Maintain Muscle Strength Research Articles

Effects of wheelchair Tai Chi ball exercise on physical and mental health and functional abilities among elderly with physical disability

ABSTRACT The purpose of this study was to examine the effect of a 12-week Wheelchair Tai Chi Ball (WTCB) intervention, a combination of mind-body exercise with strength training, on physical and mental health and functional abilities among elderly with disability. Twenty-six elderly persons participated in the study, nine WTCB group participants and ten control group participants completed the study. The WTCB group practised WTCB12 twice/week for one hour each time. The control group did their daily routine without WTCB intervention. The outcomes measures were: Pain Self-Efficacy Questionnaire (PSEQ), SF-36v2 for physical and mental health, heart rate, blood pressure, range of motion and muscle strength of the dominant arm at the shoulder, elbow and wrist joints. The Mixed Model ANOVA was employed to examine the differences between and within the two groups using pre-test and post-test scores. The results demonstrated the WTCB group had significant improvements on PSEQ, general physical health and had positive effects on maintaining muscle strength at the shoulder, elbow and wrist joints as compared to the control group. The WTCB12 exercise had positive effects on self-efficacy for pain management, general physical health, and maintain upper extremity muscle strength and is a feasible exercise for elderly with disability.

The effectiveness pre-operative exercise of muscle strength for early ambulation on lower limb fracture with measurement tool – The Modified Iowa Level of Assistance Scale (MILAS) – in hospital inpatients

To evaluate the effectiveness of pre-operative exercise of muscle strength before surgery, maintains muscle strength and prepare early postoperative ambulation lower limb fracture. Design research was a quasi-experiment with control and post-test only (unpaired t-test) with 28 respondents (14 respondents intervention group and 14 respondents control group). The intervention group was given muscle strength exercise before surgery, for ±1 week. Every day patients do strength exercise 3 times a day, for ±5-10min. The post-operative assessment was conducted in both groups with Modified Level of Assistance Scale (MILAS), to find out the difference in the ability to do early ambulation. The results of the independent t-test were significant differences of ambulation ability of the intervention group were better than the control group. The difference in average ambulation ability after operation between the intervention group and the control group, the average ambulation ability of respondents in the intervention group was 14.14 with a standard deviation (SD=2.93), while for the control group, the average ambulation ability was 18.50 with the standard deviation (SD=5.56). Statistical test results obtained p-value of 0.017 (α<0.005), meaning that at alpha 5% a significant difference was seen in the average ability of early ambulation between respondents in the intervention group and the control group. There is evidence to suggest that pre-operative exercise of muscle strength is beneficial to early ambulation postoperative lower limb fracture.

ARHGEF3 Regulates Skeletal Muscle Regeneration and Strength Through Autophagy

Skeletal muscle regeneration is essential for restoring muscle function upon injury and for the maintenance of muscle health with aging. ARHGEF3, a Rho-specific GEF, negatively regulates myoblast differentiation via mammalian target of rapamycin complex 2 (mTORC2)-Akt signaling in a GEF-independent manner in vitro. Here, we investigated ARHGEF3’s role in skeletal muscle regeneration by creating ARHGEF3 KO mice. These mice exhibited no discernible phenotype under normal conditions. Upon injury, however, ARHGEF3 deficiency enhanced the mass, fiber size and function of regenerating muscles in both young and aged mice. Surprisingly, these effects were not mediated by mTORC2-Akt signaling, but by the GEF activity of ARHGEF3. Furthermore, ARHGEF3 KO promoted muscle regeneration through activation of autophagy, a process that is also critical for maintaining muscle strength. Accordingly, in old mice, ARHGEF3 depletion prevented muscle weakness by restoring autophagy flux. Collectively, our findings identify an unexpected link between ARHGEF3 and autophagy-related muscle pathophysiology.

Clinico-diagnostic features of neuralgic amyotrophy in childhood.

