

2012-11-01

Management of pharyngitis is commonly based on features which are thought to be associated with Lancefield group A beta-haemolytic streptococci (GABHS) but it is debatable which features best predict GABHS. Non-group A strains share major virulence factors with group A, but it is unclear how commonly they present and whether their presentation differs. To assess the incidence and clinical variables associated with streptococcal infections. Prospective diagnostic cohort study in UK primary care. The presence of pathogenic streptococci from throat swabs was assessed among patients aged ≥5 years presenting with acute sore throat. Pathogenic streptococci were found in 204/597 patients (34%, 95% CI = 31 to 38%): 33% (68/204) were non-group A streptococci, mostly C (n = 29), G (n = 18) and B (n = 17); rarely D (n = 3) and Streptococcus pneumoniae (n = 1). Patients presented with similar features whether the streptococci were group A or non-group A. The features best predicting A, C or G beta-haemolytic streptococci were patient's assessment of severity (odds ratio [OR] for a bad sore throat 3.31, 95% CI = 1.24 to 8.83); doctors' assessment of severity (severely inflamed tonsils OR 2.28, 95% CI = 1.39 to 3.74); absence of a bad cough (OR 2.73, 95% CI = 1.56 to 4.76), absence of a coryza (OR 1.54, 95% CI = 0.99 to 2.41); and moderately bad or worse muscle aches (OR 2.20, 95% CI = 1.41 to 3.42). Non-group A strains commonly cause streptococcal sore throats, and present with similar symptomatic clinical features to group A streptococci. The best features to predict streptococcal sore throat presenting in primary care deserve revisiting.

Do baby walkers delay onset of walking in young children?

PubMed

Burrows, Patricia; Griffiths, Peter

2002-11-01

Baby walkers have been a source of considerable controversy. Some people suggest developmental benefit from their use while others focus on the potential harm that stems from accidents and even suggest developmental delay. This mini-review aimed to determine if use of a baby walker delays affects the onset of walking. The Cochrane library, Embase, CINAHL and Medline were searched for randomized controlled trials (RCTs) and cohort studies, which compared the onset of walking in infants who used baby walkers with a group who did not. Two RCTs and two cohort studies were identified and available for consideration. All of the studies examined the effect of infant walkers on the onset of walking. The results of the two RCTs did not demonstrate a significant effect on the onset of walking. The cohort studies suggest that the use of infant walkers delayed the onset of walking in young children and a pooled analysis of the four studies suggested a delay of between 11 and 26 days. Although the quality of the studies was relatively poor these studies lend no support to the argument that walkers aid the development of walking. The significance of a delay of this magnitude is however unclear. Further work is required to determine whether walkers are an independent causal factor in accidents.

Are automatic postural responses in patients with Parkinson's disease abnormal due to their stooped posture?

PubMed

Bloem, B R; Beckley, D J; van Dijk, J G

1999-02-01

Abnormal automatic postural responses are thought to contribute to balance impairment in Parkinson's disease. However, because postural responses are modifiable by stance, we have speculated that some postural abnormalities in patients with Parkinson's disease are secondary to their stooped stance. We have studied this assumption by assessing automatic postural responses in 30 healthy subjects who were instructed either to stand upright or to assume a typical parkinsonian posture. During both conditions, subjects received 20 serial 4 degrees 'toe-up' rotational perturbations from a supporting forceplate. We recorded short-latency (SL) and medium-latency (ML) responses from stretched gastrocnemius muscles and long-latency (LL) responses from shortened tibialis anterior muscles. We also assessed changes in the center of foot pressure (CFP) and the center of gravity (COG). The results were qualitatively compared to a previously described group of patients with Parkinson's disease who, under these circumstances, typically have large ML responses, small LL responses and insufficient voluntary postural corrections, accompanied by a slow rate of backward CFP displacement and an increased posterior COG displacement. The stooped posture resulted in unloading of medial gastrocnemius muscles and loading of tibialis anterior muscles. Onset latencies of stretch responses in gastrocnemius muscles were delayed in stooped subjects, but the onset of LL responses was markedly reduced. Amplitudes of both ML and LL responses were reduced in stooped subjects. Prestimulus COG and, to a lesser extent, CFP were shifted forwards in stooped subjects. Posterior COG displacement and the rate of backward CFP displacement were diminished in stooped subjects. Voluntary postural corrections were unchanged while standing stooped. These results indicate that some postural abnormalities of patients with Parkinson's disease (most notably the reduced LL responses) can be reproduced in healthy subjects mimicking a stooped parkinsonian posture. Other postural abnormalities (most notably the increased ML responses and insufficient voluntary responses) did not appear in stooped controls and may contribute to balance impairment in Parkinson's disease.

Objective measures of sleep and dim light melatonin onset in adolescents and young adults with delayed sleep phase disorder compared to healthy controls.

PubMed

Saxvig, Ingvild W; Wilhelmsen-Langeland, Ane; Pallesen, Ståle; Vedaa, Oystein; Nordhus, Inger H; Sørensen, Eli; Bjorvatn, Bjørn

2013-08-01

Delayed sleep phase disorder is characterized by a delay in the timing of the major sleep period relative to conventional norms. The sleep period itself has traditionally been described as normal. Nevertheless, it is possible that sleep regulatory mechanism disturbances associated with the disorder may affect sleep duration and/or architecture. Polysomnographic data that may shed light on the issue are scarce. Hence, the aim of this study was to examine polysomnographic measures of sleep in adolescents and young adults with delayed sleep phase disorder, and to compare findings to that of healthy controls. A second aim was to estimate dim light melatonin onset as a marker of circadian rhythm and to investigate the phase angle relationship (time interval) between dim light melatonin onset and the sleep period. Data from 54 adolescents and young adults were analysed, 35 diagnosed with delayed sleep phase disorder and 19 healthy controls. Results show delayed timing of sleep in participants with delayed sleep phase disorder, but once sleep was initiated no group differences in sleep parameters were observed. Dim light melatonin onset was delayed in participants with delayed sleep phase disorder, but no difference in phase angle was observed between the groups. In conclusion, both sleep and dim light melatonin onset were delayed in participants with delayed sleep phase disorder. The sleep period appeared to occur at the same circadian phase in both groups, and once sleep was initiated no differences in sleep parameters were observed. © 2013 European Sleep Research Society.

Tandem mass spectrometry, but not T-cell receptor excision circle analysis, identifies newborns with late-onset adenosine deaminase deficiency.

PubMed

la Marca, Giancarlo; Canessa, Clementina; Giocaliere, Elisa; Romano, Francesca; Duse, Marzia; Malvagia, Sabrina; Lippi, Francesca; Funghini, Silvia; Bianchi, Leila; Della Bona, Maria Luisa; Valleriani, Claudia; Ombrone, Daniela; Moriondo, Maria; Villanelli, Fabio; Speckmann, Carsten; Adams, Stuart; Gaspar, Bobby H; Hershfield, Michael; Santisteban, Ines; Fairbanks, Lynette; Ragusa, Giovanni; Resti, Massimo; de Martino, Maurizio; Guerrini, Renzo; Azzari, Chiara

2013-06-01

Adenosine deaminase (ADA)-severe combined immunodeficiency (SCID) is caused by genetic variants that disrupt the function of ADA. In its early-onset form, it is rapidly fatal to infants. Delayed or late-onset ADA-SCID is characterized by insidious progressive immunodeficiency that leads to permanent organ damage or death. Quantification of T-cell receptor excision circles (TRECs) or tandem mass spectrometry (tandem-MS) analysis of dried blood spots (DBSs) collected at birth can identify newborns with early-onset ADA-SCID and are used in screening programs. However, it is not clear whether these analyses can identify newborns who will have delayed or late-onset ADA-SCID before symptoms appear. We performed a retrospective study to evaluate whether tandem-MS and quantitative TREC analyses of DBSs could identify newborns who had delayed-onset ADA-SCID later in life. We tested stored DBSs collected at birth from 3 patients with delayed-onset ADA-SCID using tandem-MS (PCT EP2010/070517) to evaluate levels of adenosine and 2'-deoxyadenosine and real-time PCR to quantify TREC levels. We also analyzed DBSs from 3 newborns with early-onset ADA-SCID and 2 healthy newborn carriers of ADA deficiency. The DBSs taken at birth from the 3 patients with delayed-onset ADA-SCID had adenosine levels of 10, 25, and 19 μmol/L (normal value, <1.5 μmol/L) and 2'-deoxyadenosine levels of 0.7, 2.7, and 2.4 μmol/L (normal value, <0.07 μmol/L); the mean levels of adenosine and 2'-deoxyadenosine were respectively 12.0- and 27.6-fold higher than normal values. DBSs taken at birth from all 3 patients with delayed-onset ADA deficiency had normal TREC levels, but TRECs were undetectable in blood samples taken from the same patients at the time of diagnosis. Tandem-MS but not TREC quantification identifies newborns with delayed- or late-onset ADA deficiency. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Accelerated recovery of Atlantic salmon (Salmo salar) from effects of crowding by swimming.

