Contracted Muscle Research Articles

Effects of repetitive practice of motor tasks on somatosensory gating.

During voluntary muscle contraction, the amplitude of the somatosensory evoked potential (SEP) is reduced by inhibiting sensory information from a peripheral nerve supplying the contracted muscle. This phenomenon is called "gating." We reported that participants with good motor skills indicated strong suppression of somatosensory information. The present study investigated the effects of motor performance improvement following repetitive practice on the SEP amplitude. The ball rotation task (BR task) was practiced by 15 healthy participants repetitively. SEPs were recorded before (pre) and after (post) repetitive practice. The BR task performance was significantly improved and the required muscle activation to perform the task was significantly reduced after the repetitive practice. The degree of gating was not significant between pre and post- for the SEP amplitude. A significant correlation was found between changes in SEP amplitude from pre to post and performance improvement. After repetitive practice, the degree of gating did not change, but the performance of the BR task improved, and the muscle activity required for the BR task decreased. These results suggest that repetitive practice does not change the degree of gating but changes the mechanism of gating. Furthermore, they indicate that suppression of the somatosensory area may play a role in improving task performance.

Dose-dependent tandem responses of osteoblasts during osteogenesis

Irisin, a myokine mainly secreted from contracted skeleton muscle, plays a profound role in bone formation and remodeling. Although irisin has been revealed to elevate bone mass in vivo, details whether there is a dose-dependent relationship between irisin and bone formation remain unclear. In this study, we explored the dose-dependent effects of irisin on osteoblast proliferation and differentiation. Our results first demonstrated a remarkable increase in cell proliferation rate and viability in response to elevated concentrations of r-irisin, which was further enhanced over time. Notably, this increase was subject to complex dose-response relationships as the proliferation-enhancing effects of r-irisin may have a saturation point between 10 ​ng/ml and 100 ​ng/ml. Furthermore, we determined that 1, 10, and 100 ​ng/ml r-irisin were able to upregulate the expression of osteogenic transcription factors (Runx2, Osx, and Atf4), as well as osteogenic markers (Alp, Col1a1 and Spp1), albeit without significant difference among these 3 concentrations. Interestingly, nutrient-depleted osteoblasts and those with standard culture showed distinct responses to higher doses of irisin regarding osteogenic differentiation. Further investigation is required to uncover the molecular mechanisms underlying the observed tandem effects of irisin on osteogenesis.

The effect of elastic and viscous force fields on bimanual coordination

Bimanual in-phase and anti-phase coordination modes represent two basic movement patterns with distinct characteristics—homologous muscle contraction and non-homologous muscle contraction, respectively. A method to understand the contribution of each limb to the overall coordination pattern involves detuning (Δω) the natural eigenfrequency of each limb. In the present experiment, we experimentally broke the symmetry between the two upper limbs by adding elastic and viscous force fields using a Kinarm robot exoskeleton. We measured the effect of this symmetry breaking on coordination stability as participants performed bimanual in-phase and anti-phase movements using their left and right hand in 1:1 frequency locking mode. Differences between uncoupled frequencies were manipulated via the application of viscous & elastic force fields and using fast and slow oscillation frequencies with a custom task developed using the Kinarm robotic exoskeleton. The effects of manipulating the asymmetry between the limbs were measured through the mean and variability of relative phase (ϕ) from the intended modes of 0 ° or 180 °. In general, participants deviated less from intended phase irrespective of coordination mode in all matched conditions, except for when elastic loads are applied to both arms in the anti-phase coordination. Second, we found that when force fields were mismatched participants exhibited a larger deviation from the intended phase. Overall, there was increased phase deviation during anti-phase coordination. Finally, participants exhibited higher variability in relative phase in mismatched force conditions compared to matched force conditions, with overall higher variability during anti-phase coordination mode. We extend previous research by demonstrating that symmetry breaking caused by force differences between the limbs disrupts stability in each coordination mode.

Association between swallowing muscle mass and dysphagia in older adults: A case-control study.