Neuralgic amyotrophy (NA), even known as Personage-Turner's syndrome (PTS), is a neurologic condition, affecting the lower motor neurons of brachial plexus and/or individual nerves or nerve branches, characterized by pain, muscle weakness/atrophy, and sensory symptoms. NA has an acute/subacute onset, after an infection or vaccination; it is more common in male and is rare in the pediatric population. The etiology remains uncertain, being considered heterogeneous and multifactorial. A severe acute neurologic pain around the shoulder girdle is the classic presenting symptom at onset. As the pain subsides, weakness and paresis develop. NA is usually unilateral, but sometimes, a subclinical contralateral limb involvement could be present and bilateral affection has been described. The diagnosis is clinical, through a comprehensive history and neurological examination. However, electrophysiological testing and imaging are critical, because there is no diagnostic test for PTS and it remains a diagnosis of exclusion. Upper brachial plexus peripheral involvement with weakness of periscapular and perihumeral muscles is the classic presentation, associated with electrophysiological evidence of denervation in the affected muscles. Imaging, laboratory, and genetic testing can be useful for the differential diagnosis. NA is in most cases a self-limiting condition, and it is characterized by good recovery. Treatment of NA usually involves a combination of corticosteroids, analgesics, immobilization, and physical therapy, even if limited data are available in children. Physiotherapy is required to maintain muscle strength.

The Relationship between Body Mass Index, Body Fat Percentage, and Dietary Intake with Muscle Fatigue in Adolescent Football Players.

It is important for football players to maintain muscle strength through the entire match. The aim of this study was to investigate body mass index (BMI), body fat percentage (BF%), dietary intake (energy, carbohydrate, and protein) and its relationship with muscle fatigue among adolescent football players. This was a cross-sectional study involving 26 football players aged 15-17 y. BMI was determined using WHO Anhtro Plus, BF% was analyzed using Bioelectrical Impedance Analysis (BIA) and categorized using bodyfat curves for children, and dietary intake was assessed using 3×24 h dietary recall. Running-Based Anaerobic Sprint Test (RAST) was conducted twice and averaged to identify muscle fatigue. Pearson correlation and multiple-regression analysis were performed to determine the relationship between variables. The results showed that overall participants had healthy weight (17.61±1.82 kg/m2), good diet pattern (energy 99.08±14.34%, carbohydrate 92.88±9.54% and protein 95.96±23.41%), but low body fat (6.76±2.12%). In pearson test, negative correlations were found in muscle fatigue and BMI (r=-0.393, p=0.047), as well as BF% (r=-0.458, p=0.019), but positive between muscle fatigue and energy intake (r=0.538, p=0.005). Furthermore, multiple-regression analysis only confirmed statistically significant relationship between energy intake and muscle fatigue (p=0.028). We conclude that the higher BMI and BF% may lead to greater muscle fatigue, while higher energy intake has significant improvement to reduce muscle fatigue. Hence, it is essential for football players to consume adequate energy, and consider to maintain BMI and BF% at optimal range.

Nutrition and Muscle Strength, As the Key Component of Sarcopenia: An Overview of Current Evidence.

Much has been achieved by recent research to increase understanding of the links between nutrition and muscle health. Focusing on muscle strength as the key component of sarcopenia, the aim of this overview was to evaluate its links to nutrition, both to variation in habitual diets in older populations, as well as considering supplementation effects in trials. A main message from the reviewed studies is that while many provide suggestive evidence of benefits of higher nutrient intakes and diets of higher quality, findings are inconsistent, and data on muscle strength are often lacking. To assess the potential of optimising diets as a strategy to promote and maintain muscle strength, gaps in current evidence need to be addressed. These include the need for (i) better understanding of individual differences in responsiveness to dietary change, and the need for targeted nutritional support; (ii) clearer distinction between protective and therapeutic actions of diet; and (iii) definition of the role of dietary patterns and their influence on muscle strength, to allow effects of changes in food consumption to be evaluated—particularly when combined with physical activity. Development of this evidence is needed to enable translation into appropriate dietary recommendations for older populations.

A Chalcone from Ashitaba (Angelica keiskei) Stimulates Myoblast Differentiation and Inhibits Dexamethasone-Induced Muscle Atrophy.