PubMed

Veiseth, Eva; Fjaera, Svein Olav; Bjerkeng, Bjørn; Skjervold, Per Olav

2006-07-01

The effects of post-crowding swimming velocity (0, 0.35, and 0.70 m/s) and recovery time (1.5, 6, and 12 h) on physiological recovery and processing quality parameters of adult Atlantic salmon (Salmo salar) were determined. Atlantic salmon crowded to a density similar to that of a commercial slaughter process (>200 kg/m(3), 40 min) were transferred to a swimming chamber for recovery treatment. Osmolality and concentrations of cortisol, glucose and lactate in blood plasma were used as physiological stress indicators, whereas image analyses of extent and duration of rigor contraction, and fillet gaping were used as measures of processing quality. Crowded salmon had a 5.8-fold higher plasma cortisol concentration than control salmon (P<0.05). The elevated plasma cortisol concentration was reduced by increasing the swimming velocity, and had returned to control levels after 6 h recovery at high water velocity. Similar effects of swimming velocity were observed for plasma osmolality and lactate concentration. A lower plasma glucose concentration was present in crowded than in control fish (P<0.05), although a typical post-stress elevation in plasma glucose was observed after the recovery treatments. Lower muscle pH was found in crowded compared with control salmon (P<0.05), but muscle pH returned to control levels after 6 h recovery at intermediate and high swimming velocities and after 12 h in the low velocity group. Crowding caused an early onset of rigor mortis contraction. However, subjecting crowded salmon to active swimming for 6 h before slaughter delayed the onset of rigor mortis contraction from 2.5 to 7.5 h post mortem. The extent of rigor mortis contraction was also affected by crowding and post-stress swimming activity (P<0.05), and the largest degree of contraction was found in crowded salmon. In conclusion, active swimming accelerated the return of plasma cortisol, hydromineral balance, and the energy metabolism of adult Atlantic salmon to pre-stress levels. Moreover, an active swimming period delayed the onset of rigor mortis contraction, which has a positive technological implication for the salmon processing industry.

Neuromuscular Fatigue and Physiological Responses After Five Dynamic Squat Exercise Protocols.

PubMed

Raeder, Christian; Wiewelhove, Thimo; Westphal-Martinez, Marc P; Fernandez-Fernandez, Jaime; de Paula Simola, Rauno A; Kellmann, Michael; Meyer, Tim; Pfeiffer, Mark; Ferrauti, Alexander

2016-04-01

This aimed to analyze neuromuscular, physiological and perceptual responses to a single bout of 5 different dynamic squat exercise protocols. In a randomized and counterbalanced order, 15 male resistance-trained athletes (mean ± SD; age: 23.1 ± 1.9 years, body mass: 77.4 ± 8.0 kg) completed traditional multiple sets (MS: 4 × 6, 85% 1 repetition maximum [RM]), drop sets (DS: 1 × 6, 85% 1RM + 3 drop sets), eccentric overload (EO: 4 × 6, 70% 1RM concentric, 100% 1RM eccentric), flywheel YoYo squat (FW: 4 × 6, all-out), and a plyometric jump protocol (PJ: 4 × 15, all-out). Blood lactate (La), ratings of perceived exertion (RPE), counter movement jump height (CMJ), multiple rebound jump (MRJ) performance, maximal voluntary isometric contraction force, serum creatine kinase (CK) and delayed onset muscle soreness were measured. Immediately post exercise, La was significantly (p < 0.001) higher in FW (mean ± 95% confidence limit; 12.2 ± 0.9 mmol·L) and lower in PJ (3.0 ± 0.8 mmol·L) compared with MS (7.7 ± 1.5 mmol·L), DS (8.5 ± 0.6 mmol·L), and EO (8.2 ± 1.6 mmol·L), accompanied by similar RPE responses. Neuromuscular performance (CMJ, MRJ) significantly remained decreased (p < 0.001) from 0.5 to 48 hours post exercise in all protocols. There was a significant time × protocol interaction (p ≤ 0.05) in MRJ with a significant lower performance in DS, EO, and FW compared with PJ (0.5 hours post exercise), and in EO compared with all other protocols (24 hours post exercise). A significant main time effect with peak values 24 hours post exercise was observed in CK serum concentrations (p < 0.001), but there was no time × protocol interaction. In conclusion, (a) metabolic and perceptual demands were higher in FW and EO compared with MS, DS and PJ, (b) neuromuscular fatigue was consistent up to 48 hours post exercise in all protocols, and (c) EO induced the greatest neuromuscular fatigue.

Effect of diabetic neuropathy severity classified by a fuzzy model in muscle dynamics during gait

PubMed Central

2014-01-01

Background Electromyography (EMG) alterations during gait, supposedly caused by diabetic sensorimotor polyneuropathy, are subtle and still inconsistent, due to difficulties in defining homogeneous experimental groups with a clear definition of disease stages. Since evaluating these patients involve many uncertainties, the use of a fuzzy model could enable a better discrimination among different stages of diabetic polyneuropathy and lead to a clarification of when changes in muscle activation start occurring. The aim of this study was to investigate EMG patterns during gait in diabetic individuals with different stages of DSP severity, classified by a fuzzy system. Methods 147 subjects were divided into a control group (n = 30) and four diabetic groups: absent (n = 43), mild (n = 30), moderate (n = 16), and severe (n = 28) neuropathy, classified by a fuzzy model. The EMG activity of the vastus lateralis, tibialis anterior, and gastrocnemius medialis were measured during gait. Temporal and relative magnitude variables were compared among groups using ANOVA tests. Results Muscle activity changes are present even before an established neural involvement, with delay in vastus lateralis peak and lower tibialis anterior relative magnitude. These alterations suggest an impaired ankle shock absorption mechanism, with compensation at the knee. This condition seems to be more pronounced in higher degrees of neuropathy, as there is an increased vastus lateralis activity in the mild and severe neuropathy groups. Tibialis anterior onset at terminal stance was anticipated in all diabetic groups; at higher degrees of neuropathy, the gastrocnemius medialis exhibited activity reduction and peak delay. Conclusion EMG alterations in the vastus lateralis and tibialis anterior occur even in the absence of diabetic neuropathy and in mild neuropathic subjects, seemingly causing changes in the shock absorption mechanisms at the heel strike. These changes increase with the onset of neural impairments, and the gastrocnemius medialis starts presenting altered activity in the later stages of the disease (moderate and severe neuropathy). The degree of severity of diabetic neuropathy must be taken into account when analyzing diabetic patients’ biomechanical patterns of locomotion; we recommend the use of a fuzzy model for classification of disease stages. PMID:24507153

Cold water immersion recovery after simulated collision sport exercise.

PubMed

Pointon, Monique; Duffield, Rob

2012-02-01

This investigation examined the effects of cold water immersion (CWI) recovery after simulated collision sport exercise. Ten male rugby athletes performed three sessions consisting of a 2 × 30-min intermittent-sprint exercise (ISE) protocol with either tackling (T) or no tackling (CONT), followed by a 20-min CWI intervention (TCWI) or passive recovery (TPASS and CONT) in a randomized order. The ISE consisted of a 15-m sprint every minute separated by self-paced bouts of hard running, jogging, and walking for the remainder of the minute. Every sixth rotation, participants performed 5 × 10-m runs, receiving a shoulder-led tackle to the lower body on each effort. Sprint time and distance covered during ISE were recorded, with voluntary (maximal voluntary contraction; MVC) and evoked neuromuscular function (voluntary activation; VA), electromyogram (root mean square (RMS)), ratings of perceived muscle soreness (MS), capillary and venous blood markers for metabolites and muscle damage, respectively measured before and after exercise, immediately after recovery, and 2 and 24 h after recovery. Total distance covered during exercise was significantly greater in CONT (P = 0.01), without differences between TPASS and TCWI (P > 0.05). TCWI resulted in increased MVC, VA, and RMS immediately after recovery (P < 0.05). M-wave amplitude and peak twitch were significantly increased after recovery and 2 h after recovery, respectively, in TCWI (P < 0.05). Although TCWI had no effect on the elevation in blood markers for muscle damage (P > 0.05), lactate was significantly reduced after recovery compared with TPASS (P = 0.04). CWI also resulted in reduced MS 2 h after recovery compared with TPASS (P < 0.05). The introduction of body contact reduces exercise performance, whereas the use of CWI results in a faster recovery of MVC, VA, and RMS and improves muscle contractile properties and perceptions of soreness after collision-based exercise.

Comparison of Muscle Onset Activation Sequences between a Golf or Tennis Swing and Common Training Exercises Using Surface Electromyography: A Pilot Study.

PubMed

Vasudevan, John M; Logan, Andrew; Shultz, Rebecca; Koval, Jeffrey J; Roh, Eugene Y; Fredericson, Michael

2016-01-01

Aim. The purpose of this pilot study is to use surface electromyography to determine an individual athlete's typical muscle onset activation sequence when performing a golf or tennis forward swing and to use the method to assess to what degree the sequence is reproduced with common conditioning exercises and a machine designed for this purpose. Methods. Data for 18 healthy male subjects were collected for 15 muscles of the trunk and lower extremities. Data were filtered and processed to determine the average onset of muscle activation for each motion. A Spearman correlation estimated congruence of activation order between the swing and each exercise. Correlations of each group were pooled with 95% confidence intervals using a random effects meta-analytic strategy. Results. The averaged sequences differed among each athlete tested, but pooled correlations demonstrated a positive association between each exercise and the participants' natural muscle onset activation sequence. Conclusion. The selected training exercises and Turning Point™ device all partially reproduced our athletes' averaged muscle onset activation sequences for both sports. The results support consideration of a larger, adequately powered study using this method to quantify to what degree each of the selected exercises is appropriate for use in both golf and tennis.