Swallowing function is formed by the synergistic, coordinated, and complex movements of approximately 30 muscles. However, There is no study on which one(s) of these muscles can predict the possibility of dyspfagia. The purpose of this study was to investigate whether there is a relation between dysphagia and ultrasonographic measurements of swallowing muscles mass, and to determine which muscle mass would predict the possibility of dysphagia. This prospective and controlled study was performed on 87 older people (aged >65 years). Clinical (Eating assessment tool-10 and The Gugging Swallowing Screen test), endoscopic, electrophysiological (dysphagia limit and swallowing intervals), and ultrasonographic (masseter [MM], genioglossus [GGM], geniohyoid [GHM], myohyoid [MH] and anterior digastric muscles [ADM]) evaluations were performed on all patients. The relationship between ultrasound measurements and demographic/swallowing characteristics and presence of dysphagia were investigated. The muscle mass measurement which was associated with dysphagia was contracted masseter muscle. In terms of diagnostic performance, the sensitivity was the highest in GHM (92.3%) and the specificity was the highest in contracted MM thickness (90.3%). The probability of dysphagia increases from 54% to 80-89% with a decrease in contracted MM thickness, and the probability of dysphagia increased from 48% to 72% with a decrease in contracted GGM thickness. In addition, the highest AUC level was detected in contracted MM and contracted GGM muscles. Moreover, it was determined that the risk of dysphagia increased from 9.6 to 14.1 times with one unit decrease in muscle thickness in contracted MM muscles, and the risk of dysphagia increased 9.1 times with one unit decrease in contracted GGM muscles. Decreased swallowing muscle mass in older adults are independent risk factors for dysphagia. Especially the decrease in the thickness of the contracted MM increases the possibility of dysphagia at high rate.

Effect of 11-Deoxycorticosterone in the Transcriptomic Response to Stress in Rainbow Trout Skeletal Muscle.

In aquaculture, many stressors can negatively affect growth in teleosts. It is believed that cortisol performs glucocorticoid and mineralocorticoid functions because teleosts do not synthesize aldosterone. However, recent data suggest that 11-deoxycorticosterone (DOC) released during stress events may be relevant to modulate the compensatory response. To understand how DOC modifies the skeletal muscle molecular response, we carried out a transcriptomic analysis. Rainbow trout (Oncorhynchus mykiss) were intraperitoneally treated with physiological doses of DOC in individuals pretreated with mifepristone (glucocorticoid receptor antagonist) or eplerenone (mineralocorticoid receptor antagonist). RNA was extracted from the skeletal muscles, and cDNA libraries were constructed from vehicle, DOC, mifepristone, mifepristone plus DOC, eplerenone, and eplerenone plus DOC groups. The RNA-seq analysis revealed 131 differentially expressed transcripts (DETs) induced by DOC with respect to the vehicle group, mainly associated with muscle contraction, sarcomere organization, and cell adhesion. In addition, a DOC versus mifepristone plus DOC analysis revealed 122 DETs related to muscle contraction, sarcomere organization, and skeletal muscle cell differentiation. In a DOC versus eplerenone plus DOC analysis, 133 DETs were associated with autophagosome assembly, circadian regulation of gene expression, and regulation of transcription from RNA pol II promoter. These analyses indicate that DOC has a relevant function in the stress response of skeletal muscles, whose action is differentially modulated by GR and MR and is complementary to cortisol.

Linear contracting and air-stable electrochemical artificial muscles based on commercially available CNT yarns and ionically selective ionogel coatings

Artificial muscles, or soft actuators, that could exhibit contractile stroke and operate in open-air, would be crucial for many applications, such as robotics, prosthetics, or powered exoskeletons. Amongst the different artificial muscle technologies, electrochemical carbon nanotube (CNT) yarn muscles, transducing capacitively ionic accumulation at the electrochemical double layer into linear contraction, are amongst the most promising candidates. However, their performances are either limited by an undesired bipolar behaviour or short lifetime due to the inevitable drying of water-based electrolytes. In this paper, we present here the fabrication of air-operating contractile linear artificial muscles from commercially available CNT yarns exhibiting outstanding performance. The synthesis and the junction of two ionogels based on cationic and anionic polyelectrolyte have been designed for the coating process on CNT yarns, and for selectively orienting the ionic flow allowing optimal electromechanical energy conversion. The dual-electrode CNT yarn actuators showed air-stable unipolar contractile stroke, reaching 9.7% without loss of performances after 2000 cycles.