Ashitaba, Angelica keiskei Koidzumi (AK), as a traditional medicine in Korea, Japan, and China, has been known as an elixir of life having therapeutic potential. However, there is no scientific evidence to support that Ashitaba can enhance or maintain muscle strength. To find a new therapeutic agent from the medicinal plant, we evaluated the anti-myopathy effect of chalcones from ethanol extract of AK (EAK) in cellular and animal models of muscle atrophy. To examine anti-myopathy activity, EAK was treated into dexamethasone injected rats and muscle thickness and histopathological images were analyzed. Oral administration of EAK (250 or 500 mg/kg) alleviated muscle atrophic damages and down-regulated the mRNA levels of muscle-specific ubiquitin-E3 ligases. Among ten compounds isolated from EAK, 4-hydroxyderricin was the most effective principle in stimulating myogenesis of C2C12 myoblasts via activation of p38 mitogen-activated protein kinase (MAPK). In three cellular muscle atrophy models with C2C12 myoblasts damaged by dexamethasone or cancer cell-conditioned medium, 4-hydroxyderricin protected the myosin heavy chain (MHC) degradation through suppressing expressions of MAFbx, MuRF-1 and myostatin. These results suggest that the ethanol extract and its active principle, 4-hydroxyderricin from AK, can overcome the muscle atrophy through double mechanisms of decreasing muscle protein degradation and activating myoblast differentiation.

Thyroid Function as a Predictor of Handgrip Strength Among Middle-Aged and Older Euthyroid Adults: The TCLSIH Cohort Study

ObjectivesThyroid hormones (THs) play a critical role in skeletal muscle function, such as protein synthesis and energy metabolism, suggesting that thyroid function may be involved in the decline of muscle strength. Studies regarding the long-term effects of THs on muscle strength are limited. Therefore, this large-scale longitudinal study aimed to explore how TH levels were associated with handgrip strength (HGS) among middle-aged and older euthyroid adults. DesignLongitudinal population-based cohort study (approximately 4-year follow-up period, median: 3.0 years). SettingThe Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study, Tianjin, China. ParticipantsA total of 2152 participants were enrolled, and annual measures were conducted in this longitudinal study. MeasuresChemiluminescence immunoassay was used to measure free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH). HGS was measured using a handheld digital dynamometer. Multiple linear regression analysis was used to evaluate the association between THs, FT3/FT4 ratio, TSH levels, and annual change in HGS and weight-adjusted HGS. ResultsAfter adjusting for multiple confounding factors, significant associations between FT3 levels, FT3/FT4 ratio, and annual change in HGS [standard regression coefficient (SRC) = 0.073, P < .01, and and SRC = 0.059, P = .01, respectively] were observed. However, no significant difference was observed between FT4, TSH, and annual change in HGS (SRC = 0.021, P = .34; and SRC = −0.017, P = .44, respectively). Similar associations between FT3, FT4, FT3/FT4 ratio, TSH, and weight-adjusted HGS were observed. Conclusions and implicationsThis longitudinal study is the first to demonstrate that high-normal FT3 levels and higher FT3/FT4 ratios significantly predict annual change in HGS and weight-adjusted HGS and that FT4 and TSH levels are not associated with HGS among middle-aged and older euthyroid subjects. The findings suggest that new therapeutic approaches aimed at FT3 levels and FT3/FT4 ratios may be proposed to maintain muscle strength.

The correlation between serum thyroid hormone levels and hand grip among elderly male Chinese inpatients

Introduction Thyroid dysfunction is closely associated with skeletal muscle weakness. However, data on the optimal serum range of thyroid hormones for maintaining muscle strength in the elderly is lacking. Methods We conducted a cross-sectional analysis in male elderly inpatients from the Geriatric Department of Zhongshan Hospital (affiliated to Fudan University, Shanghai, China). Serum biochemical parameters and thyroid hormones were detected for each participant. Hand grip (HG) was measured, with low hand grip defined as HG <26 kg according to the standard of the Asian Working Group for Sarcopenia. Logistic regression was used to evaluate the effects of different serum thyroid hormone levels on HG. Results The majority of the subjects were euthyroid. The prevalence of low hand grip was 48.5%. Stratified by the free thyroxine (FT4) quartiles, the results showed HG was the highest in the third quartile. Multiple logistic regression analysis showed that compared with those in the first quartile, subjects in the third quartile of FT4 had a significantly lower risk of low hand grip (OR = 0.133, 95%CI: 0.020–0.610, p = .009), after adjusting potential confounding factors. Conclusion In elderly male inpatients, maintaining a narrower serum range of thyroid hormone might be needed to protect skeletal muscle strength.