Comparison of Muscle Onset Activation Sequences between a Golf or Tennis Swing and Common Training Exercises Using Surface Electromyography: A Pilot Study

PubMed Central

Shultz, Rebecca; Fredericson, Michael

2016-01-01

Aim. The purpose of this pilot study is to use surface electromyography to determine an individual athlete's typical muscle onset activation sequence when performing a golf or tennis forward swing and to use the method to assess to what degree the sequence is reproduced with common conditioning exercises and a machine designed for this purpose. Methods. Data for 18 healthy male subjects were collected for 15 muscles of the trunk and lower extremities. Data were filtered and processed to determine the average onset of muscle activation for each motion. A Spearman correlation estimated congruence of activation order between the swing and each exercise. Correlations of each group were pooled with 95% confidence intervals using a random effects meta-analytic strategy. Results. The averaged sequences differed among each athlete tested, but pooled correlations demonstrated a positive association between each exercise and the participants' natural muscle onset activation sequence. Conclusion. The selected training exercises and Turning Point™ device all partially reproduced our athletes' averaged muscle onset activation sequences for both sports. The results support consideration of a larger, adequately powered study using this method to quantify to what degree each of the selected exercises is appropriate for use in both golf and tennis. PMID:27403454

Etiology and Progression of Acute Muscle Tension Related Low Back Pain Occurring During Sustained Activity Including Combat Training Exercises

DTIC Science & Technology

1992-01-31

pattern of paraspinal muscle contraction , and (3) onset of low back pain. (b) That patterns of muscle tension recorded throughout the normal day in the...intensity and duration of activity being performed, (b) the pattern of paraspinal muscle contraction , and (c) onset of low back pain. (2) To determine whether... muscle contraction , and activity by performing continuous recordings of these factors among groups of low back pain subjects in their normal

Notes from the Field: Group A Streptococcal Pharyngitis Misdiagnoses at a Rural Urgent-Care Clinic--Wyoming, March 2015.

PubMed

Harrist, Alexia; Van Houten, Clayton; Shulman, Stanford T; Van Beneden, Chris; Murphy, Tracy

2016-01-01

Group A Streptococcus (GAS) is the most common bacterial cause of pharyngitis, implicated in 20%-30% of pediatric and 5%-15% of adult health care visits for sore throat (1). Along with the sudden onset of throat pain, GAS pharyngitis symptoms include fever, headache, and bilateral tender cervical lymphadenopathy (1,2). Accurate diagnosis and management of GAS pharyngitis is critical for limiting antibiotic overuse and preventing rheumatic fever (2), but distinguishing between GAS and viral pharyngitis clinically is challenging (1). Guidelines for diagnosis and management of GAS pharyngitis have been published by the Infectious Diseases Society of America (IDSA)* (1). IDSA recommends that patients with sore throat be tested for GAS to distinguish between GAS and viral pharyngitis; however, IDSA emphasizes the use of selective testing based on clinical symptoms and signs to avoid identifying GAS carriers rather than acute GAS infections (1). Therefore, testing for GAS usually is not recommended for the following: patients with sore throat and accompanying symptoms (e.g., cough, rhinorrhea) that strongly suggest a viral etiology; children aged <3 years, because acute rheumatic fever is extremely rare in this age group; and asymptomatic household contacts of patients with GAS pharyngitis (1). IDSA recommends penicillin or amoxicillin as the treatment of choice based on effectiveness and narrow spectrum of activity. To date, penicillin-resistant GAS has never been documented (1).

The ER-bound RING finger protein 5 (RNF5/RMA1) causes degenerative myopathy in transgenic mice and is deregulated in inclusion body myositis.

PubMed

Delaunay, Agnès; Bromberg, Kenneth D; Hayashi, Yukiko; Mirabella, Massimiliano; Burch, Denise; Kirkwood, Brian; Serra, Carlo; Malicdan, May C; Mizisin, Andrew P; Morosetti, Roberta; Broccolini, Aldobrando; Guo, Ling T; Jones, Stephen N; Lira, Sergio A; Puri, Pier Lorenzo; Shelton, G Diane; Ronai, Ze'ev

2008-02-13

Growing evidence supports the importance of ubiquitin ligases in the pathogenesis of muscular disorders, although underlying mechanisms remain largely elusive. Here we show that the expression of RNF5 (aka RMA1), an ER-anchored RING finger E3 ligase implicated in muscle organization and in recognition and processing of malfolded proteins, is elevated and mislocalized to cytoplasmic aggregates in biopsies from patients suffering from sporadic-Inclusion Body Myositis (sIBM). Consistent with these findings, an animal model for hereditary IBM (hIBM), but not their control littermates, revealed deregulated expression of RNF5. Further studies for the role of RNF5 in the pathogenesis of s-IBM and more generally in muscle physiology were performed using RNF5 transgenic and KO animals. Transgenic mice carrying inducible expression of RNF5, under control of beta-actin or muscle specific promoter, exhibit an early onset of muscle wasting, muscle degeneration and extensive fiber regeneration. Prolonged expression of RNF5 in the muscle also results in the formation of fibers containing congophilic material, blue-rimmed vacuoles and inclusion bodies. These phenotypes were associated with altered expression and activity of ER chaperones, characteristic of myodegenerative diseases such as s-IBM. Conversely, muscle regeneration and induction of ER stress markers were delayed in RNF5 KO mice subjected to cardiotoxin treatment. While supporting a role for RNF5 Tg mice as model for s-IBM, our study also establishes the importance of RNF5 in muscle physiology and its deregulation in ER stress associated muscular disorders.

The ER-Bound RING Finger Protein 5 (RNF5/RMA1) Causes Degenerative Myopathy in Transgenic Mice and Is Deregulated in Inclusion Body Myositis

PubMed Central

Delaunay, Agnès; Bromberg, Kenneth D.; Hayashi, Yukiko; Mirabella, Massimiliano; Burch, Denise; Kirkwood, Brian; Serra, Carlo; Malicdan, May C.; Mizisin, Andrew P.; Morosetti, Roberta; Broccolini, Aldobrando; Guo, Ling T.; Jones, Stephen N.; Lira, Sergio A.; Puri, Pier Lorenzo; Shelton, G. Diane; Ronai, Ze'ev

2008-01-01

Growing evidence supports the importance of ubiquitin ligases in the pathogenesis of muscular disorders, although underlying mechanisms remain largely elusive. Here we show that the expression of RNF5 (aka RMA1), an ER-anchored RING finger E3 ligase implicated in muscle organization and in recognition and processing of malfolded proteins, is elevated and mislocalized to cytoplasmic aggregates in biopsies from patients suffering from sporadic-Inclusion Body Myositis (sIBM). Consistent with these findings, an animal model for hereditary IBM (hIBM), but not their control littermates, revealed deregulated expression of RNF5. Further studies for the role of RNF5 in the pathogenesis of s-IBM and more generally in muscle physiology were performed using RNF5 transgenic and KO animals. Transgenic mice carrying inducible expression of RNF5, under control of β-actin or muscle specific promoter, exhibit an early onset of muscle wasting, muscle degeneration and extensive fiber regeneration. Prolonged expression of RNF5 in the muscle also results in the formation of fibers containing congophilic material, blue-rimmed vacuoles and inclusion bodies. These phenotypes were associated with altered expression and activity of ER chaperones, characteristic of myodegenerative diseases such as s-IBM. Conversely, muscle regeneration and induction of ER stress markers were delayed in RNF5 KO mice subjected to cardiotoxin treatment. While supporting a role for RNF5 Tg mice as model for s-IBM, our study also establishes the importance of RNF5 in muscle physiology and its deregulation in ER stress associated muscular disorders. PMID:18270596

Coping with Cold Sores

MedlinePlus

... Staying Safe Videos for Educators Search English Español Cold Sores KidsHealth / For Kids / Cold Sores What's in ... sore." What's that? Adam wondered. What Is a Cold Sore? Cold sores are small blisters that is ...

Sciatic nerve block causing heel ulcer after total knee replacement in 36 patients.

PubMed

Todkar, Manoj

2005-12-01

Femoral and sciatic nerve blocks are often used for postoperative analgesia following total knee replacement surgery. In this report, we focus on cases of heel ulcers which occurred following the implementation of peripheral nerve block in concert with knee replacement surgery. In some instances, heel ulcers have resulted in delayed rehabilitation and prolonged hospital stays in this group of patients, which makes this phenomenon a potential burden on the healthcare system. Pressure points in the foot should be protected after the implementation of nerve blocks to prevent pressure sores. An awareness of this unusual complication related to knee replacement surgery is necessary to prevent its occurrence and avoid delays in patient rehabilitation and recovery.

Humans Optimize Decision-Making by Delaying Decision Onset

PubMed Central

Teichert, Tobias; Ferrera, Vincent P.; Grinband, Jack

2014-01-01

Why do humans make errors on seemingly trivial perceptual decisions? It has been shown that such errors occur in part because the decision process (evidence accumulation) is initiated before selective attention has isolated the relevant sensory information from salient distractors. Nevertheless, it is typically assumed that subjects increase accuracy by prolonging the decision process rather than delaying decision onset. To date it has not been tested whether humans can strategically delay decision onset to increase response accuracy. To address this question we measured the time course of selective attention in a motion interference task using a novel variant of the response signal paradigm. Based on these measurements we estimated time-dependent drift rate and showed that subjects should in principle be able trade speed for accuracy very effectively by delaying decision onset. Using the time-dependent estimate of drift rate we show that subjects indeed delay decision onset in addition to raising response threshold when asked to stress accuracy over speed in a free reaction version of the same motion-interference task. These findings show that decision onset is a critical aspect of the decision process that can be adjusted to effectively improve decision accuracy. PMID:24599295

Control of upper airway muscle activity in younger versus older men during sleep onset

PubMed Central

Fogel, Robert B; White, David P; Pierce, Robert J; Malhotra, Atul; Edwards, Jill K; Dunai, Judy; Kleverlaan, Darci; Trinder, John