Tissue Characterization of Puborectalis Muscle From 3-D Ultrasound.

Pelvic floor (PF) muscles have the role of preventing pelvic organ descent. The puborectalis muscle (PRM), which is one of the female PF muscles, can be damaged during child delivery. This damage can potentially cause irreversible muscle trauma and even lead to an avulsion, which is disconnection of the muscle from its insertion point, the pubic bone. Ultrasound imaging allows diagnosis of such trauma based on comparison of geometric features of a damaged muscle with the geometric features of a healthy muscle. Although avulsion, which is considered severe damage, can be diagnosed, microdamage within the muscle itself leading to structural changes cannot be diagnosed by visual inspection through imaging only. Therefore, we developed a quantitative ultrasound tissue characterization method to obtain information on the state of the tissue of the PRM and the presence of microdamage in avulsed PRMs. The muscle was segmented as the region of interest (ROI) and further subdivided into six regions of interest (sub-ROIs). Mean echogenicity, entropy and shape parameter of the statistical distribution of gray values were analyzed on two of these sub-ROIs nearest to the bone. The regions nearest to the bones are also the most likely regions to exhibit damage in case of disconnection or avulsion. This analysis was performed for both the muscle at rest and the muscle in contraction. We found that, for PRMs with unilateral avulsion compared with undamaged PRMs, the mean echogenicity (p=0.02) and shape parameter (p < 0.01) were higher, whereas the entropy was lower (p < 0.01). This method might be applicable to quantification of PRM damage within the muscle.

Alteration of Lower Limb Kinematics and Kinetics due to Bilateral Triple Arthrodesis.

The study aimed at discovering the existing differences in lower limb joints' kinematics, and EMG signals of 4 particular muscles of the ankle joint during gait, between normal subjects and patients with bilateral triple arthrodesis. In this research, a 3D motion analysis system was used and joints' angles were calculated using a MATLAB code, and based on the data collected from markers movements, for patients with bilateral triple arthrodesis and normal subjects. Moreover, the EMG signals of ankle muscles in each subject, and the graphs of mean plus and minus standard deviation of lower limb joint angles and muscles' EMG were calculated by MATLAB. In all patients, an initial ankle eversion and valgus deformity were observed in their knee joints. In addition, for all patients, the maximum knee extension was less than that of the average value of the normal subjects. Furthermore, the results of the electromyography showed that, in all patients, delay occurred in gastrocnemius and soleus muscles in maximum contraction in their EMG signals. Besides, during the early stance phase of gait cycles, the mean value of EMG of peroneus brevis muscle for patients was more than that of normal subjects. Atrophy of four ankle muscles including (soleus, lateral gastrocnemius, tibialis anterior and peroneus brevis), also limitation of joints movement were observed in patients, compared to normal subjects. Based on the results of this work, in order to reduce further musculoskeletal disorders in patients who underwent bilateral triple arthrodesis surgery, there is a serious need to use physiotherapy after the surgery.

Genome-wide analysis of a cellular exercise model based on electrical pulse stimulation

Skeletal muscle communicates with other organs via myokines, which are secreted by muscle during exercise and exert various effects. Despite much investigation of the exercise, the underlying molecular mechanisms are still not fully understood. Here, we applied an in vitro exercise model in which cultured C2C12 myotubes were subjected to electrical pulse stimulation (EPS), which mimics contracting muscle. Based on the significantly up- and down-regulated genes in EPS, we constructed an in silico model to predict exercise responses at the transcriptional level. The in silico model revealed similarities in the transcriptomes of the EPS and exercised animals. Comparative analysis of the EPS data and exercised mouse muscle identified putative biomarkers in exercise signaling pathways and enabled to discover novel exercise-induced myokines. Biochemical analysis of selected exercise signature genes in muscle from exercised mice showed that EPS mimics in vivo exercise, at least in part, at the transcriptional level. Consequently, we provide a novel myokine, Amphiregulin (AREG), up-regulated both in vitro and in vivo, that would be a potential target for exercise mimetics.