Nemaline myopathies: a current view

Nemaline myopathies are a heterogenous group of congenital myopathies caused by de novo, dominantly or recessively inherited mutations in at least twelve genes. The genes encoding skeletal α-actin (ACTA1) and nebulin (NEB) are the commonest genetic cause. Most patients have congenital onset characterized by muscle weakness and hypotonia, but the spectrum of clinical phenotypes is broad, ranging from severe neonatal presentations to onset of a milder disorder in childhood. Most patients with adult onset have an autoimmune-related myopathy with a progressive course. The wide application of massively parallel sequencing methods is increasing the number of known causative genes and broadening the range of clinical phenotypes. Nemaline myopathies are identified by the presence of structures that are rod-like or ovoid in shape with electron microscopy, and with light microscopy stain red with the modified Gömöri trichrome technique. These rods or nemaline bodies are derived from Z lines (also known as Z discs or Z disks) and have a similar lattice structure and protein content. Their shape in patients with mutations in KLHL40 and LMOD3 is distinctive and can be useful for diagnosis. The number and distribution of nemaline bodies varies between fibres and different muscles but does not correlate with severity or prognosis. Additional pathological features such as caps, cores and fibre type disproportion are associated with the same genes as those known to cause the presence of rods. Animal models are advancing the understanding of the effects of various mutations in different genes and paving the way for the development of therapies, which at present only manage symptoms and are aimed at maintaining muscle strength, joint mobility, ambulation, respiration and independence in the activities of daily living.

Developmental factors associated with decline in grip strength from midlife to old age: a British birth cohort study

ObjectivesTo test whether developmental factors are associated with grip strength trajectories between 53 and 69 years, and operate independently or on the same pathway/s as adult factors.DesignBritish birth cohort study.SettingEngland,...

Musculoskeletal Alterations of Hindlimb During Simulated Microgravity and Reloading in Rats: Compared by Gender

Although several researches have reported potential gender differences in adaptations during microgravity, the musculoskeletal alterations of different genders are still under debate. Besides, there were few researches which involved recovery phase after reloading. In the present study, we investigated the musculoskeletal alterations of rats hindlimb via tail-suspension in both genders, and analyzed the serum sex hormone at the same time. Thirty-two Sprague Dawley rats were equally divided by gender into four groups randomly: control of male (CONM), tail-suspension of male (TSM), control of female (CONF) and tail-suspension of female (TSF). The experiment consisted two phases, which were 21 days of tail suspension phase and 21 days’ reloading phase, and parameters of bone, muscle and serum were tested at the end point of each phase. The results indicated that during tail suspension phase, male rats showed a greater and earlier bone loss and microstructure deterioration compared with females, but they could maintain muscle strength much better. In addition, during reloading phase, male rats showed a slower bone recovery and some parameters could not recover until the end, while loss in muscle mass and strength in both genders could recover to control level.

A case of lymphangioleiomyomatosis with maintained muscle strength by rehabilitation during lung transplantation standby period

A case of lymphangioleiomyomatosis with maintained muscle strength by rehabilitation during lung transplantation standby period

Decline in tongue pressure during perioperative period in cancer patients without oral feeding

Systemic muscle wasting during perioperative periods has a major impact on postoperative morbidity. However, data on oropharyngeal muscle weakness after surgery are scarce. We examined whether maximum tongue pressure (MTP) and hand grip strength (HGS) diminished during the perioperative period without and with oral feeding in patients receiving cancer surgery. A total of 258 patients undergoing cancer surgery who had visited a hospital dental clinic were prospectively recruited between October 2015 and February 2016. MTP and HGS were measured on the day before and 4 days after surgery. Data on age, sex, tumor location, surgical procedure, and oral feeding status were obtained from patient medical records. We analyzed for differences in the perioperative changes of MTP and HGS according to surgical procedure, oral feeding, and tumor location using ANOVA. Neither MTP nor HGS differed significantly among tumor locations before surgery. The proportion of patients with an oral diet at 4 days after surgery was 36.7% and 34.5% for upper GI and colorectum groups versus 89.2% and 86.4% for genitourinary and lung groups, respectively. During the perioperative period, MTP decreased more significantly in patients without oral feeding than in those with oral feeding at 4 days after surgery (P<0.01). HGS was not affected by postoperative oral feeding status. Both MTP and HGS decreased more significantly in the upper gastrointestinal group than in the genitourinary and lung groups (P<0.05), except for MTP between upper GI and genitourinary groups (P=0.10). MTP, but not HGS, diminishes significantly during the perioperative period without oral feeding. As tongue muscle disuse after surgery may adversely impact postoperative oropharyngeal muscle decline, perioperative tongue muscle strengthening exercises may assist in maintaining muscle strength and good oral feeding.

