Improve Muscle Power Research Articles

Whole-Body Vibration Training and Its Application to Age-Related Performance Decrements: An Exploratory Analysis.

Middle age is associated with a pronounced decline in power and flexibility. Whilst whole-body vibration training (WBVT) improves performance in a range of populations, whether WBVT can improve muscle power and flexibility in a middle-aged population is not known. The present study aimed to determine the influence of 5 weeks progressive WBVT in middle-aged (45-55 years) and younger (20-30 years) recreationally active females. Participants in each age group were randomly allocated to an intervention (WBVT) or control group. The WBVT groups trained for 5 weeks on a vibration platform, while the control groups performed identical exercises, with no vibration. Prior to, and after, the 5-week study vertical countermovement jump (VCMJ) and range of motion (ROM) performance were measured. WBVT significantly (p = 0.001) improved VCMJ performance when compared to the control groups. This improvement was significantly (p = 0.001) greater in the middle-aged compared with the younger WBVT group. WBVT significantly (p = 0.001) improved ROM irrespective of age. Taken together, these results suggest that WBVT can off-set age related performance decrements, which has therapeutic implications for musculoskeletal aging. Therefore, WBVT could be undertaken to minimise age-related performance deterioration in middle-aged female populations.

Neurological Recovery in Two Patients with Cauda Equina Syndrome Secondary to L5 Lumbar Spine Giant Cell Tumour after Treatment with Denosumab without Surgery.

We report two patients with cauda equina syndrome (CES) secondary to L5 giant cell tumour (GCT) who achieved good neurological recovery after treatment with denosumab without surgery. The first patient was a 26-year-old man with L5 GCT causing CES who regained bowel and urinary control, muscle power improvement from grade 2 to grade 4 and Oswestry disability index (ODI) improvement from 48 to 23 after denosumab treatment. The second patient was a 25-year-old woman with L5 GCT causing CES who regained bowel and urinary control, muscle power improvement from grade 0 to grade 4 and ODI improvement from 42 to 20 after denosumab treatment. The usage of denosumab in the treatment of patients with CES due to GCT allows potential neurological recovery without any surgical intervention. If surgery is not contraindicated, more time is obtained to prepare the patient preoperatively to attain safer surgery and to achieve complete tumour clearance.

Dermatomyositis: A Rare Extra-intestinal Manifestation of Ulcerative Colitis

Inflammatory myositis as an extra-intestinal manifestation of inflammatory bowel disease (IBD) is rare. Coexistence of immuno-mediated diseases in patients with IBD and myositis suggests a common etiopathogenic mechanism underlying these conditions. The current report refers to a rare case of a 45-year-old Korean female with ulcerative colitis (UC) who developed dermatomyositis. She presented with skin rash and proximal muscle weakness, and her disease activity of UC was in remission state. Electromyography, magnetic resonance imaging, and deltoid muscle biopsy were performed. She was diagnosed with dermatomyositis associated with UC and treatment with glucocorticoids and azathioprine resulted in improvement in muscle power and skin rash. Clinicians should be aware of this unusual extra-intestinal manifestation. (J Rheum Dis 2016;23:183-186)

Mitochondria to motion: optimizing oxidative phosphorylation to improve exercise performance.

Mitochondria oxidize substrates to generate the ATP that fuels muscle contraction and locomotion. This review focuses on three steps in oxidative phosphorylation that have independent roles in setting the overall mitochondrial ATP flux and thereby have direct impact on locomotion. The first is the electron transport chain, which sets the pace for oxidation. New studies indicate that the electron transport chain capacity per mitochondria declines with age and disease, but can be revived by both acute and chronic treatments. The resulting higher ATP production is reflected in improved muscle power output and locomotory performance. The second step is the coupling of ATP supply from O2 uptake (mitochondrial coupling efficiency). Treatments that elevate mitochondrial coupling raise both exercise efficiency and the capacity for sustained exercise in both young and old muscle. The final step is ATP synthesis itself, which is under dynamic control at multiple sites to provide the 50-fold range of ATP flux between resting muscle and exercise at the mitochondrial capacity. Thus, malleability at sites in these subsystems of oxidative phosphorylation has an impact on ATP flux, with direct effects on exercise performance. Interventions are emerging that target these three independent subsystems to provide many paths to improve ATP flux and elevate the muscle performance lost to inactivity, age or disease.