2003-01-01

Pharyngeal dilator muscles are clearly important in the pathophysiology of obstructive sleep apnoea syndrome (OSA). We have previously shown that the activity of both the genioglossus (GGEMG) and tensor palatini (TPEMG) are decreased at sleep onset, and that this decrement in muscle activity is greater in the apnoea patient than in healthy controls. We have also previously shown this decrement to be greater in older men when compared with younger ones. In order to explore the mechanisms responsible for this decrement in muscle activity nasal continuous positive airway pressure (CPAP) was applied to reduce negative pressure mediated muscle activation. We then investigated the effect of sleep onset (transition from predominantly α to predominantly θ EEG activity) on ventilation, upper airway muscle activation and upper airway resistance (UAR) in middle-aged and younger healthy men. We found that both GGEMG and TPEMG were reduced by the application of nasal CPAP during wakefulness, but that CPAP did not alter the decrement in activity in either muscle seen in the first two breaths following an α to θ transition. However, CPAP prevented both the rise in UAR at sleep onset that occurred on the control night, and the recruitment in GGEMG seen in the third to fifth breaths following the α to θ transition. Further, GGEMG was higher in the middle-aged men than in the younger men during wakefulness and was decreased more in the middle-aged men with the application of nasal CPAP. No differences were seen in TPEMG between the two age groups. These data suggest that the initial sleep onset reduction in upper airway muscle activity is due to loss of a ‘wakefulness’ stimulus, rather than to loss of responsiveness to negative pressure. In addition, it suggests that in older men, higher wakeful muscle activity is due to an anatomically more collapsible upper airway with more negative pressure driven muscle activation. Sleep onset per se does not appear to have a greater effect on upper airway muscle activity as one ages. PMID:12963804

One night of sleep restriction following heavy exercise impairs 3-km cycling time-trial performance in the morning.

PubMed

Chase, John D; Roberson, Paul A; Saunders, Michael J; Hargens, Trent A; Womack, Christopher J; Luden, Nicholas D

2017-09-01

The goal of this project was to examine the influence of a single night of sleep restriction following heavy exercise on cycling time-trial (TT) performance and skeletal muscle function in the morning. Seven recreational cyclists (age, 24 ± 7 years; peak oxygen consumption, 62 ± 4 mL·kg -1 ·min -1 ) completed 2 phases, each comprising evening (EX1) and next-morning (EX2) exercise sessions. EX1 and EX2 were separated by an assigned sleep condition: a full night of rest (CON; 7.1 ± 0.3 h of sleep) or sleep restriction through early waking (SR; 2.4 ± 0.2 h). EX1 comprised baseline testing (muscle soreness, isokinetic torque, and 3-km TT performance) followed by heavy exercise that included 60 min of high-intensity cycling intervals and resistance exercise. EX2 was performed to assess recovery from EX1 and included all baseline measures. Magnitude-based inferences were used to evaluate all variables. SR had a negative effect (very likely) on the change in 3-km TT performance compared with CON. Specifically, 3-km TT performance was 'very likely' slower during EX2 compared with EX1 following SR (-4.0% ± 3.0%), whereas 3-km TT performance was 'possibly' slower during EX2 (vs. EX1) following CON (-0.5% ± 3.0%). Sleep condition did not influence changes in peak torque or muscle soreness from EX1 to EX2. A single night of sleep restriction following heavy exercise had marked consequences on 3-km TT performance the next morning. Because occasional sleep loss is likely, strategies to ameliorate the consequences of sleep loss on performance should be investigated.

Nerve-muscle interactions during flight muscle development in Drosophila

NASA Technical Reports Server (NTRS)

Fernandes, J. J.; Keshishian, H.

1998-01-01

During Drosophila pupal metamorphosis, the motoneurons and muscles differentiate synchronously, providing an opportunity for extensive intercellular regulation during synapse formation. We examined the existence of such interactions by developmentally delaying or permanently eliminating synaptic partners during the formation of indirect flight muscles. When we experimentally delayed muscle development, we found that although adult-specific primary motoneuron branching still occurred, the higher order (synaptic) branching was suspended until the delayed muscle fibers reached a favourable developmental state. In reciprocal experiments we found that denervation caused a decrease in the myoblast pool. Furthermore, the formation of certain muscle fibers (dorsoventral muscles) was specifically blocked. Exceptions were the adult muscles that use larval muscle fibers as myoblast fusion targets (dorsal longitudinal muscles). However, when these muscles were experimentally compelled to develop without their larval precursors, they showed an absolute dependence on the motoneurons for their formation. These data show that the size of the myoblast pool and early events in fiber formation depend on the presence of the nerve, and that, conversely, peripheral arbor development and synaptogenesis is closely synchronized with the developmental state of the muscle.

Dynamic modulation of corticospinal excitability and short-latency afferent inhibition during onset and maintenance phase of selective finger movement.

PubMed

Cho, Hyun Joo; Panyakaew, Pattamon; Thirugnanasambandam, Nivethida; Wu, Tianxia; Hallett, Mark

2016-06-01

During highly selective finger movement, corticospinal excitability is reduced in surrounding muscles at the onset of movement but this phenomenon has not been demonstrated during maintenance of movement. Sensorimotor integration may play an important role in selective movement. We sought to investigate how corticospinal excitability and short-latency afferent inhibition changes in active and surrounding muscles during onset and maintenance of selective finger movement. Using transcranial magnetic stimulation (TMS) and paired peripheral stimulation, input-output recruitment curve and short-latency afferent inhibition (SAI) were measured in the first dorsal interosseus and abductor digiti minimi muscles during selective index finger flexion. Motor surround inhibition was present only at the onset phase, but not at the maintenance phase of movement. SAI was reduced at onset but not at the maintenance phase of movement in both active and surrounding muscles. Our study showed dynamic changes in corticospinal excitability and sensorimotor modulation for active and surrounding muscles in different movement states. SAI does not appear to contribute to motor surround inhibition at the movement onset phase. Also, there seems to be different inhibitory circuit(s) other than SAI for the movement maintenance phase in order to delineate the motor output selectively when corticospinal excitability is increased in both active and surrounding muscles. This study enhances our knowledge of dynamic changes in corticospinal excitability and sensorimotor interaction in different movement states to understand normal and disordered movements. Published by Elsevier Ireland Ltd.

Neuromuscular control of fundamental frequency and glottal posture at phonation onset

PubMed Central

Chhetri, Dinesh K.; Neubauer, Juergen; Berry, David A.

2012-01-01

The laryngeal neuromuscular mechanisms for modulating glottal posture and fundamental frequency are of interest in understanding normal laryngeal physiology and treating vocal pathology. The intrinsic laryngeal muscles in an in vivo canine model were electrically activated in a graded fashion to investigate their effects on onset frequency, phonation onset pressure, vocal fold strain, and glottal distance at the vocal processes. Muscle activation plots for these laryngeal parameters were evaluated for the interaction of following pairs of muscle activation conditions: (1) cricothyroid (CT) versus all laryngeal adductors (TA/LCA/IA), (2) CT versus LCA/IA, (3) CT versus thyroarytenoid (TA) and, (4) TA versus LCA/IA (LCA: lateral cricoarytenoid muscle, IA: interarytenoid). Increases in onset frequency and strain were primarily affected by CT activation. Onset pressure correlated with activation of all adductors in activation condition 1, but primarily with CT activation in conditions 2 and 3. TA and CT were antagonistic for strain. LCA/IA activation primarily closed the cartilaginous glottis while TA activation closed the mid-membranous glottis. PMID:22352513

Pattern of Corticospinal Projections Defined by Brain Mapping During Resective Epilepsy Surgery in a Patient with Congenital Hemiparesis and Intractable Epilepsy.

PubMed

Yang, Chen-Ya; Chen, Hsin-Hung; Chen, Chien; Chiu, Jan-Wei; Chou, Chen-Liang; Yang, Tsui-Fen

2017-11-01

Congenital or early-onset brain structural lesions often cause contralateral hemiparesis, cognitive deficits, developmental delays, and seizures. Seizure is the most debilitating condition, as it greatly impairs quality of life in both the affected individuals and their caregivers and prevents them from active social participation. A 34-year-old man with hemiparesis and early-onset seizures since childhood owing to a congenital brain lesion developed intractable seizures in the last 2 years and was subsequently admitted for resective epileptic surgery. During the operation, we employed an innovative intraoperative neurophysiologic monitoring technique. In contrast to routine application for transcranial stimulation, we recorded compound muscle action potentials over the bilateral limb muscles simultaneously, instead of over the contralateral muscles only, to determine the patterns of the corticospinal projections. Transcranial stimulation over the bilateral hemispheres was applied before craniotomy, and direct cortical stimulation over the lesioned hemisphere was applied after craniotomy. By integrating both approaches, we could first identify the pattern of corticospinal projections before craniotomy and then accurately define the noneloquent area, which guided the resection to successfully accomplish the surgical goal. This technique is simple because no patient participation is required. We believe that it has the potential to replace conventional preoperative functional magnetic resonance imaging and transcranial magnetic stimulation in resective epilepsy surgery, particularly for young patients. Not only can it improve the safety of surgical procedures, but also it can help predict functional outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

An elderly-onset limb girdle muscular dystrophy type 1B (LGMD1B) with pseudo-hypertrophy of paraspinal muscles.

PubMed

Furuta, Mitsuru; Sumi-Akamaru, Hisae; Takahashi, Masanori P; Hayashi, Yukiko K; Nishino, Ichizo; Mochizuki, Hideki

2016-09-01

Mutations in LMNA, encoding A-type lamins, lead to diverse disorders, collectively called "laminopathies," which affect the striated muscle, cardiac muscle, adipose tissue, skin, peripheral nerve, and premature aging. We describe a patient with limb-girdle muscular dystrophy type 1B (LGMD1B) carrying a heterozygous p.Arg377His mutation in LMNA, in whom skeletal muscle symptom onset was at the age of 65 years. Her weakness started at the erector spinae muscles, which showed marked pseudo-hypertrophy even at the age of 72 years. Her first episode of syncope was at 44 years; however, aberrant cardiac conduction was not revealed until 60 years. The p.Arg377His mutation has been previously reported in several familial LMNA-associated myopathies, most of which showed muscle weakness before the 6th decade. This is the first report of pseudo-hypertrophy of paravertebral muscles in LMNA-associated myopathies. The pseudo-hypertrophy of paravertebral muscles and the elderly-onset of muscle weakness make this case unique and reportable. Copyright © 2016 Elsevier B.V. All rights reserved.