Study protocol for single-center, open-label, randomized controlled trial to clarify the preventive efficacy of electrical stimulation for muscle atrophy after trauma

BackgroundManagement of trauma involves long-term bed rest even when muscle strength in the lower extremities is preserved. Prolonged bed rest reduces muscle mass and causes muscle atrophy. A recent study reported the efficacy of rehabilitation using electrical muscle stimulation (EMS) for muscle strength maintenance in intensive care unit patients with disturbance of consciousness. However, despite the expected benefits of EMS in maintaining muscle strength, little is known about its efficacy in trauma patients.Methods/designA single-center, open-label, randomized controlled trial of 40 patients with pelvic fracture to test the effectiveness of 14 days of EMS. The primary outcome will be change in cross-sectional area of the thigh muscle between pre and post intervention, as measured on computed tomography images. We will analyze the primary endpoint by analysis of covariance (ANCOVA) and analyze the secondary endpoints in an exploratory manner.ConclusionIf our hypothesis is confirmed, this study will provide evidence that the use of EMS can be effective in preventing muscle atrophy.Trial registrationUMIN registration number: UMIN000030190. Registered on 1 December 2017.

Low Doses of G-CSF Prevent Cerebral Infarction and Maintain Muscle Strength in an Experimental Model of Global Ischemic Stroke.

Stroke is a major cause of severe and long-term disability in adult individuals. Treatment of this disease is limited by the narrow therapeutic window in which intervention is crucial. An alternative therapy for stroke could be cellular growth factors, which participate in several pathways that mediate neuronal cell death. We evaluated the neuroprotective ability of different doses of granulocyte colonystimulating factor (G-CSF; 5, 50 and 100 μg/kg/day) in the mouse model of global cerebral ischemia induced by bilateral occlusion of the common carotid arteries for 80 minutes. The control group received vehicle (5% glucose solution) and the treated group was administered with G-CSF at two postsurgery time-points: immediately after and 24 hours after. Subsequently, muscle strength, leukocyte count, infarcted cortical area, and apoptosis/TUNEL were evaluated. The global ischemia promoted an impairment of the strength (16%) and a cerebral infarction (0.437±0.08 cm2) which were accompanied by apoptosis evaluated by TUNEL in control mice. In mice treated with G-CSF the strength function was maintained, the infarcted area (~70%) and apoptosis were decreased in a similar magnitude in all treated groups. Accordingly, the cytokine activities were confirmed by blood leukocyte count that was increased approximately 2-fold than that observed in the control group. The results indicate a neuroprotective effect of G-CSF, even in small doses, in mice subjected to global cerebral ischemia, thereby reducing the neurofunctional impairment caused by stroke, when considering the maintenance of muscle strength in the treated animals.

Feasibility of early postoperative mobilisation after colorectal surgery: A retrospective cohort study

BackgroundEnhanced Recovery After Surgery (ERAS) guidelines advocate early postoperative mobilisation to counteract catabolic changes due to immobilisation and maintain muscle strength. The present study aimed to assess compliance to postoperative mobilisation according to ERAS recommendations. Materials and methodsThis is a retrospective cohort study on consecutive colorectal surgical procedures treated within an established ERAS protocol within a single center between May 2011 and May 2017. Demographics, surgical details, ERAS related items and surgical outcome were prospectively assessed in a dedicated database and compared between ambulant patients (at least 6 h out of bed at postoperative day (POD) 1) vs. patients not meeting the target (delayed mobilisation). Risk factors for decreased postoperative mobilisation were identified through multivariable logistic regression. Results1170 patients were retained. 676 patients (58%) did not mobilise as recommended by ERAS protocol at POD1. Emergency operation (Odds Ratio (OR) 0.40; 95% Confidence Interval (CI) 0.18–0.91, p = 0.028), age > 70 years (OR 0.69; 95% CI 0.47–1.00, p = 0.050) and intraoperative total fluids > 2000 mL (OR 0.59; 95% CI 0.37–0.93, p = 0.025) were independent risk factors for delayed mobilisation. Patients with delayed mobilisation had significantly more overall (Clavien grade IV) (55% vs. 29%, p=<0.001), major (Clavien grade IIIb-V) (16% vs. 7%, p=<0.001) and respiratory (12% vs. 4%, p=<0.001) complications, as well as longer length of stay (12 ± 14 vs. 6±7days, p=<0.001). ConclusionsMore than half of patients did not mobilise as recommended by ERAS guidelines. Emergency surgery, advanced age and fluid overload were independent risk factors for delayed mobilisation, which was associated with increased postoperative complications.