Dual-frequency whole body vibration enhances vertical jumping and change-of-direction ability in rugby players

BackgroundTraditional vertical and side-alternating whole body vibrations (WBV) can effectively improve muscle power performance but have a limited efficacy for enhancing change-of-direction (COD) ability. Novel dual-plate WBV uniquely providing various directions of movements with higher and distinctive frequencies for each leg may cause better acute effect on muscle power and stretch-shortening cycle efficacy contributing to COD ability. Therefore, the purpose of this study was to investigate the acute effect of dual- or single-frequency WBV on squat jumps (SJs), countermovement jumps (CMJs), eccentric utilization ratios (EURs), and COD ability in rugby players. MethodsFourteen male rugby players were recruited and performed a 4 min partial squat with 3 types of WBV protocols on a dual-plate WBV machine, including 1 dual-frequency WBV protocol (DFW) with the dominant leg receiving 35 Hz and the non-dominant leg receiving 45 Hz, and 2 single-frequency WBV protocols (SFWs) with 35 Hz or 45 Hz provided to both legs (SFW35Hz and SFW45Hz) on 3 different days. ResultsThe results showed that all the vibration protocols significantly improved SJ and CMJ performances (SJ: p = 0.008; CMJ: p < 0.001), but did not significantly change EURs (p > 0.05). In addition, only the DFW significantly improved COD ability (p = 0.001 for the pre–post comparison). ConclusionA 4 min dual-frequency WBV session improved both vertical jumping and COD ability in rugby players, suggesting that this could be a potential warm-up protocol for athletes.

Effects of a Supervised versus an Unsupervised Combined Balance and Strength Training Program on Balance and Muscle Power in Healthy Older Adults: A Randomized Controlled Trial

Background: Losses in lower extremity muscle strength/power, muscle mass and deficits in static and particularly dynamic balance due to aging are associated with impaired functional performance and an increased fall risk. It has been shown that the combination of balance and strength training (BST) mitigates these age-related deficits. However, it is unresolved whether supervised versus unsupervised BST is equally effective in improving muscle power and balance in older adults. Objective: This study examined the impact of a 12-week BST program followed by 12 weeks of detraining on measures of balance and muscle power in healthy older adults enrolled in supervised (SUP) or unsupervised (UNSUP) training. Methods: Sixty-six older adults (men: 25, women: 41; age 73 ± 4 years) were randomly assigned to a SUP group (2/week supervised training, 1/week unsupervised training; n = 22), an UNSUP group (3/week unsupervised training; n = 22) or a passive control group (CON; n = 22). Static (i.e., Romberg Test) and dynamic (i.e., 10-meter walk test) steady-state, proactive (i.e., Timed Up and Go Test, Functional Reach Test), and reactive balance (e.g., Push and Release Test), as well as lower extremity muscle power (i.e., Chair Stand Test; Stair Ascent and Descent Test) were tested before and after the active training phase as well as after detraining. Results: Adherence rates to training were 92% for SUP and 97% for UNSUP. BST resulted in significant group × time interactions. Post hoc analyses showed, among others, significant training-related improvements for the Romberg Test, stride velocity, Timed Up and Go Test, and Chair Stand Test in favor of the SUP group. Following detraining, significantly enhanced performances (compared to baseline) were still present in 13 variables for the SUP group and in 10 variables for the UNSUP group. Conclusion: Twelve weeks of BST proved to be safe (no training-related injuries) and feasible (high attendance rates of >90%). Deficits of balance and lower extremity muscle power can be mitigated by BST in healthy older adults. Additionally, supervised as compared to unsupervised BST was more effective. Thus, it is recommended to counteract intrinsic fall risk factors by applying supervised BST programs for older adults.

Influence of nitric oxide in the improvement of muscle power.