Effects of a sour bolus on the intramuscular electromyographic (EMG) activity of muscles in the submental region.

PubMed

Palmer, Phyllis M; McCulloch, Timothy M; Jaffe, Debra; Neel, Amy T

2005-01-01

A sour bolus has been used as a modality in the treatment of oropharyngeal dysphagia based on the hypothesis that this stimulus provides an effective preswallow sensory input that lowers the threshold required to trigger a pharyngeal swallow. The result is a more immediate swallow onset time. Additionally, the sour bolus may invigorate the oral muscles resulting in stronger contractions during the swallow. The purpose of this investigation was to compare the intramuscular electromyographic activity of the mylohyoid, geniohyoid, and anterior belly of the digastric muscles during sour and water boluses with regard to duration, strength, and timing of muscle activation. Muscle duration, swallow onset time, and pattern of muscle activation did not differ for the two bolus types. Muscle activation time was more tightly approximated across the onsets of the three muscles when a sour bolus was used. A sour bolus also resulted in a stronger muscle contraction as evidenced by greater electromyographic activity. These data support the use of a sour bolus as part of a treatment paradigm.

Protocol for a randomised controlled trial of 90% kanuka honey versus 5% aciclovir for the treatment of herpes simplex labialis in the community setting.

PubMed

Semprini, Alex; Singer, Joseph; Shortt, Nicholas; Braithwaite, Irene; Beasley, Richard

2017-08-03

Worldwide, about 90% of people are infected with the herpes simplex virus, 30% of whom will experience recurrent herpes simplex labialis, commonly referred to as 'cold sores', which can last up to 10 days. The most common treatment is aciclovir cream which reduces healing time by just half a day compared with no specific treatment. This is a protocol for a randomised controlled trial (RCT) to determine the efficacy of medical grade kanuka honey-based topical treatment (Honevo) in reducing the healing time and pain of cold sores, compared with topical aciclovir treatment (Viraban). This open-label, parallel-group, active comparator superiority RCT will compare the efficacy of medical grade kanuka honey with 5% aciclovir cream in the treatment of cold sores in the setting of a pharmacy research network of 60 sites throughout New Zealand. Adults presenting with a cold sore (N=950) will be randomised by pharmacy-based investigators. The pharmacy-based investigators will dispense the investigational product to randomised participants and both study groups apply the treatment five times daily until their skin returns to normal or for 14 days, whichever occurs first. In response to a daily SMS message, participants complete an assessment of their cold sore healing, with reference to a visual guide, and transmit it to the investigators by a smartphone eDiary in real time. The primary outcome variable is time (in days) from randomisation to return to normal skin. Secondary endpoints include total healing time stratified by stage of the lesion at onset of treatment, highest pain severity and time to pain resolution. New Zealand Ethics Registration 15/NTB/93. Results will be published in a peer-reviewed medical journal, presented at academic meetings and reported to participants. Australia New Zealand Clinical Trials Registry: ACTRN12615000648527, pre-results.SCOTT Registration: 15/SCOTT/14 PROTOCOL VERSION: 4.0 (12 June 2017). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Improvements in throat function and qualities of sore throat from locally applied flurbiprofen 8.75 mg in spray or lozenge format: findings from a randomized trial of patients with upper respiratory tract infection in the Russian Federation

PubMed Central

Burova, Natalia; Bychkova, Valeria; Shephard, Adrian

2018-01-01

Objective To assess the speed of relief provided by flurbiprofen 8.75 mg spray and lozenge and their effect on many of the different qualities and characteristics of throat pain and discomfort, and the many articulations of the broad term “sore throat” (ST). Patients and methods Four hundred and forty adults with recent-onset, moderate-to-severe ST due to upper respiratory tract infection (URTI) were randomized to a single dose of either flurbiprofen 8.75 mg spray (n=218) or flurbiprofen 8.75 mg lozenge (n=222). Throat swabs for bacterial culture were taken at baseline. ST relief was assessed at 1 minute, 1 and 2 hours post-dose using the Sore Throat Relief Rating Scale. The change from baseline at 1 and 2 hours post-dose in difficulty swallowing and swollen throat was assessed using the difficulty swallowing scale and the swollen throat scale, respectively. Patients’ experience of URTI symptoms was assessed using a URTI questionnaire at baseline and 2 hours post-dose. The change in Qualities of Sore Throat Index, a 10-item index of qualities of ST, from baseline at 2 hours post-dose was also measured. Results ST relief was evident in the spray and the lozenge treatment groups at 1 minute, 1 and 2 hours post-dose (P>0.05). In both groups, scores for difficulty swallowing and swollen throat significantly improved at 1 and 2 hours post-dose compared with baseline. At 2 hours post-dose, the number of patients experiencing URTI symptoms that can be attributed to or associated with ST decreased relative to baseline. The mean change from baseline to 2 hours post-dose for each individual score on the Qualities of Sore Throat Index showed significant improvements for flurbiprofen spray and lozenge (all P<0.0001). Conclusion Non-inferiority was established, and flurbiprofen spray and lozenge provided effective relief from ST pain and many of the other commonly reported qualities of ST.

Improvements in throat function and qualities of sore throat from locally applied flurbiprofen 8.75 mg in spray or lozenge format: findings from a randomized trial of patients with upper respiratory tract infection in the Russian Federation.

PubMed

Burova, Natalia; Bychkova, Valeria; Shephard, Adrian

2018-01-01

To assess the speed of relief provided by flurbiprofen 8.75 mg spray and lozenge and their effect on many of the different qualities and characteristics of throat pain and discomfort, and the many articulations of the broad term "sore throat" (ST). Four hundred and forty adults with recent-onset, moderate-to-severe ST due to upper respiratory tract infection (URTI) were randomized to a single dose of either flurbiprofen 8.75 mg spray (n=218) or flurbiprofen 8.75 mg lozenge (n=222). Throat swabs for bacterial culture were taken at baseline. ST relief was assessed at 1 minute, 1 and 2 hours post-dose using the Sore Throat Relief Rating Scale. The change from baseline at 1 and 2 hours post-dose in difficulty swallowing and swollen throat was assessed using the difficulty swallowing scale and the swollen throat scale, respectively. Patients' experience of URTI symptoms was assessed using a URTI questionnaire at baseline and 2 hours post-dose. The change in Qualities of Sore Throat Index, a 10-item index of qualities of ST, from baseline at 2 hours post-dose was also measured. ST relief was evident in the spray and the lozenge treatment groups at 1 minute, 1 and 2 hours post-dose ( P >0.05). In both groups, scores for difficulty swallowing and swollen throat significantly improved at 1 and 2 hours post-dose compared with baseline. At 2 hours post-dose, the number of patients experiencing URTI symptoms that can be attributed to or associated with ST decreased relative to baseline. The mean change from baseline to 2 hours post-dose for each individual score on the Qualities of Sore Throat Index showed significant improvements for flurbiprofen spray and lozenge (all P <0.0001). Non-inferiority was established, and flurbiprofen spray and lozenge provided effective relief from ST pain and many of the other commonly reported qualities of ST.

Nutrition and physical activity for the prevention and treatment of age-related sarcopenia.

PubMed

Bosaeus, Ingvar; Rothenberg, Elisabet

2016-05-01

Sarcopenia, defined as loss of skeletal muscle mass and function, is associated with adverse outcomes such as physical disability, impaired quality of life and increased mortality. Several mechanisms are involved in the development of sarcopenia. Potentially modifiable factors include nutrition and physical activity. Protein metabolism is central to the nutritional issues, along with other potentially modifying nutritional factors as energy balance and vitamin D status. An increasing but still incomplete knowledge base has generated recent recommendations on an increased protein intake in the elderly. Several factors beyond the total amount of protein consumed emerge as potentially important in this context. A recent summit examined three hypotheses: (1) A meal threshold; habitually consuming 25-30 g protein at breakfast, lunch and dinner provides sufficient protein to effectively stimulate muscle protein anabolism; (2) Protein quality; including high-quality protein at each meal improves postprandial muscle protein synthesis; and (3) performing physical activity in close temporal proximity to a high-quality protein meal enhances muscle anabolism. Optimising the potential for muscle protein anabolism by consuming an adequate amount of high-quality protein at each meal, in combination with physical activity, appears as a promising strategy to prevent or delay the onset of sarcopenia. However, results of interventions are inconsistent, and well-designed, standardised studies evaluating exercise or nutrition interventions are needed before guidelines can be developed for the prevention and treatment of age-related sarcopenia.

Delayed onset infections after lower third molar germectomy could be related to the space distal to the second molar.

PubMed

Monaco, G; Cecchini, S; Gatto, M R; Pelliccioni, G A

2017-03-01

The onset of delayed infection after lower third molar germectomy is influenced by the amount of distal space. This retrospective study aimed to determine whether the incidence of delayed onset infection is related to the space distal to the second molar. The ratio between the distal space and the crown width, measured according to the Ganss protocol on panoramic radiographs, was obtained for 218 surgical germectomies performed for orthodontic reasons in 134 patients. A delayed onset infection occurred following 20 germectomies at between 2 and 8 weeks after surgery; purulent exudates from the alveolus and swelling were present. In 16 of the 20 cases of infection, a Ganss ratio of <0.5 showed the almost complete absence of space distal to the second molar. This study found that the distal space was significantly and inversely correlated with delayed onset infection (P=0.004). From a clinical point of view, it is important for the surgeon to be aware that a higher Ganss ratio may indicate that a delayed onset infection is less likely to occur and that a lower Ganss ratio could indicate a greater likelihood of this type of infection, so that the patient can be properly informed. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial.