Thermal acclimation in brook trout myotomal muscle varies with fiber type and age

As climate change alters the thermal environment of the planet, interest has grown in how animals may mitigate the impact of a changing environment on physiological function. Thermal acclimation to a warm environment may, for instance, blunt the impact of a warming environment on metabolism by allowing a fish to shift to slower isoforms of functionally significant proteins such as myosin heavy chain. The thermal acclimation of brook trout (Salvelinus fontinalis) was examined by comparing swimming performance, myotomal muscle contraction kinetics and muscle histology in groups of fish acclimated to 4, 10 and 20 °C. Brook trout show a significant acclimation response in their maximum aerobic swimming performance (Ucrit), with acclimation to warm water leading to lower Ucrit values. Maximum muscle shortening velocity (Vmax) decreased significantly with warm acclimation for both red or slow-twitch and white or fast-twitch muscle. Immunohistochemical analysis of myotomal muscle suggests changes in myosin expression underly the thermal acclimation of swimming performance and contraction kinetics. Physiological and histological data suggest a robust acclimation response to a warming environment, one that would reduce the added metabolic costs incurred by an ectotherm when environmental temperature rises for sustained periods of time.

System Identification and Two-Degree-of-Freedom Control of Nonlinear, Viscoelastic Tissues.

This paper presents a force control scheme for brief isotonic holds in an isometrically contracted muscle tissue, with minimal overshoot and settling time to measure its shortening velocity, a key parameter of muscle function. A two-degree-of-freedom control configuration, formed by a feedback controller and a feedforward controller, is explored. The feedback controller is a proportional-integral controller and the feedforward controller is designed using the inverse of a control-oriented model of muscle tissue. A generalized linear model and a nonlinear model of muscle tissue are explored using input-output data and system identification techniques. The force control scheme is tested on equine airway smooth muscle and its robustness confirmed with murine flexor digitorum brevis muscle. Performance and repeatability of the force control scheme as well as the number of inputs and level of supervision required from the user were assessed with a series of experiments. The force control scheme was able to fulfill the stated control objectives in most cases, including the requirements for settling time and overshoot. The proposed control scheme is shown to enable automation of force control for characterizing muscle mechanics with minimal user input required. This paper leverages an inversion-based feedforward controller based on a nonlinear physiological model in a system identification context that is superior to classic linear system identification. The control scheme can be used as a steppingstone for generalized control of nonlinear, viscoelastic materials.

Supercharge End-to-Side Sensory Transfer to A Long Nerve Graft to Enhance Motor Regeneration in A Brachial Plexus Model-An Experimental Rat Study.

Long nerve grafts will affect muscle recovery. Aim of this study is to investigate if supercharged end-to-side (SETS) sensory nerve transfer to long nerve graft can enhance functional outcomes in brachial plexus animal model. A reversed long nerve graft (20-23-mm) was interposed between C6 and musculocutaneous nerve (MCN) in 48 SD rats. The sensory nerves adjacent to the proximal and distal coaptation sites of the nerve graft were used for SETS. There were four groups with 12 rats in each: (A) nerve graft alone, (B) proximal SETS sensory transfer, (C) distal SETS sensory transfer, and (D) combined proximal and distal SETS sensory transfers. Grooming test at 4, 8, 12 and 16 weeks, and compound muscle action potentials (CMAP), biceps tetanic muscle contraction force, muscle weight and MCN axon histomorphologic analysis at 16 weeks were assessed. Grooming test was significantly better in group C and D at 8 weeks (p = 0.02 and p = 0.04) and still superior at 16 weeks. There was no significant difference in CMAP, tetanic muscle contraction force, or muscle weight. The axon counts showed all experimental arms were significantly higher than the unoperated arms. Although the axon count was lowest in group C and highest in group D (p = 0.02), the nerve morphology tended to be better in group C overall. Distal sensory SETS transfer to a long nerve graft showed benefits of functional muscle recovery and better target nerve morphology. Proximal sensory inputs do not benefit the outcomes at all.