ABSTRACTOBJECTIVETo evaluate whether nitric oxide (NO) supplementa-tion is directly related to increased muscle power in response to strength exercise trainingMETHODSThe study included 36 individuals who underwent training for eight weeks (three times per week) with weights, who were randomly divided into two groups, both receiving the same training protocol, but one group used 3g of arginine, as a precursor of NO, and the other received placeboRESULTSThere was no significant difference between groups, only a significant difference for both groups between moments: before and after the training protocolCONCLUSIONOral administration of arginine asso-ciated with a training program did not increase the muscular power of individuals. Level of Evidence I, Study Type: Highquality randomized trial with statistically significant diffe-rence or no statistically significant difference but narrow confidence intervals.

What is a Clinically Meaningful Improvement in Leg-Extensor Power for Mobility-limited Older Adults?

Muscle power is a key predictor of physical function in older adults; however, clinically meaningful improvements in leg-extensor muscle power have yet to be identified. The purpose of this study is to establish the minimal clinically important improvement (MCII) and substantial improvement (SI) for leg-extensor power and muscle contraction velocity in mobility-limited older adults. Data were extracted from three randomized trials of leg-extensor muscle power training interventions (3- to 6-month duration). Measurements of leg-extensor power and velocity were obtained using dynamic bilateral leg press at 40% and 70% of the one-repetition maximum. Anchor-based MCIIs were calculated using selected items extracted from the Late Life Function and Disability Instrument. Standard error of measurement and effect size methods were used to calculate the distribution-based MCII. Data from 164 participants (mean age: 76.6 ± 5.6 years; Short Physical Performance Battery score: 7.8 ± 1.3) were used in this analysis. The respective MCII and SI estimates for 40% leg-extensor power were 18.3 (9%) and 30.5 (15%) W, and 23.1 (10%) and 41.6 (18%) W for 70% leg-extensor power. The respective MCII and SI estimates for 40% average velocity were 0.03(7%) and 0.08(18%) m/s, and 0.02(6%) and 0.05(15%) m/s for 70% average velocity. This is the first study to establish a clinically meaningful improvement of leg-extensor power (9%-10%) and velocity (6%-7%) in mobility-limited older adults. These findings should be used to aid in the design and interpretation of clinical trials and interventions that target improvements in muscle power in this high-risk population.

Ultrasound-guided Perineural Vitamin B12 Injection for Peripheral Neuropathy

The objective of this article is to present an innovative treatment for peripheral neuropathy using ultrasound-guided perineural vitamin B 12 injection. A 37-year-old patient presented with a progressive dropped foot for 2 months. Preceding trauma was denied. On examination, severe weakness of ankle dorsiflexion was revealed. Ultrasound showed peroneal nerve swelling. Nerve conduction velocity and electromyography study showed results compatible with peroneal neuropathy. Under the diagnosis of peroneal neuropathy, the patient was given 500 μg of methylcobalamin around the peroneal nerve under ultrasound guidance two times, with an interval of 2 weeks. The patient showed improvement of muscle power within 2 weeks. Full muscle power was regained after 3 months. There was no adverse symptom after ultrasound-guided perineural vitamin B 12 injection. Ultrasound-guided perineural vitamin B 12 has the advantage of precise delivery of high-dose vitamin B 12 directly around the defective nerve.

Evaluation of characteristics and surgical outcomes in cervical spondylotic amyotrophy.

Background:Cervical spondylotic amyotrophy (CSA) is a rare clinical syndrome resulting from cervical spondylosis. Surgical treatment includes anterior cervical decompression and fusion (ACDF), and laminoplasty with or without foraminotomy. Some studies indicate that ACDF is an effective method for treating CSA because anterior decompression with or without medial foraminotomy can completely eliminate anterior and/or anterolateral lesions. We retrospectively evaluated outcome of surgical outcome by anterior cervical decompression and fusion (ACDF).Materials and Methods:28 CSA patients, among whom 12 had proximal type CSA and 16 had distal type CSA, treated by ACDF, were evaluated clinicoradiologically. The improvement in atrophic muscle power was assessed by manual muscle testing (MMT) and the recovery rate of the patients was determined on the basis of the Japanese Orthopedic Association (JOA) scores. Patient satisfaction was also examined.Results:The percentage of patients, who gained 1 or more grades of muscle power improvement, as determined by MMT, was 91.7% for those with proximal type CSA and 37.5% for those with distal type CSA (P < 0.01). The JOA score-based recovery rates of patients with proximal type and distal type CSA were 60.8% and 41.8%, respectively (P < 0.05). Patient satisfaction was 8.2 for those with proximal type CSA and 6.9 for those with distal type CSA (P < 0.01). A correlation was observed among the levels of improvement in muscle power, JOA score based recovery rate, patient satisfaction and course of disease (P < 0.05).Conclusion:ACDF can effectively improve the clinical function of patients with CSA and result in good patient satisfaction despite the surgical outcomes for distal type CSA being inferior to those for proximal type CSA. Course of disease is the fundamental factor that affects the surgical outcomes for CSA. We recommend that patients with CSA undergo surgical intervention as early as possible.