PubMed

Yale, Steven H; Liu, Kejian

2004-06-14

Echinacea purpurea stimulates the immune response and is promoted to reduce symptom severity and the duration of upper respiratory tract infections. We sought to determine the efficacy of a standardized preparation of E purpurea in reducing symptom severity and duration of the common cold. A randomized, double-blind, placebo-controlled design was used. Patients received either 100 mg of E purpurea (freeze-dried pressed juice from the aerial portion of the plant) or a lactose placebo 3 times daily until cold symptoms were relieved or until the end of 14 days, whichever came first. Symptoms (sneezing, nasal discharge, nasal congestion, headache, sore or scratchy throat, hoarseness, muscle aches, and cough) were scored subjectively by the patient and recorded daily in a diary. Kaplan-Meier curves were used to estimate the survival function of time to resolution in each group. The Wilcoxon rank sum test was used to compare time to resolution between the 2 groups. One hundred twenty-eight patients were enrolled within 24 hours of cold symptom onset. Group demographic distribution was comparable for sex, age, time from symptom onset to enrollment in the study, average number of colds per year, and smoking history. No statistically significant difference was observed between treatment groups for either total symptom scores (P range,.29-.90) or mean individual symptom scores (P range,.09-.93). The time to resolution of symptoms was not statistically different (P =.73). Some studies have concluded that Echinacea effectively reduces the symptoms and duration of the common cold. We were unable to replicate such findings. Further studies using different preparations and dosages of E purpurea are necessary to validate previous claims.

Biomechanical analyses of prolonged handwriting in subjects with and without perceived discomfort.

PubMed

Chang, Shao-Hsia; Chen, Chien-Liang; Yu, Nan-Ying

2015-10-01

Since wrist-joint position affects finger muscle length and grip strength, we studied its biomechanical relevance in prolonged handwriting. We recruited participants from young adults, aged 18-24, and separated them into control (n=22) and in-pain (n=18) groups, based whether or not they experience pain while handwriting. The participants then performed a writing task for 30 min on a computerized system which measured their wrist-joint angle and documented their handwriting kinematics. The in-pain group perceived more soreness and had a less-extended wrist joint, longer on-paper time, and slower stroke velocity compared to control group. There was no significant difference in handwriting speed and quality between the two groups. The wrist extension angle significantly correlated with perceived soreness. Ergonomic and biomechanical analyses provide important information about the handwriting process. Knowledge of pen tip movement kinematics and wrist-joint position can help occupational therapists plan treatment for individuals with handwriting induced pain. Copyright © 2015 Elsevier B.V. All rights reserved.

Bit-1 is an essential regulator of myogenic differentiation

PubMed Central

Griffiths, Genevieve S.; Doe, Jinger; Jijiwa, Mayumi; Van Ry, Pam; Cruz, Vivian; de la Vega, Michelle; Ramos, Joe W.; Burkin, Dean J.; Matter, Michelle L.

2015-01-01

Muscle differentiation requires a complex signaling cascade that leads to the production of multinucleated myofibers. Genes regulating the intrinsic mitochondrial apoptotic pathway also function in controlling cell differentiation. How such signaling pathways are regulated during differentiation is not fully understood. Bit-1 (also known as PTRH2) mutations in humans cause infantile-onset multisystem disease with muscle weakness. We demonstrate here that Bit-1 controls skeletal myogenesis through a caspase-mediated signaling pathway. Bit-1-null mice exhibit a myopathy with hypotrophic myofibers. Bit-1-null myoblasts prematurely express muscle-specific proteins. Similarly, knockdown of Bit-1 expression in C2C12 myoblasts promotes early differentiation, whereas overexpression delays differentiation. In wild-type mice, Bit-1 levels increase during differentiation. Bit-1-null myoblasts exhibited increased levels of caspase 9 and caspase 3 without increased apoptosis. Bit-1 re-expression partially rescued differentiation. In Bit-1-null muscle, Bcl-2 levels are reduced, suggesting that Bcl-2-mediated inhibition of caspase 9 and caspase 3 is decreased. Bcl-2 re-expression rescued Bit-1-mediated early differentiation in Bit-1-null myoblasts and C2C12 cells with knockdown of Bit-1 expression. These results support an unanticipated yet essential role for Bit-1 in controlling myogenesis through regulation of Bcl-2. PMID:25770104

Mechanism of soman-induced contractions in canine tracheal smooth muscle. (Reannouncement with new availability information)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Adler, M.; Moore, D.H.; Filbert, M.G.

1992-12-31

The actions of the irreversible organophosphorus cholinesterase (ChE) inhibitor soman were investigated on canine trachea smooth muscle in vitro. Concentrations of soman > or - 1 nM increased the amplitude and decay of contractions elicited by electric field stimulation. The effect on decay showed a marked dependence on stimulation frequency, undergoing a 2.4-fold increase between 3 and 60 Hz. Soman also potentiated tensions due to bath applied acetylcholine (ACh). Little or no potentiation was observed for contractions elicited by carbamylcholine, an agonist that is not hydrolyzed by ChE. Concentration of soman > or - 3 nM led to the appearancemore » of sustained contractures. These contractures developed with a delayed onset and were well correlated with ChE activity. Alkylation of muscarinic receptors by propylbenzilylcholine mustard antagonized the actions of soman on both spontaneous and electrically-evoked muscle contractions. The results are consistent with a mechanism in which the toxic actions of soman are mediated by accumulation of neurally-released ACh secondary to inhibition of ChE activity. An important factor in this accumulation is suggested to be the buffering effect of the muscarinic receptors on the efflux of ACh from the neuroeffector junction. Tracheal smooth muscle, Cholinesterase inhibitors, Muscarinic receptor, Soman, Organophosphate.« less

Gravitational force modulates G2/M phase exit in mechanically unloaded myoblasts

PubMed Central

Benavides Damm, Tatiana; Franco-Obregón, Alfredo; Egli, Marcel

2013-01-01

Prolonged spaceflight gives rise to muscle loss and reduced strength, a condition commonly referred to as space atrophy. During exposure to microgravity, skeletal muscle myoblasts are mechanically unloaded and respond with attenuated cell proliferation, slowed cell cycle progression, and modified protein expression. To elucidate the underlying mechanisms by which muscle mass declines in response to prolonged microgravity exposure, we grew C2C12 mouse muscle cells under conditions of simulated microgravity (SM) and analyzed their proliferative capacity, cell cycle progression, and cyclin B and D expression. We demonstrated that the retarded cell growth observed in SM was correlated with an approximate 16 h delay in G2/M phase progression, where cells accumulated specifically between the G2 checkpoint and the onset of anaphase, concomitantly with a positive expression for cyclin B. The effect was specific for gravitational mechanical unloading as cells grown under conditions of hypergravity (HG, 4 g) for similar durations of time exhibited normal proliferation and normal cell cycle progression. Our results show that SM and HG exert phenomenological distinct responses over cell cycle progression. The deficits of SM can be restored by terrestrial gravitational force, whereas the effects of HG are indistinguishable from the 1 g control. This suggests that the mechanotransduction apparatus of cells responds differently to mechanical unloading and loading. PMID:23974110

Effects of Statins on Skeletal Muscle: A Perspective for Physical Therapists

PubMed Central

Di Stasi, Stephanie L.; MacLeod, Toran D.; Winters, Joshua D.

2010-01-01

Hyperlipidemia, also known as high blood cholesterol, is a cardiovascular health risk that affects more than one third of adults in the United States. Statins are commonly prescribed and successful lipid-lowering medications that reduce the risks associated with cardiovascular disease. The side effects most commonly associated with statin use involve muscle cramping, soreness, fatigue, weakness, and, in rare cases, rapid muscle breakdown that can lead to death. Often, these side effects can become apparent during or after strenuous bouts of exercise. Although the mechanisms by which statins affect muscle performance are not entirely understood, recent research has identified some common causative factors. As musculoskeletal and exercise specialists, physical therapists have a unique opportunity to identify adverse effects related to statin use. The purposes of this perspective article are: (1) to review the metabolism and mechanisms of actions of statins, (2) to discuss the effects of statins on skeletal muscle function, (3) to detail the clinical presentation of statin-induced myopathies, (4) to outline the testing used to diagnose statin-induced myopathies, and (5) to introduce a role for the physical therapist for the screening and detection of suspected statin-induced skeletal muscle myopathy. PMID:20688875

The relationship of hip muscle performance to leg, ankle and foot injuries: a systematic review.

PubMed

Steinberg, Nili; Dar, Gali; Dunlop, Martin; Gaida, James Edmund

2017-02-01

Hip control affects movement and muscle firing patterns in the leg, ankle and foot, and may contribute to overuse injuries. Muscle performance can be measured as strength, endurance or muscle activation patterns. Our objective was to systematically review whether hip muscle performance is associated with leg, ankle and foot injuries. A structured and comprehensive search of six medical literature databases was combined with forward and backward citation tracking (AMED, CINAHL, EMBASE, Medline, Scopus and SportDiscus). Eligible studies measured hip muscle performance in individuals with musculoskeletal injuries below the tibial tuberosity, using dynamometry or electromyography (EMG). All studies compared an injured group with a control group or compared the injured and non-injured limb in the same individual. Data was extracted from each study independently by two authors. Twenty case-control and four prospective studies (n = 24) met the inclusion criteria. Injury classifications included chronic ankle instability (n = 18), Achilles tendinopathy (n = 2), medial tibial stress syndrome and tibial stress fracture (n = 1), posterior tibial tendon dysfunction (n = 1), and exertional medial tibial pain (n = 2). Eleven of the studies revealed differences in hip muscle performance indicating less strength, delayed onset activation and decreased duration of activation in the injured groups. Two studies found evidence for differences between groups only in some of their measurements. Three out of the four prospective studies revealed that hip muscle performance was not a risk factor for leg, ankle and foot injuries. This review provides limited evidence that hip muscle performance variables are related to leg, ankle and foot injuries. Emerging evidence indicates this might be a result of the injury rather than a contributor to the injury.