Mechanistic Study of Coffee Effects on Gut Microbiota and Motility in Rats.

Consumption of coffee has benefits in postoperative ileus. We tested the hypothesis that the benefits may be related to the effects of coffee on gut microbiota and motility and studied the mechanisms of action in rats. The in vitro and in vivo effects of regular and decaffeinated (decaf) coffee on gut microbiota of the ileum and colon were determined by bacterial culture and quantitative RT-PCR. Ileal and colonic smooth muscle contractility was determined in a muscle bath. In the in vivo studies, coffee solution (1 g/kg) was administered by oral gavage daily for 3 days. Compared to regular LB agar, the growth of microbiota in the colon and ileal contents was significantly suppressed in LB agar containing coffee or decaf (1.5% or 3%). Treatment with coffee or decaf in vivo for 3 days suppressed gut microbiota but did not significantly affect gut motility or smooth muscle contractility. However, coffee or decaf dose-dependently caused ileal and colonic muscle contractions in vitro. A mechanistic study found that compound(s) other than caffeine contracted gut smooth muscle in a muscarinic receptor-dependent manner. In conclusion, coffee stimulates gut smooth muscle contractions via a muscarinic receptor-dependent mechanism and inhibits microbiota in a caffeine-independent manner.

Differences in the Contractile Properties of the Biceps Femoris and Semitendinosus Muscles Throughout a Season in Professional Soccer Players.

The aim of this study was to monitor seasonal changes in the mechanical and neuromuscular characteristics of the knee flexor muscles with tensiomyography, the biceps femoris (BF) and semitendinosus (ST) muscles, of 27 soccer players. All male professional soccer players (age 25 ± 4 years) were measured at the beginning of the preseason (second week) and in the competitive season (10 weeks later). The variables contraction time (Tc) and muscle displacement (Dm) showed significant differences in some muscles, and in others they indicated a tendency to change. In general, the BF improved (more explosive and better muscle tone) and the ST worsened (slower and worse muscle tone) its values during the season. The findings of this study suggest that usual daily soccer training and weekly competition might produce antagonistic changes between the knee flexor muscles.

Masseter muscle contraction and cervical muscle sensitization by nerve growth factor cause mechanical hyperalgesia in masticatory muscle with activation of the trigemino-lateral parabrachial nucleus system in female rats.

To establish a new rat model of craniofacial myalgia, and to clarify which central nervous system pathways are activated in the model. Craniofacial myalgia, represented by myogenous temporomandibular disorder and tension-type headache with pericranial tenderness, is more common in female patients. The pain is thought to be a type of multifactorial disorder with several coexisting causes. To our knowledge, there are no models of craniofacial muscle hyperalgesia caused by multiple types of stimuli. We injected nerve growth factor into the trapezius muscle of female and male rats and repeatedly stimulated the masseter muscle (MM) electrically for 10 days. We determined the mechanical head-withdrawal threshold of MM and extent of phosphorylated extracellular signal-related kinase 1/2 (pERK) immunoreactivity in various regions of the lower brainstem. We conducted retrograde tract-tracing to determine the projection of mechanosensitive MM-innervating secondary neurons to the lateral parabrachial nucleus. Finally, we administered morphine in rats to determine whether increases of pERK immunoreactivity were dependent on noxious inputs. In female rats, but not male rats, the mechanical head-withdrawal threshold was decreased significantly from days 9 to 12. The number of pERK-immunoreactive neurons in the brainstem was increased significantly in female rats in the group with both stimuli compared to rats in other groups with a single stimulus. Mechanosensitive MM-innervating neurons in the brainstem projected to the parabrachial nucleus. Morphine administration blocked the increase in the number of pERK-immunoreactive neurons in both the brainstem and parabrachial nucleus. We established a model of craniofacial myalgia by combining trapezius and MM stimuli in female rats. We found mechanical hyperalgesia of the MM and activation of the pain pathway from the brainstem to parabrachial nucleus. The model reflects the characteristics of patients with craniofacial myalgia and might be helpful to clarify the pathogenic mechanisms underlying these disorders.