Direct cord implantation in brachial plexus avulsions: revised technique using a single stage combined anterior (first) posterior (second) approach and end-to-side side-to-side grafting neurorrhaphy

BackgroundThe superiority of a single stage combined anterior (first) posterior (second) approach and end-to-side side-to-side grafting neurorrhaphy in direct cord implantation was investigated as to providing adequate exposure to both the cervical cord and the brachial plexus, as to causing less tissue damage and as to being more extensible than current surgical approaches.MethodsThe front and back of the neck, the front and back of the chest up to the midline and the whole affected upper limb were sterilized while the patient was in the lateral position; the patient was next turned into the supine position, the plexus explored anteriorly and the grafts were placed; the patient was then turned again into the lateral position, and a posterior cervical laminectomy was done. The grafts were retrieved posteriorly and side grafted to the anterior cord. Using this approach, 5 patients suffering from complete traumatic brachial plexus palsy, 4 adults and 1 obstetric case were operated upon and followed up for 2 years. 2 were C5,6 ruptures and C7,8T1 avulsions. 3 were C5,6,7,8T1 avulsions. C5,6 ruptures were grafted and all avulsions were cord implanted.ResultsSurgery in complete avulsions led to Grade 4 improvement in shoulder abduction/flexion and elbow flexion. Cocontractions occurred between the lateral deltoid and biceps on active shoulder abduction. No cocontractions occurred after surgery in C5,6 ruptures and C7,8T1 avulsions, muscle power improvement extended into the forearm and hand; pain disappeared.Limitations includespontaneous recovery despite MRI appearance of avulsions, fallacies in determining intraoperative avulsions (wrong diagnosis, wrong level); small sample size; no controls rule out superiority of this technique versus other direct cord reimplantation techniques or other neurotization procedures; intra- and interobserver variability in testing muscle power and cocontractions.ConclusionThrough providing proper exposure to the brachial plexus and to the cervical cord, the single stage combined anterior (first) and posterior (second) approach might stimulate brachial plexus surgeons to go more for direct cord implantation. In this study, it allowed for placing side grafts along an extensive donor recipient area by end-to-side, side-to-side grafting neurorrhaphy and thus improved results.Level of evidenceLevel IV, prospective case series.

High-speed resistance training is more effective than low-speed resistance training to increase functional capacity and muscle performance in older women

ObjectiveTo examine the effects of 12weeks of high-speed resistance training (RT) versus low-speed RT on muscle strength [one repetition of maximum leg-press (1RMLP) and bench-press (1RMBP), plus dominant (HGd) and non-dominant maximum isometric handgrip], power [counter-movement jump (CMJ), ball throwing (BT) and 10-m walking sprint (S10)], functional performance [8-foot up-and-go test (UG) and sit-to-stand test (STS)], and perceived quality of life in older women. Methods45 older women were divided into a high-speed RT group [EG, n=15, age=66.3±3.7y], a low-speed RT group [SG, n=15, age=68.7±6.4y] and a control group [CG, n=15, age=66.7±4.9y]. The SG and EG were submitted to a similar 12-week RT program [3 sets of 8 reps at 40–75% of the one-repetition maximum (1<RM), CMJ and BT] using slow, controlled (3s) concentric muscle actions for the SG and using fast, explosive (<1s) concentric muscle actions for the EG (20% less work per exercise without CMJ and BT). ResultsOver the 12-week training period, both RT groups showed small to large clinically significant improvements in the dependent variables; however, a significant difference was found between the EG and SG for the performance changes in BT, S10 and UG (20% vs. 11%, p<0.05; 14% vs. 9%, p<0.05; 18% vs. 10%, p<0.01; respectively). No significant changes were observed for the CG. ConclusionBoth RT interventions are effective in improving functional capacity, muscle performance and quality of life in older women, although a high-speed RT program induces greater improvements in muscle power and functional capacity.

