Abstract
Aging is a one-way process associated with profound structural and functional changes in the organism. Indeed, the neuromuscular system undergoes a wide remodeling, which involves muscles, fascia, and the central and peripheral nervous systems. As a result, intrinsic features of tissues, as well as their functional and structural coupling, are affected and a decline in overall physical performance occurs. Evidence from the scientific literature demonstrates that senescence is associated with increased stiffness and reduced elasticity of fascia, as well as loss of skeletal muscle mass, strength, and regenerative potential. The interaction between muscular and fascial structures is also weakened. As for the nervous system, aging leads to motor cortex atrophy, reduced motor cortical excitability, and plasticity, thus leading to accumulation of denervated muscle fibers. As a result, the magnitude of force generated by the neuromuscular apparatus, its transmission along the myofascial chain, joint mobility, and movement coordination are impaired. In this review, we summarize the evidence about the deleterious effect of aging on skeletal muscle, fascial tissue, and the nervous system. In particular, we address the structural and functional changes occurring within and between these tissues and discuss the effect of inflammation in aging. From the clinical perspective, this article outlines promising approaches for analyzing the composition and the viscoelastic properties of skeletal muscle, such as ultrasonography and elastography, which could be applied for a better understanding of musculoskeletal modifications occurring with aging. Moreover, we describe the use of tissue manipulation techniques, such as massage, traction, mobilization as well as acupuncture, dry needling, and nerve block, to enhance fascial repair.
Highlights
In animal species, aging is associated with substantial modifications to the molecular determinants of cells, which alter their morphology, activity, and functional properties
Aging is associated with metabolic, structural, and functional modifications of cells, tissues, and organs, which lead to a gradual decline in psycho-physical performance
The locomotory apparatus loses its effectiveness, due to the molecular and cellular changes occurring in the myofascia, the skeletal muscle tissue, the nervous system, and their structural and functional coupling
Summary
In animal species, aging is associated with substantial modifications to the molecular determinants of cells, which alter their morphology, activity, and functional properties. These events affect the characteristics of tissues and organs, resulting in overall decayed performance of the organism (Narici et al, 2008; Zullo et al, 2017). Sensitive, specific, and non-invasive methods to investigate the structural and morphological changes occurring in these tissues during aging are needed, and therapeutic interventions should be implemented. We outline the structural and functional changes occurring within skeletal muscle, fascial tissue, and nervous system during aging. We describe some approaches for the study and the treatment of age-associated modifications in the neuromuscular system, such as imaging and ultrasound-based methods, as well as tissue manipulation techniques
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