Acute Exertional Compartment Syndrome with Rhabdomyolysis: Case Report and Review of Literature

PubMed Central

Gaunder, Christopher; Schumer, Ross

2018-01-01

Patient: Male, 17 Final Diagnosis: Acute exertional compartment syndrome Symptoms: Foot drop • leg pain • paresthesia Medication: — Clinical Procedure: Fasciotomy Specialty: Orthopedics and Traumatology Objective: Rare disease Background: Acute exertional compartment syndrome (AECS) is a rare cause of leg pain often associated with a delay in diagnosis and potentially leading to irreversible muscle and nerve damage. Case Report: We present the case of a previously healthy, high-level athlete who presented with the acute onset of unilateral anterior leg pain and foot drop the day after a strenuous workout. He was diagnosed with compartment syndrome and rhabdomyolysis. His management included emergent fluid resuscitation, fasciotomies, debridement of necrotic muscle from his anterior compartment, and delayed primary closure. After six months of intensive outpatient physical therapy, including the use of blood flow restriction treatments, the patient returned to sports and received a NCAA Division I Football scholarship. Conclusions: We describe the details of this patient’s case and review the literature related to acute exertional compartment syndrome. The occurrence of acute compartment syndrome in the absence of trauma or fracture, though rare, can have devastating consequences following delays in treatment. AECS requires prompt diagnosis and surgical intervention to prevent these consequences. Diagnosis of atraumatic cases can be difficult, which is why awareness is equally as important as history and physical examination. While diagnosis is primarily clinical, it can be supported with direct intra-compartmental pressure measurements and maintaining a high index of suspicion in acute presentations of exertional limb pain. PMID:29415981

Vascular delay and administration of basic fibroblast growth factor augment latissimus dorsi muscle flap perfusion and function.

PubMed

Carroll, S M; Carroll, C M; Stremel, R W; Heilman, S J; Steffen, J M; Tobin, G R; Barker, J H

2000-03-01

Ischemia of the distal latissimus dorsi muscle flap occurs when the entire muscle is acutely elevated. Although this level of ischemia may not be critical if the muscle is to be used as a conventional muscle flap, the ischemia causes decreased distal muscle function if it is used for dynamic muscle flap transfer. This experiment was designed to determine whether or not the administration of exogenous basic fibroblast growth factor (bFGF), combined with a sublethal ischemic insult (i.e., vascular delay), would further augment muscle perfusion and function. Both latissimus dorsi muscles of nine canines were subjected to a bipedicle vascular delay procedure immediately followed by thoracodorsal intraarterial injection of 100 microg of bFGF on one side and by intraarterial injection of vehicle on the other. Ten days later, both latissimus dorsi muscles were raised as thoracodorsally based island flaps, with perfusion determined by laser-Doppler fluximetry. The muscles were wrapped around silicone chambers, simulating cardiomyoplasty, and stimulating electrodes were placed around each thoracodorsal nerve. The muscles were then subjected to an experimental protocol to determine muscle contractile function. At the end of the experiment, latissimus dorsi muscle biopsies were obtained for measurement of bFGF expression. The results demonstrated that the administration of 100 microg of bFGF immediately after the vascular delay procedure increases expression of native bFGF. In the distal and middle muscle segments, it also significantly increased muscle perfusion by approximately 20 percent and fatigue resistance by approximately 300 percent. The administration of growth factors may serve as an important adjuvant to surgical procedures using dynamic muscle flap transfers.

On the Behavioral Side of Procrastination: Exploring Behavioral Delay in Real-Life Settings

PubMed Central

Svartdal, Frode; Granmo, Sjur; Færevaag, Fredrik S.

2018-01-01

This paper examines how procrastinators behave differently from non-procrastinators in implementing intended behavior. By focusing on time-related attributes of behavior, we demonstrate in five studies (aggregated N = 965) that onset delay seems to be a preferred option for procrastinators in common daily situations. Thus, when an action possibility is available for intended behavior, procrastinators tend to delay behavior onset, both in actual behavior and in onset preferences, often instigating chains of events with negative consequences. We discuss possible mechanisms responsible for such delays and explore how such mechanisms generate and sustain dilatory behavior. We conclude that a better understanding of why behavioral delays occur in early phases of action implementation is of importance in understanding and preventing procrastination. PMID:29867696

On the Behavioral Side of Procrastination: Exploring Behavioral Delay in Real-Life Settings.

PubMed

Svartdal, Frode; Granmo, Sjur; Færevaag, Fredrik S

2018-01-01

This paper examines how procrastinators behave differently from non-procrastinators in implementing intended behavior. By focusing on time-related attributes of behavior, we demonstrate in five studies (aggregated N = 965) that onset delay seems to be a preferred option for procrastinators in common daily situations. Thus, when an action possibility is available for intended behavior, procrastinators tend to delay behavior onset, both in actual behavior and in onset preferences, often instigating chains of events with negative consequences. We discuss possible mechanisms responsible for such delays and explore how such mechanisms generate and sustain dilatory behavior. We conclude that a better understanding of why behavioral delays occur in early phases of action implementation is of importance in understanding and preventing procrastination.

Rehabilitation of traumatic brain injury in Italy: a multi-centred study.

PubMed

Zampolini, M; Zaccaria, B; Tolli, V; Frustaci, A; Franceschini, M

2012-01-01

The aims of this study were to analyse TBI rehabilitation in Italy, identifying the main factors conditioning motor and functional recovery and destination upon discharge of traumatic severe acquired brain injury (sABI) patients who had undergone intensive rehabilitative treatment. An observational prospective study of 863 consecutive patients admitted to 52 Rehabilitation Centres from January 2001 to December 2003. The main cause of trauma was road accidents (79.8%), the mean length of stay was 87.31 ± 77.26 days and 40.4% access to rehabilitation facilities after a month. Pressure sore rates fell from 26.1% to 6.6% during the rehabilitation programme. After discharge 615 patients returned home, whilst 212 were admitted to other health facilities. This study highlights some major criticisms of rehabilitation of TBI. The delay of admission and evitable complications such as pressure sores are correlated to a worse outcome. While LOS causes a problem of cost-effectiveness, the rate of home discharge is prevalent and very high compared with other studies.

Analysis of statistical and standard algorithms for detecting muscle onset with surface electromyography.

PubMed

Tenan, Matthew S; Tweedell, Andrew J; Haynes, Courtney A

2017-01-01

The timing of muscle activity is a commonly applied analytic method to understand how the nervous system controls movement. This study systematically evaluates six classes of standard and statistical algorithms to determine muscle onset in both experimental surface electromyography (EMG) and simulated EMG with a known onset time. Eighteen participants had EMG collected from the biceps brachii and vastus lateralis while performing a biceps curl or knee extension, respectively. Three established methods and three statistical methods for EMG onset were evaluated. Linear envelope, Teager-Kaiser energy operator + linear envelope and sample entropy were the established methods evaluated while general time series mean/variance, sequential and batch processing of parametric and nonparametric tools, and Bayesian changepoint analysis were the statistical techniques used. Visual EMG onset (experimental data) and objective EMG onset (simulated data) were compared with algorithmic EMG onset via root mean square error and linear regression models for stepwise elimination of inferior algorithms. The top algorithms for both data types were analyzed for their mean agreement with the gold standard onset and evaluation of 95% confidence intervals. The top algorithms were all Bayesian changepoint analysis iterations where the parameter of the prior (p0) was zero. The best performing Bayesian algorithms were p0 = 0 and a posterior probability for onset determination at 60-90%. While existing algorithms performed reasonably, the Bayesian changepoint analysis methodology provides greater reliability and accuracy when determining the singular onset of EMG activity in a time series. Further research is needed to determine if this class of algorithms perform equally well when the time series has multiple bursts of muscle activity.

The effect of sleep onset on upper airway muscle activity in patients with sleep apnoea versus controls

PubMed Central

Fogel, Robert B; Trinder, John; White, David P; Malhotra, Atul; Raneri, Jill; Schory, Karen; Kleverlaan, Darci; Pierce, Robert J

2005-01-01

Pharyngeal dilator muscles are important in the pathophysiology of obstructive sleep apnoea syndrome (OSA). We have previously shown that during wakefulness, the activity of both the genioglossus (GGEMG) and tensor palatini (TPEMG) is greater in patients with OSA compared with controls. Further, EMG activity decreases at sleep onset, and the decrement is greater in apnoea patients than in healthy controls. In addition, it is known that the prevalence of OSA is greater in middle-aged compared with younger men. Thus, we had two goals in this study. First we compared upper airway muscle activity between young and middle-aged healthy men compared with men with OSA. We also explored the mechanisms responsible for the decrement in muscle activity at sleep onset in these groups. We investigated muscle activity, ventilation , and upper airway resistance (UAR) during wakefulness and sleep onset (transition from α to θ EEG activity) in all three groups. Measurements were obtained during basal breathing (BB) and nasal continuous positive airway pressure (CPAP) was applied to reduce negative pressure-mediated muscle activation). We found that during wakefulness there was a gradation of GGEMG and UAR (younger < older < OSA) and that muscle activity was reduced by the application of nasal CPAP (to a greater degree in the OSA patients). Although CPAP eliminated differences in UAR during wakefulness and sleep, GGEMG remained greater in the OSA patients. During sleep onset, a greater initial fall in GGEMG was seen in the OSA patients followed by subsequent muscle recruitment in the third to fifth breaths following the α to θ transition. On the CPAP night, and GGEMG still fell further in the OSA patients compared with control subjects. CPAP prevented the rise in UAR at sleep onset along with the associated recruitment in GGEMG. Differences in TPEMG among the groups were not significant. These data suggest that the middle-aged men had upper airway function midway between that of young normal men and the abnormal airway of those with OSA. Furthermore it suggests that the initial sleep onset reduction in upper airway muscle activity is due to loss of a ‘wakefulness’ stimulus, rather than to loss of responsiveness to negative pressure, and that this wakefulness stimulus may be greater in the OSA patient than in healthy controls. PMID:15695240

Exercise improves adipose function and inflammation and ameliorates fatty liver disease in obese diabetic mice.