IRIS manifesting as chronic inflammatory demyelinating polyneuropathy in HIV

Case report 45 year old female was diagnosed to have HIV with a CD4 count of 86. At the time of diagnosis, she was very much emaciated with a BMI of 16, had oral candidiasis and sensory neuropathy with numbness upto both ankles. After ruling out other opportunistic infections, she was started on tenofovir, lamivudine and nevirapine. Three months later, she presented to us with difficulty in walking and dribbling of saliva. History was suggestive of gradual worsening of peripheral neuropathy and progressive ascending limb weakness after initiation of anti retroviral therapy. Bowel and bladder involvement were not present. Clinical examination revealed areflexic quadriparesis with bilateral LMN facial palsy. Evidence of both small and large fiber neuropathy was present in both upper and lower limbs. Digital clawing was noted in both upper limbs in both ulnar and median nerve distribution. CSF study was suggestive of lymphocytic pleocytosis with mild protein elevation. MRI brain and spine were normal. Electromyographic nerve Sconduction studies were consistent with a primary demyelinating polyneuropathy involving all nerves in upper and lower limbs. CSF PCR for Cytomegalovirus, Ebstein barr virus, herpes and mycobacterium tuberculosis were negative. Since duration of symptoms was more than 2 months, a diagnosis of CIDP was made. She was given inj methylprednisolone 1 gm for 5 days followed by tapering doses of prednisolone. There was dramatic improvement in muscle power after initiation of steroids and after 2 weeks she was able to walk without support, facial palsy and digital clawing had recovered.

The effects of high-intensity versus low-intensity resistance training on leg extensor power and recovery of knee function after ACL-reconstruction.

Objective. Persistent weakness is a common problem after anterior cruciate ligament- (ACL-) reconstruction. This study investigated the effects of high-intensity (HRT) versus low-intensity (LRT) resistance training on leg extensor power and recovery of knee function after ACL-reconstruction. Methods. 31 males and 19 females were randomized to HRT (n = 24) or LRT (n = 26) from week 8–20 after ACL-reconstruction. Leg extensor power, joint laxity, and self-reported knee function were measured before and 7, 14, and 20 weeks after surgery. Hop tests were assessed before and after 20 weeks. Results. Power in the injured leg was 90% (95% CI 86–94%) of the noninjured leg, decreasing to 64% (95% CI 60–69%) 7 weeks after surgery. During the resistance training phase there was a significant group by time interaction for power (P = 0.020). Power was regained more with HRT compared to LRT at week 14 (84% versus 73% of noninjured leg, resp.; P = 0.027) and at week 20 (98% versus 83% of noninjured leg, resp.; P = 0.006) without adverse effects on joint laxity. No other between-group differences were found. Conclusion. High-intensity resistance training during rehabilitation after ACL-reconstruction can improve muscle power without adverse effects on joint laxity.

High-Intensity Interval Training for Improvement of Overhand Throwing Velocity

Context:High intensity interval training (HIIT) has been shown to improve muscle power and endurance, as well as aerobic power.Objective:To assess the effects of HIIT that utilizes resistive elastic bands to improve overhand throwing velocity.Participants:Healthy female volunteers (n = 13) ranging in age from 18–29 years.Interventions:Participants were randomly assigned to either a control group or an experimental group that exercised 3 days per week for 3 weeks. Each training session involved performance of 5 sets of 20 throwing motions against elastic band resistance, which was performed by both extremities.Main Outcome Measures:Maximal oxygen consumption was measured during performance of a graded exercise test that utilized an upper extremity cycle ergometer. A radar gun was used to assess peak throwing velocity and the extent to which throwing velocity was sustained during performance of a 20-throw endurance test.Results:After completing the training, the experimental group exhibited faster peak throwing velocity (61.6 ± 6.6 km/hr to 63.2 ± 8.6 km/hr) and a reduced fatigue index (1.18 ± 0.16 to 1.01 ± 0.02). Training also resulted in a 14% improvement in maximum oxygen consumption (1.40 ± 0.46 L/min to 1.60 ± 0.49 L/ min) and longer time to fatigue (9.99 ± 1.84 min to 11.43 ± 2.29 min).Conclusion:The high-intensity interval training program was effective for improvement of overhand throwing performance.