Insulin Sensitization Following a Single Exercise Bout Is Uncoupled to Glycogen in Human Skeletal Muscle: A Meta-analysis of 13 Single-Center Human Studies.

Exercise profoundly influences glycemic control by enhancing muscle insulin sensitivity, thus promoting glucometabolic health. While prior glycogen breakdown so far has been deemed integral for muscle insulin sensitivity to be potentiated by exercise, the mechanisms underlying this phenomenon remain enigmatic. We have combined original data from 13 of our studies that investigated insulin action in skeletal muscle either under rested conditions or following a bout of one-legged knee extensor exercise in healthy young male individuals (n = 106). Insulin-stimulated glucose uptake was potentiated and occurred substantially faster in the prior contracted muscles. In this otherwise homogenous group of individuals, a remarkable biological diversity in the glucometabolic responses to insulin is apparent both in skeletal muscle and at the whole-body level. In contrast to the prevailing concept, our analyses reveal that insulin-stimulated muscle glucose uptake and the potentiation thereof by exercise are not associated with muscle glycogen synthase activity, muscle glycogen content, or degree of glycogen utilization during the preceding exercise bout. Our data further suggest that the phenomenon of improved insulin sensitivity in prior contracted muscle is not regulated in a homeostatic feedback manner from glycogen. Instead, we put forward the idea that this phenomenon is regulated by cellular allostatic mechanisms that elevate the muscle glycogen storage set point and enhance insulin sensitivity to promote the uptake of glucose toward faster glycogen resynthesis without development of glucose overload/toxicity or feedback inhibition.

Ultrasound exploration of muscle characteristic changes and diabetic peripheral neuropathy in diabetic patients.

Using brightness mode ultrasound combined with shear wave elastography, this study aims to detect structural and functional changes of the medial head of gastrocnemius (MG) in type 2 diabetes mellitus (T2DM) patients with or without diabetic peripheral neuropathy (DPN). 149 T2DM patients (DPN group and non-DPN group) and 60 healthy volunteers (control group) were enrolled. We measured the absolute difference of fascicle length (FL), pennation angle (PA), and shear wave velocity (SWV) of both MG in neutral position and maximal ankle joint's plantar flexion and calculated ΔFL, ΔPA, and ΔSWV. These three parameters, along with muscle thickness (MT), were compared among the three groups. In the DPN group, the MG's MT, ΔPA, and ΔSWV were significantly lower than in the non-DPN group (p < 0.01); these parameters achieved the highest scores in the control group (p < 0.01). The area under the receiver operating characteristic curve of the combination of ΔSWV and ΔFL was the largest for predicting inpatients with or without DPN. Decreased muscle mass (MT) and muscle contractibility (ΔFL and ΔSWV) were detected in patients with T2DM, with or without DPN. ΔSWV and ΔFL of the MG showed high-diagnostic accuracy for DPN warning signs.

Reducing Proteoglycan Synthesis and NOX Activity by ROCK Inhibitors: Therapeutic Targets in Atherosclerosis.

Atherosclerosis is a chronic inflammatory disease of the arteries characterized by the accumulation of inflammatory cells in the arterial wall. Hypertension, dyslipidemia, and hyperglycemia are major risk factors of atherosclerosis. Rho-associated protein kinase (ROCK), a serine/threonine kinase, is a downstream effector of the small GTPase RhoA. ROCK is involved in different stages of atherosclerosis. Accumulating evidence has demonstrated that ROCK signaling plays vital roles in various cellular functions, such as contraction, migration, and proliferation of smooth muscle cells. Dysregulation of the ROCK pathway is associated with atherosclerosis and hypertension. Experimental studies have shown that ROCK inhibitors may have favorable effects in ameliorating atherosclerosis. ROCK signaling has a role in proteoglycan synthesis through transactivation of the TGF-β receptor Type I (TβRI) mediated by G-protein-coupled receptor (GPCR) agonists (endothelin-1, angiotensin II and …), and ROCK inhibitors could decrease proteoglycan synthesis and atherosclerotic plaque formation. Based on the hypothesis that targeting ROCK pathway may be effective in ameliorating atherosclerosis, we suggest that ROCK inhibitors may have a potential therapeutic role in inhibition or slowing atherogenesis. However, for this hypothesis more research is needed.