Chapter 3 Prevention of sarcopenia.

Chapter 3 Prevention of sarcopenia.

Maintenance of muscle strength retains a normal metabolic cost in simulated walking after transtibial limb loss.

Recent studies on relatively young and fit individuals with limb loss suggest that maintaining muscle strength after limb loss may mitigate the high metabolic cost of walking typically seen in the larger general limb loss population. However, these data are cross-sectional and the muscle strength prior to limb loss is unknown, and it is therefore difficult to draw causal inferences on changes in strength and gait energetics. Here we used musculoskeletal modeling and optimal control simulations to perform a longitudinal study (25 virtual “subjects”) of the metabolic cost of walking pre- and post-limb loss (unilateral transtibial). Simulations of walking were first performed pre-limb loss on a model with two intact biological legs, then post-limb loss on a model with a unilateral transtibial prosthesis, with a cost function that minimized the weighted sum of gait deviations plus metabolic cost. Metabolic costs were compared pre- vs. post-limb loss, with systematic modifications to the muscle strength and prosthesis type (passive, powered) in the post-limb loss model. The metabolic cost prior to limb loss was 3.44±0.13 J/m/kg. After limb loss, with a passive prosthesis the metabolic cost did not increase above the pre-limb loss cost if pre-limb loss muscle strength was maintained (mean -0.6%, p = 0.17, d = 0.17). With 10% strength loss the metabolic cost with the passive prosthesis increased (mean +5.9%, p < 0.001, d = 1.61). With a powered prosthesis, the metabolic cost was at or below the pre-limb loss cost for all subjects with strength losses of 10% and 20%, but increased for all subjects with strength loss of 30% (mean +5.9%, p < 0.001, d = 1.59). The results suggest that maintaining muscle strength may prevent an increase in the metabolic cost of walking following unilateral transtibial limb loss, and that a gait with minimal deviations can be achieved when muscle strength is sufficiently high, even when using a passive prosthesis.

Fatigue, Muscle Oxygen Consumption and Blood Flow to the Skeletal Muscle After Allogeneic Hematopoietic Stem Cell Transplantation.

The purpose of this study was to compare the differences in fatigue to those in muscle oxygen consumption and blood flow to the skeletal muscles before and after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This study included 25 male patients who had received allo-HSCT between November 2009 and August 2012. Fatigue was assessed by using the Piper fatigue scale. Muscle oxygen consumption, shown by the change in deoxyhemoglobin (ΔHHb), and blood flow to the skeletal muscle, shown by the change in total hemoglobin (ΔtHb), were measured non-invasively in the tibialis anterior muscle during endurance exercise using near-infrared spectroscopy. ΔHHb and ΔtHb were significantly lower following allo-HSCT than before it (p<0.05). Before allo-HSCT, no relationship was observed between fatigue and either ΔHHb or ΔtHb. However, after allo-HSCT, a significant relationship was found between fatigue and ΔHHb (p<0.05). Patients experience decreased muscle oxygen consumption and blood flow to skeletal muscles after allo-HSCT. Furthermore, fatigue may have a relationship with decreased muscle oxygen consumption in patients after allo-HSCT. Rehabilitation staff, nurses, and physicians should recognise both decreases in muscle oxygen consumption and blood flow in patients who have undergone allo-HSCT, and physiotherapists may need to promote muscle oxidative metabolism through exercise in order to maintain muscle strength.