Leg muscle power is enhanced by training in people with Parkinson’s disease: a randomized controlled trial

Objective: To determine the effects of leg muscle power training in people with Parkinson’s disease. Design: Randomized controlled trial. Setting: University laboratory (outcome measures and experimental intervention), community (control intervention). Subjects: Community-dwelling people with Parkinson’s disease. Interventions: Leg muscle power training using pneumatic variable resistance equipment (experimental) was compared with low intensity sham exercise (control). Both groups exercised twice weekly for 12 weeks. Main measures: Primary outcomes were peak power of four leg muscle groups. Secondary outcomes were measures of muscle strength, mobility, balance and falls. Results: Exercise adherence was high in both groups. Leg muscle power was significantly better in the experimental group than the control group in all four primary outcome measures at 12 weeks after adjusting for baseline values: leg extensors (57.9 watts, 95% confidence interval (CI) 22.0–93.7, p = 0.002); knee flexors (29.6 watts, 95% CI 7.4–51.8, p = 0.01); hip flexors (68.1 watts, 95% CI 19.6–116.5, p = 0.007); and hip abductors (37.4 watts, 95% CI 19.9–54.9, p < 0.001). The experimental group performed significantly better on tests of leg muscle strength (p < 0.001 to 0.07) and showed trends toward better performance in the Timed Up and Go (p = 0.13) and choice stepping reaction time (p = 0.11). There was a non-significant reduction in the rate of falls in the experimental group compared with the control group (incidence rate ratio 0.84, p = 0.76). Conclusions: This programme significantly improved muscle power in all trained muscle groups.

Anaerobic Power in Road Cyclists Is Improved After 10 Weeks of Whole-Body Vibration Training

Whole-body vibration (WBV) training has previously improved muscle power in various athletic groups requiring explosive muscle contractions. To evaluate the benefit of including WBV as a training adjunct for improving aerobic and anaerobic cycling performance, road cyclists (n = 9) performed 3 weekly, 10-minute sessions of intermittent WBV on synchronous vertical plates (30 Hz) while standing in a static posture. A control group of cyclists (n = 8) received no WBV training. Before and after the 10-week intervention period, lean body mass (LBM), cycling aerobic peak power (Wmax), 4 mM lactate concentration (OBLA), VO2peak, and Wingate anaerobic peak and mean power output were determined. The WBV group successfully completed all WBV sessions but reported a significant 30% decrease in the weekly cycling training time (pre: 9.4 ± 3.3 h·wk(-1); post: 6.7 ± 3.7 h·wk(-1); p = 0.01) that resulted in a 6% decrease in VO2peak and a 4% decrease in OBLA. The control group reported a nonsignificant 6% decrease in cycling training volume (pre: 9.5 ± 3.6 h·wk(-1); 8.6 ± 2.9 h·wk(-1); p = 0.13), and all measured variables were maintained. Despite the evidence of detraining in the WBV group, Wmax was maintained (pre: 258 ± 53 W; post: 254 ± 57 W; p = 0.43). Furthermore, Wingate peak power increased by 6% (668 ± 189 to 708 ± 220 W; p = 0.055), and Wingate mean power increased by 2% (553 ± 157 to 565 ± 157 W; p = 0.006) in the WBV group from preintervention to postintervention, respectively, without any change to LBM. The WBV training is an attractive training supplement for improving anaerobic power without increasing muscle mass in road cyclists.