PubMed

Haczeyni, Fahrettin; Barn, Vanessa; Mridha, Auvro R; Yeh, Matthew M; Estevez, Emma; Febbraio, Mark A; Nolan, Christopher J; Bell-Anderson, Kim S; Teoh, Narci C; Farrell, Geoffrey C

2015-09-01

Adipose inflammation and dysfunction underlie metabolic obesity. Exercise improves glycemic control and metabolic indices, but effects on adipose function and inflammation are less clear. Accordingly, it was hypothesized that exercise improves adipose morphometry to reduce adipose inflammation in hyperphagic obese mice. Alms1 mutant foz/foz mice housed in pairs were fed an atherogenic or chow diet; half the cages were fitted with a computer-monitored wheel for voluntary exercise. Insulin-induced AKT-phosphorylation, adipocyte size distribution, and inflammatory recruitment were studied in visceral versus subcutaneous depots, and severity of fatty liver disease was determined. Exercise prevented obesity and diabetes development in chow-fed foz/foz mice and delayed their onset in atherogenic-fed counterparts. Insulin-stimulated phospho-AKT levels in muscle were improved with exercise, but not in adipose or liver. Exercise suppressed adipose inflammatory recruitment, particularly in visceral adipose, associated with an increased number of small adipocyte subpopulations, and enhanced expression of beige adipocyte factor PRDM16 in subcutaneous fat. In atherogenic-fed foz/foz mice liver, exercise suppressed development of nonalcoholic steatohepatitis and related liver fibrosis. Exercise confers metabo-protective effects in atherogenic-fed hyperphagic mice by preventing early onset of obesity and diabetes in association with enhanced muscle insulin sensitivity, improved adipose morphometry, and suppressed adipose and liver inflammation. © 2015 The Obesity Society.

Metabolic Dysfunctions in Amyotrophic Lateral Sclerosis Pathogenesis and Potential Metabolic Treatments

PubMed Central

Tefera, Tesfaye W.; Borges, Karin

2017-01-01

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease primarily characterized by loss of motor neurons in brain and spinal cord. The death of motor neurons leads to denervation of muscle which in turn causes muscle weakness and paralysis, decreased respiratory function and eventually death. Growing evidence indicates disturbances in energy metabolism in patients with ALS and animal models of ALS, which are likely to contribute to disease progression. Particularly, defects in glucose metabolism and mitochondrial dysfunction limit the availability of ATP to CNS tissues and muscle. Several metabolic approaches improving mitochondrial function have been investigated in vitro and in vivo and showed varying effects in ALS. The effects of metabolic approaches in ALS models encompass delays in onset of motor symptoms, protection of motor neurons and extension of survival, which signifies an important role of metabolism in the pathogenesis of the disease. There is now an urgent need to test metabolic approaches in controlled clinical trials. In addition, more detailed studies to better characterize the abnormalities in energy metabolism in patients with ALS and ALS models are necessary to develop metabolically targeted effective therapies that can slow the progression of the disease and prolong life for patients with ALS. PMID:28119559

Experimental teeth clenching in man.

PubMed

Christensen, L V

1989-01-01

The thesis develops an electromyographic (EMG) method to quantify maximum voluntary teeth clenching (MVC), studies the onset and endurance of jaw muscle fatigue and pain from MVC, and explores the prevention of the discomforts through pharmacological and physical means. MVC, or maximum voluntary static work efforts by the elevator muscles of the mandible, was quantified by continuous (integral) functions of variations in both time and recruitment/rate coding of motor units in the masseter muscle. Fatigue was felt in the masseter muscle after about 30 seconds of MVC; differential calculus suggested that the appearance and disappearance of fatigue was associated with primarily recruitment and decruitment of masseteric motor units, respectively. About 60 seconds of MVC elicited a mild pain in the masseter and temporalis muscles; about 120 seconds of MVC induced a moderate pain and complete exhaustion of the isometrically contracting muscles. Although pain releasing maximum static work efforts are stable variables they cannot predict the pain magnitude of brief and prolonged MVC, probably because of modulations (recruitment/decruitment/rate coding) of masseteric motor units. It is suggested that the modulations begin with the onset of fatigue, are practically complete with the onset of pain, and are absent or negligible with an experience of exhaustion. A single oral dose of 1000 mg of ibuprofen did not affect the onset, endurance, and magnitude of pain from MVC. By contrast, 30 minutes of cooling (ice) of the masseter muscle effectively prevented the onset of pain; it also increased the masseteric EMG, credibly because of modulations of myoelectrical signals and, possibly, increased MVC efforts in the absence of pain.

PubMed Central

MAGGI, LORENZO; SALERNO, FRANCO; BRAGATO, CINZIA; SAREDI, SIMONA; BLASEVICH, FLAVIA; MACCAGNANO, ELIO; PASANISI, BARBARA; DANESINO, CESARE; MORA, MARINA; MORANDI, LUCIA

2013-01-01

The adult-onset form of Pompe disease had a wide clinical spectrum, ranging from asymptomatic patients with increased CK to muscle cramps and pain syndrome or rigid-spine syndrome. In addition clinical severity and disease progression are greatly variable. We report on a family with 3 siblings characterized by an unusual adult-onset Pompe disease including dysphagia and weakness of tongue, axial and limb-girdle muscles, in association with atypical globular inclusions in muscle fibres. Our study confirms the great clinical and histological variability of adult-onset Pompe disease and further supports the need of careful evaluation of bulbar function in patients affected by this pathology. PMID:24399864

Osteoid Osteoma of the Femoral Neck in Athletes

PubMed Central

Cordova, Christopher B.; Dembowski, Scott C.; Johnson, Michael R.; Combs, John J.; Svoboda, Steven J.

2015-01-01

The diagnosis of an intra-articular osteoid osteoma can be a challenging and lengthy process, with reports of delayed diagnosis of greater than 2 years. In the young, athletic patient with an atraumatic onset of groin pain, an overuse injury or muscle strain is the most likely etiology. However, an overuse injury of femoral neck stress fracture must be identified because of the potentially disastrous outcome of fracture completion. The similar clinical presentation of a femoral neck stress fracture and intra-articular osteoid osteoma of the femoral neck can further delay the diagnosis of the osteoid osteoma. In a patient with these differential diagnoses that do not improve with a period of nonweightbearing activity, a more intensive workup must ensue. The purpose of this case report is to describe the initial presentations, subsequent follow-up, and imaging findings leading to the diagnosis of osteoid osteoma as well as to differentiate an osteoid osteoma from femoral neck stress injuries. PMID:26517936

Adult onset Still's disease accompanied by acute respiratory distress syndrome: A case report.

PubMed

Xi, Xiao-Tu; Wang, Mao-Jie; Huang, Run-Yue; Ding, Bang-Han

2016-09-01

Adult onset Still's disease (AOSD) is a systemic inflammatory disorder characterized by rash, leukocytosis, fever and arthralgia/arthritis. The most common pulmonary manifestations associated with AOSD are pulmonary infiltrates and pleural effusion. The present study describes a 40-year-old male with AOSD who developed fever, sore throat and shortness of breath. Difficulty breathing promptly developed, and the patient was diagnosed with acute respiratory distress syndrome (ARDS). The patient did not respond to antibiotics, including imipenem, vancomycin, fluconazole, moxifloxacin, penicillin, doxycycline and meropenem, but was sensitive to glucocorticoid treatment, including methylprednisolone sodium succinate. ARDS accompanied by AOSD has been rarely reported in the literature. In conclusion, in a patient with ARDS who does not respond to antibiotic treatment, the involvement of AOSD should be considered.

Onset of rigor mortis is earlier in red muscle than in white muscle.

PubMed

Kobayashi, M; Takatori, T; Nakajima, M; Sakurada, K; Hatanaka, K; Ikegaya, H; Matsuda, Y; Iwase, H

2000-01-01

Rigor mortis is thought to be related to falling ATP levels in muscles postmortem. We measured rigor mortis as tension determined isometrically in three rat leg muscles in liquid paraffin kept at 37 degrees C or 25 degrees C--two red muscles, red gastrocnemius (RG) and soleus (SO) and one white muscle, white gastrocnemius (WG). Onset, half and full rigor mortis occurred earlier in RG and SO than in WG both at 37 degrees C and at 25 degrees C even though RG and WG were portions of the same muscle. This suggests that rigor mortis directly reflects the postmortem intramuscular ATP level, which decreases more rapidly in red muscle than in white muscle after death. Rigor mortis was more retarded at 25 degrees C than at 37 degrees C in each type of muscle.