Factors influencing and long-term effects of manual myotomy phenomenon during physiotherapy for congenital muscular torticollis

PurposeTo investigate the factors influencing and long-term effects of manual myotomy (MM) occurring during physiotherapy for congenital muscular torticollis (CMT).MethodsWe retrospectively collected the clinical data of children with CMT receiving physiotherapy between 2008 and 2018. The children were divided into manual myotomy (MM) and non-manual myotomy (NMM) groups according to whether MM occurred during treatment. We assessed physiotherapy outcomes in children with CMT using craniofacial asymmetry parameters and the Cheng–Tang rating score. By measuring the ear-eye distance, ear-nose distance, eye-mouth distance, ear-mouth distance, half-head circumference, and half-head top at two sides to evaluate craniofacial asymmetry. Based on the Cheng–Tang assessment criteria, we recorded the range of rotation, range of lateral flexion, the status of the contracted muscle, the hardness of the mass, the extent of head tilting during activities and sleeping, the status of daily activities, face size, type of head shape, cranial changes, and subjective head tilting to assess the effectiveness of treatment. Clinical data and outcome indicators (craniofacial asymmetry parameters and Cheng–Tang rating score) were compared.ResultsThe MM group had a significantly higher total Cheng–Tang rating score than the NMM group (P < 0.05). Age at initial physiotherapy session was the risk factor for MM during physiotherapy.ConclusionChildren with CMT developing MM during physiotherapy generally have a good outcome, although we do not recommend MM as a goal of treatment. Physiotherapists should understand this phenomenon, assess relevant factors to predict risk, and carefully observe treatment to prevent possible complications.

Association between Pelvic Floor Dysfunction and Pelvic Floor Ultrasonography Evaluation in Pregnant Women: A Cross-Sectional Study

Background: Pelvic floor dysfunctions (PFDs) are commonly encountered in pregnancy, which may include urinary and fecal incontinence, pelvic pain, sexual dysfunction and pelvic organ prolapse. Identifying these problems and their risk factors in pregnancy is crucial for prevention and management. The primary outcome of this study is to investigate the relationship between the PFD symptoms in pregnant women and perineal ultrasonography measurements. Secondary outcomes are to figure out the risk factors for PFDs in pregnancy and also to identify the relationship between these risk factors with transperineal ultrasonography measurements and pelvic floor muscle strength (PFMS). Methods: 49 pregnant women recruited in the study, were asked to fill questionnaires, underwent transperineal ultrasonography and pelvic floor muscle strength examination. Results: The hiatal area at rest, pelvic contraction and Valsalva are positively correlated with stress urinary incontinence (SUI) (p = 0.018, p = 0.003 and p = 0.006 respectively), pelvic organ prolapse (POP) (p = 0.015, p = 0.022 and p = 0.011 respectively) and sexual dysfunction (SD) (p = 0.033, p = 0.041 and p = 0.023 respectively). Hiatal area at Valsalva and detrusor muscle thickness are positively correlated with urge urinary incontinence (UUI) (p = 0.021 and p = 0.012). The hiatal area value at pelvic contraction and Valsalva are positively correlated with feacal/flatal incontinence (FFI) (p = 0.024 and p = 0.037). Hiatal areas at rest, pelvic contraction, Valsalva and detrussor muscle thickness are correleated with age (r = 0.287, r = 0.335, r = 0.315 and r = 0.421 respectively), body mass index (r = 0.380, r = 0.420, r = 0.415 and r = 0.447 respectively) and pelvic floor muscle strength (r = –0.539, r = –0.583, r = –0.550 and r = –0.545 respectively). Bladder neck descent is correlated with body mass index (r = 0.284). Conclusions: Transperineal ultrasound measurements of Detrusor muscle thickness, hiatal area (HA) at rest, pelvic contraction and Valsalva Manoeuvre are found to be associated with PFDs in pregnant women. Risk factors for PFDs in pregnancy are body mass index, age, gestational week, parity, birth weight and delivery method.