Resistance Training and Pioglitazone Lead to Improvements in Muscle Power During Voluntary Weight Loss in Older Adults

The prevalence of obesity in older adults is increasing but concerns exist about the effect of weight loss on muscle function. Demonstrating that muscle strength and power are not adversely affected during "intentional" weight loss in older adults is important given the wide-ranging negative health effects of excess adiposity. Participants (N = 88; age = 70.6 ± 3.6 years; body mass index = 32.8 ± 4.5 kg/m(2)) were randomly assigned to one of four intervention groups: pioglitazone or placebo and resistance training (RT) or no RT, while undergoing intentional weight loss via a hypocaloric diet. Outcomes were leg press power and isometric knee extensor strength. Analysis of covariance, controlling for baseline values, compared follow-up means of power and strength according to randomized groups. Participants lost an average of 6.6% of initial body mass, and significant declines were observed in fat mass, lean body mass, and appendicular lean body mass. Compared with women not randomized to RT, women randomized to RT had significant improvements in leg press power (p < .001) but not in knee extensor strength (p = 0.12). No significant differences between groups in change in power or strength from baseline were detected in men (both p > .25). A significant pioglitazone-by-RT interaction for leg press power was detected in women (p = .006) but not in men (p = .88). In older overweight and obese adults, a hypocaloric weight loss intervention led to significant declines in lean body mass and appendicular lean body mass. However, in women assigned to RT, leg power significantly improved following the intervention, and muscle strength or power was not adversely effected in the other groups. Pioglitazone potentiated the effect of RT on muscle power in women but not in men; mechanisms underlying this sex effect remain to be determined.

Anterior Decompression in the Management of Unilateral Cervical Spondylotic Amyotrophy

Cervical spondylotic amyotrophy is a rare clinical condition. The purpose of this study was to investigate the effects of anterior decompression in patients with unilateral upper-extremity amyotrophy caused by cervical spondylosis. The authors retrospectively analyzed the records of 31 patients (23 men and 8 women) who underwent anterior decompressive surgery for cervical spondylotic amyotrophy at the authors' institution between 2000 and 2011. Demographic characteristics, pre- and postoperative results of imaging studies, and postoperative muscle power improvement were reviewed at a mean follow-up of 22.2 months (range, 14-36 months). Patients were divided into proximal (n=21) and distal (n=10) types according to the most severely atrophic muscle, and the 2 groups were compared statistically. The most commonly affected intervertebral level in proximal-type patients was C4-C5, whereas that in distal-type patients was C5-C6. Impingements against the ventral nerve root and anterior horn were observed in 22 and 25 cases, respectively, with 16 cases having both impingements. Eighty-one percent of proximal-type patients gained 1 or more grades of muscle power improvement on manual muscle testing, whereas 40% of distal-type patients improved. Within 15 postoperative days, 57% of proximal-type patients attained subjective or objective improvement of muscle power, whereas all distal-type patients failed to improve. Anterior decompression was effective for most patients with unilateral cervical spondylotic amyotrophy, although postoperative muscle power improvement in distal-type patients was inferior to that in proximal-type patients. Furthermore, compared with the proximal type, the distal type showed a slower postoperative recovery.

Administration of Autologous Bone Marrow-Derived Mononuclear Cells in Children with Incurable Neurological Disorders and Injury is Safe and Improves their Quality of Life

Neurological disorders such as muscular dystrophy, cerebral palsy, and injury to the brain and spine currently have no known definitive treatments or cures. A study was carried out on 71 children suffering from such incurable neurological disorders and injury. They were intrathecally and intramuscularly administered autologous bone marrow-derived mononuclear cells. Assessment after transplantation showed neurological improvements in muscle power and a shift on assessment scales such as FIM and Brooke and Vignos scale. Further, imaging and electrophysiological studies also showed significant changes in selective cases. On an average follow-up of 15 ± 1 months, overall 97% muscular dystrophy cases showed subjective and functional improvement, with 2 of them also showing changes on MRI and 3 on EMG. One hundred percent of the spinal cord injury cases showed improvement with respect to muscle strength, urine control, spasticity, etc. Eighty-five percent of cases of cerebral palsy cases showed improvements, out of which 75% reported improvement in muscle tone and 50% in speech among other symptoms. Eighty-eight percent of cases of other incurable neurological disorders such as autism, Retts Syndrome, giant axonal neuropathy, etc., also showed improvement. No significant adverse events were noted. The results show that this treatment is safe, efficacious, and also improves the quality of life of children with incurable neurological disorders and injury.